Tracking the misallocation and reallocation of spatial attention towards auditory stimuli.

Completely ignoring a salient distractor presented concurrently with a target is difficult and sometimes attention is involuntarily attracted to the distractor's location (attentional capture). Employing the N2ac component as a marker of attention allocation towards sounds, in this study we investigate the spatio-temporal dynamics of auditory attention across two experiments. Human participants (male and female) performed an auditory search task, where the target was accompanied by a distractor in 2/3rd of the trials. For a distractor more salient than target (Exp. 1), we observe not only a distractor N2ac (indicating attentional capture), but the full chain of attentional dynamics implied by the notion of attentional capture, namely: (a) the distractor captures attention before the target is attended, (b) allocation of attention to the target is delayed by distractor presence, and (c) the target is attended after the distractor. Conversely, for a distractor less salient than the target (Exp. 2), although responses were delayed, no attentional capture was observed. Together, these findings reveal two types of spatial-attentional dynamics in the auditory modality (distraction with and without attentional capture).Significance Statement Oftentimes, we find it hard to avoid attending to a salient sound that distracts us from our current tasks. Although, a common everyday experience, little is known about how spatial distraction unfolds at the neural level in the auditory modality. Using electrophysiological markers of attention allocations, we report comprehensive evidence of spatial attentional capture by a salient auditory distractor, indicating that attention is first misallocated to the distractor and only afterwards reallocated towards the target. Similar patterns were observed earlier only in vision and their discovery in the auditory modality indicates towards the existence of domain-general spatial attentional dynamics consistent across sensory modalities. We also demonstrate that only a distractor more salient than the target reliably captures attention.

The surprising robustness of visual search against concurrent auditory distraction.

People often complain about distraction by irrelevant sounds that reportedly hamper performance on concurrent visual tasks demanding the allocation of focused attention toward relevant stimuli, such as processing street signs during driving. To study this everyday issue experimentally, we devised a cross-modal distraction paradigm, inspired by a standard visual-distraction paradigm (additional-singleton paradigm) that is highly sensitive to measure interference on the allocation of attention. In a visual-search pop-out task, participants reported whether a salient target (a tilted bar) was present or absent, while a completely irrelevant, but salient auditory distractor accompanied some trials. To our surprise, the results revealed no notable distraction on visual-search performance (controlled for speed-accuracy tradeoffs). Reliable auditory distraction failed to occur even when the distractor was a (highly salient) auditory oddball or was additionally presented with a temporal advantage of 300 ms. However, when the auditory modality was made relevant globally while maintaining its irrelevance to the visual-search task, we finally observed the expected interference effect. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Distractor Positivity Component and the Inhibition of Distracting Stimuli.

There has been a long-lasting debate about whether salient stimuli, such as uniquely colored objects, have the ability to automatically distract us. To resolve this debate, it has been suggested that salient stimuli do attract attention but that they can be suppressed to prevent distraction. Some research supporting this viewpoint has focused on a newly discovered ERP component called the distractor positivity (PD), which is thought to measure an inhibitory attentional process. This collaborative review summarizes previous research relying on this component with a specific emphasis on how the PD has been used to understand the ability to ignore distracting stimuli. In particular, we outline how the PD component has been used to gain theoretical insights about how search strategy and learning can influence distraction. We also review alternative accounts of the cognitive processes indexed by the PD component. Ultimately, we conclude that the PD component is a useful tool for understanding inhibitory processes related to distraction and may prove to be useful in other areas of study related to cognitive control.

Pregabalin and Amitriptyline as Monotherapy or as Low-Dose Combination in Patients of Neuropathic Pain: A Randomized, Controlled Trial to Evaluate Efficacy and Safety in an Eastern India Teaching Hospital.

OBJECTIVES: The main objective is to compare efficacy and safety of pregabalin and amitriptyline monotherapy with their low-dose combination in patients of neuropathic pain (NeuP). METHODOLOGY: In this parallel-group, open-label interventional study at the Neurology Outpatient Department of Bankura Sammilani Medical College, a total of 147 patients were randomly allocated into three groups and were prescribed the following drugs - Group P (n = 42) pregabalin 150 mg once daily, Group A (n = 34), amitriptyline 25 mg once daily, and Group Z (n = 37) = pregabalin (75 mg) + amitriptyline (10 mg) as combination once daily. They were followed up after 4, 8, and 12 weeks. Efficacy was assessed by NeuP symptom inventory score (NPSI) and safety was assessed by treatment-emergent adverse events. RESULTS: Final assessment was done on 92 patients (P = 31, A = 31, Z = 30). Males were predominant (71.7%). NPSI score significantly decreased in every group from baseline (P < 0.0001). There was no difference of NPSI score between groups at any level of follow-up. Percentage of adverse drug reactions were maximum (44.9%) in amitriptyline monotherapy group and lowest in combined group. However, amitriptyline monotherapy was the cheapest treatment option among these three. CONCLUSION: Combining pregabalin and amitriptyline at low doses proved to be equally effective but more tolerable compared to individual higher dosage monotherapy. However, if tolerability is good, amitriptyline monotherapy can be an attractive choice in economically challenged group of patients.

Is This a Drug?" Answers From Medical Students in a Tertiary Care Teaching Hospital in Eastern India.

INTRODUCTION: World Health Organization (WHO) defines what is drug and what is not. Second year MBBS students learn the principles of Pharmacology that they use in their later clinical practice life. The aim of the survey was to determine how medical students classify a range of preparations they might encounter in their professional lives and whether a brand name or a commercial preparation of a drug would influence their decision in the categorization of the preparation as a 'drug' or 'not a drug'. AIM: To assess the knowledge of medical students, if a substance or product is a drug. MATERIALS AND METHODS: We surveyed 2 concurrent years of medical students to classify 60 candidate medicinal preparations into "drug" and "not-drug" from a validated questionnaire. The candidate preparations were named either in generic or in their commercially available forms and they were all essential drugs as per WHO definition. RESULTS: The two groups of students, A and B, included 192 and 215 students respectively. Demographically there was little difference in the two groups. Agents like Aspirin, Paracetamol, Amphetamine, Salbutamol, Atropine, Dextromethorphan, Codeine, Diazepam, Ciprofloxacin ear drops, Levonorgestrol, Neosporin eye ointment, Furosemide, Metronidazole, Penicillin, Sorbitrate, Lignocaine, Methotrexate, Penicillin, Zolpidem and Thalidomide received almost unanimous votes as drugs. Arsenic trioxide, Fentanyl and petroleum jelly were considered to be "non-drugs" by most participants. The two groups did not differ significantly in their responses. CONCLUSION: Some major lacunae were noted in the knowledge of the participating students despite book teaching on the definition of a drug. Drugs used for prophylaxis and those used in physiological conditions or topically, were often missed. These gaps need to be filled by more emphasis on definition of a drug and its clinical applicability based on example and case based studies.

Comparison of Effectiveness and Safety of Add-on Therapy of Saroglitazar and Fenofibrate with Metformin in Indian Patients with Diabetic Dyslipidaemia.

INTRODUCTION: Diabetic dyslipidaemia poses a therapeutic challenge. New therapies have emerged in this patient subgroup to enhance outcome and improve compliance. AIM: The aim of this study was to compare the effectiveness and safety of add on therapy of saroglitazar and fenofibrate with metformin in Indian patients with diabetic dyslipidaemia. MATERIALS AND METHODS: Adults patients with diabetic dyslipidaemia fulfilling the inclusion criteria were randomized in two groups. Group A patients received metformin (1000 mg/ day) and fenofibrate (160 mg/day) while group B patients received metformin (1000 mg/day) and saroglitazar (4 mg/day). Glycosylated haemoglobin (HbA1C), triglyceride (TG), LDL- cholesterol (LDL-C), HDL-cholesterol (HDL-C) levels were measured at baseline and week 12 visits. Fasting plasma glucose (FPG) and post prandial plasma glucose (PPPG) were measured at baseline and on week 4, 8 and 12 visits. RESULTS: TG and HbA1C levels decreased significantly at week 12 from their respective baseline values (p< 0.05) in both groups. FPG and PPPG levels significantly decreased at weeks 4, 8 and 12 compared to their pretreatment values (p< 0.05) in both groups. TG and HbA1C levels in group B decreased significantly compared to group A at week 12. FPG and PPPG levels in group B also decreased significantly compared to group A at every interval. Inter group analysis did not show any statistically significant change in body weight, LDL-C and HDL-C at week 12. CONCLUSION: Add on therapy of saroglitazar with metformin significantly decreased TG, HbA1C, FPG and PPPG levels compared to add on therapy of fenofibrate with metformin in Indian patients with diabetic dyslipidaemia.

A Study on the Performance of Medical Students in Internal Assessment and its Correlates to Final Examinations of 2(nd) MBBS Pharmacology Curriculum in a Medical College of Eastern India.

OBJECTIVES: The present study was undertaken to assess whether performance in the continuous assessment method as determined by internal assessment, correlates to the final summative evaluation in 2(nd) professional MBBS students in Pharmacology for the last four years (2009-2012). MATERIALS AND METHODS: This study was conducted over a period of three months at Nilratan Sircar Medical College and Hospital, Kolkata (West Bengal, India). It was a retrospective non-interventional record-based study based on the students' score sheets of 2(nd) MBBS Pharmacology examinations. RESULTS: The strength of correlation between internal assessment marks and total summative examination was fond to be highly significant at p < 0.0001, thereby implying that continuous assessment plays a vital role in influencing the overall performance of the undergraduate medical students. CONCLUSION: This study revealed that performance in the internal assessment and final examination have a direct correlation although not completely linear, thereby indicating that other possible variables would have influenced the final result of the 2(nd) MBBS Pharmacology curriculum.

Small cell carcinoma of the urinary bladder: a case report and review of the literature.

Small cell carcinoma of the urinary bladder is extremely rare. In this report, a case of non-metastatic small cell carcinoma of the urinary bladder treated by systemic chemotherapy followed by adjuvant external radiotherapy, with a brief review of the epidemiology, clinical features, diagnosis, pathological features, staging, treatment and prognosis about this neoplasm is reported. A 53 years old man attended with sign and symptoms suggestive of a bladder cancer. Computed tomography of the whole abdomen showed a large tumour at right lateral wall of the bladder. Transurethral resection and histopathological study of the bladder tumour established the diagnosis of a small cell carcinoma. The patient received six cycles of platinum based chemotherapy with adjuvant locoregional external radiotherapy. He had an invasive bladder recurrence thirteen months later and died shortly afterwards.

Cefditoren pivoxil associated rash and arthralgia in a child.

Cefditoren pivoxil is an oral antimicrobial used increasingly in pediatric bacterial infections. We report a case of rash and arthralgia following administration of cefditoren pivoxil for lower respiratory tract infection in a four-year-old female child. On discontinuation of the antibiotic, the child recovered full function of the knee joint within seven days. The causality of the event assessed as per the WHO-UMC system for standardized case causality assessment criteria can be considered as 'probable'. Analyzed by the Naranjo's ADR probability scale, the score was 7, which also makes it a 'probable' event.

Factors affecting the performance of undergraduate medical students: a perspective.

CONTEXT: Performance of medical students in developing nations like India is perceived to have largely declined. AIMS: We attempted to assess the reasons behind such trends. SETTINGS AND DESIGN: Students in their third year of medical study were given a predesigned, pretested structured and validated questionnaire that they filled in anonymously. The key areas assessed were concentration, interest and understanding of the subject and other perceived causes of poor performance. Tests for descriptive statistics were applied for evaluation. RESULTS AND CONCLUSIONS: One hundred and fifty students participated in the study. Fifty-five (36.66%) students performed poorly. Male gender, inability to clear the previous professional examination at the first attempt, difficulty in understanding medium of instruction, self-assessed depression, sleep disorders and perceived parental and peer pressure and dissatisfaction with career choice were significantly linked with poor performance (P<0.05 for each factor). Socioeconomic status and regularity in class were not linked to academic performance.

Comparison of the effectiveness and safety of cefpodoxime and ciprofloxacin in acute exacerbation of chronic suppurative otitis media: A randomized, open-labeled, phase IV clinical trial.

OBJECTIVE: To compare the effectiveness and safety of cefpodoxime and ciprofloxacin for the treatment of mild to moderate cases of acute exacerbation of chronic suppurative otitis media (AECSOM). MATERIALS AND METHODS: Adult patients diagnosed with AECSOM were screened and patients fulfilling the inclusion criteria were randomized to receive either cefpodoxime 200 mg twice daily or ciprofloxacin 500 mg twice daily orally for 7 days. The primary outcome of this randomized, open-labeled, phase IV clinical trial (Registration Number - CTRI/2011/10/002079) was clinical success rate at day 14 visit and the secondary outcome was incidence of adverse events (AEs). Forty-six patients were enrolled: 23 in the cefpodoxime group and 23 in the ciprofloxacin group. RESULTS: The clinical success rates were 95.6% in the cefpodoxime group versus 90.9% in the ciprofloxacin group. These rates are comparable, but no statistically significant difference was observed between the groups. Few mild and self-limiting AEs were observed and the tolerability of both the drugs was also good. CONCLUSION: The results of this randomized, open-labeled phase IV clinical trial showed that a 7-day course of cefpodoxime is therapeutically comparable to ciprofloxacin in terms of both clinical effectiveness and safety for the treatment of patients with AECSOM.

Drug safety monitoring in patients of movement disorders of a tertiary care hospital.

BACKGROUND: Movement disorders (MD) are neurological conditions that affect the speed, fluency, quality, and ease of movement and commonly include Parkinson's disease, tremor and dystonias. Drugs are important causes of MD, and the incidence and prevalence of such disorders are possibly underappreciated because of the lack of recognition. OBJECTIVES: To assess the incidence of all adverse drug reactions (ADRs) and estimate the prevalence of drug-induced MD among patients attending the clinic. MATERIALS AND METHODS: This prospective observational study was conducted at an outpatient referral MD clinic of a tertiary care hospital for 1 year. The demographic data, drug intake, diagnosis, and ADRs experienced by the subjects were recorded. Causality assessment was done by Naranjo's scale. RESULTS: Incidence of ADR among patients who attended this clinic was 19.7% (151 out of 768 patients experienced at least one ADR). A total of 299 ADRs were detected out of which 30.8% were gastrointestinal, 28.4% psychiatric, and 26% MD effects. The commonly implicated suspect drugs were levodopa (37.8%) and trihexyphenidyl (25.1%). The prevalence of drug-induced MD was 10.15% and drug-induced dyskinesias and dystonias were the most common. CONCLUSION: MDs are clinically important neurological disorders which are often caused by drugs and interestingly drugs used for its management are also associated with high incidence of ADRs. Hence these ADRs should be carefully monitored.

Ocular adverse effects of Topiramate: Two case reports.

Topiramate, an antiepileptic drug is reported to cause various ocular adverse effects like acute onset myopia, glaucoma. Visual field defect is an uncommon, serious treatment emergent adverse effect. We are reporting two cases of suspected topiramate induced visual field defects.Both the cases were on topiramate for more than 6 months as add-on therapy at daily doses ranging from 100-150mg. The presenting complaints were insidious onset visual disturbances. Diagnosis was based of temporal association with drug intake, clinical examination and investigations. Automated perimetry revealed bilateral superior quadrantic and arcuate field defects in the two cases respectively. Marked improvement with drug dechallenge was noted which was also corroborated by perimetry. Using Naranjo's ADR Probability Scale, both cases revealed a "probable" association with topiramate. This report intends to improve awareness amongst clinicians to facilitate early diagnosis and intervention.

Drug utilization study in a neonatology unit of a tertiary care hospital in eastern India.

OBJECTIVES: To evaluate the drug prescribing trends in a neonatal intensive care unit (NICU) of a tertiary care hospital in eastern India. METHODS: The study was a prospective study that spanned for a period of 6 months from March 2005 to August 2005. Prescriptions and patient records were reviewed and analyzed using the World Health Organization (WHO) indicators for drug utilization studies. Rationality of drug usage was also evaluated by analyzing the drug prescriptions. RESULTS: A total of 176 neonates were admitted and 21 deaths were noted. The total number of drugs prescribed were 849. The average number of drugs per prescription was 4.8. The intravenous route (92.1%) was the commonest route of drug administration. 79.7% of the drugs were prescribed in generics. 30.2% of the total drugs prescribed were antimicrobials. It was noted that 88.6% of the drugs prescribed were in compliance with the National list of Essential Medicines 2003. CONCLUSION: The common diseases for which the neonates sought admission in the NICU were suspected septicaemia, birth asphyxia, neonatal jaundice and major congenital malformations. As antibiotics were the most frequently used drugs, their usage was analyzed in all cases. It was found to be rational in 84% of suspected septicaemia cases, as the provisional diagnosis on admission was confirmed with subsequent investigations thereby justifying appropriate antibiotic therapy. The diagnosis and treatment of other cases like neonatal jaundice, birth asphyxia, congenital malformations and electrolyte imbalance were rational and treatment was given as per treatment guidelines. Irrational usage of vitamins, nutritional supplements and parenteral fluids was not noted. The absence of the latest National essential list of medicines at the neonatology unit was noted. Secondly an antibiotic usage policy for the unit depending on the local microbial sensitivity pattern should have been in place.