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Background: Integrating mobile technologies in healthcare (mHealth) is helpful to manage various medical conditions. mHealth applications can bridge the gap in the management of patients with opioid use disorder (OUD). Research evaluating the feasibility of mHealth to address OUD is limited in developing countries. We aimed to assess the digital capacity and interest in mHealth interventions in patients maintained on opioid agonist treatment (OAT).Methods: 150 patients on OAT from a community drug treatment clinic in New Delhi, India, were included. We assessed the participants on their pattern of mobile and Internet use and their willingness to use mHealth technology to access health information and services related to OUD.Results: 88% of participants (n= 132) owned a mobile phone at assessment; 2.7% (n= 4) had never used a mobile phone in their lifetime. 70% (n= 105) participants had Internet access. 80% (n= 120) of participants showed interest in receiving text messages related to the management of OUD. 60% of participants showed a willingness to download and use applications for monitoring their substance use.Conclusions: In India, there is an interest among people on OAT to use mHealth interventions to manage their substance use. This population also has access to mobile phones and the necessary knowledge to install and run applications needed for various mHealth interventions.

A 63-year-old diabetic and hypertensive lady presented in New York Heart Association class III–IV dyspnea on exertion. Echocardiography showed a large mass attached to the anterior mitral leaflet and the base of the interatrial septum. After removal of the mass and excision of the anterior and posterior mitral leaflets, a bioprosthetic valve was deployed. The postoperative course was uneventful. Histopathology showed that the tumor was a high-grade rhabdomyosarcoma. Although it is a highly lethal tumor, surgical removal was indicated to relieve dyspnea, clarify the diagnosis, and improve short-term survival. Our patient survived for 8 months after surgical excision.

Objective: To develop efficient method for the synthesis of naphtha-quinoxaline derivatives via the reaction of β-lapachone with various 1,2-diamines. Methods: A mixture of β-lapachone (1mmol), 1,2-diamine (1mmol) and graphene oxide (20mg) in methanol (3mL) was heated at 60°C, under constant stirring for appropriate time. After completion of the reaction, the catalyst was filtered off, washed with ethyl acetate (3x3mL) and the combined filtrate was washed with H2O, dried (anhy. Na2SO4) and concentrated under vacuum. The residue was chromatographed over a column of silica gel eluting with a mixture of hexane and ethyl acetate in different ratios, to afford the desired product. All synthesized compounds were assigned with the help of analytical and 1H, 13C NMR, IR, and mass spectral studies. Results: To establish the catalytic role of GO in the synthesis of naphtha-quinoxaline derivatives, the reaction of β-lapachone with 3,4-diaminotoluene was selected as a model reaction. The catalytic activity of graphene oxide in comparison with other catalysts like acidic resin amberlyst-15 and solid acid catalyst like montmorillonite K-10 were studied. The reaction was also observed in various solvents such as water, acetonitrile, toluene, dichloromethane, ethanol and 1,4-dioxane using GO as a catalyst. Excellent yields were obtained at 60°C in methanol. The efficacy of the present protocol was investigated by the reaction of β- lapachone with other 1,2-diamines. Conclusion: An attractive green metal free carbocatalyst Graphene Oxide (GO) has been successfully utilized for the expedient synthesis of naphtha-quinoxaline derivatives. GO showed high catalytic activity which is attested by the desired products being produced in shorter time. The main advantage of this method is the reusability of the catalyst which makes the procedure sustainable.

Objective: This study was performed to explore the perceptions of treatment utilization patterns and the risk of overdose of both opioid users and their peer educators in Kolkata, India.Methods: This study used a qualitative approach for data collection between September and December 2023. In-depth interviews (IDIs) of 20 opioid users from two authorized opioid substitution therapy (OST) centers (10 registered clients) and their respective field practice areas (10 unregistered clients) in Kolkata were conducted. Key informant interviews (KIIs) of six peer educators were also conducted. Semi-structured interviews were conducted; audio was recorded, transcribed, and translated for coding and analysis. An inductive thematic analysis was performed.Results: Six broad themes (individual knowledge, logistics, legal/administrative, treatment effectiveness, self-confidence of treatment, and poor knowledge about the antidote of opioid poisoning, i.e., naloxone) emerged from the data analysis of IDIs. Four broad themes (high-risk behavior, raising awareness, the benefits of OST, and poor knowledge about naloxone) emerged from the data analysis of KIIs. Both opioid users and their peer educators were aware of the dangers of opioid overdose. However, they lacked sufficient knowledge in recognizing and offering immediate assistance in instances of opioid overdose, including the administration of naloxone.Conclusion: The findings recognize the necessity of drawing and retaining opioid users in an efficient healthcare facility, such as OST centers, and providing them adequate training to identify and provide immediate assistance in cases of overdose, including naloxone administration. Our findings will assist policymakers in designing programs to prevent and treat opioid overdoses.

Background: South Asia generally reports low levels of amphetamine-type stimulant (ATS) use, with few studies on the pattern of ATS use. We assessed the pattern of ATS use and associated high-risk behavior in Manipur, a north-eastern state of India.Methods: 209 adult male ATS users (mean age 28.8 years) from three districts of Manipur were interviewed. Data were collected on the patterns of high-risk behavior with ATS use, health consequences, and help-seeking. The severity of use with various substances was assessed using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Depression and anxiety were assessed by the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) scale, respectively.Results: The mean duration of ATS use was 3.7 years (SD 2.3). The majority used ATS almost daily (88%) and depended on ATS (77%). Methamphetamine (99.5%) was the most used ATS orally. Around 87% also suffered from opioid dependence. About 76% injected drugs, most commonly heroin. Almost three-fourths (78%) used ATS before their sexual intercourse, 31% of whom did not use condoms. Most reported physical problems with ATS and had above-cut-off scores on PHQ-9 and GAD-7. The majority (95%) reported that they could procure ATS easily. Also, the majority (93%) had thought of quitting ATS use.Discussion: Most ATS users start using ATS at a young age and have comorbid other drug use, including heroin. ATS use is associated with various physical and psychological problems. Focusing on ATS use in India and developing strategies to address this problem is essential.

The most recent versions of the two main mental disorders classifications—the World Health Organization's ICD-11 and the American Psychiatric Association's DSM–5—differ substantially in their diagnostic categories related to transgender identity. ICD-11 gender incongruence (GI), in contrast to DSM-5 gender dysphoria (GD), is explicitly not a mental disorder; neither distress nor dysfunction is a required feature. The objective was compared ICD-11 and DSM-5 diagnostic requirements in terms of their sensitivity, specificity, discriminability and ability to predict the use of gender-affirming medical procedures.

Calcified coronaries still remain a major challenge for interventional cardiologist. This study aims to evaluate safety and efficacy of intravascular lithotripsy (IVL) in management of coronary artery calcification.

Urinary ethyl glucuronide (EtG), an alcohol biomarker, plays an essential role in monitoring alcohol abstinence and relapse during treatment for alcohol dependence. Detection of this biomarker has become a routine in many clinical and forensic laboratories over the last few years. Most previously published methods commonly use hyphenated chromatographic techniques along with extensive extraction procedure before analysis. This work aimed to develop and validate an electron impact ionization mode gas chromatography–mass spectrometry method to measure ethyl glucuronide levels in human urine. For its determination, urine samples were dried under a gentle stream of nitrogen, derivatized with N,O-bis(trimethylsilyl) trifluoroacetamide, incubated, and injected into the instrument. The analysis was performed using single quadrupole gas chromatography–mass spectrometry (GC-MS) technology and validation was performed according to the guidelines of the German Society of Toxicology and Forensic Chemistry (GTFCh). The linearity of urinary EtG was obtained in the range of 30–5000 ng/ml with a correlation coefficient (r) above 0.999. The extraction recoveries exceeded 80%, and the obtained inter-day and intra-day precisions were below 15%. The achieved limit of detection was 10 ng/ml and limit of quantification achieved was 30 ng/ml. The electron ionization gas chromatography–mass spectrometry technique proves to be a feasible option for determining EtG in human urine when other sophisticated techniques are unapproachable. This method provides a good sensitivity and proves to be cost-effective, robust, and advantageous for both clinical as well as forensic settings.

COVID-19, a pandemic has led the whole globe through unprecedented times and unpredictability that has adversely affected the humanity as a whole. Although the severe acute respiratory syndrome was reported in the year 2002-2004 of zoonotic origin caused by SARS-CoV-1 strain. Now recently, in December 2019, SARS-CoV-2 virus has emerged and swiftly spread to the whole world, taking a heavy toll on life. Studies are being conducted worldwide to find antiviral drugs acting specifically on the virus and to develop the vaccine for the disease. The present review article summarizes the currently undergoing clinical trials of Indian Ayurvedic herbs and their role in promoting immunity. It also includes studies focused on repurposing the existing drugs and finding alternative treatment methods that can be opted for potential treatment/management of COVID-19. Last but not the least, this paper provides a background on the development of preventive vaccines and the various bioinformatic tools utilized in order to help accelerate the research on coronavirus. The manuscript gives a brief outline of all the possible strategies and therapeutics underway in India and at the global level to fight against the microscopic adversary and lead to an affordable and speedy remedy for COVID-19.

Objective: To report a case of psychosis induced by therapeutic doses of baclofen.Case Summary: A 32-year-old Hindu man was prescribed oral baclofen 10 mg twice daily for relief of muscular spasms secondary to tetanus. After 4 weeks of baclofen use, he presented to the psychiatry emergency facility with a 4 day history of third-person auditory hallucinations and persecutory and referential delusions without underlying mood symptoms. These symptoms resolved within 1 week of discontinuing baclofen. Rechallenge with baclofen resulted in reemergence of psychotic symptoms, which disappeared after discontinuing baclofen.Discussion: Reemergence of psychotic symptoms after rechallenge with baclofen suggests baclofen-induced psychosis. Use of the Naranjo probability scale indicates a probable association of baclofen with this patient's psychosis. The absence of underlying mood disorder makes this case different from previously reported ones.Conclusions: Baclofen may be associated with the occurrence of psychosis. Clinicians should consider baclofen-induced psychosis as a differential diagnosis in patients presenting with psychosis during treatment with this drug.