Impact of clinical rotational posting on attitude toward psychiatry of undergraduate medical students in Malaysia.

Background: Almost all over the world, psychiatry training of undergraduate medical students has been criticized to be deficient in imparting required knowledge and improving the perception of students towards psychiatry and psychiatric treatment. Considering the large mental health need gap in the community, it is essential to improve undergraduate students' attitude toward psychiatry. Aim: Hence, this study was planned to study the impact of psychiatry clinical posting on attitude toward psychiatry of undergraduate medical students. Materials and Methods: Undergraduate medical students undergoing psychiatry posting were assessed on the first and last day of clinical posting with the help of semi-structured proforma consisting of sociodemographic information, favored future career choice, the relevance of psychiatry to their future careers, the usefulness of particular knowledge and skills, the value of knowledge of psychiatric specialties and the utility of different settings for learning psychiatry. Results: After their clinical posting, students had a more positive attitude towards the usefulness of psychiatry knowledge in future general practice and the usefulness of psychiatry knowledge from undergraduate training in the future. Knowledge of alcohol withdrawal management, detection and management of delirium, and Mental Health Acts were perceived more essential in the future. Also, specialties such as deaddiction and child and adolescent psychiatry were felt more useful in future practice. After posting, students perceived that psychiatry can also be learned at medical and surgical wards as well as during home visits. However, despite some positive changes in attitude toward psychiatry, there was no significant change in choosing psychiatry as a career by the students after posting. Conclusion: Undergraduate psychiatry training during clinical posting was able to make some positive changes in the knowledge and attitude of students. However, still, there were lacunae in some areas of concern. Preference of psychiatry as a branch of specialization was not increased after posting. This indicates the need for better reforms in psychiatry education at the undergraduate level to improve the perception of undergraduate students about psychiatry.

Risk factors associated with self-medication among the indigenous communities of Chittagong Hill Tracts, Bangladesh.

BACKGROUND: In developing countries like Bangladesh, self-medication has become a predicament associated with health risks and clinical complications. To date, no studies have been conducted on the practice of self-medication among the indigenous population living in Chittagong Hill Tract (CHT). OBJECTIVES: This study was aimed to determine the prevalence of self-medication and analyzing the factors associated with it among the indigenous population in CHT. METHODS: This cross-sectional study was conducted from late October to early December 2020; among different indigenous group populations residing in the three districts of CHT aged 18 or more. A pre-tested and semi-structured questionnaire was developed to collect data on socio-demographic characteristics, health status, frequency of self-medication, reasons for self-medication in last one year, as well as other variables. Multivariate logistic regression was performed to assess associated factors with self-medication. RESULTS: A total of 1350 people from different indigenous populations were interviewed, among whom 49.9% practiced self-medication. The rate of self-prescribed antibiotics usage (80.9%) was significantly higher compared to other drugs. Self-prescribed medications were mostly used for diarrhea and food poisoning (60.6%), cough, cold and fever (51.4%), and headache (51.4%). A common source of self-prescribed medicines was community or retail pharmacy and the most reported reason for self-prescribed medication was the long-distance of healthcare facilities from home. CONCLUSION: The prevalence of self-medication is substantially high among indigenous people and the effect is alarming. Particular concern is the misuse of antibiotics and analgesic drugs. Increasing awareness among the population of the negative effect of self-medication and implementation of proper policies and actions are urgently needed to prevent self-medication among indigenous population in Bangladesh.

Trends and issues in community mental health programs in India: The Ranchi Institute of Neuropsychiatry and Allied Sciences experience.

Psychiatric disorders are among the leading causes of disability the world over. With the World Health Organization, spearheading the crusade to incorporate the mental health component into primary health care, developing countries also have accepted the need for community care of patients with psychiatric disorders. Since independence various initiatives by the government has led to a significant change in the place of mental health care as part of the general health care. At the time of independence apart from mental hospitals, there was practically no organized mental health care. Since then General Hospital Psychiatry units and also Psychiatric Nursing homes have started. Currently, mental health issues are actively seen as part of the public agenda in the various forms. The overall effect has been the movement to recognize mental health as an important issue in the community and services to move beyond mental hospital care to care to the community. Majority of population in Jharkhand is residing in rural areas. Due to the lack of proper communications and infrastructure, Ranchi Institute of Neuropsychiatry and Allied Sciences (RINPAS) had started community outreach program way back in 1999. At present, these centers are running in four different areas of the state with great success. RINPAS experience shows that how even with resource constraints, quality services can be provided to unreached population.

Neuroplasticity--a paradigm shift in neurosciences.

Neuroplasticity is the phenomenon in brain where different stimuli lead to increase or decrease in the number of brain cells and remodelling of synapses. Neuroplasticity research has now established beyond doubt that instead being a static cell mass, our brain is actually a dynamic system of neural network that has the capability of significant growth under favourable circumstances. This obviously opens up new possibilities in treatment of disorders where neural loss or synaptic decay is major factor in molecular aetiopathogeneis. Neuroplasticity research unravels the way stress acts. Similarly it gives new hypothesis regarding depression and epilepsy. Novel therapeutic approaches based on neuroplastic findings are also discussed.