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This study aimed to understand the experiences of bereaved family members in view of restrictive COVID guidelines using qualitative approach. 10 Hindu, Gujarati bereaved family members who lost their loved ones during the first wave were interviewed telephonically after a month of their loss. Findings were difficulty in proper communication during hospitalization, disrupted end-of-life and funeral rituals and accepting harsh realities related to the changes imposed by using content analysis. Most of the family members felt that there was a need of staying with the patients. Telephonic mode of communication was not sufficient for them and created doubts related to death. Most of them felt remorseful as they were not able to see or bring their loved one home during their last moments and felt deprived of the traditional rituals. Also, they had to deal with their grief by themselves. [ABSTRACT FROM AUTHOR]

Hair loss in children is an important cosmetic concern, especially in adolescents where body image matters. Trichotillomania manifests through patchy hair loss which reflects underlying psychiatric conditions. It is a challenge for the dermatologist, who are first contact physicians, to deal with such cases who are secretly struggling with their inner turmoil. Hence, they must be well versed to deal with such patients. The current review aims to facilitate the dermatologist to handle them effectively. We performed PubMed and Google Scholar searches of English literature using the terms "Trichotillomania", "Trichotillosis," "Trichotillomania in Children," "Trichotillomania in pediatrics," "Trichotillomania in adolescents," "Hair pulling disorder," "Obsessive-Compulsive disorders AND Dermatology," "Psychodermatology," and "Psychocutaneous disorders." The selected publications were reviewed for additional resources. Thorough psychological evaluation of the patient along with the cutaneous examination will help the dermatologists in establishing the diagnosis. Dermatologists should be empowered regarding the need of mental health referral and should be able to convey the same to the patient/family members empathetically. They can offer habit reversal therapy, mainstay treatment, as well as pharmacotherapy as and when needed after adequate training. [ABSTRACT FROM AUTHOR]

Introduction: Bovine-derived collagen membrane is usually and regularly used as a temporary cover or dressing for extraoral wounds and burns. It has wide applications because of its usefulness and biocompatibility. This has provoked us to do a study with the use of collagen membrane even for minor intraoral surgical defects. The aim of this evaluative study was to evaluate the clinical efficacy of collagen membrane in intraoral wounds created by removal of various soft tissue lesions. Materials and Methods: A total of 25 healthy patients (16 males and 9 females) were taken for this study. This study was confined to secondary defects of the oral mucosa, which occur after excision of premalignant lesions and other conditions, such as benign lesions, reactive proliferations, and incisional biopsy wounds. Only those lesions that were sufficiently large and could not be closed primarily were included in the study. Results: The results were evaluated on the day of surgery and in the postoperative period. The usefulness of collagen membrane as an intraoral temporary wound dressing material to promote haemostasis, relieve pain, induce granulation, and assist in rapid epithelialization at the wound site and prevent infection, contracture, scarring, and donor-site morbidity was evaluated, and finally, the efficacy of collagen membrane was tested by the use of Chi-square test and P < 0.001, which is a statistically and clinically significant value. Discussion: Collagen membrane was observed as both biological dressing material and drug carrier. It was found to be a suitable alternative to other graft materials mentioned for the repair of defects in the mucous membrane created by surgical excision of lesions. Therefore, when used judiciously in a controlled clinical situation, collagen membrane is biologically acceptable in nature. It is an alternative to autologous grafts rather than a replacement of other grafts used in the oral cavity. [ABSTRACT FROM AUTHOR]

Introduction: The treatment of subcondylar mandible fractures is a topic of debate and can be variable even though these fractures are commonly seen. The present study aimed at evaluation of various treatment modalities for unilateral condylar fracture in adults. Materials and Methods: Thirty patients with unilateral condylar fractures between the age of 18 and 60 years were evaluated. Treatment protocol included closed reduction for 15 patients and open reduction for 15 patients. Results: Assessment was done functionally for maximum interincisal mouth opening, deviation on maximum interincisal mouth opening, occlusion and facial nerve function, and radiologically for ramus height shortening. In general, there were no statistically significant differences between closed and open methods. Discussion: Both the treatment options for condylar fractures of the mandible yielded acceptable results. Closed treatment appears to be a safe and appropriate modality for most unilateral condylar fractures. Although the open group, in general, showed similar outcomes, this treatment should be reserved for limited indications. The present study has confirmed that both treatment options can yield acceptable results. On clinical examination, there was no significant difference in mouth opening measures, the incidence of occlusal disturbances or in the degree of pain perception. [ABSTRACT FROM AUTHOR]

Adenomatoid odontogenic tumor (AOT) is a relatively rare, benign, hamartomatous, and cystic odontogenic neoplasm that was first described more than a century ago. It accounts for 2-7% of all odontogenic tumors. The lesion still continues to intrigue experts with its varied histomorphology and controversies regarding its development. The present article describes a case of cystic AOT with an unusual histomorphology associated with an impacted 43 in a 15-year-old male. [ABSTRACT FROM AUTHOR]

Objectives:To assess prevalence and pattern of movement disorders among patients taking antipsychotic medications. Methods:This cross-sectional, intensive monitoring (patient interview, case record form review and clinical examination) study was conducted in patients taking antipsychotic drugs irrespective of duration for the development of movement disorders. The psychiatrist used Modified Simpson-Angus Scale score (10-item scale), Barnes’ rating scale and Abnormal Involuntary Movement Scale to diagnose parkinsonism, akathisia and tardive dyskinesia, respectively. We assessed movement disorders for the preventability and seriousness. Results:The overall prevalence of antipsychotic induced movement disorders was 5.67% (95% CI: 4.19–7.62). The prevalence of parkinsonism, akathisia and tardive dyskinesia was 5.10% (95% CI: 3.71–6.98), 0.85% (95% CI: 0.39–1.84) and 0.57% (95% CI: 0.22–1.45), respectively. There was a trend of high proportions of movement disorders in extreme of age group, female gender, patients treated with conventional antipsychotics, on poly therapy, patients of epilepsy with psychosis, schizophrenia and bipolar mood disorder. The movement disorder was lowest with quetiapine (2.02%). Conclusions:The higher use of atypical antipsychotics had reduced the occurrence of movement disorders in our setup. [ABSTRACT FROM PUBLISHER]

Background & Objective: To study the patterns of psychiatric referrals in a newly established tertiary care teaching Hospital has been important for understanding consultation liaison psychiatry and setting up better general hospital psychiatric units. The aim of the present study was to study referral characteristics' of patients of various departments to psychiatric unit at a tertiary care teaching hospital. Methodology: All referrals made to psychiatry department over a period of one year were assessed by psychiatrist based on structured performa including demographic data, referring department, referral note, present complaints, past history of psychiatric illness, family history of psychiatric illness, mental status examination and DSM -IV-TR criteria to diagnose psychiatric illness and analyzed. Results: Out of 400 referred patients to psychiatry unit over a period of one year, majority were from Medicine department (62.75%). Substance use disorder (37.25%) was the most common diagnosis followed by depressive disorders (15.75%) and anxiety disorders (8.25%). 235 (58.75%) references were with statement like 'psychiatry reference' and no reason mentioned for that. Significantly higher proportions of OPD referrals (71.81%) were made with statement like 'psychiatry reference' and no reason mentioned for that as compared IPD referrals (41.62%). Significantly higher proportions of patients (66.75%) with past history of psychiatric illness were referred with statement like 'psychiatry reference' and no reason mentioned for that as compared to patients (52.81%) without past history of psychiatric illness. Conclusion: Study highlights importance of consultation-liaison psychiatry through referral pattern in a tertiary care teaching hospital. More referrals for Substance use disorders suggest emerging need to develop separate deaddiction services in our setting. Past history of psychiatric illness was considered significant factor for referrals from other departments and majority of references were without any details. There is need to sensitize other specialists, especially general physicians who are the common source of referrals regarding common psychiatric conditions and proper referral note to improve consultation liaison psychiatry in general hospital setup. [ABSTRACT FROM AUTHOR]

Spindle Cell Carcinoma (SpCC) also known as sarcomatoid carcinoma, is a rare and peculiar biphasic malignant neoplasm that occurs mainly in the upper aerodigestive tract. It is most frequently encountered in the larynx, and also occurs in the nasal cavity, hypopharynx, oral cavities, esophagus, trachea, skin and breast. It is a variant of squamous cell carcinoma which has spindled or pleomorphic tumor cells which simulate a true sarcoma but are epithelial in origin. It consists of sarcomatoid proliferation of pleomorphic spindle cells and squamous cell carcinoma. Spindle cell carcinoma is an unusual aggressive variant of Squamous Cell Carcinoma (SCC) that frequently recurs and metastasizes, reinforcing the importance of its correct diagnosis.We report a rare case of SpCC, present in unusual locatoion i.e. maxillary alveolar ridge region with immunohistochemical findings as well as review of literature. [ABSTRACT FROM AUTHOR]

Schwannoma (Neurilemmoma) is a benign nerve sheath tumor that is composed entirely of well differentiated Schwann cells. Intraosseous neurilemmomas are rare and they represent less than 1% of all benign primary bone tumors. It is important to highlight that the Schwannoma is usually found in the head and neck, and rarely in the oral cavity. Schwannoma is a benign tumor that originates from the Schwann cells of the peripheral nerves. They are usually asymptomatic, do not recur, and malignant transformation is rare. We report here on an additional case of intraosseous neurilemmoma that was located in unusual lacation i.e. anterior palatal region. [ABSTRACT FROM AUTHOR]

Background: Worldwide, studies show negative attitude among medical students toward psychiatry and mental illness. The knowledge of the attitude and awareness of the undergraduate medical students toward psychiatry, mental health, and psychiatric disorders are most important as they are going to be involved in the care of these patients either directly or indirectly during the later years of their careers., Aim: This study aims to assess attitude toward psychiatry and mental illness among undergraduate medical students., Methodology: The responses of 67 medical students from the 6 th semester (third professional year) batch who completed their 2-week clinical posting of psychiatry in 4 th semester (i.e., second professional year) were collected using validated questionnaires, attitude towards mental illness (AMI), and attitude towards psychiatry (ATP) that assessed their attitudes to psychiatry and mental illness. Double data entry and validation were done using EpiData and analysis using Epi Info software., Results: Median AMI score was 54 (out of maximum 100) showing a neutral AMI. Median ATP score was 82 (out of maximum 150) also showing a neutral ATP. The theme-wise analysis showed that the attitude of students toward psychiatrist and psychiatry branch was relatively better compared to their AMI., Conclusion: Undergraduate students have a neutral attitude to psychiatry and mental illness. More efforts are needed to change the attitude to favorable side., Competing Interests: There are no conflicts of interest.

Background: Looking at the burden of suicide, there is a dire need for medical schools to incorporate suicide prevention training. Effective communication helps in early detection and management of suicidal behavior. Medical students can act as a GATEKEEPER if they receive adequate training., Methodology: This was an educational intervention study done at tertiary care teaching hospital to assess the knowledge and attitude of medical students toward depression and suicide and to impart and assess communication skills for suicide prevention in one of the four batches of students in 4 th semester. Pretest was conducted to assess knowledge and attitude toward depression and suicide, followed by training using interactive lectures, demonstration of interview, and hands-on training with patients and role-plays. The posttest and objective structured clinical examination (OSCE) were administered for skill assessment. Feedback was taken regarding this intervention., Results: The mean marks of the pre- and post-test were 8.96 (8.3-9.6) and 14.58 (13.8-15.3), respectively, out of 25. The difference was statistically significant ( t = 13.24, P ≤ 0.0001) which suggests improvement in knowledge. We found mixed responses in attitude statements showing limited change. Mean obtained marks on OSCE examination out of 66 was 42.7. Among various components of OSCE, students scored high on rapport building. The most useful components of trainings were role-play, OSCE, and interaction with patients as per their feedback., Conclusion: The intervention was found effective in increasing knowledge, changing attitude, and enhancing communication skills of medical students toward suicide prevention. Training of communication skills for suicide prevention in depressed person should be given to every medical student as suggested by feedback., Competing Interests: There are no conflicts of interest.

Deteriorated male reproductive health has been connected to overexposure to estrogens or to imbalanced androgen-estrogen ratio. Transgenic male mice expressing human aromatase (AROM(+) mice) serve as an apt model for the study of the consequences of an altered androgen-estrogen ratio. Our previous studies with AROM(+) mice showed that low androgen levels together with high estrogen levels result in cryptorchidism and infertility. In the present study, the AROM(+) mice were shown to have severe abnormalities in the structure and function of Leydig cells before the appearance of spermatogenic failure. Decreased expression of adult-type Leydig cell markers (Ptgds, Vcam1, Insl3, Klk21, -24 and -27, Star, Cyp17a1, and Hsd17b3) indicated an immature developmental stage of the Leydig cells, which appears to be the first estrogen-dependent alteration. Genes involved in steroidogenesis (Star, Cyp17a1, and Hsd17b3) were suppressed despite normal LH levels. The low expression level of kallikreins 21, 24, and 27 potentially further inhibited Leydig cell function via remodeling extracellular matrix composition. In connection with disrupted steroidogenesis, Leydig cells showed enlarged mitochondria, a reduced amount of smooth endoplasmic reticulum, and an accumulation of cholesterol and precursors for cholesterol synthesis. The results of studies with AROM(+) mice crossed with estrogen receptor alpha or beta (ERalpha and ERbeta, respectively) knockout mice lead to the conclusion that the structural and functional disorders caused by estrogen exposure were mediated via ERalpha, whereas ERbeta was not involved.