Publications

BACKGROUND: Sphenopalatine ganglion (SPG) block combined with occipital nerve block can attenuate the hemodynamic response to the painful stimulus of skull pin application.

MATERIALS AND METHODS: About 60 patients, aged 18-65 years, were randomly assigned to two groups. All patients were classified as American Society of Anesthesiologists (ASA) grades I and II, had a Glasgow Coma Scale (GCS) score of 15/15, and were scheduled for elective craniotomy. Group S was given a scalp block with 0.25% bupivacaine, while group SPG was given a bilateral transnasal SPG block with 0.5% bupivacaine, along with greater and lesser occipital nerve blocks using 0.25% bupivacaine. The primary objective was to assess the change in mean arterial pressure (MAP) following skull pin application. The dose of propofol used as rescue was also noted.

RESULTS: All 60 patients completed the study. The MAP differed significantly in group SPG from prior to pin insertion to 2 (p-value = 0.034) and 3 minutes (p-value = 0.026) following pin insertion. The maximum percent change from the prior to pin insertion timepoint was observed at 2 minutes (p < 0.001). The heart rate (HR) also differed significantly in group SPG from the prior to pin insertion to 2 (p-value = 0.001) and 3 (p-value = 0.006) minutes following pin insertion. The maximum percent change from the prior to pin insertion was observed at 2 minutes following pin insertion (p < 0.001). There was no significant difference in the percent change in HR between the two groups from prior to pin insertion to any of the timepoints.

CONCLUSION: Bilateral SPG block with posterior scalp block can attenuate the hemodynamic response following skull pin insertion in patients undergoing craniotomy under general anesthesia.

INTRODUCTION: Medical students often experience high levels of stress, anxiety, and depression due to the demanding nature of their studies. Academic pressure can be a significant factor in the development of stress, depression, and anxiety among medical students. The situation may deteriorate if these students have personal, academic, or institutional problems. Hence, this study was planned to identify the prevalence of mental health problems among medical students and their association with personal, academic, and institutional issues.

MATERIALS AND METHODS: We conducted a cross-sectional study among medical students from Sangli District, Maharashtra, India. Data were collected using a predesigned and pretested questionnaire. Chi-square and multivariate regression analysis were used for the statistical analysis. Microsoft Office 365 and SPSS 22 were used for analysis purposes.

RESULTS: A significant proportion of medical students reported experiencing symptoms of mental health challenges: 50.0% depression, 73.6% anxiety, and 22.2% stress. The significant predictors for depression were birth order, physical health, and religiosity; for anxiety-age, upbringing, and stress; gender, year in which they are studying, upbringing, birth order, and physical health. By using binary logistic regression, it was found that personal issues are significant predictors related to depression, anxiety, and stress.

CONCLUSION: Various academic, personal, and institutional issues were contributing to mental health problems among medical students. A robust support system is required to identify and alleviate these problems, which can empower them to cope with challenges and succeed in their academic challenges.

BACKGROUND: Diabetes mellitus is a global epidemic, with an increasing number of undiagnosed individuals, particularly those with type 2 diabetes mellitus (T2DM). However, there is limited data on treatment delays among drug-naïve patients in India. The present study aimed to ascertain the incidence of treatment delay among drug-naïve patients and the sequence of alternate treatments sought since diagnosis.

MATERIALS AND METHODS: This cross-sectional, multicentric, observational study was conducted across 10 primary and secondary care settings in Mumbai from October 2023 to April 2024. Adults of either gender, diagnosed with T2DM, who are drug-naïve, were included. Patient's demographic data, comorbidities, current medications, and medical history were recorded in an electronic case report form and analyzed.

RESULTS: Of the 625 patients enrolled, 591 completed the study. The mean age of the patients was 46.7 years. The proportion of male patients was 54.1%. Overall, 57% of patients had no treatment delays, while 43% experienced delays of ≥3 months. Patients with treatment delays of ≥3 months used alternative/traditional medicines (56.0%), with Ayurveda being preferred by 56.7% of these patients.

CONCLUSION: The study indicated considerable treatment delays among drug-naïve patients in India.

We would like to highlight the clinical spectrum of human metapneumovirus (hMPV) infection in 11 patients diagnosed in the year 2024 at our center, clarifying that it is neither new nor does it resemble COVID-19. Our observations aim to provide insights and contribute to a clearer understanding of its role in respiratory diseases.

Amidst the global disparities in providing Paediatric Palliative Care (PPC), the compounded realities in the Eastern Mediterranean region intensify the need for palliative care for children with cancer. This region hosts 12% of children needing PPC worldwide within limited specialised services, training and resources exacerbated by political instabilities. Immediate effective responses may reside in promoting interdisciplinary capacity-building combined with action planning among healthcare professionals, stakeholders and advocates for patients and their families. In response to these pressing needs, the First Regional Interdisciplinary PPC Workshop was held in-person in Rabat, Morocco on 6-8 November 2024, aiming to strengthen regional interdisciplinary healthcare professionals' capacity through training and collaborative action planning to improve PPC integration in cancer treatment. Eighty-five attendees representing 15 countries including regional healthcare professionals, international experts, foundation representatives and policymakers united in the commitment to promote PPC integration and enhance the quality of life for children with palliative care needs, particularly those with cancer living in this region. Over 3 days, participants engaged in training, discussions and action planning. Day one provided essential skills to deliver PPC at the patient care level (micro-level), day two discussed institutional implementation of PPC services (meso-level), day three tackled national and regional endeavours to promote PPC integration (macro-level). At the conclusion of the workshop, participants gained knowledge and confidence in various PPC skills. They shared their plans to establish PPC teams/units, apply symptom management and communication skills, train colleagues within their settings, conduct research and maintain networking to encourage collaboration opportunities. The workshop marked a pivotal step to deepen understanding of the PPC landscape and resources in the region. This impactful experience laid the foundations for different opportunities in practice, research, policy and advocacy to accelerate PPC integration in the Eastern Mediterranean region, fostering collective efforts to improve childhood cancer care globally.