Publications by authors named "Kiran Jakhar"

8 Publications

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Prevalence of self-reported anxiety and self-medication among upper and middle socioeconomic strata amidst COVID-19 pandemic.

J Educ Health Promot 2021 27;10:73. Epub 2021 Feb 27.

Department of Pediatrics, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India.

Background: Amidst corona virus disease-2019 (COVID-19) pandemic, disruption to the usual ways of life can lead to anxiety and feeling of being unsafe, which may be associated with self-medication. The study was planned to investigate the prevalence of anxiety and self-medication during COVID-19 pandemic.

Materials And Methods: In this cross-sectional study, data were collected through an anonymous online survey with questionnaire consisting of four sections: demographic data of the participants, validated COVID-19 Anxiety Inventory Items, Self-rating Anxiety Scale, and self-medication practices during COVID-19 pandemic. The data were organized and analyzed using Windows Microsoft excel and SPSS software (Version 21). Descriptive statistics were calculated for all patient characteristics and survey responses. Analytical analysis included relationship between various parameters using Chi-square test.

Results: A total of 1100 responses were received. Approximately half of the participants were worried about getting severely ill. Majority reported reduced social contact (71.3%, = 784) and also communicated that the pandemic has influenced their use of safety measures (86.5%, = 951). The prevalence of mild-to-moderate, moderate-to severe, and extremely severe anxiety cases were 23.1%, 4.7%, and 0.54%, respectively. One-fourth of the responders reported self-medication, out of which 60% were found to be anxious. Nonsteroidal anti-inflammatory drugs were most commonly used.

Conclusions: Rising to the present challenge will require integration across different sectors with the immediate aim of getting people safely through the pandemic. As the world focuses on containing and delaying the spread of the COVID-19, with burdened health-care systems, we should not miss out on people with anxiety disorders and self-medication problem, which may worsen with the pandemic.
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http://dx.doi.org/10.4103/jehp.jehp_864_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057176PMC
February 2021

Stressor Combat Strategies and Motivating Factors Among Health Care Service Providers During COVID-19 Pandemic.

Cureus 2021 Apr 27;13(4):e14726. Epub 2021 Apr 27.

Community Medicine, Government Institute of Medical Sciences, Greater Noida, IND.

Context Since its inception in December 2019 in Wuhan, China, the severe acute respiratory syndrome coronavirus-2, the etiological agent for coronavirus disease 2019 (COVID-19), is spreading rapidly both locally and internationally, and became certified as a pandemic by the World Health Organization (WHO) in March 2020. Working in an environment of high risk, coupled with adherence to quarantine and stressors related to the job, has been found to exacerbate the psychological health of frontline healthcare workers. Aims To assess the perceived stressors, combat strategies, and motivating factors among health care service providers during the COVID-19 pandemic. Setting and design A cross-sectional study was conducted among healthcare workers at a tertiary care hospital in the north-central region of India from May to September 2020. Methods and materials A convenience sample of 150 health care workers was taken. A self-reported pretested structured "COVID 19 staff questionnaire" was used as a study tool. The health care workers (HCWs) included nurses, physicians, laboratory technicians, and radiology technicians who worked in high-risk areas (isolation ward, COVID intensive care unit, emergency department, and outpatient cough outdoor walk-in clinics) during the outbreak constituted our study population.  Statistical analysis used The varying levels of stress or effectiveness of measures were reported as mean and standard deviation, as appropriate. Descriptive statistics were used for data presentation. A Mann-Whitney U test was used to analyse differences between two groups of non-normally distributed data. A p-value of less than 0.05 was considered statistically significant. Results As compared to doctors, paramedical staffs were more stressed with frequent protocol changes (88%), emotional exhaustion (68%), and conflicts with duties (62.7%). The factors like seeing colleague getting better (78.7%) and hoping for financial compensation (49.3%) were reported as stress busters; family compensation in case of death at the workplace and disability benefits in case of disease-related disability development were more effective motivational factors for paramedical staff in case of future outbreaks (p-value <0.05). Conclusions It is needful that secondarily traumatized team members should be always observed, educated, and properly handled. Certain personal coping strategies adopted by health workers should be well addressed and motivated if scientifically sustainable. We have to include psychiatric preparedness and stress monitoring also for health care teams along with emphasizing hygiene, temperature monitoring, and fever management, in planning to fight the pandemic.
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http://dx.doi.org/10.7759/cureus.14726DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8160474PMC
April 2021

COVID-19 and Obstetrical Care: Coping With New Stress.

Cureus 2020 Dec 16;12(12):e12116. Epub 2020 Dec 16.

Department of Psychiatry, Government Institute of Medical Sciences, Greater Noida, IND.

Objective Our study aimed to assess the mental health outcomes and coping strategies among healthcare workers (HCWs) in an already over-burdened maternity ward and labour room during the coronavirus disease 2019 (COVID-19) pandemic. Methods This cross-sectional questionnaire survey was conducted using Google Forms (Google LLC, Mountain View, CA), which included demographic characteristics, perceived stressors, and validated scales: the Depression, Anxiety and Stress Scale - 21 Items (DASS-21), Insomnia Severity Index, and the Brief Coping Orientation to Problems Experienced (Brief COPE) scale. The results were evaluated and compared among COVID-19 caregivers and other HCWs. Results A total of 184 participants were included in the study, out of which 112 (60.9%) were COVID-19 caregivers. Overall, HCWs managing COVID-19 patients experienced significantly higher levels of depression, anxiety, and stress. They often adopted an avoidant coping style (p-value: 0.006). The results of binary logistic regression analysis revealed that living with family and perceiving multiple stressors appeared to be associated with increased risk of anxiety while being a COVID-19 caregiver and appeared to be a risk factor for stress. Avoidant coping was found to be associated with insomnia while approach coping was less associated with anxiety. The most prevalent stressor among HCWs at our institute was distancing from family and friends (62%) followed by fear of getting infected (51.1%). Compared to other HCWs, the stressors perceived in significantly higher proportion by COVID-19 caregivers included distancing from family and friends (p-value: 0.003), scarcity of workforce (p-value: 0.005), and dealing with non-cooperative patients (p-value: <0.001). Conclusion We would request the immediate attention of the concerned authorities to implement interventions to buffer the impact of COVID-19 in the already stressed-out maternity wards and labour rooms.
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http://dx.doi.org/10.7759/cureus.12116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7808962PMC
December 2020

Informed consent in psychiatry outpatients.

Indian J Med Res 2020 01;151(1):35-41

Division of Psychiatry, University College London, London, UK.

Background & Objectives: Comprehension and process of consent are important for persons with mental illness as they may not be impaired in considering research participation. The American Psychiatric Association developed a detailed Cultural Formulation Interview (CFI). The present study was a part of field testing of CFI, aimed to standardize cultural information affecting the patients' management in India. This paper describes the process and conclusions from the consent-seeking process of this study.

Methods: The purpose and procedures about field trial of the CFI were introduced and the patient and caregiver were requested for participation. Consent process was carried out step by step, by reading out the consent form to the first new patient of the day in the psychiatry outpatients department of a tertiary care hospital in north India, inviting questions followed by the 'comprehension' questions. The entire process was audiotaped without any personal identifiers. The process was repeated if not comprehended.

Results: A total of 67 patients consented, 11 refused and majority were educated more than secondary school. Some concerns shown by the patients and caregivers included risk of participation, loss or benefits of participation, privacy, etc. All types of mentally ill patients participated in the study.

Interpretation & Conclusions: Translations of consent forms used simple words, consonant with understanding of the potential participants. Patients' belief that participating in this long process would improve their care, and serve humanity, influenced their decision to participate. Except for intoxication and severe psychosis, patients could understand and comprehend issues around consent. Main issues were confidentiality and culture. Our experience in the psychiatry OPD refutes the commonly held belief that mentally ill persons lack comprehension and ability to consent.
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http://dx.doi.org/10.4103/ijmr.IJMR_1036_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055165PMC
January 2020

Informed consent in psychiatry outpatients.

Indian J Med Res 2020 01;151(1):35-41

Division of Psychiatry, University College London, London, UK.

Background & Objectives: Comprehension and process of consent are important for persons with mental illness as they may not be impaired in considering research participation. The American Psychiatric Association developed a detailed Cultural Formulation Interview (CFI). The present study was a part of field testing of CFI, aimed to standardize cultural information affecting the patients' management in India. This paper describes the process and conclusions from the consent-seeking process of this study.

Methods: The purpose and procedures about field trial of the CFI were introduced and the patient and caregiver were requested for participation. Consent process was carried out step by step, by reading out the consent form to the first new patient of the day in the psychiatry outpatients department of a tertiary care hospital in north India, inviting questions followed by the 'comprehension' questions. The entire process was audiotaped without any personal identifiers. The process was repeated if not comprehended.

Results: A total of 67 patients consented, 11 refused and majority were educated more than secondary school. Some concerns shown by the patients and caregivers included risk of participation, loss or benefits of participation, privacy, etc. All types of mentally ill patients participated in the study.

Interpretation & Conclusions: Translations of consent forms used simple words, consonant with understanding of the potential participants. Patients' belief that participating in this long process would improve their care, and serve humanity, influenced their decision to participate. Except for intoxication and severe psychosis, patients could understand and comprehend issues around consent. Main issues were confidentiality and culture. Our experience in the psychiatry OPD refutes the commonly held belief that mentally ill persons lack comprehension and ability to consent.
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http://dx.doi.org/10.4103/ijmr.IJMR_1036_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055165PMC
January 2020

Sphenoid Wing Meningioma Presenting as Cognitive Impairment.

Shanghai Arch Psychiatry 2016 Jun;28(3):173-176

Department of Psychiatry and Deaddiction, Postgraduate Institute of Medical Education and Research (PGIMER), Dr. Ram ManoharLohia Hospital, New Delhi.

Frontal meningioma may present solely withpsychological symptoms that resemble dementia. We present the case of a 42-year-old man who initially was thought to have dementia, but he was eventually diagnosed with dementia caused by a sphenoid wing meningioma. Diagnosis of this illness is often delayed due to the insidious nature of the symptoms, which may be mistaken as symptoms of dementia. As cognitive impairment is complex and easily overlooked, it is important to accurately assess neuropsychological function in patients with large brain tumors.
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http://dx.doi.org/10.11919/j.issn.1002-0829.215142DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434305PMC
June 2016

Oligodendroglioma presenting as chronic mania.

Shanghai Arch Psychiatry 2015 Jun;27(3):183-5

Department of Psychiatry and Deaddiction; PGIMER, Dr Ram Manohar Lohia Hospital, New Delhi, India.

Summary: Oligodendrogliomas may present with a variety of psychological symptoms but it only rarely presents with mania. The patient described in this case report is a 55-year-old man with a three year history of progressive mania who was initially diagnosed as chronic mania but a subsequent MRI identified a brain tumor. This report highlights the importance of considering differential organic diagnosis when patients present with atypical presentations of psychiatric disorders. A brain tumor should be considered and brain imaging studies conducted for patients with a late age of onset who do not respond to appropriate medication.
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http://dx.doi.org/10.11919/j.issn.1002-0829.215039DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526832PMC
June 2015

A cross sectional study of prevalence and correlates of current and past risks in schizophrenia.

Asian J Psychiatr 2015 Apr 3;14:36-41. Epub 2015 Feb 3.

Dept. of Psychiatry, PGIMER-Dr. RML Hospital, New Delhi, India. Electronic address:

Background: The growing burden of chronic often untreated mental illness has increased the importance of risk assessment in people suffering from major mental disorders.

Aims: The present study was undertaken to obtain prevalence of various risks and predictive factors for self-harm, violence and various other risks among randomly recruited schizophrenia subjects (N=270) on the basis of past history of their disorder.

Method: Using a rigorous translation, back translation and acceptability process, a specially constructed semi-structured assessment interview, based on a prior NHS Trust risk assessment interview along with the Diagnostic Interview for Genetic Studies (DIGS), detailed information was obtained for various risks.

Results: Risk of violence (historical) was reported among 65.55%, and risk of self-neglect among 53.33%, risk to others (47.41%), risk of coming to harm (24.07%), self-harm (22.59%), risk from others (11.85%), fire risk (2.96%). Risk of violence (historical) and risk to others was related to 'ever' having emotions related to harm and self-harm, 'current' emotions related to violence and poor compliance to treatment.

Conclusion: Regular risk assessment is essential to assess emotions related to violence and non-adherence to treatment. Assessment of risk helps clinicians predict the risks involved in management and in timely intervention.
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http://dx.doi.org/10.1016/j.ajp.2015.01.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4450129PMC
April 2015
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