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Background: The REFOCUS intervention was a whole team, complex intervention, designed to increase the recovery support offered by community based, mental health staff. The intervention consisted of two components: Recovery promoting relationships, which focused on how staff work with service users, and Recovery working practices, which focused on what activities and tasks staff and service users could do together. Aim: We aimed to investigate the experiences of community mental health workers using the REFOCUS intervention to support personal recovery. Method: In the context of the REFOCUS Trial (ISRCTN02507940), 28 semi-structured individual interviews and 4 staff focus groups, with 24 participants were conducted and thematically analyzed. Results: Staff valued coaching training and used coaching skills to have tough as well as empowering, motivational conversations with service users. They were positive about the resources within the ‘working practices’ intervention component. The whole team training and reflection sessions helped create team cultures, structures and processes which were conducive to supporting recovery practice. Conclusion: We recommend the wider use of coaching skills, strengths-based assessments, and approaches to support clinicians to broaden their understanding of service users’ values, treatment preferences and to support striving towards personally-meaningful goals. Staff who used these working practices changed their beliefs about what their service users were capable of, and became more hopeful practitioners. A team-based approach to support recovery creates a learning environment in which staff can support and challenge one another, making sustained practice change more likely.

We demonstrated intrinsic connections between left ventricular hypertrophy (LVH) and arterial hypertension (AHT) through the recently announced centralized aerobic-anaerobic energy balance compensation (CAAEBC) theory. CAAEBC has already demonstrated achievements in the treatment of AHT, diabetes myelitis (DM), and osteochondrosis. Such demonstration lifts the necessity to check the applicability of this theory to other non-communicable diseases (NCDs) and develop the proper way to model the main idea of CAAEBC.

Introduction: Obesity (BMI ≥ 30 kg m-2) is epidemic globally and is associated with increased risk for a wide range of physical and mental health comorbidities. This is a particular concern for rural residents who have a greater rate of obesity than urban residents, but are disadvantaged in obtaining care because of a shortage of health care professionals. Community health fairs provide an opportunity for rural residents to receive health care services and education at reduced or no cost. Therefore, this study explored the role of community health fairs for providing health services and improving the health of residents in a rural community where obesity is a serious health concern. Methods: This study involved a retrospective longitudinal analysis of data collected during community health fairs conducted in a rural western Nebraska, USA community during 2014, 2015, and 2016 (n = 83). The Planned Approach to Community Health (PATCH) framework was used to target health education in this rural community. This approach involved 1. Mobilizing the community (via health fairs), 2. Collecting and organizing data (from consented attendees), 3. Selecting health priorities (obesity), 4. Developing a comprehensive intervention (nutrition and physical activity education), and 5. Evaluating the effectiveness of the framework (declines in measures of obesity over time). Analyses characterized BMI, percent body fat, visceral fat, and BP and explored differences between genders. The sample was recruited by advertising with flyers for health fairs at the College of Nursing. Most booths provided printouts of results for participants in order for them to keep and track their health information. Once potential participants arrived at the health fair site, there were asked if they would like to participate in the study via an invitation letter. They could then decline or sign the consent. Results: Percent body fat and visceral fat level differed between genders (p = < .001 and .001, respectively). Mean body fat levels (women 39.4%, men 28.8%) were unhealthy. Mean visceral fat level was unhealthy in men (16), but healthy in women (10). BMI and systolic and diastolic blood pressure did not differ between genders. Mean BMI was 31 kg m-2; 33% of participants were overweight, 44% were obese. Mean systolic and diastolic BP were 134 and 78 mg Hg, respectively. Most participants were hypertensive (systolic: men 57%, women 32%; diastolic: men 24%, women 7%) or prehypertensive (systolic: men 21%, women 39%; diastolic: men and women 36%). Conclusion: Obesity and high BP were common in this rural population, supporting the need for effective education and intervention efforts to address these health issues. Health fairs provide a manner in which to reach community persons needing referrals to local clinics, mental health providers and physicians. Education provided at such events is valuable as well and may in fact be the only health care contact they receive. Though community health fairs provide an economical way for individuals to receive screenings and health information, few men participated and few individuals attended in multiple years. The lack of repeat attendees prevented assessment of the efficacy of the education intervention. Means of enhancing participation, particularly by men and previous attendees, need to be explored. Repeatedly attending health fairs enables participants to monitor their progress, seek physical and mental health screenings and discuss any health concerns and helps researchers assess the efficacy of interventions. 

Coronavirus disease 2019 (COVID-19) which originated in China spread progressively all over the world [1]. On 11th March 2020 WHO declared COVID-19 outbreaks as a pandemic [2]. As of 22nd May 2020, there have been more than 5.3 million confirmed cases of COVID-19, with more than 340 thousand deaths and more than 2.2 million recovered [3]. Slowly, South Asia is also entering the ranks of COVID-19 affected regions. This region comprises more than 21% of the world’s population which remains vulnerable to COVID-19 [4].

The Diagnostic Statistical Manual of Mental Disorders volume 5 (DSM-5) is the influential textbook published in 2013, by the American Psychiatric Association, as a guide to psychiatric diagnosis. It helps to ensure that doctors are consistent in their use of diagnostic terms.

Parry-Romberg syndrome is an uncommon condition, self-limiting with slow progressive hemifacial atrophy. This syndrome can lead to several progressive congenital and developmental deformities. It can cause severe facial asymmetry and subsequently lead to esthetic and psychological problems and adversely affect patient’s quality of life, so its treatment holds great importance. Still, there is no exact treatment protocol for this disease, treatment approaches are bounded and patient’s response to the treatment is imponderable. However, most of the patients can benefit from conservative treatments. In this paper, we have reported a moderate case of Parry-Romberg syndrome, with no familial history of any syndromes. We also have discussed about present anomalies and the steps of exerted conservative treatments.

Herpes simplex virus (HSV)-1 encephalitis is the most common infectious cause of sporadic encephalitis. Despite treatment with acyclovir, HSV encephalitis is still associated with severe morbidity characterized by persistent neurological deficits. HSV encephalitis usually follows a monophasic course, however, some patients might develop relapsing symptoms caused by the formation of auto-antibodies directed against the N-methyl-D-aspartate receptor (NMDAR). Here we present an 82-year-old male patient with HSV encephalitis who developed shortly after his hospital discharge a Post-HSV NMDAR encephalitis, characterized by recurrent epileptic seizures and deterioration of his residual aphasia. First-line immunotherapy with intravenous immunoglobulins (IgIV) was administered and the patient returned almost to his baseline residual deficits of HSV encephalitis. Subsequently, he presented with recurrent relapses of NMDAR encephalitis. Since periodic treatment with IgIV has been started the patient is seizure-free and his neuropsychiatric condition is stable. In conclusion, the recognition of Post-HSV NMDAR encephalitis is very important because neurological manifestations can markedly improve with immunotherapy. Interestingly, in some patients cerebral HSV infection seems to trigger a chronic inflammatory disorder with persistent autoimmune activation which requires chronic treatment.

Accumulated condylomas are exophytic tumors with a warty and hyperkeratosic surface due to the Human papillomavirus (HPV). Its prevalence in children is difficult to estimate due to limitations in epidemiological data. Its recurrent character is found in 30% of patients. Its management is very complex in children because of skin fragility. Circumcision is an operation consisting of the removal of part of the foreskin. This practice is done either with a simple knife or a pair of non-aseptic scissors which can be a source of contamination including HPV (Condyloma). Traditional circumcision does not seem to be reported in the literature as a mode of contamination. We report a case of genital condyloma in a child 2 years after circumcision. This is a 2-year-old male with no medical history but with a surgical history of circumcision that was brought by his parents in dermatological consultation for papular lesions accumulated on the penis. At the interrogation, we found the notion of recent circumcision performed by a tradithérapeute. The physical examination finds a good general condition. Dermatological examination reveals on the glans of multiple papules, exophitic, with warty and hyperkeratotic surface, of normal skin color. Furthermore, the physical examination of both parents was normal. The diagnosis of accumulated condyloma secondary to probable circumcision was retained before the clinical appearance of the lesions. Two electrocoagulation sessions spaced one month apart under local anesthesia were the treatment with a favorable evolution.

Acute Kidney Injury (AKI) is defined as an abrupt decrease in kidney function within hours to days and is caused by multiple factors. Community-acquired AKI (CA-AKI) is common in developing countries, and it is crucial to bring awareness about its epidemiology and simple preventive strategies that can tackle this potentially serious complication. Infections, use of over-the-counter medicines, traditional herbal remedies, animal (and insect) bites, and pregnancy-related complications are common causes of CA-AKI in developing countries. The incidence of vector-borne disease-related AKI and obstetric causes of AKI have decreased following better public health policies in most developing countries. Appropriate fluid management is critical in AKI, both in terms of prevention of development and progression of AKI. Timely initiation and de-escalation of fluid therapy are both equally important. Kidney replacement therapy (KRT) is indicated when AKI progresses to stage 3 and/or patients develop refractory fluid overload or electrolyte imbalances and/or uremic complications. Hemodialysis is the most common modality of KRT in adults, whereas peritoneal dialysis is the dominant modality in small children. Convective renal replacement therapy, such as hemofiltration, is increasingly used in critically sick patients with AKI and hemodynamic instability. To summarize, CA-AKI is a common, serious, and often preventable complication of certain conditions acquired in the community, and is, therefore, a matter of utmost concern from the public health perspective. 

Aim:The work was to perform a comparative study of the neuroprotective and nootropic activities of two pharmaceutical substances, the HLDF-6 peptide and its amide form (HLDF-6-NH2). Materials and Methods: We used in the study healthy adult male Wistar rats aged 180–200 days weighing 280–300 g. We modelled ischemic stroke in rats by chronical occlusion of carotid arteries. Solutions of the HLDF-6-NH2 and HLDF-6 peptides were administered intranasally. Cognitive functions we assessed with Novel object recognition test and Morris maze. Results: The amide form of HLDF-6 peptide is more efficient: the neuroprotective activity of HLDF-6-NH2, evaluated by improvement of cognitive functions in animals, surpassed that of the native HLDF-6 peptide. A dose of 250 µg/kg of HLDF-6-NH2 peptide resulted in practically complete restoration of the disturbed functions. In the model of ischemic stroke, the amide form of the peptide significantly excelled the reference substance mexidol both in the effective dose and biological activity. Conclusion: The results of study of the agent allow hoping for its success in further clinical investigation. In view of high demand for the agent and in case of successful clinical trials, it will surely become widely used in clinical practice in treatment of IS.