Effect of clinical rotation on attitude of medical students towards psychiatry and mental patients: a cross-sectional study from Western Rajasthan

Background: People with mental illnesses experience extreme stigmatization and discrimination despite their ubiquitous presentation. Studies have reported that these negative stereotypes are shared by health care professionals too. Attitude of undergraduate medical students towards psychiatry is vital as it reflects their willingness to deal with psychiatric and behavioral disorders in general practice.Methods: A descriptive cross-sectional study was conducted in a government medical college in Rajasthan to explore the impact of sociodemographic variables and undergraduate psychiatry training on the attitude of medical students towards mental illness and psychiatry. 105 first year MBBS students and 75 interns participated in the study. Attitude towards mental illness (AMI) scale and attitude towards psychiatry-30 (ATP-30) scale were used to document AMI and ATP respectively. Data collected were analyzed using SPSS statistical software and appropriate tests were used to compare mean scores of both groups.Results: There was no statistically significant difference on AMI and ATP scores between the undergraduate medical students and interns. Females, students belonging to urban setting and more educated families had a favorable attitude towards psychiatric patients. A notable shift in scores on ATP scale towards positive side was reflected between male MBBS students and interns and among students coming from rural background with exposure to medical curriculum.Conclusions: No attitude change was observed in majority of participants indicating need for greater emphasis on mental health and psychiatry.

Evaluation of healthcare waste management among health functionaries of Gujarat

Introduction: Health Care Waste (HCW) is generated by various activities in healthcare facilities like hospitals, clinical, research institutions, laboratories, blood banks, etc. HCW is both infectious and hazardous and, unless rendered noninfectious and safe, can prove to be hazardous to people coming in contact with it. Objectives: To assess the Knowledge and Practice regarding HCW Management among health functionaries of districts of Gujarat and its association between the designation and qualification with the Knowledge and Practice score. Methodology: It was an observational and cross-sectional study using pretested, reliable, and valid questionnaire. A sample size of 152 was calculated based on the findings of a pilot study. We have implemented our study in Gujarat, divided into four parts (Saurashtra, Central, South, and North Gujarat). Study sites were selected equally in all four areas. Results: A total of 163 healthcare participants were involved in the study, most respondents were from primary healthcare centers (31.7%), followed by medical college hospitals (14.5%). In our study, Bhavnagar district had the highest number of contributors (21.7%), followed by Morbi district (19.1%). The hospital administrator category had the highest knowledge score, while Infection Control or Waste Management Officer had the highest practice score. MBBS/AYUSH graduates had the highest knowledge and practice scores. It is also apparent that staff nurses had better knowledge and practice scores than ANM. Conclusion: The overall assessment score was good for all health workers. Doctors' better knowledge and practice scores signify qualification's role in BMW management

Occupational Stress among Health Care Workers

Occupational stress is a harmful response particularly physical and emotional, due to a mismatch between job requirements and the qualifications, resources, and worker’s needs; its chronic form is termed “Burnout.” Stress among health care workers is multifactorial. Its prevalence among healthcare professionals ranges from 27−87.4%. Occupational stress is a significant reason for physical and mental health, substance use, work-related delay, absenteeism, and emigration rate. Additionally, it can lead to patient safety concerns and poor quality of care. The mismatch between job requirements and the available resources, work overload, working environment, work experience, workplace conflict, gender discrimination, marital status, educational status, job satisfaction, and not being rewarded were some of the factors significantly associated with occupational stress among health care professionals. Moreover, the coronavirus disease 2019 (COVID-19) pandemic introduced additional stressors, such as staff redeployment and the fear of infection. WHO identified good primary health care as fundamental for achieving universal health coverage without financial hardship. Healthcare professionals’ physical and mental well-being is crucial for attaining this. Developing culturally and organizationally appropriate early interventions is the need of the hour to prevent a health care worker from entering a stress level that is non-adaptable beyond their coping abilities

Truenat: Can it be A Game Changer in Extrapulmonary Tuberculosis?

Tuberculosis is a leading health problem worldwide, with India accounting for the majority of cases. Owing to the diverse clinical presentation and paucibacillary nature of extrapulmonary tuberculosis, it is tough to diagnosis by routine microbiological methods. Newer chip/cartridge based nucleic amplification tests (NAATs) like Truenat and Xpert have proved to be game changer in diagnosis of pulmonary tuberculosis. However, role of Truenat in extrapulmonary tuberculosis is still to be evaluated. This study was undertaken to evaluate the diagnostic yield of truant in various extrapulmonary tuberculosis. The study was conducted during 01 June 2021 to 31 July 2022. Of the total 1481 samples received during study, 761 (52%) were extrapulmonary samples. The highest yield of 36% was found in pus aspirate, followed by a 12% yield in pleural fluid. Overall yield of 12% in various extrapulmonary samples is encouraging. Further studies are required for evaluating Truenat role in rapid diagnosis of EPTB and rifampicin resistance detection for better patient care

Auditing of prescriptions in relation to diarrhea in children below 5 years of age: a multicenter study

Background: This study was planned to determine the prescribing pattern of drugs in children below 5 years of age suffering from diarrhea by different categories of doctors in the city of Jaipur (Rajasthan).Methods: This observational retrospective study was conducted in the Pediatric Outpatient Department of SMS Medical College and other hospitals in Jaipur (Rajasthan). In this study, 300 prescription (10% of total prescription) of the children aged below 5 years, suffering from acute diarrhea, were randomly selected.Results: As alone, norfloxacin was noted in 49.2% prescriptions followed by ofloxacin in 24.6% out of 61 prescriptions. In combination, the most common antimicrobial (77.78%) prescribed was norfloxacin with either metronidazole or tinidazole.Conclusions: Antimicrobials should be prescribed rationally for pediatric patients suffering from diarrhea to avoid potential adverse events and increased cost of the treatment . Regular prescription audits in hospitals should be undertaken to promote rational use of drugs

RLIP76, a non-ABC transporter, and drug resistance in epilepsy

BACKGROUND: Permeability of the blood-brain barrier is one of the factors determining the bioavailability of therapeutic drugs and resistance to chemically different antiepileptic drugs is a consequence of decreased intracerebral accumulation. The ABC transporters, particularly P-glycoprotein, are known to play a role in antiepileptic drug extrusion, but are not by themselves sufficient to fully explain the phenomenon of drug-resistant epilepsy. Proteomic analyses of membrane protein differentially expressed in epileptic foci brain tissue revealed the frequently increased expression of RLIP76/RALBP1, a recently described non-ABC multi-specific transporter. Because of a significant overlap in substrates between P-glycoprotein and RLIP76, present studies were carried out to determine the potential role of RLIP76 in AED transport in the brain. RESULTS: RLIP76 was expressed in brain tissue, preferentially in the lumenal surface of endothelial cell membranes. The expression was most prominent in blood brain barrier tissue from excised epileptic foci. Saturable, energy-dependent, anti-gradient transport of both phenytoin and carbamazepine were demonstrated using recombinant RLIP76 reconstituted into artificial membrane liposomes. Immunotitration studies of transport activity in crude membrane vesicles prepared from whole-brain tissue endothelium showed that RLIP76 represented the dominant transport mechanism for both drugs. RLIP76(-/- )knockout mice exhibited dramatic toxicity upon phenytoin administration due to decreased drug extrusion mechanisms at the blood-brain barrier. CONCLUSION: We conclude that RLIP76 is the predominant transporter of AED in the blood brain barrier, and that it may be a transporter involved in mechanisms of drug-resistant epilepsy

Improving compressive strength of low calcium fly ash geopolymer concrete with alccofine

Geopolymer concrete is environmentally friendly and could be considered as a construction material to promote the sustainable development. In this paper fly ash based geopolymer concretes with different percentages of alccofine were made by mixing sodium hydroxide and sodium silicate as an alkaline activator and cured at ambient as well as heat environment in an electric oven at 90°C. Effects of various parameters such as the percentage of alccofine, curing temperature, a period of curing, fly ash content, was studied on compressive strength as well as workability of geopolymer concrete. The study concludes that the presence of alccofine improves the properties of geopolymer concrete during a fresh and hardened state of concrete. Geopolymer concrete in the presence of alccofine can be used for the general purpose of concrete as required compressive strength can be achieved even at ambient temperature. The 28 days compressive strength of 73 MPa, when cured at 90-degree Celsius, confirmed that it is also very suitable for precast concrete components.peer-reviewe

RLIP76, a Glutathione-Conjugate Transporter, Plays a Major Role in the Pathogenesis of Metabolic Syndrome

PURPOSE: Characteristic hypoglycemia, hypotriglyceridemia, hypocholesterolemia, lower body mass, and fat as well as pronounced insulin-sensitivity of RLIP76⁻/⁻ mice suggested to us the possibility that elevation of RLIP76 in response to stress could itself elicit metabolic syndrome (MSy). Indeed, if it were required for MSy, drugs used to treat MSy should have no effect on RLIP76⁻/⁻ mice. RESEARCH DESIGN AND METHODS: Blood glucose (BG) and lipid measurements were performed in RLIP76⁺/⁺ and RLIP76⁻/⁻ mice, using Ascensia Elite Glucometer® for glucose and ID Labs kits for cholesterol and triglycerides assays. The ultimate effectors of gluconeogenesis are the three enzymes: PEPCK, F-1,6-BPase, and G6Pase, and their expression is regulated by PPARγ and AMPK. The activity of these enzymes was tested by protocols standardized by us. Expressions of RLIP76, PPARα, PPARγ, HMGCR, pJNK, pAkt, and AMPK were performed by Western-blot and tissue staining. RESULTS: The concomitant activation of AMPK and PPARγ by inhibiting transport activity of RLIP76, despite inhibited activity of key glucocorticoid-regulated hepatic gluconeogenic enzymes like PEPCK, G6Pase and F-1,6-BP in RLIP76⁻/⁻ mice, is a salient finding of our studies. The decrease in RLIP76 protein expression by rosiglitazone and metformin is associated with an up-regulation of PPARγ and AMPK. CONCLUSIONS/SIGNIFICANCE: All four drugs, rosiglitazone, metformin, gemfibrozil and atorvastatin failed to affect glucose and lipid metabolism in RLIP76⁻/⁻ mice. Studies confirmed a model in which RLIP76 plays a central role in the pathogenesis of MSy and RLIP76 loss causes profound and global alterations of MSy signaling functions. RLIP76 is a novel target for single-molecule therapeutics for metabolic syndrome