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The purpose of this study was to examine the relationship between sleep hygiene, excessive daytime sleepiness and work hours among resident physicians in Chandigarh, India. Data were collected from 350 volunteering junior resident doctors and included sociodemographic variables, excessive daytime sleepiness (EDS) as measured by the Epworth Sleepiness Scale (ESS), sleep hygiene as measured by the Sleep Hygiene Index and hours worked. Almost half of the resident physicians studied reported a problem of EDS and maladaptive sleep hygiene practices. Physicians working more than 80 hours per week and physicians with more maladaptive sleep behaviours were much more likely to report EDS. The authors propose that sleep hygiene and number of hours slept should be considered as EDS prevention and treatment strategies, especially for physicians working less than 80 hours per week. The authors also propose that the most salient intervention for physicians working more than 80 hours per week is one of workplace advocacy, where the government is encouraged to adopt legally binding guidelines as seen in other countries.

This study aimed to detect perilesional gliosis around solitary cerebral cysticerci (SCC) by magnetisation transfer imaging (MTI), to compare its incidence between patients administered and not administered albendazole. We prospectively randomised patients with SCC and new-onset seizures to treatment with albendazole plus antiepileptics (treatment), or antiepileptics only (control), and performed MRI scans at zero, three, six, 12 and 24 months. Data were analysed for lesion characteristics, perilesional MT hyperintensity and MT ratios, calculated from the lesion and perilesional area. Eighty-one patients' data were analysed (M-41, F-40; ages 6-52 years). About 13% scolices appeared hyperintense on MTI at baseline. T1-isointense cyst walls and perilesional area showed MT hyperintensity in 30 - 41.4%; this proportion increased over time. Persistently visible SCC and stage of degeneration at enrolment did not predict development of MT hyperintensity. MT ratios (range - 98.75 to 49.79) increased over time and differed significantly from normal parenchyma. No difference in MT ratios was noted between treatment and control groups. Qualitative perilesional MT hyperintensity was more often seen in control group. Perilesional gliosis is present in >20% of SCC at six months, and continues to appear on later scans. Gliosis is independent of lesion persistence and stage of degeneration. Pre- and post-contrast MT imaging is equally useful in detection of gliosis. MT ratios from the lesion and perilesional parenchyma are significantly lower than from normal brain tissue at all stages of degeneration, but increase as degeneration occurs and healing progresses. Albendazole therapy does not affect the formation of perilesional gliosis.

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Background: Modern socio-occupational settings, especially medical settings, often involve shift work, long work hours, and concomitant maladaptive sleep habits. These factors may result in daytime sleepiness, an increase in the prevalence of sleep disorders, and/or an exacerbation of existing sleep disorders in the contemporary workforce. Aim was to measure the prevalence and determinants of excessive daytime sleepiness (EDS) among medical residents at a Tertiary Care Institution in India.Methods: A cross-sectional study was designed and a list of all enrolled medical residents was obtained (N=430). The eligible subjects (N=428) were interviewed and administered the study instruments. The information on socio-demographics and sleep-related factors were collected using the sleep assessment proforma. The Epworth sleepiness scale (ESS) was used to measure excessive daytime sleepiness (EDS) and the sleep hygiene index (SHI) was used to measure sleep hygiene. Data were analyzed with appropriate statistical methods.Results: A total of 350 residents responded (82%). The prevalence of EDS and Maladaptive sleep hygiene were 47.4% and 85.5% respectively. A positive association was found between EDS and weekly work hours, SHI score, sleep duration, sleep quality, midnight awakenings, clinical stream, and rotating shift work. Coffee intake and smoking within 4 hours of bedtime, restless legs and allergies had weak association with EDS.Conclusions: EDS and unhygienic sleep were highly prevalent among resident doctors. The factors associated with EDS were mainly related to work, sleep quantity, sleep quality and sleep hygiene which are amenable to suitable modifications by behavioural change communications, awareness programs and by administrative actions.