Papers by Venu Gopal Jhanwar
Industrial Psychiatry Journal, 2010
Zotepine is an antipsychotic used in Japan and Europe for years and recently being introduced in ... more Zotepine is an antipsychotic used in Japan and Europe for years and recently being introduced in Indian markets. It is claimed to be particularly effective for negative symptoms, and somnolence and weight gain are the most common side effects. Our aim is to share our clinical experience of use of zotepine with respect to its tolerability. We reviewed the first 10 patients who were prescribed zotepine at our center.
Indian Journal of Psychological Medicine, 2011
Indian Journal of Psychological Medicine, 2011
Transcranial magnetic stimulation (TMS) is a noninvasive application of pulsed magnetic field nea... more Transcranial magnetic stimulation (TMS) is a noninvasive application of pulsed magnetic field near an area of scalp, which causes depolarization of neurons in underlying part of cerebral cortex. At cellular level, mechanisms of electroconvulsive therapy (ECT) and TMS are the same. [1] In psychiatry, the application of rTMS was tested including major depressive disorder (MDD) [2,3] which was based on observation that a single pulse of magnetic stimulation elevated the mood for some period, though it was transient. Current challenges in the field include determining how to enhance the efficacy of rTMS in the psychiatric disorders and how to identify patients for whom rTMS can be a useful method of treatment. Depression is a common disorder with serious personal, interpersonal, and societal consequences, affecting about 15% of the general population and accounting for approximately 10% of consultations in primary care. [4] The World Health Organization has ranked MDD as the fourth most disabling disorder. [5] Despite New Horizon About 30 to 46% of patients with major depressive disorder (MDD) fail to fully respond to initial antidepressants. Treatmentresistant depression (TRD) is a severely disabling disorder with no proven treatment options; novel treatment methods like rTMS can be used as augmentation to ongoing pharmacotherapy or as a solitary method of treatment. To evaluate the utility of repetitive transcranial magnetic stimulation as an augmenting method in TRD. In an open-label study, 21 patients with DSM-IV MDD without psychotic features who had failed to respond to an adequate trial of at least 2 antidepressants were given rTMS therapy for 4 weeks, keeping the dose of pre-existing antidepressants unchanged. High-frequency (10 Hz) stimulations were delivered over left dorsolateral prefrontal cortex at intensity of 110% of patient's motor threshold. Treatment response was defined as a reduction in score on the Hamilton Rating Scale for Depression (HAM-D) from baseline to end of treatment. Secondary efficacy measures included scores on the Clinical Global Impressions-Change and-Severity scales. At the end of 4 weeks, 19 patients completed the 4-week study and were assessed. In ITT analysis, the mean HAM-D17 scores were reduced from 30.80±5.00 to 19.00±6.37 (t=8.27, P<0.001). Only four patients reported headache, but there was no discontinuation due to adverse effects. The study indicates the potential utility of rTMS as an augmenting agent in TRD. Adequately powered, randomized controlled trials are necessary to evaluate the role of rTMS in TRD.
Indian Journal of Psychological Medicine, 2010
There is a consensus regarding the importance of informed consent in clinical research. The proce... more There is a consensus regarding the importance of informed consent in clinical research. The process of obtaining informed consent from subjects is a critical point of entry for research participants. [1] Patients learn about clinical trials from numerous ways and also there are several factors affecting their decisionmaking capacity. Educational materials for patients and informed-consent documents present highly complex information that must be understood by patients. [2,3] Kuczewski and Marshall [4] recommend adopting the approach that consent is an interactive and dynamic process and many factors can influence the study participant's willingness to sign the document. These factors include socioeconomic background, cultural traditions, literacy and language ability, and interactions with physicians, and other healthcare professionals. The manner and context in which information is conveyed is as important as the information itself. The ability to understand is dependent upon patients' intelligence, rationality, maturity, and language, and it is necessary to adopt the presentation of information in subject's capacity to understand. (Belmont report). [5] The informed consent process presents some major challenges for study participants and research staff. Several researchers have addressed these problems Original Article Background: Informed consent forms are required in all clinical trials which are approved by an independent Ethics Committee before practical use in the trials. However, how much the average subject actually understands of the information contained in these informed consent forms is uncertain. Aim: In a cross sectional study, the translated informed consent forms used in psychiatric clinical trials were assessed with respect to their ease of readability. Materials and Methods: We analyzed 30 informed consent forms translated from English to Hindi used in multinational and multicentre psychiatric clinical trials sponsored by different sponsors. We examined consent forms for readability scores and factors that might relate to readability. Results: The mean readability score for the informed consent forms, determined by the Flesch-Kincaid Grade Level Index (FKGL) was grade levels of 13.66. The ease of readability assessed by the Flesch Reading Ease Score (FRES) was 46.08 suggesting significant complexity of the texts. These values carry even more significance when the average years of schooling for India as a whole are 6.2 years. Conclusion: Our results show that the most informed consent forms were too complex to understand by an average adult subject. We suggest reducing this complexity and increasing the ease of readability so those average subjects receive the intended information as exactly as it could be. This can be achieved by few simple measures like improving the deficiencies in translation processes, encouraging the investigators to participate while preparing these forms, and enhanced understanding of the site specific requirements, namely culture, language (dialect), general literacy rate, etc.
Indian Journal of Psychiatry, 2011
including major depressive disorder (MDD), [2-3] which was based on observation that a single pul... more including major depressive disorder (MDD), [2-3] which was based on observation that a single pulse of magnetic stimulation elevated the mood for some period, although it was transient. Current challenges in the field include determining how to enhance the efficacy of rTMS in the psychiatric disorders and how to identify patients for whom rTMS can be a useful method of treatment.
Chronicles of Young Scientists, 2011
The major trends of public health research in India since 2001 show an increase in the public hea... more The major trends of public health research in India since 2001 show an increase in the public health research output from India over the past few years. [1] But, the quality of research in public health is not yet satisfactory enough and distributions of research areas are too inconsistent with the disease burden trends. Public mental health is major health system component, which continues to be overlooked. Several policy-making bodies in India have arrived at an estimate of their own, the precise basis of which is not clearly known supporting the need for public mental health research in India. For the matter of estimation, the mental health advisory committee of India estimated the prevalence to be 2% of the total population. [2]
Asian Journal of Psychiatry, 2011
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Papers by Venu Gopal Jhanwar