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Background: Depression is a major public health concern among Indian adolescents. Pre- and post-natal depression can often alter fetal development and have negative consequences on the physical and mental health of the mother. This paper aims to draw attention to the prevalence of depression and its correlates among currently married, ever-pregnant adolescents from two Indian States, i.e. Uttar Pradesh and Bihar. Methods: This study utilizes data from a subsample (n = 3116) of the prospective cohort study Understanding the Lives of Adolescents and Young Adults (UDAYA) among 10 to 19 year-old adolescents. Bivariate analysis was performed to assess the prevalence of depression by sociodemographic and behavioral characteristics. To further access the predictors associated with depression a logistic regression model was applied. Results: Around one-tenth (9%) of pregnant adolescents had depression. Regression analysis indicated that substance use, religion, autonomy, considering attempting suicide, premarital relationship, violence, dowry, adverse pregnancy outcome, menstrual problem, and parental pressure for the child immediately after marriage were significantly associated with depression. Conclusions: This study confirms the pre-existing annotation that teen pregnancy is linked with depression. Findings indicate that Adolescent mothers experiencing violence, and a history of adverse pregnancy outcomes are at increased risk of developing depression. These study findings call for an urgent need to address depression among adolescent mothers. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) reports that Asia and Africa have the highest Chronic Liver Disease (CLD) mortality rate. Cirrhosis, responsible for 22.2 fatalities per 100,000 people, is India's 10th most common cause of mortality. The increasing prevalence of chronic liver disease necessitates a study to identify predictive factors for patients who visit the emergency department. Identifying elements that enhance the predictive value of mortality in unstable patients with CLD complications is important in emergency departments. This study aims to determine Clinical and Laboratory Parameters as mortality predictors in adult chronic liver disease patients. Methodology: The study was conducted at the emergency department of a tertiary healthcare center in Northern India. Patients with chronic liver disease above 18 years of age who satisfied the inclusion criteria were clinically evaluated. Clinical and demographic details were collected, and data was analyzed. Results: Two hundred thirty-six patients were enrolled. The mean age was 50.77 ± 14.26 years. 78.4% of the participants were men. Abdominal distension, affecting 59.7% of patients, was the most common presenting ailment, followed by melena and hematemesis, affecting 41.9% and 32.6%, respectively. The mean stay in the emergency department was 10.29 ± 8.10 h. Refractory septic shock, the leading cause of mortality, accounts for 69.2% of all deaths, alongside grade 4 hepatic encephalopathy and massive Upper Gastrointestinal (UGI) bleeding, as identified in our study. Factors such as altered mental sensorium, high respiratory rate, low SpO2, increased heart rate, low systolic blood pressure, low diastolic blood pressure, and low Glasgow Coma Scale (GCS) on Emergency Department (ED) arrival are significantly associated with mortality. Conclusions: Chronic liver disease, a prevalent condition in India, most commonly seen in middle aged men and lower socioeconomic groups. The parameters independently associated with mortality in our study were presence of altered mental sensorium, Glasgow coma scale, Child Pugh class and need for ICU admission. Understanding the presentation pattern, and mortality predictors can help ED physicians in managing acute events and follow-ups. [ABSTRACT FROM AUTHOR]

Medical professionals face high stress due to the type of work they do and the prolonged working hours. Frequent burnout results due to the challenging nature of their work. Added to the stress of work, malpractice lawsuits add to their burden. In India, most doctors work in compromised settings with poor infrastructure and manpower but are expected to follow the best practices. In court, they are judged with the Bolam and Bolitho tests being essential considerations. Several tragic incidents have been reported, including depression, anger issues, and even suicide deaths of healthcare professionals (HCPs) after accusations of negligence and subsequent inquiry. Such incidents demonstrate the multitude of challenges an HCP faces in day-to-day practice. It is crucial to find ways to tackle these problems and enhance the capacity of HCP to handle such demanding circumstances. Malpractice litigation can significantly impact the mental health of HCPs. It is common to experience emotional turmoil when faced with a lawsuit. Second victim syndrome (SVS) is a term used to describe a set of symptoms experienced by HCPs who make an error leading to injury to a patient. However, it also happens if he is traumatized by the consequences of violence during healthcare services or a lawsuit or defamation article in newspaper/social media. Following a litigation crisis in their career, many HCPs go through various stages of grief, including shock, denial, anger, bargaining, depression, and acceptance. At times, death by suicide of the HCPs is well known. SVS is known to profoundly affect the personal, family, economic, professional (defensive practice), and social life of HCPs. HCPs should accept the allegations of negligence as an occupational hazard and prepare for the eventual litigation at least once in a lifetime by knowing about the medical laws, HCP's rights, becoming aware of the emotional turmoil of the lawsuit, preparing to cope with the lawsuit, and seeking help from colleagues and indemnity insurance. Frequent training of the HCPs is strongly recommended to know about the changing laws and also to undergo periodic professional competence enhancement to reduce the incidents of errors amounting to medical negligence. Medical and hospital administration should debrief after any incident and conduct internal investigations to identify systemic flaws and prevent future recurrence, resolve issues within their control at their level, and manage media (mainstream and social media) appropriately. If established, a reporting system with online and offline services will ease the internal administrative investigation process and take appropriate, timely actions. During the crisis, HCPs should have adequate and appropriate insurance or indemnity coverage and mental health support systems. [ABSTRACT FROM AUTHOR]

Background: The amount and frequency of internet use are often used to forecast its pros and cons, with mixed findings. After COVID-19, technological advances and sociological upheavals have shown the internet's ability to support numerous activities, necessitating a change in internet use. Beyond internet use frequency, it has been advised to examine why people use it and how it affects their well-being. Hence, we aimed to investigate the various mediators and moderators in the relationship between the quality of internet use (type of activity) and well-being. Further, we investigated whether user attributes such as initial age and frequency of internet use moderate the influence of internet use quality on problematic internet use, loneliness, and well-being. Methods: 131 students in Manipur who were 18 years old were included in this cross-sectional study. Self-rated measures of the Adult Internet Usage questionnaire, Internet Addiction Test, and Mental Health Continuum-Short Form assessed internet use, dependence, and well-being. Results: Loneliness mediates the association between well-being and internet behaviors related to personal use-self-actualization (BootSE = .53, BootLLCI = .10, BootULCI = 2.18), cultural use-belonging (BootSE =.57, BootLLCI = -2.23, BootULCI = -.02). Average online hours moderate economic use-education, loneliness, and well-being (BootSE =.13, BootLLCI = -.55, BootULCI = -.04). Conclusion: To conclude, the effectiveness of internet use affects well-being differently depending on the type of activity. After a certain point, even seemingly good internet activities may have diminishing returns. [ABSTRACT FROM AUTHOR]

Background: Adolescents are vulnerable to stressors because of the rapid physical and mental changes that they go through during this life period. Young people residing in slum communities experience additional stressors due to living conditions, financial stress, and limited access to healthcare and social support services. The Adolescents' Resilience and Treatment nEeds for Mental Health in Indian Slums (ARTEMIS) study, is testing an intervention intended to improve mental health outcomes for adolescents living in urban slums in India combining an anti-stigma campaign with a digital health intervention to identify and manage depression, self-harm/suicide risk or other significant emotional complaints. Methods: In the formative phase, we developed tools and processes for the ARTEMIS intervention. The two intervention components (anti-stigma and digital health) were implemented in purposively selected slums from the two study sites of New Delhi and Vijayawada. A mixed methods formative evaluation was undertaken to improve the understanding of site-specific context, assess feasibility and acceptability of the two components and identify required improvements to be made in the intervention. In-depth interviews and focus groups with key stakeholders (adolescents, parents, community health workers, doctors, and peer leaders), along with quantitative data from the digital health platform, were analysed. Results: The anti-stigma campaign methods and materials were found to be acceptable and received overall positive feedback from adolescents. A total of 2752 adolescents were screened using the PHQ9 embedded into a digital application, 133 (4.8%) of whom were identified as at high-risk of depression and/or suicide. 57% (n = 75) of those at high risk were diagnosed and treated by primary health care (PHC) doctors, who were guided by an electronic decision support tool based on WHO's mhGAP algorithm, built into the digital health application. Conclusion: The formative evaluation of the intervention strategy led to enhanced understanding of the context, acceptability, and feasibility of the intervention. Feedback from stakeholders helped to identify key areas for improvement in the intervention; strategies to improve implementation included engaging with parents, organising health camps in the sites and formation of peer groups. Trial Registration: The trial has been registered in the Clinical Trial Registry India, which is included in the WHO list of Registries, Reference number: CTRI/2022/02/040307. Registered 18 February 2022. [ABSTRACT FROM AUTHOR]

Postpartum depression (PPD) is a psychological illness that affects women following delivery. According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), PPD is a serious form of depression that begins four weeks following birth and continues for one year. Pregnancy and the period after delivery can be hazardous for women. Mothers undergo significant biological, emotional, financial, and societal changes during this time. Some women are predisposed to mental health disorders such as melancholy and worry. Many postpartum women do not acknowledge the seriousness of their condition, and many depressed mothers go untreated. Untreated PPD is harmful to both the mother and the newborn. The exact cause of PPD is unclear; however, hormonal fluctuations during pregnancy and childbirth, genetic susceptibility, birth trauma as well as psychosocial and demographic factors may serve as potential risk factors. The objective of this study is to determine the prevalence and risk factors of PPD in India. The review evaluates English language literature on PPD using Scopus, PubMed, and Google Scholar databases searched electronically between 2000 and 2022. The keywords "postpartum depression," or "postnatal depression," and "prevalence," and "causes," and "risk factors," or "predisposing factors," or "predictive factors" were used to search the database. The prevalence of PPD varies in different geographical regions and study settings. In India, the overall prevalence of PPD is 22%. However, the greatest prevalence was in the southern regions (26%; 95% confidence interval [CI]: 19-32) and the lowest in the northern regions (15%; 95% CI: 10-21). This study outlines the burden of PPD in India. Comprehensive intervention programs should be implemented to address the disease at a national level. The national authorities should incorporate PPD screening in the National Mental Health Program and emphasize health promotion activities. [ABSTRACT FROM AUTHOR]