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Background: Sensitization plays a pivotal role in raising awareness about critical youth issues and encouraging them to access support services, contributing to the success of programs like Yuva Spandana, a youth-centric mental health promotion initiative in Karnataka, India. For youth to access support within YSKs, the quality and effectiveness of sensitization programs (SPs) are crucial. A standard quality assessment through indicators for SPs is required to provide recommendations for improvement. To enlist quality indicators and assess the quality of SP conducted under Yuva Spandana (YS) program across Karnataka. Material and Methods: We performed secondary data analysis (utilizing data available within the computerized management information system over 5 years; 2017-2022) and direct/in-person observation of SPs (by the researcher and the core team of YS between June and July 2022 using a specifically developed checklist). Quality indicators were developed using a process of consensus building. Each attribute within the checklist was scored, and a composite mean score and mean percentage scores for quality were calculated. Results: Overall, 33257 SP reports and 31 in-person SPs were assessed. A total of 36 quality indicators (10 quality indicators based on SP reports and 26 based on in-person observation) were developed. The average quality score of report-based SPs was 10.93 (±2.59; range 1-20) and in-person assessment was 63.06 (±6.61; range 50-73). Conclusion: The study emphasizes the importance of addressing all youth issues, including sensitive topics like gender, sex, and sexuality, to ensure a holistic approach to youth mental health. Challenges faced during program execution and the distribution of Information, Education, and Communication (IEC) materials also contribute to program quality. This research offers valuable insights for improving the conduct of SPs, enhancing youth access to services, and guiding future community-based health promotion initiatives. [ABSTRACT FROM AUTHOR]

Background: Stroke is a major public health and clinical challenge that results in significant mortality and disability. Stroke survivors require care and support, particularly during the crucial 3 months post-stroke when 95% of functional neurological recovery occurs. To estimate case-fatality and extent of disability, assess perceived needs, barriers, and unmet needs for care, and ascertain pathways to care post-discharge (at 3 months) among first-ever stroke patients attending a tertiary care neuro-specialty center in India. Material and Methods: A cross-sectional descriptive study was conducted among patients receiving care within [NIMHANS]. Patients with confirmed computed tomography (CT) scans experiencing their first-ever stroke between September 1 and October 31, 2022, were contacted between November 1, 2022, and March 31, 2023. A pre-tested semi-structured questionnaire was used to collect information. Descriptive statistics were performed using STATA version 16. Results: Stroke fatality among study subjects was 13.8%. Almost half (49.09%) had some form of disability, with 40% having moderate to severe disability. The majority perceived the need for follow-up visits (87%) and compliance with stroke medication (84%). Distance and transportation (60%) were cited as the main barriers to care. After discharge, the majority preferred healthcare facilities close to their homes (60%). Conclusions: This study emphasizes the need for stroke survivors to have follow-up and compliance with medication, along with various unmet needs such as de-addiction services, vocational training, and emotional support. A network-based multi-disciplinary approach, along with a comprehensive hub and spoke model of stroke management services, could help address these challenges and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Stroke is a leading cause of death and disability worldwide. In India, it is the fourth leading cause of death and fifth leading cause of disability, posing a major public health concern. National surveys reveal an increasing trend in stroke risk factors such as tobacco use, physical activity, alcohol use, hypertension, and dyslipidemia. However, knowledge regarding the combined effect of these risk factors and their various combinations is limited. Understanding the individual, combined, and synergistic effects of known risk factors, along with new risk factors, is essential to address gaps in stroke epidemiology. This study aims to examine the effect of various risk factors of acute stroke and their association with stroke occurrence and its outcomes (survival, disability and quality of life). Methods: This retrospective-prospective cohort will be conducted in one taluka of Kolara district and two urban wards of Bengaluru with a total population of ~400,000. All stroke-free individuals above 30 years of age ~200,000 individuals in the selected sites will be participants of stroke-free period and all first ever stroke patients in the community will be part of stroke and post-stroke period respectively. The study subjects will be recruited through a complete house-to-house survey at baseline and undergo annual follow-ups during the stroke-free period, with specific assessments at defined time points during the stroke and post-stroke period for a period of one year. Efforts are implemented to minimize loss to follow-up, including community engagement, a helpline number, and hospital-based surveillance. Discussion: This large population-based cohort study addressing stroke epidemiology in the country, is one -of-its-kind, attempting to fill certain critical gaps in the natural history, management, and outcomes of stroke in India. This research has the potential to provide important insights into the effect of novel risk factors of stroke and various combinations of risk factors of stroke. Furthermore, the development of a stroke risk predictability calculator will add value to the existing Indian National Programme for Prevention & Control of Non-Communicable Diseases (NP-NCD) and offers a model for similar countries once developed. [ABSTRACT FROM AUTHOR]

Byline: Gautham. Sukumar, Vaishali. Dagar, Kowshik. Kupatira, Pradeep. Banandur, Gururaj. Gopalkrishna Introduction: With nearly 1,612,505 industrial workers in Karnataka, controlling hypertension among them is necessary to reduce subsequent non-communicable diseases [...]

Background: A staggering 85% of the global population resides in low- and middle-income countries (LAMICs). India stands as an exemplary pioneer in the realm of mental health initiatives among LAMICs, having launched its National Mental Health Program in 1982. It is imperative to effectively evaluate mental health systems periodically to cultivate a dynamic learning model sustained through continuous feedback from mental healthcare structures and processes. Materials and Methods: The National Mental Health Survey (NMHS) embarked on the Mental Health Systems Assessment (MHSA) in 12 representative Indian states, following a pilot program that contextually adapted the World Health Organization's Assessment Instrument for Mental Health Systems. The methodology involved data collection from various sources and interviews with key stakeholders, yielding a set of 15 quantitative, 5 morbidity, and 10 qualitative indicators, which were employed to encapsulate the functional status of mental health systems within the surveyed states by using a scorecard framework. Results: The NMHS MHSA for the year 2015--16 unveiled an array of indices, and the resultant scorecard succinctly encapsulated the outcomes of the systems' evaluation across the 12 surveyed states in India. Significantly, the findings revealed considerable interstate disparities, with some states such as Gujarat and Kerala emerging as frontrunners in the evaluation among the surveyed states. Nevertheless, notable gaps were identified in several domains within the assessed mental health systems. Conclusion: MHSA, as conducted within the framework of NMHS, emerges as a dependable, valid, and holistic mechanism for documenting mental health systems in India. However, this process necessitates periodic iterations to serve as critical indicators guiding the national mental health agenda, including policies, programs, and their impact evaluation. [ABSTRACT FROM AUTHOR]

Introduction: Encephalitis is a major public health problem worldwide that causes huge emotional and economic loss to humanity. Encephalitis, being a serious illness, affects people of all ages. The aim is to describe the sociodemographic, clinical, etiological, and neuroimaging profile among 101 acute encephalitis syndrome (AES) patients visiting a tertiary neuro-specialty care hospital in India. Methods: Record review of medical records of all patients attending neurology emergency and outpatient services at NIMHANS Hospital, diagnosed with AES in 2019, was conducted. Data were collected using standardized data collection forms for all cases in the study. Descriptive analyses (mean and standard deviation for continuous variables and proportions for categorical variables) were conducted. The Chi-square test/Fisher's exact test was used for the comparison of independent groups for categorical variables, and t-test for comparing means for continuous variables. Results: About 42.6% of AES patients had viral etiology, while in 57.4%, etiology was not ascertained. Common presenting symptoms were fever (96%), altered sensorium (64.4%), seizures (70.3%), headache (42.6%), and vomiting (27.7%). Herpes simplex was the most common (21.8%) identified viral encephalitis, followed by chikungunya (5%), arboviruses (chikungunya and dengue) (4%), Japanese encephalitis (4%), rabies (3%), dengue (1%), and varicella virus (1%). About 40% of AES patients showed cerebrospinal fluid pleocytosis (44%), increased protein (39.6%), abnormal computed tomography brain (44.6%), and magnetic resonance imaging abnormalities (41.6%). Conclusion: The study highlights the need to ascertain etiology and importance of evidence-based management of AES patients. A better understanding of opportunities and limitations in the management and implementation of standard laboratory and diagnostic algorithms can favor better diagnosis and management of AES. [ABSTRACT FROM AUTHOR]

Background: Suicidality among youth is one of the most challenging public health issues. A thorough understanding of the risk factors that contribute to youth suicidality is necessary. The main aim of the study is to estimate the proportion of suicidality and understand factors associated with suicidality amongst clients attending youth mental health promotion clinics in Karnataka, India. Methods: A retrospective cross-sectional case record analysis was performed utilising data from real-time digitised management information system specifically developed for the programme. All case records of clients aged 15 to 35 years who received mental health promotion (MHP) services between January 2017 and December 2020 across 30 districts of Karnataka were included in this analysis. Multivariate logistic regression analysis was performed with suicidality among clients as outcome. Socio-demographic characteristics, issues reported, feelings/emotions that indicate underlying mental health issue/crisis, being aware of suicidality among friends and family and personal habits (smoking/chewing tobacco and drinking alcohol) were considered potential exposure variables. Findings: Overall proportion of suicidality among youth presenting to youth mental health promotion clinics in Karnataka was 3.5% (357/10,340). Among factors associated with suicidality, the strongest association was found among those clients who reported attempted suicide among friends (AOR 8.94; 95% CI 5.95–13.45), family members (AOR 5.50; 95% CI 3.66–8.29), being anxious (AOR 4.90; 95% CI 3.43–6.99), inability to trust anyone (AOR 4.07; 95% CI 2.75–6.03), had issues of Gender, Sex and Sexuality (AOR 3.16; 95% CI 1.93–5.17) and relationship issues (AOR 2.77; 95% CI 2.05–3.73). Conclusion: The results alert all institutions, organisations and departments that cater to services and development of youth, to be sensitive towards risk factors of suicidality. The study advocates youth mental health promotion clinics to be equipped with measures/interventions to identify and manage such risk factors. This study has implications for Youth mental health promotion in India and other similar South-East Asian countries. [ABSTRACT FROM AUTHOR]

Abstract Background In the context of AVAHAN, the India AIDS Initiative of the Bill & Melinda Gates Foundation, general population surveys (GPS) were carried out between 2006 and 2008 in Belgaum (northern), Bellary (mid-state) and Mysore (southern) districts of Karnataka state, south India. Data from these three surveys were analysed to understand heterogeneity in HIV risk. Methods Outcome variables were the prevalence of HIV and sexually transmitted infections (STIs). Independent variables included age, district, place of residence, along with socio-demographic, medical and behavioural characteristics. Multivariate logistic regression was undertaken to identify characteristics associated with HIV and differences between districts, incorporating survey statistics to consider weights and cluster effects. Results The participation rate was 79.0% for the interview and 72.5% for providing a blood or urine sample that was tested for HIV. Belgaum had the highest overall HIV (1.43%) and Herpes simplex type-2 (HSV-2) (16.93%) prevalence, and the lowest prevalence of curable STIs. In Belgaum, the HIV epidemic is predominantly rural, and among women. In Bellary, the epidemic is predominantly in urban areas and among men, and HIV prevalence was 1.18%. Mysore had the lowest prevalence of HIV (0.80%) and HSV-2 (10.89%) and the highest prevalence of curable STIs. Higher HIV prevalence among men was associated with increasing age (p25-29years=11.22,95%CI:1.42-88.74, AOR30-34years=13.13,95%CI:1.67-103.19 and AOR35-39years=11.33,95%CI:1.32-96.83), having more than one lifetime sexual partner (AOR=4.61,95%CI:1.26-16.91) and having ever used a condom (AOR=3.32,95%CI:1.38-7.99). Having a dissolved marriage (being widowed/divorced/separated) was the strongest predictor (AOR=10.98,95%CI: 5.35-22.57) of HIV among women. Being a muslim woman was associated with lower HIV prevalence (AOR=0.27,95%CI:0.08-0.87). Conclusion The HIV epidemic in Karnataka shows considerable heterogeneity, and there appears to be an increasing gradient in HIV prevalence from south to north. The sex work structure in the northern districts may explain the higher prevalence of HIV in northern Karnataka. The higher prevalence of HIV and HSV-2 and lower prevalence of curable STIs in Belgaum suggests a later epidemic phase. Similarly, higher prevalence of curable STIs and lower HIV and HSV-2 prevalence in Mysore suggests an early phase epidemic.