Cultural Expression of Anxiety Symptoms in Kannada Language: A Qualitative Study.

Background: In anxiety disorders, culture is important in symptom presentation and help-seeking. Most tools for anxiety disorders are not validated in India and thus might not capture culture-specific aspects of anxiety. This study aims to identify and generate culturally specific terms to describe symptoms of anxiety as part of the development of the Kannada version of the Panic and Anxiety National Indian Questionnaire (PANIQ). The PANIQ is a tool under development to identify anxiety and panic in Indian settings. Methods: This study used qualitative methods like focus group discussions (FGDs) and in-depth interviews (IDIs) to identify and generate items related to anxiety and panic in Kannada from stakeholders like individuals with anxiety disorders, their caregivers, healthcare workers, and mental health professionals who treat individuals with anxiety and panic disorders. Five FGDs (n = 28), one triad (n = 3), and 34 IDIs (n = 34) were conducted. Results: The mean age of the participants was 38.9 (standard deviation: 12.28) years; 57.1% were from rural areas. We generated 615 Kannada items. These were classified into 21 domains and facets. Items in domains like Somatic symptoms, Fear, and Impairment in day-to-day life were higher than those noted in existing tools for anxiety that focus more on cognitive symptoms of anxiety. Conclusions: This study generated culturally specific items of anxiety through a qualitative process of tool development incorporating subjective experiences of persons with anxiety disorders and other stakeholders. This is among the first steps toward the development of PANIQ.

The Initial Epoch of Psychosurgery in India: A Retrospective Data Review from Mysore Government Mental Hospital.

Background: In the early 20th century, psychosurgery had gained worldwide popularity for treating mentally ill persons, especially in western countries. We attempt to chronicle its journey in the Mysore Government Mental Hospital (MGMH), now the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru. Methods: Archived case records and registers of patients admitted from 1939 to 1947 were reviewed to identify those who had undergone psychosurgery. Case records of the identified patients were assessed for clinical information, including the details of psychosurgery. Results: Among the patients, 107 had undergone psychosurgery, primarily leucotomy. Schizophrenia (51.5%) was the most common diagnosis in them, and 33.7% of all patients were reported to have improved. Yet, inconsistencies were found about the presence and degree of improvement. Possible side effects were not consistently documented. Conclusion: Psychosurgery was adopted at the MGMH very soon following its introduction in the western world. However, ambiguity about its benefits and risks was noted in the current study.

Contributions of Trauma and Economic Insecurity to Psychological Distress in Response to the COVID-19 Pandemic.

Background: Racially minoritized women with limited socioeconomic resources are at increased risk for adverse psychological outcomes in response to the COVID-19 pandemic. Disproportionate rates of trauma exposure and economic insecurity likely heighten risk for these outcomes among socioeconomically vulnerable individuals, but the unique contributions of these factors are poorly understood. As such, we examined trauma and economic factors as predictors of pandemic-related psychological distress and symptoms. Methods: Ninety-six women recruited for a trauma research study (91.7% Black, Mage=38.3 years, SDage=11.8 years) completed measures of trauma exposure, economic insecurity, and several items assessing psychological distress and symptoms related to the COVID-19 pandemic. We examined concern for mental and physical health impacts of COVID-19 as well as changes in self-reported levels of anxiety and anhedonia from the three months prior to the pandemic to the past two weeks. Linear regression analyses were used to assess contributions of trauma exposure and economic insecurity to COVID-19-related distress. Results: Childhood maltreatment and lifetime trauma exposure did not predict COVID-19-related distress; however, financial concern significantly contributed to concern for the physical health impact of COVID-19 (B = .30, p < .05). Food insecurity emerged as the only significant predictor of concern for mental health impact of COVID-19 (B=.91, p < .01). Housing instability was the only significant predictor of COVID-19-related increases in anhedonia (B = -.30, p < .05). Conclusions: Economic insecurity, namely self-reported financial concern, food insecurity, and housing instability, was related to COVID-19-related psychological distress in a sample of predominately Black American women living in under-resourced communities. Findings may help identify populations at risk for COVID-19-related psychological distress and symptoms and develop effective interventions, such as expanding access to nutritious food sources and housing support, for minoritized community members.

A comparison study of dental pulp stem cells derived from healthy and orthodontically intruded human permanent teeth for mesenchymal stem cell characterisation.

The objective of this study was to compare the characteristics of Dental Pulp Stem Cells (DPSCs) derived from healthy human permanent teeth with those that were orthodontically-intruded to serve as potential Mesenchymal Stem Cells (MSC). Recruited subjects were treated with orthodontic intrusion on one side of the maxillary first premolar while the opposite side served as the control for a period of six weeks before the dental pulp was extracted. Isolated DPSCs from both the control and intruded samples were analyzed, looking at the morphology, growth kinetics, cell surface marker profile, and multilineage differentiation for MSC characterisation. Our study showed that cells isolated from both groups were able to attach to the cell culture flask, exhibited fibroblast-like morphology under light microscopy, able to differentiate into osteogenic, adipogenic and chondrogenic lineages as well as tested positive for MSCs cell surface markers CD90 and CD105 but negative for haematopoietic cell surface markers CD34 and HLA-DR. Both groups displayed a trend of gradually increasing population doubling time from passage 1 to passage 5. Viable DPSCs from both groups were successfully recovered from their cryopreserved state. In conclusion, DPSCs in the dental pulp of upper premolar not only remained viable after 6 weeks of orthodontic intrusion using fixed appliances but also able to develop into MSCs.

Effectiveness of microosteoperforations in accelerating alignment of maxillary anterior crowding in adults: A randomized controlled clinical trial.

INTRODUCTION: This trial aimed to investigate the effectiveness of microosteoperforations (MOPs) in overall time taken for alignment of maxillary anterior crowding and to evaluate the alignment improvement percentage within 6 months between MOPs and control groups. METHODS: Thirty adult participants (25 females and 5 males; mean age, 22.66 ± 3.27 years) with moderate upper labial segment crowding were randomly assigned into intervention and control groups using block randomization. All participants had first premolar extractions, bonded conventional fixed appliances, and 0.014-in, followed by 0.018-in nickel-titanium archwire placement for initial alignment. The intervention group received a 3-mm deep MOPs procedure under local anesthesia using a Propel device (Propel Ortho Singapore, Pte, Ltd, Winstedt Rd, Singapore) on the labial attached gingivae of maxillary incisors at monthly visits until complete alignment. Little's irregularity index was used to assess the overall changes and measure the change of tooth alignment of the 6 maxillary anterior teeth. Assessor blinding was employed. RESULTS: There was no statistically significant difference in the median overall alignment duration between MOPs and control groups (139 days [95% confidence interval, 115.32-161.83] vs 143 days [95% confidence interval, 107.12-179.74]; hazard ratio, 0.829; P = 0.467). The MOPs procedure had no significant effect on the alignment duration (P = 0.657) and no overall significant difference in alignment improvement percentage among 2 groups on the basis of time (F = 2.53; P = 0.124). No harm was encountered. CONCLUSIONS: The application of MOPs is no more effective in accelerating initial orthodontic alignment than conventional treatment. TRIAL REGISTRATION: This trial was registered at the ISRCTN registry with the study ID ISRCTN15080404. PROTOCOL: https://doi.org/10.1186/ISRCTN15080404. FUNDING: This work was supported by the Postgraduate Trust Fund, Faculty of Dentistry, Universiti Teknologi MARA.

Effect of micro-osteoperforations on external apical root resorption: A randomized controlled trial.

OBJECTIVE: This study aimed to investigate the effect of micro-osteoperforations (MOPs) on external apical root resorption (EARR) during the initial orthodontic alignment phase of maxillary anterior crowding. METHODS: Thirty patients (25 females, 5 males; mean age, 22.66 ± 3.27 years) who presented with moderate crowding of the upper labial segment and underwent extraction-based fixed appliance treatment were recruited. They were randomly allocated to receive adjunctive therapy with MOPs (n = 15) or treatment with fixed appliances only (control group; n = 15). EARR was measured from long-cone periapical radiographs taken at the start and the sixth month of treatment. A correction factor for the enlargement difference was used to calculate EARR. Data were analyzed with descriptive statistics and repeated-measures analysis of variance. RESULTS: The mean root lengths of 168 teeth were measured and showed no statistically significant difference (p > 0.05) after six months of fixed appliance treatment in the MOP (mean difference [MD] = 0.13 mm; 95% confidence interval [CI] = -0.10-0.35) and control group (MD = 0.14 mm; 95% CI = -0.10-0.37). Most of the roots in the MOP and control groups (42.86% and 52.38%, respectively) showed only mild resorption. Less than 8% of the roots in both groups (7.14% in the MOP group and 4.76% in the control group) showed moderate resorption. CONCLUSIONS: Acceleration of orthodontic tooth movement with adjunctive MOPs therapy during the alignment phase does not exacerbate EARR in patients with moderate crowding of the upper labial segment in comparison with controls.

Pain experience with micro-osteoperforations during Initial orthodontic alignment: a randomized clinical trial / Experiencia de dolor con micro-osteoperforaciones durante la alineación ortodóncica inicial: un ensayo clínico aleatorizado

Objetive: The objective of this clinical trial was to investigate the perception of pain during initial maxillary alignment with an adjunctive procedure of micro-osteoperforations (MOPs) compared to conventional orthodontics. Material and methods: This study design was a single-centre, two-arm parallel prospective randomised clinical trial. Thirty consecutive adult subjects (25 females and 5 males; mean age ± SD, 22.66 ± 3.27 years) with 5-8mm moderate upper labial segment crowding were randomly allocated using block randomisation into intervention and control group. All subjects had first premolar extractions, bonded conventional fixed appliances and 0.014-inch nickel-titanium archwire was placed for initial alignment. The intervention group received a 3-mm deep MOPs procedure under local anaesthesia using a Propel device (PROPEL Ortho Singapore) on the labiogingival aspect between the maxillary incisors. Both groups received a set of 100 mm visual analogue scale to complete over the first week, recording pain at 24 hours, 3 days and 1 week. Data were analysed using repeated-measures analysis of variance (ANOVA). Results: There was a statistically significant difference observed in perceived pain levels between MOPs and the control group on day 1, day 3 and day 7 postoperatively. Pain perception was significantly lower in the intervention group at all time points. Conclusion: Accelerating orthodontic tooth movement with MOPs did not accentuate pain perceived during initial maxillary alignment with fixed appliances.

Objetivo: El objetivo de este ensayo clínico fue investigar la percepción del dolor durante la alineación maxilar inicial con un procedimiento adyuvante de micro-osteoperforaciones (MOP) en comparación con la ortodoncia convencional. Material y Métodos: El diseño de este estudio fue un ensayo clínico aleatorizado prospectivo paralelo de dos brazos y un solo centro. Treinta sujetos adultos consecutivos (25 mujeres y 5 hombres; edad media ± DE, 22,66 ± 3,27 años) con apiñamiento moderado del segmento labial superior de 5-8 mm se asignaron al azar mediante la asignación al azar en bloques en el grupo de intervención y de control. A todos los sujetos se les realizaron extracciones de los primeros premolares, se colocaron aparatos fijos convencionales adheridos y se colocó un arco de níquel-titanio de 0,014 pulgadas para la alineación inicial. El grupo de intervención recibió un procedimiento de MOP de 3 mm de profundidad bajo anestesia local utilizando un dispositivo Propel (PROPEL Ortho Singapore) en la cara labial de los incisivos superiores. Ambos grupos recibieron un conjunto de escala analógica visual de 100 mm para completar durante la primera semana, registrando el dolor a las 24 horas, 3 días y 1 semana. Los datos se analizaron mediante análisis de varianza de medidas repetidas (ANOVA). Resultados: Se observó una diferencia estadísticamente significativa en los niveles de dolor percibido entre los MOP y el grupo de control el día 1, el día 3 y el día 7 del postoperatorio. La percepción del dolor fue significativamente menor en el grupo de intervención en todos los momentos. Conclusión: La aceleración del movimiento dental de ortodoncia con MOP no acentuó el dolor percibido durante la alineación maxilar inicial con aparatos fijos.

Syphilis and psychiatry at the Mysore Government Mental Hospital (NIMHANS) in the early 20th century.

Prior to the advent of the Wasserman Test as a diagnostic tool for Syphilis, the identification rate for Syphilis at the Mysore Government Mental Hospital in Southern India was 1%. With the introduction of the test, there was a dramatic increase in the diagnosis of Syphilis, with 17% of the patients testing positive. This paper throws light on the early notions of Syphilis and GPI, societal responses to the disease, early misdiagnosis, the advent of the Wasserman test and treatment management as reflected in the records of the early 20th century at the Mysore Government Mental Hospital (currently known as NIMHANS).

Human resources and models of mental healthcare integration into primary and community care in India: Case studies of 72 programmes.

BACKGROUND: Given the scarcity of specialist mental healthcare in India, diverse community mental healthcare models have evolved. This study explores and compares Indian models of mental healthcare delivered by primary-level workers (PHW), and health workers' roles within these. We aim to describe current service delivery to identify feasible and acceptable models with potential for scaling up. METHODS: Seventy two programmes (governmental and non-governmental) across 12 states were visited. 246 PHWs, coordinators, leaders, specialists and other staff were interviewed to understand the programme structure, the model of mental health delivery and health workers' roles. Data were analysed using framework analysis. RESULTS: Programmes were categorised using an existing framework of collaborative and non-collaborative models of primary mental healthcare. A new model was identified: the specialist community model, whereby PHWs are trained within specialist programmes to provide community support and treatment for those with severe mental disorders. Most collaborative and specialist community models used lay health workers rather than doctors. Both these models used care managers. PHWs and care managers received support often through multiple specialist and non-specialist organisations from voluntary and government sectors. Many projects still use a simple yet ineffective model of training without supervision (training and identification/referral models). DISCUSSION AND CONCLUSION: Indian models differ significantly to those in high-income countries-there are less professional PHWs used across all models. There is also intensive specialist involvement particularly in the community outreach and collaborative care models. Excessive reliance on specialists inhibits their scalability, though they may be useful in targeted interventions for severe mental disorders. We propose a revised framework of models based on our findings. The current priorities are to evaluate the comparative effectiveness, cost-effectiveness and scalability of these models in resource-limited settings both in India and in other low- and middle- income countries.