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Background: First responders are at high risk for adverse mental health outcomes following trauma exposure during disaster response. This mixed methods study aimed to quantify psychological impacts and explore personal experiences among first responders after the Bahanaga train accident that killed 294 passengers in the month of June 2023., Methods: For qualitative data, in-depth interviews (IDIs) were conducted, and quantitative data was collected using the PTSD checklist for DSM-5 (PCL-5), generalized anxiety disorder scale (GAD-7), and patient health questionnaire (PHQ-9) for symptoms of post-traumatic stress disorder (PTSD), depression, and anxiety. The study was conducted over one month during July 2023., Results: Among 225 responders, alarming rates of symptoms of probable PTSD (10.2%), anxiety (11.6%), and depression (24.9%) were noted. Those with no prior exposure to disasters and those with no formal training in disaster response scored higher in measures for PTSD. IDIs were conducted with 22 first responders, including various stakeholders. Qualitative analysis identified themes of preoccupation with witnessing trauma, feeling overwhelmed, scary and terrible emotions, avoidance, guilt, hypervigilance, intrusive memories, emotional numbing, unmet needs for mental health support, worsening physical health, re-emergence of past traumas, compounding impact of graphic images in the media, certain positive impact, including increased empathy, resilience and finding purpose, and the beneficial role of peer support., Conclusion: Significant psychological impacts are noted with elevated rates of probable PTSD, anxiety, and depressive symptoms among first responders one month after the Bahanaga train tragedy. These results underscore the vulnerability of first responders to mental health challenges following disaster response in India., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Journal of Psychiatry.)

There are limitations to traditional treatment approaches in addressing the needs of individuals with dual comorbidity of TB and SUD. The concept of harm reduction as a distinct approach to addressing substance use, focusing on minimising the negative consequences associated with it rather than advocating for complete abstinence. Different harm reduction strategies, such as opioid substitution therapy, needle and syringe programmes, testing for viral infections etc. have been effectively employed for SUDs in past. Similarly, TB risk minimization approaches like improving housing and nutrition and focused testing strategies are considered as harm reduction strategies for TB management. The relationship between tuberculosis (TB) and substance use disorders (SUDs) involves a complex interplay of biopsychosocial factors. It is crucial to prioritise integrated and closely monitored care in order to address the treatment challenges and potential drug interactions that may arise. In light of the acknowledged challenges like limited awareness, infrastructure, drug resistance, and stigma, it is imperative to explore potential avenues for the implementation of harm reduction strategies targeting individuals with comorbid TB and SUD in India. Potential strategies for addressing the issue includes a range of measures, such as augmenting investments in healthcare, integrating policies, tackling social determinants, and establishing shared platforms for psychosocial rehabilitation., Competing Interests: Conflicts of interest The authors have none to declare., (Copyright © 2023 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.)

Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

With proliferation in research on high-risk psychosis spectrum diseases, it is crucial to distinguish a prodrome or psychosis-like episode in children and adolescents from true psychosis. The limited role of psychopharmacology in such circumstances is well-documented, underlining the difficulties in diagnosing treatment resistance. To add to the confusion is emerging data on the head-to-head comparison trials for treatment-resistant and treatment-refractory schizophrenia. Clozapine, the gold-standard drug for resistant schizophrenia and other psychotic psychopathology, lacks FDA or manufacturer guidelines for use in the pediatric population. Possibly due to developmental pharmacokinetic (PK) considerations, clozapine-related side effects are more commonly seen in children than adults. Despite evidence of an increased risk for seizures and hematological problems in children, clozapine is widely used off-label. Clozapine reduces the severity of resistant childhood schizophrenia, aggression, suicidality, and severe non-psychotic illness. There is inconsistent prescribing, administration, and monitoring of clozapine, and limited database evidence-backed guidelines. Despite the overwhelming efficacy, problems remain regarding unambiguous indications of use and risk-benefits assessments. This article reviews the nuances in the diagnosis of treatment resistance psychosis in childhood and adolescents and its management, in particular highlighting the evidence base for clozapine in this population group., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Pattnaik, Panda, Chandran, Padhy and Ravan.)

Background: Depression among elderly is an emerging public health concern. Along with other comorbidities, depression affects the quality of life and functional ability of the geriatric population. This study aimed to assess the depression and quality of life among elderly and compare these parameters among the inhabitants of old age home and in the community., Materials and Methods: A cross-sectional study was conducted among the elderly of the community and old-age homes in the urban areas of Raipur, Chhattisgarh between March and July 2016. Hundred elderly (50 in each group) participated in the study. Geriatric Depression Scale 15 (GDS-15) and Older People Quality of Life (OPQoL)-35 scale were used to assess the geriatric depression and quality of life, respectively. Association between depression and demographic variables were analyzed by Chi-square/Fisher's exact test. Pearson's correlation coefficient was calculated between GDS-15 and OPQoL-35 scale., Results: The prevalence of geriatric depression was 59%. Quality of life was better among the old-age home elderly participants than that of community elderly when compared for score of life over all (11.78 vs. 13.56), health (12.8 vs. 14.0), social relationship (10.48 vs. 13.9), control over life (11.92 vs. 14.08), home and neighborhoods (9.38 vs. 12.36), psychological and emotional wellbeing (10.96 vs. 13.7), financial circumstances (14.5 vs. 16.7), and leisure and activities (13.86 vs. 15.28). Moderate positive correlation was observed between depression and quality of life., Conclusion: The higher prevalence in our study emphasizes the need to delineate the actual burden in the elderly population and provide necessary supportive measures. It needs to be addressed adequately through a coordinated primary care approach and community and social support. Timely and adequate management of depression can improve the quality-of-life outcomes., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Education and Health Promotion.)

Background: Ovarian cancer is the fifth common cause of death due to cancer in women. It constitutes 3% of all cancers in females and 15%-20% of genital malignancy. Most of the ovarian cancers are serous type followed by the endometrioid type. Sometimes, glands of these two carcinomas are indistinguishable histologically. It also becomes difficult to differentiate these two types when they are poorly differentiated., Aims: The aim of this study was to find differences in immunomarker expressions between serous and endometrioid carcinomas and the association of their staining patterns with other clinicopathological prognostic factors., Materials and Methods: Immunohistochemical staining for WT1, B-cell lymphoma 2 (Bcl2), Ki67 (MIB1), and Her2/Neu were done in paraffin-embedded tissues of histologically diagnosed 38 cases of ovarian serous and endometrioid carcinomas and staining patterns were correlated with other clinicopathological prognostic factors., Results: Of these 38 cases (21 serous and 17 endometrioid), 24 cases were in Stage I/II and 14 cases Stage III/IV. On the other hand, 16 cases were in low grade, 12 cases intermediate grade, and 10 cases high grade. Twenty of 21 serous carcinomas were strongly positive for WT1, whereas most of the endometrioid carcinomas were negative. Ki67 (MIB1) labeling index and Her2/Neu were higher in both higher grade and stages. On the contrary, the intensity of Bcl2 staining was lower in higher grades and stages lesions., Conclusions: The use of WT1 may be useful in resolving diagnostic dilemma between serous and endometrioid carcinoma, especially in difficult cases. Ki67, Bcl2, and Her2/Neu may be used as prognostic markers., Competing Interests: None

Introduction: HIV/AIDS-related stigma and discrimination together have long been recognized as one of the main obstacles in the prevention, care, and treatment of HIV and AIDS. Yet, little has been done on a large scale to combat them. Stigma still precludes many in need of treatment and care for people living with HIV/AIDS (PLHIV). The purpose of this study was to assess the social stigma among PLHIV and the factors influencing it., Material and Methods: This hospital-based cross-sectional study was conducted among four hundred PLHIV attending the antiretroviral therapy (ART) center of a tertiary care institute of Haryana, India, using a semi-structured questionnaire and Berger Stigma Scale. Data analysis was performed using SPSS version 20.0 software to explore the relationship between a dependent (social stigma score) and other independent variables., Results: The overall mean stigma score in our study was found to be 110.96 ± 17.05. The stigma score in the male PLHIV was higher than in females. Male gender, younger age group (18-25 years), nuclear family, and rural residents PLHIV experienced more stigma as showed by the logistic regression analysis., Conclusion: Stigma and discrimination are a continuous deterrent for program implementation or successful outcomes. Education, behavior change strategies, and building supportive environments to the targeted population (young, single, and rural residents) can provide a roadmap in ending stigma and discrimination., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Family Medicine and Primary Care.)

Aim: To assess the impact of COVID-19-related lockdown in India on alcohol-dependent persons., Method: We examined the change in the incidence of severe alcohol withdrawal syndrome presenting to hospitals in the city of Bangalore., Results: A changepoint analysis of the time series data (between 01.01.20 to 11.04.20) showed an increase in the average number of cases from 4 to 8 per day (likelihood ratio test: χ2 = 72, df = 2, P < 0.001)., Conclusion: An unintended consequence of the lockdown was serious illness in some patients with alcohol use disorders., (© The Author(s) 2020. Medical Council on Alcohol and Oxford University Press. All rights reserved.)

Background: Hydatidiform mole (HM) is characterized histologically by cystic swelling of the chorionic villi, accompanied by variable trophoblastic proliferation. The most important reason for the correct recognition of moles is that they are associated with an increased risk of persistent trophoblastic disease (invasive mole) or choriocarcinoma., Aims and Objectives: The aim of the study was to determine whether there is any role of p57 in differentiating partial and complete moles by immunohistochemical staining., Materials and Methods: A prospective observational study was undertaken in which 40 cases of molar pregnancy included over a period of 2 years. Detailed clinical and family histories were obtained from each patient. Histopathological examination followed by immunohistochemical study with p57 done in each case. Ultrasonography findings and serial titers of serum beta-human chorionic gonadotropin were noted whenever necessary., Results: Among the forty cases included, 25 (62%) had complete molar (CM) pregnancy, whereas the rest 15 (38%) had partial mole (PM). Both CM and PM were more pronounced in the age group of 20-25 years (44% and 60%, respectively), and among nulliparous women (68% and 70% respectively), 17 (42.5%) mothers had a prior history of abortion. In the histologically unequivocal cases of complete mole, 96% (24 of 25) did not express p57 and a single case was focal positive. In contrast, it was strongly and continuously expressed in both villous cytotrophoblast and stromal cells in all cases of PM (15 of 15)., Conclusion: p57 immunomarker is very helpful to diagnose and differentiate complete and partial HM., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 Journal of Laboratory Physicians.)

Prader-Willi syndrome is a neurodevelopmental disorder characterized by mental retardation and distinct physical, behavioral, and psychiatric features. Maladaptive behaviours, cognitive impairment, and impediments in speech and language seriously affect the early development and long-term functioning of individuals affected by the illness. We present a case of a 9-year-old child with Prader-Willi syndrome whose behavioural symptoms were treated with low-dose antipsychotic medications., Competing Interests: The authors declare that they have no conflict of interest related to this manuscript.