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Background: Low- and middle-income countries (LMICs) bear the majority of the neurosurgical burden of diseases but lack the resources to meet these needs.Objective: As we increase access to neurosurgical care in LMICs, we must understand patient attitudes toward neurosurgery.Methods and Material: PubMed, LILACS, and African Journals Online databases were searched systematically from inception to January 4, 2020, for studies on neurosurgical patient perceptions in LMICs. The articles found were blindly reviewed with Rayyan by two authors. The two authors resolved conflicts between themselves, and when this was not possible, a third reviewer was consulted. All the articles included were then appraised, and the results were summarized.Results: Six of the 1,175 articles met the inclusion criteria. The studies were set in Brazil, Ethiopia, India, Nigeria, South Korea, and Sub-Saharan Africa. Four of the studies (50%) were phenomenological studies, and the other two were grounded theory and narrative. The studies identified patient attitudes toward neurosurgical practitioners, diseases, and interventions. Ethiopian and Nigerian patients believed cranial diseases to be otherworldly and resorted to traditional medicine or spiritual healing first, whereas Brazilian patients were more comfortable with cranial diseases and even more so if they had had a previous craniotomy. The Indian paper was a recount of a neurosurgeon's experience as a spine patient.Conclusions: There are few studies on neurosurgery patient perception in LMICs. LMIC neurosurgeons should be encouraged to study their patient beliefs concerning neurosurgical diseases and interventions, as this can explain health-seeking behaviors. [ABSTRACT FROM AUTHOR]

Of the 70 million persons with epilepsy (PWE) worldwide, nearly 12 million PWE are expected to reside in India; which contributes to nearly one-sixth of the global burden. This paper (first of the two part series) provides an in-depth understanding of the epidemiological aspects of epilepsy in India for developing effective public health prevention and control programs. The overall prevalence (3.0-11.9 per 1,000 population) and incidence (0.2-0.6 per 1,000 population per year) data from recent studies in India on general population are comparable to the rates of high-income countries (HICs) despite marked variations in population characteristics and study methodologies. There is a differential distribution of epilepsy among various sociodemographic and economic groups with higher rates reported for the male gender, rural population, and low socioeconomic status. A changing pattern in the age-specific occurrence of epilepsy with preponderance towards the older age group is noticed due to sociodemographic and epidemiological transition. Neuroinfections, neurocysticercosis (NCC), and neurotrauma along with birth injuries have emerged as major risk factors for secondary epilepsy. Despite its varied etiology (unknown and known), majority of the epilepsy are manageable in nature. This paper emphasizes the need for focused and targeted programs based on a life-course perspective and calls for a stronger public health approach based on equity for prevention, control, and management of epilepsy in India. [ABSTRACT FROM AUTHOR]

Background: Epistemic injustice and the so-called "predators" or illegitimate publishers are the challenges of Southern scholarly publishing. Even though open access (OA) publishing is revolutionary in academic publishing, increased compensation from authors in the form of author processing charges (APCs) by commercial publishers has marginalized knowledge creation in the Global South. The purpose of this study was to map the nature and scope of dental journal publishing in India. Methods: We searched databases like Scopus, WoS, DOAJ, and the UGC CARE list for dental journals published in India. Result: There are currently 35 active dental journals, which mostly belong to or are affiliated with non-profit organizations (26, 55.9%) or educational institutions (9, 25.8%). The publication of 25 journals has been outsourced to international commercial publishers, with most of these linked to non-profit organizations. About 39.8% of Indian dental journals are OA and almost half charge APCs. Around 60% of the Indian journals are indexed in Scopus, and slightly less than half (12) are included in the Web of Science (WoS). Discussion: The monopoly of international commercial publishers and the presence of APCs are the real culprits of epistemic injustice in Indian dental journal publishing. Besides, the identification of regional legitimate publishers would help demarcate the term "predatory publishing". Conclusion: The post-colonial world witnessed an emergence in Southern scholarly publishing. However, the hegemony or neoliberal exploitation of international commercial publishers and the prolonged use of "predators" in scholarly debates marginalized the knowledge produced in the Global South. [ABSTRACT FROM AUTHOR]

An acquired brain injury (ABI) is an injury to the brain, which is not hereditary, congenital, degenerative, or induced by birth trauma. In India, rapid urbanization, economic growth and changes in lifestyle have led to a tremendous increase in the incidence of ABI, so much so that it is being referred to as a ‘silent epidemic'. Unlike developed countries, there is no well-established system for collecting and managing information on various diseases in India. Thus it is a daunting task to obtain reliable information about acquired brain injury. In the course of conducting a systematic review on the epidemiology of ABI in India, we recognized several challenges which hampered our effort. Inadequate case definition, lack of centralized reporting mechanisms, lack of population based studies, absence of standardized survey protocols and inadequate mortality statistics are some of the major obstacles. Following a standard case definition, linking multiple hospital-based registries, initiating a state or nationwide population-based registry, conducting population-based studies that are methodologically robust and introducing centralized, standard reporting mechanisms for ABI, are some of the strategies that could help facilitate a thorough investigation into the epidemiology and understanding of ABI. This may help improve policies on prevention and management of acquired brain injury in India. [ABSTRACT FROM AUTHOR]

Introduction: Enhanced recovery after surgery (ERAS) principles is an evidence-based surgical management approach that requires cooperation across various medical specialties. In this study, we applied ERAS principles in total laparoscopic hysterectomy (TLH) and the post-operative outcomes like post-operative pain, nausea and vomiting, opioid requirement, day of discharge, and any other complaints were studied. Methods: The study was conducted in a private healthcare setup in Jodhpur, Rajasthan, India. In this non-randomised controlled study 103 patients who underwent TLH over a period of 1 year were alternatively allocated to the study group and the control group. There were 51 patients in the study group in whom ERAS principles were applied and 52 patients in control group in whom traditional post-operative care was given. Results: Post-operative nausea and vomiting and opioid requirement were significantly reduced in the study group (P < 0.05). The post-operative pain was similar in both groups. The majority of patients in study group were discharged within 24 h as compared to the routine discharge after 48 h. Conclusion: Following ERAS principles in TLH results in decrease in post-operative nausea and vomiting, post-operative opioid requirement and hospital stay. Hence, the ERAS principles should be the standard practice in TLH even in a developing country setup. [ABSTRACT FROM AUTHOR]

Background: The prevalence of childhood blindness is 0.3/1000 children in industrialized countries, 1.2/1000 children in developing countries and 0.17% in India. The visually impaired face difficulty in learning as they depend on speech and touch to orient themselves, making it challenging for the dentist to manage them. In such patients, there are limitations of moving around in different surroundings and performing basic activities due to which managing them becomes a challenging task for pediatric dentists. Therefore, there is a need to treat and train the visually impaired individuals with the aid of modified behavior management techniques so that the outcome of the treatment could be perceived at its best. Case Presentation: This case report aims to demonstrate successful full-mouth rehabilitation, in a 5-year-old boy with visual impairment using "Audio-tactile Performance (ATP) technique" and "Tell-Feel-Do technique." ATP is a multisensory health education method, specially designed for training visually impaired children. "Tell-feeldo" technique can be used instead of "tell show-do" to demonstrate the ongoing procedures to the patient. This case report emphasizes the successful treatment of a visually impaired child using these techniques. With the introduction of ATP, it has become easier for both the dentist and the child to get along with each other, and also the dentist can easily convey all the procedures to be done in the child. Clinical significance: A case of visually impaired child with "Tell- Feel-Do" and ATP. [ABSTRACT FROM AUTHOR]

Context: Data from the Western countries suggest that obsessive-compulsive disorder (OCD) in children and adolescents is associated with male preponderance, comorbid neurodevelopmental disorders, and high family loading. However, data are limited from the developing countries with respect to the demographic and clinical characteristics of OCD in children and adolescents. Aims: To study the demographic and clinical characteristics of children and adolescents (age ≤18 years) with OCD. Setting and Design: This was a cross‑sectional study, conducted in outpatient treatment setting, across six centers in India. Materials and Methods: Participants were assessed using a semi‑structured pro forma for sociodemographic information, clinical characteristics, the Children’s Yale Brown Obsessive Compulsive Scale (CYBOCS), Structured Clinical Interview for Diagnostic and Statistical Manual, 5th Edition Research Version, Children’s Depression Rating Scale, and Family Interview for Genetic Studies. Results: The sample was largely male with a moderate illness severity. Nearly 75% of the sample had illness onset before the age of 14 years. Aggressive, contamination‑related obsessions and washing, checking, and repeating compulsions were the most common symptoms. CYBOCS assessment revealed that >2/3rd of children and adolescents endorsed avoidance, pathological doubting, overvalued sense of responsibility, pervasive slowness, and indecisiveness. Family history and comorbidity rates were low. OC‑related disorders were present in about 10% of the sample. Conclusions: This study suggests that the clinical characteristics of OCD in children and adolescents in developing countries differ on certain aspects as reported from developed countries. [ABSTRACT FROM AUTHOR]

Issues related to the management of pleural effusion in India are unique. With high incidence of tuberculosis and malignancy, managing patients with pleural effusion may not be the same between patients. Decisions on intercostal chest drain insertion, volume of fluid to be removed during therapeutic thoracentesis, and further diagnostic imaging and investigations are often taken with difficulty in low‑resource settings. Pleural manometry can help resolve these issues and help in the management of such patients. Pleural manometry has been advocated as a valuable tool to characterize underlying lung behavior during thoracentesis and has been proposed to be useful in diagnosing unexpandable lung, predicting the success of pleurodesis, and preventing the development of excessively negative pleural pressures which in turn may lead to the development of reexpansion pulmonary edema. There is very little literature on pleural manometry from India and other developing countries. In this article, the utility of pleural manometry in managing patients with malignant pleural effusion is discussed. [ABSTRACT FROM AUTHOR]

Background: There is limited scientific evidence on the relationship of job stress with quality of life (QoL). Purpose: This study aims to explore different domains of job stress affecting IT/ITES professionals and estimate the levels of stress that these professionals endure to reach positive levels of QoL given that other determinants operating between these two variables are accounted for. Materials and Methods: We estimated levels of stress that software professionals would have endured to reach positive levels of QoL considering that other factors operating between these two variables are accounted for. The study participants comprised 1071 software professionals who were recruited using a mixed sampling method. Participants answered a self-administered questionnaire containing questions on job stress, QoL, and confounders. Results: All the domains (physical, psychological, social, and environmental) of QoL showed statistically significant positive associations with increasing stress domains of autonomy, physical infrastructure, work environment, and emotional factors. Conclusions: The respondents clearly found the trade-off of higher stress to be acceptable for the improved QoL they enjoyed. It is also possible that stress might actually be responsible for improvements in QoL either directly or through mediation of variables such as personal values and aspirations. "Yerkes-Dodson law" and stress appraisal models of Folkman and Lazarus may explain the plausible positive association. [ABSTRACT FROM AUTHOR]

Background: Knowledge of community medicine is essential for health care professionals to function as efficient primary health care physicians. Medical students learning Community Medicine as a subject are expected to be competent in critical thinking and generic skills so as to analyze community health problems better. However, current teaching by didactic lectures fails to develop these essential skills. Problem-based learning (PBL) could be an effective strategy in this respect. This study was hence done to compare the academic performance of students who were taught Community Medicine by the PBL method with that of students taught by traditional methods, to assess the generic skills of students taught in a PBL environment and to assess the perception of students toward PBL methodology. Materials and Methods: This study was conducted among seventh-semester final-year medical students between June and November 2014. PBL was introduced to a randomly chosen group of students, and their performance in an assessment exam at the end of postings was compared with that of the remaining students. Generic skills and perception toward PBL were also assessed using standardized questionnaires. Results: A total of 77 students took part in the brainstorming session of PBL. The correlation between self-assigned scores of the participants and those assigned by the tutor in the brainstorming session of PBL was significant (r = 0.266, P = 0.05). Out of 54 students who took part in the presentation session, almost all 53 (98.1%) had good perception toward PBL. Demotivational scores were found to be significantly higher among males (P = 0.024). The academic performance of students (P < 0.001) and success rates (P = 0.05) in the examination were higher among students who took part in PBL compared to controls. Conclusion: PBL helped improve knowledge of students in comparison to those exposed only to didactic lectures. As PBL enabled students to identify the gaps in their knowledge and enhanced their group functioning and generic skills, we recommend PBL sessions: They would help optimize the training in Community Medicine at medical schools. Good correlation of tutor and self-assessment scores of participants in the brainstorming session suggests that the role of tutors could be restricted to assessment in presentation sessions alone. Demotivation, which hinders group performance in PBL, needs to be corrected by counselling and timely feedback by the tutors. [ABSTRACT FROM AUTHOR]