The infection caused by the novel coronavirus (COVID-19) started from China and reached the whole world and was declared as pandemic by WHO. The COVID 19 poses challenges in all aspects of life including mental health for the entire human race. In the disturbed and crisis situation, the mental health care of people at different levels carries great importance: promotion, prevention and clinical care. First of all, we should not refer "COVID-19 case," "victim," "COVID-19 family," but "person who have COVID-19," "people who are being treated for COVID-19", etc. Social distancing is a public health strategy to limit the spread of COVID-19. There may be a feeling of ostracism, abandonment and being neglected in people, particularly the elderly when they are isolated. Older adults, especially in isolation and those with cognitive decline or dementia, may become more anxious, angry, stressed, agitated, and withdrawn during the outbreak or while in quarantine. These people need emotional support through informal networks (families) and health professionals. Maintaining social networks in situations of isolations is essential for mental health. The treating physician should ensure basic emotional and practical support to affected people. Children need special attention to express their fear and sadness.Media has highlighted COVID-19 as a unique threat, rather than one of many, which has added to panic, stress, and the potential for hysteria. Information should be sought from WHO website and government health authorities' platforms, in order to distinguish facts from rumours. Individuals with mental illness may be particularly vulnerable to the effects of widespread panic and threat. Instead of harassment, people with COVID 19 should be offer compassion, support via phone and texts, and assistance as appropriate, but never hostility or judgment.

Objectives:To assess the myths, beliefs and perceptions about mental disorders and health-seeking behavior in general population and medical professionals of India.Materials and Methods:A cross-sectional study was carried out with a sample of 436 subjects (360 subjects from urban and rural communities of Delhi and 76 medical professionals working in different organizations in Delhi). A pre-tested questionnaire consisting items on perceptions, myths, and beliefs about causes, treatment, and health-seeking behavior for mental disorders was used. The collected data were statistically analyzed using computer software package Epi-info. Appropriate tests of significance were applied to detect any significant association.Results:The mental disorders were thought to be because of loss of semen or vaginal secretion (33.9% rural, 8.6% urban, 1.3% professionals), less sexual desire (23.7% rural, 18% urban), excessive masturbation (15.3% rural, 9.8% urban), God's punishment for their past sins (39.6% rural, 20.7% urban, 5.2% professionals), and polluted air (51.5% rural, 11.5% urban, 5.2% professionals). More people (37.7%) living in joint families than in nuclear families (26.5%) believed that sadness and unhappiness cause mental disorders. 34.8% of the rural subjects and 18% of the urban subjects believed that children do not get mental disorders, which means they have conception of adult-oriented mental disorders. 40.2% in rural areas, 33.3% in urban areas, and 7.9% professionals believed that mental illnesses are untreatable. Many believed that psychiatrists are eccentric (46.1% rural, 8.4% urban, 7.9% professionals), tend to know nothing, and do nothing (21.5% rural, 13.7% urban, 3.9% professionals), while 74.4% of rural subjects, 37.1% of urban subjects, and 17.6% professionals did not know that psychiatry is a branch of medicine. More people in rural areas than in urban area thought that keeping fasting or a faith healer can cure them from mental illnesses, whereas 11.8% of medical professionals believed the same. Most of the people reported that they liked to go to someone close who could listen to their problems, when they were sad and anxious. Only 15.6% of urban and 34.4% of the rural population reported that they would like to go to a psychiatrist when they or their family members are suffering from mental illness.Conclusion:It can be concluded from this study that the myths and misconceptions are significantly more prevalent in rural areas than in urban areas and among medical professionals, and the people need to be communicated to change their behavior and develop a positive attitude toward mental disorders so that health-seeking behavior can improve.

A prospective study was conducted on 90 patients of tuberculosis at 2 directly observed treatment short course (DOTS) cum microscopy centers in an urban area of Delhi. The WHOQOL-BREF (Hindi) questionnaire was used to assess the QOL at the onset of treatment, after 3 months of treatment under DOTS, and at completion of treatment. Patients with tuberculosis had significantly lower mean scores than controls for overall QOL. The most affected domains were physical and psychological. Women scored significantly better than men in the physical and environmental domains. Overall QOL scores were lowest for category II and significantly lower for the psychological and social domains. The mean scores after treatment were significantly lower than controls for overall QOL, the social and environmental domains. The DOTS regimen improves the QOL and its domains; however, they remain significantly affected compared to the healthy controls.

The present study evaluated the effect of psychological stress on male fertility hormones and seminal quality in male partner of infertile couples. Seventy male partners of infertile couples were evaluated for level of psychological stress using Hospital Anxiety and Depression Score (HADS) questionnaire, serum total testosterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH) by electrochemiluminescence assay and serum GnRH by ELISA. Seminal analysis was performed as per WHO guideline. Nineteen (27%) of them had HADS anxiety and depression score ≥8 (abnormal HADS score). The persons having abnormal HADS had lower serum total testosterone, higher serum FSH and LH than those of persons having normal HADS. Serum total testosterone correlated negatively with HADS, but LH and FSH correlated positively. There was no change in GnRH with the change in stress or testosterone levels. Sperm count, motility and morphologically normal spermatozoa were lower in persons having abnormal HADS. Sperm count correlated positively with total testosterone and negatively with FSH and LH. Abnormal sperm motility and morphology were related to lower testosterone and higher LH and FSH levels. Psychological stress primarily lowers serum total testosterone level with secondary rise in serum LH and FSH levels altering seminal quality. Stress management is warranted for male infertility cases.

Nicotine in tobacco smoke causes not only pathophysiological changes in the smoker's body, but also develops tolerance to its own action with repeated use. Repeated exposure to nicotine develops neuroadaptation of the receptors, resulting in tolerance to many of the effects of nicotine. Pharmacotherapies for smoking cessation should reduce withdrawal symptoms and block the reinforcing effects of nicotine without causing excessive adverse effects. All forms of nicotine replacement therapy (NRT) – gum, patches and inhaler – and bupropion are safe and effective for increasing smoking cessation rates in the short and long-term use. Combination NRT (more than one therapy) may be indicated in patients who have failed monotherapy.

Tobacco use became common all over the world after discovery of Americas. Tobacco, a plant carries in its leaves an alkaloid called nicotine, which is responsible not only for several pathophysiological changes in the body but also develops tolerance to its own action with repeated use. Studies suggest that the alpha-4 beta-2 nicotine acetylcholine receptor subtype is the main receptor that mediates nicotine dependence. Nicotine acts on these receptors to facilitate neurotransmitter release (dopamine and others), producing pleasure and mood modulation. Repeated exposure to nicotine develops neuroadaptation of the receptors, resulting in tolerance to many of the effects of nicotine. Withdrawal symptoms appear on stoppage of tobacco use, which are characterized by irritability, anxiety, increased eating, dysphoria, and hedonic dysregulation, among others. Smoking is also reinforced by conditioning. Pharmacotherapies for smoking cessation should reduce withdrawal symptoms and block the reinforcing effects of nicotine obtained from smoking without causing excessive adverse effects.

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