Effect of Smartphone Use on Sleep in Undergraduate Medical Students: A Cross-Sectional Study.

Smartphone use, particularly at night, has been shown to provoke various circadian sleep-wake rhythm disorders such as insomnia and excessive daytime tiredness. This relationship has been mainly scrutinized among patient groups with higher rates of smartphone usage, particularly adolescents and children. However, it remains obscure how smartphone usage impacts sleep parameters in adults, especially undergraduate college students. This study sought to (1) investigate the association between smartphone use (actual screen time) and four sleep parameters: Pittsburgh sleep quality score (PSQI), self-reported screen time, bedtime, and rise time; (2) compare the seven PSQI components between good and poor sleep quality subjects. In total, 264 undergraduate medical students (aged 17 to 25 years) were recruited from the Government Doon Medical College, Dehradun, India. All participants completed a sleep questionnaire, which was electronically shared via a WhatsApp invitation link. Hierarchical and multinomial regression analyses were performed in relation to (1) and (2). The average PSQI score was 5.03 ± 0.86, with approximately one in two respondents (48.3%) having a poor sleep index. Smartphone use significantly predicted respondents' PSQI score (ß = 0.142, p = 0.040, R2 = 0.027), perceived screen time (ß = 0.113, p = 0.043, R2 = 343), bedtime (ß = 0.106, p = 0.042, R2 = 045), and rise time (ß = 0.174, p = 0.015, R2 = 0.028). When comparing poor-quality sleep (PSQI ≥ 5) to good-quality sleep (PSQI < 5), with good-quality sleep as the reference, except sleep efficiency and sleep medications (p > 0.05), five PSQI components declined significantly: subjective sleep quality (ß = -0.096, p < 0.001); sleep latency (ß = -0.034, p < 0.001); sleep duration (ß = -0.038, p < 0.001); sleep disturbances (ß = 1.234, p < 0.001); and sleep dysfunction (ß = -0.077, p < 0.001). Consequently, public health policymakers should take this evidence into account when developing guidelines around smartphone use-i.e., the when, where, and how much smartphone use-to promote improved sleep behaviour and reduce the rate of sleep-wake rhythm disorders.

Epitranscriptomic Approach: To Improve the Efficacy of ICB Therapy by Co-Targeting Intracellular Checkpoint CISH.

Cellular immunotherapy has recently emerged as a fourth pillar in cancer treatment co-joining surgery, chemotherapy and radiotherapy. Where, the discovery of immune checkpoint blockage or inhibition (ICB/ICI), anti-PD-1/PD-L1 and anti-CTLA4-based, therapy has revolutionized the class of cancer treatment at a different level. However, some cancer patients escape this immune surveillance mechanism and become resistant to ICB-therapy. Therefore, a more advanced or an alternative treatment is required urgently. Despite the functional importance of epitranscriptomics in diverse clinico-biological practices, its role in improving the efficacy of ICB therapeutics has been limited. Consequently, our study encapsulates the evidence, as a possible strategy, to improve the efficacy of ICB-therapy by co-targeting molecular checkpoints especially N6A-modification machineries which can be reformed into RNA modifying drugs (RMD). Here, we have explained the mechanism of individual RNA-modifiers (editor/writer, eraser/remover, and effector/reader) in overcoming the issues associated with high-dose antibody toxicities and drug-resistance. Moreover, we have shed light on the importance of suppressor of cytokine signaling (SOCS/CISH) and microRNAs in improving the efficacy of ICB-therapy, with brief insight on the current monoclonal antibodies undergoing clinical trials or already approved against several solid tumor and metastatic cancers. We anticipate our investigation will encourage researchers and clinicians to further strengthen the efficacy of ICB-therapeutics by considering the importance of epitranscriptomics as a personalized medicine.

The necessity of psychological interventions to improve compliance with Tuberculosis treatment and reduce psychological distress.

CONTEXT: One of the major obstacles in treating TB is the patient's nonadherence to the treatment regimen resulting in prolonged disease transmission and development of resistance to anti-TB drugs. An individual's mental health affects his/her adaptation to the disease. Mental health issues and TB both are inextricably connected and research into this area will provide an opportunity to develop a more holistic model of TB treatment and prevention. AIMS: The aim of this study is to investigate the prevalence of mental health issues in patients with TB and its influence on individual perception of well-being with an emphasis on psychopathology as a major obstacle to treatment adherence. Research into this area will provide an opportunity to develop a more holistic model of TB treatment and prevention. SETTINGS AND DESIGN: Primary data were collected with the help of ASHA workers, and primary survey-based study was designed. METHODS AND MATERIAL: A total of 249 diagnosed Tuberculosis cases were included in the study. A digitalized version of the PGIHQN-1 questionnaire was made and used to separate the psychiatric population from the normal group. Asha workers were trained to use the digital version on tablets. STATISTICAL ANALYSIS USED: Using Microsoft Excel, Graphic Tables, and corelation were done using SPSS Statistics. RESULTS: Mental health issues were found in diagnosed TB cases, which required further evaluations. Along with mental health issues, limited resources, gender, limited education, lack of proper knowledge about the disease, having responsibilities (Marital status), locality were found to be the important factors that complicate TB outcomes, hence should be taken into consideration while imparting psychological interventions. CONCLUSION: Mental health issues complicate TB outcome and hence need to be properly addressed, and thorough psychoeducation, psychological first aid (listen, protect, connect, model& teach), and timely intervention in the form of proper diagnosis and specific treatment and rehabilitation are needed.

Dolichos biflorus Linn. ameliorates diabetic complications in streptozotocin induced diabetic rats.

BACKGROUND: Horsegram (Dolichos biflorus Linn.) is a known antilithiatic, hypolipedemic and has free radical scavenging activity and increased production of reactive oxygen species play a role in pathophysiological mechanisms that trigger diabetic complications. AIM: To see the effect of daily oral feeding of D.biflorous on nephropathy and retinopathy in streptozotocin (STZ) induced-diabetic rats. MATERIALS AND METHODS: A total of 24 healthy rats were randomly grouped into controls, diabetic and diabetic on Dolichos. Diabetes was induced by a single dose of STZ (55 mg/kg) and animals were given prepared food and water ad libitum. Dolichos was orally given at 300 mg/kg/day to rats in diabetic on Dolichos group for next 30 days. Fasting blood glucose levels was monitored at beginning and at the end of the experiment while assessment of serum creatinine levels and histopathological study of kidney and retina was carried only at the end of the experiment. Statistical differences between groups were analyzed using analysis of variance followed by, Bonferroni test as posthoc test. RESULTS: Results indicated improvement in serum creatinine levels and reduced glomerular sclerosing and Bowman's space with interstitial alterations and significantly reduced renal hypertrophy in diabetic rat son Dolichos diabetic rats (P < 0.001). Retinal layers showed inconsistent improvement in the width of the neuronal layers and decreased vacuolization of plexiform layers and retinal vessel density. CONCLUSION: D. biflorus at doses of 300 mg/kg/day for 30 days resulted in gradual but significant decreased diabetic nephropathy.