A study on Instinctive Feelings, Perceived Stressors and Factors that helped in reducing Stress during COVID 19 pandemic among Health Care Workers

Background: Healthcare workers at the forefront of the battle against COVID 19 are not only putting their own health and lives at risk but are also fighting to keep their own worries and emotional stress at bay. Aim & Objective: To evaluate emotions, perceived stressors, and factors that helped in reducing stress of healthcare workers who worked during a COVID19 pandemic. Settings and Design: This cross sectional study was conducted among Health Care staff involved in COVID 19 duty in tertiary care hospital of Gujarat. Methods and Material: Google form link was shared though what’s up and mail. The questionnaire was completed online. Consent for voluntarily participation was also obtained through online Google form. Statistical analysis used: Data was entered and analysed through Microsoft Excel 2010. Results: Total 106 participants responded to the questionnaire. It was extremely stressful for health care workers to see their colleagues getting infection, as well as the fear that they could transmit the disease to their families or friends. Main factors that helped to reduce the stress were positive attitude from colleagues, improvement of patients conditions and availability of protective equipment. Conclusions: Personal safety, the protection of family members and unpredictability of pandemic were the main concerns. Hospitals should prioritise stress monitoring for health care workers and provide targeted psychological guidance for HCWs during the pandemic.

Effectiveness And Safety Assessment Of Fixed Dose Combination Of Non-Steroidal Antiinflammatory Drugs Prescribed For Orthopedic Patients

Objective: Many Fix Dose Combinations (FDCs) being introduced in India are usually irrational. The most pressing concern with irrational FDCs is that they expose patients to unnecessary risk of adverse drug reactions, for instance, pediatric formulations of nimesulide+paracetamol. Despite their wide clinical use, their gastro-intestinal toxicity is a major limitation. The aim of the present work was to evaluate the efficacy and safety of FDCs in non-steroidal anti-inflammatory drugs in the orthopedic department at a tertiary care teaching hospital. To study the effectiveness and safety parameters of fixed-dose combinations of Non-Steroidal Anti-inflammatory Drugs. Methods: This prospective, observational study was conducted among 150 out-patients of the orthopedic ward over a period of July 2013 to December 2013(Each combination with 50 patients). Three fixed-dose combinations utilized were paracetamol+diclofenac, paracetamol+ibuprofen and paracetamol+nimesulide. The effectiveness was analyzed by using Visual Analogue Scale (VAS) and Disease Activity Scale (DAS) and the safety criteria were analyzed by using the WHO probability scale and Naranjo scale. 150 orthopedic patients attending Out Patient Department were included. 50 participants for each of the combinations of fixed-dose combination (FDCs) of NSAIDs. Results: Out of 150 patients 33 patients developed adverse effects, and 17(51.51%) adverse effects due to the combination of Paracetmol+Nimuselide, 11(33.34%) adverse effects due to the Paracetamol+Ibuprofen and 5 (15.15%) were due to the combination of Paracetamol+Diclofenac. The maximum effectiveness (3.55±0.208) showed in the combination of paracetamol+diclofenac compared to the other two combinations. Conclusion: It was concluded from this study that the effectiveness and safety profile of PCM+DICLO is better than the other two FDCs.

Assessment of mental health in medical students of GMERS Medical College, Patan, Gujarat

Background: Medical students are more likely to developmental disorders such as anxiety disorders, major depressive disorder, and psychiatric comorbidity as compared to other students. Mental distress can lead to poor classroom performance, poor communication, and frequent medical errors, burnout, social isolation, suicidal thoughts, substance abuse, cynicism, and harm to self and others. An active coping approach such as positive framing, talking to friends, family member, leisure activities, and sport activities can reduce stress level. Objectives: The objectives of the study were (a) to find out the prevalence of depression, anxiety, and stress among medical students and (b) to assess risk factors for emotional distress. Materials and Methods: This study was conducted among 530 MBBS student of Gujarat Medical Education and Research Society Medical College, Patan during October 2018–March 2019 after the Institutional Ethical Committee permission. A Depression Anxiety Stress Scale-21 was used to collect data on depression, anxiety, and stress. Other information such as sociodemographic, academic profile, and personal characteristics of students were collected. Results: The prevalence of depression, anxiety, and stress was 10.5%, 33.6%, and 38.3%, respectively, in medical students. The risk factors for emotional distress were female gender, residing at home, nuclear family, addiction, poor academic performance, less extracurricular activities, and positive family history. Joint family and strong relationship with friends were found protective against emotional distress. The prevalence of any emotional state was not affected by the number of supplementary exams, personal choice to join MBBS, and personal satisfaction with body image and life. Conclusion: Anxiety and depression are significant hidden problems in medical students. Substance abuse, less extracurricular activities, poor relationship with friends, and positive family history are risk factors for depression. Therefore, these risk factors should be identified and interventions to reduce stress should be carried out.

A cross-sectional study on awareness regarding breast cancer and its screening techniques in field practice area of GMERS Medical College, Dharpur, Patan, North Gujarat, India

Background: Breast cancer is one of the most dangerous and lately diagnosed cancers which precipitate high number of morbidity and mortality. Breast cancer is now the most common cancer in most cities in India. To prevent its occurrence, women should be aware of early signs of it. Early detection can be done by different screening techniques such as self-breast examination, clinical examination, and mammogram. Objectives: The objectives of this study were as follows: (a) To assess the awareness regarding breast cancer and their screening techniques among women and (b) to find out the associated factors of breast cancer and their awareness among women. Materials and Methods: The study was carried out among 100 women selected by purposive sampling residing in the field practice area of Gujarat Medical Education and Research Society Medical College, Dharpur, Patan, during January 2019–March 2019 after approval of the institutional ethics committee. Self-tested semi-structured questionnaire was used after performing a pilot study. Results: Very few female had personal and family history of breast cancer. Awareness regarding breast cancer was found higher in educated as compared to illiterate. Working women had more knowledge regarding the issue than housewife. Awareness regarding how often breast self-examination (BSE) should be performed and what to look for while doing BSE was awareness regarding BSE as a screening tool was found only in half of the study participants. Conclusions: The study participants who had personal and family history of breast cancer were well aware of the clinical signs of breast cancer and its screening techniques. Literate and working women were having more knowledge regarding breast cancer. Overall awareness regarding the disease and its screening techniques was low in the study population.

Perspectives of older person on health problem and health service utilization: A focus group study

Background: The state of well-being is generally involved happiness, autonomy, satisfying social relationships, and self-contentment. Joint pain was the most common morbidity followed by dental and chewing problem and decreased visual acuity. The community needs and perceptions about geriatric health are often ignored. Therefore, this study was conducted to assess the health of geriatric patient and awareness about medical service. Objectives: The objectives of the study were (a) to assess the health of the geriatric patient and (b) to obtain a perception of elderly participants about health service. Materials and Methods: Three Focus Group Discussions with seven participants in each group were conducted at rural area of Patan after taking permission from the Institutional Ethics Committee. The principal investigator was the moderator and observer noted down the verbatim. Seven to eight questions were prepared to direct the flow of discussion. The discussion lasted from 60 to 90 m. Results: Females were seen dominant in the discussions. Majority of participants (81.0%) had at least one disease. Most of them were suffering from aches followed by loss of vision, reducing hearing ability, and loss of teeth. Preserving good mental health, staying alert, and independent were important contributors to the health of elder person. Concept of Self Help Groups was suggested for increasing social participation. Poor economic status, self-rated poor health status, and having no faith in government medicine were obstacle in health-care services utilization. Conclusion: Dependency, low social participation and loneliness, negative attitude, no respect to elderly by a family member and ignored in decision-making may adversely affect the health of elderly. There is a need for caregiver support services to improve the health of the elderly.

In Vitro Evaluation Of Anti-Cancer Potential Of A3 Adenosine Receptor Agonist On A549 Human Lung Cancer Cell Line

Objective: The objective of this study was to evaluate the cytotoxic potential of A3AR agonist (ABMECA) against human lung cancer cell line A549 by using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay. Methods: Adenocarcinoma cell line A549 was used to assess MTT based cells viability. In vitro cytotoxic activity was evaluated for 3 different concentration of doxorubicin and A3AR by MTT cytotoxicity assay. Cytotoxicity assay carried out for 3 consecutive days that involves culturing cells into Dulbecco’s MEM medium modified with 10% FBS for 24 h then treatment with different dose of standard and test drug with incubation period of 24 h followed by treatment with MTT for estimation of cytotoxicity and finally, optical density (OD) was measured at 570-630 nm. Results: Different concentration of doxorubicin (1, 5, 10 µM) and ABMECA (10-6M, 10-5M and 10-4M) shown dose-dependent cytotoxicity. There was a significant decrease (p<0.05) in cell viability in both doxorubicin and ABMECA concentration in a dose-dependent manner. This study may guide further for in vivo evaluation of test drug in the lung cancer model. Conclusion: A3 Adenosine Receptor agonist could be potential moiety for the treatment of lung cancer and it would require in vivo study for further research.

Young onset colorectal cancer: How does it differ from its older counterpart.

BACKGROUND: Colorectal cancer in the young has been a debated topic in literature with conflicting reports as to its pattern of occurrence and survival as compared to the older age group. MATERIALS AND METHODS: Retrospective study to analyze the clinicopathological characteristics, treatment modalities and survival of sporadic young‑onset colorectal cancer (YOCR) patients (<40 years) and compare them with the older group (>40 years). RESULTS: Of 172 patients managed, 72 (42%) were in the YOCR group. Among 72 patients, six were excluded because of hereditary syndromes. Incontinence (P = 0.02) and obstruction at time of presentation (P = 0.03) was significantly more common in the YOCR group. Left sided disease was more common in YOCR group (47/66) compared to the older group (65/100), but the difference was not statistically significant (P = 0.45). The proportion of rectal cancers was significantly more in the YOCR group (39/47) compared to the older group (39/65) (P = 0.01). Significant difference in resectability was noted in the left sided (YOCR 26/47 vs. older 49/65 P = 0.04) and the rectal cancers (YOCR 18/39 vs. Older 29/39 P = 0.02). The survival was similar among the two groups. CONCLUSIONS: Sporadic colorectal cancers in the young are more advanced and less resectable when compared to older population. Genetic studies are needed to elaborate the reasons for left sided predominance and aggressiveness of sporadic colorectal cancers in the younger subgroups.