Acaricide resistance status of deltamethrin and coumaphos in Hyalomma anatolicum ticks collected from different districts of Haryana.

To study the acaricide resistance status and possible mechanisms of action in conferring resistance to commonly used acaricides (deltamethrin and coumaphos), Hyalomma anatolicum ticks were collected from 6 dairy farms of Hisar and Charkhi Dadri districts of Haryana. By using standard larval packet test, H. anatolicum tick larvae of Charkhi Dadri isolates were found to be susceptible (100% mortality) to both the acaricides. Level-I resistance against coumaphos was recorded from four isolates, whereas, level-II was observed in only one isolate, collected from Hisar. One isolates (Kaimri) from Hisar also showed level-I resistance against deltamethrin. Biochemically, the ticks having higher values of resistance factor (RF) against coumaphos were found to possess increased enzymatic activity of α-esterase, ß-esterase, glutathione-S-transferase (GST) and mono-oxygenase enzymes, whereas, the monoamine oxidase did not show any constant trend. However, the RF showed a statistical significant correlation with GST only. Native PAGE analysis of H. anatolicum ticks revealed the presence of nine types of esterases (EST-1 h to EST-9 h) by using napthyl acetate as substrate. In the inhibitory assay, esterases were found to be inhibited by PMSF, indicating the presence of serine residue at catalytic triad. The partial cds of carboxylesterase and domain II of sodium channel genes were sequenced to determine any proposed mutations in resistant isolates of H. anatolicum ticks, however, no mutations were observed in either gene, indicating that increased expression of detoxification enzymes as a possible mechanism for resistance development, in the current study.

Understanding the resistance mechanisms of Rhipicephalus microplus ticks to synthetic pyrethroids and organophosphates in south-west regions of Haryana, North India.

Chemical control of tick infestation on dairy farms in India strongly relies upon the use of synthetic pyrethroids (deltamethrin) and organophosphate (coumaphos) drugs. Therefore, the present manuscript aims to investigate the resistance status of Rhipicephalus microplus ticks against these acaricides. Fully engorged adult R. microplus ticks were randomly collected from 8 dairy farms in North India and evaluated for acaricide resistance by using the Larval Packet Test (LPT). Of these, ticks collected from one and three farms showed the emergence of Level I acaricide resistance against deltamethrin and coumaphos, respectively. Significant positive correlations were found in the enzymatic activity (α-esterase, ß-esterase, glutathione-S-transferase, and mono-oxygenase) of R. microplus tick resistant against coumaphos. Native electrophoretogram analysis showed six different types of esterase activity in R. microplus (EST-1b to EST-6b), and EST-5b activity was more predominantly expressed in resistant ticks. Further, inhibitor studies using various esterase inhibitors suggested that EST-5b is a putative acetylcholine-esterase (AchE), and increased expression of one of the AchE might be responsible for the emergence of acaricide resistance. Further, no mutations were detected in the carboxylesterase (G1120A) and domain II S4-5 linker region (C190A) of the sodium channel genes of resistant R. microplus ticks, indicating that increased expression of detoxification enzymes was the probable mechanism for the development of acaricide resistance in the resistant ticks.

Molecular characterization of Hyalomma dromedarii and evaluation of acaricidal potential of herbal methanolic extracts against H. dromedarii larvae in comparison to synthetic acaricides.

The present study had two aims: molecular characterization of Hyalomma dromedarii infesting one-humped camels of Haryana (North India), and assessment of the acaricidal potential of herbal methanolic extracts against H. dromedarii larvae in comparison to synthetic acaricides. Phylogenetics and population neutrality indices were assessed by targeting partial amplification of mitochondrial 16S rDNA sequences. Larval packet test (LPT) was performed to evaluate the acaricidal efficacy of herbal extracts (Ferula asafoetida and Trachyspermum ammi) and synthetic acaricides (deltamethrin and fipronil). Phylogenetic studies established the collected ticks to be H. dromedarii, exhibiting a homology of 99.8-100%. However, the present study isolates formed a different sub-clade compared to H. dromedarii sequences from Egypt, Senegal, Tunisia and Saudi Arabia. Nucleotide and haplotype diversity values were indicative of demographic expansion and low gene flow. Negative values of Tajima's D (-0.612) and Fu and Li's Fst (-0.479) highlighted deviations from neutrality and emphasized recent population expansion. The median lethal concentration (LC50) values recorded for T. ammi, F. asafoetida and their combination were 3.68, 2.87 and 2.59 mg/mL, respectively, whereas the 90% lethal concentration (LC90) values were 4.09, 3.58 and 3.35 mg/mL, respectively. It was also observed that the H. dromedarii population under study was completely susceptible to both the formulated synthetic acaricides. In conclusion, combination of methanolic extracts of F. asafoetida and T. ammi could provide a potential substitute to toxic synthetic chemical acaricides and might prove a valuable component of integrated tick management strategies.

Youth Suicide in India: A Critical Review and Implication for the National Suicide Prevention Policy.

Youth suicide is a significant public health problem in Low-and middle-income countries (LMIC), including India. It is a distinct phenomenon with various bio-psycho-social determinants. Despite this, comprehensive literature on this topic is lacking from India. Thus, the current paper aimed to review the available literature on youth-suicide from India and other LMIC, discusses the contentious issues, including potential solutions for the possible roadblocks, and provides recommendations for the national suicide-prevention policy and strategy (NSPPS) in the Indian context. We found that the magnitude of youth suicide in India is substantial with the distinct bio-psycho-social determinants. Although, youth-specific suicide prevention and therapeutic intervention do exist; its feasibility and effectivity in the Indian context are yet to be established. The is an urgent need for the NSPPS; experiences from other LMIC should be incorporated while framing such policies. More research is required from India in this area.

Seroprevalence and immunological characterization of Trypanosoma evansi infection in livestock of four agro-climatic zones of Himachal Pradesh, India.

Trypanosoma evansi, a hemoflagellate protozoan parasite, causes wasting disease called surra in wide range of animals. Although the organism has been reported from various parts of India, data generated from organized epidemiological study is still in infancy in majority states of India. In the present study, livestock of Himachal Pradesh, India, was targeted for epidemiological investigation of T. evansi infections. A total of 440 equines and 444 cattle serum samples were collected from four agro-climatic zones. Furthermore, serum samples of 280 buffaloes from three different agro-climatic zones of Himachal Pradesh were also collected and evaluated for the presence of T. evansi infection by indirect ELISA. Data generated showed higher prevalence in buffalo (23.57%) followed by cattle (22.52%) and equines (1.82%). Disease was found to be more prevalent (P < 0.01) in cattle of lower altitude as compared to those of higher altitudes. No significant variation was seen in prevalence of disease on the basis of age and sex of the animals. Serum biochemical analysis revealed increased levels of BUN in T. evansi-infected equines. Levels of liver function enzymes such as ALT/GGT and AST were found to be significantly elevated (P < 0.01) in seropositive animals whereas glucose levels were significantly lower in surra-seropositive animals as compared to seronegative animals. Immunoblot analysis of whole cell lysate (WCL) antigen of T. evansi using surra-seropositive samples of equines showed immunodominant bands in the range of 100-25 kDa. Bovine-seropositive samples recognized polypeptide bands in the range of 85-32 kDa, including protein clusters of 52-55 and 48-46 kDa. Polypeptide cluster of 62-66 kDa was found common in seropositive samples of bovines and equines from all agro-climatic zones. T. evansi was found to be highly prevalent in livestock of Himachal Pradesh, and thus, there is dire need for designing of proper control strategies against surra.

In vitro anti-trypanosomal effect of ivermectin on Trypanosoma evansi by targeting multiple metabolic pathways.

High cytotoxicity and increasing resistance reports of existing chemotherapeutic agents against T. evansi have raised the demand for novel, potent, and high therapeutic index molecules for the treatment of surra in animals. In this regard, repurposing approach of drug discovery has provided an opportunity to explore the therapeutic potential of existing drugs against new organism. With this objective, the macrocyclic lactone representative, ivermectin, has been investigated for the efficacy against T. evansi in the axenic culture medium. To elucidate the potential target of ivermectin in T. evansi, mRNA expression profile of 13 important drug target genes has been studied at 12, 24, and 48 h interval. In the in vitro growth inhibition assay, ivermectin inhibited T. evansi growth and multiplication significantly (p < 0.001) with IC50 values of 13.82 µM, indicating potent trypanocidal activity. Cytotoxicity assays on equine peripheral blood mononuclear cells (PBMCs) and Vero cell line showed that ivermectin affected the viability of cells with a half-maximal cytotoxic concentration (CC50) at 17.48 and 22.05 µM, respectively. Data generated showed there was significant down-regulation of hexokinase (p < 0.001), ESAG8 (p < 0.001), aurora kinase (p < 0.001), casein kinase 1 (p < 0.001), topoisomerase II (p < 0.001), calcium ATPase 1 (p < 0.001), ribonucleotide reductase I (p < 0.05), and ornithine decarboxylase (p < 0.01). The mRNA expression of oligopeptidase B remains refractory to the exposure of the ivermectin. The arginine kinase 1 and ribonucleotide reductase II showed up-regulation on treatment with ivermectin. The ivermectin was found to affect glycolytic pathways, ATP-dependent calcium ATPase, cellular kinases, and other pathway involved in proliferation and maintenance of internal homeostasis of T. evansi. These data imply that intervention with alternate strategies like nano-formulation, nano-carriers, and nano-delivery or identification of ivermectin homologs with low cytotoxicity and high bioavailability can be explored in the future as an alternate treatment for surra in animals.

First report of molecular and phylogenetic analysis of Physaloptera praeputialis in naturally infected stray cats from India.

Nematodes of the genus Physaloptera are globally distributed and infect a multitude of hosts. Their life cycle involves orthopterans and coleopterans as intermediate hosts. The morphological characters alone are inadequate to detect and differentiate Physaloptera spp. from its congeners. Moreover, molecular studies are limited to compare them precisely. The present communication reports the first molecular phylogenetic characterization of feline Physaloptera spp. from India based on mitochondrial cytochrome c oxidase subunit 1 (COX1) and small subunit ribosomal DNA (18S rDNA). The nematodes were first isolated from the stomach of adult stray cats during necropsy examination. Based on the gross and microscopic characters, the worms were identified as P. praeputialis. Morphological identification was further confirmed through PCR targeting the barcode region of the mitochondrial cytochrome c oxidase subunit I (MT-COI) gene, using nematode-specific primers cocktail followed by species specific primers targeting partial COX1 and 18S rRNA genes. Generated sequences were submitted in NCBI GenBank (MW517846, MW410927, MW411349), and phylogenetic trees were constructed using the maximum likelihood method. When compared with other sequences of Physaloptera species across the globe, the present isolates showed 85.6-97.7% and 97.3-99% nucleotide homology based on COX1 and 18S rRNA gene, respectively. BLASTn analysis revealed a strong identity to other Physaloptera spp., and the phylogenetic tree placed all Physaloptera spp. in the same cluster. This study again indicates the usefulness of molecular techniques to substantiate the identity of species that may lack adequate descriptions and impart new insight for the potentially overlooked significance of P. praeputialis infections in felines.

Effectiveness of Interventions Based on Yogic Breathing Practices (IB-YBP) on Substance Use Disorders-A Systematic Review of the Randomized Control Trials and Quasi-Experimental Trials.

INTRODUCTION: Interventions based on Yogic Breathing Practices (IB-YBP) have shown promising results for substance use disorders (SUD). Research in this area is methodologically heterogeneous and only a few, but restricted, systematic reviews are available. The current systematic review aims to assess the effectiveness of IB-YBP for SUD. Materials and Methods: PubMed, Cochrane's Library, EBSCO-Medline, and Google Scholar databases were searched for the randomized- (RCTs) and quasi-randomized trials. Research involving participants with SUD, of either gender or any age, assessing the effectiveness of the IB-YBP either as a standalone intervention or as an adjuvant to standard treatment versus standard pharmacological/non-pharmacological treatment or no-intervention control were included. Studies having participants with co-morbid psychiatric illness and interventions not having IB-YBP as the predominant component were excluded. Results: The initial literature search yielded 396 articles and upon screening, only 14 studies were found eligible for this review. Most studies have researched IB-YBP as an adjunct to the standard treatment for SUD. Evidence for the effectiveness of IB-YBP is mostly available for tobacco and opioid use disorders, though only for short-term outcomes; however, literature is scarce for alcohol- and cocaine-use disorders. This review documented the effectiveness of the IB-YBP for substance use-related outcome parameters such as abstinence, quality of life (QoL), mood, craving, and withdrawal symptoms. Conclusion: IB-YBP may be an effective adjuvant to standard treatment for various SUD. However, more research is required to compare its effectiveness with standard treatment, and assessing its long-term efficacy, for it to be strongly recommended as a treatment strategy.

Molecular tools-advances, opportunities and prospects for the control of parasites of veterinary importance.

The recent advancement in genome sequencing facilities, proteomics, transcriptomics, and metabolomics of eukaryotes have opened door for employment of molecular diagnostic techniques for early detection of parasites and determining target molecules for formulating control strategies. It further leads to the introduction of several purified vaccines in the field of veterinary parasitology. Earlier, the conventional diagnostic methods was entirely based upon morphological taxonomy for diagnosis of parasites but nowadays improved molecular techniques help in phylogenetic study and open an another area of molecular taxonomy of parasites with high precision. Control measures based upon targeting endosymbionts in parasites like Dirofilaria immitis is also under exploration in veterinary parasitology. Metagenomics have added an inside story of parasites bionomics which have created havoc in human and animals population since centuries. Omics era is playing a key role in opening the new approaches on parasite biology. Various newer generations of safer vaccines like edible vaccines and subunit vaccines and diagnostic techniques based upon purified immunologically active epitopes have become commercially available against the parasites (helminths, protozoa and arthropod borne diseases). Nowadays, a transgenic and gene knock out studies using RNA interference and CRISPR are also helping in understanding the functions of genes and screening of target genes, which are not available before the advent of molecular tools. Molecular techniques had paramount impact on increasing the sensitivity of diagnostic tools, epidemiological studies and more importantly in controlling these diseases. This review is about the advancements in veterinary parasitology and their impact on the control of these pathogens.

Standardization of tick specific biochemical tools for estimation of esterases, monooxygenases and glutathione S-transferase for characterization of acaricide resistance.

Protocols to determine metabolic resistance in ticks were mainly derived from reports published using mosquitoes and agriculturally important insects without prior standardization. In the present study, biochemical assays were standardized to quantify acaricide metabolizing enzymes in tick homogenates. Three variables viz., age, number of larvae and reaction time were optimized using reference susceptible IVRI-I and deltamethrin resistant IVRI-IV (Resistance Factor = 194) tick strains. The optimum conditions for estimation of general esterases were 10-15 day old 40 larvae with 15 mins reaction time, 15-20 day old 40 larvae with 20 mins reaction time for Glutathione S- transferase, while 10-15 day old 80 larvae with 5 mins reaction time for monooxygenase. The standardized protocols were further validated in multi acaricide resistant strain (IVRI-V) and in nine field isolates having variable resistant factors to different acaricides. In all the nine heterogeneous field isolates, a significant correlation (p < .05) between resistance to synthetic pyrethroids and over-expression of esterases and monooxygenase was noticed. Similarly, esterases and GST activities were significantly correlated with resistance to organophosphates. The details of the assay protocol are explained for adoption in different laboratories.

Acaricidal efficacy of Calotropis procera (Asclepiadaceae) and Taraxacum officinale (Asteraceae) against Rhipicephalus microplus from Mardan, Pakistan.

Medicinal plants are used by traditional folk healers, modern physicians, and veterinarians as an alternative to conventional drugs to treat a wide range of disorders including parasitic diseases. Some compounds from these plants have been shown to have acaricidal activity and repel arthropods. The cattle tick Rhipicephalus microplus is one of the most destructive pests to the livestock industry in tropical and subtropical parts of the world. The potential to develop herbal acaricides to control R. microplus infestations is critical in maintaining cattle herd productivity, reducing economic losses, and curtailing the overuse of synthetic chemical acaricides. Calotropis procera, the apple of Sodom, and Taraxacum officinale, the common dandelion, were evaluated for acaricidal activity against R. microplus larvae and adults in vitro. Both plant species tested are common indigenous species of Pakistan where R. microplus infestations are widespread across livestock species including cattle, sheep, and goats. Whole-plant extracts derived from C. procera and T. officinale significantly reduced the index of egg laying (P < 0.01) and increased the percent inhibition of oviposition of adult female ticks at a concentration of 40 mg/mL when assessed by the adult immersion test (AIT). Calotropis procera and T. officinale treatments at the same concentration also resulted in larval mortality of 96.0% ± 0.57 and 96.7% ± 0.88, respectively, as measured using the larval packet test (LPT). An increasing range of extract concentrations was tested to determine the LD50 and LD90 for C. procera, 3.21 and 21.15 mg/mL, respectively, and T. officinale, 4.04 and 18.92 mg/mL, respectively. These results indicate that further studies are warranted to determine the relative contribution of individual phytochemicals from whole-plant extracts on acaricidal activity. This information will guide the design of further acaricidal efficacy tests using livestock infested with R. microplus.

Characterization and establishment of a reference deltamethrin and cypermethrin resistant tick line (IVRI-IV) of Rhipicephalus (Boophilus) microplus.

The problem of ticks and tick borne diseases is a global threat and growing reports of resistance to commonly used insecticides further aggravated the condition and demands for country specific resistance monitoring tools and possible solutions of the problem. Establishment of standard reference is prerequisite for development of monitoring tools. For studying possible role of different mechanisms involved in development of resistance in Rhipicephalus (Boophilus) microplus population and to develop newer drug to manage the problem of resistance, a deltamethrin exposed and selected tick colony, referred to as IVRI-IV, was characterized using reference susceptible IVRI-I tick line as control. The RF values of IVRI-IV ticks against deltamethrin, cypermethrin and diazinon were determined as 194.0, 26.6, 2.86, respectively, against adults. The esterase enzyme ratios of 2.60 and 5.83 was observed using α-naphthyl and ß-naphthyl acetate while glutathione S-transferase (GST) ratio was 3.77. Comparative analysis of IVRI-I and IVRI-IV carboxylesterase gene sequences revealed 13 synonymous and 5 non synonymous mutations, reported for the first time. The C190A mutation in the domain II S4-5 linker region of sodium channel gene leading to leucine to isoleucine (L64I) amino acid substitution was also detected in the IVRI-IV population. In the present study, monitorable indicators for the maintenance of the reference IVRI-IV colony, the first established deltamethrin and cypermethrin resistant tick line of India, were identified.

Esterase mediated resistance in deltamethrin resistant reference tick colony of Rhipicephalus (Boophilus) microplus.

Monitoring of acaricide resistance is considered as one of the important facets of integrated tick management. In an attempt of development of resistance monitoring indicators, in the present study two reference tick lines of Rhipicephalus (Boophilus) microplus maintained in the Entomology laboratory, Indian Veterinary Research Institute (IVRI), Izatnagar, India, were studied to determine the possible contributing factors involved in development of resistance to deltamethrin. Electrophoretic profiling of esterase enzymes detected high activities of EST-1 in reference resistant tick colony designated as IVRI-IV whereas it was not detectable in reference susceptible IVRI-I line of R. (B.) microplus. Esterases were further characterized as carboxylesterase or acetylcholinesterase based on inhibitor study using PMSF, eserine sulphate, malathion, TPP and copper sulphate. It was concluded that an acetylcholinesterase, EST-1, possibly plays an important role for development of deltamethrin resistance in IVRI-IV colony of R. (B.) microplus.

caTissue Suite to OpenSpecimen: Developing an extensible, open source, web-based biobanking management system.

The National Cancer Institute (NCI) Cancer Biomedical Informatics Grid® (caBIG®) program established standards and best practices for biorepository data management by creating an infrastructure to propagate biospecimen resource sharing while maintaining data integrity and security. caTissue Suite, a biospecimen data management software tool, has evolved from this effort. More recently, the caTissue Suite continues to evolve as an open source initiative known as OpenSpecimen. The essential functionality of OpenSpecimen includes the capture and representation of highly granular, hierarchically-structured data for biospecimen processing, quality assurance, tracking, and annotation. Ideal for multi-user and multi-site biorepository environments, OpenSpecimen permits role-based access to specific sets of data operations through a user-interface designed to accommodate varying workflows and unique user needs. The software is interoperable, both syntactically and semantically, with an array of other bioinformatics tools given its integration of standard vocabularies thus enabling research involving biospecimens. End-users are encouraged to share their day-to-day experiences in working with the application, thus providing to the community board insight into the needs and limitations which need be addressed. Users are also requested to review and validate new features through group testing environments and mock screens. Through this user interaction, application flexibility and interoperability have been recognized as necessary developmental focuses essential for accommodating diverse adoption scenarios and biobanking workflows to catalyze advances in biomedical research and operations. Given the diversity of biobanking practices and workforce roles, efforts have been made consistently to maintain robust data granularity while aiding user accessibility, data discoverability, and security within and across applications by providing a lower learning curve in using OpenSpecimen. Iterative development and testing cycles provide continuous maintenance and up-to-date capabilities for this freely available, open-access, web-based software application that is globally-adopted at over 25 institutions.

Change in psychological parameters and quality of life among individuals with pulmonary and extrapulmonary tuberculosis following the intensive phase of therapy: A longitudinal observational study from central India.

BACKGROUND: Tuberculosis (TB) is a global health concern, impacting millions annually, with limited attention to the psychological distress it inflicts. Psychological comorbidities, such as depression, anxiety, and stress, significantly affect the quality of life (QoL) of TB patients. Available literature on this topic is restricted to the pulmonary TB (PTB) patients; while psychological issues of the extrapulmonary TB (EPTB) patients who comprise a significant proportion of this disease entity remains unexplored. Additionally, the impact of anti-TB treatment on psychological parameters has received limited attention and vice-versa. This study aimed to assess depression, anxiety, stress, and QoL of TB patients at diagnosis and to understand how these parameters change after the intensive phase of treatment. METHODS: A longitudinal observational study involving 40 TB patients (31 EPTB and 9 TB) was conducted to assess depression, anxiety, stress and QoL among them. Participants were followed up after the intensive treatment phase. RESULTS: At baseline, 32.5% (n = 13) and 65% (n = 26) participants experienced moderate-severe depression, and moderate-severe anxiety, and stress, respectively. QoL was notably compromised, especially in the psychological domain. Post-intensive treatment, anxiety and depression showed significant improvement (Z = -2.271, p = 0.023 and Z = -2.093, p = 0.036), but QoL and stress levels remained largely unchanged (p > 0.05). CONCLUSION: This study highlights the high prevalence of psychological distress and poor QoL among TB patients. Following intensive phase of therapy, severity of depression and anxiety reduced significantly; however, change in stress-level and QoL was non-significant. Although study is limited by in terms for small sample size, the need of holistic, multidisciplinary treatment approach (including mental health professionals) for such patients can't be overemphasized. Implementing baseline psychological screenings and providing mental health support if required, are critical to improve the overall health and QoL of these individuals.

Post-traumatic stress disorder in maxillofacial trauma victims- A systematic review and meta-analysis.

BACKGROUND: Maxillofacial trauma often results in visible facial disfigurements and can lead to psychological complications such as post-traumatic stress disorder (PTSD). However, PTSD often remains unrecognized and un/undertreated. The goal of the current systematic review was to determine the incidence of PTSD after maxillofacial trauma, associated risk factors, assessment tools employed, and management. METHODS: A literature search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane Library databases following PRISMA guidelines up to March 2024. Collected variables included the number of patients included, PSTD assessment tool, PTSD incidence, and risk factors and management. The meta-analysis was conducted using random effect models in STATA 16. RESULTS: The review included 14 studies (1633 patients, male=1025, female=230, not mentioned=378). Assessment tools varied widely among studies. Meta-analysis revealed a pooled incidence of PTSD of 27 % (n = 14, 95 % CI, 24 %-30 %) at 1-3 months post-trauma and 10 % (n = 3, 95 % CI, 3 %-17 %) at the 6-12 months follow-up, with a statistically significant 60 % reduction between these periods. CONCLUSION: The overall incidence of PTSD following maxillofacial trauma was 27 % at 1-3 months and decreased to 10 % after 6 months. The emphasis should be given to the importance of early intervention strategies and awareness among the treating surgeon to prevent PTSD.

Survey of Felt Needs Among Teachers of Psychiatry in Institutes of National Importance (INI) to Improve the Quality of Undergraduate and Postgraduate Training.

Background: Several institutes of national importance (INI) have been established in the last few years to improve the quality of medical education in the country. Most INIs are autonomous and outside the purview of the National Medical Commission (NMC). Little is known about the needs of the psychiatry teachers working in INIs. The current study was planned to obtain feedback from the psychiatry teachers in INIs about the various issues pertaining to training in psychiatry. Methods: This was an online survey conducted using Google Forms involving psychiatry teachers working in autonomous INIs outside the purview of NMC. The questionnaire had mandatory items (which provided quantitative data) and optional questions (which were used for thematic analysis). Results: Our study's response rate was estimated at 48.73%. About 92.7% of respondents appreciated the need for training in undergraduate psychiatry. Though fewer residents were trained in medical education, the felt need for training among residents was comparable to that among faculty members. The major themes of targeted training, as reported, were found to be in sync with the current demands of the curriculum. Conclusion: There is a substantial need for training among the teachers of psychiatry in the INIs. This study provided with some groundwork regarding the strengths and weaknesses of teaching psychiatry in INIs. Further studies on this topic, using a qualitative design, should be planned to understand the nuances of working in an autonomous institute.

Mental health stigma and its relationship with mental health professionals - A narrative review and practice implications.

The extent and magnitude of the mental health stigma are enormous, with substantial clinical and social implications. There is a complex relationship between mental health stigma and mental health professionals (MHPs); MHPs can be anti-stigma crusaders, victims of stigma, and even a source of stigma. Unfortunately, literature is scarce talking about the relationship between stigma and MHPs. Hence, the current review aims to bridge the existing gap in the literature on various aspects of stigma and the role of MHPs. For the current review, we ran a search in PubMed and Google Scholar databases; we restricted our study to records focusing on the interplay of mental health stigma and the MHPs, published during 2012-2022, in English, and having a full text available. We found that MHPs (psychiatrists, psychologists, and psychiatric nurses) can also be the recipients of the stigma. The stigma faced by the MHPs is determined by the negative stereotypes set by the media, or medical students, or other health professionals; the marginal position of psychiatry in the health system; difficult-to-treat mental disorders; MHPs' own experience of stigma; and the attitude or beliefs of various caders of the MHPs, their professional experience, and expertise in managing various mental health conditions. Notably, MHPs can also be a source of stigma (stigmatizers). MHPs need to be sensitized concerning this, and the anti-stigma interventions must incorporate this aspect of stigma. Novel interventions, such as digital-based programs, should be used instead of traditional anti-stigma programs in order to decrease stigma around mental health issues and make anti-stigma initiatives more appealing and scalable. To address the issues of stigma, there has to be more communication between MHPs, other health professionals, service users, and policymakers.

Perceived Learning and Feedback of Students Following the Competency-based Clinical Rotation in Psychiatry: A Retrospective Review From Tertiary-care Teaching Institute in Central India.

Background: Competency-based medical education (CBME) offers avenues for effective psychiatry teaching to medical students. However, data concerning the feasibility, effectiveness, and students' perspectives on CBME-based clinical rotation, including psychiatry, needs to be explored in India. Therefore, this research aims to evaluate the student's learning effectiveness and feedback on the CBME-informed psychiatry posting. Methods: This cross-sectional retrospective research evaluated the 7th-semester MBBS students (n = 101, 39 [38.6%] females and 62 [71.4%] males), from a tertiary-care teaching hospital in central India, perceived change in Knowledge, Attitude, and Skill and feedback on the CBME-based clinical rotation (July-December 2023) using a mixed-method approach through an online feedback form. Results: A "considerable or marked perceived change," ranging from 70% to 97%, in the knowledge, attitude, ethical aspects, psychomotor skills, and soft skills were noted. 84%-91% of students were "satisfied/quite satisfied (or rated it good to very good)" with the pattern and content of the program, including the assessment. 37% expressed their desire to take psychiatry as an elective. Descriptive responses showed that participants felt improvement in their communication skills, knowledge about non-pharmacological interventions, opportunity to observe and present cases in the Outpatient Department, and satisfaction with the teaching and assessment methods. The need for minor changes regarding case-based formative assessment and the opportunity for more case workups were also cited. Conclusion: The CBME-informed psychiatry clinical rotation can be instrumental in improving psychiatry training and promoting mental health among students. Research involving a comparison arm, longitudinal design, and validated assessment tools can bring greater insights into the subject.

Training Needs Analysis for Medical Students in Assessing Cognitive Functioning: An Observational Study.

Backgrounds: Research shows that medical students' knowledge and skills concerning the assessment of cognition in various neuropsychiatric conditions (e.g., Alzheimer's disease and schizophrenia) are unsatisfactory. This research aims to conduct a training needs analysis (TNA) for medical students to identify and refer patients with neuropsychiatric conditions. Methods: The study comprised two phases. First, developing a TNA toolkit to assess training needs in clinical tasks related to cognitive function assessment (by adopting the Hennessy-Hicks TNA toolkit); and second, through a self-reported survey, their training needs in cognitive function assessment were assessed. Data analysis involved calculating training gaps, importance scores, performance scores, training scores, and organization scores for various clinical tasks-stratified participants' study year; for training needs and trends, factor analysis and post-hoc analyses were conducted. Results: A total of 153 medical students from a tertiary care center participated in the survey. The participants rated their performance lower than the perceived importance of tasks, indicating a need for improvement in all competencies (P < .01). Pre-final-year students had the highest training needs, particularly in accessing literature, planning, and organizing care for patients with cognitive impairment, performing mental status examination, screening patients for cognitive deficits, and counseling them/caregivers about interventions (P < .01). Factor analysis identified a single dominant factor, suggesting a correlation among these skills. Conclusion: Pre-final-year students require targeted training, whereas students beyond this stage can benefit from special training modules and awareness of available resources for cognitive assessment. The findings also suggest the importance of a hybrid approach involving training and organizational modifications.