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Byline: Utpala. Kharod, Nirali. Panchal, Jagdish. Varma, Krupa. Sutaria Background and Aims: Pre-operative anxiety can affect psychological and physiological parameters during the intra-operative period. Pharmacological measures used to reduce pre-operative [...]

Background. We initiated a conversation regarding the concept of professional identity formation (PIF) with faculty of Institute of Nursing at our university through a participatory workshop. We report the planning and conduct of the workshop, as well as lessons learnt from the discussions in the workshop. Methods. We designed and implemented a day-long workshop for 28 nursing faculty at Institute of Nursing, Bhaikaka University, Gujarat. The expected learning outcomes of the workshop were to: (i) understand the concept of PIF and process of socialization; (ii) identify factors influencing socialization; and (iii) discuss strategies to support PIF. The workshop included a series of four small group discussions, each followed by debriefing. We collected feedback using a questionnaire with 4 open-ended questions and written reflections on the learnings, within 2 days of the workshop. We carried out manual content analysis of text data generated during group work, reflections and feedback. Results. Twenty-six of the 28 participants responded to the questionnaire. Thirteen mentioned interactions during group activities and discussions with facilitators as a good part of the workshop. Constructive suggestions on improving the workshop were received from 13 respondents. Twenty-three respondents reported they would make changes in their practice after the workshop. Five respondents found the activity on roles and responses during socialization as needing more discussion. Key themes identified from the participants' reflections were: (i) their different views about professional identity, (ii) experiences and reactions and (iii) their future action plan. Conclusions. The workshop was well received by the participants. Our approach to the workshop might help other institutions design and implement similar activities as a part of their faculty development programme. [ABSTRACT FROM AUTHOR]

Background. Medical educators in India made rapid adjustments to maintain continuity and integrity of medical education in the midst of disruption caused by the Covid-19 pandemic. However, there are concerns regarding achievement of competence by undergraduate medical students due to inadequate clinical exposure. We explored the focus of initiatives from medical educators in India by a scoping review of published articles on developments in medical education during the pandemic to map concepts, main sources and the literature available in PubMed. Methods. We did this scoping review of published articles in PubMed database in four steps: (i) identification of research questions; (ii) identification of relevant studies; (iii) selection of studies meeting inclusion and exclusion criteria, and charting of data; and (iv) collating the summary and reporting of results. Manual content analysis was done to derive frequencies of variables. Results. Of the 52 articles identified, 22 met the requirements. Most studies (68.2%) were published in 2020. Half of the studies were conducted among undergraduate students and the remaining among postgraduates (27.3%), faculty (18.2%) and interns (4.5%). All the studies were evaluations at Kirkpatrick level-1 (18; 81.8%) and level-2 (4; 18.2%). Most of the studies (9, 41%) focused on exploration of perspectives about online learning among students and faculty, 9 (27.3%) on teaching-learning, 4 (18.2%) on formative assessment and 3 (13.6%) on summative assessment. Conclusions. Most studies were evaluations at Kirkpatrick level-1 and level-2 among undergraduate medical students with a focus on conceptual understanding. [ABSTRACT FROM AUTHOR]

Background: India's population has seen increasing access to the Internet and gaming mainly in adolescents and young adults. Aim: The aim of the study was to assess the prevalence and correlates of Internet gaming and its effects on the psychological well-being of gamers versus nongamers. Materials and Methods: Cross-sectional survey was done to enroll a convenient sample of nongamers, violent gamers, and nonviolent gamers. Measures included Psychological general well-being scale-short (PGWB-S), Internet Gaming Disorder-Short Form-9 (IGDS9-SF), name, frequency, and duration of game use. Results: The study enrolled 119 nongamers, 62 violent gamers, and 58 non-violent gamers. The prevalence of IGD was 0.8%. PGWB-S scores of gamers were comparable to nongamers. On multiple linear regression, lower PGWB-S score and higher frequency of use were found significantly associated with higher IGDSF-S9 scores. Violent gaming was found significantly associated with male gender (P ≤ 0.001), frequency (P = 0.012), and duration of game use (P ≤ 0.001). Conclusions: The study provides empirical evidence for the "gaming as a consequence of self-medication" hypothesis. [ABSTRACT FROM AUTHOR]

Introduction: In the face of the coronavirus disease 2019 (COVID-19) pandemic, the leadership of the institute felt a need for mental health interventions among patients admitted in COVID-19 isolation, university students, and health-care workers engaged in COVID-19 care. This article aims to share our experience in providing these services. Methodology: COVID-19 inpatients were telephonically counseled. Counseling protocol was based on national guidelines. Students of the university were assessed for emotional problems using a symptom checklist and Kessler 10‑item Distress Scale. Subsequently, the faculty assigned as mentors were trained in providing telephonic psychological first aid (PFA) to the students. Psychosocial help was offered to health‑care workers through daily guided relaxation sessions. Results: Forty-two of 69 COVID‑19 inpatients were telephonically contacted. New‑onset mental health problems were found in 40%. Half of the COVID‑19 confirmed patients and half of the females had a higher prevalence of mental health problems. On the symptom checklist, 330 students were responded. Worry about the future, contagion, and boredom were reported by the majority of students. On the Kessler 10-item Distress Scale, 272 students were responded. Thirty-seven percent had likely mental disorders (22 males and 79 females). Twenty-two students contacted psychiatrists through mentors and were provided teleconsultation. Eighty health-care workers attended guided relaxation sessions. Twenty-nine responded on the feedback form. Most respondents felt guided relaxation was useful in reducing stress, with strongly agree (n = 12) and agree (n = 14) responses. Conclusions: Emotional problems were significantly prevalent among students and COVID‑19 patients. Training faculty in PFA can help address students in distress. Guided relaxation may help frontline workers manage stress. [ABSTRACT FROM AUTHOR]

Background: Burnout syndrome has been widely reported in nursing staff. It is more pronounced in intensive care setting (up to 80%). This survey was designed to assess the prevalence of burnout and its correlates among critical care nurses. Methods: Anonymous questionnaire was distributed to all ICU nursing staff of a tertiary care teaching hospital. Questionnaire had 25 questions covering – demography, job characteristics, Visual Analogue Scale for stress, co-worker support, work–life balance, question for measuring burnout, job satisfaction, turnover intention, organizational commitment, for depression screening and psychosomatic symptoms. The burnout scale score was used to dichotomize into low burnout (<3) or high burnout (> = 3) group. These two groups were compared using Chi-square test, Fischer's exact test for categorical variables and independent t-test for continuous variables. Significant variables were entered in multivariate logistic regression analysis. Results: Out of 150 ICU nurses, 125 (83.3%) gave completely filled questionnaires which were evaluated. 47 (37.6%) participants reported experiencing high burnout. Binary logistic regression model revealed that lack of specialized ICU training (OR = 4.28, 95% CI: 1.62 to 11.34, P = 0.003), performing extra duty in last month (OR = 5.28, 95% CI: 1.90 to 14.67, P = 0.001), High physical symptoms in last 12 months (OR = 4.73, 95% CI: 1.56 to 14.36, P = 0.006) and mid-level experience (1–5 years) were significantly associated with burnout. Conclusions: Burnout is significantly prevalent (37.6%) among intensive care nurses. Specialized training and limiting work hours can help in mitigating this problem. High frequency of physical symptoms could be early indicators of burnout. [ABSTRACT FROM AUTHOR]

Context: Vitiligo is an autoimmune pigmentary disorder characterized by localized or generalized depigmentation of the skin. It is associated with significant stigma and has impact on patient's quality of life (QoL) and psychological wellbeing. Aims: To see the variance in QoL and level of depression in vitiligo patients with extent of vitiligo. Materials and Methods: Vitiligo patients aged ≥18 years attending OPD were included in the study. Impairment in QoL was assessed by administering DLQI (Dermatology Life Quality Index) and VIS22 (Vitiligo Impact Scale22). Depression was assessed by administering QIDSSR16 (Quick Inventory of Depressive Symptomatology). The Vitiligo Area Scoring Index (VASI) was calculated based on clinical examination. Results: One hundred and fifty patients enrolled. Most common age group was 18–30 years. Mean DLQI, VIS22, QIDSSR16 scores were 7.02, 16.37, 5.87, respectively. QoL was affected to some extent in 85.3% and 86.7% according to the DLQI and VIS22, respectively. Depression was seen in 44%. Coclusion: Young patients showed higher impairment in QoL and also higher levels of depression. It would be useful to offer psychiatric consult and counseling in addition to specific treatment.Context: Vitiligo is an autoimmune pigmentary disorder characterized by localized or generalized depigmentation of the skin. It is associated with significant stigma and has impact on patient's quality of life (QoL) and psychological wellbeing. Aims: To see the variance in QoL and level of depression in vitiligo patients with extent of vitiligo. Materials and Methods: Vitiligo patients aged ≥18 years attending OPD were included in the study. Impairment in QoL was assessed by administering DLQI (Dermatology Life Quality Index) and VIS22 (Vitiligo Impact Scale22). Depression was assessed by administering QIDSSR16 (Quick Inventory of Depressive Symptomatology). The Vitiligo Area Scoring Index (VASI) was calculated based on clinical examination. Results: One hundred and fifty patients enrolled. Most common age group was 18–30 years. Mean DLQI, VIS22, QIDSSR16 scores were 7.02, 16.37, 5.87, respectively. QoL was affected to some extent in 85.3% and 86.7% according to the DLQI and VIS22, respectively. Depression was seen in 44%. Conclusion: Young patients showed higher impairment in QoL and also higher levels of depression. It would be useful to offer psychiatric consult and counseling in addition to specific treatment. [ABSTRACT FROM AUTHOR]

Context: Adolescent well-being is a priority area for health-care interventions in the 21st century. Yoga-nidra is an ancient Indian method of enabling individuals to attain a positive state of deep physical, mental, and emotional relaxation. The practice produces a state of simultaneous relaxation and detachment resulting in inner awareness and release of stress on all planes of one's being. Aim: This mixed method study was carried out in adolescent students aged 13–15 years with an aim to assess effects of Yoga-nidra on various dimensions of well-being. Materials and Methods: Thirty-six students received Yoga-nidra sessions 30 min daily for 3 days in a week for 1 month. Primary outcome measures were happiness, perceived stress, overall quality of life, and psychological general well-being. These and other experiential dimensions of well-being comprising of enthusiasm, alertness, quietude, clarity of thought, control over anger, self-confidence, and self-awareness were evaluated before and after intervention. Qualitative observations were recorded from participants, their teachers, and parents. Results of quantitative and qualitative methods were analyzed and compared. Results: Yoga-nidra intervention resulted in significant improvement in all primary outcome measures. Participants reported significant improvement in the feelings of happiness, enthusiasm, quietude, being more inspired and alert, active, having clarity of thought, control over anger, and self-confidence at the end of the study period. Mixed method design of the study provided cross-validation and convergence of results obtained from quantitative and qualitative assessment tools. Conclusion: Yoga-nidra is beneficial in improving multiple dimensions of adolescent well-being. [ABSTRACT FROM AUTHOR]

Higher attendance rates may be explained by 1) optimum use of teaching-learning methods (TL methods) to generate interest amongst the students, regular assessment process (for theory and practical) and 2) strict adherence to the attendance policy. Sir, We read the article "Absence of undergraduate medical students from psychiatric training: A study from central India" with interest.[[1]] The authors have reported low attendance by undergraduate medical students in psychiatry. TL methods used by the department include the use of OSCE, simulated role-plays, and mental status examinations skills practice on patient videos. [Extracted from the article]

Background. Our medical college is running a mentoring programme for undergraduate medical students since 2009. The academic leadership of the college identified the need to change the focus of the programme from mere problemsolving to professional and personal development of mentees. Methods. A core group of mentors designed and implemented a workshop on mentoring for 28 students. The workshop included reflections on the participants' previous experiences about mentoring, discussion on perceptions of mentees about the existing mentoring programme, self-analysis of mentoring skills, overview of the Surrendering, Accepting, Gifting and Extending (SAGE) model and demonstration of effective mentoring skills using role plays and a film. We collected written anonymous feedback from participants at the end of the workshop to elicit their responses regarding various aspects of the programme, change in their views about mentoring and suggestions for future workshops. Results. A majority of the participants (17, 60.7%) said that role plays and reflection on role plays were the most valuable part of workshop as they provided clarity on the concepts about mentoring. The most frequently identified take-home messages were: building trust with the mentee (7, 25%), balance in life and approach towards the mentee (6, 21.4%), and understanding that mentoring is a process geared towards personal and professional development of the mentee (6, 21.4%). Conclusion. The participants' reaction to the workshop was positive. The responses of participants suggested that the workshop was successful in changing their views regarding the purpose of the mentoring programme. [ABSTRACT FROM AUTHOR]

Depression is a common illness, affecting >264 million people worldwide. According to the literature, depression patients have baseline subclinical inflammation. The immunomodulatory effects of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), are largely unclear and poorly understood. Using evidence-based medicine, this study aimed to determine the immunomodulatory effects of SSRIs by assessing changes in immunomodulatory markers following SSRI treatment. Using the PubMed website, a literature search was conducted with various terminologies related to the treatment of depression and various markers of inflammation. Out of 387 retrieved articles, after critical appraisal and screening based on inclusion and exclusion criteria, 17 were selected. Qualitative synthesis and quantitative analysis were carried out. RevMan 5 software was used to synthesize and evaluate the data. Microsoft Word and Excel (Microsoft Corporation, Redmond, Washington, United States) were used for generating tables and figures. We extracted data from a total of 839 patients in 17 studies. A highly significant reduction in interleukins-6 (IL-6) (standardised mean difference (SMD) = 1.32 (95% confidence interval (CI): 0.58, 2.06), Z = 3.48, P = 0.0005), a significant reduction in tumor necrosis factor-alpha (TNF-α) (SMD = 1.29 (95% CI: 0.19, 2.39), Z = 2.30, P = 0.02) but no change in overall C-reactive protein (CRP) (SMD = 0.40 (95% CI: -0.26, 1.07), Z = 1.19, P = 0.23) levels were observed by using the random-effects model. There was substantial heterogeneity found between the studies. SSRIs have an immunomodulatory effect in patients with depression by significantly reducing the peripheral pro-inflammatory cytokine markers of IL-6 and TNF-α, which may contribute to ameliorating the response to antidepressant drug treatment. In contrast, no effects of SSRIs on acute-phase protein CRP were found., Competing Interests: 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, Patel et al.)