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Introduction: The increment in marijuana use across the world is concerning and needs to be addressed. There has been a cultural change regarding the perception and use of marijuana medicinally and recreationally, even among medical students. This needs to be studied to understand the outlook towards marijuana among young adults, including future doctors, to help improve their awareness of the risks and pitfalls of marijuana usage. Aim: To evaluate the knowledge, attitude, and practices regarding marijuana usage among medical students. Materials and Methods: This cross‑sectional study recruited 159 medical undergraduate students from the tertiary healthcare institute, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India via an online, anonymised, semistructured, self-designed questionnaire that was circulated over social media. The duration of the study was from October 2023 to February 2024. The study population was grouped into first-year and final-year MBBS students to identify differences, if any, in knowledge, attitude, and practices regarding marijuana usage among students between the start and end of their MBBS training. The responses to questions were compared to establish any statistical significance. Results: Out of the total 159 participants, 106 (66.67%) were first-year MBBS students, and 53 (33.33%) were final-year MBBS students. Most students from both groups reported that marijuana was illegal in India. Both groups responded affirmatively to questions regarding their awareness of the effects of marijuana and whether it could be used as a medical therapeutic drug. The majority of students, 81 (76.42%) and 32 (60.38%), respectively in both groups, agreed with the statement that marijuana impairs concentration and movement. A total of 88 (83.02%) and 41 (77.36%) participants, respectively, were largely in favour of legalising marijuana, with a greater proportion of respondents from both groups opining that marijuana should be legalised, be it for medical therapeutic use or as a recreational drug. Conclusion: Study results showed that the majority of students from both groups responded positively to the question about the legalisation of marijuana in India. Some interesting differences were found between the two groups with respect to marijuana use and the perceptions about its positive or negative effects. It is essential to educate medical students, as future physicians, on the adverse effects and implications of marijuana use.

Introduction: COVID-19 has led to an increase in burden on health-care workers. Postgraduate residents are at the forefront of the pandemic. Understanding its impact and the perspectives of postgraduate residents could provide better solutions to their problems. Objectives: 1. To assess the psychological impact of the COVID-19 pandemic on postgraduate doctors. 2. To assess the perception of postgraduate doctors regarding the medical profession and its association to the psychological impact of the COVID-19 pandemic. Methodology: This cross-sectional study recruited 65 postgraduate medical resident doctors working in teaching hospitals involved in the care of COVID-19 patients. They were requested to complete the questionnaire consisting of qualitative as well as quantitative questions. For an objective assessment of anxiety, the Generalized Anxiety Disorder-7 (GAD-7) scale was used. Relevant statistical methods were employed and statistical analysis was done using IBM SPSS software version 20.0. Results: The qualitative data showed themes of concern regarding social awareness about COVID-19 (hygiene, masks, and social distancing), working conditions of doctors, and increased stress and burnout. 47.54% (n = 29) of respondents said that they would reconsider their profession/specialty, out of which 21 said that they would switch to another profession. The resident doctors who would reconsider their choice of profession/specialty had significantly higher (P < 0.05) scores for anxiety (GAD-7). Conclusion: Owing to the significant association between anxiety and desire to change their profession altogether, greater psychological support for doctors appears to be a pressing need. It is important that the concerns of the postgraduate residents are addressed promptly and holistically.

Introduction: Depression is the second leading cause of morbidity worldwide. Currently, available antidepressants mostly target the monoamine system. The onset of action and response rates for these antidepressants are varied. Ketamine, an N-methyl-Daspartate (NMDA) receptor antagonist has shown rapid onset of action in the treatment of depression. The available literature about intravenous (i.v.) ketamine as an adjuvant to oral antidepressants is limited. Aim: To study if ketamine is beneficial as an adjuvant to antidepressants in the treatment of depression. Materials and Methods: This study was a prospective interventional study conducted at JSS Medical College and Hospital, Mysuru, Karnataka, India, between January 2019 to January 2021. Total 60 patients diagnosed with depression and receiving 20 mg per day of the Selective Serotonin Reuptake Inhibitor (SSRI) escitalopram were recruited. The patients were divided into two groups of 30. Group I was continued only on the oral antidepressant antidepressant and the group II in addition to the oral antidepressant received 3 doses of i.v. infusion of ketamine hydrochloride, on alternate days. All the patients were assessed using the Montgomery-Asberg Depression Rating Scale (MADRS) and the Beck Scale for Suicidal Ideation (BSSI) at baseline and after 14 days. Statistical measures like Cramer’s V, Independent samples t-test (to match both groups for age) and repeated measure Analysis of Variance (ANOVA) was employed and data collected were analysed through the IBM Statistical Package for the Social Sciences (SPSS) statistics for windows, version 20.0. Results: The mean age of the sample population was 37.883±8.128 years. There was statistically significant improvement in depressive symptoms in group II when compared to group I. There was a decrease in mean MADRS scores by 6.07 in Group I and by 8.10 in Group II (p-value=0.011). The improvement was statistically significant in four items on the MADRS scale, namely, reported sadness (p-value=0.015), inner tension (p-value=0.021), pessimistic thoughts (p-value=0.00034) and suicidal thoughts (p-value=0.001), as well as the total MADRS score (p-value=0.011). The mean change in BSSI scores from baseline to final reading improved in both the groups (p-value=0.740). Conclusion: Intravenous ketamine as an adjuvant to oral antidepressant medications, showed greater and more rapid improvement than that seen with oral antidepressants alone. It can be considered as an effective adjuvant to other antidepressants and future studies are required to establish this.

Abstract The inseparable relationship between mind and body, though known since ages, has been acknowledged in modern medicine only in recent times. There is abundant literature about the effects of various illnesses on different organ systems, but their effect on sexuality has not been emphasized. Research on sexuality has been fore fronted by the West and data, though available, cannot be extrapolated to the Asian population due to marked differences in physical and socio-cultural aspects. The authors have reviewed articles published in Clinical Key, PubMed and Scopus.