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Objectives. This study aimed to examine the peculiarities of strength effort assessment in girls aged 10, 11, and 12 years. Specifically, it sought to understand how these age groups evaluate effort at different percentages of their maximum strength (1/3, 1/2, and 2/3). Materials and methods. The study involved 75 girls divided into three age groups: 10 years (n = 20), 11 years (n = 25), and 12 years (n = 30). Participants' maximum hand strength was measured using a dynamometer, and their ability to assess effort at 1/3, 1/2, and 2/3 of this maximum was recorded. Results. The error of effort assessment was calculated and analyzed using paired and independent samples t-tests. Statistical significance was set at α = 0.05. The analysis revealed no significant age-related differences in hand maximum strength or strength effort assessment among the different age groups. The most accurate assessment of effort occurred at 2/3 of maximum strength for all age groups. Significant differences were found in effort assessment between 1/3 and 1/2 of maximum strength, and between 1/3 and 2/3 of maximum strength, with improvements noted as the effort percentage increased. However, no significant differences were observed between effort levels at 1/2 and 2/3 of maximum strength. Conclusions. The study indicates that the ability to assess strength effort remains stable across the age range of 10 to 12 years, with the most precise assessment occurring at 2/3 of maximum strength. The findings suggest that while overall strength assessment abilities are consistent, targeted training may enhance precision at different effort levels. This contributes to the understanding of motor function development and highlights the need for interventions to improve effort assessment skills in young girls. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: The effect of dental malocclusion and management on functional and psychological wellbeing is a topic of interest. Aim: The study was conducted to assess the change in the psychological effect of malocclusion using PIDAQ (Psychosocial Impact of Dental Aesthetics Questionnaire) adopted for Indian subjects after 1 year of orthodontic treatment. Methods: The study assessed 186 subjects needing fixed orthodontic treatment where PIDAQ translated in Hindi was used after pretesting. All subjects were asked to answer the questionnaire at pretreatment and 1 year following treatment as T1 and T2. Also, IOTN (Index of Orthodontic Treatment Need) was used to assess self-perception and severity of malocclusion. Results: A statistically significant decrease in each factor and total PIDAQ score was seen after 1 year of treatment (P < 0.001). A positive association was seen between IOTN-AC (IOTN-Aesthetic Component) and psychological malocclusion impact. Conclusion: The psychometric PIDAQ scores instrument can be used as an OHRQoL (Oral Health-Related Quality of Life) assessment tool in Indian subjects for further research assessment. [ABSTRACT FROM AUTHOR]

Background: Understanding pathways to dual diagnosis (DD) care will help organize DD services and facilitate training and referral across healthcare sectors. Aim: The aim of our study was to characterize the stepwise healthcare and other contacts among patients with DD, compare the characteristics of the first contact persons with common mental disorder (CMD) versus severe mental illness (SMI), and estimate the likelihood of receiving appropriate DD treatment across levels of contacts. Methods: This cross-sectional, descriptive study in eight Indian centers included newly enrolled patients with DD between April 2022 and February 2023. The research spans varied geographic regions, tapping into regional variations in disease burden, health practices, and demographics. The study categorized healthcare contacts by using the WHO Pathways Encounter Form. Results: The sample (n = 589) had a median age of 32 years, mostly males (96%). Alcohol was the most common substance; SMI (50.8%) and CMD were equally represented. Traditional healers were a common first contact choice (18.5%); however, integrated DD care dominated subsequent contacts. Assistance likelihood increased from the first to the second contact (23.1% to 62.1%) but declined in subsequent contacts, except for a significant rise in the fifth contact (97.4%). In the initial contact, patients with CMD sought help from public-general hospitals and private practitioners for SUD symptoms; individuals with SMI leaned on relatives and sought out traditional healers for psychiatric symptoms. Conclusion: Recognizing the cultural nuances, advocating for integrated care, and addressing systemic challenges pave the way to bridge the gap in DD treatment. [ABSTRACT FROM AUTHOR]

Background: Substance use disorders (SUDs) are among the leading causes of morbidity in the population. In low- and medium-income countries like India, there is a wide treatment gap for SUD. A multicentric study on the care pathways for SUD in India can help to understand service provision, service utilization, and challenges to improve existing SUD care in India. Aim: We aimed to map pathways to care in SUD. We compared the clinical and demographic characteristics of patients who first consulted specialized services versus other medical services. Methods: This was a cross-sectional study of consecutive, consenting adults (18-65 years) with SUD registered to each of the nine participating addiction treatment services distributed across five Indian regions. We adapted the World Health Organization's pathway encounter form. Results: Of the 998 participants, 98% were males, 49.4% were rural, and 20% were indigenous population. Addiction services dominated initial (50%) and subsequent (60%) healthcare contacts. One in five contacted private for-profit healthcare. Primary care contact was rare (5/998). Diverse approaches included traditional healers (4-6%) and self-medication (2-8%). There was a 3-year delay in first contact; younger, educated individuals with opioid dependence preferred specialized services. Conclusion: There is a need to strengthen public healthcare infrastructure and delivery systems and integrate SUD treatment into public healthcare. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the effects of two sessions per week plyometric training on different surfaces on the counter movement jump height, take-off force, and maximum concentric power of collegiate athletes. Material and methods: Male collegiate athletes (n=24, age=18.46±1.14 years, weight=64.88±5.61 kg and height=1.72±0.07 metres)) from a physical training centre were randomly and equally assigned to three groups, each trained on different surfaces (synthetic, cinder and sand). The training intervention was implemented twice a week and lasted for 8 weeks. The athletes were tested before and after the intervention to assess changes in the performance of counter movement jump height (CMJHT), take-off force (CMJTOF) and maximum concentric power (CMJMCP). Results: Results showed that overall measurement of CMJHT, CMJTOF and CMJM-CP improved significantly (p≤0.05, Δ%=10.50; p≤0.05, Δ%=11.11; p≤0.05, Δ%=11.41). However, training surfaces have no significant effect on the improvement of the selected variables (CMJHT:F(2,21)=2.37, p=0.118, ηp²=0.184; CMJTOF:F(2,21)=1.28, p=0.299, ηp²=0.109; CMJMCP:F(2,21)=0.061, p=0.941, ηp²=0.006). Further, for the synthetic track surface group CMJHT, CMJTOF and CMJMCP improved significantly (p≤0.05, Δ%=16.36; p≤0.05, Δ%=17.50; p≤0.05, Δ%=17.99); for the cinder track surface group CMJHT and CMJMCP improved significantly (p≤0.05, Δ%=9.15; p≤0.05, Δ%=10.33) and for the sand surface group only CMJHT improved significantly (p≤0.05, Δ%=5.68). Conclusions: The findings suggest that plyometric training on different surfaces can effectively improve athletic performance, but the specific surface type does not appear to impact the outcomes significantly. The study further suggested analysing the injury risk associated with plyometric training on various training surfaces and discovering the optimal training surface for minimising injury risk while maximising performance gains. [ABSTRACT FROM AUTHOR]

Background and Aim: Pandemic and consequent lockdowns are likely to affect the drug market by the sudden disruption of the supply chain. We explored the change in the availability, access, purity, and pricing during lockdown from respondents seeking treatment for drugs, alcohol, and tobacco dependence. Materials and Methods: A cross-sectional survey was conducted among 404 respondents from seven treatment centers across India. A structured questionnaire assessed the change in availability, access, quality, and price of substances used during the first phase (March 24–April 14) and the second phase (April 15–May 3) of lockdown. Results: A majority of the respondents in treatment used tobacco (63%) and alcohol (52%). Relatively few respondents used opioids (45%) or cannabis (5%). Heroin (44%) was the most common opioid the respondents were treated for. Seventy-five percent, 65%, and 60% of respondents treated for alcohol, tobacco, and opioid problems, respectively, reported a reduction in the availability and access during the first phase of the lockdown. In the second phase, respondents with alcohol and tobacco dependence reported greater availability than those with opioid and cannabis dependence. The reported price of all substances increased more than 50% during the first phase of lockdown and remained higher throughout the second phase. Deterioration in purity was reported by more than half of the people who used opioid. Conclusion: Lockdown could have affected both licit and illicit drug markets, albeit to a varying degree. The observed changes seemed short-lasting, as suggested by the recovering trends during the second phase of lockdown. [ABSTRACT FROM AUTHOR]

Background: The unprecedented first wave of the COVID-19 pandemic severely impacted mental health services globally. However, the negative impact of such disruptions on people with substance use disorders (SUD) seeking treatment remains unclear. We aim to explore the behaviors adopted by these individuals to overcome the service disruptions. Materials and Methods: We explored the changes related to substance use behavior (quit attempts, withdrawal experienced, treatment-seeking, and risky behaviors), and behavioral changes in response to COVID-19 lockdown. A cross-sectional survey was conducted among 404 people with SUD seeking treatment from seven centers across India. They were assessed by a specially designed structured questionnaire during the first wave (June–September) of the pandemic. Results: An overwhelming majority experienced withdrawal symptoms, with close to half making quit attempts and seeking treatment during the lockdown. Three-fourth of the sample reported difficulty in accessing treatment services and medications. Patients with opioid use were significantly more likely to think about quitting (χ2 = 20.408, P = 0.000), make attempts (χ2 = 12.436, P = 0.000), seek treatment (χ2 = 7.536, P = 0.006), and self-medicate for withdrawal symptoms (χ2 = 5.885, P = 0.015). In turn, those with alcohol use were more likely to use telepsychiatry services (χ2 = 35.143, P = 0.000) and experience stigma by family members (χ2 = 29.951, P = 0.000) and neighbors (χ2 = 17.725, P = 0.000). Among COVID-19 safety precautions, majority practised wearing masks and social distancing but not others. Conclusion: COVID-19 lockdown led a significant proportion of substance users, especially opioid users, to make quit attempts and seek help. However, these could not be sustained due to difficulty in accessing treatment services. Further, significant proportion failed to adhere to COVID-19 safety precautions. [ABSTRACT FROM AUTHOR]

Background: The literature on sexual dysfunction in patients on buprenorphine-naloxone (BNX) substitution is limited. Materials and Methods: This research aimed to study the prevalence and correlates of sexual dysfunction in men on BNX substitution therapy. We recruited consecutive forty men from BNX clinic, who had received BNX for at least 6 months, who were free from any recent illicit drug use (confirmed by urine chromatographic immune assay), and who were either married or had a stable sexual partner. Men with other psychiatric and substance use disorders (except tobacco) were excluded from the study. Data for the control group were obtained from a published study (with similar selection criteria) from our center. We assessed sexual dysfunction with two cross-culturally validated instruments: Arizona Sexual Experience Scale (ASEX) and International Index of Erectile Function. Results: The sample had a mean age of 31.6 (±8) years; the mean duration of BNX treatment was 9 (±4.2) months and the mean BNX dose was 4.5 (±1.6) mg. ASEX showed the prevalence of sexual dysfunction to be 40%. The IIEF demonstrated intercourse dissatisfaction (95%) and hypoactive sexual desire (92.5%) as almost universal, while 77.5% of the participants reported erectile dysfunction. In comparison to the published data, these figures were significantly more than among the controls. We found no correlation of sexual dysfunction with marital status, age, duration or dose of BNX, duration of illicit opioid use, the severity of opioid dependence, and tobacco dependence. Conclusion: All men on BNX maintenance therapy must be screened for sexual dysfunction. With the rapid scaling up of office-based BNX substitution, assessment and management of sexual dysfunction ought to be incorporated in the training curriculum. [ABSTRACT FROM AUTHOR]

Next question is whether dystonias in these patients occurred as a result of direct effect of heroin or due to the adulterants (or cutting agents) mixed with it. The exact mechanism of chloroquine-induced dystonia has not been identified, but chloroquine is believed to cause an imbalance in the neurochemical control of psychomotor activity in the basal ganglia.[[10]] So, chloroquine could be the second candidate which can produce dystonia. [Extracted from the article]

Background and objective Substance use disorders pose significant global public health challenges, with India being no exception. Bihar, one of India's most populous states, implemented alcohol prohibition in April 2016 to address the adverse effects of alcohol abuse. However, the impact of this policy on overall substance use behavior among patients in healthcare settings remains to be explored. This cross-sectional study aimed to evaluate the changing trends in substance use behavior among patients in the tertiary care setting following the prohibition of alcohol use in Bihar. Methods A total of 372 patients diagnosed with substance use disorders were recruited from tertiary care facilities in Bihar. Data on demographic characteristics, types of substances used, frequency and quantity of use, reasons for use, and awareness of prohibition laws were collected through structured interviews and reviews of medical records. Descriptive and inferential statistics were used for data analysis. Results The majority of the participants were male (n = 346, 93.01%), with a mean age of 38.5 years. While tobacco use remains stable, there are significant increases in opioid and cannabis consumption post-prohibition, highlighting unintended consequences (p-values - opioids: 0.008, cannabis: 0.021). Additionally, heightened daily and weekly substance use after prohibition is evident (p-values: daily: 0.008, weekly: 0.021), emphasizing the necessity for nuanced policy considerations. Reasons for substance use, including coping with stress and peer pressure, showed significant differences before and after the prohibition (p<0.05). Moreover, awareness of alcohol prohibition laws increased significantly after the implementation of the prohibition (p = 0.003). Conclusions Our findings suggest that while alcohol prohibition in Bihar did not significantly lead to any changes in terms of the types of substances used among patients in tertiary care settings, it did influence the frequency and quantity of tobacco and cannabis consumption. Increased awareness of prohibition laws underscores the importance of policy enforcement and public education initiatives in addressing substance use behavior., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Research Committee, All India Institute of Medical Sciences, Patna issued approval AIIMS/Pat/IRC/2020/349. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Prasad et al.)

The role of lacosamide (LCM) as add on treatment modality in dissociative disorders (DD) is of interest. It was a randomized control trial in which 300 patients diagnosed with dissociative disorders having treatment for the dissociative disorders were included. They were divided into two groups. Group one consisted of intervention group in which LCM was also administered along with conventional psychiatric medication for different dissociative disorders. Group two consisted of control group where the patients of dissociative disorders were found to have conventional medication. There was analysis of improvements in recovery of symptoms and quality of life. There was statistically significant increase in excellent, very good, good and fair quality of life and decrease in poor and satisfactory quality of life in intervention group after drug intervention. It was observed that symptoms of the patients improved in 50.67% cases in intervention group and 10.67% cases in control group. There was greater improvement in recovery of symptoms and quality of life in patients of DD in which LCM was administered as add on medication., (© 2024 Biomedical Informatics.)

Background: The COVID-19 pandemic is known to affect mental health of sufferers. Psychological First Aid (PFA) is a mental health service for individuals in crisis, which can be provided to anyone regardless of age and it does not require mental health expertise. Its effect on mental health issues of COVID-19 patients has not been studied effectively. The present study aimed to assess the psychological impact and effect of PFA on mental health in stable COVID-19 hospitalized patients., Subjects and Methods: This was an interventional study with a pre-post research design in a tertiary government teaching hospital in eastern India. 93 stable patients who were admitted in a period of a month with COVID-19 were included in the study after obtaining appropriate consent. They were provided PFA (both structured individual and group sessions) by trained nurses. The Depression, Anxiety, and Stress scale (DASS-21) was used to assess depression, anxiety, and stress in the patients before and after intervention., Results: The mean age of study population which comprised of 68.8% males was 56.2 ± 13.7 years. Median scores for depression, anxiety and stress were 4, 6 and 6 on admission and 0, 2 and 2 respectively before discharge after intervention (P<0.001). 13%, 25.9% and 8.6% were the combined percentages scores of patients with varying levels of depression, anxiety and stress at the time of admission which were reduced to 4.3% (P=0.046), 5.4% (P=0.001), 2.2% (P=0.03) respectively before discharge after intervention within one week., Conclusion: PFA may be a cost-effective intervention in stable COVID-19 admitted patients who had depression, anxiety, and stress.