Association of mid sleep time and social jetlag with psychosocial behaviour of Indian population during COVID-19 lockdown

Background: India, being the third worst affected country from COVID-19 pandemic at the time of study, faced complete lockdown to minimize community transmission that confined people to social isolation for extended durations. Design and Methods: Therefore, we conducted an online questionnaire-based survey for the Indian population after 37 days of complete lockdown to assess the integrative effects of such home restriction and social isolation on mid-sleep time, social jetlag, and their associated psychosocial behaviour. From the reports of sleep onset and waking-up times before and during lockdown as obtained from a total of 1511 respondents of ≥18 years, mid-sleep time (MST) and social jetlag (SJL) were calculated. Participants also rated their psychosocial behaviour related variables on a Likert scale.  Results: Significantly delayed MST was noted during the lockdown. The majority showed reduced social jetlag; however, younger people and female subjects exhibited more SJL with delay in MST. Also, delayed MST and elevated SJL problems were more clearly demonstrated in people exhibiting more disturbances in sleep quality and daily routine, lower general mood status, irregular feeding habits (snacking frequency), worsened personal relationship, quality of life, and increased daydreaming events.Conclusion: The study emphasizes the importance of maintaining a regular daily routine with respect to sleep-wake patterns and eating habits to minimize the impact of such a crisis situation on sleep behaviour, social jetlag, and associated psychosocial wellbeing

Impact of COVID-19 lockdown on sleep-wake schedule and associated lifestyle related behavior: A national survey

Background: Lockdowns to prevent the community transmission of COVID-19 pandemic has confined the people at home and imposed social restrictions, which is expected to cause alterations in circadian driven sleep-wake schedule and its associated lifestyle behaviors. Design and Methods: An online questionnaire-based survey was conducted to assess the impact of lockdown on the sleep-wake pattern, meal timings and digital media exposure time on the Indian population during lockdown. Responses of 1511 participants (age ≥18 years) were analyzed to assess the effect of gender and age on these parameters before and during lockdown.Results: The sleep onset-wakeup times and meals’ time was significantly delayed during lockdown, which was more pronounced in younger subjects. However, young individuals reported increased sleep duration at this time. Increased digital media duration was evident in all age groups, mainly in males. However, females reported more delay in sleep onset-waking time and first meal timing with longer sleep duration during lockdown.Conclusions: Discord with social and natural cues due to complete lockdown during COVID-19 pandemic leads to a state of social jetlag with delayed sleep-wake, meal timings and excessive digital media exposure among Indians, which has differential impact on males and females as well as across different age groups. These findings have applied implications in sleep health and related behavior during longer social isolation conditions such as current COVID-19 or similar situations and may help to prepare better for any such future events

Correlation of MCQ subtypes with grading of performance among undergraduate students in a preclinical discipline

Background: Multiple choice questions (MCQs) remain an important tool for objective assessment in medical students wherein different types of MCQs reflect students’ performance towards various aspects of cognitive domain. Thus, all students may not perform with similar ability across all different types of MCQs. In this context, the current study aim to investigate whether performance of medical students in MCQ based assessment relates to the performance in different subtypes of MCQs in Physiology.Methods: Marks obtained in 65 MCQ during formative assessment by 145 first year MBBS students were segregated into four different types of standard MCQs attempted (i.e. Single Response-SRQ, Multiple Response-MRQ, Reason-Assertion-RAQ and Problem based-PBQ) while students were grouped into High, Medium and Low achievers (HA, MA and LA respectively) in relation to their total score.Results: Result showed highest scores in SRQ (69.00±11.6%, 57.34±11.12% and 40.11±13.03%) and PBQ (71.04±11.68%, 59.38±15.36% and 42.35±15.72%) but lowest in MRQ (49.16±11.58%, 41.39±12.42% and 30.78±14.10%) and RAQ (48.82±12.48%, 44.17±14.25% and 31.80±13.05%) for HA, MA and LA respectively with significant differences among all groups. However, total MCQ marks were significantly correlated with MRQ and PBQ for HA; with SRQ and MRQ for MA; and SRQ, MRQ and PBQ for LA.Conclusions: MRQ might have significant influence on the outcome of MCQ based assessment in differentiating between high and medium achievers, whereas both MRQ and PBQ shows potential to differentiate between high and low achieving students. This may be utilized for effective screening in summative assessments or progress of learning in formative assessment

Infection and Potential Challenge of Childhood Mortality in Sickle Cell Disease: A Comprehensive Review of the Literature from a Global Perspective

Sickle cell disease (SCD) is a complex genetic disorder associated with multiple clinical manifestations, including increased susceptibility to bacterial and viral infections. This review article presents a comprehensive analysis of the current literature obtained from various online databases focusing on the relationship between SCD and infections caused by specific pathogens, such as pneumonia- and influenza-causing pathogens, Escherichia coli, Staphylococcus aureus, parvovirus, and hepatitis viruses. We discuss the underlying mechanisms that contribute to the increased susceptibility of individuals with SCD to these infections, primarily related to the pathophysiology of variant hemoglobin (HbSS) and its impact on vascular occlusion, hemolysis, functional asplenia, and immune deficiency. Moreover, we highlight the significant burden of infections on SCD patients, particularly children under five years of age, where they are the leading cause of morbidity and mortality. Additionally, we address the challenges faced in attempts for reducing the global mortality rate associated with SCD, particularly in low-income countries, where factors such as increased pathogen exposure, co-morbidities like malnutrition, lower vaccination rates, and limited healthcare facilities contribute to the high disease burden. This review emphasizes the need for targeted interventions, improved healthcare access, vaccination programs, and infection prevention strategies to alleviate the impact of infections on individuals with SCD and reduce the global mortality rates associated with the disease