Goa Medical College

Background: Vitamins, minerals and trace elements are essential micronutrients widely prescribed in clinical practice for prevention and treatment of deficiencies and various disease conditions. However, their increasing use is often empirical and not always evidence based, leading to concerns about irrational prescribing, inappropriate dosing and unnecessary combinations. Methods: Prospective, observational study was conducted in OPD pharmacy of Goa Medical College and two Private pharmacies of North Goa from August 2022 to August 2024. Approval was obtained from Institutional Ethics Committee. The prescriptions were photographed only after getting the patient's consent and then returned to them. Patient details were kept confidential. Prescriptions that had legible writing, prescribed by only allopathic doctors were included in this study. Results: Among the 765 vitamin and mineral preparations analyzed, 406 (53.1%) were single preparations and 359 (46.9%) were combinations. Brand-name preparations accounted for 51.0% of the total, while 40.0% were not included in either the National List of Essential Medicines (NLEM) 2022 or the WHO Model List of Essential Medicines 2023. Drug interaction analysis identified 638 distinct potential interactions from 202 of the 392 prescriptions. Cost analysis revealed that single mineral formulations contributed the largest share of expenditure (33%), followed by vitamin–mineral combinations (32%). Conclusions: This study highlights the need for rational multivitamin use, emphasizing evidence-based prescribing, generic names and adherence to the National List of Essential Medicines (NLEM) and WHO Model List. It also improves understanding of prescribing patterns, interactions and costs, supporting safer, cost-effective practices.

ABSTRACT Clinical relevance Convergence insufficiency is a common binocular vision anomaly among college students, and its impact on routine near work activities of students needs to be assessed. Background This study assessed the reading, writing, and typing speed of young college students with convergence insufficiency and age-matched controls. Methods A case-control study was conducted among 50 students with convergence insufficiency and 50 control students aged 18 to 25 years. All subjects underwent visual examinations including refractive assessments and evaluations of accommodative and binocular vision parameters. Reading and writing speeds were assessed using the International Reading Speed Texts (IReST) charts while typing speed was measured using the Psychology Experiment Building Language (PEBL) software. Reading, writing and typing speeds were compared between the two groups; and their correlation with clinical parameters related to convergence insufficiency was examined. Additionally, speeds were compared among symptomatic and asymptomatic students, assessed using the Convergence Insufficiency Symptomatic Survey (CISS) scale. Results The mean ± standard deviation age of the participants was 20.72 ± 2.00 years. The two groups did not differ in age, gender distribution, visual acuity or spherical equivalent (p > .05 for all). The median [interquartile range] reading speed was 160.34 [152.32–172.00] words per minute (WPM) in convergence insufficiency students, and 183.52 [168.34–201.36] WPM in control students (p < .001). Writing speed averaged 32.98 ± 4.31 WPM in convergence insufficiency students versus 36.48 ± 4.23 WPM in controls (p < .001). The median typing speed was 19.57 [17.57–24.73] WPM in convergence insufficiency students, and 24.15 [19.31–27.40] WPM in control students (p = .007). Correlation analysis showed none to poor correlations between speeds and clinical parameters. No significant differences were observed in speeds between symptomatic and asymptomatic students with convergence insufficiency. Conclusion College students with convergence insufficiency were found to have reduced reading, writing and typing speeds.

Background: Computed tomography (CT)-based ventriculo-hemispheric indices provide quantitative measures of ventricular size relative to overall brain dimensions. While these indices are traditionally used in the assessment of hydrocephalus, they also serve as indicators of cerebral atrophy in various neurodegenerative and neuropsychiatric disorders. This study evaluates the Frontal Horn Index (FHI), Evans Ratio (ER), Bicaudate Index (BCI), and Cella Media Index (CMI) as potential neuroimaging markers in schizophrenia, dementia, and chronic alcoholism. Methodology: An analytical cross-sectional study was conducted among 667 adults undergoing CT brain imaging at a tertiary care center. The study population included 45 chronic alcoholics, 51 dementia patients, 65 schizophrenia patients, and 506 normal controls. CT-derived indices such as FHI, ER, BCI, and CMI, were measured and compared among diagnostic groups using the One-way analysis of variance and Independent t -tests. Results: Dementia patients demonstrated the highest mean ventricular indices (FHI: 0.393 ± 0.041; ER: 0.364 ± 0.041; BCI: 0.174 ± 0.046; and CMI: 0.222 ± 0.0397), followed by alcoholics and schizophrenics. All indices were significantly elevated in dementia and chronic alcoholism compared to controls ( P &lt; 0.001). In schizophrenia, BCI and CMI were significantly higher ( P &lt; 0.05), whereas FHI and ER showed no significant difference. The control group showed mean ER (0.322 ± 0.035) and BCI (0.126 ± 0.033), aligning with published normative data. Conclusion: CT-based ventriculohemispheric indices are reliable and reproducible measures for assessing ventricular enlargement in dementia and chronic alcoholism and to a lesser extent in schizophrenia. Their practicality and cost-effectiveness highlight their clinical utility as neuroimaging biomarkers in the resource-limited settings.

Surgical intervention triggers a complex physiological cascade, also known as the surgical stress response, which entails well-coordinated immunological, metabolic, and neuroendocrine processes. This systematic review summarizes the existing evidence from 11 studies published between 2015 and 2025, investigating the underlying mechanisms, regulatory interactions, and clinical implications of this multifactorial response. Central stress pathway activation triggers immediate hormonal increase, stabilizing circulation and energy reserves, but chronic endocrine stimulation has the potential to increase metabolic and immune imbalances and results in a delayed recovery. The ensuing immune dynamics display an initial inflammatory phase followed by transient suppression, collectively influencing tissue repair and infection susceptibility. Parallel metabolic adaptations enhance energy production but often induce insulin resistance and protein catabolism, contributing to postoperative fatigue and functional decline. These interdependent mechanisms form a unified neuroendocrine-immune-metabolic network that can shift from adaptive to maladaptive under persistent stress. New evidence indicates that biomarkers such as cortisol, IL-6, glucose, and albumin serve as predictors of postoperative complications, including infection, impaired wound healing, and increased morbidity. Various perioperative interventions, such as the Enhanced Recovery After Surgery programs, immunonutrition, and metabolic administration, exhibit the possibility of maximizing such responses. The review combines both mechanistic and clinical perspectives to promote precision-based perioperative tactics to enhance surgical and recovery outcomes.

Social media has become a dominant force on modern communication, education and commerce, offering many remarkable benefits along with significant challenges. This paper investigates the positive and negative nature of social media by qualitative research. This work carried out an intensive survey on the usage of mobile phones and its impact on human mental health. The study identifies usage trends, perceived advantages, and common problems experienced by the users. Further it applies clustering and natural language processing (NLP) to derive insights and propose rectification strategies. The findings aim to support users, developers, and policymakers fostering a healthier and more productive digital social environment.

Dear Editor, Myopia has emerged as a significant global challenge, with its prevalence reaching epidemic proportions in certain regions.[1] Prevalence among urban Indian children is expected to rise to 48.14% by 2050.[2] A rising trend is also seen among rural Indian children, reflecting a nationwide concern.[3] Early parental involvement has been shown to reduce the risk of developing myopia in children.[4] Since excessive near work and insufficient outdoor time[5] are modifiable risk factors, parents are in a unique position to shape daily behaviors that influence both the onset and progression of myopia. As primary decision-makers in their children’s healthcare, parents also play a pivotal role in the adoption and implementation of myopia control measures. A structured questionnaire [Supplementary File 1] based on a logical model was used to assess parental awareness and knowledge regarding myopia, its progression, and available myopia control measures in Goa. Parents (mother or father) residing in Goa with at least one child aged 18 years or younger were eligible to participate.Among the 238 respondents [Table 1], a majority (151, 63.4%) had never heard of myopia or near-sightedness. Of the 87 (36.6%) who were aware, most cited medical professionals (56, 64.4%) and mass/social media (46, 52.9%) as primary information sources. When asked to define myopia, 76 (87.4%) parents correctly identified it as difficulty seeing far objects clearly. Additionally, 72 (82.8%) believed that frequent use of electronic devices is a cause of myopia. Univariate analysis showed that parents aged 41–50 and 51–60 years, those with higher education level (graduation and above), and an annual income of 2 lakhs or more were significantly more likely to be aware of myopia (P < 0.05).Table 1: Demographic characteristics of parentsFurther questions revealed that of the 87 parents aware of myopia, 53 (22.3%) lacked awareness of its progression. Those who were aware (34, 14.3%) again identified medical professionals (26, 76.5%) as the main source of information. Excessive near work (31, 91.2%) and uncorrected myopia at a young age (25, 73.5%) were frequently cited causes of progression. Only 39 (44.8%) of the 87 parents knew of myopia control methods. The most commonly known methods were myopia control spectacles (34, 87.2%) and myopia control contact lenses (31, 79.5%) [Fig. 1]. Some parents also identified outdoor activities (17, 43.6%) and reduced near work (15, 38.5%) as helpful strategies. Eye drops were the least known (2, 5.1%). Parents were also asked about their preference for commercially available myopia control methods in a hypothetical scenario. Most parents (32, 84.2%) preferred myopia control spectacles for their child [Fig. 1].Figure 1: Percentage of parents aware of (blue) and willing to opt for (orange) different myopia control methodsThe findings suggest low awareness of myopia, its progression, and available control methods among parents, highlighting the need for targeted educational interventions. Eye care professionals should actively engage parents through clinics, schools, and digital platforms to build awareness and promote early action. Educating parents about modifiable risk factors and available control strategies is essential. Recognizing parents as key stakeholders in myopia prevention and management can lead to better visual outcomes in children and help reduce the broader societal burden of visual impairment. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.