Shivananda Nayak

Shivananda Nayak
University of the West Indies, St. Augustine | UWI · Department of Pre-Clinical Sciences

MSc, PhD, NRCC-CC, FACB, FAGE, FABMS PGDCHC DSC

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142
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Introduction
Biochemical markers and anthropometric variables in type 2 diabetes and cardiovascular diseases
Featured research
Article
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The COVID-19 pandemic has caused increased anxiety among medical students due to the uncertainty of the long-term effects on the future of medical education. There are currently insufficient studies aimed at investigating the changes in the mental health and studying habits of medical students during public health emergencies such as this pandemic, as well as methods that can be incorporated to appropriately manage anxiety effectively. To investigate the psychological impact and associated factors on medical students during the pandemic. This retrospective, cross-sectional study consisted of 291 medical students of the faculty of medical sciences at the university of the West Indies, St. Augustine campus, Trinidad and Tobago. The mental health and study habits of said students were assessed with the use of questionnaires via an online survey platform. Data of our study showed that 56% of the students were experiencing increased stress and anxiety. Students of 82.8% experienced irregular sleeping habits and 76.3% of participants experienced a change in eating habits brought on by the pandemic. Participants of 67.4% studied less than 4 hrs. a day, 61.5% were less productive, 62.2% showed an inability to focus and avoid distractions in their study environment during the COVID-19 pandemic. There is a need for proper supportive strategies to assist students in effectively managing anxiety and depression during public health emergencies such as COVID-19. It is suggested that all universities, colleges and education bodies alike implement a pandemic preparedness course as well as an accessible online support forum.
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Background: Postpartum depression (PPD) is a debilitating mental disorder which affects mainly females usually after giving birth. Objectives: We aimed to study the risk factors and concerns of PPD among mothers seeking health care at regional health authority hospitals in Trinidad. Materials and Methods: The cross-sectional study consisted of 360 mothers from the postnatal and neonatal clinics of the North Central Regional Health Authority, Trinidad. Data were collected via a questionnaire using convenience sampling to study the risk factors and concerns of PPD among mothers. Participants were asked to sign a consent form before filling out the questionnaire. The questions were geared toward obtaining mother's perspective on predisposing factors of PPD, identifying if they are at risk for perinatal depression, the outcomes of having PPD, and determining if they were screened and treated for it. Results: This study comprised 360 postnatal women among which 4.7% were diagnosed with postpartum while 40% scored ≥10 in the Edinburgh Postnatal Depression Scale which indicated a risk for PPD. This research revealed seven significant predictors of PPD: family history of mental illness, baby blues, mood swings during period, use of oral contraceptives, emotional support, life stress, and being diagnosed with depression (P < 0.05). Other characteristics like sociodemographics were not remarkably correlated but marginally indicative of depressive signs. Conclusion: The study shows that many risk factors of PPD exist, and screening and treatment should be used to avoid the consequences of PPD.
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Objectives To determine the prevalence and factors associated with depression, anxiety and stress among healthcare workers (HCWs) during COVID-19 pandemic. Design Cross-sectional online survey. Setting HCWs from four major hospitals within the Regional Health Authorities of Trinidad and Tobago. Participants 395 HCWs aged ≥18 years. Main outcome measures Depression, anxiety and stress scores. Results Among the 395 HCWs, 42.28%, 56.2% and 17.97% were found to have depression, anxiety and stress, respectively. In the final stepwise regression model, contact with patients with confirmed COVID-19, p<0.001 (95% CI 3.072 to 6.781) was reported as significant predictors of depression. Further, gender, p<0.001 (95% CI 2.152 to 5.427) and marital status, p<0.001 (95% CI 1.322 to 4.270) of the HCWs were considered to be correlated with anxiety. HCWs who had contact with patients with suspected COVID-19 had lower depression, p<0.001 (95% CI −5.233 to −1.692) and stress, p<0.001 (95% CI −5.364 to −1.591). Conclusions This study has depicted the prevalence and evidence of depression, anxiety and stress among HCWs during the COVID-19 pandemic. The findings of the study will serve as supportive evidence for the timely implementation of further planning of preventative mental health services by the Ministry of Health, for frontline workers within the public and private health sectors.
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ABSTRACT Depression, anxiety and stress are the most prevalent mental health problems among health professions’ students. The study was aimed to explore the socio-demographic and educational factors associated with depression, anxiety and stress among health professions’ students. Using non-random purposeful sampling, 366 health professions’ students studied in 2018/19 were surveyed via a selfreported questionnaire that included Depression, Anxiety and Stress Scale (DASS-21) and questions on sociodemographic and educational characteristics. The majority of respondents were from the School of Medicine (59.8%), with 116 males and 250 females. Sleep duration, communication problems with teaching staff, feelings of inferiority to friends and family problems were determined to be independent predictors of depression in the current study. Communication problems with teaching staff, feelings of inferiority to friends and family problems were important predictors of anxiety. Further, we found that feelings of inferiority to friends and family problems were found to be important risk factors for stress. Our results suggest that the overall prevalence of depression,anxiety and stress among health professions’ students wereconsiderably high. All students having a severe mental health issuesshould be supported by the student counselling centre and expertclinicians in order to confirm the diagnosis and implement subsequent treatment strategies.

Publications

Publications (142)
Article
Full-text available
The COVID-19 pandemic has caused increased anxiety among medical students due to the uncertainty of the long-term effects on the future of medical education. There are currently insufficient studies aimed at investigating the changes in the mental health and studying habits of medical students during public health emergencies such as this pandemic,...
Article
Full-text available
Article
Full-text available
Background: Postpartum depression (PPD) is a debilitating mental disorder which affects mainly females usually after giving birth. Objectives: We aimed to study the risk factors and concerns of PPD among mothers seeking health care at regional health authority hospitals in Trinidad. Materials and Methods: The cross-sectional study consisted of 360...
Article
Full-text available
Objectives To determine the prevalence and factors associated with depression, anxiety and stress among healthcare workers (HCWs) during COVID-19 pandemic. Design Cross-sectional online survey. Setting HCWs from four major hospitals within the Regional Health Authorities of Trinidad and Tobago. Participants 395 HCWs aged ≥18 years. Main outcome...
Article
Full-text available
ABSTRACT Depression, anxiety and stress are the most prevalent mental health problems among health professions’ students. The study was aimed to explore the socio-demographic and educational factors associated with depression, anxiety and stress among health professions’ students. Using non-random purposeful sampling, 366 health professions’ studen...
Article
Full-text available
Context: The process of communication includes intense observation based on which opinions are formed or situations are created. A patient whose is in state of panic due to the health conditions feels neglected and becomes skeptical about the treatment hi/she is going to receive. Aims: The aim of the study is to understand the need for being sen...
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Introduction: Small group teaching is an educational strategy that may be used to facilitate learning. Tutorials enable an adult approach toward learning where students take responsibility for their own learning. We aimed to investigate the students' engagement and perceptions of small group tutorial classes among undergraduate medical students....
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Background: Dyslipidemia has for long been associated with the development of complications such as cardiovascular diseases (CVD) and is an important component of the metabolic syndrome .
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Background: Stressful environment in medical school often has a negative effect on students' psychosocial well-being. An in-depth understanding of how medical students experience psychological distress and coping is necessary for the prospective students. Objectives: To estimate the prevalence of psychological distress among undergraduate medica...
Research
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The prevalence and concerns of polycystic ovary syndrome in youngfemale university students aged 18 to 25 in Trinidad
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The Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2), previously known as 2019 Novel Coronavirus (2019 nCoV) originated in the city of Wuhan, China and has spread rapidly around the world, sending billions of people into lockdown. Consequently, the World Health Organisation (WHO) declared the Coronavirus Disease (COVID-19) a pandemic. G...
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Background: Autism, Cerebral Palsy and Down Syndrome are three lifelong, non-curable common developmental disorders that affect approximately 1 in 59, 1 in 323, and 1 in 700 children respectively. This research is to study the effects of prenatal, perinatal, and postnatal factors on the development of Autism, Cerebral Palsy (CP) and Down Syndrome (...
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Serum uric acid is associated with an increased risk of hypertension, cardiovascular disease and chronic kidney disease. Hyperuricemia raises the risk of insulin resistance and metabolic syndrome including diabetes. Aim: To find the association between purine metabolites and diabetic complications in rats. Materials and methods: Alloxan was adminis...
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Background: A medical professional is viewed with great nobility and prestige worldwide. A medical education is perceived as being stressful, and a high level of stress may have a negative effect on cognitive functioning and learning of students in a medical school
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Introduction: Polycystic Ovarian Syndrome (PCOS) affects 4-18% of reproductive women worldwide. It is observed to have associations with metabolic syndromes, psychological mentality and reproductive organs in women. Diet and lifestyle play an important role in the development of PCOS and their modification remain the first line of treatment. Object...
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Inflammatory bowel disease is an idiopathic, immune mediated and chronic inflammatory condition of intestine. The objective of the present study was to elucidate the protective effect of aqueous extract of fruits of Garcinia pedunculate (AEGP) in acetic acid induced ulcerative colitis in Swiss albino mice. The mice were grouped into four different...
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Objective: To develop a novel sex independent anthropometric index, termed as angle index, related to type 2 diabetes. Design: Case-control. Participants: The study comprised 121 participants and were divided into two groups. One group had no form of diabetes and served as controls (n=50). The other group had the condition of type 2 diabetes (...
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The effect of partial replacement of commercial sheep ration (CSR) with Trichanthera gigantea (Nacedero) leaves (TGL) was studied using 27 Barbados Blackbelly lambs (12 males and 15 females) aged between 12 and 15 weeks. The diet consisted of (i) Tanner grass (Brachiara arrecta ad libitum) offered + CSR @ 2% of the body weight as a supplement-TGL-0...
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Polycystic Ovary Syndrome is a multifactorial reproductive problem and a leading cause of female infertility worldwide. Evidences have shown that Oxidative Stress and decreased antioxidant status are often linked with PCOS. Insulin Resistance in PCOS patients ranges from 50% to 70% and may encourage OS by production of reactive oxygen species. Obje...
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Aim: To study the Framingham cardiovascular risk assessment scores in male and female subjects without micro and macro vascular complications. Materials and Methods: This study enrolled with 205 subjects without diabetes. All the subjects were without micro and macro vascular complications and were between 30-70 years of age. The Framingham cardiov...
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Aim: This study seeks to examine the major causative factors for lower extremities amputation (LEA) amongst a Trinidadian diabetic patients as well as to analyse the resulting concerns of said patients. Study Setting and Design: This study mainly comprised patients who were subject to or will be subject to lower limb amputations of differing degree...
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Aim: Polycystic ovary syndrome (PCOS) is a leading cause of female infertility. Adipose tissue releases various adipokines, including visfatin and adiponectin, which have influence on insulin resistance (IR). Objective: To determine serum insulin levels, IR, serum visfatin and adiponectin levels in PCOS subjects. Materials and methods: Case-control...
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Aim: To study the Framingham cardiovascular risk assessment scores in male and female subjects without micro and macro vascular complications. Materials and Methods: This study enrolled with 205 subjects without diabetes. All the subjects were without micro and macro vascular complications and were between 30-70 years of age. The Framingham cardiov...
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A number of published journals were examined in order to gather information and insight into the matter. Based on the results it was noted that statins actively reduce cholesterol (LDLc and total cholesterol) and apolipoprotein B levels and prevent the risk of cardiovascular diseases. However, it was also presented that statins can be linked to a n...
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Objectives: To determine the relationship of adenosine deaminase (ADA) concentration in a population of community acquired pneumonia (CAP) patients and evaluate its potential link to factors such as ethnicity, smoking and hypertension. Study design: This study followed a cross-sectional design wherein the differences between two groups of patients...
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Abstract: OBJECTIVES: The objective of this study was designed to investigate medical students’ perceptions of small group teaching effectiveness in a hybrid curriculum. MATERIALS AND METHODS: A cross‑sectional, descriptive survey was conducted at the School of Medicine, The University of the West Indies, St. Augustine where we collected the data f...
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Objectives: To determine the awareness of HbA1c values and correlate this with educational levels, dietary intake and physical activity in type II diabetic population of Trinidad. Methods: Total of 222 type II diabetic subjects were assessed via questionnaire evaluating their demographics, type and duration of diabetes, type and frequency of glu...
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Creatine kinase-MB (CK-MB) is a widely tested enzyme in cardiac disease and thus has important clinical implications. We relate the scenario of a young patient presenting with chest pain whose CK-MB levels remained inordinately elevated despite a normal total CK level, resolution of symptoms and exclusion of coronary artery disease. Further analysi...
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Background: Persistent bouts of extended exercise and heavy training are associated with depressed immune cell function. It has recently been demonstrated that IL-6 is produced locally in contracting skeletal muscles and acts on a wide range of tissues. Larger amounts of IL-6 are produced in response to exercise than any other cytokines. Though th...
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Objective: To evaluate the wound-healing activity of oil of Hypercium perforatum (St. John's wort), in excision wounds of male white rats. Approach: The current methods of wound management involve the use of antibiotic creams. The search for more natural materials for the purpose of healing of wounds has led to the discoveries of potential agents p...
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Purpose: i) To determine the relationship between the cardiac biomarkers ST2 and NT-proBNP with ejection fraction (EF) in heart failure (HF) patients. ii) Assess whether a superiority existed between the aforementioned cardiac markers in diagnosing the HF with reduced EF. iii) Determine the efficacy of both biomarkers in predicting a 30-day cardiov...
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Aims: To investigate the link between benign prostatic hypertrophy, BMI and type 2 diabetes mellitus. Materials and methods: This was the retrospective study conducted at the urology clinic of NCRHA and SWRHA, in Trinidad. Data was obtained from 85 patients with high PSA values (>4.0ng/mL). The data collected were age, ethnicity, weight, height,...
Article
Jasmine flowers and leaves are used extensively in folk medicine in different parts of the world to treat a variety of diseases. However, there are very few published reports on the neuropsychiatric effects of Jasmine extracts. Hence, the objectives of the present study were to examine the effects of an alcohol extract of Jasminum multiflorum leave...
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p> Objective: This was an cross-sectional observational study wherein clinical parameters were compared between the population of two countries like India and Trinidad. Methods: One hundred and six diabetic and 100 healthy individuals from Dakshina Kannada District of India were chosen and compared with 106 Type 2 diabetic and 100 healthy individu...
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Objective To investigate whether relationships exist among vitamin D, type 2 diabetes mellitus (T2DM), and blood pressure in Trinidadian subjects with T2DM. Research design and methods This was a case–controlled study to determine if vitamin D levels were lower in patients with T2DM. After data analysis, an exploratory hypothesis of vitamin D rela...
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Aim of the study: High dose acetaminophen (APAP) increases the risk of liver injury caused by oxidative stress due to accumulation of reactive species. Although N-acetyl cysteine is the standard antidote used to treat acute APAP-induced liver failure, we proposed that known antioxidant phytochemicals in Leonotis nepetifolia extracts would protect a...
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Objective: This study aimed in finding out if drinking coffee over a long term showed a marked influence on the serum uric acid level and Fasting blood glucose level. Methods: The study population had 200 healthy subjects out of whom 143 were coffee drinkers and 90 diabetic subjects out of which 48 were coffee drinkers. Results: It was seen that th...
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Background: Diabetes mellitus is a common metabolic disorder causing hyperglycemia affecting the world wide population. In recent years most of the plant extracts with their potential antioxidant property are used in the treatment of diabetes mellitus. The aim of our study is to determine protein thiols and glycogen content to evaluate the hypoglyc...
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Aim: This study evaluating N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and high-sensitivity C-reactive protein (hs-CRP) relationship with features of the metabolic syndrome (MS) in high risk subgroups for cardiovascular disease (CVD) in Trinidad. Materials and methods: The sample population consisted of 160 subjects, 78 of whom were A...
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Oxidative stress is believed to be a pathogenic factor in the development of diabetic complications. In the present study, we aimed to evaluate the effects of different fractions of heart wood of Pterocarpus marsupium on antioxidant enzyme like protein thiols and also check the efficacy of the extract for the protection of the renal function in all...
Article
Background: Type 2-diabetes (T2D), is a public health problem which has reached epidemic proportions due to the rapidly increasing rates of this disease worldwide. It is known that adipose tissue can synthesize and release pro-inflammatory cytokines, tumor necrosis factor-alpha, interleukin-1, adiponectin and leptin that are associated with body f...
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A Review on adiponectin in diabetic subjects without any micro- or macro vascular complications has shown to be of high statistical significance from a cross-sectional study conducted of 229 T2D and 205 healthy patients. This has been observed in many other studies and therefore requires longitudinal studies for clinical applications in managing ob...
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Key Clinical Message Familial hypercholesterolemia (FH) is a common but commonly missed diagnosis. Tendon xanthomas are a physical sign strongly suggestive of FH. Physicians must identify tendon xanthomas, apply validated clinical scoring such as the Dutch Lipid Clinic Network criteria and offer cascade screening. This approach will increase recogn...
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Coffee though not usually thought of as healthy food but can be treated as one of the beneficial drink. Many researchers have found strong evidence that coffee reduces the risk of several serious ailments, including diabetes, heart disease, cirrhosis of the liver, etc. The long term beneficial effect of coffee on diabetes is now understood to be mo...
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The aim of the study is to document the morphological details of the forelimb bones of the orange rumped agouti (Dasyprocta leporina). The bones were collected from 12 adult animals of both sexes. Each limb comprised of 47 bones (30 bones, 17 sesamoid bones). The clavicle was poorly developed while the metacromion process of the scapula was very we...
Article
Background: The aim of this study was to determine the differences amongst the anthropometric measurements, lipid profile, blood pressure and body shape in diabetics as well as non-diabetics. Methods: This was a cross-sectional study comprised of 309 subjects with 91 males and 218 females. Of this, there were 217 diabetics and 92 non-diabetics. The...
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To determine the adiponectin levels in diabetic subjects without any pre-existing micro or macrovascular complications. This was a cross sectional study comprised 205 healthy individuals and 229 diabetic subjects without any pre-existing micro or macrovascular complications.The mean values of adiponectin of diabetic group were significantly lower w...
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Asian Indians have more visceral fat and a greater insulin resistance. Obesity is associated with a low-grade inflammation of adipose tissue resulting in activation of the cytokine system which leads to exaggerated insulin resistance, impaired glucose tolerance and even vascular complications. Leptin, known to control the appetite has also been sho...
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Background: The leaves of the Neurolaena lobata (Asteraceae) plant are used to control diabetes and heal wounds and infections. Aim: The ethanolic extract of N. lobata leaf was evaluated for its ability to heal inflicted wounds in rats using the excision wound model. Materials and methods: Animals were divided into three groups of six each. Te...
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C-reactive protein is considered as one of the most sensitive markers of systemic inflammation. Studies have found that increase in the levels of C reactive protein is associated with the vascular complications. Hence we aimed in finding the correlation of hs-CRP with other risk factors like BMI, FBS and HbA1c in diabetic subjects who have still no...
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Increased amount of adipose tissue or its disproportionate distribution between central and peripheral body regions is related to the development of insulin resistance, type 2 diabetes mellitus. To assess the relationship of various anthropometric variables and leptin with the glycemic index in type 2 diabetic subjects who have still no developed a...
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Adipose tissue functions as an endocrine organ, and also a role in fuel storage, thermal insulation, and mechanical protection, releasing biologically active and diverse cytokines.Exercise is known to increase the insulin sensitivity in muscles. Most of the type 2 diabetes occurs due to life style changes and increased fat accumulation resulting in...
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Aims: To assess the impact of risk factors such as age, gender, ethnicity, family history, body mass index (BMI), waist circumference and hypertension, on the development of type 2 diabetes mellitus in the Trinidadian population. Materials and methods: A cross-sectional case control study comprised 146 non-diabetics and 147 type 2 diabetics ≥18...
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Aims: This study attempts to investigate variations in skin and wound healing, by comparatively examining the rate of healing between Sprague Dawley rats (Rattus Norveigicus) and Brazilian agouti (Dasyprocta Leporina), reflective of two skin types. Materials and Methods: Following the excision wound model, wound healing times and dimensions between...
Article
Objective of the study is to identify the predictors of plasma triglycerides. A stratified random sample of university staff categories underwent measurements of anthropometry, blood pressure, and fasting blood glucose, insulin, lipids, CRP and homocysteine. Dietary intakes were assessed using duplicate 24h recalls. HOMA-IR was calculated. Stepwise...
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Abstract The skin of the fruit and the bark of Punica granatum are used as a traditional remedy against diarrhea, dysentery, and intestinal parasites. The fruit skin extract of P. granatum was tested for its wound healing activity in rats using an excision wound model. The animals were divided into three groups of six each. The experimental group o...