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Study of referrals to department of psychiatry in tertiary care general hospital setting, p strong Background: /strong Study of referral pattern to psychiatry helps us to understand the type of patients and the rate of referral from individual departments. It also helps us to understand the need for consultation liaison services (CLP)

Introduction: Homicide and attempt to murder are unique and serious violent offences. These serious offences have a huge impact on society. But there are a very few studies available in India to understand the psychiatric morbidity and the profile of these offenders. Hence the need for present study. Aim: To study the various socio-demographic factors, crime characteristics and psychiatric morbidity in violent offenders. Materials and Methods: It is a cross sectional study conducted at the central prison, Hyderabad. Study sample includes 60 violent offenders involved in serious crimes like murder (IPC SEC 302), attempt to murder (IPC SEC 307) and others. Results and Conclusions: Although certain characteristics stood out, it is important to note that violent crime is multi-factorial, complex and embraces several theories. With that stated, the purpose of this study was mainly to be able to produce one or more profiles of offenders convicted of murder, attempted murder, in Telangana. The common profile which emerged was persons of young age, low education, married, low socio economic status, and rural background, unemployed with no criminal background, committed crime under intoxication, perpetrated due to provocation by other person and impulsive due to domestic reasons. It is remarkable to know that no one had other psychiatric disorders apart from substance dependence and intoxication at the time of commission of crime. o more awareness programs and campaigns regarding influence of alcohol on the crimes, can be conducted with the help of Police, Government, Private organisations and media, especially in vulnerable and at risk population for crime, which would indirectly decrease alcohol intake in the vulnerable population and decrease crime rate. Keywords: Crime, Prisoners, Violence, Offenders, Victims, Psychopathology.

Depersonalization-derealization syndrome is an under researched clinical phenomenon and is often under diagnosed. We present a case of 42 years old female, who presented with complaining of feeling that her stomach is always empty in spite of adequate food and water intake for the past 7 months. She also reported that all the emotions, bodily movements appeared as if they are not her own. However, reality testing was intact. Phenomenon of primary depersonalization derealization syndrome is relatively rare. Selective serotonin reuptake inhibitors (SSRIs) may be considered as a pharmacological treatment option for the treatment of the condition. Keywords: Depersonalization, Derealization, SSRIs.

Introduction: The novel coronavirus disease-19 (COVID-19) which started in China has now spread across the world. Many measures to contain the pandemic are being employed like hospitalization of patients tested positive, quarantine of contacts, and social distancing. The consequent social isolation and the uncertainty of the disease has led to psychological distress. Aims and Objectives: The aim was to study the psychological distress and its associated factors in patients hospitalized for COVID-19. Materials and Methods: A cross-sectional study was done in a designated COVID center where patients tested positive were admitted from all over the state. A total of 222 hospitalized COVID-19 patients were screened using the Patient Health Questionnaire-4 and those who screened positive had their diagnosis confirmed by using the International Classification of Disease 10 criteria. Results: A total of 222 patients were screened of which 22.1% showed distress, 12.6% showed mild distress, and 9.5% moderate distress. Depression criteria were met by 5.5% and 3.2% had generalized anxiety disorder. Factors significantly associated with distress were deaths in the family and duration of hospitalization, whereas family members affected with COVID-19 were inversely related to psychological distress. Conclusion: Having a number of family members affected and simultaneously admitted in the same hospital seems to have acted as a buffer against psychological distress. However, deaths in the family due to COVID-19 and long duration of hospitalization were found to be factors associated with psychological distress. Efforts should be made to treat not only the physical health but also address the psychological distress in patients hospitalized for COVID-19.

Objective: This study was carried out to assess bone regeneration following the use of polycaprolactone (PCL) scaffold in maxillary and mandibular osseous defects. Materials and Methods: This prospective study included ten patients with maxillary or mandibular osseous defects present due to enucleation of periapical cysts or alveolar clefts requiring bone grafting and for lateral ridge augmentation that were treated with PCL scaffold. The patients were assessed clinically for pain, swelling, infection, and graft exposure at 1 week, 3rd, and 5th month postoperatively and were also evaluated radiographically for bone fill using intraoral periapical and/or panoramic radiographs at 4th, 6th, and 9th month postoperatively. Results: PCL scaffold was used in a total of six alveolar clefts and three cases of periapical cysts and one case of lateral ridge augmentation. Nine out of ten cases demonstrated wound dehiscence and scaffold exposure in the oral cavity. Radiographically, on comparison to the control regions, all these nine cases failed to demonstrate appreciable bone density gain. Only one case of radicular cyst in the mandible was recorded to have satisfactory healing. Conclusion: Although PCL scaffold has the potential for bone regeneration in osseous defects, the scaffold exhibited marked tendency for dehiscence in intraoral defects that significantly affected bone healing. A long-term study designed with a larger sample size and categorization of the defects is required to assess its efficacy in varied defects. Moreover, comparative evaluation of PCL and autogenous or alloplastic bone grafting material could provide assenting results.

Objective: The objective of this study was to evaluate the process of surgical site marking (SSM) and compare the actual practice with the recommended practices. Methodology: This was a prospective study involving 768 patients from 19 accredited hospitals located in different regions of India and are members of the Consortium of Accredited Healthcare Organizations. The study was performed over a period of 45 days. While performing the study, proportionate to size sampling methodology was used. The total number of surgeries performed per month in the top six specialties (in terms of volume) of the participating hospitals were considered. Further, in a particular specialty out of the six top specialties of the hospital, the auditors randomly selected the top three most frequently performed surgeries and studied the SSM process as per the predefined Pro forma. The observations of the study were then compared (and analyzed) with the recommended practices as per the guide to SSM, High 5 S by Haute Autorite d e Sante and CEPPRAL, October 2012. Results: In this study, the actual side marking was done in 85% of the surgeries that required side marking and 81% had site marking done. Surgical site in majority of the patients was marked in preoperative bay (43.8%). Moreover, surgical sites in 57.9% of the patients were marked by operating surgeons themselves, while others were delegated to nurses or technicians. Surgical side marking was done on 88.3% of the surgeries performed on paired organs. In surgeries with laterality such as hernia repair, the marking was done in 90% when the open surgery was performed and 70% for laparoscopic surgeries. Surgical site markings were visible before and after the site preparation in 63.2% and 46.5% of patients, respectively. It was pertinent to note that the SSM markings were not visible in 17.8% and 34.5% of the cases before and after skin preparation and 19% did not have the site marking. This percentage is quite high and thus an important area of concern. In addition, only in 36.1% of the patients, the SSM was visible within 6 inches from the incision. Crosses (27.7%) were the most common markings used. It is crucial that the nurses checked the patient's SSM only in 42.7% of cases in the wards and 74.1% of cases preoperatively in operation theater (OT), thereby a strong need to strengthening, streamlining, and standardization of the process of SSM to avoid missing out of cases. The surgical site marks were verbally and physically checked in 6.8% and 67.3% of the patients and not checked for 25.9% of the cases. Similarly, the surgical team inside the OT checked the surgical site marks verbally and physically in 17.6% and 77.7% of the patients, respectively. Conclusions: The findings of this study demonstrate that SSM procedure is practiced in majority of the hospital audited, but operating surgeons involved in this procedure were far from desired. Surgeons should be sensitized and educated and specialty-based protocols are to be framed so that they are strictly followed. There is a need to bring about national guidelines on the safe practice of SSM. Once protocols are in place and implemented, further studies will be required in future to assess their practice.

Background: Public transportation is an example of high-strain occupation and its workers are dealing with immense stress. Occupational stress has been seen to promote tobacco use and this habit is widely present among the transit workers. Both occupational stress and tobacco habit have their adverse effect on general as well as oral health. Aim: This study aims to assess the association of occupational stress and nicotine dependence with oral health status among public transit workers in Bangalore city. Materials and Methods: This cross-sectional survey was conducted among 450 public transit workers in Bangalore. The extent of occupational stress was assessed using 20-item questionnaire. Nicotine dependence was measured using the Modified Fagerstrom Tolerance scale for smoking and smokeless tobacco. Recording of oral mucosal lesion and community periodontal index were done for the assessment of oral health status. Data were analyzed using statistical Package for Social Sciences software (SPSS version 24) using Chi-square test and binary logistic regression (P < 0.05). Results: The results of bivariate and multivariate analysis elicited significant association of periodontal health with gender (P = 0.011), level of nicotine dependence for smoking (P = 0.008) and smokeless tobacco (P = 0.002) and occupational stress (P = 0.035). The oral mucosal lesion was seen to be associated only with level of nicotine dependence for smoking (P = 0.008) and smokeless tobacco (P < 0.001). Conclusion: In the present study, poor oral health status was associated with occupational stress and nicotine dependence. As these factors have individual as well as synergistic effect on oral health, a multirisk approach and workplace interventions to reduce job stress and strategies to promote oral health are the need for status quo.