BackgroundEvidence for efficacy of cognitive-behavioural therapy (CBT) in treatment of schizophrenia is growing. CBT is effective and cost efficient in treating positive and negative symptoms. To effectively meet the needs of diverse cultural groups, CBT needs to be adapted to the linguistic, cultural and socioeconomic context. We aimed to assess the feasibility, efficacy and acceptability of a culturally adapted CBT for treatment of psychosis (CaCBTp) in a low-income country.MethodsRater-blind, randomised, controlled trial of the use of standard duration CBT in patients with psychosis from a low-income country. Participants with a ICD-10 diagnosis of psychosis were assessed using Positive and Negative Syndrome Scale for Schizophrenia (PANSS), Psychotic Symptom Rating Scales (PSYRATS), and the Schedule for Assessment of Insight (SAI) (baseline, 3 months and 6 months). They were randomized into the intervention group (n = 18) and Treatment As Usual (TAU) group (n = 18). The intervention group received 12 weekly sessions of CaCBTp.ResultsThe CaCBTp group had significantly lower scores on PANSS Positive (p = 0.02), PANSS Negative (p = 0.045), PANSS General Psychopathology (p = 0.008) and Total PANSS (p = 0.05) when compared to TAU at three months. They also had low scores on Delusion Severity Total (p = 0.02) and Hallucination Severity Total (p = 0.04) of PSYRATS, as well as higher scores on SAI (p = 0.01) at the same time point. At six months only the improvement in PANSS positive scores (p = 0.045) met statistical significance..ConclusionsIt is feasible to offer CaCBTp as an adjunct to TAU in patients with psychosis, presenting to services in a lower middle-income country.Trial registrationClinicaltrials.gov identifier NCT02202694 (Retrospectively registered).

Introduction: Devastating floods from July to September 2010 broke all previous records of havoc caused by natural disasters in Pakistan. Flood caused 20 million people to loose their homes, profession and community making them internally displaced. Devastating consequences are still continuous within the country. Objectives: To find out the prevalence of anxiety, depression and post-traumatic stress disorder among flood affected Internally Displaced Persons (IDPs) of Sind. Aims: To find out psychiatric morbidity in IDPs so that proper attention should be paid to rehabilitation of these effectees and psychiatric support should be provided specially to those who are more affected by psychological trauma. Methods: Cross sectional study conducted in Razzakabad, an area located in periphery of Karachi. PTSD prevalence was measured using the Harvard Trauma Questionnaire and levels of anxiety and depression were measured using the Hopkins Symptom Checklist-25. SPSS 17 was used for data entry and analysis. Results: Total 303 subjects were included in this study out of which 55% were females.The total Scores on Hopkins symptoms checklist-25 (HSCL-25) and on Harvard trauma Questionnaire were significantly high and psychiatric morbidity was present in 42% of the population. The presence of psychological distress was more in females (65.6%) (p= .05).32% of the subjects had symptoms of PTSD.44% of the population was screened positive for anxiety and depression symptoms were present in 39% of the population. Conclusions: Besides being displaced from their residence exposure to trauma come out to be the important causative factor in creating psychological disturbance among IDPs.

Background: The patient's follow-up is a significant challenge for managing the psychiatric illness, especially psychotic disorders. Although many factors affect patients' clinical non-attendance with psychosis, patients and their families' approach toward medication influences treatment follow-up. The study evaluates the patient's and family's approach regarding OPD follow-up and the effect of SMS reminder on OPD follow-up of patients with psychosis. Methodology: This study was conducted on a psychotic patient attending OPD at Karwan e Hayat, Karachi. A total of 248 patients were randomly divided into two groups, the SMS reminder group and the treatmentas-usual or control group. Computer-based SMS to improve patient follow-up was sent in Urdu and English to the SMS group. A total of four reminder messages were sent to the SMS group within 15 days of each clinical appointment over a period of 24-weeks, while no message was sent to the control group. Results: All patients (Intervention & Control groups) were divided further into two groups based on the caring family approach reflected through several follow-ups, including a poor follow-up group with less than five visits and an appropriate follow-up group having five or more than five visits. The impact of SMS follow-up reminders on both groups was observed through OPD follow-ups. At baseline, all groups were comparable, but after a 3-month appropriate group of intervention were found with a significant (p=0.053) increase in the number of follow-ups compared to patients with poor follow-up groups. Conclusion:It is concluded from the study results that SMS reminders are an effective intervention in those psychotic patients and families who have a positive approach to illness.

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The role of Information and, Communication Technology (ICT) in developing teacher competencies through promotion-linked training is a growing field of interest. This qualitative with case study research explores the impact of ICT on teacher training programs aimed at promoting competencies and improving teacher performance. By analyzing the use of technology in teacher training, this study seeks to understand how ICT can enhance teacher competencies and improve the overall quality of Education. Ten participants in the study were selected through a purposive sampling technique. For the data collection, face-to-face self-developed semi-structured interviews were conducted. Data were analyzed through thematic analysis. It was found that ICT has a great impact and role in developing teachers’ competencies through promotion-linked training of BS-17 to BS-18 during PLT at the Punjab level. The participants described the importance of ICT regarding their professional development. This training was described to be useful through different platforms. Resource persons used different engaging techniques like blended learning, flipped classrooms, project-based learning, and personalized learning. Microsoft applications helped them for smooth, efficient, and effective working. The results of this research provide valuable insights for policymakers, educators, and technology experts as they work to integrate ICT into teacher training programs and improve the effectiveness of teacher development initiatives.