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Task-shifting is an important means to address the barrier of inadequate specialist human resources for mental health in countries such as India. This paper aims to report the impact of one such task-shifting initiative. Twenty-two non-specialist Medical Officers of Bihar, an eastern Indian state were engaged in a ten-month long hybrid (a 15-days onsite orientation to psychiatry and periodic online mentoring in primary care psychiatry) training program to enable them to identify commonly presenting psychiatric disorders in their respective clinics. 20 online sessions (hub and spoke ECHO model) occurred over the next 10 months. Apart from didactic topics, 75 cases covering severe mental disorders, common mental disorders and substance use disorders were discussed (case presentations by the primary care doctors (PCDs)) and moderated by a specialist psychiatrist and clinical psychologist). 12 successive self-reported monthly reports (comprising of the number and nature of psychiatric cases seen by the trainee PCDs) were analyzed. The mean (SD) number of sessions attended was 9 (8.0) and median was 13 (Range: 0–20). Mean number of cases (per PCD) discussed was 3.4 (3.4) (Median: 4; Range: 0–10). Total 20,909 patients were cared for in the 12 months after initiation of the training program. Increasingly, a greater number of patients were cared for as the training progressed. This pattern was mainly driven by more identifications of severe mental disorders (SMDs), common mental disorders (CMDs), dementias and substance use disorders. Mean (SD) number of patients seen per month before and after training was 1340.33 (86.73) and 1876.44 (236.51) (t = − 3.5, p < 0.05) respectively. A hybrid model of training PCDs is feasible and can be effective in identification of persons with psychiatric disorders in the community. Prospective, well designed studies are essential to demonstrate the effectiveness of this model. [ABSTRACT FROM AUTHOR]

Objective: To analyze the outcome of children with posterior urethral valves who presented with antenatal hydronephrosis. Methods: A 10-year retrospective review of records of 70 children with posterior urethral valves. Results: The mean (SD) gestational age at diagnosis was 34 (4.48) weeks, and age at intervention was 130.5 (170.9) days. The nadir creatinine was significantly raised (>1.2 mg/dl) in children with oligohydramnios and diversion. Conclusion: All boys with antenatally detected hydronephrosis need postnatal evaluation to rule out posterior urethral valves. Short term outcome is improved with postnatal treatments, and longer follow-up is needed to ensure a favourable outcome. [ABSTRACT FROM AUTHOR]

Epidemiological studies have shown that high glucose levels and oxidative stress cause elevation of advanced glycation end products (AGEs) that are known to contribute to diabetic complications. Thus, agents that hamper reactive oxygen species (ROS) load can be used as a potential drug against AGEs-mediated complications. Hence, the present study investigated the protective role of gallic acid (GA) against the effects of AGEs in cardiac H9C2(2-1) cells. Exposure of cells to AGEs resulted in release of ROS ( P < 0.05) with significant ( P < 0.05) decline in antioxidant enzyme levels and increase in collagen ( P < 0.01) content. In addition, the altered mitochondrial membrane potential (mmp) ( P < 0.01) was also observed in cells exposed to AGEs, whereas AGEs-exposed cells pretreated with GA prevented the release of ROS, and there were no significant changes in the antioxidant status, collagen content and mmp. Thus, the results of the present study provide evidence that GA exhibits protective role against AGEs-induced cardiovascular complications probably through its free radical scavenging activity. [ABSTRACT FROM AUTHOR]