Pradeep R. Jadhav

Depression during pregnancy: Prevalence and obstetric risk factors among pregnant women attending a tertiary care hospital in Navi Mumbai.

Context: Depression affects about 20% of women during their lifetime, with pregnancy being a period of high vulnerability. Prevalence of depression during pregnancy ranges from 4% to 20%. Several risk factors predispose to depression during pregnancy including obstetric factors. Depression during pregnancy is not only the strongest risk factor for post-natal depression but also leads to adverse obstetric outcomes. Aims: To study the prevalence of depression during pregnancy and its associated obstetric risk factors among pregnant women attending routine antenatal checkup. Settings and Design: Cross-sectional observational survey done at the outpatient department (OPD) of the department of obstetrics of a tertiary care hospital in Navi Mumbai. Materials and Methods: One hundred and eighty-five pregnant women were randomly administered the Beck Depression Inventory (BDI) for detecting depression. Additional socio-demographic and obstetric history was recorded and analyzed. Results: Prevalence of depression during pregnancy was found to be 9.18% based upon BDI, and it was significantly associated with several obstetric risk factors like gravidity (P = 0.0092), unplanned pregnancy (P = 0.001), history of abortions (P = 0.0001), and a history of obstetric complications, both present (P = 0.0001) and past (P = 0.0001). Conclusions: Depression during pregnancy is prevalent among pregnant women in Navi-Mumbai, and several obstetric risk factors were associated to depression during pregnancy. Future research in this area is needed, which will clearly elucidate the potential long-term impact of depression during pregnancy and associated obstetric risk factors so as to help health professionals identify vulnerable groups for early detection, diagnosis, and providing effective interventions for depression during pregnancy.

Prevalence of Mobile Phone Dependence in Secondary School Adolescents.

INTRODUCTION Mobile phones have become an essential part of modern human life. They have many attributes which makes them very attractive to both young and old. There has been an increasing trend of use of mobile phones among students. Data has now started emerging with respect to the negative physical and psychological consequences of excessive use of mobile phones. New research has shown excessive use of mobile phones leading to development of symptoms suggestive of dependence syndrome. AIM To study the prevalence of Mobile Phone Dependence (MPD) in secondary school adolescents. SETTING AND DESIGN Cross-sectional, observational study conducted in secondary section of English-medium schools at Navi Mumbai (India). MATERIALS AND METHODS Four hundred and fifteen students studying in 8(th), 9(th) and 10(th) standards of schools at Navi Mumbai (India) having personal mobile phone were randomly included in the study. Participant information like age, gender, family type, phone type, duration of use per day and years of mobile phone usage was recorded. They were administered an MPD questionnaire based upon the dependence syndrome criteria as per ICD-10. According to their responses, participants who fulfilled three or more of the diagnostic criteria were rated as having MPD. RESULTS Mobile Phone Dependence was found in 31.33% of sample students. It was significantly associated with gender (p=0.003, OR=1.91, CI: 1.23-2.99), family type (p=0.0012), type of mobile phone used (p<0.001, OR=2.6, CI: 1.63-4.35), average time per day spent using mobile phone (p<0.001) and years of mobile phone usage (p =0.004, OR=2.4, CI: 1.31-4.55). CONCLUSION Mobile Phone Dependence has been found to be an emerging public health problem. There is need to recognize and identify early the growing trends and negative consequences of inappropriate mobile phone use in young users so as to generate awareness, and plan educational and treatment interventions, if need be, so as to prevent a major public health concern.

Prescribing pattern and efficacy of anti-diabetic drugs in maintaining optimal glycemic levels in diabetic patients

Context: Despite the availability of efficacious anti-diabetic drugs, which act by different mechanisms to reduce the blood-glucose, the majority of people with diabetes on anti-diabetic drug therapy, have poor glycemic control and diabetic vascular complications. Aim and Objectives: The aim was to study the prescribing pattern and efficacy of anti-diabetic drugs in maintaining optimal glycemic levels in diabetic patients attending tertiary care teaching hospital in Navi Mumbai. Materials and Methods: A prospective, cross-sectional, observational survey was carried out in 100 patients of diabetes mellitus attending diabetes outpatient/medicine outpatient departments, to assess their prescribing pattern of anti-diabetic drugs, and their blood-glucose level was measured by Accu-Chek Active glucometer to determine their glycemic control. Results: Average number of anti-diabetic drugs per prescription was 1.4. Sulfonylureas were the most commonly prescribed class, but metformin (biguanide) was the commonest prescribed individual drug among oral hypoglycemic agents (OHA). Fixed dose combination of biguanide and sulfonylurea was prescribed commonly. Monotherapy dominated over polytherapy and there was a higher percentage of use of insulin in Type 2 diabetics. Only 41% of patients on anti-diabetic therapy had optimal glycemic control. The association between anti-diabetic therapy along with lifestyle modification and glycemic control was statistically significant (P = 0.0011). Conclusions: OHAs still dominate the prescribing pattern, but there was a shifting trend toward the use of insulin preparations in the management of Type 2 diabetes mellitus. In achieving optimal glycemic control, the efficacy of the anti-diabetic drugs was only 41%; therefore intensification of current drug treatment as well as planning multiple drug interventions with lifestyle modification is necessary.

Drug Utilization Study in Ophthalmology Outpatients at a Tertiary Care Teaching Hospital

In view of the advancement in drug development and availability of new ocular therapeutics in the discipline of ophthalmology, we attempted to study the drug utilization and describe the prescribing practices of ophthalmologists in a tertiary care teaching hospital. Method. A prospective, cross-sectional, observational study was conducted on patients attending Outpatient Department of Ophthalmology for curative complaints. Prescriptions of 600 patients treated were analyzed by the WHO prescribing indicators and additional indices. Results. Analysis showed that the average number of drugs per prescription was 1.49. Percentage of drugs prescribed by generic name was 2.35%. Percentage of encounters with antibiotics was 44.83%. Percentage of drugs prescribed from National Essential drug list (NEDL)/National Formulary of India (NFI) was 19.48%. Patients knowledge of correct dosage was 93.83%. Antimicrobial agents were the most commonly prescribed drugs followed by antiallergy drugs and ocular lubricants. Fluoroquinolones accounted for 60% of the total antimicrobial drugs, of which gatifloxacin was the most frequently prescribed fluoroquinolone. Conclusion. The study indicated an awareness of polypharmacy, but showed ample scope for improvement in encouraging the ophthalmologists to prescribe by generic name and selection of essential drugs from NEDL/NFI.

Bullying and Victimization Trends in Undergraduate Medical Students - A Self-Reported Cross-Sectional Observational Survey.

INTRODUCTION Bullying is a form of behaviour that can negatively impact a person. It can lead to several deleterious consequences like low self-confidence, drop in academic performance and depression. Studies have shown that bullying behaviour exists amongst medical students also. In the medical field, it is known to negatively impact dispensing of health care and attitudes of medical students towards becoming doctors. It is very difficult for medical students to cope with such a menace as they are already burdened with a vast curriculum and rigorous schedules. There exists paucity of studies regarding bullying amongst undergraduate medical students in Indian context. AIM To study prevalence of peer-based bullying and victimization along with their associated factors in undergraduate medical students. MATERIALS AND METHODS Four hundred randomly chosen undergraduate medical students were included in the study. Socio-demographic and personal details including history of substance use were recorded in a self-designed case record form. Illinois Bullying Scale was used to assess bullying behaviours. Out of total 400 students, 383 completed the survey and this data was analysed. RESULTS In this study, 98.69% participants self-reported to having indulged in bullying while 88.77% reported feeling victimized. Physical (p<0.001) as well as verbal (p=0.001) bullying was found to be of significantly greater severity in males as compared to females. Students of the third year of medical school indulged in significantly (p=0.034) greater severity of physical bullying than those of other years. Alcohol consumption (p=0.001) and cigarette smoking (p<0.001) were significantly associated with physical bullying. CONCLUSION Peer-based bullying and victimization was found to be highly prevalent amongst undergraduate medical students. There is an urgent need for more detailed studies on bullying in medical students so that remedial measures can be initiated and steps to limit such behaviours can be looked at seriously.

Knowledge of hand hygiene in undergraduate medical, dental, and nursing students: A cross-sectional survey.

Background: Hand hygiene is of paramount importance for the prevention of healthcare associated infections and the spread of antimicrobial resistance. There is a need to explore the concept of hand hygiene among the cross-disciplinary undergraduate healthcare students. Aim: To evaluate and compare the knowledge of hand hygiene among medical, dental, and nursing undergraduate students. Materials and Methods: A cross-sectional survey was conducted among 84 medical, 74 dental, and 40 nursing undergraduate students in a Tertiary Care Teaching Institute in Navi Mumbai, Maharashtra, India. Knowledge was assessed using the World Health Organization hand hygiene questionnaire. The scores for each were calculated and compared. The scores were further graded as low, moderate, and good. Results: Overall, only 7.5% of the participants had good knowledge regarding hand hygiene while majority (69.1%) had moderate knowledge. Medical students’ hand hygiene knowledge was significantly (P < 0.01) higher than that of dental and nursing students. Conclusion: The overall low scores on hand hygiene knowledge indicate that undergraduate healthcare students require increased emphasis on hand hygiene education, behavior, and improvement in their current primary training as well as undergraduate curricula.

Evaluation of analgesic activity of levofloxacin in human experimental pain model

Abstract Background: Levofloxacin, an optically active isomer of ofloxacin, exerts broad spectrum antibacterial activity. Apart from its antibacterial action, experimental studies have documented antinociceptive properties in animal pain models suggesting an analgesic effect. This study was conducted with the aim to evaluate the analgesic activity of levofloxacin in healthy human volunteers. Methods: This was an open label, prospective, non-randomized, interventional study conducted on 12 apparently healthy volunteers at a tertiary care teaching hospital in India. Permission from the Institutional Ethics Committee was obtained. After obtaining informed consent, volunteers fulfilling the inclusion criteria were enrolled. Analgesic activity was assessed by Cola cap and sphygmomanometer, a human experimental pain model. Observation of pain threshold and tolerance was recorded at baseline and at an interval of 2 h and 4 h after administration of levofloxacin (500 mg oral) in all 12 subjects. The results were analysed using repeated measures one way analysis of variance. Results: The mean age of the volunteers was 27.5±3.26 years. A statistically significant increase in the pain threshold and tolerance was found at 2 h and 4 h when compared to baseline. Conclusions: Levofloxacin exhibited significant analgesic activity in a human pain model and can be used in infections associated with pain or for pre-operative prophylaxis. Further investigations are required to understand the precise mechanism and pathway of antinociception exhibited by levofloxacin.

Mindfulness-based hypnotherapy for common psychological disorders

′Mindfulness′ is an essential element of Buddhist meditative practices. It is paying attention to the present moment and to what we experience. Hypnosis is a state of a state of increased suggestibility with constriction of peripheral awareness and increased focal concentration on task at hand. Thus there are many similarities between hypnosis and mindfulness and they are, many a times, complementary. This review article focuses on the applications and evidences for using mindfulness- based hypnotherapy in the management of psychological disorders.