To study childhood trauma in patients with bipolar affective disorder and its association with leucocyte telomere length.

Background: Childhood traumatic (CT) events are more frequent in Bipolar Affective Disorder (BD) than in healthy individuals. As per existing studies, telomere shortening might be associated with psychiatric illnesses and aging-related disorders. One basis could be CT in BD aiding in telomere shortening. Methods: 100 BD patients and 100 healthy controls (HC) were matched for age and sex. All the participants were administered Childhood Trauma Questionnaire (CTQ). Subsequently, Quantitative Polymerase Chain Reaction (q-PCR) was performed in order to verify leukocyte telomere length (LTL) for both cases and controls. Results: Presence of subtypes of moderate to severe CT among cases revealed emotional abuse in 35%, physical abuse in 16%, and sexual abuse in 15%. BD patients had significantly shorter telomeres in comparison to HC. BD patients with CT had significantly shorter LTL as compared to healthy controls with CT. The association between CT and LTL was not statistically significant in cases as well as in controls. Conclusions: Our study revealed presence of CT (moderate to severe) in 46% of BD patients and 12% in age and sex-matched healthy controls. All CT subtypes except sexual abuse were significantly higher among cases than in healthy controls. Mean score of LTL among cases including that with CT was significantly lower than the healthy controls.

Correlation of brain-derived neurotrophic factor with severity of depression and treatment response.

Background: Brain-derived neurotrophic factor (BDNF) is a modulator of neuroplasticity in the brain. It plays an important role in the pathophysiology of depression through the stress pathway. The information about correlation of BDNF levels with depression severity and treatment response in Indian population is scarce. Methods: Consecutive 60 never treated cases with depression reporting to a large tertiary care psychiatry unit and 60 healthy matched controls from 01 January 2016 to 31 December 2016 were enrolled for study. Sociodemographic data were collected. Diagnosis of depression was carried out as per International Classification of Diseases-10th revision (ICD-10) diagnostic criteria for research. The Hamilton Rating Scale for Depression (HRSD) was administered and accordingly scored. Venous blood for BDNF levels was collected from all cases and controls. Cases were reassessed after 04 weeks of treatment with HRSD and BDNF levels. Results: The mean level of serum BDNF among cases (18.56 ng/ml) was found to be reduced significantly as compared with healthy controls (32.41 ng/ml). The mean serum BDNF level (18.56 ng/ml) in never treated cases was significantly negatively correlated with the median clinical HRSD score (18.5). There was a significant increase in the mean level of serum BDNF after antidepressant treatment. Conclusion: The study has revealed statistically significant low levels of serum BDNF in cases not exposed to treatment with depression compared with healthy controls. There was significant negative correlation of levels of serum BDNF with depression severity. The levels of serum BDNF significantly increased after four weeks of treatment.

Personality traits associated with Alcohol Dependence Syndrome and its relapse.

Background: Course of Alcohol Dependence Syndrome (ADS) is studded with multiple relapses. Personality factors are implicated as one of the influencing factors in the course of this disorder. Keeping in view of scarcity of Indian data available, the study was planned with the aim to find Personality traits more commonly associated with ADS patients, and identify specific traits, associated with relapses of ADS. Method: With sample size of 100 consecutive cases and 100 controls, socio-demographic data was collected. Alcohol Use Disorder Identification Test (AUDIT) and Severity of Alcohol Use Disorder Test (SAD-Q) were administered to each of these patient. Personality dimensions were assessed with NEO-five factor inventory (NEO-FFI) (Costa and McCrae), for both groups and further compared for differences in the dimensions in each of its subscale. Results: The NEO scores, showed statistically significant difference with Cases having higher scores in Neuroticism and control group in Openness and Conscientiousness. Neuroticism linked to higher scores of AUDIT and SADQ and also associated with relapses. Other traits also showed statistically significant association which are discussed. Conclusion: As new factors are being explored for effective management, routine personality profiling is easily accomplished and can give delightful insight into focused and designed management plan.

Impact of cognitive behavioural intervention on caregiver burden in mothers of children diagnosed with cancer.

Background: Mothers of children diagnosed with cancer are found to have coping difficulties in various studies. Most of the studies were done on parents after their child has been newly diagnosed with malignancy, and very few studies were done on coping skills intervention. Hence, this study has been done to assess the impact of cognitive behavioural intervention on caregiver burden in mothers of children diagnosed with cancer. Methods: Twenty mothers coming to the outpatient department of paediatric oncology from 01 September 2018 to 30 April 2019 were enrolled for the study. The participants were administered General Health Questionnaire, Brief Coping Operation Preference Enquiry Scale, Zung Self-Rating Anxiety Scale, and Coping Inventory for Stressful Situations-21 (CISS-21) Scale. Sixteen sessions of cognitive behavioural intervention were given over 8 weeks to all the participants. Reassessment was done after 3 months by use of the above mentioned scales. Results: Participants' mean anxiety score was 49.40 (standard deviation [SD] ±8.89). They used adaptive (active coping and positive reframing) more than the maladaptive (denial and self-blame) coping strategies. Task- and emotion-focused coping mean score on CISS-21 revealed 19.25 (SD ±6.20) and 18.90 (SD ±5.76), respectively. Reassessment after cognitive behavioural intervention revealed statistically significant improvement in maladaptive coping styles, mean anxiety index score, avoidance, and emotion-focused coping. Conclusion: The study has revealed mild to moderate anxiety and the use of both adaptive and maladaptive coping strategies by participants. There is statistically significant improvement in anxiety, maladaptive coping strategies with cognitive behavioural intervention.

Acceptability and effectiveness of a poetic narrative video facilitated large classroom teaching in psychiatry.

BACKGROUND: Lecture based large classroom teaching is limited in scope of learning by being primarily. Teacher focussed, directive and monotonous with students often being passive participants. In psychiatry, problem is further compounded because of stigma around the subject and lack of summative assessment. Narratives and poems have been used in education to facilitate teaching. METHODS: 50 randomly selected medical undergraduate students were subjected to short poetic narrative video facilitated large classroom interactive lecture, while 50 other students were imparted traditional classroom lecture. Acceptability and effectiveness of this teaching learning modality was done with a questionnaire and multiple-choice questions on the given topic post the lecture. RESULT: Around 90 percent of the student found the modified classroom teaching to be acceptable. It was equally effective as traditional classroom teaching. Student and faculty reflected on the whole experience as innovative, immersive and appealing to empathy. CONCLUSION: Poetic narrative facilitated classroom teaching is an acceptable and equally effective modality of large classroom teaching.

Assessment of depression, anxiety and stress in COVID-19 infected individuals and their families.

BACKGROUND: Pandemics have been associated with widespread psychological distress in the normal population due to quarantine and lockdown, however there are only few studies on psychiatric symptoms in COVID infected patients and their families. This study was planned to assess the depressive, anxiety and stress symptoms in individuals and their families infected with COVID19, during current pandemic. METHODS: A cross-sectional, observational study was conducted on hospitalised, COVID infected patients and their immediate family members. Ninety-three, COVID patients and fifty-four family members were studied through Google forms which contained socio-demographic proforma and Depression Anxiety Stress Scale-21 (DASS21). Collected data was tabulated to assess depression, anxiety and stress symptoms in the given population and study their relation with various sociodemographic variables. RESULTS: Almost one-third of the sample showed increased score on depression and anxiety subscales and one-fifth on stress subscales. 30-45% of the family members studied had higher score on either of the subset. There was also a high correlation between the scores of depression, anxiety and stress subset in the study sample. CONCLUSION: This study, reflects high magnitude of depression, anxiety and stress symptoms in these patients and their families which alert us to the need for definitive interventions in these affected individuals.

The psychological impact of COVID-19 among newly diagnosed patients: COVID Impact study.

BACKGROUND: COVID-19 has had adverse psychological impact on the general population. Most surveys published till date are online questionnaires targeting general population/health care providers. There is lack of data on the psychological impact of disease on newly diagnosed COVID-19 patients. METHODS: The study was conducted at a tertiary care hospital, actively involved in the management of COVID patients. Newly diagnosed COVID-19 patients who had presented to the outpatient COVID care clinic were interviewed face to face by an interviewer using 'Impact of Event Scale-Revised (IES-R)', a validated and universally accepted research questionnaire. RESULTS: Most of the respondents were males (83.2%), mean age: 40.8 years. 31.7% were graduates and 58.5% were actively employed. Fever (57.4%), cough (37.6%), and progressive breathlessness (08.9%) were the three most common clinical symptoms. The mean score on 'IES-R' was 31.8. 30.7% respondents had suffered 'severe' psychological impact, 30.7% had 'minimal' impact. 19.8% and 1.8% had 'mild' and 'moderate' psychological impact respectively. On linear regression analysis, increasing age had statistically significant corelation with increasing scores on 'IES-R scale' (p = 0.004). Educational qualifications of the patient had negative corelation (Pearson correlation=- 0.117) while none of the clinical parameters had any statistically significant correlation with the patients' psychological impact scores. CONCLUSION: COVID-19 patients are at an increased risk of suffering from disease-related adverse psychological impact. Certain risk groups especially like the elderly need close follow-up for early diagnosis and management. Future studies may be required to assess and manage 'post-traumatic stress disorder' that may arise in the aftermath of pandemic.

Chlorella vulgaris cultivation in airlift photobioreactor with transparent draft tube: effect of hydrodynamics, light and carbon dioxide on biochemical profile particularly ω-6/ω-3 fatty acid ratio.

Chlorella vulgaris is used for food and feed applications due to its nutraceutical, antioxidant and anticancer properties. An airlift photobioreactor comprising transparent draft tube was used for C. vulgaris cultivation. The effect of reactor parameters like hydrodynamics (0.3-1.5 vvm), light intensity (85-400 µmol m-2 s-1), photoperiod (12-24 h) and gas-phase carbon dioxide (CO2) concentration (5-15% v/v) were evaluated on microalgae and associated bacterial growth, biochemical profile; with special emphasis on ω-3, ω-6 fatty acids, and vitamin B12. The optimal growth of C. vulgaris without CO2 supplementation was observed at 1.2 vvm, which was associated with higher algal productivity, chlorophyll, vitamin B12 content, and bacterial load along with 72% of nitrate removal. The higher light intensity (400 µmol m-2 s-1) and photoperiod (24:0) increased biomass productivity and ω-3 fatty acid content (in lipid) up to 2-3 fold. The elevated levels of gas-phase CO2 concentration (15% v/v) enhanced EPA content up to 7% and biomass productivity up to 171 mg L-1 day-1. However, the increase in CO2 concentration lowered vitamin B12 content (up to 30%) and bacterial load (2-3 log). Also, all the cultivation conditions favoured desirable ω-6/ω-3 ratio(in the range of 1-2).

Growth and biochemical characteristics of an indigenous freshwater microalga, Scenedesmus obtusus, cultivated in an airlift photobioreactor: effect of reactor hydrodynamics, light intensity, and photoperiod.

The freshwater green algae, Scenedesmus obtusus, was cultivated in a 3.4 L airlift photobioreactor. The hydrodynamic parameters were estimated at different inlet gas flow rates (1, 2, 3, and 4 LPM) and their subsequent impact on the growth and biochemical characteristics of microalgae was studied. The biomass concentration and productivity increased with an increase in flow rates from 1 to 4 LPM. A maximum of 0.07 g L-1 day-1 productivity of biomass was attained at 3 LPM. An increase of total carbohydrate content from 19.6 to 26.4% was noticed with increment in the inlet flow rate of gas from 1 to 4 LPM. Major variations in total fatty acid content were not observed. The impact of light irradiance on growth and biochemical characteristics of S. obtusus was also evaluated. A maximum biomass productivity of 0.103 g L-1 day-1 was attained at an illumination of 150 µmol m-2 s-1 under continuous light. The major fatty acids reported were palmitic acid (C16:0), α-linolenic acid (C18:3), linoleic acid (C18:2), and oleic acid (C18:1). Biodiesel properties of the microalgae were estimated under various culture conditions. The light profile inside the airlift reactor was experimentally measured and the predictive modelling of light profile was also attempted.

Circulating microRNA profiling identifies microRNAs linked to prediabetes associated with alcohol dependence syndrome.

BACKGROUND: MicroRNAs are abundant in serum and have emerged as important regulators of gene expression, implicating them in a wide range of diseases. The purpose of this study was to discover and validate serum miRNAs in prediabetes associated with alcohol dependence syndrome (ADS). METHOD: Serum samples from ADS patients with or without prediabetes and normoglycemic controls were subjected to microarray. Validation of identified candidate miRNAs was performed by RT-qPCR. Additionally, GO and KEGG pathway analyses were carried out to uncover target genes anticipated to be controlled by the candidate miRNAs. RESULTS: Notably, 198, and 172 miRNAs were differentially expressed in ADS-patients with or without prediabetes compared to healthy controls, and 7 miRNAs in ADS-patients with prediabetes compared to ADS-normoglycemic patients, respectively. Furthermore, hsa-miR-320b and hsa-miR-3135b were differentially expressed exclusively in ADS-patients with prediabetes, and this was further validated. Interestingly, GO and KEGG pathway analysis revealed that genes predicted to be modulated by the candidates were considerably enriched in numerous diabetes-related biological processes and pathways. CONCLUSION: Our findings revealed that ADS-patients with or without prediabetes have different sets of miRNAs compared to normoglycemic healthy subjects. We propose serum hsa-miR-320b and hsa-miR-3135b as potential biomarkers for the diagnosis of prediabetes in ADS-patients.

Depression among rheumatoid arthritis patients and barriers to seeking professional help: An observational study.

Background: A few studies have reported the association of rheumatoid arthritis (RA) with emotional changes including anxiety and depression. There is a paucity of Indian studies in this area. Aim: To assess depression and its correlates in diagnosed cases of RA. Materials and Methods: This was a cross-sectional and hospital-based study. A total of 70 patients with RA fulfilled the inclusion and exclusion criteria. Their demographic characteristics were recorded. They were individually assessed with the Clinical Disease Activity Index, Numerical Pain Rating Scale, Barriers to Access Care Evaluation, and Beck Depression Inventory. Statistical analysis was undertaken with SPSS. Results: In the patients with RA the prevalence of depression was 44.2%. Analysis revealed that there was a significant positive correlation between depression with the severity of RA. Barriers to help-seeking were mainly attitudinal rather than stigma-related or instrumental barriers. Conclusion: In the RA patients, the prevalence of depression was 44.2%. Clinical disease activity and the pain index were higher in patients with depression.

In vivo analysis of translation initiation sites in Plasmodium falciparum.

Regulation of gene expression in the malaria parasite Plasmodium falciparum is tightly controlled and little is known about the many steps involved. One step i.e. translation initiation is also poorly understood and in P. falciparum, choice of the translation initiation site (TIS) is a critical decision largely due to the high frequency of AUGs in the relatively long 5' untranslated regions of parasite mRNAs. The sequences surrounding the TIS have a major role to play in translation initiation and this report evaluates these sequences by mutational analysis of the heat shock protein 86 gene, transient transfection and reporter assays in the parasite. We find that purines at the -3 and +4 positions are essential for efficient translation in P. falciparum, similar to other eukaryotes. Interestingly, a U at the -1 position results in 2.5-fold higher reporter activity compared to wild type. Certain classes of protein biosynthetic genes show higher frequencies of U at the -1 position, suggesting that these genes may exhibit higher levels of translation. This work defines the optimal sequences for TIS choice and has implications for the design of efficient expression vectors in an important human pathogen.

Adult attention-deficit Hyperactivity disorder: From clinical reality toward conceptual clarity.

There is ambiguity about the clinical picture and concept of attention-deficit hyperactivity disorder (ADHD) in adults. Relevant literature was extracted from various search engines, analyzed, and interpreted. Available literature suggests a significant prevalence of ADHD in the adult population affecting the quality of socio-occupational functioning. Inattentiveness was more commonly present than hyperactivity-impulsivity. Frequent comorbidities with other psychiatric disorders like anxiety disorders and substance use disorders were noted. Pharmacological management and psychotherapy have been found effective in its management. ADHD is a disorder across the lifespan and fairly prevalent among adults. Greater awareness and more research are required for a better understanding of Adult ADHD and its effective management.

Neurobiological underpinnings of emotions.

Emotion is a stirred-up state caused by physiological changes occurring as a response to some event and which tends to maintain or abolish the causative event. Understanding the neuroanatomical basis of the genesis and control of emotions is quintessential in understanding how biology affects the mind and in turn, helps in understanding our own nature. We present a short communication explaining the neurological basis of emotions.

First-episode psychosis: How long does it last? A review of evolution and trajectory.

Study of first-episode psychosis (FEP), an episode of psychotic nature which manifests for the first time in an individual in the longitudinal continuum of his/her illness, has been study matter of research interest in recent years. A comprehensive review of the literature will help us understand the evolution and trajectory of this concept better. A literature review of available articles addressing the concept, phenomenology, evolution, identification, course, and outcome of FEP was done; the same was subsequently divided into broad topics for better clarity and analyzed. FEP constituted a clinical psychotic phenomenon with underlying significant heterogeneity in diagnosis, stability, course, and outcome. The study has attempted to view FEP both as horizontal spectrum across various diagnoses and longitudinally ranging from asymptomatic individual with unknown risk status to attenuated psychosis to multiple relapses/unremitting illness. Many risk and protective factors have been brought out with varying certainty ranging bio-psycho-social spectrum. Efforts have been made to calculate polygenic risk score based on genes involvement/sharing between various psychotic spectrum disorders; as well as biomarker panels to identify people at risk. FEP may prove to be an important concept to understand psychosis in general; without putting things into the diagnostic rubric. It may help understand multiple risk and protective factors for the course and outcome of psychotic illness and may clear the cloud to sharpen the evidence toward commonality and distinctiveness between various psychotic diagnoses in vogue for more comprehensive concept.

Mental health impact of COVID-19 among health-care workers: An exposure-based cross-sectional study.

BACKGROUND: Health-care workers (HCWs) in COVID-19 pandemic have faced the major impact in providing care to infected persons. Most of the studies on mental health impact among HCW have not incorporated paramedical staff. Furthermore, they have not compared psychological morbidity among HCW on the basis of high COVID exposure (HCE) and low COVID exposure (LCE). To address the above gap, this study aimed at evaluating mental health impact among HCW and its associated risk factors. MATERIALS AND METHODS: Consecutive 200 HCWs each in the HCE and LCE groups (between the age group of 18 and 60 years) were enrolled from two tertiary care hospitals providing COVID-19 treatment from August 1, 2020. After collection of sociodemographic data, participants were administered Impact of Event Scale-Revised, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 Scale. RESULTS: The difference in stress, depression, and anxiety symptom scores between the HCE and LCE groups was not statistically significant. Multiple regression analysis revealed that female sex was associated with higher scores in all the three domains. The effect remained significant even after adjusting for effect of other risk factors. CONCLUSION: HCE or LCE was associated with similar impact in terms of stress, depression, and anxiety among HCWs. Female HCWs had a higher prevalence of stress, depression, and anxiety. Doctors, nurses, and paramedics had a similar prevalence of stress, depression, and anxiety when odds were adjusted.

Stress induced modifications in photosystem II electron transport, oxidative status, and expression pattern of acc D and rbc L genes in an oleaginous microalga Desmodesmus sp.

The study aimed at understanding the biochemical and molecular level modifications in Desmodesmus sp. under lipid inducing stress conditions. The low-temperature (5 °C) incubation and nitrogen starvation reduced the PS II electron transport in microalga with a maximum reduction of 50-57% in ET0/ABS values. The PS II electron transport recovered in UV treated cultures after an initial reduction of 87-93% in ET0/ABS values. A 2.7-4.4 fold increase in ROS and MDA levels was observed under low-temperature incubation, and nitrogen starvation. The UV treatment caused 1.3-2.4 fold higher ROS and MDA levels than control. The low-temperature incubated, nitrogen starved, and UV treated cultures showed 2.4-4 fold higher acc D gene expression. A higher rbc L gene expression was observed under low-temperature stress. The study showed modifications in PS II electron transport, oxidative status, and expression of acc D and rbc L genes under stress conditions.