Scooping Review on the Symptoms of Apana vayu vaigunya in relation with Atiyana

The science of life which explains the knowledge of various guidelines to be followed to make a healthy living is called Ayurveda. With the expansion of facilities of travel and occupation, man has to undertake extensive journeys, through diverse modes such as rail, road, water, etc. Most of these situations cited have been principally implicated in the vaigunya (state of altered functioning) of Apanavayu. The manifestation of Apana vayu vaigunya varies from mild cases of constipation to severe cases of mental disturbances. One of the prominent factors highlighted as a cause of Apana vaigunya is Atiyana (excessive travel by any modality). Symptoms of Apana Vayu vaigunya told in major classical books of Ayurveda were gathered to deduce a comprehensive understanding of the context. Apanavata is invariably associated with the component of pathogenesis in 45 diseases starting from Vatavyadi, Arsas(piles), Asmari, Prameha, Sosha, Jwara, Rakthapitta(Bleeding disorders), Vatarakta, Gulma(phatom tumour), Udara, Mutrakrcha(difficulty in urination), etc. Later the symptoms possibly associated with the vitiation of Apanavata present in diseases were listed and 332 symptoms were found to be associated with Apana kopa (vitiation of apana). These symptoms were further tabulated according to the order of frequency of occurrence as most repeatedly occurring symptoms, moderately repeated symptoms and least repeated symptoms. Thus out of 332 symptoms, 28 symptoms which can possibly occur due to atiyana were selected. In the modern era, due to irregular and bad habits of ahara, vihara along with the suppression of natural urges, the percentage of Apanavaigunyajanya vyadhis are increasing, which affects physical as well as psychological factors also. Work related travel is also now increasing, so it is the right time to concentrate this issue from the concepts of Ayurveda, Apana vayu vaigunya and athiyana. Based on these observations, aim of the present study is to explore the hidden concept of Apana vaigunya mentioned in Ayurvedic literature in relation with atiyana.

Neglected Nasal Foreign body discovered by Nasal Deformity: A Case Report and Review of the Literature

Foreign bodies of the nose are mostly common in paediatric population. In teenagers and adults, they are predominately seen in patients with mental disturbances. Usually with acute presentation, they also can remain in place for a long time. The main clinical presentation is unilateral purulent rhinorrhea possibly associated, in chronic cases, to nasal deformities, nasomaxillary abnormalities or rhinolithes. The removal can require a surgical procedure under general anaesthesia specifically in front of neglected foreign bodies covered by mucosa or previous multiple failed attempts. We report the case of a 14-years-old girl, with mental retardation, who consulted in our structure for a swelling in the left nasal alar base evolving progressively since 4 months, with intermittent purulent rhinorrhea not improved after medical treatment. No incident of nasal foreign body insertion was reported or witnessed by the patient and its family. The facial CT scan confirmed the diagnosis and the removal required surgical procedure. The diagnosis of neglected nasal foreign body should always be considered in front of unilateral nasal obstruction and discharge specifically in children and mentally disabled patients. Its removal should be rapid in order to avoid the constitution of rhinolithes and nasal deformities.

Mental State of Inpatients with COVID-19: a Computational Psychiatry Approach

ABSTRACTThe overload of healthcare systems around the world and the danger of infection have limited the ability of researchers to obtain sufficient and reliable data on psychopathology in hospitalized patients with COVID-19. The relationship between severe SARS-CoV-2 infection and specific mental disturbances remains poorly understood.Aimto reveal the possibility of identifying the typology and frequency of psychiatric syndromes associated with acute COVID-19 using cluster analysis of discrete psychopathological phenomena.Materials and methodsDescriptive data on the mental state of 55 inpatients with COVID-19 were obtained by young-career physicians with psychiatric backgrounds. Classification of observed clinical phenomena was performed with k-means cluster analysis of variables codded from the main psychopathological symptoms. Dispersion analysis with p-level 0.05 was used to reveal the cluster’s differences in demography, parameters of inflammation and respiration function collected on the basis of the original medical records.ResultsThree resulting clusters of patients were identified: persons with anxiety, disorders of fluency and tempo of thinking, mood, attention, motor-volitional sphere, reduced insight, and pessimistic plans for the future (n=11); persons without psychopathology (n=37); persons with disorientation, disorders of memory, attention, fluency, and tempo of thinking, reduced insight (n=7). The development of a certain type of impaired mental state was specifically associated with: age, lung lesions according to computed tomography, saturation, respiratory rate, C-reactive protein level, platelet count.ConclusionThe prevalence and typology of psychiatric disorders in patients with acute COVID-19 were described using the computational psychiatry approach.

Autozygosity mapping in consanguineous Pakistani families identifies nine non-overlapping novel linkage intervals for autosomal recessive non-syndromic mental retardation (AR-NSMR); shows genetic heterogeneity for AR-NSMR

Psychological disturbance (PD) or cerebral dysfunction (CD) occupying several clinical areas having defining features of mental retardation. Currently we have designed to investigate heritable heterogeneity in Pakistani consanguineous couples with recessive autosomal intellectual abnormilaties. Department of Biotechnology UST-Bannu and WJC Panum institute University of Copenhagen Denmark from January 2017 to March 2019. Cohort of Three consanguineous families with multiple birth defects was selected from different regions of Pakistan for molecular analysis analysis. All affected individuals in the cohort showed mental disturbances. Deoxyribonucleic acid (DNA) was extracted and subjected to STS (Single tagged sequence) marker analyses to all known non syndromic autosomal recessive mental retardation (NS-ARMR) genes while autozygosity mapping was performed by advanced SNP techniques. STS (Single tagged sequence) marker analyses showed exclusion to all known non syndromic autosomal recessive mental retardation (NS-ARMR) genes. Autozygosity mapping have shown novel nine linkage intervals. Continuous...

Psychological impact of COVID-19 pandemic on Pakistani doctors

Introduction: The COVID-19 pandemic has caused a significant burden on healthcare system and adversely affected the health care professionals all over the world including Pakistan. Therefore, the short- and long-term effects of this pandemic on mental health of Pakistani medical doctors need to be established. Objective: This study aimed to assess the mental health status and associated factors among doctors exposed to COVID-19 in Pakistan. Methodology: An online survey was carried among doctors working in different government hospitals. A Questionnaire was developed which comprised of three different sections. Mental health was assessed on basis of scoring in three Likert scales including Generalized anxiety disorder -7 scale (GAD-7), Insomnia severity index (ISI-7) and Patient health questionnaire (PHQ-9). Cluster analysis was used, and chi-square test was applied for comparison of characteristics. Results: Study was conducted on 73 specialists /consultants working in different government hospitals of the country. 54.8% of them suffered from subthreshold mental disturbances while 23.3% had mild disorders, 12.3% had moderate disorders and 9.6% suffered from severe mental disturbances. Various factors having significant relationship with psychological status of doctors were identified. Conclusion: COVID-19 outbreak has significantly affected the psychological health of Pakistani doctors. The factors adversely affecting the mental health of our health care professionals need to be addressed by providing psychological support to them.

Atypical Thyrotoxic Psychosis with Seizure: A Case Report

Thyrotoxicosis results in alteration in functioning of nervous system in some patients. However, these mental disturbances may be severe in rare cases in the form of manic-depressive, schizoid or paranoid reaction. The pathophysiological basis of these nervous system findings is not well understood.

Certified Insane: Concepts and Practices

This chapter explores psychiatric concepts and clinical issues relating to patients in the asylums, including classification of disorders; research; nature and nurture hypotheses; and treatment and convalescence. From medical and legal standpoints, definitions of insanity were vague, subjective and their value debated. Physical illness and mental disturbances overlapped and there was little consensus on the relative contributions of heredity, brain disease, psycho-social, spiritual and other non-medical factors to causing mental disorders. Treatment became more custodial, often relying on sedative medications, restraint and seclusion. Individually focussed treatment was an ideal but hard to implement in large impersonal, overcrowded and inadequately staffed asylums. Particularly during the war, the asylums lost the precious commodity of staff time to build therapeutic relationships and provide psycho-social treatments to assist recovery and manage the most disturbed patients humanely.

Effects of Region, Epidemic Stage, and Demographic Characteristics on Sleep Quality and Mental Disturbances among Health Care Workers during COVID-19 Outbreak

Objective To investigate the prevalence of sleep quality and mental disturbances of medical staff and identify the effects of region, epidemic stage, and demographic characteristics during the COVID-19 outbreak in China. Method Self-administered questionnaire were sent to health care workers (HCWs) in China from 30 Jan to 2 March, 2020. The Pittsburgh Sleep Quality Index, the Patient Health Questionare-9, the Generalized Anxiety Disorder-7 and the Impact of Event Scale were used to assess sleep quality, depression symptoms, anxiety symptoms and Post-traumatic stress disorder (PTSD) of HCWs, respectively. The influencing factors of psychological and sleep disturbances were identified by univariate analysis and multiple regression. Result The incidence of people getting depression, anxiety or PTSD symptoms were 11.6%,13.3%, 14.3%, respectively. HCWs in Hubei province experienced significantly poorer sleep quality (t=5.034, P<0.001). The predictors of sleep quality among HCWs were COVID-19 stage 2 (β=.135, p=.014) and 3 (β=.184, p=.001), female (β=.141, p=.003) and older age (β=.160, p=.001).Not working in Hubei province (β=-.264, P<0.001) showed to be a protective factor of sleep quality. The risk factors of depression symptoms were not working in Hubei province (OR=4.318, P<0.001), administrative and logistic staff and others (OR=3.538, p=.011), and higher PSQI score (OR=1.282, P<0.001). Having children (under-age: OR=.292, p=.001, grown-up: OR=.293, p=.042) was identified as a protective factor of having depression symptoms. Poor sleep quality showed to be the risk factor of anxiety and PTSD symptoms as well (both p<.001). Furthermore, administrative and logistic staff and others (OR=3.399, p=.006) were found to be the risk factor of PTSD symptoms among HCWs. Conclusion HCWs had poorer sleep quality on stage 2and 3 of the outbreak. HCWs in Hubei had poorer sleep quality but lighter depression condition. gender, age, occupation and status of having children were associated with sleep and mental health. Mental health programs should be considered for HCWs especially those with specific characteristics. Key words COVID-19, Depression, Anxiety, PTSD, Sleep quality, Health care workers

Perceptions and possible solutions for violence against children among mothers of under five

Background: Violence has been one of the most complex contemporary phenomena and their manifestations are responsible for social and mental disturbances of children. This phenomenon is a serious problem of global public health, presenting various causes that compromise socio-cultural levels of society. The objective of the study was to assess the perceptions on causes and consequences of violence against children among mothers of under five children and to describe the common solutions for the violence against children as perceived by mothers.Methods: This qualitative research was undertaken in the urban field practice area of Department of Community Medicine, JSS Medical College, Mysore. A total of 20 women were interviewed for free-listing exercise and the data regarding their perception about causes, consequences and methods of prevention of violence on children were collected. The data collected through free listing and pile sorting was analyzed using Visual Anthropac 1.0.Results: Among 20 subjects interviewed, mean age of the women interviewed was 29.6 years, 70% were completed basic schooling, 30% had history of substance abuse by family members. Common themes emerged out were subjects being not aware of child abuse, opined that child abuse was solely from family members, claimed that they do not abuse their children, opted to remain silent in the circumstances of child abuse, believed it hamper child growth.Conclusions: It is necessary to intervene violence as it means to prevent it through short- and long-term goals such as the implementation of public policies, programs that aim at changes capable of modifying the conditions that favour this phenomenon.

The Degenerating Sex: Female Sterilisation, Medical Authority and Racial Purity in Catholic Brazil

This article examines female sterilisation practices in early twentieth-century Rio de Janeiro, Brazil. It argues that the medical profession, particularly obstetricians and psychiatrists, used debates over the issue to solidify its moral and political standing during two political moments of Brazilian history: when the Brazilian government separated church and state in the 1890s and when Getúlio Vargas’s authoritarian regime of the late 1930s renewed alliances with the Catholic church. Shifting notions of gender, race, and heredity further shaped these debates. In the late nineteenth century, a unified medical profession believed that female sterilisation caused psychiatric degeneration in women. By the 1930s, however, the arrival of eugenics caused a divergence amongst physicians. Psychiatrists began supporting eugenic sterilisation to prevent degeneration – both psychiatric and racial. Obstetricians, while arguing that sterilisation no longer caused mental disturbances in women, rejected it as a eugenic practice in regard to race. For obstetricians, the separation of sex from motherhood was more dangerous than any racial ‘impurities’, both phenotypical and psychiatric. At the same time, a revitalised Brazilian Catholic church rejected eugenics and sterilisation point blank, and its renewed ties with the Vargas regime blocked the medical implementation of any eugenic sterilisation laws. Brazilian women, nonetheless, continued to access the procedure, regardless of the surrounding legal and medical proscriptions.