Depression among Medical Students of a Medical College: A Descriptive Cross-sectional Study.

Introduction: Medical students encounter multiple psychological changes in the transformation from young insecure students to efficient physicians. They have to balance the personal, social and academic dimention in a busy schedule. So, this study aimed to find out the prevalence of depression among medical students of a medical college. Methods: A descriptive cross-sectional study was conducted among medical students of a medical college from 2 May 2017 to 16 October 2017 after taking ethical approval from the Departmental Research Unit (Reference number: Psy/73/078/079). Students participated voluntarily in the study from first to fourth year and written informed consent was taken. Depression, Anxiety and Stress Scale-42 scale was filled by the students taking their own time and privacy to assess their depression, anxiety and stress. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 302 medical students, 86 (28.47%) (23.38-33.56, 95% Confidence Interval) had depression. A total of 31 (36.04%) had mild, 31 (36.04%) had moderate, 12 (13.95%) had severe and 12 (13.95%) had extremely severe depression. Among them 55 (63.95%) were males and 31 (36.04%) were females. Conclusions: The prevalence of depression among medical students was similar to the other studies conducted in similar settings. Studies concerning the subjective well-being of medical students should be continued and strategic plans and programs should be conducted to help the students manage their stress and depressive symptoms right from the time they join the medical school and continued till they finish the course. Keywords: depression; medical students; mental health.

Depression among Armed Police Force Soldiers Serving in a Police Headquarter: A Descriptive Cross-sectional Study.

Introduction: Depression is a common mental health problem among soldiers worldwide. Depression decreases the efficiency and productivity of the soldiers. The objective of this research is to find out the prevalence of depression among armed police force soldiers serving in a police headquarter. Methods: A descriptive cross-sectional study was done on a total of 314 soldiers serving in the eastern regional armed police force headquarters of Nepal from January 15, 2017 to June 14, 2017 after receiving ethical clearance was taken from the Institutional Review Committee (Reference number: 140/073/074-IRC). Convenience sampling was done. Beck Depression Inventory was used to assess the prevalence of depression. Data were collected and entered in the Statistical Package for the Social Science version 15.0. which was used for data analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Among 314 soldiers, 133 (42.36%) (36.89-47.83 at a 95% Confidence Interval) soldiers had depression where, 47 (14.97%) had mild mood disturbance, 33 (10.51%) had borderline depression, 40 (12.74%) had moderate depression, 10 (3.18%) had severe depression and 3 (0.96%) had extreme depression. Conclusions: The prevalence of depression in our study was lower when compared to other studies conducted in similar settings. Keywords: armed forces personnel; depression; depressive symptoms; soldiers.

Association of geographic distribution and birth weight with sociodemographic factors of the maternal and newborn child of hilly and mountain regions of eastern Nepal: a cross-sectional study.

OBJECTIVES: To determine the association of geographic distribution, and birth weight with sociodemographic factors of the maternal and newborn child of hilly region (lower altitude) and mountain region (high altitude) of eastern Nepal as well as the prevalence of low birth weight (LBW) and large for gestational age (LGA) among term singleton deliveries in eastern Nepal. METHODOLOGY: A cross-sectional study was conducted in the district-level hospitals of Dhankuta, Tehrathum, Solukhumbu and Taplejung districts of eastern Nepal of Province 1. Mothers with preterm or post-term delivery, multiple pregnancies, stillbirth/intrauterine fetal death and incomplete records were excluded from the study with only 1386 term pregnancies (37-42 weeks) delivered at the respective facilities between 17 July 2019 and 16 July 2020 were included. The appropriate data were entered in Microsoft Excel 2019 V.16.0 and statistical analysis was performed by using the statistical package for social sciences, IBM SPSS V.29. RESULTS: The low maternal age, Dalit ethnic group, low gravidity, low parity, higher antenatal care (ANC) visits (≥4), incomplete deworming and dT vaccination status, breech deliveries and LBW newborns were significantly attributed to hilly region (lower altitude) (p value <0.05). Similarly, the hilly region, lower and/or no ANC visits and early term gestation had significant negative association with birth weight at the lower quantiles only. Meanwhile, the female newborn had significant and negative association with birth weight distribution at all seven quantiles. The prevalence of the LBW, average for gestational age and LGA newborn child among term singleton deliveries in Eastern Nepal is 6.6%, 85.8% and 7.6%, respectively. CONCLUSIONS: The local organisations should focus on adequate antenatal care visits in mountain region and coverage of dT vaccine and deworming medications in hilly region. Appropriate measures and programmes should be initiated to bring down LBW in hilly region.

Neurological Manifestations of COVID-19 Associated Multi-system Inflammatory Syndrome in Children: A Systematic Review and Meta-analysis.

BACKGROUND: Children comprise only 1-5% of COVID-19 cases. Recent studies have shown that COVID-19 associated multisystem inflammatory syndrome in children (MIS-C) can present with neurological signs and symptoms. In this systematic review and meta-analysis, we have reviewed neurological involvement in these patients. METHODS: A comprehensive electronic literature search was done on PubMed, Google Scholar, Embase, Cochrane database, and SCOPUS for the published English language articles from December 1, 2019, to February 28, 2021. A meta-analysis of the proportion was expressed as a pooled proportion with a 95% confidence interval (CI). Representative forest plots showing individual studies and the combined effect size were generated to provide an overview of the results. RESULTS: This systematic review and meta-analysis analyzed 15 published MIS-C studies with a total of 785 patients. Neurological manifestations in patients with MIS-C was found in 27.1%. We found that 27% developed headaches, 17.1% developed meningism/meningitis and 7.6 % developed encephalopathy. Other uncommon neurological manifestations of MIS-C includes anosmia, seizures, cerebellar ataxia, global proximal muscle weakness and bulbar palsy. In MIS-C patients with neurological feature, neuroimaging showed signal changes in the splenium of the corpus callosum. Electroencephalography showed slow wave pattern and nerve conduction studies and electromyography showed mild myopathic and neuropathic changes. CONCLUSIONS: Our study revealed that neurological manifestations are not uncommon in patients with MIS-C. Further large prospective studies are needed to better explore the disease spectrum and to unravel the underlying pathophysiology.

Protective effect of interleukin-1beta on motor neurons after sciatic nerve injury in rats.

Protective effect of interleukin-1beta (IL-1beta) on motor neurons was studied after peripheral nerve injury. Twenty Wistar rats were divided into 2 groups randomly. The right sciatic nerve of each rat was resected. After silicon tubulization of sciatic nerve in rat, 15 microl 1 ng/ml IL-1beta and PBS solution were injected into the silicon capsule respectively. Enzyme histochemistry was performed to show acetyle cholesterase (AchE) and nitric oxide staining (NOS) activity of spinal alpha motor neurons in spinal segments 2 weeks later. Neurons were counted and the diameter and cross sectional (c/s) area of neurons were analyzed by using computer image analysis system. The results showed that as compared with the normal side, both enzyme activities significantly changed in motor neurons in PBS group. The diameter and c/s area of both neurons changed significantly too (P < 0.01). These results suggest that exogenous IL-1beta protects alpha-motor neurons from degeneration and necrosis after peripheral nerve injury.

Leprosy affects facial nerves in a scattered distribution from the main trunk to all peripheral branches and neurolysis improves muscle function of the face.

Current literature rejects nerve release in leprous facial neuropathy and states that lesions are restricted to the peripheral zygomatic branches. Since there are approximately 500,000 patients with this disease throughout the world, we wanted to clarify the precise location of facial nerve's affection and the benefit of neurolysis. Our study showed that in patients with leprosy, the facial nerve's main trunk, the peripheral zygomatic branches, and all other branches were affected. Follow-up showed improvement in lagophthalmos and in misreinnervation, with no improvement in the control cohort. Nerve release improves muscle function in leprous facial neuropathy, provided surgery is performed on all affected segments. Intraoperative electroneurodiagnostics is an effective tool for detecting the most proximal site of lesion and ensuring effective surgery.

Leprosy affects facial nerves in a scattered distribution from the main trunk to all peripheral branches and neurolysis improves muscle function of the face

Current literature rejects nerve release in leprous facial neuropathy and states that lesions are restricted to the peripheral zygomatic branches. Since there are approximately 500,000 patients with this disease throughout the world, we wanted to clarify the precise location of facial nerve's affection and the benefit of neurolysis. Our study showed that in patients with leprosy, the facial nerve's main trunk, the peripheral zygomatic branches, and all other branches were affected. Follow-up showed improvement in lagophthalmos and in misreinnervation, with no improvement in the control cohort. Nerve release improves muscle function in leprous facial neuropathy, provided surgery is performed on all affected segments. Intraoperative electroneurodiagnostics is an effective tool for detecting the most proximal site of lesion and ensuring effective surgery.