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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]

Background: Lockdown is one of the prevalent tools that are used to control the spread of COVID‐19 virus in India. Under the circumstances created during lockdown period, children are deprived from the social interaction and companionship; because of which, they are susceptible to psychiatric disorders. Therefore, in this study, efforts were to understand the impacts of lockdown on the mental status of the children of India and their specific causes. Study Design: It is a questionnaire‐based study. Methods: A web‐based questionnaire was prepared, and 400 parents from four districts of Punjab, India, namely, Ludhiana, Sahibzada Ajit Singh (SAS) Nagar, Sangrur and Ferozepur, were telephonically interviewed. Further, the information collected from the interviews was statistically analysed using Statistical Package for the Social Sciences (SPSS) software. Results: Findings from this study revealed that 73.15% and 51.25% of the children were having signs of increased irritation and anger, respectively; 18.7% and 17.6% of the parents also mentioned the symptoms of depression and anxiety, respectively, among their children, which were also augmented by the changes in their diet, sleep, weight and more usage of the electronic equipment. Children (~76.3%) persistently urge to go outdoors and play with their friends; therefore, they could lag in social development. Further, observations from Pearson's correlation revealed that during lockdown, children's mental health is significantly related to the area of their house, number of children in the family, qualification of their mother and socio‐economic status of their family. Conclusions: This study made it evident that the mental health of the children residing in Punjab, India, was compromised during the lockdown period induced by the COVID‐19 pandemic. Findings of this study may also trigger the international authorities to frame the guidelines of lockdown in the interest of mental health of their native children. [ABSTRACT FROM AUTHOR]

Background: While the patterns of consumption of areca nut and its by-products (ANBP) vary across South Asia and the rest of the world, all users share the probable severe outcome of oral submucous fibrosis (OSMF), and this is well reported. The role of psychosocial drivers of habit initiation and addiction is reported less. Objective: To reveal the burden of ANBP abuse, exploring the psychosocial relationship between sex, age at first exposure (AFE), the reason for initiation (RFI) with the type of habit (TOH). Methodology: Data came from the prospective hospital-based study conducted at K.M. Shah Dental College and Hospital covering years 2017 and 2018. Patients with oral lesions were assessed with complete history recording demographics, TOH, AFE, RFI, duration of habit, and clinical diagnosis of any oral and systemic diseases. Patients with a history of scleroderma, facial burns, and oral malignancy were excluded. Results: Of the 13,874 patients, 9.89% reported ANBP. We included 1000 OSMF patients. The mean age of the study cohort was 38.97 ± 14.29 years, with a range of 17–75 years. Males constituted the majority (80.1%). The most common TOH reported was regular use of gutkha (60.1%) followed by mawa (31.4%) with tension and stress (30.3%) being the most common RFI among the cohort. TOH was notably different in relation to AFE. Interestingly, mawa chewing (38.69%) was observed more in females. Importance: This study reveals the burden of ANBP abuse and reports the complex psychosocial relationships between sex, AFE, and RFI with TOH in OSMF patients in this high incidence population. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has led to a complete shut-down of the entire world and almost all the countries are presently in a "lockdown" mode. While the lockdown strategy is an essential step to curb the exponential rise of COVID-19 cases, the impact of the same on mental health is not well known. Aim: This study aimed to evaluate the psychological impact of lockdown due to COVID-19 pandemic on the general public with an objective to assess the prevalence of depression, anxiety, perceived stress, well-being, and other psychological issues. Materials and Methods: It was an online survey conducted under the aegis of the Indian Psychiatry Society. Using the Survey Monkey platform, a survey link was circulated using the Whatsapp. The survey questionnaire included perceived stress scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Warwick-Edinburgh Mental Well-being Scale to assess perceived stress, anxiety, depression, and mental well-being, respectively. The survey link was circulated starting from April 6, 2020 and was closed on April 24, 2020. Results: During the survey, a total of 1871 responses were collected, of which 1685 (90.05%) responses were analyzed. About two-fifth (38.2%) had anxiety and 10.5% of the participants had depression. Overall, 40.5% of the participants had either anxiety or depression. Moderate level of stress was reported by about three-fourth (74.1%) of the participants and 71.7% reported poor well-being. Conclusions: The present survey suggests that more than two-fifths of the people are experiencing common mental disorders, due to lockdown and the prevailing COVID-19 pandemic. This finding suggests that there is a need for expanding mental health services to everyone in the society during this pandemic situation. [ABSTRACT FROM AUTHOR]

Group therapy dates back to the beginning of the 20th century, although brought in as a necessity, today it is widely practiced by counselors, across the globe. As compared to individual psychotherapy, group therapy has been a less researched area, especially pertaining to general health, rather than specific illnesses or behaviors. This study thus was conducted to assess the General Health Questionnaire (hereafter, GHQ) scores of participants (social workers) who were given short term group therapy, using transactional, behavioral and cognitive approaches along with mindfulness meditation, for four consecutive days. 20 participants from across India were selected using convenience sampling technique. The outcome of the Wilcoxon test approved the hypothesis (z = -2.87, p<0.005), i.e. there is a statistically note worthy distinction among the GHQ scores of participants pre and post receiving group intervention. The post test GHQ scores of the participants had a significant drop than the pretest GHQ scores of the participants, depicting an improvement in their general health. [ABSTRACT FROM AUTHOR]

Illness behavior comprises of the way one's own bodily symptoms are monitored, and treatment sought. A palliative care team includes doctors, nurses and counselors, who take holistic care of terminally ill patients and their families. This study explored the illness behavior of these professionals practicing in Pune, India. Six palliative care professionals' responses to an in-depth interview, were analysed for themes. The results provided valuable insight into their need for support. The incurable and terminal nature of their patients' condition impacted them. [ABSTRACT FROM AUTHOR]

Background: Common Mental disorders are distress states manifesting with anxiety, depressive and unexplained somatic symptoms categorized as 'neurotic, stress-related and somatoform disorders' in ICD-10. These are 2-3 times more common in women than in men and also more in urban area than rural. Women of reproductive age are at higher risk especially those with social disadvantage, low income and low education. Aims & Objectives: To assess the prevalence of common mental disorders and associated socio-demographic factors among women of reproductive age (15-49 years) residing in urban and rural area of Meerut. Material and Methods: This was a cross-sectional study done in urban and rural area of Meerut from June 2018 to October 2019. 267 women in reproductive age (15-49years) were interviewed in urban as well as rural area using a predesigned pretested questionnaire regarding socio-demographic profile. Self- Reporting Questionnaire-20 was used to determine presence of common mental disorders. Results: Overall prevalence of common mental disorders among women of reproductive age group was 19.8%(106) with 24.2%(65) in urban and 15.4%(41) in rural area. Statistical analysis revealed that various socio-demographic variables like belonging to urban area (24.2%),being widowed/separated (urban-85.7%;rural- 75.0%), belonging to broken family(urban-54.5%%; rural-58.3%), being employed(urban-39.6%;rural-33.3%) and lower socioeconomic status(urban-54.5%;rural-40.0%) were significantly associated with presence of common mental disorders. In urban women increasing age was also associated with common mental disorders. Conclusion: The study revealed a high prevalence of common mental disorders in both urban and rural area and a significant association with various sociodemographic variables. [ABSTRACT FROM AUTHOR]

The article informs about COVID-19, India, lockdown and psychosocial challenges. Topics include pandemic threat COVID-19 mitigation is crucial to the human life and for reducing distortion of livelihood; countries with considerable confirmed cases and deaths and has caused public panic and mental health stress; and current outbreak of COVID-19 is heavily impacting the global health and mental health.

National estimates of the health and economic burdens of exposure to ambient fine particulate matter (PM 2.5 ) in India reveal substantial impacts. This information, often lacking at the local level, can justify and drive mitigation interventions. Here, we assess the health and economic gains resulting from attainment of WHO guidelines for PM 2.5 concentrations – including interim target 2 (IT-2), interim target 3 (IT-3), and the WHO air quality guideline (AQG) – in Nagpur district to inform policy decision making for mitigation. We conducted a detailed assessment of concentrations of PM 2.5 in 9 areas, covering urban, peri-urban and rural environments, from February 2013 to June 2014. We used a combination of hazard and survival analyses based on the life table method to calculate attributed annual number of premature deaths and disability-adjusted life years (DALYs) for five health outcomes linked to PM 2.5 exposure: acute lower respiratory infection for children < 5 years, ischemic heart disease, chronic obstructive pulmonary disease, stroke and lung cancer in adults ≥ 25 years. We used GBD 2013 data on deaths and DALYs for these diseases. We calculated averted deaths, DALYs and economic loss resulting from planned reductions in average PM 2.5 concentration from current level to IT-2, IT-3 and AQG by the years 2023, 2033 and 2043, respectively. The economic cost for premature mortality was estimated as the product of attributed deaths and value of statistical life for India, while morbidity was assumed to be 10% of the mortality cost. The annual average PM 2.5 concentration in Nagpur district is 34 ± 17 μg m − 3 and results in 3.3 (95% confidence interval [CI]: 2.6, 4.2) thousand premature deaths and 91 (95% CI: 68, 116) thousand DALYs in 2013 with economic loss of USD 2.2 (95% CI: 1.7, 2.8) billion in that year. It is estimated that interventions that achieve IT-2, IT-3 and AQG by 2023, 2033 and 2043, would avert, respectively, 15, 30 and 36%, of the attributed health and economic loss in those years, translating into an impressively large health and economic gain. To achieve this, we recommend an exposure-integrated source reduction approach. [ABSTRACT FROM AUTHOR]

In this study, focus groups were conducted with 16 rural women living with AIDS (WLA) from Andhra Pradesh, India, who had previously participated in a clinical trial wherein 68 WLA were randomized into either an Accredited Social Health Activists (ASHA)-Life (AL) intervention or a usual care program. Findings are discussed in terms of (a) mental health issues, (b) perceived stressors, (c) individual resources for coping with mental health issues, and (d) role of ASHA support in coping with mental health issues. These findings highlight the salience of mental health issues in the lives of WLA and the role played by ASHA in addressing some of these issues. The discussion section makes a case for increased emphasis on mental health care in future community-based interventions for this population. [ABSTRACT FROM AUTHOR]

Aim: To determine the influence of the demographic and the psychosocial factors on the intensity of pain manifestation among the chronic ill patients. Materials and Methods: A descriptive, cross-sectional study was carried out among 328 chronic patients under home-based nursing care in Southern State of Kerala, India, from July to August 2015. Each patient was interviewed during a scheduled home visit by a trained health professional. The translated version of the assessment tool questionnaire "Medical Outcome Study-Short Form Health Survey" was used for the data collection. Results: Sixty-four (19.5%) out of 328 patients reported pain as one of the primary symptoms of their disease. The percentage of the patients who were suffering from pain increases with the improvements in both the educational level and the monthly income (P = 0.002 and 0.019, respectively). The social interaction with the relatives and other community members was significantly related to pain manifestation (P = 0.013). A higher degree of social interaction was associated with lower pain intensity (P = 0.019). Conclusion: The results of this study showed that certain demographic and psychosocial factors carry a significant level of influence on the pain manifestation and its intensity among the chronic patients. Hence, improvements in education, economic status, and psychosocial support should be considered for the management of the chronic patients. [ABSTRACT FROM AUTHOR]

Management of HIV in India has significantly improved with many international and local programmes supporting prevention and treatment. However, there are areas in India where women and children living with HIV endure a myriad of medical, psychological and social challenges. Women in rural poor areas in India have little control over important aspects of their life. Often, they have little decision-making powers within their families on matters that affect them personally. They find themselves unable to negotiate to protect themselves from harm or risk of infection. Those who are known to have contracted HIV are reluctant to access health care for fear of discrimination and marginalization, leading to a disproportionate death rate in HIV women. India is arguably home to the largest number of orphans of the HIV epidemic. These children face an impenetrable barrier in many Indian societies and endure stigmatization. This situation encourages concealment of the disease and discourages children and their guardians from accessing available essential services. This article provides an overview of the relevant literature and presents an insight into a complex mix of issues that arise directly out of the HIV diagnosis, including the role of social attitudes in the spread of HIV, and in creating barriers to accessing care. The review identifies international programmes and local initiatives that have ensured better access to antiretroviral therapy and have led to prolonged survival and reduction in the vertical transmission of HIV in India. [ABSTRACT FROM AUTHOR]

Objectives Paan chewing is a recognized risk factor for oral cancer in the Asian population. However, there is currently little evidence about the intergenerational psychosocial transmission of paan chewing in South Indian families. We investigated the association between parental and participant's paan chewing in a South Indian population. Methods A subset of data was drawn from a hospital-based case-control study on oral cancer, the He NCe Life study, conducted at Government Dental and Medical Colleges of Kozhikode, South India. Analyses were based on 371 noncancer control participants having diseases unrelated to known risk factors for oral cancer. Demographics, behavioral habits (e.g., paan chewing, smoking), and indicators of socioeconomic position ( SEP) of both participants and their parents were collected with the use of a questionnaire-based interview and a life grid technique. Unconditional logistic regression assessed odds ratios ( OR) and 95% confidence intervals (95% CI) for the associations between parental and participant's paan chewing, adjusted for confounders. Results Over half of the participants were males (55.2%), and the mean age of participants was 59 ( SD = 12) years. After adjusting for age, religion, parents' SEP, parents' education, smoking and alcohol consumption, and perceived parenting behavior, we observed that maternal paan chewing and paternal paan chewing were significantly associated with the participant's paan chewing ([ OR = 2.40, 95% CI = 1.11-5.21] and [ OR = 3.05, 95% CI = 1.48-6.27], respectively). Conclusions Intergenerational psychosocial transmission of the habit of paan chewing could occur through shared sociocultural or environmental factors. [ABSTRACT FROM AUTHOR]

Background: Epidemiological study provides us important information regarding the understanding of prevalence, incidence and severity of oral diseases on a specific population. Apart from the evaluation of oral health for dental caries and periodontal diseases, the need for epidemiological study of oral mucosal lesion is also being emphasized. Aim and objectives: The present study was undertaken to study the presence of various oral mucosal lesions in the Amritsar (Punjab). Results: Out of the 700 cases examined, Leukoplakia was present in 0.57% ,Tobacco pouch in 1%, Lichen Planus in 0.57% , Candidiasis in 0.57%, Fordyce Granule in 3.14%, Apthous Ulcer in 1.7%, Pigmentation in 5.1% and whereas in 85.7% of the cases no lesion was reported. Conclusion: The result of present study shows that, still there is lack of awareness among population regarding the ill effects of tobacco products, and there is a lot of need of Health Education. [ABSTRACT FROM AUTHOR]

Families of children with Duchenne muscular dystrophy (DMD) go through significant challenges in dealing with the condition. Few studies have looked into the situation, especially in the sociocultural scenario that is unique to India. The authors' aim was to identify the psychosocial challenges for caregivers of children with DMD. A cross-sectional descriptive study was performed among the caregivers of 60 children with DMD who were attending the neuromuscular disorders clinic ofa national tertiary referral center for neurological disorders. The knowledge and attitude, psychosocial needs, burden, and coping patterns were assessed in an interview. The findings showed that parents of children with DMD tended to have inadequate understanding of the disease but had a positive attitude, had a moderate family burden, and tended to rely more on religion, focus on and venting of emotions, and instrumental and emotional social support for coping. Caregivers of children with DMD would benefit from psychosocial intervention to address their understanding of and attitude toward the disease, as well as burden of dealing with it, and to help them develop their coping skills and meet their children's and their own needs. [ABSTRACT FROM AUTHOR]