Technology- Can it Emancipate the Void in India s Mental Healthcare Delivery?

Mobile application-based delivery of mental health awareness programs may help in reducing the knowledge gap in mental healthcare in India. Apps can be used to educate our community about mental health first aid protocols. Apps have shown effectiveness in high-income settings, but they suffer from lack of applicability in low resource scenarios due to challenges of availability of apps in local vernaculars and digital illiteracy. We wanted to determine the potential of technology usage in mental healthcare awareness. We also wanted to explore the acceptability and willingness of caregivers in using mobile based mental health apps.METHODSA cross-sectional quantitative survey was conducted in outpatient setting of Dr. Bhimrao Ambedkar Memorial Hospital, Raipur, in which a semi structured questionnaire was provided electronically to collect data. A total of 120 participants, including 60 caregivers of mentally ill patients and rest 60 caregivers of patients suffering from diseases other than mental illness were included in the study. All 120 participants were included for data calculation. Data obtained was analysed statistically, using Cross Tab Analysis which includes chi-square and Cramer’s V with the help of SPSS (16th) version.RESULTSOut of 120 participants, 85 (70.83%) use smart phone with internet facility. 34 (28.33%) participants already use internet as their primary source of health-related information. 42 (35%) cases and 30 (25%) controls were keen to learn about Mental Health First Aid (MHFA) protocols. Those who had a mentally ill patient in their family were more likely to use a MHFA learning App (Pearson chi square = 11.528; df = 4; p = 0.02 < 0.05; Cramer’s V = 0.031; p= >0.021). There was no significant difference in both the groups’ eagerness to help their loved ones after learning MHFA protocols. Lack of knowledge and awareness and unavailability of an appropriate app were significant barriers.CONCLUSIONSThe study looks into the scope and limitations of implementing a mobile technology-based intervention for low resource setting. Handholding of caregivers and frequent encouragement from treating doctors might significantly help in technology adoption and in surmounting the apprehension related to using technology. The scope of delivering mental health services through technology is immense.

Impact of Dengue Surveillance Workers on Community Participation and Satisfaction of Dengue Virus Control Measures in Semarang Municipality, Indonesia: A Policy Breakthrough in Public Health Action

OBJECTIVES: The aim of this study was to assess community participation in Dengue virus control measures, and community satisfaction in the Dengue surveillance workers (DSWs) performance in Semarang municipality after 3 years of empowerment.METHODS: A cross-sectional survey involved 1,018 selected participants from 12 groups of social roles in 141 villages in Semarang municipality, Indonesia. A direct interview was performed using a structured questionnaire to evaluate the acceptance, and satisfaction of the community towards the DSWs. The data were analyzed descriptively.RESULTS: The majority of the members of the community considered that the DSWs play an important role in reducing Dengue cases, and vectors of the Dengue virus, as well as increasing the community participation in Dengue control measures. The survey showed that DSWs performance, attitudes, and abilities regarding their main tasks were perceived to be good.CONCLUSION: Overall, people in Semarang municipality were satisfied with the performance of the DSWs, and considered them important enough to be maintained and strengthened in the future so that Dengue could be controlled. This new policy needs to be disseminated to other regions that may encounter the problems associated with Dengue virus.

Two unusual neuro-psychiatric manifestations of malaria in a tertiary care hospital: a review of literature.

Malaria, a highly prevalent parasitic disease in tropical country, have some atypical neuro-psychiatric manifestations seen in both vivax and falciparum malaria. We are reporting two cases of unusual neuro-psychiatric manifestations of malaria admitted in our hospital, one with intralobar haemorrhage and other with atypical psychiatric features. The rarity of the presentation has been highlighted with possible pathogenesis discussed after literature review.

Molecular based detection for drug resistance in mycobacterium tuberculosis.

Multi- drug resistant tuberculosis continues to be a serious problem, particularly among some developing countries. Early detection of drug resistance in clinical M. tuberculosis isolates is crucial for appropriate treatment and to prevent the development of further resistance. Compared to conventional methods using solid media, the introduction of manual and automated methods (BACTEC or MB/BacT) for susceptibility testing in liquid media has resulted from 4 to 6 weeks to 3 to 15 days. The identification of resistance mutations, e.g., the genetic basis for RIF resistance, enables the development of molecular test that allows the detection of resistant strains within 1 day. One approach is the use of molecular analysis to detect mutations that are associated with resistance to drugs including INH and RIF. In the case of INH, mutations of the katG, inhA, kasA, and ahpC genes are responsible for the majority of INH-resistant M. tuberculosis, whereas mutations of rpoB are responsible for RIF-resistant M. tuberculosis.

Nasopharyngeal carcinoma: correlation of histopathology with radiation response.

Forty-nine cases of NPC were evaluated histopathologically and the radiation responses of the tumor types were assessed. The overall radiation response were as follows: CR 40.8%, PR 14.3%, NC 42.9%, PD 2.0%. The distribution of tumor types were: Squamous cell carcinoma (WHO type I) 4.08%; Non-keratinizing carcinoma (WHO type II) 4.08%; Undifferentiated carcinoma (WHO type III) 91.84% var. Lympho-epitheliomatous (LE), Anaplastic (A), Spindle cell (SC), Clear cell (CC). 94.38% of the cases were classified as clinical stage II, III and IV (tumor found beyond the nasopharyngeal space). The radiation response rate of the tumor in the lymphnode was reversed to the clinical stage and extent of node involvement, namely the higher stage and node involvement, the less rate of radiation response. Twelve cases received radiation dose of less than 4000 cGy, which comprised 11 NC cases and 1 PD case. Of the 37 cases who got 4000 cGy and over, the response rate was 72.97%. Of these WHO type I was not evaluated because of insufficient radiation dose; WHO type II showed 50% response rate; WHO type III showed 74.29% response rate. Radiation response (as assessed from the cervical lymphnode involvement) of NPC was influenced by tumor burden and histologic type of the tumor, namely the less differentiated tumor responded better than the more differentiated one. No definite conclusion can be drawn yet of the different behaviour (if any) of the variants of undifferentiated carcinoma (WHO type III) toward irradiation.