ABSTRACT
INTRODUCTION: In India about 95% of individuals who need treatment for common mental disorders like depression, stress and anxiety and substance use are unable to access care. Stigma associated with help seeking and lack of trained mental health professionals are important barriers in accessing mental healthcare. Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health integrates a community-level stigma reduction campaign and task sharing with the help of a mobile-enabled electronic decision support system (EDSS)-to reduce psychiatric morbidity due to stress, depression and self-harm in high-risk individuals. This paper presents and discusses the protocol for process evaluation of SMART Mental Health. METHODS AND ANALYSIS: The process evaluation will use mixed quantitative and qualitative methods to evaluate implementation fidelity and identify facilitators of and barriers to implementation of the intervention. Case studies of six intervention and two control clusters will be used. Quantitative data sources will include usage analytics extracted from the mHealth platform for the trial. Qualitative data sources will include focus group discussions and interviews with recruited participants, primary health centre doctors, community health workers (Accredited Social Health Activits) who participated in the project and local community leaders. The design and analysis will be guided by Medical Research Council framework for process evaluations, the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework, and the normalisation process theory. ETHICS AND DISSEMINATION: The study has been approved by the ethics committee of the George Institute for Global Health, India and the Institutional Ethics Committee, All India Institute of Medical Sciences (AIIMS), New Delhi. Findings of the study will be disseminated through peer-reviewed publications, stakeholder meetings, digital and social media platforms. TRIAL REGISTRATION NUMBER: CTRI/2018/08/015355.
Subject(s)
Mental Disorders , Mental Health , Community Health Workers , Humans , India , Mental Disorders/psychology , Mental Disorders/therapy , Randomized Controlled Trials as Topic , Referral and ConsultationABSTRACT
Background: Recently, there are many covid-19 like asymptomatic cases reported with negative RT-PCR presentation and this condition is classified as sub-clinical covid-19. It primarily affects the respiratory system and cause inflammation triggering blood clot formation leading to complications such as Stroke, Myocardial infarction. Very limited COVID-19 cases with Transient Ischemic Attack were observed. We report a case where the patient presented with Transient Ischemic Attack with underlying subclinical COVID-19. Case Presentation: A 70 years old male patient was admitted in medical intensive care unit with chief complaints of weakness and tingling sensation of left upper and lower limbs, slurred speech. The patient described that he had experienced with shortness of breath, cough, fever 10 days before hospitalization. Patient was primarily managed with IV-mannitol, oral-ecosprin and intravenous fluids. Laboratory test was advised which showed elevated levels of inflammatory markers such as ESR, CRP, d-dimer, white blood cells, neutrophils, decreased lymphocytes. CT scan of chest revealed ground glass opacities and CT of brain suggested diffuse cerebral atrophy. But RT-PCR and Rapid antigen test was negative. Based on all these parameters patient was diagnosed with subclinical covid-19 with transient ischemic attack(TIA). Patient was treated with antibiotics, antiviral and supportive treatment was given for 8 days and then discharged from hospital after complete recovery. Conclusion: The patient presented with symptoms of transient ischemic attack and later diagnosed with subclinical covid-19 based on laboratory data and the symptoms he had experienced before 10 days of hospitalization. The patient was provided with appropriate treatment and discharged from hospital after complete recovery. Neurological complications and clotting disorders are increasingly observed with covid-19. Hence appropriate care should be taken for monitoring such conditions.
ABSTRACT
The Wuhan outbreak of novel Corona virus infection has been the global focus since December 2019. This infection has become a global pandemic. It is highly important to understand the virology of the pathogen and to explore the therapeutic options for management of this pandemic. Drug repurposing strategies are being considered for management of COVID 19. Among the identified drugs, Baricitinib has become a keen interest for researchers because of its ability to inhibit the viral assembly by the prevention of Clarithrin associated endocytosis. We tried to explore the reasons on why Baricitinib is not an ideal option for COVID 19.