The National medical journal of India最新文献

As Covid-19 becomes, for better or worse, an endemic disease, the future of the revolutionary Covid-19 Vaccine Intelligence Network (Co-WIN) platform needs to be considered seriously. Rather than being made obsolete, the Co-WIN platform can serve as a stepping stone to catalyse a true digital healthcare revolution in India if steps are taken to harness its features and data for varied uses as part of the Ayushman Bharat Digital Mission. By bringing these features to other vaccinations, as well as integrating outbreak data from the Integrated Health Information Platform for public knowledge and awareness, disease responses can become faster and more public-driven (rather than government-driven as currently). This will also create a data pool that will be of value in post-vaccination monitoring.

Background There are concerns over the reliability and comprehensibility of health-related information on the internet. We analyzed the readability, reliability and quality of online patient education materials obtained from websites associated with chronic low back pain (cLBP). Methods On 26 April 2022, the term 'cLBP' was used to perform a search on Google, and 95 eligible websites were identified. The Flesch Reading Ease Score (FRES) and Gunning Fog (GFOG) index were used to evaluate the readability. The Journal of the American Medical Association (JAMA) score was used to assess the reliability and the Health on the Net Foundation code of conduct (HONcode) was used to assess quality. Results The mean (SD) FRES was 55.74 (13.57) (very difficult) and the mean (SD) GFOG was 12.76 (2.8) (very difficult) of the websites reviwed. According to the JAMA scores, 28.4% of the websites had a high reliability rating and 33.7% adhered to the HONcode. Websites of different typologies were found to significantly differ in their reliability and the quality scores (p<0.05). Conclusion The reading ability required for cLBP-related information on the internet was found to be considerably higher than that recommended by the National Health Institute and had low reliability and poor quality. We believe that online information should have readability appropriate for most readers and must have reliable content that is appropriate to educate the public, particularly for websites that provide patient education material.

Background Untreated co-occurring substance use and substance use disorders (SUDs) in patients with medical conditions may be associated with unfavourable medical outcomes. Understanding the prevalence of substance use and SUDs among patients admitted to hospital for medical illness may help in developing appropriate strategies to manage SUDs in this population and improve the outcomes of medical illness. We assessed the prevalence of substance use and SUDs among patients admitted for medical illnesses and the association between substance use and medical illness. Methods This cross-sectional study was done in an in-patient setting in a multidisciplinary teaching medical institution in India. Using systematic sampling, adult patients admitted in various departments for at least 24 hours were interviewed using standard instruments by psychiatrists trained in the study methodology. Results Two hundred and ninety patients participated. Their mean (SD) age was 42.2 (15.6) years. One hundred and nine participants (37.6%) reported lifetime use of any psychoactive substance, with tobacco being the most common substance used (91, 31.4%), followed by alcohol (69, 23.8%) and cannabis (12, 4.1%). Lifetime alcohol use was significantly associated with diseases of the circulatory system. Lifetime use of any substance or of alcohol, and current use of any substance or tobacco were significantly associated with injuries, poisoning and other consequences of external causes. Conclusions A large proportion of patients hospitalized for medical illness reported the use of psychoactive substances or had SUDs. The use of some of these substances was also associated with injuries as well as diseases of the circulatory system.

Wilson disease is a rare genetic disorder of copper metabolism causing hepatic dysfunction and neuro-psychiatric manifestations. While psychosis in Wilson disease is uncommon, it can occur, especially with certain medications. We describe a 40-year-old woman diagnosed with Wilson disease who developed psychotic symptoms following the initiation and dose escalation of amantadine, a drug commonly used to treat parkinsonism associated with the disorder. Her symptoms included delusions of persecution, irritability and anomalous self-experiences such as 'made' phenomena, which are typically seen in schizophrenia. The psychosis resolved after discontinuing amantadine, without worsening her neurological symptoms. This underscores the importance of monitoring for psychiatric side-effects, particularly Schneiderian first-rank symptoms, in patients with Wilson disease being treated with amantadine. The findings suggest a probable adverse drug reaction, highlighting the need for careful evaluation and dose adjustments in such complex clinical cases.