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Mamtani H, Jain K, Reddy P, Arasappa R, Ganjekar S, Thippeswamy H, Bhat M, Netravathi M, Desai G. The co-occurrence of multiple sclerosis and bipolar disorder: A case series on clinical and neuroimaging correlates. Asian J Psychiatr 2024; 96:104041. [PMID: 38615578 DOI: 10.1016/j.ajp.2024.104041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 03/12/2024] [Accepted: 03/30/2024] [Indexed: 04/16/2024]
Abstract
There is a dearth of studies on neuroimaging correlates of Bipolar Disorder (BD) in Multiple Sclerosis (MS). We describe the clinical profile and neuroimaging findings of four cases of MS with BD. Among them, two patients had multiple mood episodes preceding the neurological symptoms, one had concurrent manic and neurological symptoms, and one had multiple depressive episodes and an isolated steroid-induced manic episode. Frontal and temporal lobes, and Periventricular White Matter were involved in all four cases, and hence may be considered biological substrates of BD in MS. Larger studies are needed to validate the utility of these findings.
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Affiliation(s)
- Harkishan Mamtani
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India
| | - Kshiteeja Jain
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India
| | - Preethi Reddy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India
| | - Rashmi Arasappa
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India
| | - Sundarnag Ganjekar
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India
| | - Harish Thippeswamy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India
| | - Maya Bhat
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India
| | - M Netravathi
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India
| | - Geetha Desai
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru 560029, India.
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2
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Kanakaraj L, Mamtani H, Dahale AB, M N, S N, Sinha S, Thippeswamy H. Psychiatric manifestations of neurosyphilis over past two decades: Findings from a tertiary care neuropsychiatric hospital in south India. Asian J Psychiatr 2024; 94:103952. [PMID: 38364749 DOI: 10.1016/j.ajp.2024.103952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/20/2023] [Accepted: 02/01/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE To assess presentation of neurosyphilis with a focus on the psychiatric aspects. METHOD File review of the cases with a positive cerebrospinal fluid venereal disease research laboratory test between 1999 to 2020. RESULTS Medical records of 143 neurosyphilis patients were analysed. Hallucinations, delusions, and catatonia were the commonest psychiatric symptoms. Brain atrophy was the commonest neuroimaging finding. The number of neurosyphilis patients and the proportion with delirium or catatonia declined during the second decade (2010-2020). CONCLUSION Atypical presentation of psychiatric symptoms around the fifth decade, with associated neurological symptoms or brain imaging changes, should prompt evaluation for neurosyphilis.
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Affiliation(s)
- Logesh Kanakaraj
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India
| | - Harkishan Mamtani
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India
| | - Ajit Bhalchandra Dahale
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India.
| | - Netravathi M
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India
| | - Nagarathna S
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India
| | - Sanjib Sinha
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India
| | - Harish Thippeswamy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India
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Narasimhappa K, Mamtani H, Jain K, Holla VV, Ganjekar S, Manjunath N, Kulanthaivelu K, Desai G. Unmasking bipolarity in recurrent depressive disorder following herpes simplex virus triggered n-methyl-D-aspartate encephalitis. Bipolar Disord 2024; 26:192-195. [PMID: 37973382 DOI: 10.1111/bdi.13393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Herpes simplex virus (HSV) infection triggered n-methyl-D-aspartate (NMDA) encephalitis can lead to varied neuropsychiatric manifestations, including movement disorders and manic symptoms. HSV is known to affect the same brain regions as in secondary mania. METHOD We present a 35-year-old female diagnosed with recurrent depressive disorder (RDD) who developed NMDA encephalitis triggered by HSV infection. RESULT HSV-triggered NMDA encephalitis led to a manic switch in a woman with RDD on antidepressants, along with the new onset of dyskinetic movements. CONCLUSION A neurological insult predisposed our patient to the variable effects of antidepressant drugs.
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Affiliation(s)
- Karthik Narasimhappa
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Harkishan Mamtani
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Kshiteeja Jain
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Vikram V Holla
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Sundarnag Ganjekar
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Netravathi Manjunath
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Karthik Kulanthaivelu
- Department of Neuro Imaging and Interventional Radiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Geetha Desai
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
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Mamtani H, Utagi S, Chaurasia KK, Reddy PV, Arasappa R, Prasad C, Srinivas D, Rao MB, Thippeswamy H. Bell's mania as a clinical presentation in a neurosurgical setting from a tertiary care neuropsychiatric hospital in India. Indian J Psychiatry 2024; 66:208-212. [PMID: 38523764 PMCID: PMC10956591 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_417_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/12/2023] [Accepted: 01/15/2024] [Indexed: 03/26/2024] Open
Abstract
Bell's mania is the co-occurrence of delirium and mania. We present two cases of Bell's mania in a neurosurgical setting. The first case is of a 52-year-old male who presented with holocranial headache, disorientation, and manic symptoms for five months. He was found to have suprasellar craniopharyngioma. He significantly improved with olanzapine, but re-emergence of mood symptoms was noted after surgery. The second case is of a 42-year-old male who presented with a 15-day history of seizures and disorientation. He was found to have a dural arteriovenous fistula. He developed Bell's mania in the post-procedural period, which improved with olanzapine. Compression of the hypothalamo-pituitary stalk in the first case and vascular and inflammatory changes in the second case could have led to Bell's mania. Atypical age of onset and presence of neurological symptoms in patients presenting with psychiatric symptoms should raise the suspicion of an underlying organicity. Atypical anti-psychotics can be a useful management strategy for Bell's mania.
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Affiliation(s)
- Harkishan Mamtani
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Shridhar Utagi
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Kavish K. Chaurasia
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Preethi Veerappa Reddy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Rashmi Arasappa
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Chandrajit Prasad
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Dwarakanath Srinivas
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Malla Bhaskara Rao
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Harish Thippeswamy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Mamtani H. Fantasy gaming apps and mental health in India. Lancet Psychiatry 2023; 10:e16-e17. [PMID: 37353266 DOI: 10.1016/s2215-0366(23)00178-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 06/25/2023]
Affiliation(s)
- Harkishan Mamtani
- Department of Psychiatry National Institute of Mental Health and Neuro Sciences, Bengaluru 560029, India.
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Mamtani N, Mamtani H, Thippeswamy H, George RJ, Chaturvedi SK. Comments on "A Prospective Observational Study on Changes in Intraocular Pressure and Iridocorneal Angle Following the Use of Escitalopram and Amitriptyline". Indian J Psychol Med 2023; 45:323-324. [PMID: 37152398 PMCID: PMC10159559 DOI: 10.1177/02537176231164741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Affiliation(s)
- Nidhi Mamtani
- Dept. of Glaucoma, Vision Research
Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Harkishan Mamtani
- Dept. of Psychiatry, National Institute of
Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
- Harkishan Mamtani, Dept. of Psychiatry, National
Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka 560029,
India. E-mail:
| | - Harish Thippeswamy
- Dept. of Psychiatry, National Institute of
Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Ronnie Jacob George
- Dept. of Glaucoma, Vision Research
Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Santosh K. Chaturvedi
- Dept. of Psychiatry, National Institute of
Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Shivraj P, Chandna AS, Mamtani H. When Art Invalidates Trauma - Movie review of "Chup: The Revenge of the Artist". Indian J Psychol Med 2023; 45:321-322. [PMID: 37152378 PMCID: PMC10159570 DOI: 10.1177/02537176231164849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Affiliation(s)
- Phurailatpam Shivraj
- Dept. of Psychiatry, National Institute of
Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Ateev Sudhir Chandna
- Dept. of Psychiatry, National Institute of
Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Harkishan Mamtani
- Dept. of Psychiatry, National Institute of
Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
- Harkishan Mamtani, Dept. of Psychiatry, National
Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka 560029,
India. E-mail:
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Mamtani H, Chaturvedi SK. Alprazolam: Good for Some, Not Good for All! J Clin Psychopharmacol 2023; 43:204-208. [PMID: 37040158 DOI: 10.1097/jcp.0000000000001669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
BACKGROUND Although alprazolam is approved only for use in panic disorder and generalized anxiety disorder, it is used for numerous other conditions, not only by psychiatrists but also by medical professionals in general. This commentary critically analyzes the use of alprazolam. METHODS A narrative review approach was adopted, using relevant articles and textbooks, to compile pertinent literature for the aforementioned topic. RESULTS Among all its adverse reactions, the most bothersome concern about the use of alprazolam is its potential for abuse and dependence. This can be attributed to certain unique pharmacokinetic and pharmacodynamic properties of this benzodiazepine. Also, the withdrawal triggered by use of alprazolam is challenging to treat. Alternate pharmacological and non-pharmacological strategies for use in anxiety and insomnia are available, which might be safer than alprazolam. Also, policy changes can serve as an answer to curb alprazolam abuse to some extent. Alprazolam might still be a good choice for individuals who do not have a history of abuse of other substances, with adequate psychoeducation and close monitoring of their usage pattern. CONCLUSION There is a need to reconsider the need for long-term use of benzodiazepines in general, and alprazolam in particular. However, they still might be an appropriate choice in individuals where abuse and dependence are less likely.
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Affiliation(s)
- Harkishan Mamtani
- From the Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Santosh K Chaturvedi
- Department of Psychiatry, Leicestershire Partnership, NHS Trust, Leicester, United Kingdom
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Mamtani H, Mamtani N, Chaturvedi SK. THE CURIOUS CASE OF 'PSYCHO-OPHTHALMOLOGY': A NARRATIVE REVIEW OF OPHTHALMOLOGICAL ASPECTS OF PSYCHIATRIC DISORDERS. Psychiatr Danub 2023; 35:163-173. [PMID: 37480303 DOI: 10.24869/psyd.2023.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
Consultation Liaison Psychiatry (CLP) deals with the interface shared between psychiatry and various other disciplines of medicine. The interface shared by psychiatry and ophthalmology is among the lesser discussed ones in the field of CLP, despite the fact that it holds clinical relevance in the evaluation, management and outcomes of both psychiatric and ophthalmological disorders. This narrative review focusses on the ophthalmological aspects of psychiatric disorders, with respect to their manifestations, assessment, and management. Psychiatric disorders, including schizophrenia, affective disorders, 'functional' disorders, and substance use disorders, have numerous ophthalmic manifestations, which can have clinical implications for the patients. Even the psychotropic drugs given for psychiatric disorders can lead to side effects affecting the eye, but these are among the lesser-discussed side effects. Some psychiatric disorders can be investigated using various ophthalmic functions, the assessments ranging from simple physical examination to the use of instruments like a fundoscope, which can be useful for a psychiatrist in their routine practice. Lastly, eye functions can also be used in the treatment of psychiatric conditions, as is seen in eye movement desensitization and reprocessing. This review reiterates the fact that more attention needs to be given to the field of 'psycho-ophthalmology', which holds great promise in the coming days.
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Affiliation(s)
- Harkishan Mamtani
- Postdoctoral Fellow in Neuropsychiatry, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India- 560029
| | - Nidhi Mamtani
- Glaucoma Fellow, Department of Ophthalmology, Sankara Nethralaya, Chennai, India- 600006
| | - Santosh K Chaturvedi
- Consultant Psychiatrist, Former Dean and Senior Professor, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India- 560029
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Mamtani H, Pathak H, Sakhardande KA, Gowda GS, Muliyala KP, Moirangthem S, Reddi VSK, Varambally S. Can peripheral brain-derived neurotrophic factor (BDNF) be a potential biomarker of suicide risk in schizophrenia? Schizophr Res 2022; 243:203-205. [PMID: 35398726 DOI: 10.1016/j.schres.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/14/2022] [Accepted: 03/21/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Harkishan Mamtani
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Harsh Pathak
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Kasturi Atmaram Sakhardande
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Guru S Gowda
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Krishna Prasad Muliyala
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Sydney Moirangthem
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Venkata Senthil Kumar Reddi
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India.
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
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Mamtani H, Shiva L, Nanjundaswamy MH, Kamble N, Prasad C, Desai G, Chandra PS, Thippeswamy H. Treatment resistance in bipolar affective disorder with recurrent mania course-Role of periventricular leukomalacia. Bipolar Disord 2022; 24:93-96. [PMID: 34596304 DOI: 10.1111/bdi.13138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | | | - Chandrajit Prasad
- Department of Neuro Imaging and Interventional Radiology, NIMHANS, Bangalore, India
| | - Geetha Desai
- Department of Psychiatry, NIMHANS, Bangalore, India
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Affiliation(s)
- Prateek Varshney
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Harkishan Mamtani
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | | | - Prabha S Chandra
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Abstract
Under the circumstances of the current COVID-19 pandemic, videoconferencing applications (apps) have come into the mainstream across the world. Owing to their easy availability and cost-effectiveness, they are used in personal as well as professional lives to communicate. They have been very helpful for students and professionals to ensure that their routine work did not halt when various countries imposed lockdown rules restricting travel, social gatherings and other measures that resulted in reduced in-person meetings. However, they have their own set of disadvantages, aptly called ‘Zoom gloom/fatigue’, named after a popular videoconferencing platform. Users are also noted to have anxiety while using these apps. Therefore, immediate attention is warranted to ensure cautious usage and to reduce the distress associated with videoconferencing apps while maintaining the obvious advantages that these methods have rapidly spread all over the world.
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