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Olanzapine is widely used during pregnancy to manage mood and psychotic disorders with overall beneficial effects. There have been past reports of olanzapine exposure during early pregnancy and clubfoot in two newborns from India and Israel. We report a woman in Nepal diagnosed with schizophrenia and treated with olanzapine throughout the pregnancy delivering a baby boy with congenital talipes equinovarus deformity. Like in many other low-income settings, pregnancy was unplanned, and pre-conception counselling was not done. Research in mice has revealed the negative effects of olanzapine on bone development. Further reports would strengthen this potential association between exposure to olanzapine in the first trimester and the occurrence of clubfoot in the baby.
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Pé Torto Equinovaro , Animais , Pé Torto Equinovaro/induzido quimicamente , Pé Torto Equinovaro/epidemiologia , Feminino , Humanos , Índia , Recém-Nascido , Israel , Camundongos , Olanzapina/efeitos adversos , GravidezRESUMO
Herein, we utilized our previously reported highly porous CuMOF, {[Cu2(L)(H2O)2]·(5DMF)·(4H2O)}n, decorated with amine and trifluoromethyl functional groups for energy storage application. This robust framework in CuMOF enhances the chemical and thermal stabilities as well as improves the interfacial binding interactions. The poor conductivity of CuMOF usually restricts its practical utility in energy storage systems, due to which rGO was introduced along with CuMOF to form a CuMOF/rGO composite (1) through a facile ultrasonication technique. The synergistic effects between CuMOF and rGO induce a dramatic enhancement in specific capacitance (462 F g-1 at 0.8 A g-1) of 1 with a cycle life of 93.75% up to 1000 cycles. The results highlight 1 as an emerging contestant for next generation supercapacitors.
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A porous, Cu(II)-metal organic framework (Cu-MOF) constituted of a rigid lactam functionalized ditopic ligand (H2L) was synthesized at room temperature under slow evaporation conditions {H2L = (5-(1-oxo-2,3-dihydro-1H-inden-2-yl)isophthalic acid)}. The single crystal X-ray structure revealed the formation of a 3D framework of Cu-MOF with one-dimensional (1D) channels decorated with lactam groups and exposed metal centers in the crystallographic c-axis. Interestingly, Cu(II) coordinated DMF molecules were eliminated from the Cu(II) metal center on activation of Cu-MOF at a temperature of 150 °C under high vacuum to generate a solvent free framework with pores lined with unsaturated Lewis acidic Cu(II) ions, i.e., Cu-MOF'. The lactam functionalized channels inclined toward the CO2, which interact with the Cu(II) metal sites lined in the channels of Cu-MOF' and exhibit fascinating solvent-free heterogeneous catalytic conversion of CO2 to cyclic carbonates at atmospheric pressure of CO2, under mild conditions. Furthermore, the Cu-MOF' catalyst was easily recycled and reused for several cycles without a significant loss in catalytic activity.
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A chiral tetracarboxylic acid ligand, H4L, incorporating the (S)-(+)-2-methylpiperazine moiety in its middle, solvothermally forms a homochiral Cu(II) framework, {[Cu2(L)(H2O)2]·(4DMF)(4H2O)}n (LCu). It forms a non-interpenetrated structure consisting of [Cu2(COO)4] paddle-wheel secondary bonding units (SBUs) with NbO topology. Interestingly, the framework LCu exhibits excellent ferroelectric properties. It shows a remnant polarization (Pr) of â¼3.5 µC cm-2 and a coercive field (Ec) of â¼12 kV cm-1 with a distinct electric hysteresis loop. Dielectric studies of LCu reveal almost frequency-independent behavior with a dielectric constant (εr) of â¼42 and a low dielectric loss (tan δ) of â¼0.04 up to 106 Hz, for potential use in high-frequency applications. In addition, activated framework LCu' having uncoordinated metal sites acts as an efficient heterogeneous catalyst in the three-component coupling of amines, aldehydes, and alkynes, as well as in Pechmann reactions of phenols with ß-ketoesters.
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COVID-19 , Pandemias , Países em Desenvolvimento , Humanos , Saúde Mental , Pandemias/prevenção & controle , SARS-CoV-2 , ViolênciaRESUMO
Background: The coronavirus disease (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has detrimental effects on physical and mental health. Patients with severe mental illness are at higher risk of contracting the virus due to social determinants of health. Vulnerable populations include the elderly, people with pre-existing conditions, and those exposed to SARS-CoV-2. Unfortunately, only a few countries have updated vaccination strategies to prioritize patients with mental illnesses. Therefore, we aimed to explore whether individuals with mental disorders are prioritized in vaccine allocation strategies in different world regions. They are often neglected in policymaking but are highly vulnerable to the threatening complications of COVID-19. Methods: A questionnaire was developed to record details regarding COVID-19 vaccination and prioritizations for groups of persons with non-communicable diseases (NCDs), mental disorders, and substance use disorders (SUDs). NCDs were defined according to the WHO as chronic diseases that are the result of a combination of genetic, physiological, environmental, and behavioral factors such as cardiovascular diseases, cancer, respiratory diseases, and diabetes. Results: Most countries surveyed (80%) reported healthcare delivery via a nationalized health service. It was found that 82% of the countries had set up advisory groups, but only 26% included a mental health professional. Most frequently, malignancy (68%) was prioritized followed by diabetes type 2 (62%) and type 1 (59%). Only nine countries (26%) prioritized mental health conditions. Conclusion: The spread of the coronavirus has exposed both the strengths and flaws of our healthcare systems. The most vulnerable groups suffered the most and were hit first and faced most challenges. These findings raise awareness that patients with mental illnesses have been overlooked in immunization campaigns. The range of their mortality, morbidity, and quality of life could have widened due to this delay.
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INTRODUCTION: Nepal is a country in South-east Asia with high suicide. There is ongoing trend of emerging research on suicide from Nepal but there is lack of validated scale in measuring literacy or stigma. In the view of poor media reporting and large treatment gap, this study was conducted. All previous validation studies were done in non-Hindu populations. METHODS: A cross-sectional study was planned where the short forms of Nepalese literacy of suicide scale (LOSS-SF-Nep) and Stigma of Suicide Scale (SOSS-SF-Nep) were validated using standard procedure at a medical college in southern Nepal. Medical and nursing students of all batches were approached offline after successful pretesting. The psychometric properties of the scales were tested, and the statuses of literacy and stigma were assessed. Patient Health Questionnaire-9 and General Anxiety Disorder Scale-7 were used for revealing depression and generalized anxiety. RESULTS: Three hundred and nineteen Nepalese students participated and most of them were males, belonged to nuclear family, upper-middle socioeconomic status and represented 46 out of 77 districts of Nepal. The mean score of LOSS-SF-Nep was 6.36 ± 1.92 and literacy ranged from 37.9% to 89.7%. The deeper exposure to suicidal patients was associated with better literacy. Factor analysis of SOSS-SF-Nep revealed three subscales: stigmatization, isolation/depression, and normalization/glorification and had acceptable psychometric properties. Gender, occupation of head of the family, region and years of education, using mental health services, and depression were associated with variable literacy or stigma. CONCLUSION: Literacy and stigma scales were validated in Nepali, and SOSS factor structures were revealed with modified descriptors. The literacy and stigma levels in medical students were calculated for the first time in Nepal and Hindu majority population.
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Estudantes de Enfermagem , Suicídio , Masculino , Humanos , Feminino , Nepal , Alfabetização , Estudos Transversais , Comparação Transcultural , Suicídio/psicologia , Inquéritos e QuestionáriosRESUMO
Introduction: COVID-19 outbreak brought unprecedented pressure on dental and oral health care workers leading to increased depression. This study aimed to find the prevalence of depression among online respondent oral healthcare workers during the COVID-19 pandemic. Methods: A descriptive cross-sectional study was conducted from 24 June 2020 to 13 July 2020 among oral health care workers in a tertiary care centre. Ethical approval was taken from the Ethical Review Board (Reference number: 2710). Convenience sampling method was used. The data were collected using a questionnaire through Google Forms. Point estimate and 95% confidence interval were calculated. Results: Among 133 oral health care workers, the prevalence of depression was found to be 29 (21.80%) (14.78-28.82, 95% Confidence Interval). Conclusions: The prevalence of depression among oral health care workers was lower than similar studies done in similar settings. Keywords: COVID-19; depression; oral health.
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COVID-19 , Humanos , COVID-19/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Pandemias , Pessoal de SaúdeRESUMO
The history of psychiatry as a discipline in Nepal has been poorly studied. We have attempted to summarise historical landmarks to explore how it began and its evolution over time in relation to contemporary political events. Although Nepal has achieved several milestones, from establishing a psychiatric out-patient department with one psychiatrist in 1961 to having more than 500 psychiatric in-patient beds with 200 psychiatrists by 2020, the pace, commitment and dedication seem to be slower than necessary: the current national mental health policy dates back to 1996 and has not been updated since; there is no Mental Health Act; the number of psychiatric nurses and in-patient psychiatric beds has increased only slowly; and there is a dearth of professional supervision in rehabilitation centres. Thus, despite making significant progress, much more is required, at greater intensity and speed, and with wide collaboration and political commitment in order to improve the mental health of all Nepali citizens, including those living in rural areas and or in deprived conditions.
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INTRODUCTION: Varying public views on cannabis use across countries may explain the variation in the prevalence of use, policies, and research in individual countries, and global regulation of cannabis. This paper aims to describe the current state of cannabis use, policies, and research across sixteen countries. METHODS: PubMed and Google Scholar were searched for studies published from 2010 to 2020. Searches were conducted using the relevant country of interest as a search term (e.g., "Iran"), as well as relevant predefined keywords such as "cannabis," "marijuana," "hashish," "bhang "dual diagnosis," "use," "addiction," "prevalence," "co-morbidity," "substance use disorder," "legalization" or "policy" (in English and non-English languages). These keywords were used in multiple combinations to create the search string for studies' titles and abstracts. Official websites of respective governments and international organizations were also searched in English and non-English languages (using countries national languages) to identify the current state of cannabis use, policies, and research in each of those countries. RESULTS: The main findings were inconsistent and heterogeneous reporting of cannabis use, variation in policies (e.g., legalization), and variation in intervention strategies across the countries reviewed. European countries dominate the cannabis research output indexed on PubMed, in contrast to Asian countries (Thailand, Malaysia, India, Iran, and Nepal). CONCLUSIONS: Although global cannabis regulation is ongoing, the existing heterogeneities across countries in terms of policies and epidemiology can increase the burden of cannabis use disorders disproportionately and unpredictably. There is an urgent need to develop global strategies to address these cross-country barriers to improve early detection, prevention, and interventions for cannabis use and related disorders.
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Cannabis , Humanos , Internacionalidade , Irã (Geográfico) , Políticas , PrevalênciaRESUMO
In this paper, we studied the behavior of silicon quantum dots (Si-QDs) after etching and surface oxidation by means of photoluminescence (PL) measurements, Fourier transform infrared spectroscopy (FTIR) and electron paramagnetic resonance spectroscopy (EPR). We observed that etching of red luminescing Si-QDs with HF acid drastically reduces the concentration of defects and significantly enhances their PL intensity together with a small shift in the emission spectrum. Additionally, we observed the emergence of blue luminescence from Si-QDs during the re-oxidation of freshly etched particles. Our results indicate that the red emission is related to the quantum confinement effect, while the blue emission from Si-QDs is related to defect states at the newly formed silicon oxide surface.
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The formation of stable colloidal dispersions of silicon nanoparticles (Si-NPs) is essential for the manufacturing of silicon based electronic and optoelectronic devices using cost-effective printing technologies. However, the development of Si-NPs based printable electronics has so far been hampered by the lack of long-term stability, low production rate and poor optical properties of Si-NPs ink. In this paper, we synthesized Si-NPs in a gas phase microwave plasma reactor with very high production rate, which were later treated to form a stable colloidal dispersion. These particles can be readily dispersed in a variety of organic solvents and the dispersion is stable for months. The particles show excellent optical properties (quantum yields of about 15%) and long-term photoluminescence (PL) stability. The stable ink containing functionalized Si-NPs was successfully used to print structures on glass substrates by ink-jet printing. The homogeneity and uniformity of large-area printed film was investigated using photoluminescence (PL) mapping.
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Acute disseminated encephalomyelitis (ADEM) is an autoimmune inflammatory disease of the central nervous system that is characterized by widespread demyelination, predominantly involving the white matter of the brain and spinal cord. Often caused by a viral infection or vaccination, its clinical features include an acute encephalopathy with multifocal neurologic signs and deficits in children. It can present with psychosis, depression, or abnormal behavior, and it might mimic a dissociative disorder. This report involves a similar rare case of a 14-year-old female patient who presented with fluctuating weakness of body, slurring of speech, tremor, loss of responsiveness, and abnormal behavior after her fever waned. Diagnosis of dissociative disorder was considered in the absence of neurological findings and ongoing significant stressor. Eventually, it turned out to be ADEM, which was confirmed by late neurological manifestations and radiological evaluation. Neuroimaging also revealed its differences from multiple sclerosis.
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Mental health professionals across the globe foresaw the mental health impact of the coronavirus disease 2019 (COVID-19) pandemic. They have faced scarcity of trained professionals, rising morbidities, lack of protective gear, shortage of psychotropic drugs, and poor rapport building due to masking and social distancing. Amidst all, they have responded with approaches that focus on continuing mental health services to the patients already in care, education of the vulnerable people to help them cope with these stressors, and provide counselling services to patients and families affected by the pandemic.
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INTRODUCTION: This study aims to review recent scientific publications and research output in the field of psychiatry, from a series of countries in the Asia-Pacific region (Australia, India, Indonesia, Iran, Lebanon, Malaysia, and Nepal), with a view to identify themes and similarities across regions, as well as to examine the barriers and challenges in mental health research faced by countries in the region. METHODS: Seven psychiatrists from seven countries reviewed recent published and ongoing research in psychiatry in their respective nations, with respect to themes, as well as any barriers or challenges faced by mental health researchers. RESULTS: While the seven nations included in this review vary in terms of research capabilities and economic development level, they share many similarities both in terms of research direction, and with regards to challenges faced. Limitations in the form of sociocultural differences from the West, and a lack of funding were some of the barriers identified. DISCUSSION: Mental health research in the region has been progressing well. However, more varied research in the form of qualitative or economic studies are lacking, as are multi-center studies. The similar issues that nations face with regards to research could perhaps benefit from collaborative efforts and initiatives for the furtherance of research in the region.
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Psiquiatria/métodos , Pesquisa , Austrália , Humanos , Índia , Indonésia , Irã (Geográfico) , Líbano , Malásia , NepalRESUMO
BACKGROUND: Pathways to care studies are feasible and tested means of finding the actual routes taken by patients before reaching proper care. In view of the predominance of nonprofessional service providers and the lack of previous large studies on pathways in Nepal, this multicenter study is needed. The aim of the study was to trace the various pathways and carers involved in mental health care; assess clinical variables such as the duration of untreated illness, clinical presentation and treatment; and compare geographically and culturally diverse landscapes. METHODS: This was a cross-sectional, convenience sampling study performed at 14 centers where new cases were being taken. The World Health Organization Study of the Pathways-to-Care Schedule was applied. The Nepali version of the encounter form was used. The data were collected between 17 September and 16 October 2020 and were analyzed using the Statistical Package for the Social Sciences (SPSS). Additionally, perspectives from local investigators were collected and discussed. RESULTS: Most of the first carers were native/religious faith healers (28.2%), followed by psychiatrists (26%). The median duration for the first psychiatric consultation was 3 weeks. The duration of untreated illness was 30.72 ± 80.34 (median: 4) weeks, and the time taken for this journey was 94.99 ± 274.58 (median: 30) min. The longest delay from the onset of illness to psychiatric care was for epilepsy {90.0 ± 199.0 (median: 25.5)} weeks, followed by neurotic illness {22.89 ± 73.45 (median: 2)} and psychotic illness {10.54 ± 18.28 (median: 2)} weeks. Overall, most patients with severe mental illnesses (SMIs) had their first contact with faithhealers (49%), then met with medical doctors (13%) or psychiatrists (28%). Marked differences in clinical presentation surfaced when hilly centers were compared with the Terai belt. CONCLUSIONS: Faith healers, general practitioners and hospital doctors are major carers, and the means of educating them for proper referral can be considered. The investigators see several hindrances and opportunities in the studied pathways. The employment of more mental health professionals and better mental health advocacy, public awareness programs and school education are suggested strategies to improve proper mental health care.
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OBJECTIVES: Because of high rates of co-occurrence, common familial risk, and phenotypic similarities, we conjectured that substance use and bipolar disorder might have a common substrate of origin in bipolarity and that they might lie on a continuum of bipolarity. Thus it was aimed to investigate the association between bipolarity and substance use through a controlled, clinic based study. METHODS: Cross sectional assessment and comparison of bipolarity as trait in four groups, namely the substance use disorder (SUD), bipolar disorder (BPAD), dual diagnosis (DD), and the healthy control (HC) groups. Bipolar spectrum diagnostic scale (BSDS) was used. The quality of life in these four groups was also assessed using WHOQOL-Bref scale. RESULTS: The mean Bipolar spectrum diagnostic scale (BSDS) score in SUD was 11.0 ± 5.3 which was more than that of HC (6.2 ± 3.9) and lesser than that in BPAD (18.4 ± 4.2) and DD (20.6 ± 3.6). Differences among all four groups were statistically significant. SUD group was found to have significantly higher score than healthy control. The BSDS score of DD and BPAD groups were higher than those of SUD but the difference between BPAD and DD was non-significant. DISCUSSION: The results showed a potential association between substance dependence and bipolarity. Mood dysregulation appears to be the link between the two. The gradient of bipolarity detected by BSDS screener suggests a continuum model between substance use and bipolar disorder. However, this is a clinic based study and only male patients have been taken for study.
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Sintomas Afetivos/fisiopatologia , Transtorno Bipolar/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Adulto , Estudos Transversais , Diagnóstico Duplo (Psiquiatria) , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Stigma against those who suffer from mental illness is a major issue in many nations. Stigma, which is comprised of prejudice, ignorance, and discrimination, serves as a barrier to seeking help and staying in contact with mental health services. It is thus imperative that concerted efforts are taken against stigma. METHODS: Eight young psychiatrists from eight Asian nations offer a narrative review of the state of stigma in their respective nations, the sociocultural reasons behind this stigma, recent anti-stigma efforts and the effects, if any, of such efforts. RESULTS: Despite these eight nations lying varying significantly in terms of economic developmental levels, there are sociocultural commonalities that undergird stigma across these nations. It is also evident that there have been more recent concerted efforts to combat this stigma, and in some countries, there has been a change in the perceptions of mental illness. CONCLUSION: The causes of stigma tend to be similar across various nations, and this perhaps suggests that international collaboration and a concerted global effort to combat this problem might thus be a possibility.