Relationship of emotional intelligence and capability of answering higher-order knowledge questions in physiology among first-year medical students.

Emotional intelligence (EI) has a positive correlation with the academic performance of medical students. However, why there is a positive correlation needs further exploration. We hypothesized that the capability of answering higher-order knowledge questions (HOQs) is higher in students with higher EI. Hence, we assessed the correlation between EI and the capability of medical students to answer HOQs in physiology. First-year undergraduate medical students (n = 124) from an Indian medical college were recruited as a convenient sample. EI was assessed by the Schutte Self-Report Emotional Intelligence Test (SSEIT), a 33-item self-administered validated questionnaire. A specially designed objective examination with 15 lower-order and 15 higher-order multiple-choice questions was conducted. The correlation between the examination score and the EI score was tested by Pearson's correlation coefficient. Data from 92 students (33 females and 59 males) with a mean age of 20.14 ± 1.87 yr were analyzed. Overall, students got a percentage of 53.37 ± 14.07 in the examination, with 24.46 ± 9.1 in HOQs and 28.91 ± 6.58 in lower-order knowledge questions (LOQs). They had a mean score of 109.58 ± 46.2 in SSEIT. The correlation coefficient of SSEIT score with total marks was r = 0.29 (P = 0.0037), with HOQs was r = 0.41 (P < 0.0001), and with LOQs was r = 0.14 (P = 0.19). Hence, there is a positive correlation between EI and the capability of medical students to answer HOQs in physiology. This study may be the foundation for further exploration of the capability of answering HOQs in other subjects.NEW & NOTEWORTHY This study assessed the correlation between emotional intelligence (EI) and the capability of medical students to answer higher-order knowledge questions (HOQs) in the specific context of physiology. The finding reveals one of the multifaceted dimensions of the relationship between EI and academic performance. This novel perspective opens the door to further investigations to explore the relationship in other subjects and other dimensions to understand why students with higher EI have higher academic performance.

Paroxysmal dystonia and psychotic exacerbations in chronic psychosis: Diagnostic dilemmas and preliminary treatment approaches.

Patients with chronic psychosis on prolonged antipsychotic therapy may present with paroxysmal dystonia along with an exacerbation of their psychotic symptoms: paroxysmal dystonia and psychotic exacerbations (PDPE). The interindividual variability in the clinical presentations of PDPE can pose challenges in its diagnosis and treatment. The objectives of this work are to (i) discuss this rare phenomenon through a series of 10 patients and a relevant literature review, (ii) conceptualize its neurobiological underpinnings, and (iii) explore the preliminary treatment approaches for its management. Acute stress and/or a dysfunctional gamma-aminobutyric acid (GABA) ergic or dopaminergic system may be implicated in the pathogenesis of PDPE. The episodes respond acutely to parenteral benzodiazepines, while long-term management can be achieved by reducing antipsychotic doses, switching to clozapine or using central GABA enhancers. This article is the first attempt at conceptualizing and exploring treatment options for the rare condition PDPE and intends to guide future research in this regard.

PROBLEMATIC USE OF SMARTPHONE AND NOMOPHOBIA AMONG MEDICAL AND NURSING UNDERGRADUATE STUDENTS OF A TERTIARY CARE REFERRAL HOSPITAL IN INDIA AND ITS ASSOCIATION WITH QUALITY OF LIFE: A CROSS-SECTIONAL OBSERVATIONAL STUDY.

BACKGROUND: Overuse of smartphone amongst today's young generation has assumed an epidemic proportion. Assessment of severity of Nomophobia and Smartphone use related problems is important as it can help to ascertain the current adverse consequences of Smartphone problematic use. The study aims to assess the association between smartphone dependence, nomophobia and quality of life in undergraduate medical and nursing students in a tertiary care referral hospital cum medical institution in India. SUBJECTS AND METHODS: This cross-sectional study involved 437 medical and nursing undergraduate students, which involved assessing their dependence for smartphone and nomophobia using the Test for Mobile Phone dependence (TMD) questionnaire brief version and Nomophobia Questionnaire (NMP-Q) respectively. RESULTS: The average hours spent on smartphone per day for the study population was 3.2 hours. Smartphone dependence was found in 12% of study participants. Nearly 50% in each batch had moderate degree of nomophobia and around 13-15% had severe nomophobia. Both smartphone dependence and nomophobia were significantly associated with each other and had significant associations with poorer quality of life in the medical and nursing students. Preclinical medical students scored higher in all the domains of Smartphone dependence and nomophobia questionnaire and were associated with poor quality of life compared to other batches. CONCLUSION: Excessive smartphone use is associated with poorer quality of life in medical and nursing students. More studies in future are required that will involve various age groups and other educational streams which willadd up to the existing knowledge on technology addiction.

COVID-19 Pandemic and the Provision for Electroconvulsive Therapy and Other Non-Invasive Brain Stimulation in India: A Template for Future Pandemics.

The coronavirus disease (COVID-19) has emerged as a major public health concern worldwide. While containing the infection and caring for the ill has been a focus over the last 2 years, there has also been a burgeoning concern for mental health issues during this never-ending pandemic. The focus of health care machinery prioritized confronting and containing the pandemic that had majorly side-lined other aspects of public health. This also impacted persons with mental illness (PMI) requiring Electroconvulsive Therapy (ECT), an often essential and life-saving treatment and thus an essential procedure. ECT and other non-invasive brain stimulation (NIBS) services have seen a setback during this pandemic both in terms of its accessibility by the PMI and in effectively delivering its benefits by psychiatrists. In this article, we will be discussing the problems with provision and delivery of ECT services as well as other NIBS during this pandemic with a brief outline on the solutions for such with special focus on a developing country like India. This article will also endeavour in providing a roadmap in the delivery and provision of NIBS modalities of therapy for future pandemics, if any.

EFFECT OF PSYCHOLOGICAL FIRST AID ON MENTAL HEALTH IN HOSPITALIZED STABLE COVID-19 PATIENTS: A PRE-POST RESEARCH DESIGN.

BACKGROUND: The COVID-19 pandemic is known to affect mental health of sufferers. Psychological First Aid (PFA) is a mental health service for individuals in crisis, which can be provided to anyone regardless of age and it does not require mental health expertise. Its effect on mental health issues of COVID-19 patients has not been studied effectively. The present study aimed to assess the psychological impact and effect of PFA on mental health in stable COVID-19 hospitalized patients. SUBJECTS AND METHODS: This was an interventional study with a pre-post research design in a tertiary government teaching hospital in eastern India. 93 stable patients who were admitted in a period of a month with COVID-19 were included in the study after obtaining appropriate consent. They were provided PFA (both structured individual and group sessions) by trained nurses. The Depression, Anxiety, and Stress scale (DASS-21) was used to assess depression, anxiety, and stress in the patients before and after intervention. RESULTS: The mean age of study population which comprised of 68.8% males was 56.2 ± 13.7 years. Median scores for depression, anxiety and stress were 4, 6 and 6 on admission and 0, 2 and 2 respectively before discharge after intervention (P<0.001). 13%, 25.9% and 8.6% were the combined percentages scores of patients with varying levels of depression, anxiety and stress at the time of admission which were reduced to 4.3% (P=0.046), 5.4% (P=0.001), 2.2% (P=0.03) respectively before discharge after intervention within one week. CONCLUSION: PFA may be a cost-effective intervention in stable COVID-19 admitted patients who had depression, anxiety, and stress.

Neuroplasticity in Depression: A Narrative Review with Evidence-Based Insights.

Major Depressive Disorder (MDD) is one of the leading causes of disability worldwide. The current pharmacological treatment options for MDD, which rely on the mono-amine hypothesis, has their limitations with respect to treatment non-response, partial response etc. This propels for a search for a novel neurobiological understanding of MDD that can lead to novel treatment options. A literature search strategy was thus employed using relevant keywords pertaining to the topic in PubMed, Embase and Google Scholar. Systematic reviews and meta-analyses, narrative reviews and clinical trials were reviewed to incorporate the most robust evidence-based literature available. A total of 37 publications were narrowed down based upon the topic. Alterations in brain neuroplasticity, as evidenced by changes in neurotrophic factors and from neuroimaging, has been found to be a strong patho-mechanism for MDD. This link has been exploited to stimulate psychopharmacological research to treat MDD.

Effect of Sertraline, Dosulepin, and Venlafaxine on Non-BDNF Neurotrophins in Patients With Depression: A Cohort Study.

BACKGROUND: The neurotrophic hypothesis of depression has been mostly studied with a focus on brain-derived neurotrophic factor (BDNF) leading to lack of data on non-BDNF neurotrophins (NTs). The aim of this study was to evaluate the effect of antidepressant drugs on changes in serum nerve growth factor (NGF), neurotrophin 3 (NT-3), and neurotrophin 4 (NT-4). METHODS: A prospective cohort study was conducted on 105 patients with depression who were subgrouped to the group 1 (mild and moderate depression without somatic syndrome treated with sertraline), group 2 (mild and moderate depression with somatic syndrome treated with dosulepin), and group 3 (severe depression without psychotic symptoms treated with venlafaxine). At baseline, the severity of depression (Montgomery-Asberg Depression Rating Scale [MADRS]), serum NGF, NT-3, and NT-4 were estimated. Thirty-five healthy volunteers were recruited as controls for a baseline comparison of NTs. All patients were followed up after 6 weeks to evaluate the changes in NT levels and correlate it with the change in MADRS scores. RESULTS: At baseline, NT levels were significantly lower in patients with depression in comparison with healthy control. In group 1, serum NGF, NT-3, and NT-4 level were found to increase significantly after treatment, whereas changes in groups 2 and 3 were statistically not significant. Montgomery-Asberg Depression Rating Scale score and serum NGF at baseline had an inverse relation (r = -0.648), whereas the change in MADRS score in sertraline group had a positive correlation (r = 0.86) with the change of serum NGF. CONCLUSIONS: Monotherapy with sertraline increased the level of non-BDNF NTs; however, treatment with dosulepin and venlafaxine did not produce any significant changes in patients with depression.

National Drug Laws, Policies, and Programs in India: A Narrative Review.

Background: Drug use is a major public health issue in India. Significant changes in the approach toward drug use have happened in the last few decades. Despite this, no systematic attempt has been made to document the same in the scientific literature. This narrative review attempts to discuss the major drug laws, policies, and national programs of the Government of India (GoI). Methods: A thorough search was conducted to look for policies, programs, acts, and notifications related to substance use/drug use on various websites of different ministries of the GoI. Acts, programs, and policies addressing substance use were identified. Results: Various drug laws, programs, and acts from the GoI provide a multipronged approach to curbing the procurement of drug use along with its prevention and cure. The Ministry of Social Justice and Empowerment (MoSJE) is the nodal ministry for drug demand reduction. The enactment of the Narcotic Drugs and Psychotropic Substances (NDPS) Act 1985 and Policy 2012 and the implementation of India's Drug De-Addiction Program (DDAP) are important landmarks in this journey. Conclusion: The GoI initiatives for reducing the mental health burden in this country in general and substance use disorders (SUDs), in particular, are immense. The acts/statutes/laws/notifications are all interlinked. Stakeholders in mental health, public health, and policy-making need to upgrade themselves with the relevant statutes to curb the menace of drug use.

Effect of Social Media on Diet, Lifestyle, and Performance of Athletes: A Review of Current Evidence.

PURPOSE OF REVIEW: Social media (SM) plays an important role in providing diet and health advice to athletes, but it also carries with it a risk of credibility in the information sought for and received. The objective of this review is to assess the knowledge gap on how SM influences dietary and lifestyle practices in athletes. RECENT FINDINGS: For this, relevant literature was searched in three leading databases with appropriate keywords, which were subjected to proper scrutiny that led to inclusion of 22 articles (original research papers, reviews, viewpoints, and commentaries). The current era of digitalization has seen an over-reliance on internet and SM for nutrition and lifestyle advice for an athlete. SM has become a powerful tool in athlete's choice of food, nutrition information, healthy living, and performance, with merits and demerits. Their role in choosing dietary supplements and particular food types (e.g., ketogenic diet), body image, self-esteem and eating disorders, and in lifestyle and performance are discussed. SM should be used with caution and should not be used alone as a source of information for nutrition related pieces of advise by athletes. Any food type and supplements trending in SM should be discussed with a sports nutritionist before consumption. SM influencers having a big follower base may not always be disseminating the right knowledge on food and nutrition, thus caution should be exercised. For optimal benefit to the athlete, SM information should be in alignment with recommendations provided by sports nutrition and coaches.

Childhood gratification syndrome: Demystifying the clinical conundrum with a narrative literature review of the past 5 decades.

Background: Childhood gratification syndrome (CGS) refers to self-stimulatory or masturbatory behaviors in children, which may have an onset as early as in infancy (IGS). Aim: The aim of this review is to understand the various clinical manifestations of CGS/IGS and their clinical differentiation from commonly misdiagnosed neurological and physical illnesses and to formulate a preliminary approach to their diagnosis and management. Methods: This narrative review is based on a search of literature over the past 50 years (1972-2022) in three online databases (PubMed/Medline, Embase, and Google Scholar). Results: The behaviors are episodic, occurring for brief periods, involving posturing, stereotypical limb movements, pubic pressure with autonomic hyperactivity, and postepisodic lethargy. They mimic seizures, movement disorders, abdominal pain, and tics. The paper also highlights the gap in the current knowledge to guide future research in the area. CGS usually represents nonpathological "pleasure-seeking" habits of childhood, but at times, it may become problematic for the child and his family. A careful history and videotape analysis of the events confirms the diagnosis and behavioral therapy with parental reassurance as the mainstay of treatment. Conclusion: A better understanding and clinical awareness of the CGS are necessary to prevent misdiagnosis and delay in appropriate intervention.

Association between impulsivity and depressive symptoms in recently detoxified patients with alcohol dependence.

Background: Depression and impulsivity are etiologically linked to alcohol dependence (AD) and are known to affect course and outcomes. The relationship between impulsivity and depressive symptoms has been investigated only in a few studies of individuals with AD. Aim: This study aimed to explore the association between impulsivity and depressive symptoms in patients with AD. Materials and Methods: Our study was conducted in the inpatient setup of a tertiary care psychiatry institute. The study design is cross-sectional. The Barratt Impulsiveness Scale (BIS-11) and stop signal task (SST) were used to assess levels of global impulsivity and behavioral impulsivity, respectively, among 60 recently detoxified inpatients with AD. The Hamilton Depression Rating Scale (HAM-D) was used to measure depressive symptoms. The results were analyzed to examine the association of depressive symptoms with impulsivity. Pearson's coefficient of correlation or Spearman's rank correlation and linear regression analysis were performed to explore the association between quantitative variables. Results: Patients with higher HAM-D scores were found to have significantly higher score on all three subscales of the BIS-11. The attention impulsivity subscale had the strongest correlations (r = 0.53, P < 0.001). Depressive symptoms were more strongly correlated with cognitive impulsivity (r = 0.54, P< 0.0001) compared with motor impulsivity and were not significantly associated with behavioral impulsivity. Adjusting for other variables, cognitive impulsivity was found to be the strongest predictor of the severity of depressive symptoms. Conclusions: The study showed a strong association between impulsivity and depressive symptoms in individuals with AD. This relationship may apply more to cognitive impulsivity, reflecting the role of impulsive decisions compared with impulsive actions.