2D material-based surface plasmon resonance biosensors for applications in different domains: an insight.

The design of surface plasmon resonance (SPR) sensors has been greatly enhanced in recent years by the advancements in the production and integration of nanostructures, leading to more compact and efficient devices. There have been reports of novel SPR sensors having distinct nanostructures, either as signal amplification tags like gold nanoparticles (AuNPs) or as sensing substrate-like two-dimensional (2D) materials including graphene, transition metal dichalcogenides (TMDCs), MXene, black phosphorus (BP), metal-organic frameworks (MOFs), and antimonene. Such 2D-based SPR biosensors offer advantages over conventional sensors due to significant increases in their sensitivity with a good figure of merit and limit of detection (LOD). Due to their atomically thin structure, improved sensitivity, and sophisticated functionalization capabilities, 2D materials can open up new possibilities in the field of healthcare, particularly in point-of-care diagnostics, environmental and food monitoring, homeland security protection, clinical diagnosis and treatment, and flexible or transient bioelectronics. The present study articulates an in-depth analysis of the most recent developments in 2D material-based SPR sensor technology. Moreover, in-depth research of 2D materials, their integration with optoelectronic technology for a new sensing platform, and the predicted and experimental outcomes of various excitation approaches are highlighted, along with the principles of SPR biosensors. Furthermore, the review projects the potential prospects and future trends of these emerging materials-based SPR biosensors to advance in clinical diagnosis, healthcare biochemical, and biological applications.

To study childhood trauma in patients with bipolar affective disorder and its association with leucocyte telomere length.

Background: Childhood traumatic (CT) events are more frequent in Bipolar Affective Disorder (BD) than in healthy individuals. As per existing studies, telomere shortening might be associated with psychiatric illnesses and aging-related disorders. One basis could be CT in BD aiding in telomere shortening. Methods: 100 BD patients and 100 healthy controls (HC) were matched for age and sex. All the participants were administered Childhood Trauma Questionnaire (CTQ). Subsequently, Quantitative Polymerase Chain Reaction (q-PCR) was performed in order to verify leukocyte telomere length (LTL) for both cases and controls. Results: Presence of subtypes of moderate to severe CT among cases revealed emotional abuse in 35%, physical abuse in 16%, and sexual abuse in 15%. BD patients had significantly shorter telomeres in comparison to HC. BD patients with CT had significantly shorter LTL as compared to healthy controls with CT. The association between CT and LTL was not statistically significant in cases as well as in controls. Conclusions: Our study revealed presence of CT (moderate to severe) in 46% of BD patients and 12% in age and sex-matched healthy controls. All CT subtypes except sexual abuse were significantly higher among cases than in healthy controls. Mean score of LTL among cases including that with CT was significantly lower than the healthy controls.

Building psychological resilience in Armed Forces worldwide.

Psychological resilience among troops can be enhanced through relatively simple interventions. Globally, various Armed Forces have successfully implemented modules for building psychological resilience. Programs from different countries are listed, evaluated and their underpinnings explored. Recommendations for a variety of feasible and culturally acceptable interventions targeted at individuals, families, units, community and organizations in the Indian context have been made; ranging from mindfulness training to embedded combat psychologists. Interventions are likely to succeed if integrated within existing basic training and unit/career programs.

Personality traits associated with Alcohol Dependence Syndrome and its relapse.

Background: Course of Alcohol Dependence Syndrome (ADS) is studded with multiple relapses. Personality factors are implicated as one of the influencing factors in the course of this disorder. Keeping in view of scarcity of Indian data available, the study was planned with the aim to find Personality traits more commonly associated with ADS patients, and identify specific traits, associated with relapses of ADS. Method: With sample size of 100 consecutive cases and 100 controls, socio-demographic data was collected. Alcohol Use Disorder Identification Test (AUDIT) and Severity of Alcohol Use Disorder Test (SAD-Q) were administered to each of these patient. Personality dimensions were assessed with NEO-five factor inventory (NEO-FFI) (Costa and McCrae), for both groups and further compared for differences in the dimensions in each of its subscale. Results: The NEO scores, showed statistically significant difference with Cases having higher scores in Neuroticism and control group in Openness and Conscientiousness. Neuroticism linked to higher scores of AUDIT and SADQ and also associated with relapses. Other traits also showed statistically significant association which are discussed. Conclusion: As new factors are being explored for effective management, routine personality profiling is easily accomplished and can give delightful insight into focused and designed management plan.

Coupled Diffusion-Binding-Deformation Modelling for Phase-Transition Microneedles-Based Drug Delivery.

Phase-transition microneedles (PTMNs)-based transdermal drug delivery (TDD) is gaining popularity due to its non-invasiveness and ability to deliver a wide range of drugs. PTMNs absorb interstitial skin fluid (ISF) and transport drugs from microneedle (MNs) domain to the skin without polymer dissolution. To establish PTMNs for practical use, one needs to understand and optimise the key parameters governing drug transport mechanisms to achieve controlled drug delivery. In addressing this point, we have developed a coupled diffusion-binding-deformation model to understand the effect of physicochemical parameters (e.g., swelling capacity, drug binding) of MN and skin mechanical properties on overall drug transport behaviour. The contact mechanics at the MN and skin interface is introduced to account for the resistive force exerted by the deformed skin to MN swelling. The model is validated with the reported data of in vitro insulin delivery using polyvinyl alcohol (PVA) MN. The drug binding parameters are estimated from the fitting of the cumulative release of insulin within 6 hours of MN insertion. To predict the in vivo data of insulin delivery using the PVA MN, one-compartment model of drug pharmacokinetics is incorporated. It is shown in the paper that the model is able to predict the final insulin concentration in blood and in good agreement with the reported experimental data. The proposed model is concluded to be a tool for the predictive design and development of PTMNs-based TDD systems.

Delusional parasitosis: Report on response to olanzapine in a case series of 04 patients.

Delusional parasitosis (DP) is a type of delusional disorder which is characterised by single hypochondriacal delusion in which patient believes that he/she is infested with insects/worms/parasite. The authors present a case series of four cases of DP which were assessed in the outpatient department of psychiatry of a tertiary care hospital in Western Maharashtra. The patients with DP were predominantly women around 50 years of age who were treated successfully with Tab Olanzapine and psychotherapy with favourable response.

Helicopter parenting, from good intentions to poor outcomes. What parents needs to know?

Background: A single child is precious for every parent. There is an increasing demand for children to perform and to excel in all aspects of their lives. Due to increased unemployment and less job opportunities, tough competition to get admission in good school and college and to get respectable job put every parent under constant stress. These circumstances lead to parents starting micromanagement of their children. This micromanagement can be harmful to the mental and emotional wellbeing of the child, and is especially seen in single-child parents. Objective: This study aimed to ascertain if parents of single child show behavior of helicopter parenting as compared to patents having more than one child. Methods: This is an open-ended observational study, wherein 100 families with single child and 50 families with more than one child were interviewed based on self-explanatory questionnaire methods. Results: We noted that 83% parents showed behavior of helicopter parenting, especially those who have single child as compared to those having more than one child. Conclusion: Based on our survey, we can conclude that parents of single child showed behavior of helicopter parenting as compared to patents having more than one child because only child is precious and center of attraction in the families especially in Indian culture. However, large studies are required to reach a definitive conclusion.

Adding pre-emptive anticholinergics to antipsychotics: Is it justified?

Anti-psychotics are the mainstay of treatment for Schizophrenia and psychotic disorders. Historically, anticholinergics have been prescribed to prevent or treat extrapyramidal side effects (EPS) associated with first-generation antipsychotics (FGAs). Even though newer antipsychotics are associated with markedly lower rates of EPS, concurrent anticholinergic use remains high. Use of these medications has potential for long-term side effects, worsening of EPS and poor adherence. We have briefly discussed the limited association between second-generation antipsychotics (SGAs) and EPS, the efficacy of anticholinergics for different types of EPS, and summarized various national and international guidelines on the subject. In conclusion, there is no evidence for prophylactic use of anticholinergics with antipsychotics. Clinicians need to guard against this tendency to be unduly cautious.

Analysis of relationship of hormonal, hematological and biochemical parameters in Indian alcoholics with severity of alcohol dependence.

Background: Alcohol dependence syndrome (ADS) is a major problem in India. ADS is known to be a systemic disorder involving almost all organ-systems. The evaluation of ADS patients' needs successive assessment of severity of clinical condition. In this study, we attempted to explore Severity of Alcohol Dependence Questionnaire (SADQ-C) as a severity measure by studying its association with laboratory parameters. Methods: During the two months study period 155 diagnosed ADS male patients who had been admitted to the Psychiatric Ward of two zonal level hospitals were enrolled for the study. The participants were examined by the Psychiatrist and the severity of alcoholism ascertained by the SADQ-C scoring. Based on SADQ-C scoring they were divided into three groups: severe alcohol dependence, moderate dependence and mild physical dependence. The patients' blood samples were collected and tested. Results: In our study, morning and evening level of serum cortisol showed positive correlation with increasing SADQ-C scoring. The differences in morning and evening cortisol level also augmented with increasing severity score (r=0.257; p=0.001). Hemoglobin, mean corpuscular volume (MCV) and serum level of LH, FSH and testosterone levels were not shown any statistically significant alterations amongst the studied groups. Serum LH, total bilirubin, direct bilirubin, AST, ALT and GGT level showed positive correlation with SADQ-C scoring but AST/ALT ratio showed negative correlation. Conclusion: This study elaborated relationship between SADQ-C scoring and laboratory parameters in Indian male ADS patients. It highlighted the requirement of incorporation of serum cortisol along with presently evaluated laboratory parameters for ADS severity evaluation.

Scholastic performance and ambitions in retropositive and vulnerable pediatric patients: A prospective study.

Introduction: It is widely recognized that HIV epidemic has a negative impact on retropositive pediatric patients. However, at present, the school performance and ambitions in retropositive and vulnerable pediatric patients from India are lacking. Aims: The aim of this study was to analyze the possible association between scholastic performance and ambitions in retropositive and vulnerable status in pediatric patients. Materials and Methods: Case-control study was conducted over a period of 2 years. Forty-two retropositive, vulnerable, and equal age- and gender-matched controls between the age of 6 and 16 years were included. All children or parents were enquired about performance, attendance, grades in last academic year, and their ambitions in life. The data were collected in a prevalidated questionnaire and analyzed using SPSS Version 20. Results: A total 42 children between the age of 6 and 16 years were included. Twenty-seven (64.3%) were males and 15 (35.7%) females. Eleven (26.2%) were retropositive, 27 (64.3%) had one infected parent, and 4 (9.5%) patients had both the parents retropositive. Twelve (28.5%) cases failed their previous academic years compared to 1 (2.3%) control. Only 2 (4.7%) had attendance more than 90% in cases as compared to 18 (42.8%) among controls. Twenty-one (50%) attributed feeling of isolation as a cause of poor academic performance, while none of the controls did the same. There was a significant association between poor grades and poor attendance at school and retropositive (P < 0.001). The odds ratio of feeling of isolation was 1.62. Conclusion: Retropositive and vulnerable status significantly affect the academic performance and ambitions in these children.

Super-swelling hydrogel-forming microneedle based transdermal drug delivery: Mathematical modelling, simulation and experimental validation.

Super-swelling hydrogel-forming microneedles (HFMNs) based transdermal drug delivery (TDD) is gaining significant interest due to their non-invasiveness and ability to deliver a wide range of drugs. The HFMNs swell by imbibing interstitial skin fluid (ISF), and they facilitate drug transport from the reservoir attached at the base into the skin without polymer dissolution. To develop HFMNs for practical applications, a complete understanding of the drug transport mechanism is required, allowing for controlled TDD and geometrical optimisation. A three-phase system consisting of a reservoir, microneedle, and skin is considered. A mathematical model is developed to incorporate the drug binding within the matrix of the compartment, which was not considered earlier. Super-swelling nature of the HFMNs is incorporated through the swelling ratio obtained experimentally for a polymer. The results are validated with in vitro diffusion studies of ibuprofen sodium (IBU) across excised porcine skin, showing that around 20% of the loaded IBU in lyophilised wafer was delivered in 24 h. It was observed that increasing IBU solubility in reservoir can achieve high drug transport across the skin. The developed model is shown to be in good agreement with the experimental data. It is concluded that the proposed model can be considered a tool with predictive design and development of super-swelling HFMNs based TDD systems.

Mental health impact of COVID-19 among health-care workers: An exposure-based cross-sectional study.

BACKGROUND: Health-care workers (HCWs) in COVID-19 pandemic have faced the major impact in providing care to infected persons. Most of the studies on mental health impact among HCW have not incorporated paramedical staff. Furthermore, they have not compared psychological morbidity among HCW on the basis of high COVID exposure (HCE) and low COVID exposure (LCE). To address the above gap, this study aimed at evaluating mental health impact among HCW and its associated risk factors. MATERIALS AND METHODS: Consecutive 200 HCWs each in the HCE and LCE groups (between the age group of 18 and 60 years) were enrolled from two tertiary care hospitals providing COVID-19 treatment from August 1, 2020. After collection of sociodemographic data, participants were administered Impact of Event Scale-Revised, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 Scale. RESULTS: The difference in stress, depression, and anxiety symptom scores between the HCE and LCE groups was not statistically significant. Multiple regression analysis revealed that female sex was associated with higher scores in all the three domains. The effect remained significant even after adjusting for effect of other risk factors. CONCLUSION: HCE or LCE was associated with similar impact in terms of stress, depression, and anxiety among HCWs. Female HCWs had a higher prevalence of stress, depression, and anxiety. Doctors, nurses, and paramedics had a similar prevalence of stress, depression, and anxiety when odds were adjusted.

Gut-brain axis: Synergistic approach.

Since decades, there is a change in concept of the gut-brain axis. There is differential increase in evidences focusing on the bidirectional communication between the gut microbiome and the brain. It supports existence of far-reaching model of "gut-brain axis." This axis is attaining more adherence to fields investigating biological and physiological footing of psychiatric, neuro-developmental, age-related, and neurodegenerative disorders. Many factors can change microbiota composition in early life as well as with the increasing age. Stress can affect the microbiota-gut-brain axis at every stages of life. Recent advances have involved the gut microbiota in many conditions including severe mental illness, autism, anxiety, obesity, Parkinson's disease, and Alzheimer's disease. The current studies target on elaborating the underlying mechanisms of microbiota-gut-brain axis and attempt to exemplify intervention and therapeutic strategies for neuropsychiatric disorders.

Complex psychological trauma.

Complex psychological trauma is more complicated and pervasive than the isolated traumatic event, occurring mainly in vulnerable periods resulting in severe compromise of childhood development. It causes increased activation of the survival-focused brain leading to alterations in brain structure and function. It has an impact on behavioral, biological, and cognitive domains resulting in sequelae of complex trauma exposure. The assessment of complex trauma is demanding as the clinician is required to be patient, transparent, noncoercive, and corroborative in approach. The management depends on a good therapist-client alliance, appropriate evidence-based treatment models and emerging pharmacotherapy for treatment as well as prevention.

Alzheimer's disease: Newer biomarkers.

Fifty million people are affected with dementia worldwide with Alzheimer's disease (AD) accounting for 70%-80% of these cases. In India alone, 4.1 million people suffered from dementia in 2015. To date, there are no definitive treatment options for AD and the overall treatment gap in India stands at 90%. Attempts have been made to define AD biologically. This has been made possible due to advances in the identification of biomarkers that indicate the neuropathological changes responsible for AD. Identification of these biomarkers has implications for disease staging, prognostication, and identifying drug targets. Here, we summarize the advances in the field of biomarkers in AD.

Coping with the aftermath of COVID: Industrial resurgence, mental health, and resilience.

COVID-19 pandemic has affected billions of people worldwide. Economies world over have suffered slowdown with a direct impact on industry. The vulnerable industrial worker has suffered both financially and mentally. As the pandemic has begun to slow down, the industry has started showing signs of growth and economy appears to be coming back on track. Financial losses may be recovered in time, but the mental health impact of pandemic is likely to be long-lasting. In the aftermath of COVID-19, mental health needs of vulnerable sections of societies need to be addressed. An attempt has been made to understand the mental health impact of COVID-19 pandemic on industrial workers. Preventive and promotive measures for positive mental health of industrial workers are discussed with a focus on resilience-building.

Assessment of depression, anxiety and stress in COVID-19 infected individuals and their families.

BACKGROUND: Pandemics have been associated with widespread psychological distress in the normal population due to quarantine and lockdown, however there are only few studies on psychiatric symptoms in COVID infected patients and their families. This study was planned to assess the depressive, anxiety and stress symptoms in individuals and their families infected with COVID19, during current pandemic. METHODS: A cross-sectional, observational study was conducted on hospitalised, COVID infected patients and their immediate family members. Ninety-three, COVID patients and fifty-four family members were studied through Google forms which contained socio-demographic proforma and Depression Anxiety Stress Scale-21 (DASS21). Collected data was tabulated to assess depression, anxiety and stress symptoms in the given population and study their relation with various sociodemographic variables. RESULTS: Almost one-third of the sample showed increased score on depression and anxiety subscales and one-fifth on stress subscales. 30-45% of the family members studied had higher score on either of the subset. There was also a high correlation between the scores of depression, anxiety and stress subset in the study sample. CONCLUSION: This study, reflects high magnitude of depression, anxiety and stress symptoms in these patients and their families which alert us to the need for definitive interventions in these affected individuals.