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This paper describes overall socioeconomic gradients and the age patterns of socioeconomic gradients of health of Indian adults for multiple health indicators encompassing the multiple aspects of health. Cross-sectional data on 11,230 Indians aged 18 years and older from the WHO-SAGE India Wave 1, 2007 were analyzed. Multivariate logit models were estimated to examine effects of socioeconomic status (education and household wealth) and age on four health domains: self-rated health, self-reported functioning, chronic diseases, and biological health measures. Results show that socioeconomic status (SES) was negatively associated with prevalence of each health measure but with considerable heterogeneity across age groups. Results for hypertension and COPD were inconclusive. SES effects are significant while adjusting for background characteristics and health risk factors. The age patterns of SES gradient of health depict divergence with age, however, no conclusive age pattern emerged for biological markers. Overall, results in this paper dispelled the conclusion of negative SES-health association found in some previous Indian studies and reinforced the hypothesis of positive association of SES with health for Indian adults. Higher prevalence of negative health outcomes and SES disparities of health outcomes among older age-groups highlight need for inclusive and focused health care interventions for older adults across socioeconomic spectrum. [ABSTRACT FROM AUTHOR]

Both diabetes mellitus (DM) and hypertension (HTN) have been on the rise in recent decades all over the world more remarkably in developing countries like India. We intend to measure the prevalence of DM and HTN in the Indian population and to compare the trends and various correlates of these diseases in NFHS (National Family Health Survey)-4 and 5. Data of NFHS-4 and 5 were accessed from dhs program website. All statistical analyses were done in SAS (version 9.4). Mixed effects survey logistic regression models were used for estimating odds ratio (OR).p-values <0.05 were considered significant.1,637,762 individual case entries were evaluated. Both the diseases showed an increasing trend as per the advancing age in both sexes. The highest prevalence of DM is seen in the age group of 45–49 years (7.8%) in females and > 50 years (11.9%) in males as per NFHS-5. Similarly, the highest prevalence of HTN was seen in the age group of45–49 years (31.2%) in females and > 50 years (41.4%) in males as per NFHS-5. The OR (95% CI) of prevalence of DM, HTN and both the diseases in age group >50 years was 14.46 (13.14–15.7), 16.65 (15.78–17.6), 79.5 (64.76–97.73) respectively when compared to reference age group15-19 years. Highest odds for having both DM, HTN concurrently was in age >50 years with aOR(95% CI) 65.32 (52.26–72.63) in NFHS 4 and 35.57 (97.47–45.53) in NFHS 5.Rise in prevalence of DM, HTN and concurrent presence is noted with an apparent increase in cases. [ABSTRACT FROM AUTHOR]

Purpose: This research aimed to explore the deaf identity development process and to compare the identity status of deaf children in India, based on their exposure to inclusive and segregated educational institutions. The first section of the paper presents the Deaf Identity Development Models proposed by other researchers, while the second section deals with the information acquired from the deaf students in the study sample. Method: Forty pre-lingual deaf students were selected through a purposive sampling technique. The study tool was an adapted version of the Deaf Identity Development scale. The data was analysed qualitatively through content analysis. Identified themes were presented along with the verbatim statements. Results: The findings revealed that the age of onset of hearing loss, degree of hearing impairment, parents' hearing ability, family's socio-economic status, parents' education, family environment, the attitude of parents, social exposure, present and past experiences and social acceptance of the deaf child contribute tremendously to the development of an identity. The study also found that most of the deaf students who had not attended special schools possessed a culturally marginal identity, whereas students with prior special school experience possessed a bicultural identity and were better adjusted in the inclusive schools as compared to their counterparts. Conclusion: Further research is suggested, with a special focus on how people with different degrees of congenital hearing impairment experience and negotiate their identity in context. [ABSTRACT FROM AUTHOR]

Women's mental health is closely linked to their status in society. This paper outlines the clinical features of women with schizophrenia and highlights the interpersonal and social ramifications on their lives. There is no significant gender difference in the incidence and prevalence of schizophrenia. There is no clear trend in mortality, although suicides seem to be more in women with schizophrenia. In India, women face a lot of problems, especially in relation to marriage, pregnancy, childbirth, and menopause. Most studies have shown better premorbid functioning, and social adjustment for women compared with men. There is a great need to plan for gender‑sensitive mental health services targeting the special needs of these women. Women caregivers also deserve due attention. [ABSTRACT FROM AUTHOR]

Context: Postponement of fi rst pregnancy is known to be associated with a variety of interdependent factors such as age, education, income, occupation, religion, caste, and cash incentives. This paper examines the relationship and effects of some of these factors on postponement of fi rst pregnancy among newly married couples in Satara district. Objective: To study the interdependency of age, years of schooling, income, and cash incentive on postponement of fi rst pregnancy among newly married couples. Materials and Methods: This study employed quasi-experimental study design. Duly trained multipurpose workers interviewed husbands and auxiliary nurse midwives (ANMs) interviewed the wives; preferably in separate rooms using pretested semi-open proforma. Statistical analysis was done using STATA®version 12 statistical software. Results: Out of 1,355 participants; 704 couples successfully postponed fi rst pregnancy by 2 years, but 651 couples could not do so. Participants were signifi cantly successful in postponing pregnancy by 569.13 vs. 353.89 days for controls. Age and education of female participants were signifi cantly associated with postponement of fi rst pregnancy; while age, education, and income of male participants were not associated with postponement. Conclusions: Higher age, more education, and higher income appear to be associated with acceptance of postponement of pregnancy and appear to be acting synergistically in both male and female participants as compared to nonparticipants. [ABSTRACT FROM AUTHOR]

There is a consistent correlation between sporadic hereditary retinoblastoma and parental age. It has been proven beyond doubt that the birth rank is correlated with parental age. In the present study, a test for the effect of birth rank was performed in order to assess the risk of developing retinoblastoma with increased parental age. The study of the effect of birth rank showed a significant association between sporadic retinoblastoma (bilateral and unilateral) and late para, indicating that fresh germline mutations must have taken place in some of the sporadic cases. An investigation of the effect of birth rank on familial cases, obtained from published papers and our own series, showed that familial retinoblastoma is significantly associated with early para, suggesting early parental age. Further analysis of the mean paternal and maternal ages of sporadic cases (bilateral and unilateral) showed that the mean paternal age of sporadic bilateral (sporadic hereditary) cases was higher than that of sporadic unilateral cases (p<0.05). No such correlation was seen with mean maternal age. Thus, the present study shows that a high paternal age may be associated with sporadic bilateral (sporadic hereditary) retinoblastoma. [ABSTRACT FROM AUTHOR]

Introduction and Aims : Dilated cardiomyopathy (DCM) is an important cause of heart failure (HF) among children. Research on pediatric DCM remains surprisingly scarce. The primary objective of the study was to evaluate the clinical profile and outcomes of pediatric DCM and the secondary objective was to study the predictors of outcome. Methods and Results : We enrolled all patients with cardiomyopathy who presented to us between 1990 and 2020 and were younger than 18 years. During the 30-year study period, we identified 233 cases of pediatric cardiomyopathy. One hundred and nineteen (51%) cases had DCM. This retrospective cohort was analyzed to study their outcome and the possible predictors of outcome. Nearly, 8% presented in the neonatal period, and 37% in infancy. The most common mode of presentation was dyspnea on exertion (71%). Ninety-three patients presented in heart failure (78%). The median left ventricular dimension z-score in diastole was 4.3 (range 2.5--9.06). The median left ventricle (LV) ejection fraction was 31%. Seventy-two percent of this cohort were on angiotensin-converting-enzyme inhibitors, 40% on aldosterone antagonists, and 47% on beta-blockers. One-third had syndromic, metabolic, genetic, or any secondary cause identified. Twenty-seven patients satisfied the three-tiered clinical classification for the diagnosis of probable acute myocarditis. Over a mean follow-up of 3.29 years, 27% were lost to follow-up. Among the remaining patients who were on follow-up (n = 86), 39 (45%) died, 31 (36%) recovered, and 16 (18%) had persistent LV dysfunction. Heart Failure was the most common cause of death. Eight patients in this cohort (4.2%) had thromboembolic phenomena. Nine had sustained ventricular arrhythmias and six had atrial/junctional arrhythmias. Among the various risk factors studied, only infantile onset had a significant relationship with death or ventricular arrhythmias (P value-- 0.05). The 5-year survival rate of DCM patients was 59%. Conclusion : A reasonably good percentage of our population showed recovery of the left ventricular function (36%). Only infantile onset had a significant relationship with death or ventricular arrhythmias. The outcome in our DCM cohort is similar to other population cohorts. [ABSTRACT FROM AUTHOR]

The article focuses on the clinical practice guidelines for managing dissociative disorders that present as psychiatric emergencies, especially in India with dissociative motor disorder. It discusses the lack of standardized practices for managing these disorders in an emergency setting and the need to make a decision about inpatient or outpatient management are the drawbacks of managing dissociative disorders.

Introduction: Epilepsy is the most common childhood neurological illness, which occurs in four to six per 1000 children. The maximum incidence of epilepsy occurs in children less than 3 years of age. The main objective of our study was to describe the etiological spectrum, EEG, and neuroimaging abnormalities and predictors of intractability in epilepsy. Methodology: A cross-sectional observational study was conducted over a 2-year duration at Dr DY Patil Medical College, Pune, Maharashtra, India. Hundred eligible children with epilepsy aged 3months to 2 years were included in the study. Appropriate statistical test such as Chi-square test and P value has been applied. SPSS software version 23 was used in our study. Results: Out of 100 children, 45% were in the age group of 19--24 months with M:F = 1.1:1. The mean age of onset of seizure was 11.6 ± 3.3 months. The majority of children belonged to lower-middle-class families (56%). Developmental delay was seen in 50%, and 43% had refractory epilepsy. The most common seizure type was focal onset (47%), followed by generalized onset seizures (37%). EEG findings were abnormal in 66%, multifocal IEDs being the most common abnormality (54.55%). MRI brain was normal in 27 cases, and out of 73 abnormal MRIs, the most common pattern seen was changes of perinatal and postnatal insults (75.3%). There was a statistically significant correlation between the type of seizures and MRI pattern with abnormal EEG (P <0.001). In 23% of children, no etiology was found, structural cause--62 (perinatal: 55; cortical malformation: 7), metabolic cause--nine, genetic etiology--six cases. The factors associated with refractory epilepsy in our cohort were the presence of developmental delay, abnormal neurological examination, abnormal EEG, and abnormal MRI (P < 0.001). Conclusion: Our study described the etiological spectrum of infantile-onset epilepsy, with the most common being acquired cause because of perinatal and postnatal insult to the developing brain. Earlyonset seizures have a high possibility of intractability, especially if it is associated with developmental delay, abnormal neurological examination, EEG, and neuroimaging. [ABSTRACT FROM AUTHOR]

Aim: To study the clinical characteristics and incidence of microvascular complications among childhood and adolescent onset type 1 (T1DM) and type 2 diabetes (T2DM) seen at a tertiary care diabetes center in India. Methods: From our electronic medical records, we retrieved clinical and biochemical details of 4555 individuals with childhood and adolescent onset diabetes (diagnosed below the age of 20 years) seen between 1992 and 2017. T1DM was diagnosed if there was history of ketoacidosis or fasting C‐peptide <0.3 PMol/mL and stimulated C‐peptide <0.6 PMol/mL or if insulin treatment was required from the time of diagnosis. T2DM was diagnosed based on absence of ketosis, or fasting C‐peptide ≥0.6 PMol/mL and stimulated >1.0 PMoL/mL, or response to oral hypoglycemic agents for more than 2 years. We calculated the incidence rates of retinopathy (presence of at least one definite microaneurysm by retinal photography), nephropathy (urinary albumin excretion ≥30 μg/mg of creatinine) and neuropathy (vibration perception threshold ≥20 V) per 1000 person‐years of follow up. Results: Among the 4555 individuals with childhood and adolescent‐onset diabetes, 71.4% had T1DM, 19.5% T2DM and 9.1% other forms of diabetes. Age at first visit and duration of diabetes were significantly higher in T2DM when compared to T1DM. The age adjusted incidence of retinopathy was 52.9/1000 person years (Confidence Intervals [CI]: 42.9‐62.8) in T1DM and 49.8/1000 person years (CI 30.8‐68.8) in T2DM; nephropathy, 6.2 (CI 3.3‐9.0) and 13.8 (CI 5.6‐22.0); and neuropathy, 8.8(CI 3.6‐14.0) and 24.0 (CI 9.8‐38.2) in T1DM and T2DM, respectively. Conclusion: The incidence of microvascular complications is high among childhood and adolescent‐onset T1DM and T2DM and these calls for more aggressive control of diabetes. [ABSTRACT FROM AUTHOR]

Objective: Incidence of youth‐onset diabetes in India has not been well described. Comparison of incidence, across diabetes registries, has the potential to inform hypotheses for risk factors. We sought to compare the incidence of diabetes in the U.S.‐based registry of youth onset diabetes (SEARCH) to the Registry of Diabetes with Young Age at Onset (YDR—Chennai and New Delhi regions) in India. Methods: We harmonized data from both SEARCH and YDR to the Observational Medical Outcomes Partnership (OMOP) Common Data Model. Data were from youth registered with incident diabetes (2006‐2012). Denominators were from census and membership data. We calculated diabetes incidence by averaging the total cases across the entire follow‐up period and dividing this by the estimated census population corresponding to the source population for case ascertainment. Incidence was calculated for each of the registries and compared by type and within age and sex categories using a 2‐sided, skew‐corrected inverted score test. Results: Incidence of type 1 was higher in SEARCH (21.2 cases/100 000 [95% CI: 19.9, 22.5]) than YDR (4.9 cases/100 000 [95% CI: 4.3, 5.6]). Incidence of type 2 diabetes was also higher in SEARCH (5.9 cases/100 000 [95% CI: 5.3, 6.6] in SEARCH vs 0.5/cases/100 000 [95% CI: 0.3, 0.7] in YDR). The age distribution of incident type 1 diabetes cases was similar across registries, whereas type 2 diabetes incidence was higher at an earlier age in SEARCH. Sex differences existed in SEARCH only, with a higher rate of type 2 diabetes among females. Conclusion: The incidence of youth‐onset type 1 and 2 diabetes was significantly different between registries. Additional data are needed to elucidate whether the differences observed represent diagnostic delay, differences in genetic susceptibility, or differences in distribution of risk factors. [ABSTRACT FROM AUTHOR]

Monogenic forms of diabetes in children are frequently misclassified as either type 1 diabetes or young‐onset type 2 diabetes. There is a paucity of literature regarding pediatric monogenic diabetes in the Indian population. A retrospective analysis of case records of 37 children with monogenic diabetes who were diagnosed between 2008 and 2019 in a South Indian tertiary care center was performed. The write‐up describes the clinical, biochemical, and genetic characterization of these patients with the diagnoses of neonatal diabetes mellitus (15 patients), MODY (five patients), and various forms of syndromic diabetes (13 with Wolfram syndrome, two with H syndrome, one with mitochondrial diabetes, and one with thiamine responsive megaloblastic anemia). [ABSTRACT FROM AUTHOR]

Large deletions in the β-globin gene cluster lead to increased HbF levels by delaying the γ- to β-globin switch process. However, these deletions when inherited as a homozygous condition or when co-inherited with β-thalassemia result in variable clinical phenotypes. Individuals or families with a clinically presenting child, where the parents had HbF levels ≥ 10%, were further screened for the presence of large β-globin cluster deletions. Six deletions in the β-globin gene cluster were screened by GAP-PCR, and the uncharacterized deletions were further analyzed by gene dosage or by multiplex ligation-dependent probe amplification (MLPA). Among 192 individuals suspected for the inheritance of large deletions, 138 were heterozygous for large deletions, 45 were compound heterozygous of a large β-globin cluster deletion and β-thalassemia, and 9 were found to be homozygous for deletions. Among the heterozygotes, the Asian Indian inversion-deletion was found to be the most common deletion (39.9%), followed by the HPFH-3 deletion (30.0%). Other deletions 49.3 kb, δβ-thalassemia (21.2%), and 32.6 kb deletion (4.4%) were also found to be prevalent in our population. Patients compound heterozygous or homozygous for HPFH-3 and 32.6 kb deletions showed a milder clinical presentation, as compared with the patients compound heterozygous or homozygous for the Asian Indian inversion-deletion and 49.3 kb δβ-thalassemia. This comprehensive study highlights the mutation spectrum of large β-globin cluster deletions and the clinical heterogeneity in the patients homozygous or compound heterozygous with β-thalassemia, thus asserting the need for molecular characterization of these deletions. [ABSTRACT FROM AUTHOR]

Context: Data from the Western countries suggest that obsessive-compulsive disorder (OCD) in children and adolescents is associated with male preponderance, comorbid neurodevelopmental disorders, and high family loading. However, data are limited from the developing countries with respect to the demographic and clinical characteristics of OCD in children and adolescents. Aims: To study the demographic and clinical characteristics of children and adolescents (age ≤18 years) with OCD. Setting and Design: This was a cross‑sectional study, conducted in outpatient treatment setting, across six centers in India. Materials and Methods: Participants were assessed using a semi‑structured pro forma for sociodemographic information, clinical characteristics, the Children’s Yale Brown Obsessive Compulsive Scale (CYBOCS), Structured Clinical Interview for Diagnostic and Statistical Manual, 5th Edition Research Version, Children’s Depression Rating Scale, and Family Interview for Genetic Studies. Results: The sample was largely male with a moderate illness severity. Nearly 75% of the sample had illness onset before the age of 14 years. Aggressive, contamination‑related obsessions and washing, checking, and repeating compulsions were the most common symptoms. CYBOCS assessment revealed that >2/3rd of children and adolescents endorsed avoidance, pathological doubting, overvalued sense of responsibility, pervasive slowness, and indecisiveness. Family history and comorbidity rates were low. OC‑related disorders were present in about 10% of the sample. Conclusions: This study suggests that the clinical characteristics of OCD in children and adolescents in developing countries differ on certain aspects as reported from developed countries. [ABSTRACT FROM AUTHOR]

Cumulatively, breast, cervical, ovarian, and uterine cancer account for more than 70% of cancers in women in India. Distinct differences in the clinical presentation of women with cancer suggest underlying differences in cancer biology and genetics. The peak age of onset of breast and ovarian cancer appears to be a decade earlier in India (age 45-50 years) than in high-income countries (age >60 years). Understanding these differences through research to develop diagnosis, screening, prevention, and treatment frameworks that ar e specific to the Indian population are critical and essential to improving women's health in India. Since the sequencing of the human genome in 2001, applications of advanced technologies, such as massively parallel sequencing, have transformed the understanding of the genetic and environmental drivers of cancer. How can advanced technologies be harnessed to provide health-care solutions at a scale and to a budget suitable for a country of 1·2 billion people? What research programmes are necessary to answer questions specific to India, and to build capacity for innovative solutions using these technologies? In order to answer these questions, we convened a workshop with key stakeholders to address these issues. In this Series paper, we highlight challenges in tackling the growing cancer burden in India, discuss ongoing genomics research and developments in infrastructure, and suggest key priorities for future research in cancer in India. [ABSTRACT FROM AUTHOR]

Introduction: Addictive disorders are an epiphenomenon of underlying vulnerabilities. Research over the past decades into these vulnerabilities has distinguished internalizing and externalizing spectra as two distinct personality factors underlying substance use disorders (SUDs). In this study, we explore the behavioral activation and inhibition factors in patients with SUD. Materials and Methods: A total of 240 patients with SUD were recruited for the study. Behavioral inhibition system-behavioral activation/approach system (BIS-BAS) scale was used to assess the three domains of the behavioral activation, namely drive, fun seeking and reward responsiveness, and the behavioral inhibition as a single domain. BIS and BAS subscale total scores, inter-domain correlation, factor structure, and difference in the early-onset and late-onset SUD subgroup scores were calculated. Results: The drive, fun seeking, and reward responsiveness showed a moderate degree of correlation among each other ranging from 0.30 to 0.36. The behavioral inhibition subscale had a modest correlation r = 0.26 with the reward responsiveness subdomain of behavioral activation. The factor structure remained valid at two- and four-factor solutions apart from few items with inconsistent loading. The early-onset n = 209 (87.1%) and late-onset n = 31 (12.9%) SUD subgroup analysis showed a statistically significant difference in the mean scores of drive and fun-seeking subscales with P < 0.05. Discussion and Conclusions: Behavioral activation and inhibition remain two valid personality factors in patients with SUDs. Patients with early onset of SUD have a significantly higher behavioral activation scores in the drive, and fun-seeking subfactors suggesting a higher externalizing tendency. [ABSTRACT FROM AUTHOR]

Background: Increasing evidence suggests that life course factors such as education and bilingualism may have a protective role against dementia due to Alzheimer disease. This study aimed to compare the effects of education and bilingualism on the onset of cognitive decline at the stage of mild cognitive impairment (MCI). Methods: A total of 115 patients with MCI evaluated in a specialty memory clinic in Hyderabad, India, formed the cohort. MCI was diagnosed according to Petersen's criteria following clinical evaluation and brain imaging. Age at onset of MCI was compared between bilinguals and monolinguals, and across subjects with high and low levels of education, adjusting for possible confounding variables. Results: The bilingual MCI patients were found to have a clinical onset of cognitive complaints 7.4 years later than monolinguals (65.2 vs. 58.1 years; p = 0.004), while years of education was not associated with delayed onset (1-10 years of education, 59.1 years; 11-15 years of education, 62.6 years; >15 years of education, 62.2 years; p = 0.426). Conclusion: The effect of bilingualism is protective against cognitive decline, and lies along a continuum from normal to pathological states. In comparison, the role of years of education is less robust. [ABSTRACT FROM AUTHOR]

Introduction: Gallbladder cancer (GBC) falls into the top ten leading cancer sites in urban Delhi. The incidence of GBC in females is more than that among males worldwide. The present study evaluates the temporal variation of GBC incidence in an urban Delhi population.Materials and Methods: The 25-year GBC incidence data were obtained from Population-Based Cancer Registry (PBCR) of Delhi which covered nearly 97.5% of the population and 75% of Delhi. We applied joinpoint regression method to determine the trend of GBC incidence from 1988 to 2012. The estimated cumulative risk (0-74) and lifetime risk of developing GBC were also calculated.Results: GBC contributed 6% of total cancer cases in Delhi during the year 2012. In the past 25 years, 12,410 GBC cases (4010 males and 8400 females) were registered and contributed approximately 3% of male cancer cases and 6.5% of female cancer cases. The median age at diagnosis of GBC was 60.13 years and 57.22 years in males and females, respectively. Joinpoint analysis showed an overall increasing trend of age-adjusted rates of GBC incidence over 25 years. In females, a downward trend was observed during 1992-2004, whereas in males, the trend remained consistent during 1991-2005; however, thereafter, it started significant increasing for both the genders. Age-specific trend of GBC also reflects an increasing trend among males and females after 2004.Conclusion: The total and age-specific GBC cases have show an increasing trend in the past 25 years in urban Delhi. Stringent steps are required to control the modifiable risk factors for reducing the incidence of GBC in Delhi. In addition, individuals should also practice a healthy lifestyle to reduce the likelihood of GBC as well as other diseases. [ABSTRACT FROM AUTHOR]

The study of Mortality is an essential component for demographic studies and public health administration. When comparing the CDRs between any two situations, it is important to understand the contribution of various factors towards the difference in CDR; this can be done through the method of decomposition. The present study examine the decomposition of difference between CDR of India and some of its selected states from various zones of India for the period 1971 and 2011 for both sexes. We use Kitawaga (1955) decomposition method which gives an additive contribution of age compositional difference and age specific mortality rates. It has been found that Andhra Pradesh has the highest decline of CDR (4.81 points) for males which is due to the highest contribution of age specific mortality rate whereas Haryana for females (27.74 points) which is due to the contribution of both age specific mortality rates and age compositional difference. The outcome of the study at national and state level of India was rather meaningful as we observed the improvement of females' mortality rates over males. [ABSTRACT FROM AUTHOR]

Background: Neonatal mortality continues to be a significant problem in the Indian setting, especially in very low birth weight (VLBW) neonates. Selenium (Se) has been shown to possess antioxidant properties, and some recent studies have shown a reduction in the sepsis-attributable neonatal mortality with its use. India is a Se-deficient country. Blood Se concentrations in newborns are lower than those of their mothers and lower still in preterm infants.Objective: To evaluate the efficacy of Se in preventing the first episode of late-onset sepsis in VLBW preterm neonates.Methods: Ninety neonates weighing <1500 g and period of gestation <32 weeks, asymptomatic at birth and admitted to the neonatal intensive-care unit (NICU) in the first 12 h of birth with no maternal risk factors for sepsis were analyzed in the study. Se or placebo was supplemented orally once daily from 1st to 28th day of life to the test (n = 45) or control (n = 45) groups, respectively, followed by daily clinical assessment for signs or symptoms of sepsis in the hospital and weekly after discharge.Results: Preterm VLBW neonates (mean birth weight 1464.22 ± 50.14 g and mean gestational age 221.75 ± 4 days) are Se deficient at birth, with mean (SD) Se levels 31.1 ± 14.8 µg/l. Se supplementation at 10 µg/day increased serum Se levels significantly (63.9 ± 13.9 µg/l on Day 28 in Se vs. 40.9 ± 17.3 on Day 28 in placebo; p < 0.01). The incidence of the first episode of culture-proven late-onset sepsis was significantly lower in the Se than in the placebo group. [0/45 (0%) in Se vs. 6/45 (13.3%) in placebo; p = 0.033]. The incidence of probable sepsis was found to be significantly lower in the Se group [7/45 (15.55%)] than in the placebo [16/45 (35.55%)]; p = 0.02. The total incidence of any late-onset sepsis (i.e. culture-proven plus probable sepsis) was also significantly reduced by Se supplementation. [7/45 (15.55%) in Se vs. 22/45 (48.88%) in placebo; p = 0.001].Conclusion: Preterm VLBW neonates are Se deficient at birth. Se supplementation at 10 µg/day resulted in getting the Se levels into the acceptable normal level and reduced the incidence of the first episode of late-onset sepsis in these neonates. [ABSTRACT FROM AUTHOR]

The present study was conducted to examine the prevalence of elderly suffering from selected morbidities, duration of years they suffered and treatment taken or not for one or the other morbidity under consideration from any health facility across their gender background. For this purpose, data from 778 elderly persons (364 men and 414 women) who were residing in Coimbatore city, Tamil Nadu, was collected and analysed with the help of cross-tabulations/means and Chi-square/ANOVA tests. The findings revealed that the percentages of elderly suffering from Arthritis and Cataract and related closely followed by Blood Pressure, Diabetes, Back pain and Asthma are higher among women than among men. On the other hand, while the duration of years suffering from Cataract and related, Arthritis, Blood Pressure Asthma and Ulcer problem is significantly higher among men than their women counterparts, the reverse pattern is noticed in the case of Diabetes. By and large, men tend to availed/availing medical treatment for majority of the chronic morbidities under consideration to a large extent than their women counterparts. Based on the findings suitable policy implications were proposed and discussed. [ABSTRACT FROM AUTHOR]

The article looks at a study which focused on non-suicidal self-injurious (NSSI) behaviour among youth. Topics mentioned include an overview of NSSI behaviours including cutting, burning, or scratching, link between NSSI among youth and mental health vulnerabilities, and the use of the Functional Assessment of Self Mutilation questionnaire to explore occurrence of NSSI among a sample of college students in India.

Gender differences are diverse between studies of unipolar and bipolar depressive disorders. Thus gender difference reported so far in depression studies might have confounded from their level of intrinsic bipolarity. The objectives of this study were to test whether there were any gender differences in the phenomenology of unipolar Major Depressive Disorder (MDD) and whether any phenomenology reliably predicted the gender of Indian patients. Patients with the diagnosis of unipolar MDD, between 18 and 60 years of age were included. A total of 32 males and 36 females were assessed with the diagnostic criteria of DSM-IV-TR, the Hamilton Depression Rating Scale, the Beck Depression Inventory-II and the Global Assessment of Functioning. Females in our study were significantly more likely to be married (p= 0.008), unemployed (p= 0.000), with lower educational qualification (p= 0.009) and belong to a lower-socioeconomical class (p= 0.003). Males had a younger age at the onset of MDD (p= 0.004) and more recurrence (p= 0.030), loss of pleasure (melancholic feature) (p= 0.030) and perceived functional impairment (p= 0.041). In females, significant greater frequency of recurrent thoughts of death (p= 0.000), perceived sense of failure (p= 0.014) and social withdrawal (p= 0.041) were found. Recurrent thoughts of death was the only phenomenon that reliably predicted gender. The uniqueness of our findings could be attributed to relatively purer unipolarity of participants and recent changes in social and individual perspectives in rapidly developing world. [ABSTRACT FROM PUBLISHER]

Objective: The study aimed at exploring the audiological characteristics and the relationship between speech identification scores with cortical evoked potential measures and hearing aid benefit in individuals with auditory neuropathy spectrum disorder (ANSD). Study design: We initiated a retrospective study of patients who were diagnosed as having ANSD. In 198 patients with ANSD, patient history, risk factors, degree and configuration of hearing loss, speech identification scores in quiet and noise, otoacoustic emissions (OAE), immittance evaluation, auditory brainstem responses (ABR), long latency responses (LLR) and hearing aid benefit were assessed. Results: The results showed that the majority of the patients had bilateral ANSD with a female to male ratio of 1.25:1 with the majority having a rising configuration of hearing loss. OAEs were present in most with absent stapedial reflexes and ABR. The study also showed that individuals with ANSD do obtain benefit from hearing aids and it is related to the presence of LLR. Conclusions: The present study emphasizes the audiological characteristics of a large group with ANSD. Among the management options, hearing aids were found to be useful in only a few of the patients and other rehabilitation options, such as cochlear implants, need to be explored in future studies. Currently, the determining factors for benefit with hearing aid are speech identification scores and cortical auditory evoked potentials. [ABSTRACT FROM AUTHOR]

Introduction: Gynecological morbidities constitute an important health problem among women of reproductive age group in India. Many of them did not seek care and bare it silently. Aims and Objectives: The purpose of this study was to measure the prevalence of self-reported gynecological morbidities among women of 15 to 45 years and to find out association with certain selected socio-demographic factors. This study also tried to study the health seeking behavior of women. Methodology: A population based cross sectional survey was conducted across Vakkom Panchayat, it's area comes under Rural Health Centre of the Department of Community Medicine, Govt. Medical College, Thiruvananthapuram. A total of 540Women of 15 to 45 years was included in the study by two stage sampling technique. Results: Of the total, 199 {(36.85%) 95% CI -31.14, 42.94} women in the study reported at least one type of gynecological morbidity. Major morbidity reported was menstrual problems (25.0%). Prevalence of overall gynecological morbidities was found to be significantly more among women who married early (<18years) Adjusted OR 1.66 (95%CI- 1.05, 2.64).On subgroup analysis the factors like age group of women (below 30yrs), age at menarche below 13 years & presence of thyroid hormone disorders were found to be significantly (p<0.05) related to menstrual diseases in the regression model. Only 110 (55.3%) women sought treatment for any one of the morbidity. Majority took treatment from private hospitals. Conclusion: Prevalence of gynecological morbidities was high in this community. The data collected are valuable & could serve as preliminary data to pilot innovative delivery of gynecologic healthcare services. [ABSTRACT FROM AUTHOR]

Bacopa monnieri (L.) is a revered medicinal plant of traditional Indian system of medicine effective against cognitive impairment in ageing and SDAT. In our previous study, long term administration of bacosides was found to exhibit remarkable anti ageing effect, ameliorate age associated neurochemical and neurobehavioral deficits and prevent hippocampal neuronal degeneration in middle aged and aged rat brain cortex. In continuation to the previous study, the present study aims to investigate the neuroprotective effect of bacosides against age related chronic neuroinflammation in Wistar rat brain on 3 months treatment. Recently, neuroinflammation has gained considerable interest in age associated neurodegeneration and pathologies like SDAT due to its slow onset and chronic nature. The results of the present study demonstrated the significant attenuation of age dependant elevation of pro inflammatory cytokines, iNOS protein expression, total nitrite and lipofuscin content in middle aged and aged rat brain cortex on long term oral administration of bacosides. Thus, the present results suggest that bacosides possess immense potential to act as a neuroprotective agent due to its pleiotropic action for the prevention of ageing complications and SDAT progression. [ABSTRACT FROM AUTHOR]

Background: Vitamin A deficiency (VAD) continues to be a major public health nutritional problem in India, even though the National Vitamin A Prophylaxis Programme has been in operation for more than three decades. Aim: To assess the prevalence of vitamin A deficiency among rural pre-school children. Subjects and methods: A community-based cross-sectional study was carried out in rural Madhya Pradesh. A total of 8777 pre-school children were clinically examined for VAD and blood vitamin A levels were estimated in a sub-sample by dried blood spot method. Results: Prevalence of night blindness and Bitot's spot, an objective sign of VAD, was 0.8% and 1.4%, respectively, and prevalence increased significantly ( p  <  0.001) with age. The proportion of children with blood vitamin A deficiency (  <  20  μμg/dL) was 88% (95% CI: 84.8-91.2).The prevalence of Bitot's spot was significantly ( p  <  0.001) higher among children of lower socio-economic communities, 3--5-year age group and those of illiterate mothers. Conclusions: VAD is a major public health problem among rural children of Madhya Pradesh. Children of 3--5 years and those belonging to lower socio-economic communities are at high risk of VAD. Therefore, appropriate intervention measures are to be initiated to improve the vitamin A status of children. [ABSTRACT FROM AUTHOR]

Gender difference in stuttering is a much talked debated issue. A lot of studies have been done on this, mostly in the western countries. Stuttering is not only reported to be less common in females compared to males, with a 1:4 ratio, but its onset, development and recovery characteristics are more in favour of females. The present study is aimed to explore the similarities and differences in nature of disfluencies, if any, in male and female persons with stuttering, across the age groups in the Indian context. A retrospective analysis of 132 case files of all clients registered with the complaint of stuttering over a period of 6 months was made. The data was analyzed in terms of age of onset, nature and type of onset, associated problems and etiology of stuttering, across the gender and age groups. Across gender, significant differences have been obtained in most of the parameters under study and across the age and within gender too significant findings have been observed. The study confirms many of the earlier findings by other authors with regard to gender differences in stuttering. Female PWS are different in the onset, nature, development, severity characteristics of stuttering compared to male PWS. [ABSTRACT FROM AUTHOR]