ABSTRACT
Introduction: Women in India experience high rates of postpartum depression (PPD), with minimal availability of screening or treatment. India has an extensive network of community health workers, known as accredited social health activists (ASHAs). While they are knowledgeable about most maternal-child health problems, they have minimal knowledge about PPD. We trained ASHAs to deliver a simple home-based intervention, behavioral activation (BA), which involves individuals in activities that are sources of positive reinforcement to counter depression. The research questions guiding this study were as follows: 1) What are the feasibility and acceptability of ASHAs screening for and delivering a brief behavioral activation intervention addressing PPD among women in Belagavi, South India? 2) What impact did the brief behavioral activation intervention have on PPD? Methods: The mixed methods evaluation used interviews with participants and interventionists, and depression scores were assessed before and after the evaluation. After a 2-day training with 17 ASHAs that focused on understanding PPD, screening using the Edinburgh Postnatal Depression Scale (EPDS), and implementing the BA protocol, ASHAs and researcher supervisors screened the mothers 6-12 weeks postpartum presenting at pediatric immunization clinics. Mothers who screened positive were invited to participate in an ASHA-led 5-week BA intervention, with ASHAs visiting the mothers' homes. We assessed post-intervention EPDS scores and conducted satisfaction assessments and individual interviews. Results: All 26 women who screened positive on the EPDS agreed to be enrolled in the study. All participants had a significant reduction (p < 0.001) in PPD scores. Both ASHAs and mothers had high enthusiasm for the intervention methods and activities. Discussion: This ASHA-delivered BA intervention was found to be feasible, acceptable, and effective in treating PPD in rural Indian mothers. This corroborates literature that demonstrates the efficacy of a BA intervention among individuals with generalized depression in South Asia. In communities with minimal mental health resources, interventions led by trained community workers have the potential to address PPD.
ABSTRACT
Rishan Thimma SudarsanGlioblastoma are known for its aggressive intracranial course of disease, where the overall survival is less than 18 months. Of late, the World Health Organization has reclassified and renamed secondary glioblastomas as isocitrate dehydrogenase (IDH)-mutant grade 4 astrocytomas, which is relatively better than its IDH wild-type counterpart; however, overall survival remains poor. In such tumors, metastases outside the craniospinal neuraxis is very rare, and does sometimes present with symptoms which create a diagnostic dilemma and arriving at such diagnosis is still challenging even for the best of the clinicians worldwide. Here we present such a rare case scenario, where a grade 4 astrocytoma that has transformed from a low-grade glioma, presenting with bone metastases, its workup, treatment, and various possible mechanisms underlying such a rare event, and the need of such clinical scenario especially long-term survivors to be wary of distant metastases.
ABSTRACT
Mental illness is a leading cause of global morbidity. Over 10% of the Indian population experience a mental health disorder yet deficits in knowledge and negative attitudes towards metal illness limit early identification and treatment. We explored the relationship among knowledge, attitudes and practice among generalist nurses working at a large tertiary care hospital in South India. Participants demonstrated positive attitudes and sufficient knowledge about mental illness, yet these variables did not predict practice when presented with a patient case scenario of postpartum depression-related mental distress in a non-psychiatric inpatient setting. Findings warrant application-based pedagogies to facilitate nurses' enhanced recognition and treatment of patients experiencing mental distress in non-psychiatric settings.
Subject(s)
Mental Disorders , Nurses , Psychiatric Nursing , Attitude of Health Personnel , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , IndiaABSTRACT
Pericardial synovial sarcoma is an extremely rare tumor, and a challenging diagnosis due to nonspecific diverse presentation requiring a very strong clinical acumen along with an aggressive multimodal approach. Histopathological confirmation remains the gold standard. The optimal management is unclear because of very few cases reported in literature. Herein, we describe the findings on contrast-enhanced FDG PET-CT facilitating the staging, lesion characterization, and timely response assessment to chemotherapy.
