Ajish Mangot
@kimskarad.in
Associate Professor, Department of Psychiatry
Krishna Institute of Medical Sciences "Deemed to be University", Karad
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Mamta, Ajish Mangot, Abhishek Kumar, and Anupam Baliyan
IEEE
Accurate solar power forecasting is critical for efficient energy management and grid integration. This study looks into how to forecast solar power using weather forecast data and machine learning methods. Several machine learning models have been proposed to forecast solar power, including Artificial Neural Networks, Random Forests, Support Vector Regressions, Gradient Boosting, and Hybrid AI models. However, the proposed Deep Belief Networks (DBNs) model has several advantages over conventional machine learning models, including its capacity to learn intricate patterns and relationships in the data, lowering the requirement for manual feature engineering, and scalability for both short- and long-term forecasting. The comparison table and accuracy metrics show that the suggested model performs better in terms of accuracy than conventional models and takes less time to run. The proposed model provides valuable insights into the optimal design and implementation of solar power forecasting systems, supporting the transition to a sustainable energy future.
Ajish G. Mangot, Vasantmeghna S. Murthy, Sharad V. Kshirsagar, Ajay H. Deshmukh, and Dinesh V. Tembe
SAGE Publications
Background: Phantom sensations like phantom vibration (PV) and phantom ringing (PR)— the sensations of vibration and ringing of the phone when they are not, respectively—are among the latest in the category of “techno-pathology” to receive global attention. This study was conducted with the aim to estimate the prevalence of such sensations among medical interns and their association with perceived stress levels and smartphone usage pattern. Materials and Methods: Ninety-three medical interns using smartphone were recruited for the study. Data were collected anonymously using semi-structured questionnaire, perceived stress scale (PSS), and smartphone addiction scale-short version (SAS-SV). Data were analyzed using descriptive statistics, Chi-square test, independent t-test, ANOVA, and Pearson's correlation coefficient. Results: Fifty-nine percent students had a high level of stress, whereas 40% had problematic smartphone use. Sixty percent students experienced PV, whereas 42% experienced PR and both were significantly associated with higher frequency of phone use and the use of vibration mode. Mean SAS-SV score was significantly lower in students who did not perceive PR/PV, whereas mean PSS score was significantly lower in students who did not perceive PV. Conclusion: This study confirms findings from other national and international researches about the experience of cell phone phantom sensations and their relationship with the pattern of phone use and stress level. It also brings to light high levels of stress and problematic smartphone use among medical students during the internship.
Dhanya Raveendranthan, Naren P. Rao, >Mukund G. Rao, Ajish G. Mangot, Shivaram Varambally, Muralidharan Kesavan, Ganesan Venkatasubramanian, and Bangalore N. Gangadhar
SAGE Publications
Background: Antipsychotic treatment-induced hyperprolactinemia is a highly distressing and disabling side effect for patients. The use of add-on aripiprazole has been identified as a possible treatment strategy in this situation. However, data on prolactin changes with add-on aripiprazole in a real-world naturalistic clinical setting from India are sparse. Materials and Methods: The retrospective chart review was conducted at the specialty metabolic clinic at the National Institute of Mental Health and Neurosciences, Bengaluru, India. Sixteen patients (female: male = 13:3) who were on a stable dose of antipsychotic medications, complaining of either sexual dysfunction or menstrual irregularities, were prescribed add-on aripiprazole. The serum prolactin values were obtained before the initiation of aripiprazole and during the follow-up. Results: Patients were on treatment with risperidone, amisulpride, and olanzapine and had a prolactin level of 87.1 ± 60.7 ng/ml. Add-on aripiprazole treatment was given with a mean dose of 13.8 ± 7.4 mg/day. Patients had a significant reduction in prolactin level (35.6 ± 29.1 ng/ml) following treatment with aripiprazole (P = 0.004). Conclusions: Add-on aripiprazole could be a clinically useful strategy in patients who develop antipsychotic-induced hyperprolactinemia.
A. Mangot, F. Siddiqui and V. Murthy
Introduction: Sexual misconceptions have been around in India for a very long time. Growing liberal attitudes toward sex and sexual permissiveness can be expected to occur in the context of improved sexual knowledge among people. However, sexual myths continue to remain rampant. Therefore, the present study was planned with the aim to assess the level of sexual misconceptions regarding semen loss prevalent among male medical interns. Participants and Methods: This was a cross-sectional study among unmarried male medical students doing an internship. Eighty-one interns were recruited after fulfilling predecided inclusion/exclusion criteria and were asked to complete a specially made questionnaire to assess their sexual beliefs anonymously in complete privacy. Responses were analyzed using frequency distribution. Results: Seventy-nine percent of the participants believed that loss of semen can lead to reduction in the size of the penis, while 44.44% (n = 36) believed that it leads to sexual weakness, 56.8% (n = 46) believed it can lead to physical weakness, and 56.8% (n = 46) believed that excess masturbation can decrease sexual prowess. Discussion: This study helps bring to light the prevalence of sexual misconceptions among medical interns in spite of reaching a stage where they are expected to have sound conceptual, theoretical, and practical knowledge about sexual health and wellbeing. There is a dearth of national and international studies exploring the sociocultural aspects of sexuality specifically among medical students. The findings from this study are expected to stimulate researchers and academicians into further exploring the aspect of sexuality among the young medical fraternity.
Ajish G. Mangot, Vasantmeghna S. Murthy, and Shubhangi Jamale
Elsevier BV
Ajish G. Mangot
Informa UK Limited
ABSTRACT Disulfiram has been in use for treating alcohol dependence since last more than 6 decades with good results. It is usually prescribed after taking informed consent from the patient. In India, it is increasingly being prescribed by quacks and general practitioners without appropriate knowledge at the behest of the family members. It seems ethically incorrect considering it doesn’t fulfil the ethical and moral principle of patient autonomy. But looking at the issue from the perspective of autonomy of family members, it is often a desperate attempt to salvage their families. Relatives are often ready to bear the potential, often serious, side effects of disulfiram provided it ensures abstinence or at least significantly decreased consumption. Should we turn a blind eye when it comes to surreptitious use of disulfiram to alcohol dependent patients, especially if the benefits outweigh the potential risks, thereby giving precedence to beneficence and non-maleficence? Does end justify the means, or is it a strategy to subordinate the individual values to the values of family or society? An in-depth review of existing policies about philosophical aspects of practicing medicine and psychiatry is warranted by doctors and law enforcers including stricter policies for manufacturing, distributing and prescribing disulfiram.
Ajish G. Mangot
Springer Science and Business Media LLC
AjishG Mangot and VasantmeghnaS Murthy
Medknow
Phosphodiesterases (PDE) are exciting new targets in medical sciences. These enzymes are some of the key mediators of cellular functions in the body and hence are attractive sites for drug-induced modulations. With the finding that Tofisopam, a new anxiolytic, inhibits PDEs, the authors were inspired to look into the role of PDE and drugs acting on them in psychiatry. Hence, the review was undertaken. We found several research materials available highlighting the role of PDE in cellular functions and the possible newer etiological mechanisms of neuropsychiatric illnesses such as schizophrenia, depression/anxiety disorders, and cognitive dysfunction involving PDEs. We also found that there are many molecules acting on PDEs, which have the potential to alter the way we treat mental illnesses today. This article is intended to provide an in-depth look at these enzymes so that more cost-effective therapeutic molecules may be synthesized and marketed in India for managing mental illnesses.
Ajish G. Mangot, Satyakant Trivedi, Alaknanda Pandey, Desiree Saimbi, and Vaibhav Dubey
Scientific Scholar
Ajish G. Mangot
Wiley
Dear Editor, Brain stimulation techniques like repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation in schizophrenia have hitherto targeted hallucinations and cognitive/negative symptoms. Delusions have rarely been targeted. Primary delusion involves insight learning, which is a function of the anterior cingulate cortex (ACC) among others (Dietrich and Kanso, 2010). ACC has been found to be hyperfunctioning in schizophrenia (Adams and David, 2007). On the other hand, aberrant cognition like disrupted prediction errors involved in delusion persistence can be attributed to prefrontal cortex (PFC) (Corlett et al., 2007). Keeping these points in perspective, can the brain stimulation techniques be modified for targeting delusions? Combining cognitive therapy (CT) with brain stimulation has been tried for chronic depression (Brunoni et al., 2014). The underlying basis for such interactive protocols has been recently elucidated (Micoulaud-Franchi et al., 2013). Can the same technique be applied for delusions? Chronic delusions can be considered as well-elaborated, systematized memories. Memories can be modified by interference from newly acquired information (verbal or motor) and undergo reconsolidation (Schiller and Phelps, 2011). A better functioning PFC may aid this process. Bringing targeted delusions to current working memory by meticulously planned CT will make them amenable to interference. A primed frontal lobe, through simultaneous brain stimulation, should theoretically aid this process and modified beliefs could be reconsolidated. Using multicoil variant of rTMS, even deeper parts of the frontal lobe can be stimulated noninvasively, thereby modulating both PFC and ACC activity (Tzabazis et al., 2013). Although combining CT with brain stimulation for delusions is just a theoretical construct, it is certainly plausible, based on our current deeper understanding of the brain processes. How long the procedure will take, its effectiveness, and its financial implications require elucidation. Centers with adequate resources and time should seriously consider the option.
A. G. Mangot and V. S. Murthy
Wiley
Clozapine is considered the Holy Grail for treatment of chronic and resistant schizophrenia, seen in almost one-third of patients, supported by landmark effectiveness trials from different parts of the world. However, practitioners appear to exercise extreme caution in using it (1). It may be due to omnipresent danger of life-threatening agranulocytosis, myocarditis, lowered seizure threshold, and metabolic syndrome looming over clozapine-treated patients (1, 2). Gee et al. report another important factor in restricted clozapine usage – patient refusal for regular blood tests and concern about tolerability. But, clozapine offers the unique advantages of lower suicidal attempts, lower rates of aggression and hostility, better longterm outcome with regard to negative symptoms and better overall functioning, over other antipsychotics (3). However, we have begun finding a downward trend in negative practitioner attitudes to clozapine initiation, at least in a section of Indian psychiatrists in recent times. Low-dose clozapine is being prescribed in first episode psychosis, along with other oral/injectable antipsychotics, with the noble intention of sedation and better control of aggression. After a few days of treatment, clozapine is withdrawn in favor of other antipsychotics. At the outset, the prescription looks rational – clozapine is known to reduce chronic aggression and hostility, independent of its antipsychotic effect and produces sedation, which can be utilized in acutely disturbed patients. Private psychiatrists, not having in-patient treatment facility, often find this alternative very useful. The primary objective in such settings is to calm the patient as quickly as possible. Considering the inconvenience of parenteral medications and inability to use restraints in outpatient clinics, clozapine with its unique properties is seen as a risk worth taking. Since it is a low-dose treatment for a short period of time, informed consent is often not taken before starting clozapine, from the patient or relative. Such administration is also generally not associated with weekly monitoring of hemogram. Guidelines for clozapine usage insist on strict monitoring which makes such practice unethical and potentially dangerous. Latest research also does not encourage the use of clozapine as first line treatment (4). But an opinion survey of prescribing practices found 15.4% psychiatrists in India used clozapine in first episode of psychosis (5). Surprisingly this new trend is finding its way into medical colleges, probably because medical teachers who have private practice try to employ similar aggressive method of symptom control as practiced in clinics, within the hospital setting as well. From an optimistic point of view, young and dynamic psychiatrists are more confident in utilizing the power of clozapine. Although the differing practice and usage of clozapine in Indian culture has no major negative therapeutic effects (5), does end justify the means? Knowledge of good clinical practice and rational, ethical prescription among postgraduate residents is essential to guide them on the correct use of clozapine in their future practise of psychiatry. Specific national guidelines for clozapine use should also be formulated, taking into account the practical restrictions.
Ajish Mangot, Satyakant Trivedi, Ravindra Kurrey, and Vaibhav Dubey
Medknow
Received: 07-08-2014 Review completed: 08-08-2014 Accepted: 28-09-2014 6. Burke W. The neural basis of Charles Bonnet hallucinations: A hypothesis. J Neurol Neurosurg Psychiatry 2002;73:535-41. 7. Ffytche DH, Howard RJ, Brammer MJ, David A, Woodruff P, Williams S. The anatomy of conscious vision: An fMRI study of visual hallucinations. Nat Neurosci 1998;1:738-42. 8. Santhouse AM, Howard RJ, ffytche DH. Visual hallucinatory syndromes and the anatomy of the visual brain. Brain 2000;123 (Pt 10):2055-64.
Ajish G. Mangot
Scientific Scholar
Sir,
Kleptomania has been described as an inability to refrain from the urge to steal things for reasons other than personal use or financial gain. Decades of research show that both dopamine and serotonin are the primary neurotransmitters involved in the pathogenesis and management of kleptomania, respectively. Selective serotonin reuptake inhibitors (SSRIs) have been used as first-line agents for treating kleptomania. On the contrary, cases of kleptomania had been paradoxically induced in three adults who were started on SSRIs for depression.[1] A recent Indian paper also reports a similar manifestation while on fluvoxamine treatment for obsessive compulsive disorder.[2] Restlessness and impulsivity have been recognized as symptoms of behavioral activation during initiation of treatment with SSRIs. Emergence of kleptomania post SSRI treatment may be partly explained by the same phenomenon in which there could be effective depletion of synaptic serotonin post acute administration of SSRIs through serotonin-mediated action on its auto-receptor. While the role of serotonin is murky, the role of dopamine is increasingly getting clearer especially in neurological disorders. Kleptomania is seen as an emergent side effect of the use of dopamine agonists in Parkinson's disease (PD). Other impulse control disorders (ICDs) like pathological gambling, compulsive shopping, compulsive eating and hypersexuality have also been reported with the use of dopamine agonists. This phenomenon is explained by the overdose theory.[3] In PD, ventral striatal dopamine is preserved relative to dorsal striatal activity; thus, dopaminergic treatment titrated to alleviate motor dorsal striatal deficiencies may result in an “over-dosing” in ventral cortico-striatal cognitive and limbic pathways. And as such there is preliminary evidence for the benefit of atypical antipsychotics for treating impulse regulation disorders.[4]
At the same time, serotonergic and dopaminergic systems are not mutually exclusive. Could an alteration in dopamine levels post SSRI initiation explain the emergence of kleptomania in rare cases? SSRIs are known to sensitize dopamine (D2) receptors.[5] On the other hand, could the apparent effectiveness of SSRIs in kleptomania be because of their dopaminergic modulation rather than their primary effect on the serotonergic system?
Kleptomania shares certain distinct features with substance use disorders, unlike other impulse control disorders like intermittent explosive disorder. This possible association between the two has resulted in naltrexone being tried as a treatment strategy for kleptomania with favorable results.[6] Further supportive evidence can be obtained from the rare finding of new onset alcohol dependence linked to treatment with SSRI.[7] This intriguing phenomenon can be considered similar to the earlier mentioned reports of emergence of kleptomania after taking SSRIs. Probably the mechanism, although still speculative, may be similar in both phenomena. So along with the erstwhile serotonin and dopamine, treatment of kleptomania is further complicated with the involvement of opioid and glutamatergic system.[8]
Kleptomania is often been found comorbid with other psychiatric disorders including depression, addiction and personality disorders. Various structural brain lesions have been associated with kleptomania including head trauma.[9] Decreased white matter microstructural integrity in the inferior frontal brain region has also been identified in patients with kleptomania.[10] Functional anatomy of impulse control disorders including kleptomania has recently been reviewed.[11]
While medications that affect the serotonergic system have been most widely studied for the treatment of kleptomania, their clinical effects have been modest or inconsistent or even paradoxical. Medications that affect dopaminergic neurotransmission have received less research attention. Kleptomania is the final common manifestation of various underlying pathogenic mechanisms which calls for rationalization of treatment based on co-morbid symptoms and personality traits rather than blanket use of one agent. Extension of this suggestion to other impulse control disorders requires renewed research interest and further elaboration. Developments in neurobiology and pharmaco-genetics, coupled with newer pharmacological models involving the opioid and glutamate systems will surely further our understanding of the pathophysiology and pharmacotherapy of kleptomania.
Ajish G. Mangot
Elsevier BV