Psychosocial and clinical profile of chronic long-stay psychiatric patients in teaching institution.

Background: A good number of psychiatric patients continue to stay in psychiatric hospitals for longer period of time despite their recovery. Inevitably, they tend to experience limitations to their freedom, personal choice and social isolation, and loss of self. It is important to assess the characteristics of these patients and the challenges in social integration. Materials and Methods: A cross-sectional study was conducted at a mental health hospital from May 2018 to January 2023. The data were collected from a retrospective review of 101 case files of all the long-stay patients (LSPs) who were admitted to psychiatric closed wards. Furthermore, cases were utilized to analyze the psychosocial situations of LSP. Results: This study reveals that the majority of the subjects were unmarried, females, unemployed, and hailing from rural background. Nearly 50% of the patients' families are untraceable. About three-fourths of those patients had the wrong address and lacked community psychiatric rehabilitation facilities and employment opportunities in their neighborhood. Caregivers' burden and poverty are major causes for prolonged or long-term hospitalization of patients in the mental hospital and barriers to community reintegration. Conclusion: Facilitating the transition of patients from the psychiatric hospital to community care is the need of the hour.

Tensions associated with the use of electronic knowledge resources within clinical decision-making processes: a multiple case study.

CONTENT AND OBJECTIVE: Health professionals now routinely use electronic knowledge resources (EKRs). Few studies have considered EKR-related tensions which may arise in a clinical decision-making context. The present study aims to explore three types of tension: (1) user-computer tension, (2) social tensions, and (3) organizational tensions (constraints associated with organizational routines and health policies). DESIGN, PARTICIPANTS, INTERVENTION, SETTING: We conducted a multiple case study, examining Family Medicine residents' searches for information in everyday life. Cases were defined as critical searches for information among 17 first year family medicine residents using InfoRetriever 2003/2004 on a PDA over 1.5 months at McGill University. InfoRetriever-derived information was used within a resident-patient decision-making context in 84 of 156 cases. For each case, residents were interviewed, and extracts of interview transcripts were assigned to themes using specialized software (presence of tension; type of tension). Further computer-assisted lexical-semantic analysis was performed on transcripts. Authors reached consensus on assignments. RESULTS: Twenty-five cases with tension were identified (one case had two types of tension), and illustrate the above mentioned types of tensions: (T1) tension between the resident and InfoRetriever (N=16); (T2) InfoRetriever-related tension between the resident and other social actors, specifically supervisors, other health care professionals and patients (N=7); (T3) InfoRetriever-related tension between the resident and the health organization/system (N=3). CONCLUSIONS: Results suggest EKR usage in a clinical decision-making context may have negative consequences when three types of tension arise in a clinical decision-making context. Illustrated types of tension are interrelated and not mutually exclusive. Awareness of EKR-related tensions may help clinicians to integrate EKRs in practice.

Curcumin inhibits platelet-derived growth factor-stimulated vascular smooth muscle cell function and injury-induced neointima formation.

OBJECTIVE: Vascular smooth muscle cell (VSMC) migration, proliferation, and collagen synthesis are key events involved in the pathogenesis of cardiovascular disease. Growth factors, such as platelet-derived growth factor (PDGF) and fibroblast growth factor, released during vascular injury plays a pivotal role in regulating these events. Curcumin (diferuloyl methane), a major component of the spice turmeric (Curcuma longa), has been shown recently to have beneficial effects in chronic conditions, such as inflammation, cancer, cystic fibrosis, and Alzheimer's disease. The objective of this study was to investigate the ability of curcumin to inhibit PDGF-stimulated migration, proliferation, and collagen synthesis in cultured VSMCs and neointima formation after carotid artery injury in rats. METHODS AND RESULTS: Curcumin (1 to 25 microM) produced a concentration-dependent inhibition of PDGF-elicited VSMC migration, proliferation, and collagen synthesis assessed by chemotaxis, [3H]thymidine incorporation, and [3H]-L-proline incorporation, respectively. Curcumin blocked PDGF-induced VSMC actin-cytoskeleton reorganization, attenuated PDGF signal transduction, and inhibited the binding of PDGF to its receptors. Carotid artery neointima formation was significantly attenuated by perivascular curcumin compared with vehicle controls 14 days after injury, characterized by reduced DNA synthesis, collagen synthesis, and PDGF receptor phosphorylation. CONCLUSIONS: These data suggest that curcumin is a potent inhibitor of key PDGF-stimulated VSMC functions and may play a critical role in regulating these events after vascular injury.

Synthetic peptides: a modern approach to vaccination.

For induction of humoral or cell-mediated immunity, development of synthetic peptide vaccines present a novel approach and a better alternative to conventional vaccines. Construction of synthetic peptides that mimic antigenic sites is the basis of this approach. In this article various methodologies involved in the peptide synthesis are discussed. This is followed by a discussion on the strategies involved in rendering poor or non-immunogenic peptides immunogenic. These include coupling to large carrier proteins, polymeric presentation and incorporation of an identified Th cell epitope into the peptide.

Discoidal niosome based controlled ocular delivery of timolol maleate.

Non-ionic surface active agents based discoidal vesicles (discomes) bearing timolol maleate were prepared. Niosomes were incorporated with Solulan C24 in order to effect vesicle to discome transition. The discomes were relatively large in size, 12-60 microm. They were found to entrap a relatively high quantity of timolol maleate. The prepared system characterized for size, shape and drug release profile in vitro. They were found to release the contents following biphasic profile particularly in the case where the drug was loaded using a pH gradient technique. The prepared system could produce or sustain a suitable activity profile upon administration into the ocular cavity; however, systemic absorption was minimized to a negliable level. The discomes were found to be promising and of potential for controlled ocular administration of water-soluble drugs.

Some approaches to improve bioavailability of peptides and proteins through oral and other mucosal routes.

In this article, an attempt is made to review methods of protein and peptidal delivery through oral and non-oral mucosal routes. Strategies that have been or are being employed to improve the bioavailability of peptides and proteins include alteration of physiological factors by absorption enhancers and enzyme inhibitors, modification of native proteins by chemical synthesis of prodrugs and analogues and dosage form modifications, e.g. lipid vesicles and emulsions, particulate carriers or mucoadhesive polymer systems.