Body Dysmorphic Disorder (BDD) is a psychiatric, obsessive-compulsive disorder characterized by persistent, pre-occupying, intrusive thoughts regarding defects in one’s physical appearance. This leads to potentially harmful behaviors such as constant mirror checking, avoiding socialization, and the need to seek constant validation. The recent increase in social media usage and influence, especially the use of photo-editing apps, has been correlated with a steep decline in body satisfaction due to the perpetuation of unrealistic beauty standards.

This study aimed to determine the current prevalence of BDD in the general population of Pakistan and assess the association of BDD with social media usage.

A descriptive cross-sectional study was conducted from August 2022 to October 2022 on the general population of Pakistan using an online self-administered, anonymous, pretested questionnaire. It contained socio-demographic factors (age, gender, marital status, educational discipline, and household income). Participants were screened for BDD using a pre-tested Body Dysmorphic Disorder Questionnaire (BDDQ) modified to fit the revised DSM-5 criteria. They were further asked about the specifics of the defects they were concerned about, and whether or not they compared their appearance with people online. Characteristics of social media use such as the types of applications used and time spent on them were also asked. Data was analyzed using SPSS v.26.

Out of 779 participants, 5.3% (41) screened positive for BDD. The most repeated behaviors in BDD-positive participants were a comparison of how they looked with other people and checking themselves in the mirror to see how they look. Their most common defect of concern was skin (acne, scars, wrinkles, paleness, redness) followed by the shape or size of the nose, mouth, jaws, or lips. There was a significant association between age and BDD diagnosis (p < 0.001) and between the tendency to compare themselves with people online and BDD diagnosis (p = 0.001). However, no statistically significant differences were found in the BDD-positive and negative groups concerning gender, the number of social media applications used, or time spent on social media.

There is a need to educate the public about the risk of BDD, especially the more susceptible age, and promote safe social networking. Counseling about the harmful effects of social media could be helpful. This is the first study of its kind done on the Pakistani population and one of the few studies that exist on this topic worldwide. Hence, to reach a conclusive decision, there is a dire need to carry out similar investigations with larger sample sizes and on populations that have yet not been studied.

None Declared

Schizophrenia is a heterogeneous disorder with substantial heritability. The use of endophenotypes may help clarify its aetiology. Measures from the smooth pursuit and antisaccade eye movement tasks have been identified as endophenotypes for schizophrenia in twin and family studies. However, the genetic basis of the overlap between schizophrenia and these oculomotor markers is largely unknown. Here, we tested whether schizophrenia polygenic risk scores (PRS) were associated with oculomotor performance in the general population.

Analyses were based on the data of 2956 participants (aged 30–95) of the Rhineland Study, a community-based cohort study in Bonn, Germany. Genotyping was performed on Omni-2.5 exome arrays. Using summary statistics from a recent meta-analysis based on the two largest schizophrenia genome-wide association studies to date, we quantified genetic risk for schizophrenia by creating PRS at different p value thresholds for genetic markers. We examined associations between PRS and oculomotor performance using multivariable regression models.

Higher PRS were associated with higher antisaccade error rate and latency, and lower antisaccade amplitude gain. PRS showed inconsistent patterns of association with smooth pursuit velocity gain and were not associated with saccade rate during smooth pursuit or performance on a prosaccade control task.

There is an overlap between genetic determinants of schizophrenia and oculomotor endophenotypes. Our findings suggest that the mechanisms that underlie schizophrenia also affect oculomotor function in the general population.

Street working children are often poor, deprived of love and care, and lack supervision by responsible adults. The Kurdistan region of Iraq has experienced war conflicts for decades. Many families have been displaced and their children forced into the streets. However, little is known about mental health among the street working children in this region.

To explore mental health and trauma among street working boys in Duhok.

A cross sectional study was conducted on street working boys (n=100), eight to 16 years old in Duhok. A control group of age-matched school boys (n=100) were recruited. The Child Behaviour Checklist 6-18 was used for assessment of the children’s competences and behavioural problems. Mental disorders were assessed by using the Mini-International Neuropsychiatric Interview for Children and Adolescence. Experienced trauma was assessed by the Harvard-Uppsala Trauma Questionnaire for Children.

Sixty-one percent of the street working boys had at least one psychiatric disorder (57 % anxiety disorders). Street working boys reported more traumatic events than school boys, 96% vs 64% (X²= 32, p < 0.001), the largest effect size was found for torture (OR 28.4) and the smallest effect size for maltreatment or assault (OR 2.7). Also, they reported higher levels of internalising symptoms, T-score 59.4 (8.2). There was a significantly increased risk of more externalising symptoms with increasing working hours, OR 2.90 [95% CI 1.02; 8.29].

Internalizing symptoms, anxiety disorders and trauma were more common in street working boys compared to school boys. More working hours increased the risk for more externalising symptoms.

No significant relationships.

To demonstrate the feasibility of continuing cochlear implantation during the coronavirus disease 2019 crisis and to report on trends of referrals via the neonatal hearing screening programme.

A prospective case series was conducted on children who underwent cochlear implantation during the coronavirus disease 2019 crisis in the UK and a sample of referrals via the neonatal hearing screening programme. A step-by-step description of peri-operative management is included.

Regionally, between February and May 2020, 106 babies were referred via the neonatal hearing screening programme to paediatric audiology. Eleven children were operated on during the coronavirus disease 2019 study period. None of the 11 children developed coronavirus symptoms.

It is widely recognised that the demands of managing the current pandemic may compromise screening, clinical assessment and elective surgery. Time-sensitive issues such as cancer management have gained prominence, but a similar need exists for timely paediatric cochlear implantation.

Implantation in the paediatric population during the coronavirus disease 2019 pandemic is feasible with careful planning.

Tracheostomy for coronavirus disease 2019 pneumonitis patients requiring prolonged invasive mechanical ventilation remains a matter of debate. This study analysed the timing and outcomes of percutaneous tracheostomy, and reports our experience of a dedicated ENT–anaesthetics department led tracheostomy team.

A prospective single-centre observational study was conducted of patients undergoing tracheostomy, who had been diagnosed with coronavirus disease 2019 pneumonitis, between 21st March and 20th May 2020.

Eighty-one patients underwent tracheostomy after a median (interquartile range) of 16 (13–20) days of invasive mechanical ventilation. Median follow-up duration was 32 (23–40) days. Of patients, 86.7 per cent were successfully liberated from invasive mechanical ventilation in a median (interquartile range) of 12 (7–16) days. Moreover, 68.7 per cent were subsequently discharged from hospital. On univariate analysis, there was no difference in outcomes between early (before day 14) and late (day 14 or later) tracheostomy. The mortality rate was 8.6 per cent and no deaths were tracheostomy related.

Outcomes appear favourable when patients are carefully selected. Percutaneous tracheostomy performed via a multidisciplinary approach, with appropriate training, was safe and optimised healthcare resource utilisation.

The coronavirus disease 2019 (COVID-19) pandemic has led to significant strain on front-line healthcare workers.

In this multicentre study, we compared the psychological outcomes during the COVID-19 pandemic in various countries in the Asia-Pacific region and identified factors associated with adverse psychological outcomes.

From 29 April to 4 June 2020, the study recruited healthcare workers from major healthcare institutions in five countries in the Asia-Pacific region. A self-administrated survey that collected information on prior medical conditions, presence of symptoms, and scores on the Depression Anxiety Stress Scales and the Impact of Events Scale-Revised were used. The prevalence of depression, anxiety, stress and post-traumatic stress disorder (PTSD) relating to COVID-19 was compared, and multivariable logistic regression identified independent factors associated with adverse psychological outcomes within each country.

A total of 1146 participants from India, Indonesia, Singapore, Malaysia and Vietnam were studied. Despite having the lowest volume of cases, Vietnam displayed the highest prevalence of PTSD. In contrast, Singapore reported the highest case volume, but had a lower prevalence of depression and anxiety. In the multivariable analysis, we found that non-medically trained personnel, the presence of physical symptoms and presence of prior medical conditions were independent predictors across the participating countries.

This study highlights that the varied prevalence of psychological adversity among healthcare workers is independent of the burden of COVID-19 cases within each country. Early psychological interventions may be beneficial for the vulnerable groups of healthcare workers with presence of physical symptoms, prior medical conditions and those who are not medically trained.

The aim of this study is to investigate the “Hospital Service providers” perception, attitude and actual practice in managing schizophrenia in Malaysia.

In this study, it was designed as a mixed -methods study. in the first phase, quantitative surveys have been implemented among 42 service providers. in the second phase, the descriptive qualitative study method was also used.

The questionnaires designed to gather the data relating to the respondent satisfied in managing Schizophrenia in Malaysia. Thirty five (or 83.3%) of the respondents are satisfied with the current Schizophrenic overall management, but twenty one (or 50.1%) of the respondents does not satisfy with current psychosocial interventions available in Malaysia. The qualitative found that, the psychiatrists responded that they are satisfied with current use of atypical antipsychotic in the hospitals but they are concerned with the lack of community services particularly in the university hospitals. The medical officers and general practitioners responded that they received many patients who were brought by their families to see them in outpatient clinic. However, many doctors failed to diagnose the disorder as they have a lack of training in diagnosing mental illness diseases. This is mainly due to misperception about mental illness particularly in rural areas among the Malay population.

The study concluded that more community awareness program needs to be done which emphasis on mental illness to reduce the duration of untreated illness and ensure active roles of family members in supervision of treatment.

Studies have shown higher rate of various psychiatric disorders among individuals with substance abuse / dependence. There is little data in developing countries, such as Pakistan, on prevalence of psychiatric co-morbidity in this population and impact on treatment.

To assess the psychiatric co-morbidity among individuals with substance dependence and to determine its demographic associations in patients with substance dependence in Pakistan.

This was a descriptive study conducted at a tertiary care hospital in Pakistan. Participants were 588 individuals with substance dependence admitted to a tertiary care hospital in Pakistan, mainly in male inpatient substance dependence unit. The patients were assessed for psychiatric co-morbidity using DSM IV criteria. Informed consent was obtained. The study was approved by the Institutional Research Committee. The results were obtained by using chi square test on SPSS 17.

Out of 588, 200 patients (34%) were found co-morbid with other psychiatric disorders along with substance dependence. Reason of first substance use and history of previous substance dependence were observed to be significantly associated with co-morbid psychiatric disorders, x2 (48, n = 549) = 112.396, p < 0.01 and x2 (18, n = 588) = 29.66, p = 0.041 respectively.

1. 1. There was high rate of psychiatric co-morbidity among individuals with substance dependence in this sample.

2. 2. Depression, personality disorders and anxiety disorders were the major co-morbid diagnosis among this population.

Cold dissection is the most commonly used tonsillectomy technique, with low post-operative haemorrhage rates. Coblation is an alternative technique that may cause less pain, but could have higher post-operative haemorrhage rates.

This study evaluated the peri-operative outcomes in paediatric tonsillectomy patients by comparing coblation and cold dissection techniques.

A systematic review was conducted of all comparative studies of paediatric coblation and cold dissection tonsillectomy, up to December 2018. Any studies with adults were excluded. Outcomes such as pain, operative time, and intra-operative, primary and secondary haemorrhages were recorded.

Seven studies contributed to the summative outcome. Coblation tonsillectomy appeared to result in less pain, less intra-operative blood loss (p < 0.01) and a shorter operative time (p < 0.01). There was no significant difference between the two groups for post-operative haemorrhage (p > 0.05).

The coblation tonsillectomy technique may offer better peri-operative outcomes when compared to cold dissection, and should therefore be offered in paediatric cases, before cold dissection tonsillectomy.

There is increasing interest in the clinical and aetiological overlap between autism spectrum disorders and schizophrenia spectrum disorders, reported to co-occur at both diagnostic and trait levels. Individually, sub-clinical autistic and psychotic traits are associated with poor clinical outcomes, including increased depressive symptomatology, self-harming behaviour and suicidality. However, the implications when both traits co-occur remain poorly understood. The study aimed to (1) examine the relationship between autistic and psychotic traits and (2) determine if their co-occurrence increases depressive symptomatology, self-harm and suicidality.

Cross-sectional data from a self-selecting (online and poster advertising) sample of the adult UK population (n = 653) were collected using an online survey. Validated self-report measures were used to assess sub-clinical autistic and psychotic traits, depressive symptomatology, self-harming behaviour and suicidality. Correlation and regression analyses were performed.

A positive correlation between sub-clinical autistic and positive psychotic traits was confirmed (rs = 0.509, p < 0.001). Overall, autistic traits and psychotic traits were, independently, significant predictors of depression, self-harm and suicidality. Intriguingly, however, depression was associated with a negative interaction between the autistic domain attention to detail and psychotic traits.

This study supports previous findings that sub-clinical autistic and psychotic traits are largely independently associated with depression, self-harm and suicidality, and is novel in finding that their combined presence has no additional effect on depression, self-harm or suicidality. These findings highlight the importance of considering both autistic and psychotic traits and their symptom domains in research and when developing population-based depression prevention and intervention strategies.

Simultaneous PET/MR/EEG (Positron Emission Tomography – Magnetic Resonance – Electroencephalography), a new tool for the investigation of neuronal networks in the human brain, is presented here within the framework of the European Union Project TRIMAGE. The trimodal, cost-effective PET/MR/EEG imaging tool makes use of cutting edge technology both in PET and in MR fields. A novel type of magnet (1.5T, non-cryogenic) has been built together with a PET scanner that makes use of the most advanced photodetectors (i.e., SiPM matrices), scintillators matrices (LYSO) and digital electronics. The combined PET/MR/EEG system is dedicated to brain imaging and has an inner diameter of 260 mm and an axial Field-of-View of 160 mm.

It enables the acquisition and assessment of molecular metabolic information with high spatial and temporal resolution in a given brain simultaneously. The dopaminergic system and the glutamatergic system in schizophrenic patients are investigated via PET, the same physiological/pathophysiological conditions with regard to functional connectivity, via fMRI, and its electrophysiological signature via EEG. In addition to basic neuroscience questions addressing neurovascular-metabolic coupling, this new methodology lays the foundation for individual physiological and pathological fingerprints for a wide research field addressing healthy aging, gender effects, plasticity and different psychiatric and neurological diseases.

The preliminary performances of two components of the imaging tool (PET and MR) are discussed. Initial results of the search of possible candidates for suitable schizophrenia biomarkers are also presented as obtained with PET/MR systems available to the collaboration.