Mental health literacy and familiarity with the term schizophrenia in a community health care setting in North India.

INTRODUCTION: Mental health literacy (MHL) is an important mediator of mental health in the community. Recognition of schizophrenia by the presentation of a case vignette is often used to assess MHL. Various studies assessing MHL around the world have shown that the recognition of schizophrenia is low. This study was designed to use the case vignette method to assess the MHL in a sample of respondents in North India. METHODOLOGY: We translated a well-known case vignette of schizophrenia from english into hindi. A cross-sectional study design was followed. This case vignette was presented in the written format to 200 respondents in rural Punjab and Haryana. The case vignette was followed by questions regarding the identification and nature of the problem, what could be done about it and the familiarity of the respondent to the term 'schizophrenia'. The results were analysed through open coding. RESULTS: Around 22% of the responses identified mental illness. The recognition of schizophrenia by name was only in one response. Most people attributed the condition of the protagonist in the case vignette to be due to stressful life situations. The respondents used the terms 'depression' and 'tension' as descriptors of mental illness. The correction of situations leading to stress and counselling by a psychiatrist was considered by most respondents to be useful. The familiarity with schizophrenia was 18%. CONCLUSIONS: MHL in our sample was low. Measures for improving the MHL in the community are needed. There may be a case for easier nomenclature with regards to MHL.

Transforaminal Thoracic Interbody Fusion for Thoracic Disc Prolapse: Surgicoradiological Analysis of 18 Cases.

STUDY DESIGN: Retrospective observational study. OBJECTIVES: Thoracic disc prolapse (TDP) surgeries have reported complications ranging from paraplegia to approach related complications. This study is to present a series of TDP patients surgically treated with transforaminal thoracic interbody fusion (TTIF). Emphasis on surgical technique and strategies to avoid complications are analyzed. METHODS: Eighteen patients with TDP were included. Imagings were analyzed for end-plate changes and calcification. Type of disc prolapse (central/para-central) and percentage of canal occupancy were noted. Objective outcome was quantified with Visual Analogue Scale (VAS), modified Nurick's grade, and ASIA (American Spinal Injury Association) score. All complications were noted. RESULTS: Eighteen patients (average age 43.65 years) having total 22 levels operated, that included double level (n = 2) and missed level (n = 2) are reported. All patients had myelopathy. Calcification of disc (n = 13), central disc prolapses (n = 9), para-central (n = 11) and more than 50% canal occupancy (n = 8) were noted. VAS back pain, modified Nurick's grade and ASIA grade improved significantly in all patients. One patient had postoperative transient deficit. The functional score achieved its maximum at 1 year follow-up and remained static at final follow-up of 65.05 months. Union was achieved in all patients. CONCLUSIONS: The most important factor for outcome in TDP is the technical aspect of avoiding cord manhandling and avoiding wrong level surgeries. TTIF is not devoid of complications but can give good results to posterior approach trained surgeons.