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Mohandoss A.,Shri Sathya Sai Medical College and Research Institute | Thavarajah R.,Ragas Dental College and Hospital
Indian Journal of Cancer | Year: 2016

BACKGROUND: A small subset of Indian people living/diagnosed with cancer commits suicide. The prevalence and changing trends in such cancer-related suicides are not much reported in literature. An attempt is made to address this subset of suicides during 2001-2014. MATERIALS AND METHODS: Data for this study were collected from the Indian National Crime Bureau Record, cancer registry publication in open domain, and published literature. Trends in the number of suicides associated with state, age groups, genders, and years were the only available parameters. Using these data, descriptive statistics of the rate of suicides, linear trend with age groups, gender, and geographical divisions are presented. RESULTS: During the study period of 14 years, 1,721,946 suicides with an average of 122,996 suicides per year were observed. One in five suicides was related to illness. In total, a sum of 10,421 cancer-related suicides were noted accounting a mean of 744 suicides per year. Males were commonly involved than females. The commonly involved age group was 45-59 years. Southern parts of India had more instances of cancer-related suicides. Among Indian states, West Bengal reported the highest of such instances. DISCUSSION: Suicide trends among Indians living with cancer during 2001-2014 are presented. The possible causes behind this phenomenon and implications are presented. The effect of changes in the trends in terms of geographical distribution, age group distribution, and gender dynamics is presented and discussed in this context. CONCLUSION: Suicide among PLWC is a multi-dimensional, complex phenomenon, orchestrated by several factors, including mental health. The nascent field of psycho-oncology in India needs to explore this through large scale validated studies.


Ramalingam L.,Shri Sathya Sai Medical College and Research Institute | Ramesh R.,Indira Gandhi Medical College and Research Institute
National Journal of Physiology, Pharmacy and Pharmacology | Year: 2016

Background: Heart rate recovery (HRR), an important independent risk factor for cardiovascular disease and mortality is often used in research to study the cardiac autonomic status of an individual. Studies have shown that the HRR is impaired in men with metabolic syndrome, suggesting a deranged autonomic function in these individuals. An association has been found between HRR and the metabolic syndrome as well as between HRR and each of the components of this syndrome. It is well-known that HRR after exercise can be modified by weight loss, but the mechanism underlying the improvement of HRR is unclear. Aims and Objectives: The aim of this study is to assess and compare the exercise-induced changes in the cardiac autonomic status of young overweight and obese sedentary females and females with normal body mass index (BMI) using HRV. Materials and Methods: BMI and Waist/Hip ratio of 40 apparently healthy females recruited was calculated, and they were divided (following the WHO guidelines for Asians) into two groups: (1) Test group - BMI >23 Kg/m2 and W/H>0.8 and (2) control group - BMI 18.5 to 22.9 Kg/m2 and W/H<0.8. The level of physical activity of the study participants was assessed using the IPAQ questionnaire. Pre- and post-exercise ECG were recorded in all the females in lead II configuration. Short-term HRV analysis was performed with Kubios HRV software and tests of significance was done using repeated measures of ANOVA and Mann-Whitney U test using SPSS software version 23. Results: Not pre-exercise, but post-exercise time domain parameters were significantly differing at 1 min, 15 min, and 30 min after exercise in the test group, whereas, frequency domain parameters were showing significant differences (high LF nu, low HF nu, high LF/HF ratio) before as well as after exercise in the test group, but not significant in the control group. Conclusion: This shows that the sympathetic dominance after exercise is prolonged in females with higher BMI and recovery to the baseline is delayed. Hence, it is likely that these individuals could develop hypertension and other cardiac complications in their future life. Hence, the improvement of regular physical activities must be stressed on among these young females. © 2016 Latha Ramalingam and Rajalakshmi Ramesh.


Lavakumar S.,Shri Sathya Sai Medical College and Research Institute | Jacob Jesurun R.S.,Believers Church Medical College and Hospital
Asian Journal of Pharmaceutical and Clinical Research | Year: 2017

Objectives: To evaluate the drug compliance level among the patients attending the outpatient department of Shri Sathya Sai Medical College Hospital using Morisky 8-item drug compliance questionnaire and to determine the factors which hinder them from adhering to physician’s prescription. Methods: 100 patients who were on long-term drug treatment on outpatient basis were selected. Following that, Morisky 8-item drug compliance questionnaire, a self-reported scale of medication adherence was used. Along with the mentioned questions, a few questions to assess factors causing noncompliancy and their knowledge on drug compliance were included. Data were collected and based on the scale, the level of compliance, i.e., low, medium or high was estimated. Patients found noncompliant, factors hindering them from being noncompliant were assessed. Results: Among the 100 patients, 33% belonged to low adherence group, 44% to medium adherence group, and 23% to high adherence group. Patients belonging to low and medium adherence group were segregated and their individual questionnaire was assessed and reason for being noncompliant analyzed. The majority of the low adherence group said that they discontinue treatment once they feel that their symptoms were under control. Conclusion: Drug noncompliance is an important factor for treatment failure. The importance of medication adherence was re-emphasized to those patients who belonged to low/medium adherence group. © 2017 The Authors.


Prateek S.S.,Shri Sathya Sai Medical College and Research Institute | Saurabh R.S.,Shri Sathya Sai Medical College and Research Institute
African Health Sciences | Year: 2012

Background: India was the first country in world to launch - The National Family Welfare Programme in1951 but even today the couple protection rate (CPR) is still not achieved as desired. Objectives: To determine extent of awareness regarding contraception among married women. To estimate proportion of couples using contraceptive methods, identify reasons for their adoption & non adoption and to assess unmet needs for contraception. Methods: A cross sectional descriptive study of four months duration was conducted among married women in reproductive age group (15 - 49 years) attending general out-patient department in Urban Health Centre (UHC) employing universal sampling method. Participants not willing to respond and pregnant women were excluded. Total of 180 women were selected as study participants. Every woman was interviewed face to face with pre-tested questionnaire after taking informed consent. The data was analyzed by SPSS version 16. Results: 94 (52.2%) were in age group of 20 - 24years. 52.4% of women were aware about contraceptive practices, of which only 32.2% of subjects were using contraceptive methods. Out of these subjects, 89.66% used temporary methods and 10.34% used permanent methods. Cu-T (41.37%) was most preferred method. 93 subjects (51.6%) had unmet need for contraception. Religion, education status and age at marriage were significantly associated with contraceptive usage. Conclusion: The results suggest a significant Knowledge - Application Gap with regards to contraceptives knowledge and their actual usage in study participants. Almost fifty percent of the subjects had unmet need for contraception. This shows the need for more intense awareness campaigns for promoting contraceptive usage.


Shrivastava S.R.,Shri Sathya Sai Medical College and Research Institute | Shrivastava P.S.,Shri Sathya Sai Medical College and Research Institute | Ramasamy J.,Shri Sathya Sai Medical College and Research Institute
Asian Pacific Journal of Tropical Disease | Year: 2015

Ebola virus disease (EVD), previously known as Ebola hemorrhagic fever, is a severe illness caused by Ebola filovirus, and is often fatal if left untreated. The first case of the current EVD was diagnosed in Guinea in March 2014, and since then it has spread to Sierra Leone, Liberia, Nigeria, and Senegal. The current review has been performed with an objective to explore the magnitude of the current Ebola virus epidemic and identify the multiple determinants that have resulted in the exponential growth of the epidemic. An extensive search of all materials related to the topic was done for almost two months (August-October) in Pubmed, Medline, World Health Organization website and Google Scholar search engines. Relevant documents, reports, recommendations, guidelines and research articles focusing on the different aspects of Ebola virus and its current outbreak, published in the period 2002-2014 were included in the review. Keywords used in the search include Ebola virus, Ebola virus disease, Ebola hemorrhagic fever, Ebola vaccine, and Ebola treatment. The current EVD epidemic has turned out to be extensive, severe, and uncontrollable because of a delayed response and ineffective public health care delivery system. In fact, multiple challenges have also been identified and thus a range of interventions have been proposed to control the epidemic. In conclusion, the 2014 epidemic of EVD has shown to the world that in absence of a strong public health care delivery system even a rare disease can risk the lives of millions of people. The crux of this epidemic is that a large scale and coordinated international response is the need of the hour to support affected and at-risk nations in intensifying their response activities and strengthening of national capacities. © 2015 Asian Pacific Tropical Medicine Press.


Shrivastava P.S.,Shri Sathya Sai Medical College and Research Institute | Shrivastava S.R.,Shri Sathya Sai Medical College and Research Institute
International Journal of Preventive Medicine | Year: 2013

Background: Gender-based violence is recognized as a major issue on international human rights agenda. Domestic violence and abuse can happen to anyone, yet the problem is often overlooked, excused, or denied. This is especially true when abuse is psychological, rather than physical. Methods: A community-based cross-sectional study of 6 months duration was undertaken with the objective of studying the proportion and different forms of domestic violence, factors influencing it, and to study treatment-seeking behavior of these women. The study participants were married women in the age group 18-45 years residing in an urban slum area of Malwani, Mumbai. Using stratified random sampling, 274 subjects were selected. House to house visits were paid and they were interviewed face to face using a pretested semi-structured questionnaire after obtaining their informed consent. Rapport was established with the help of a Medical Social Worker. The questionnaire included information pertaining to the sociodemographic parameters and experience of domestic violence in the last 1 year and their treatment-seeking behavior for the same. Utmost care was taken to maintain privacy and confidentiality. Analysis was done using SPSS version 17. Results: The proportion of domestic violence was 36.9%. The most common form of violence was verbal in 87 (86.1%) followed by physical in 64 (63.4%). Conclusion: A significant association was found between domestic violence and age, education, spousal alcoholism, and duration of marriage.


Sinha S.P.,Shri Sathya Sai Medical College and Research Institute | Shrivastava S.R.,Shri Sathya Sai Medical College and Research Institute | Ramasamy J.,Shri Sathya Sai Medical College and Research Institute
MEDICC Review | Year: 2013

INTRODUCTION With a rapidly aging society, geriatric mental health is emerging as an important public health concern. According to the WHO, prevalence of depression in adults aged ≥60 years in developed and developing countries was 0.5 million and 4.8 million respectively in 2004. In India, increased life expectancy led to a rise in the older adult population between 2001 and 2011, expected to reach 324 million by 2050. OBJECTIVES To estimate the prevalence of depression and assess association between sociodemographic parameters and depression among older adults in a rural Indian community. METHODS A cross-sectional descriptive study was conducted in February and March 2012 in the rural village of Sembakkam, Kancheepuram District in the state of Tamil Nadu, India; the village has a population of 5948, 3.1% of whom are aged ≥60 years. Universal sampling technique was employed, in which every household in the community was visited and all elderly persons were selected. After obtaining written informed consent (a thumbprint was taken if the person was illiterate), participants were assessed face to face for depression using the Short Form Geriatric Depression Scale. The inclusion criterion was a score >24 on the mini-mental state examination. Final sample size was 103. Study variables included sociodemographic parameters such as age, sex, education, occupation, socioeconomic status, and marital status. Data entry and statistical analysis used SPSS version 17. RESULTS Of 103 respondents interviewed, 73 (70.9%) were aged 60-69 years and 58 (56.3%) were male. Forty-four (42.7%) individuals (17 males, 27 females) were found to be depressed; 23 (22.3%) with mild depression, 14 (13.6%) moderate depression and 7 (6.8%) severe depression. Female sex and widowhood were significantly associated with depression. CONCLUSIONS Depression, particularly mild depression, is common in this rural population of older adults, particularly among women and widowed elderly. These study findings can help program managers implement a more comprehensive strategy in this community for timely interventions to promote mental health and prevent geriatric depression.


Shrivastava S.R.,Shri Sathya Sai Medical College and Research Institute | Shrivastava P.S.,Shri Sathya Sai Medical College and Research Institute | Ramasamy J.,Shri Sathya Sai Medical College and Research Institute
Journal of Diabetes and Metabolic Disorders | Year: 2013

Diabetes mellitus (DM) is a chronic progressive metabolic disorder characterized by hyperglycemia mainly due to absolute (Type 1 DM) or relative (Type 2 DM) deficiency of insulin hormone. World Health Organization estimates that more than 346 million people worldwide have DM. This number is likely to more than double by 2030 without any intervention. The needs of diabetic patients are not only limited to adequate glycemic control but also correspond with preventing complications; disability limitation and rehabilitation. There are seven essential self-care behaviors in people with diabetes which predict good outcomes namely healthy eating, being physically active, monitoring of blood sugar, compliant with medications, good problem-solving skills, healthy coping skills and risk-reduction behaviors. All these seven behaviors have been found to be positively correlated with good glycemic control, reduction of complications and improvement in quality of life. Individuals with diabetes have been shown to make a dramatic impact on the progression and development of their disease by participating in their own care. Despite this fact, compliance or adherence to these activities has been found to be low, especially when looking at long-term changes. Though multiple demographic, socio-economic and social support factors can be considered as positive contributors in facilitating self-care activities in diabetic patients, role of clinicians in promoting self-care is vital and has to be emphasized. Realizing the multi-faceted nature of the problem, a systematic, multi-pronged and an integrated approach is required for promoting self-care practices among diabetic patients to avert any long-term complications. © 2013 Shrivastava et al; licensee BioMed Central Ltd.


Shrivastava S.R.,Shri Sathya Sai Medical College and Research Institute | Shrivastava P.S.,Shri Sathya Sai Medical College and Research Institute | Ramasamy J.,Shri Sathya Sai Medical College and Research Institute
International Journal of Preventive Medicine | Year: 2014

Background: Hypertension is a significant public health concern of world-wide distribution and is also the most common cardiovascular disease risk factor. Adequate control of blood pressure is a critical element in the prevention of hypertension induced-organ damage and life-threatening complications. Prevention of hypertension is possible and early detection and effective treatment can significantly reduce the incidence of adverse clinical outcomes. Methods: An extensive search of all materials related to the topic was carried out in PubMed, Medline, World Health Organization website and Google Scholar search engines. Keywords used in the search included hypertension, cardiovascular disease, public health, life-style modifications and awareness. Overall 51 articles were selected and analyzed. Results: Multiple socio-demographic and potential risk factors have been recognized in the causation and determining the long-term outcomes of the disease world-wide. As the natural history of hypertension is complex and etiology is multi-factorial the strategy to combat also should be multi-pronged based on the trends and magnitude of the disease in variable settings. Conclusions: To conclude, although progress has been observed in the area of awareness, treatment and control, the need continues to be high for sustainable and cost-effective interventions that will ultimately halt and reverse the rising tide of hypertension prevalence. Population-based health education, dietary and life-style modification and pharmacological therapy are all effective measures to reduce the prevalence and increase the control rate of hypertension.


Shrivastava S.R.,Shri Sathya Sai Medical College and Research Institute | Shrivastava P.S.,Shri Sathya Sai Medical College and Research Institute | Ramasamy J.,Shri Sathya Sai Medical College and Research Institute
Journal of Neurosciences in Rural Practice | Year: 2015

Depression is widely prevalent among women in the child-bearing age, especially during the antenatal and postnatal period. Globally, post-partum depression has been reported in almost 10% to 20% of mothers, and it can start from the moment of birth, or may result from depression evolving continuously since pregnancy. The presence of depression among women has gained a lot of attention not only because of the rising incidence or worldwide distribution, but also because of the serious negative impact on personal, family and child developmental outcomes. Realizing the importance of maternal depression on different aspects-personal, child, and familial life, there is a crucial need to design a comprehensive public health policy (including a mental health strategy), to ensure that universal psychosocial assessment in perinatal women is undertaken within the primary health care system. To conclude, depression during pregnancy and in the postnatal period is a serious public health issue, which essentially requires continuous health sector support to eventually benefit not only the woman, but also the family, the community, and health care professionals.

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