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Provision of quality health services to population of the rural areas with limited access to dental treatment and educating dental students in high standard of professional conduct when delivering health services to the population, represents the main reason for the foundation of a dental college in an area like Mangalore. The purpose of this study was to assess the satisfaction of patients visiting the dental college clinics. A cross-sectional study was conducted between May 1 and July 31, 2017. A questionnaire, covering 4 items: patient-dentist relationship; efficiency of the general clinic; patients perception of dental care quality; college healthcare opinion, was distributed to 400 patients visiting the dental clinic. Data were treated statistically using overall percentage distributions and Fisher exact test. The mean percentage of agreement for the 4 items was 85.86 ± 24.51% denoting a high level of satisfaction. Fisher exact test showed (p < 0.01) statistically important difference between first time and multiple time visitors answers. Majority of the patients were satisfied with the clinical settings and the benefits of the fast delivered treatment. The quality of the services was appreciated by the majority of visitors. The attitude of the providers of healthcare was perceived as very friendly and gentle. The assessment of patients’ contentment and perception of healthcare services could be an efficient tool to evaluate the overall activity of an educational healthcare institution.

A lot of energy is released during the cement manufacturing process, and a large amount of carbon dioxide (CO2) is discharged into the environment. Presently, researchers are focusing on reducing CO2 emissions by researching sustainable alternatives to traditional Portland cement-based materials. A comparative study on the material characterization of both calcined agro-based waste ash (calcined ash) and uncalcined agro-based waste ash (uncalcined ash) and its utilization as a binder along with granulated blast furnace slag (GGBS) in the alkali activation process is carried out in this paper. The study regarding calcined and uncalcined ash would help in better understanding the variation in the properties of the material and its behavior during the alkali activation process. The tests conducted on both calcined and uncalcined ash along with GGBS include specific gravity, X-ray fluorescence, X-ray diffraction, scanning electron microscopy, reaction degree, Brunauer-Emmett-Teller (BET) analysis, particle size distribution, and the Puntke test for understanding its microstructural characteristics. Later, alkaliactivated mortars are prepared using 30% weight of agro-based waste ash (both calcined and uncalcined) and 70% weight of GGBS. A comparison of the compressive strength of alkali-activated mortars prepared using calcined and uncalcined ash was studied, which showed a promising increase in the strength by 11.02% of mortar prepared using calcined ash (23.46 MPa) for 28 days when compared to mortar prepared using uncalcined ash (21.13 MPa). The major finding from this study indicates that calcined agro-based ash with GGBS shows better results compared to uncalcined agro-based ash with GGBS. [ABSTRACT FROM AUTHOR]

BACKGROUND Antidepressants are used to treat acute depression in patients with bipolar I disorder, but their effect as maintenance treatment after the remission of depression has not been well studied. METHODS We conducted a multisite, double-blind, randomized, placebo-controlled trial of maintenance of treatment with adjunctive escitalopram or bupropion XL as compared with discontinuation of antidepressant therapy in patients with bipolar I disorder who had recently had remission of a depressive episode. Patients were randomly assigned in a 1:1 ratio to continue treatment with antidepressants for 52 weeks after remission or to switch to placebo at 8 weeks. The primary outcome, assessed in a time-to-event analysis, was any mood episode, as defined by scores on scales measuring symptoms of hypomania or mania, depression, suicidality, and mood-episode severity; additional treatment or hospitalization for mood symptoms; or attempted or completed suicide. Key secondary outcomes included the time to an episode of mania or hypomania or depression. RESULTS Of209 patients with bipolar I disorder who participated in an open-label treatment phase, 150 who had remission of depression were enrolled in the double-blind phase in addition to 27 patients who were enrolled directly. A total of 90 patients were assigned to continue treatment with the prescribed antidepressant for 52 weeks (52-week group) and 87 were assigned to switch to placebo at 8 weeks (8-week group). The trial was stopped before full recruitment was reached owing to slow recruitment and funding limitations. At 52 weeks, 28 of the patients in the 52-week group (31%) and 40 in the 8-week group (46%) had a primary-outcome event. The hazard ratio for time to any mood episode in the 52-week group relative to the 8-week group was 0.68 (95% confidence interval [CI], 0.43 to 1.10; P=0.12 by log-rank test). A total of 11 patients in the 52-week group (12%) as compared with 5 patients in the 8-week group (6%) had mania or hypomania (hazard ratio, 2.28; 95% CI, 0.86 to 6.08), and 15 patients (17%) as compared with 35 patients (40%) had recurrence of depression (hazard ratio, 0.43; 95% CI, 0.25 to 0.75). The incidence of adverse events was similar in the two groups. CONCLUSIONS In a trial involving patients with bipolar I disorder and a recently remitted depressive episode, adjunctive treatment with escitalopram or bupropion XL that continued for 52 weeks did not show a significant benefit as compared with treatment for 8 weeks in preventing relapse of any mood episode. The trial was stopped early owing to slow recruitment and funding limitations. (Funded by the Canadian Institutes of Health Research; ClinicalTrials.gov number, NCT00958633). [ABSTRACT FROM AUTHOR]

Background: The binarian model views melancholia as a distinct depressive class, whereas the unitarian model views it as a more severe expression of depression. This study aims to investigate the sociodemographic, clinical, and course differences between melancholic and non-melancholic depression. Methods: This prospective observational study was carried out at Kasturba Hospital, Manipal, India from November 2010 to September 2011. We recruited consecutive inpatients aged 18 to 60 years who have a diagnosis of depressive disorder (based on ICD-10), with or without any psychiatric or physical comorbidities. Patients were categorised into melancholia and non-melancholia using the CORE questionnaire, with scores of >8 indicating the presence of melancholic depression. In addition, patients were evaluated using the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Somatoform Symptom Checklist, Columbia Suicide Severity Rating Scale, Clinical Global Impression, and Presumptive Stressful Life Events Scale at baseline and at 1,3, and 6 months. Results: Of 87 inpatients with a diagnosis of depression, 50 met the inclusion criteria and 37 were excluded. Compared with patients with non-melancholic depression, patients with melancholic depression had higher depression score (30.8 vs 23.8, p < 0.001), had higher number of patients with psychotic depression (39.1% vs 7.4%, p = 0.007), had higher overall illness severity score (5.9 vs 4.8, p < 0.001), and had higher number of patients with suicidal ideation and suicidal behaviour. Regarding the course of melancholia, the number of melancholic patients decreased from 23 at baseline to eight at 1 month, three at 3 months, and three at 6 months. Scores of non-interactiveness, retardation, and agitation decrease significantly over 3 months. Conclusions: The construct and course of melancholia may be viewed as a part of depression, more in line with severe depression. Melancholia increases the risk for suicidal ideation and suicidal behaviour. [ABSTRACT FROM AUTHOR]