Pediatric anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis: Exploring psychosis, related risk factors, and hospital outcomes in a nationwide inpatient sample: A cross-sectional study.

OBJECTIVE: Our study aims to examine the risk factors for comorbid psychosis in pediatric patients hospitalized for anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis and its impact on hospital outcomes. METHODS: We conducted a cross-sectional study using the nationwide inpatient sample (NIS 2018-2019). We included 3,405 pediatric inpatients (age 6-17 years) with a primary discharge diagnosis of anti-NMDAR encephalitis. We used binomial logistic regression model to evaluate the odds ratio (OR) of variables (demographic and comorbidities) associated with comorbid psychosis. RESULTS: The prevalence of comorbid psychosis in anti-NMDAR encephalitis inpatients was 5.3%, and majorly constituted of adolescents (72.2%) and females (58.3%). In terms of race, Blacks (OR 2.41), and Hispanics (OR 1.80) had a higher risk of comorbid psychosis compared to Whites. Among comorbidities, encephalitis inpatients with depressive disorders (OR 4.60), sleep-wake disorders (OR 3.16), anxiety disorders (OR 2.11), neurodevelopmental disorders (OR 1.95), and disruptive behavior disorders (OR 2.15) had a higher risk of comorbid psychosis. Anti-NMDAR encephalitis inpatients with comorbid psychosis had a longer median length of stay at 24.6 days (vs. 9.8 days) and higher median charges at $262,796 (vs. $135,323) compared to those without psychotic presentation. CONCLUSION: Adolescents, females, and Blacks with encephalitis have a higher risk of psychotic presentation leading to hospitalization for anti-NMDAR encephalitis. Identification of demographic predictors and comorbidities can aid in early recognition and intervention to optimize care and potentially reduce the healthcare burden.

Medicine or martyrdom? A peek into the rising violence against doctors during times of COVID 19.

One would think, at a time where healthcare workers are the frontline warriors against the COVID 19 pandemic, the violence against them would subside; however, this is far from the truth. This commentary article addresses the underlying causes and implications of such acts of violence against health professionals, particularly those involved in primary healthcare, in India, and barriers to implementation of laws protecting these professionals from violence. Recommendations for administrative and on ground interventions, with a proposed collaboration with government and private medical establishments, have been discussed, as a probable solution to the problem of violence at hand.

Envisioning planetary health in every medical curriculum: An international medical student organization's perspective.

BACKGROUND: With deteriorating ecosystems, the health of mankind is at risk. Future health care professionals must be trained to recognize the interdependence of health and ecosystems to address the needs of their patients and communities. Health issues related to, e.g. climate change and air pollution, are not, however, generally included in medical education. OBJECTIVES: To assess the inclusion of climate change and air pollution in medical curricula and to guide the International Federation of Medical Students' Associations' (IFMSA) Vision of Climate Change in the Medical Curriculum. METHODS: A study comprising three surveys (March 2019, August 2019, March 2020) explored medical students' perceptions of the current status of formal and non-formal elements of climate change and air pollution and health in their medical programs. RESULTS: Respondents originated from 2817 medical schools in 112 countries. Only 15% of medical schools have incorporated climate change and health into the curriculum. Students led climate-related activities in an additional 12% of medical schools. With regard to air pollution and health, only 11% of medical schools have formal education on the topic. CONCLUSIONS: It is crucial to acknowledge the current omissions from medical curricula and the importance of meaningful student involvement in curriculum transformation.