Building psychological resilience in Armed Forces worldwide.

Psychological resilience among troops can be enhanced through relatively simple interventions. Globally, various Armed Forces have successfully implemented modules for building psychological resilience. Programs from different countries are listed, evaluated and their underpinnings explored. Recommendations for a variety of feasible and culturally acceptable interventions targeted at individuals, families, units, community and organizations in the Indian context have been made; ranging from mindfulness training to embedded combat psychologists. Interventions are likely to succeed if integrated within existing basic training and unit/career programs.

Biotinylated non-ionic amphipols for GPCR ligands screening.

We present herein the synthesis of biotin-functionalized polymers (BNAPols) that have been developed for the fixation of membrane proteins (MPs) onto surfaces. BNAPols were synthesized by free-radical polymerization of a tris(hydroxymethyl)acrylamidomethane (THAM)-derived amphiphilic monomer in the presence of a thiol-based transfer agent with an azido group. Then a Huisgen-cycloaddition reaction was performed with Biotin-(PEG)8-alkyne that resulted in formation of the biotinylated polymers. The designed structure of BNAPols was confirmed by NMR spectroscopy, and a HABA/avidin assay was used for estimating the percentage of biotin grafted on the polymer end chain. The colloidal characterization of these biotin-functionalized polymers was done using both dynamic light scattering (DLS) and small angle X-ray scattering (SAXS) techniques. BNAPols were used to stabilize a model G protein-coupled receptor (GPCR), the human Growth Hormone Secretagogue Receptor (GHSR), out of its membrane environment. Subsequent immobilization of the BNAPols:GHSR complex onto a streptavidin-coated surface allowed screening of ligands based on their ability to bind the immobilized receptor. This opens the way to the use of biotinylated NAPols to immobilize functional, unmodified, membrane proteins, providing original sensor devices for multiple applications including innovative ligand screening assays.

Coping Styles and Life Satisfaction in Palliative Care.

BACKGROUND: Patients in palliative care suffer variously due to underassessment of needs and suboptimal intervention, coupled with lack of access to palliative care. This study attempts to identify effective coping strategies which lead to life satisfaction, among those afflicted with terminal cancer. MATERIALS AND METHODS: This observational, cross-sectional study was carried out among terminally-ill cancer patients undergoing palliative care. Cancer patients receiving palliative care who give consent and were aged 18 years or older were included in the study. Those with cognitive deficits, delirium, or psychosis were excluded from the study. COPE scale, Temporal Satisfaction with Life Scale, and sociodemographic Performa were administered and analyzed. Pearson's r correlation coefficient test and multiple linear regression analyses were used to evaluate correlation and effect of coping strategies on life satisfaction. RESULTS: Religious coping was the most frequently used coping strategy by patients, followed by acceptance. Females showed higher problem-focused coping, whereas males had higher emotion-focused and avoidant coping strategies. Females manifested more religious coping. Males showed more acceptance of their illness. Those without a partner had significantly higher emotion-focused coping strategies and higher religious coping. Income, social support, and problem-oriented coping were positively related to quality of life. Life satisfaction showed significant negative correlation with denial, substance use, and venting utilized as coping methods. CONCLUSION: Problem-focused coping (religious coping and acceptance) was found to be more effective than other methods. Patients in palliative care could be instructed for the use of problem-focused coping. Such training might enhance their life satisfaction, helping them experience greater control over the course of illness.

Reversible Cerebral Vasoconstriction Syndrome.

Reversible cerebral vasoconstriction syndrome (RCVS) is a disease characterized by thunderclap headache with severe vasospasm of middle sized vessels of circle of Willis or the extracranial circulation which spontaneously revert back. We report a middle aged female with severe headache and vasospasm of the vertebral arteries and vessels of circle of Willis causing multiple cerebral infarcts. The vasospasm resolved within 3 months.

Self-assembly and biophysical properties of gemini 3-alkyloxypyridinium amphiphiles with a hydroxyl-substituted spacer.

New gemini pyridinium amphiphiles having alkyl chain lengths of C10, C12, C14 , and C16 and appended with hydroxyl-substituted spacers have been synthesized, characterized, and investigated for their self-assembly as well as adsorption behavior by state-of-the-art techniques such as conductometry, tensiometry, isothermal titration calorimetry (ITC), and spectrofluorometry. Dynamic light scattering (DLS) and transmission electron microscopy (TEM) have provided excellent acumen with respect to the micellar size distribution of investigated dicationics in aqueous media. Furthermore, the interaction of these dicationics with plasmid DNA, at different charge ratios (N/P), has been studied by DLS, agarose gel electrophoresis, and ethidium bromide exclusion measurements. The cytotoxicity of these geminis has been evaluated by using an MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay on BV2 (microglial) and C6 glioma cell lines. It was found that the varying alkyl chain length, fashioned by ether linkage close to the headgroup, and the presence of a polar linker significantly altered the physicochemical properties of these new dicationics as compared to the properties of nonfunctionalized gemini surfactants.

Micellization behavior of morpholinium-based amide-functionalized ionic liquids in aqueous media.

Morpholinium-based amide-functionalized ionic liquids (ILs) [C(n)AMorph][Br], where n = 8, 12, and 16, have been synthesized and characterized for their micellization behavior in aqueous medium using a variety of state of the art techniques. The adsorption and micellization behavior of [CnAMorph][Br] ILs at the air-solution interface and in the bulk, respectively, has been found to be much better compared to that observed for nonfunctionalized homologous ILs and conventional cationic surfactants, as shown by the comparatively higher adsorption efficiency, lower surface tension at the critical micelle concentraiton (γ(cmc)), and much lower critical micelle concentration (cmc) for [C(n)AMorph][Br] ILs. Conductivity measurements have been performed to obtain the cmc, degree of counterion binding (ß), and standard free energy of micellization (ΔG(m)°). Isothermal titration calorimetry has provided information specifically about the thermodynamics of micellization, whereas steady-state fluorescence has been used to obtain the cmc, micropolarity of the cybotactic region, and aggregation number (N(agg)) of the micelles. Both dynamic light scattering and atomic force microscopy have provided insights into the size and shape of the micelles. 2D (1)H-(1)H nuclear Overhauser effect spectroscopy experiments have provided insights into the structure of the micelle, where [C16AMorph][Br] has shown distinct micellization behavior as compared to [C8AMorph][Br] and [C12AMorph][Br] in corroboration with observations made from other techniques.

Effect of cationic head group on micellization behavior of new amide-functionalized surface active ionic liquids.

Amide-functionalized surface active ionic liquids (SAILs), 1-methyl-1-dodecyl piperidinium chloride, [C12APip][Cl]; 1-methyl-1-dodecyl pyrrolidinium chloride, [C12APyrr][Cl]; 1-methyl-3-dodecyl imidazolium chloride, [C12Amim][Cl], and 1-methyl-1-dodecyl morpholinium chloride, [C12AMorph][Cl], have been synthesized, characterized and investigated for thermal stability, and micellization behavior in aqueous medium. The introduction of an amide moiety in the alkyl chain decreased the thermal stability of the functionalized SAILs compared to non-functionalized SAILs bearing a simple alkyl chain. A variety of state of the art techniques, viz. tensiometry, conductometry, steady-state fluorescence, isothermal titration calorimetry (ITC), dynamic light scattering (DLS) and atomic force microscopy (AFM), have been employed to investigate the micellization behavior. Amide-functionalized SAILs have shown much lower critical micelle concentration, cmc, and better surface active properties as compared to homologous non-functionalized SAILs. Steady-state fluorescence has provided information about cmc, aggregation number (Nagg) and polarity of the cybotactic region of the micelles, whereas ITC has provided insights into the thermodynamics of micellization. Furthermore, the size and shape of the micelles have been investigated using DLS and AFM techniques.

Gum acacia based hydrogels and their composite for waste water treatment: A review.

The non-toxic nature of natural polysaccharides and their biodegradability makes them the first choice of researchers. Various natural polysaccharides are available nowadays, like cellulose, starch, chitosan, gum acacia, guar gum etc. Among these, gum acacia is a common natural polysaccharide presently used in research and technology. It is highly biodegradable, pH stable and shows appropriate water solubility. It is used in research to synthesize hydrogels and hydrogel nanocomposites for various applications because of its antimicrobial, anti-inflammatory and excellent absorption properties. The major fields of applications include the stabilization of metal nanoparticles in the form of nanocomposites, wound dressing materials, delivery systems of various drugs and pharmaceutical agents, bioengineering, tissue engineering, purification of water, synthesis of antibacterial and antifungal composites for agricultural improvements, and many others. Due to the increasing problem of water pollution, the major focus is on research helping to reduce this problem. Gum acacia-based hydrogel and hydrogel composites were synthesized and tested for pollutant removal efficiency from wastewater by different researchers. The research on gum acacia hydrogel and their hydrogel composite applications for water purification, as well as their synthesis processes and properties, are summarized in this review article.

Prevalence of alcohol dependence syndrome in the patients of acute pancreatitis: A cross-sectional study.

Background: Acute pancreatitis (AP) is the main reason for mortality and morbidity. Numerous studies have shown a link between chronic alcohol usage and AP. However, there are few studies on the percentage of patients developing AP as a result of dependent patterns of drinking and associated risk factors. Aim: This study aimed to study the prevalence and impact of risk factors of alcohol dependence syndrome with AP patients hospitalized in tertiary care facilities. Materials and Methods: This is a cross-sectional observational study. Sociodemographic and clinical data were taken from patients with AP after consent. Eighty-five patients with AP who met the inclusion criteria were involved after each participant had clinical evaluation using the modified Marshall score, the Alcohol Use Disorder Identification Test, and the Severity of Alcohol Dependence Questionnaire (SAD-Q). The outcomes were tabulated and analyzed using Statistical Package for the Social Sciences (SPSS) software. Results: 38.8% of patients with AP were found to have features of alcohol dependence syndrome. Higher values of mean corpuscular volume (MCV), serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), Gamma-glutamyl transferase (GGT), and uric acid were associated with a greater propensity to have AP. The severity of alcohol dependence syndrome and AP was not associated. Conclusion: AP is potentially a fatal disease. In this study, 38.8% of AP patients had alcohol dependence syndrome. There was no statistical association between the severity of AP and alcohol dependence syndrome, though high values of MCV, SGOT, SGPT, and GGT were at greater risk of developing AP. As a result, alcohol dependence syndrome should be examined in all individuals with AP.

Childhood trauma and bipolar affective disorder: Is there a linkage?

Bipolar affective disorder (BPAD) is a major psychiatric illness impairing the quality of life. The etiology of BPAD is influenced by different factors possibly related to gene-environment interactions. Approximately 30% to 50% of individuals with BPAD have experienced some traumatic event in childhood. Serious adverse experiences that children may suffer early in life are often described as childhood trauma (CT). It includes physical, emotional, and sexual abuse and physical and emotional neglect. CT is linked with an elevated risk of developing BPAD. Childhood adversities play a role in modulating the early onset of illness, increased number of depressive episodes, increased suicide attempts, and other clinical severity of BPAD. Hospital-based studies comprising heterogeneous populations had researched the specific role of each trauma subtype as a predisposing factor for BPAD. Identifying and addressing CT through early intervention methods may prevent the future development of chronic disorders like BPAD. This review article is an attempt to explore and highlight the existing literature regarding the association of different subtypes of CT with BPAD.

Adding pre-emptive anticholinergics to antipsychotics: Is it justified?

Anti-psychotics are the mainstay of treatment for Schizophrenia and psychotic disorders. Historically, anticholinergics have been prescribed to prevent or treat extrapyramidal side effects (EPS) associated with first-generation antipsychotics (FGAs). Even though newer antipsychotics are associated with markedly lower rates of EPS, concurrent anticholinergic use remains high. Use of these medications has potential for long-term side effects, worsening of EPS and poor adherence. We have briefly discussed the limited association between second-generation antipsychotics (SGAs) and EPS, the efficacy of anticholinergics for different types of EPS, and summarized various national and international guidelines on the subject. In conclusion, there is no evidence for prophylactic use of anticholinergics with antipsychotics. Clinicians need to guard against this tendency to be unduly cautious.

Cognitive behavior therapy as an adjuvant in management of alcohol dependence syndrome.

Background: Treatment of alcohol dependence is a major challenge due to frequent relapses. Cognitive-behavioral therapy (CBT) has been reported to be useful in the treatment of alcohol dependence. Aim: This study aims to evaluate the effect of CBT module in management of Alcohol Dependence and compare it with treatment as usual (TAU). Materials and Methods: All newly diagnosed alcohol dependence patients during the study period meeting the exclusion and inclusion criteria were included in the study. Patients with a head injury, HIV seropositive status, or any other organic brain disorder and comorbid psychiatric disorders were excluded. The study included 226 patients with alcohol dependence randomly assigned to intervention group (n = 116) and TAU group (n = 110). Demographic and clinical data were recorded and Severity of Alcohol Dependence Questionnaire was applied. Relapse was taken as an outcome variable. Both TAU group and experimental group were followed on standard protocol of treatment. Results: The data were analyzed and relative risk (RR) was calculated. Findings revealed the study group receiving CBT had a better outcome and relapse rate was also significantly low in the experimental group as compared to the TAU group. Conclusion: The RR of relapse is lower in patients of alcohol dependence on CBT within 6 months and within 1 year as compared to cases on TAU. It is recommended that CBT be used as an adjunct to treatment in alcohol dependence cases.

Identifying entrustable professional activities for postgraduation in psychiatry: What should a psychiatrist be able to do?

Background: Competency-based medical education (CBME) has been the mandate by regulatory bodies of medical education in India, and implementation is an evolving process. This study aimed to identify and propose a set of entrustable professional activities (EPAs) for a master's degree in psychiatry. An attempt has been made to present it in the form of a portfolio. Methodology: Faculty experts in psychiatry went through phases of review to select appropriate EPAs for postgraduate residents from divergent thinking to development of portfolio. Results: One hundred and sixty-seven EPAs were identified and are presented. These were divided according to expertise required. Of these, 54% were considered vital, 30% essential, and 16% desirable. Conclusion: It is envisaged that the use of EPAs and portfolios will be instrumental in implementation and success of CBME in psychiatry. It is expected that medical universities will incorporate them in their curricula. It is also expected that data will be generated to identify challenges, which shall guide future refinement of the EPAs.

Lorazepam challenge test: A unique clinical response in catatonia.

Catatonia is a psychomotor behavioral syndrome characterized as a complex syndrome of bizarre motor behavior, impaired volition, and vegetative abnormalities. Catatonia is a medical emergency and if not recognized on time may have potentially fatal outcomes. We present a case series of three patients with catatonia, in whom Injection lorazepam 4 mg administered intravenously (Lorazepam Challenge) produced quick, optimum outcome.

Coping with the aftermath of COVID: Industrial resurgence, mental health, and resilience.

COVID-19 pandemic has affected billions of people worldwide. Economies world over have suffered slowdown with a direct impact on industry. The vulnerable industrial worker has suffered both financially and mentally. As the pandemic has begun to slow down, the industry has started showing signs of growth and economy appears to be coming back on track. Financial losses may be recovered in time, but the mental health impact of pandemic is likely to be long-lasting. In the aftermath of COVID-19, mental health needs of vulnerable sections of societies need to be addressed. An attempt has been made to understand the mental health impact of COVID-19 pandemic on industrial workers. Preventive and promotive measures for positive mental health of industrial workers are discussed with a focus on resilience-building.

Risk factors of postpartum depression.

BACKGROUND: Postpartum depression (PPD) is one of the most common puerperal psychiatric illnesses impairing quality of life and mental health of the mother and also the child. AIM: The aim is to study the prevalence and risk factors of PPD. MATERIALS AND METHODS: This cross-sectional observational study was done on a sample of 295 mothers who delivered and were followed up at a tertiary care hospital. The mothers were administered Edinburgh Postnatal Depression Scale, and demographic, psychosocial, and clinical data were collected. RESULTS: The age of the participant mothers ranged from 18 to 35 years and age at marriage ranged from 21 to 24 years. In most of the mothers, the parity was 2 and they had institutional vaginal delivery. The prevalence of PPD in this population of mothers was 30.84%. The factors that had a statistically significant association with PPD included: lower educational status of mother, lower family income, rural place of residence, higher parity, preterm delivery, and adverse events in newborn. CONCLUSION: PPD is a common mental health problem in the postpartum period. Sociodemographic factors such as low educational status of mothers, rural population, and low monthly family income were found to be associated with PPD. Primipara status, preterm delivery, and adverse events in newborn were also significantly associated.

Prevalence and risk factors associated with Internet gaming disorder: A cross-sectional study.

BACKGROUND: Internet gaming disorder (IGD) is an entity of clinical attention prominent among schoolgoing students. The reported nature and extent of Internet gaming varies widely, as does the extent of its effects. AIM: This study aimed to assess the prevalence of IGD and factors associated with it. METHODS: After institution ethics approval, individual assent, and parental consent, a cross-sectional study was conducted among 142 students of a school in western Maharashtra. A specially designed sociodemographic pro forma and IGD Scale were administered to the students. Data thus generated were statistically analyzed and compared with published literature. RESULTS: The prevalence of IGD was 10.6% among 13-19-year-old students. It was significantly higher among male students (15.3%) than female students (3.5%). Multivariate logistic regression found IGD to be significantly associated with male gender and lower age at first gameplay. CONCLUSIONS: IGD affects a tenth of our schoolgoing population with a male preponderance. Lower age at first gameplay had an adverse association.

Alzheimer's disease: Newer biomarkers.

Fifty million people are affected with dementia worldwide with Alzheimer's disease (AD) accounting for 70%-80% of these cases. In India alone, 4.1 million people suffered from dementia in 2015. To date, there are no definitive treatment options for AD and the overall treatment gap in India stands at 90%. Attempts have been made to define AD biologically. This has been made possible due to advances in the identification of biomarkers that indicate the neuropathological changes responsible for AD. Identification of these biomarkers has implications for disease staging, prognostication, and identifying drug targets. Here, we summarize the advances in the field of biomarkers in AD.

Impact of breathing and relaxation training (Sudarshan Kriya) on cases of alcohol dependence syndrome.

BACKGROUND: Alcohol abuse is a public health problem and the course of alcohol dependence syndrome (ADS) is known for its relapsing nature. Additional interventions with empirical evidence are worthy of consideration. Breathing and Relaxation Training, like Sudarshan Kriya (SK) is recommended for stress management, and have been shown to positively affect outcomes in stress-related disorders. The aim of this study was to assess the effect of an intervention of Breathing and Relaxation Training, on drinking behavior in patients of ADS. METHODOLOGY: Eighty in-patients diagnosed with ADS were included after obtaining informed consent, in this prospective study and were randomized into two groups. They were administered Alcohol Use Disorder Identification Test (AUDIT) at admission and 6-months after discharge. The Study group (n = 40) underwent a 6-day intervention of Breathing and relaxation Training (SK) apart from the standard therapy. "WHO-5 Well-Being Index" was administered before and after the training. The Control group was exposed to the standard therapy for ADS. A follow-up on a monthly basis and finally at 6-month interval was done to assess alcohol consumption status. RESULTS: Socio-demographically both the groups were comparable. The breathing and relaxation training (study) group had a significant rise in "WHO-5 Well-Being Index" (P < 0.001). There was a significant reduction in AUDIT scores after 6 months in both groups. AUDIT scores were significantly lower in the study group (11.20 ± 2.81) than the control group (15.30 ± 4.05) after 6 months (P < 0.001). The study group also reported fewer days of drinking (P = 0.004) and reduced overall drinking in the intervening period (P < 0.001). CONCLUSION: The addition of Breathing and Relaxation Training (SK) in the management of ADS provided additional therapeutic benefits in the form of fewer days of drinking and reduced total alcohol consumption.

Covalent Immobilization of Polyaniline Doped with Ag+ or Cu2+ on Carbon Nanotubes for Ethylene Chemical Sensing.

Multi-walled carbon nanotubes (MWCNTs) are promising materials for chemical gas sensing because of their high electrical and mechanical properties and significant sensitivity to changes in the local environment. However, high-content MWCNT films suffer from the low tunability of the electrical resistance, which is crucial for high chemoresistive sensing performance. This study reports the conjugation of MWCNTs and oligomers of polyaniline (PANI) doped with Ag+ or Cu2+ incorporated into a PVC/polyacrylate. MWCNTs were sonicated in n-methyl pyrrolidine (NMP), and PANI was conjugated via a 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide and an N-hydroxysuccinimide (EDC/NHS) process. MWCNT/PANI Ag+ or Cu2+ conjugates were doped to form a coordinate bond. The doped conjugates were successfully incorporated into the PVC/polyacrylate. These MWCNT/PANI conjugates doped were exposed to different concentrations of ethylene gas to examine their feasibility for ethylene detection.