A sham-controlled trial of repetitive transcranial magnetic stimulation over left dorsolateral prefrontal cortex and its effects on craving in patients with alcohol dependence.

AIM: The aim of this study is to study the effects of repetitive transcranial magnetic stimulation (rTMS) therapy over the left dorsolateral prefrontal cortex (DLPFC) in craving in drug-naive male inpatients of alcohol dependence syndrome. METHODS: A single-blind randomized sham-controlled study involving sixty inpatients of alcohol dependence syndrome in a tertiary care center. Following detoxification and consent, the patients were allocated into either active or sham groups for rTMS protocol. Daily sessions of rTMS were administered over the left DLPFC at 120% of motor threshold at high-frequency (10 Hz) stimulation with 4 s train, inter-train interval of 26 s, and a total of twenty trains per session. Alcohol craving questionnaire (ACQ-NOW) was administered thrice for each patient, i.e., before rTMS, on completion of rTMS, and 02 weeks following completion of rTMS. RESULTS: Analysis of variance of scores of ACQ NOW pre rTMS and immediately after and 2 weeks post rTMS did not show significant reduction in craving scores. CONCLUSION: Administration of ten daily sessions of high-frequency rTMS over the left DLPFC did not have significant effect in reducing craving in patients with alcohol dependence syndrome.

Personality traits and its correlation to burnout in female nurses.

BACKGROUND: Few Indian studies have deliberated on the role of personality traits in perceived stress and burnout among female nurses employed in the government sector. MATERIALS AND METHODS: A cross-sectional questionnaire-based survey was conducted among 600 female nurses employed in 30 government hospitals of India. Two hundred and ninety-eight valid questionnaires received with demographic data, NEO Five-Factor Inventory scores, Perceived Stress Scale-10, and Copenhagen Burnout Inventory scores were analyzed using linear regression analysis. RESULTS: Trait neuroticism scores had modest positive correlation for personal burnout (R 2: 0.32, F: 138.68), work-related burnout (R 2: 0.22, F: 84.09), and overall burnout scores (R 2: 0.30, F: 128.09). Extraversion scores had low negative correlation with personal burnout (R 2: 0.08, F: 27.22, P < 0.00), work-related burnout (R 2: 0.09, F: 28.81), and overall burnout scores (R 2: 0.10, F: 31.68). Scores on agreeableness trait had weak negative correlation with personal burnout (R 2: 0.09, F: 32.98), workrelated burnout (R 2: 0.06, F: 20.96), patientrelated burnout (R 2: 0.06, F: 21.27), and overall burnout scores (R 2: 0.10, F: 33.43). Openness to experience had no significant correlation to personal, work-related, patient-related, or overall burnout scores. Conscientiousness scores had low negative correlation with the scores on personal burnout (R 2: 0.12, F: 41.96), work-related burnout (R 2: 0.09, F: 27.88), and overall burnout scores (R 2: 0.10, F: 31.80). Neuroticism had modest positive correlation with perceived stress scores (R 2: 0.33, F: 145.61). Extraversion, agreeableness, and conscientiousness were weakly negatively correlated with perceived stress scores. CONCLUSIONS: Trait neuroticism increased the vulnerability to perceived stress and burnout, whereas traits of extraversion, conscientiousness, and agreeableness were protective against perceived stress and burnout in the sample of female nurses surveyed.

A study of relationship between perceived stress, coping pattern, burnout, and general psychopathology among the postgraduate medical students.

INTRODUCTION: Medical postgraduate student experience considerable stress during their training, which may cause agony to the individual or affect care rendered to the patient. Significant burnout and psychopathology has not been uncommon. MATERIALS AND METHODS: A study was done to assess the relation between perceived stress, coping pattern, burnout, and general psychopathology among the postgraduate medical students. RESULTS: Perceived stress was associated with higher scores on general psychopathology and burnout. Postgraduate students who displayed positive coping strategies had lesser perceived stress. Females had higher scores on perceived stress and psychopathology. CONCLUSION: Stress is one of the major growing mental problems among highly educated health professional, and it should not be ignored as it can cause many other health issues.

Prevalence and patterns of tobacco use and nicotine dependence among males industrial workers.

BACKGROUND: Tobacco use is an important preventable health risk factor in India. AIM: This study was carried out to estimate the prevalence of current tobacco use, factors and extent of dependence associated with its use among male workers of an industrial organization. MATERIALS AND METHODS: A total of 759 participants randomly selected from the population of employees were administered questionnaire in Hindi containing demographic profile, patterns of smoking, and use of smokeless tobacco and alcohol. RESULTS: Forty-one percent of the surveyed males (n = 750) used tobacco either by smoking or smokeless method or both (9.7% used both, 23.4% smoked, and 27.3% used smokeless tobacco). The maximum percentage was among the 26-30 years' age group, and the married persons (45.4%, OR = 2.17, P < 0.05). Tobacco use was associated with lower educational qualifications, history of tobacco use in family members, and drinking alcohol. Seventy-two percent of the nicotine users reported being influenced by their peers in initiating the habit, 59.4% of the users reported being advised to stop tobacco use by a health professional, and 52.9% had attempted quitting the habit more than once. Twenty percent of our sample were dependent on nicotine and the highest prevalence was seen in those using both smoking and the smokeless tobacco. CONCLUSIONS: The Prevalence of Tobacco Use and Nicotine Dependence among male industrial employees is significant and necessitates Tobacco awareness and cessation programs regarding Tobacco use.

Clinico-psycho-social profile of patients brought under consultation-liaison psychiatry care in a large tertiary care referral hospital.

OBJECTIVE: The aim of this study was to access the clinico-psycho-social profile of patients brought under consultation-liaison (CL) psychiatry care in a large tertiary care referral hospital. MATERIALS AND METHODS: This study included all patients who were referred for CL psychiatry from among the inpatients in the hospital and the emergency department (during off working hours of the hospital) over a period of 1 year. Data were obtained and analyzed in terms of where was the referral placed, by whom, the reason for placing the referral, the primary medical/surgical diagnosis of the patient, the presenting complaints, any past psychiatric history, the psychiatric diagnosis (as per the International Classification of Diseases, Tenth Edition), the investigations advised and their reports, the treatment advised (psychotherapeutic and psychopharmacological), the sociodemographic profile of the patients, and the follow-up details. RESULTS: A total of 157 patients were referred to the CL unit over the study period. Out of these, 125 patients were referred among the inpatients and 32 from the emergency department of the hospital. Majority of the patients were in the age group of 25-50 years and were male. The majority of the referrals were made by general physician; most of the referrals were placed from emergency department. The most common reason for referral was for altered sensorium and behavioral abnormalities. The most common diagnosis was delirium followed by depressive episode and alcohol dependence syndrome. CONCLUSION: There was higher representation of delirium and alcohol-related cases in our study compared to older studies.

CURRENT STATUS OF DISULFIRAM THERAPY.

The effectiveness of disulfiram is linked to the disulfiram-ethanol reaction in the treatment of Alcohol Dependence Syndrome. However disulfiram therapy is associated with various adverse effects and needs a structured and supervised after care program. Relapse rate is very high once disulfiram therapy is discontinued. Keeping these factors in mind disulfiram therapy is used less often today than previously.