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Background: Despite advancements in treatment, patients with Parkinson's disease (PD) experience a range of symptoms that affect their quality of life. There is a need to integrate neuropalliative care into standard care. The aim of the study is to understand the psychosocial functioning in persons with PD and explore their caregivers' burden. Methods: The study utilizes a mixed-methods design where 50 patient--caregiver dyads attending the outpatient services of the movement disorder clinic at a tertiary care hospital were measured on psychosocial functioning and caregiver burden and palliative care outcomes for a period of 6 months. Focus group discussions were conducted with 18 patient--caregiver dyads to understand the needs of palliative care. Results: It was found that caregiver burden was positively correlated with palliative care outcomes scores of patients (r = 0.586) and caregivers (r = 0.675) and psychosocial functioning was positively correlated with palliative care outcomes of patients (r = 0.708). The psychosocial functioning score was higher among female patients (indicating worse functioning) than males, and female caregivers experienced significantly higher caregiver burden. The qualitative findings reveal that there is a substantial gap in awareness about palliative care, lack of information, presence of stigmatizing beliefs, and lack of adequate accessibility to palliative facilities. Conclusion: The study lays the foundation for future PD neuropalliative care research, guiding interventions, and exploration of regional variations in PD experiences in India. There is a need to address caregiver burden in PD in India. [ABSTRACT FROM AUTHOR]

Background: The targets of Sustainable Development Goals cannot be achieved without reducing mortality of inborn as well as outborn neonates. Objective: The objective was to predict the mortality of neonates by applying Modified Sick Neonatal Score (MSNS). Material and Methods: Parameters of MSNS scoring system were applied to 450 neonates at the time of admission and followed up prospectively till discharge or death. The score and individual parameters were correlated with outcome. A receiver operating curve was plotted to determine the cutoff value for score to predict the mortality. Results: The common clinical diagnoses were respiratory distress (38%), sepsis (26%), and jaundice (14.44%). Sixty-two percent neonates were born at term and 38% were preterm while 55.56% neonates were low birth weight and 44.4% were weighted more than 2500 gms. Neonates who died were older at the time of admission, and duration of hospital stay was shorter compared to alive neonates (P < 0.001) with a mortality rate of 23.11%. The total MSNS for neonates who died was statistically significantly low, (mean ± standard deviation) 7.93 ± 2.70, compared to alive neonates, 12.02 ± 1.84 (P < 0.0001). With optimum cutoff score of ≤10, the sensitivity was 79.80% and the specificity was 82.37% while the positive predictive value and negative predictive value was 57.64% and 93.14% respectively with the area under curve was 0.89 (odds ratio-18.46, 95% confidence interval 10.3-33.64, P < 0.0001). Conclusion: The MSNS of ≤10 has a better sensitivity and specificity in predicting neonatal mortality and is easy to use with minimal resources to both preterm and term neonates. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) represents a major cause of disability in India. For implementation of best practice management, it is important to consider the views of people in India since they might deviate from those expressed in previous studies by people with OA in the Western world. The purpose of this study was to explore and describe approaches toward OA and its management among patients in a rural setting in Central Western India. Conventional content analysis was used to analyze semi-structured interviews with 24 patients diagnosed with OA from the target area of Pravara University Hospital and ten adjacent primary health care centers in Maharashtra, India. Four categories; lack of power, active ambivalence, taking control and a constant struggle were identified as patients' approaches to OA. The categories were further elaborated on in seven subcategories. Daily challenges and efforts, of which some may be unique to patients in a rural setting in India, underlie passive and active approaches to OA and its management. Understanding these may enhance Indian physiotherapists' implementation of evidence-based self-management programs adapted to Indian conditions and reduce the distress of their patients. [ABSTRACT FROM AUTHOR]