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In recent years mental health has emerged as a major health threat in low income countries like India. In response, mental health care has been integrated into primary health care, in turn creating a rising demand for trained and skillful mental health professionals. This study was conducted in district Budgam (J&K), India with the aim of providing training to community health workers (CHWs) and measuring the change using pre- and post-training evaluations. The pre and post tests were undertaken, assessing changes in mental health literacy at three different points of time: pre-training, post-training, and three month follow-up. Mental health literacy was assessed using the interviewer-administered Mental Health Literacy Survey. The training intervention was a five-day course based on a facilitator's manual developed specifically for community health workers in India. A total of 25 community health workers from rural areas of Budgam District (mostly Integrated Child Development Service supervisors), Health Educators and Anganwadi Workers, were engaged for the study. Findings demonstrate that the training course improved participants' ability to recognize any mental health disorders. There was a clear distinction between the level of awareness pre- and post- training. The results were statistically significant on various domains Ability to recognize disorders (Pre-post P= 0.001), Knowledge of the professional help available (Pre-post p= 0.000), Attitudes that promote the recognition or appropriate help-seeking behavior (Pre-post p= 0.000) (p

The adolescent age group is one of the most vulnerable periods of life span. It is the period that develops identity and integrity among individuals. The environmental influx to this group includes the SNS’s as one of the major components, having a direct impact on the transition of adolescents to adults. It is in this backdrop, the need is to critically study the impact of SNS’s on adolescent’s life and identifying the key consequences that are emerging out of either using or misusing of same. Ranging from initial exposure of SNS’s to disturbed social life a detailed assessment has been made to know how school-going adolescents are influenced. The mental health status and related illness due to misuse of SNS’s has due assessment. The study is also identifying the core areas of intervention like monitoring and participation for effective response to adolescent problems arising out of excessive usage of same.

The primary objective of this study is to identify the global research output on Taliban during the period of 25 years spanning from 1996-2020. Specific objectives are to analyze the distribution of literature, publication trends, authorship patterns, institutional productivity, collaboration networks, and prolific funding agencies. The data was harvested from the Web of Science Core Collection. A total of 614 records were retrieved on Taliban having 4416 total citations. The highest output was recorded in 2002, with a share of 7.83% to overall literature. The citation pattern depicted a fluctuating, the highest share being received in the year 2002 (14.47%), followed by the years 2010, 2004, and 2007 with the citation share of 11.03%, 10.67%, and 6.82% respectively. The results depict that among all the countries, the USA is topping the list, contributing almost 47.1% of the total research output followed by the United Kingdom, Pakistan, Australia, and Canada with the publication share of 16.78%, 6.19%, 6.03%, and 4.4% respectively.

This paper aims at presenting the findings of the study on the position of street vendors in the District Srinagar, Kashmir, in India, including both men and women, during the COVID-19 lockdown. The purpose of the study was to explore various challenges street vendors faced during the COVID-19 lockdown and to highlight the vulnerability of this particular group of informal workers. The data was collected through face-to-face interviews with the use of a questionnaire, on a sample of 150 street vendors from the District Srinagar. In addition, a certain number of in-depth interviews with selected respondents from the sample was done. The study findings show that the majority of the respondents have lost their job during the peak period of COVID-19, i.e. from March to July 2020. The findings have also revealed that the lockdown directly impacted the socio-economic conditions of the workers which made it very difficult for them to survive during the peak of COVID-19. Additionally, workers were struggling very hard in order to fulfill the basic daily needs of their families. Therefore, it is suggested that the government of India should provide financial support to street vendors in order to compensate for the loss caused due to the COVID-19 lockdown.

Chen IH, Wu PL, Yen CF, et al. Risk Manag Healthc Policy. 2022;15:435–445. Page 437, Materials and Methods, Participants and Recruitment Procedure, Taiwanese Participants section, last sentence, the text “(IRB ref: KMUHIRB-EXEMPT(I)-20200119)” should read “(IRB ref: KMUHIRB-EXEMPT(I)-20200019)”. Page 443, Ethics Approval and Informed Consent section, first line, the text “(IRB ref: KMUHIRB-EXEMPT(I)-20200119)” should read “(IRB ref: KMUHIRB-EXEMPT(I)-20200019)”. The authors apologize for these errors. Read the original article

Introduction: Mental health issues are on an exponential rise in Kashmir due to varied reasons including political instability, eco fragility, the growing lag in the provision of education and employment, and several other reasons. Impediments such as the overwhelming stigma and the cultural sensitivity associated with mental health issues both sustain and perpetuate mental ill health and also prevent any treatment and rehabilitation. This article describes the protocol of a research project, funded by the Indian Council of Medical Research, which aims to address this issue. Aim: To screen the population for mental health issues and to provide community-based intervention for the identified cases also to train community health workers for sustainable mental health support. Methods: We will conduct a household survey using the Hopkins Symptom Checklist (HSCL-25) for the identification of the clients. A multi-stage random sampling shall be used to select the villages and the households from the marginalized communities. A sample of 500 respondents shall be screened using HSCL-25. Those who screen positive for mental health issues will be offered cognitive behavioral therapy (CBT) by a qualified clinical psychologist. The research will be able to address the diagnosis of depression and anxiety-related cases and the subsequent intervention. Additionally, we will utilize the facilitator’s manual for Mental Health Training Program for Community Health Workers to build sustainable mental health services in community settings. Discussion: The study shall present a roadmap focusing on the indispensability of a comprehensive community-based intervention on mental health utilizing a non-pharmacological method. Assessing and analyzing the dynamics of mental health illness first hand, the study shall move ahead to offer a culturally tailored counseling program at the community level. The study also aims to highlight the role of the indigenous human resource (community health workers) and how its participation leads to a more scientific and sustainable intervention for more effective results, with an increased level of awareness and sensitization in a conventional society like Kashmir.

Roughly 1 3 billion persons with disabilities worldwide (80 per cent living in developing countries) are being marginalized by factors related to the coronavirus (COVID-19) pandemic For the first time in a long time, huge numbers of people are feeling segregated from ‘normal life’ and are being quarantined in homes and hospitals Due to apparently endless and restrictive lockdown rules, patterns of social isolation and detachment appear far from temporary The present paper aims to highlight the issues and challenges faced by persons with disabilities and their caregivers during the coronavirus pandemic © 2020 Sociological Demography Press

In this chapter a very high capacity and secure medical image information embedding scheme capable of hiding an Electronic Patient Record (EPR) imperceptibly in grayscale medical images for healthcare applications has been proposed. To ensure the reversibility of medical images, a new image interpolation technique has been used to scale up the original image to obtain the cover image. The cover image pixels have been divided into two types: Seed pixels and nonseed pixels. The Electronic Patient Record (EPR) has been embedded only in nonseed pixels while no embedding has been carried out in seed pixels, to facilitate reversibility. A fragile watermark has been embedded in addition to the EPR, to make the proposed scheme capable of detecting any tampering of EPR during its transit from transmitter to receiver. The fragile watermark is also used for content authentication at the receiver. At the receiving end, first we extract the fragile watermark; if it is the same as the one embedded, signaling that the EPR has not been attacked during transit, the EPR is extracted. Otherwise, the system uses a retransmission request instead of wasting time to extract the compromised Electronic Patient Record (EPR). For ensuring the security of the EPR, we encrypt it using a magic rectangle. Embedding has been carried out using least significant bit (LSB) substitution. The scheme has been evaluated for perceptual imperceptibility and content authentication by subjecting it to various image processing and geometric attacks. Experimental results reveal that the proposed system, besides being completely reversible, is capable of providing high-quality stego-images (term used to refer to the image containing the embedded data) for fairly high payload. Further, it has been observed that the proposed technique is able to detect tampering. A comparison of the observed results with those of some state-of-the-art schemes show that our scheme performs better.

An epileptic seizure is a transient occurrence of signs and or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. Epilepsy is a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures and by the neurobiological, cognitive, psychological, and social consequences of this condition. The definition of epilepsy requires the occurrence of at least one epileptic seizure (ILAE & IBE 2005). Epilepsy is a physical condition that occurs when there is a sudden, brief change in how the brain works. When brain cells are not working properly, a person's consciousness, movement, or actions may be altered for a short time. These physical changes are called epileptic seizures. Epilepsy is therefore sometimes called a seizure disorder. Epilepsy affects people in all nations and of all races (Epilepsy Foundation of America). The peak stages for the occurrence of epileptic disorders are Childhood and late adulthood as seen in developed countries but it has not been documented properly. The main causes are head injuries, cerebrovascular disease, CNS infections, and birth trauma. Availability of epilepsy-care depends largely on economic factors. Imaging and neurophysiological facilities are available in most countries, but often only in urban centres. Costly drugs, a large treatment gap, limited epilepsy surgery, and negative public attitude to epilepsy are other notable features of management in developing countries. An understanding of the psychosocial, cultural, economic, organizational and political factors influencing epilepsy causation, management, and outcome should be of high priority for future investigations. The lifetime prevalence of epilepsy varied among countries from 1•5 to 14•0 per 1000. This wide variation could partly result from the use of different methods and different types of questionnaire. Screening questionnaires were mainly derived from WHO questionnaires. The prevalence of epileptic disorders in India is 5.9 in males and 5.5 in females in the reference year of 1999. The Incidence of epileptic disorders in India is 60 out of 100,000 in the reference year of 199.

Background: The Valley of Kashmir has witnessed a growing number of suicides. It is often witnessed that whenever a person attempts or commits suicide, most of the times he/she is bought to the hospital to save his/her life. Thus, the role of health care providers in a hospital setting is very important, as this is the first point of contact with the suicide attempters. In this study, an attempt was made to assess the intervention of health care providers toward suicide attempters in Kashmir. Methodology: In-depth expert interviews were conducted with the 12 healthcare professionals (Psychiatrists, Clinical Psychologists and Primary Health Care Physicians) who were involved in the identification; assessment, management, and prevention of suicidal behaviour at an urban general hospital in Srinagar, Kashmir. Purposive sampling method was used based on the availability and willingness of the participants from August to November 2018. Results: The results revealed that the health care providers follow a systematic procedure i.e., prevention, intervention and postvention in dealing with suicide attempters. However, their main focus remains on the intervention within the walls of the hospital setting. Conclusion: The results of the study provides some broad understanding about the role of doctors in the treatment and management of suicide attempters that will go a long way in the management of people attempting suicide in Kashmir. Keyword: Suicide, health care professionals, prevention, intervention, postvention

We are reporting a case of PUO in a young male with no underlying co-morbities, which was managed as plasmodium malaria due to false positive card test initially but later found to be due to a gram negative bacteria Achromobacter denitrificans (A. denitrificans), which was sensitive to cephalosporin. The patient was treated with ceftriaxone and got cured. To our knowledge A. denitrificans bacteremia with sensitivity to cephalosporin’s in a immunocompetent person with no underlying illness, hospitalization or in person who has never underwent any medical procedure has never been described in medical literature before.

Forty years old male was admitted with fever, cough and breathlessness since five days. Examination revealed signs of pleural effusion on left side of chest. Chest X-Ray showed left sided pleural effusion and left middle zone consolidation. Pleural fluid analysis suggested empyema. Patient was managed with intravenous antibiotics and left-sided inter-costal tube drainage. A day after thoracostomy patient developed swelling around eyes and thoracostomy site. Diffuse crepts were palpable around eyes, left side of chest and neck (Figure 1). CT confirmed the diagnosis of subcutaneous emphysema around eyes and chest wall. Swelling disappeared with conservative management within next three days (Figure 2). Periorbital emphysema is mostly due to disruption in the integrity of orbital boundaries because of trauma and subsequent orbital and sinus fractures. Less frequently follows dental surgeries. As a result of continuity of facial planes it can rarely occur as a result of spread from neck and chest subcutaneous tissue.

Introduction: Migraine is a chronic, neurovascular polygenic disease where genetic and environmental factors are involved in its etiology. Dysfunction of neuronal ion transportation can provide a model for predisposition for common forms of migraine. Mutations in genes encoding ion channels disturb the rhythmic function of exposed tissue that may also explain the episodic nature of migraine. Our aim was to study the single nucleotide polymorphisms of CACNA1A gene in migraine patients. Materials and Methods: The subjects were the patients of migraine, in the age range of 18-80 years, diagnosed by a Neurologist, as per the diagnostic criteria of International Headache Society (IHS) Classification 2004 after excluding other causes of headache by clinical examination and relevant investigations. The controls were the age and sex matched healthy persons from the same population excluding the relatives of patients. Only those patients and the controls, who voluntarily participated in the study, were taken and their blood samples were taken for the study. Deoxyribonucleic acid (DNA) extraction was performed according to the manufacturer's protocol for Qiagen DNA extraction kits (Qiagen, Hilden, NRW, Germany). DNA content was quantified by spectrophotometric absorption (Nanodrop Spectrophotometer, BioLab, Scoresby, VIC, Australia). Polymerase chain reaction was performed using an iCycler Thermal Cycler (Bio-Rad, Hercules, CA, USA). The polymorphic analysis of CACNA1A gene was carried out by two methods: Restriction fragment length polymorphism and sequencing. Results: The study included a total of 25 patients of migraine, diagnosed on out-patient department basis as per IHS Classification 2004 and compared with age and sex matched 25 healthy controls. Most of the patients 23 (92%) were below the age of 50 years. 20 of the patients (80%) were females and 5 (20%) were males. The polymorphic analysis of CACNA1A gene revealed the presence of only the wild form of the gene for the codon E993V in both case and control groups. Conclusion: In our study, we could not find any polymorphism of CACNA1A gene in the selected patients. Instead the wild type of genotype was found in both patients and controls. This negative result presented here, implies that if the CACNA1A gene is involved in typical migraine (with and without aura), its contribution is very modest and therefore difficult to discern. Nevertheless, there are other genes that could be considered potential candidates for typical migraine susceptibility for which further research is needed.

Introduction Pneumonia usually connotes the infection of pulmonary parenchyma. Pneumonia is best classified according to the setting in which it occurs i.e community acquired pneumonia (CAP) hospital acquired or immunodeficiency associated. Dietary zinc deficiency is widespread in developing countries. Zinc deficiency is related to the morbidity and mortality in CAP. Aims and objectives To compare serum zinc values of community acquired pneumonia patients with healthy controls and to see the effect of zinc levels with severity of pneumonia. Methods and materials A case control study involved 100 patients of community acquired pneumonia with age and sex matched healthy controls, after getting informed consent from all subjects. The serum zinc level was measured, analyzed and interpreted with regard to age, CURB-65, comorbidity and hospital stay. Results and observation The mean age of patients was 59.74 years. 53 patients were males and 47 were females. Smoking history was present in 55 patients. The mean serum zinc level in patients was 89.9 μg/dl whereas in controls it was 105.65 μg/dl, which was statistically significant. The zinc levels were low in elderly patients and controls as compared to young ones. Mean zinc level was lower in patients of high CURB-65 score and vice versa. Summary Our study revealed a definite relation of low serum levels of zinc with community acquired pneumonia and there is definite decrease in serum zinc levels as the age increases. Considering the morbidity, mortality, hospital stay and financial burden and to reduce the use of antibiotics for pneumonia, especially in developing countries like ours, serum zinc levels should be routinely measured and thereby supplemented.