Level of happiness among medical students in Bihar-An online survey

BACKGROUND

Happiness is a state of mental well-being and influences the learning and performance of an individual. Medical education due to its academic culture and longer course duration affects the performance and happiness of the students. So, this study was done to assess the level of happiness and the factors associated with it among medical students in Bihar.

MATERIALS AND METHODS

A cross-sectional online survey was conducted among 321 medical students of all academic years from various medical colleges in Bihar. This study used a self-administered study tool using the online Google Form platform for data collection and assessed the level of happiness using Oxford Happiness Questionnaire. A multivariable binary logistic regression analysis was done to find out the predictors of happiness.

RESULTS

A total of 34.6% (95% CI: 29.5-39.9%) medical students were happy. Male (38.2%) students were found to be happier than female (29.2%) students. Age, place of stay, physical activity, meditation and yoga, frequent socialization, absence of psychiatric illness, and stressful situation in the family were the independent predictors of happiness. Around 42.4% of students had another career option, and 32.1% had a second thought about a career due to the COVID-19 pandemic. The presence of any psychiatric illness had a significant effect on the happiness level of the students.

CONCLUSION

Only one in three medical students is happy. Promotion of physical activity, meditation and yoga, and socialization will improve the happiness and thereby learning among medical students.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

Resilience level, its determinants and its effect on psychological well-being: A cross-sectional evaluation among school-going adolescents of Patna, Bihar, India

Background

Adolescents with higher resilience levels are reported to be less vulnerable to psychological illnesses. The study examined resilience level, its determinants and its effect on psychological well-being among school-going adolescents of Patna, Bihar, India.

Methods

Adopting cross-sectional design we examined resilience levels among the study participants reading in the sixth, seventh and eighth standards of selected schools of Patna district using the Child Youth Resilience Measure-Revised questionnaire during March 2021. Psychological well-being was assessed using Patient Health Questionnaire-4. Data of in total 468 enrolled participants were analysed using SPSS 22.0.

Results

The mean resilience score was observed to be 62.4 ± 8.8. In multiple linear regression analysis using backward method; increasing age (unstandardised beta [β]: 0.564, standard error [SE]: 0.271, P: 0.038), male gender (β: 2.753, SE: 0.775, P < 0.001), high per capita monthly family income (≥18 USD [median]) (β: 1.829, SE: 0.743, P: 0.014), academic satisfaction (β: 2.003, SE: 0.962, P: 0.038), no history of abuse (physical or mental) in the past 30 days (β: 2.752, SE: 1.220, P: 0.025) and increasing self-esteem score (measured by Rosenberg Self-Esteem Scale) (β: 0.808, SE: 0.098, P: < 0.001) were found to be positive determinants of the total resilience level. Resilience was found to be positively correlated with psychological well-being (spearman rho correlation co-efficient [ρ]: 0.363, P < 0.001).

Conclusions

Abuse, academic satisfaction and self-esteem were the modifiable determinates of resilience that could be elucidated in this investigation. Resilience level positively influenced psychological well-being.

Characterization of indoor bioaerosols from a hospital ward in a tropical setting

OBJECTIVES

Study was conducted to assess whether temporal variation exists in airborne microbial concentrations of a hospital ward (west-Chennai, India) using active and passive methods, and characterise the microorganisms.

METHODS

Air samples (duplicates) were collected simultaneously using exposed-plate, impingement (BioSampler) and filtration (personal sampling filter cassette loaded with gelatin filter) methods over different periods of the year. Bacterial plates were incubated at 37°C and observed for growth after 48h; fungal plates were incubated at 25°C and 37°C and observed upto 7 days. Microorganisms were identified using standard microbiological procedures.

RESULTS

Microbial loads were found to vary with the sampling method. Concentrations of bacteria were higher (exposed-plate: 45-150 CFU/plate; impingement: 1.12E+03-1.6856E+05 CFU/m(3); filtration: 3.788E+03-1.91111E+05 CFU/m(3)) than fungi (exposed-plate: 0-13 CFU/plate; impingement: 0-3.547E+03 CFU/m(3); filtration: 0-1.515E+04 CFU/ m(3)). Coagulase-negative Staphylococci and Micrococci were the predominant Gram-positive cocci in active and passive samples. Enterobacter and Pseudomonas were the predominant Gram-negative bacilli. Among fungi, Aspergillus niger was isolated throughout the year. There was no significant temporal variation in airborne microbial loads irrespective of methods.

CONCLUSIONS

Exposed-plate method was found to capture microorganisms efficiently with little variation in duplicate samples, suggesting its use in hospitals for preliminary assessment of indoor air quality and determine pathogenic microorganisms due to particle fall-out.

Nonlinear studies of acid fuchsin dye in liquid and solid media

Solid-state dye-doped polymers are attractive alternative to the conventional liquid dye solutions. In this paper, nonlinear properties of the dye Acid Fuchsin has been studied. The third-order nonlinear optical properties of Acid Fuchsin dye in 1-butanol and dye-doped polymer film were measured by the Z-scan technique using 532 nm diode pumped Nd:Yag laser. This material exhibits negative optical nonlinearity. The dye at 0.4 mM concentration exhibited nonlinear refractive coefficient (n(2)=-8.72 x 10(-8) and -10.308 x 10(-8) (cm(2)/W) in liquid and solid media, respectively), nonlinear absorption coefficient (beta=-7.69 x 10(-4) and -8.294 x 10(-4)cm/W in liquid and solid media, respectively) and susceptibility (chi(3)=4.33 x 10(-6) and 5.13 x 10(-5)esu in liquid and solid media, respectively). These results show that Acid Fuchsin dye has potential applications in nonlinear optics.

Studies of third-order optical nonlinearities and optical limiting properties of azo dyes

In order to protect optical sensors and human eyes from debilitating laser effects, the intensity of the incoming laser light has to be opportunely reduced. Here, we report our results on the third-order optical nonlinearity and optical limiting properties of three azo dyes exposed to a 532nm continuous wave laser. We have observed low power optical limiting based on nonlinear refraction in our samples.

Investigation of optical nonlinearities of an azo dye using a 532nm diode-pumped Nd:YAG laser

Solid-state dye-doped polymers are attractive alternatives to the conventional liquid dye systems. In this paper, the third order nonlinear optical property of Sudan III, an azo dye in solvents and dye doped polymer films measured using the Z-scan technique is reported. Multiple diffraction rings were observed when the dye doped in both the liquid and solid media was exposed to a diode-pumped Nd:YAG laser at 532nm.

Single-beam Z-scan measurement of the third-order optical nonlinearities of azo dyes

Organic dyes are very attractive optical materials for photonics and biophotonic applications. To quantitatively characterize their third-order nonlinear coefficients we have performed the experiments on two different azo dyes using a diode-pumped Nd:YAG laser at 532 nm. The |chi(3)| is of the order of 10(-6) esu. The relative contributions from nonlinear absorption (NLA) and nonlinear refraction (NLR) are dependent on the chemical structure and linear absorption of the dyes.

Nonlinear studies of Pararosanilin dye in liquid and solid media

Solid-state dye-doped polymers are attractive alternative to the conventional liquid dye solutions. In this paper, nonlinear properties of the dye Pararosanilin has been studied. The third-order nonlinear optical properties of Pararosanilin dye in 1-butanol and dye-doped polymer film were measured by the Z-scan technique using 532 nm diode pumped Nd:Yag laser. This material exhibits negative optical nonlinearity. The dye at 0.4 mM concentration exhibited nonlinear refractive coefficient (n(2) = -6.8 x 10(-8) and -7.11 x 10(-8) (cm(2)/W) in liquid and solid media, respectively), nonlinear absorption coefficient (beta = -7.7 x 10(-4) and -7.93 x 10(-4)cm/W in liquid and solid media, respectively) and susceptibility (chi((3))=3.38 x 10(-6) and 3.53 x 10(-5)esu in liquid and solid media, respectively). These results show that Pararosanilin dye has potential applications in nonlinear optics.

Coagulase-negative staphylococci in very-low-birth-weight infants: inability of genetic markers to distinguish invasive strains from blood culture contaminants

Selected coagulase-negative staphylococci from the blood of very-low-birth-weight infants in the Neonatal Intensive Care Unit at the Royal Women's Hospital, Melbourne, collected over a 5-year period were examined. Isolates were classified as invasive or contaminants, speciated, typed by pulsed-field gel electrophoresis, and examined for biofilm genes (icaA, icaC, and icaD), adhesion genes (atlE, fbe), and the number of copies of IS256. Of the 24 isolates studied, there were 13 contaminants and 11 invasive isolates. The collection included 15 Staphylococcus epidermidis, eight Staphylococcus capitis, and one each of Staphylococcus warneri and Staphylococcus haemolyticus. Two small clusters of S. epidermidis that belonged to the same molecular type were identified. All S. capitis isolates belonged to the same molecular type or subtype, suggesting that a particular clone was circulating in the unit. There was no significant difference in the species found, the presence of icaA, icaC, icaD, atlE, or fbe, or the number of copies of IS256 between invasive isolates and contaminants. A series of nasal isolates from nonhospitalized adults differed from hospital isolates in the absence of IS256 and the low prevalence of icaC. There was no evidence of IS256-mediated insertion into ica genes as a mechanism of phase variation. These findings suggest that contaminants and invasive isolates derived from the same pool of hospital strains capable of causing sepsis in compromised hosts and that other mechanisms of phase variation exist, apart from IS256 insertion into ica genes.

Spectral characteristics and nonlinear studies of crystal violet dye

Solid-state dye-doped polymer is an attractive alternative to the conventional liquid dye solution. In this paper, the spectral characteristics and the nonlinear optical properties of the dye crystal violet are studied. The spectral characteristics of crystal violet dye doped poly(methylmethacrylate) modified with additive n-butyl acetate (nBA) are studied by recording its absorption and fluorescence spectra and the results are compared with the corresponding liquid mixture. The nonlinear refractive index of the dye in nBA and dye doped polymer film were measured using z-scan technique, by exciting with He-Ne laser. The results obtained are intercompared. Both the samples of dye crystal violet show a negative nonlinear refractive index. The origin of optical nonlinearity in the dye may be attributed due to laser-heating induced nonlinear effect.

Role of dipole moment of solvents in formation and stabilization of the TICT states in Coumarin 445 under nitrogen laser excitation

In this paper we report the observation of dual Amplified Spontaneous Emission (ASE) from solutions of 7-ethylamino-4-methyl coumarin dye (Coumarin 445) in certain solvents such as n-butyl acetate, dioxane etc. when pumped by high power nitrogen laser. The two ASE bands appear to be from two different excited species (ICT and TICT conformation) one of which is the precursor of the other. The spectral characteristics of dye Coumarin 445 depend upon the solvent environment. The TICT coumarin photoisomers, which form exciplexes with the solvent molecules, have enough gain to produce amplified spontaneous emission even when there is apparently no detectable fluorescence. The behaviour of this dye in the excited state is studied by measuring the small signal gain and variation of the gain slope with temperature in different solvents. It is observed that polarity of the solvent plays a more dominant role in formation and stabilization of TICT states.

Photophysics of TICT states of 7-diethylamino-4-methyl coumarin dye by energy transfer techniques

Coumarin 1 exhibited dual amplified spontaneous emission (ASE) in certain solvents under nitrogen laser excitation. These emissions are known as normal and anomalous emissions. The anomalous emission corresponds to TICT state and it does not have a corresponding fluorescence peak. Energy transfer techniques have been used to study the photophysics of TICT states and the characteristics of dual ASE bands of the dye coumarin 1.

Effect of solvents on the photophysical properties of substituted imidazonaphthyridine derivatives

The absorption and fluorescence characteristics of three substituted imidazonaphthyridine derivatives are studied in a series of organic solvents. The variation of Stokes shift with the polarity parameter of the solvent is studied and the excited state dipole moment of these derivatives is higher than the ground state dipole moment. The fluorescence lifetime profile shows single exponential decay in all the solvents. The fluorescence quantum yield, radiative and non-radiative rate constants are also calculated and these parameters show much variation in the change in substitution of these derivatives.

Comparative leprosy vaccine trial in south India

This report provides results from a controlled, double blind, randomized, prophylactic leprosy vaccine trial conducted in South India. Four vaccines, viz BCG, BCG+ killed M. leprae, M.w and ICRC were studied in this trial in comparison with normal saline placebo. From about 3,00,000 people, 2,16,000 were found eligible for vaccination and among them, 1,71,400 volunteered to participate in the study. Intake for the study was completed in two and a half years from January 1991. There was no instance of serious toxicity or side effects subsequent to vaccination for which premature decoding was required. All the vaccine candidates were safe for human use. Decoding was done after the completion of the second resurvey in December 1998. Results for vaccine efficacy are based on examination of more than 70% of the original "vaccinated" cohort population, in both the first and the second resurveys. It was possible to assess the overall protective efficacy of the candidate vaccines against leprosy as such. Observed incidence rates were not sufficiently high to ascertain the protective efficacy of the candidate vaccines against progressive and serious forms of leprosy. BCG+ killed M. leprae provided 64% protection (CI 50.4-73.9), ICRC provided 65.5% protection (CI 48.0-77.0), M.w gave 25.7% protection (CI 1.9-43.8) and BCG gave 34.1% protection (CI 13.5-49.8). Protection observed with the ICRC vaccine and the combination vaccine (BCG+ killed M. leprae) meets the requirement of public health utility and these vaccines deserve further consideration for their ultimate applicability in leprosy prevention.

Glucocorticoid inhibition of fibroblast proliferation and regulation of the cyclin kinase inhibitor p21Cip1

Glucocorticoids inhibit the proliferation of fibroblastic cells in vivo and in culture; however, the molecular mechanism that accounts for this effect has remained obscure. We have undertaken to elucidate the mechanism whereby glucocorticoids decrease the rate of proliferation of mouse L929 fibroblastic cells. Addition of dexamethasone to mid-log phase fibroblasts prolongs G1 phase. This increase in the G1 interval is associated with, and probably due to, inhibition of phosphorylation of the product of the Rb-1 tumor suppressor gene, pRb. Inhibition of pRb phosphorylation by cyclin D-dependent kinases can be demonstrated in vitro. Nevertheless, there is no detectable change in the expression of cyclin D1, cyclin D2, or cyclin D3. Cyclin-dependent kinase-4 (Cdk4) and Cdk6 are not down-regulated in L929 cells after addition of glucocorticoids, and the abundance of cyclin D/Cdk4 complexes does not change. Inhibition of pRb kinase activity is associated with an increase in the abundance of one of the Cdk inhibitors, p21Cip1. The abundance of another cyclin kinase inhibitor, p27Kip1, remains constant. The amount of Cdk4 that is bound to p21Cip1 increases rapidly after addition of dexamethasone, and the activity of Cdk4-pRb kinase decreases in parallel. These results indicate that glucocorticoid inhibition of fibroblast proliferation is due to induction of p21Cip1, which binds to and inactivates cyclinD/Cdk4 complexes. The abundance of p21 mRNA increases about 5-fold within 2 h after addition of dexamethasone. This effect does not obtain in L929 mutants that are null for the glucocorticoid receptor, and a variant that expresses the glucocorticoid receptor from a tetracycline-repressible expression vector demonstrates induction of p21 mRNA only in the absence of tetracycline. Cycloheximide does not block induction of p21 mRNA, and dexamethasone has no detectable effect on the apparent rate of degradation of p21 mRNA. Nuclear run-on transcription of the Cip1 gene increases within 2 h after addition of dexamethasone. This effect can be blocked by tetracycline-mediated repression of the glucocorticoid receptor.

Inter-observer agreement and clinical diagnosis of leprosy for prophylaxis studies

Clinical diagnosis is still the most useful tool for detecting early cases of leprosy in field research. In prophylaxis studies accuracy of clinical diagnosis of leprosy is important during intake as well as for measuring efficacy of the intervention. This paper reports our observations regarding the extent of inter-observer variations in clinical diagnosis of leprosy and its implications for a prophylaxis study. Information on 225 suspects and cases of leprosy, each examined independently by three senior workers after initial standardization, was used for this purpose. Agreement among the examiners regarding the presence of skin patch, thickened nerve trunk and sensory deficit was fairly high (Kappa = 0.7). Agreement on the presence of infiltration in a skin patch was not satisfactory (Kappa = 0.4-0.5). It was observed that in clinical diagnosis of leprosy, presence of skin patch and sensory deficit, as well as thickened nerve trunk and related anaesthesia were correlated observations. The influence of inter-observer variations on defining leprosy problem in the community can be quite large. The paper suggests some ways of overcoming the problem.