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Aims: To examine if exposure to pesticides is a risk factor for PD and if living in an endemic area for Japanese encephalitis (JE) increases the risk for PD. Materials and Methods: Hospital-based case-control study consisting of 100 PD patients attending the Neurology out-patient at NIMHANS, India, between August 2005 and December 2006 and an equal number of age (± 3 years) and sex matched hospital based apparently healthy controls. Data on various risk factors was collected using standardized FAME (Farming And Movement Evaluation study) questionnaire modified to add questions about living in JE endemic areas and use of mosquito repellants. Results: We observed rural living, farming, handling farming chemicals, exposure to insecticides were associated with increased risk of developing Young onset PD (YOPD) but this association was lacking for Late onset PD (LOPD). Use of mosquito repellants (Prallethrin, d-trans Allethrin) for more than 10 yrs was associated with an increased risk for YOPD. Education status, well water drinking, exposure to in-house insecticide (excluding mosquito repellants) were not associated with an increased risk of PD. Living in JE endemic areas was not a risk factor for developing PD Conclusion: Environmental factors (rural living, farming, handling farming chemicals, exposure to insecticides, and commonly used mosquito repellants containing Prallethrin, d-trans Allethrin play a role in the causation of YOPD. Living in JE endemic areas does not increase risk for developing PD. [ABSTRACT FROM AUTHOR]

Background: Awareness of sleep related disorders among general public and practitioners is low. This is an important under-recognized public health problem. Objective: To estimate the prevalence of sleep related disorders in a healthy population in South India. Design: Prospective, cross-sectional, randomized study using interview-based questionnaires [Pittsburgh Sleep Quality index (PSQI), Epworth Sleepiness Scale (ESS) and Sleep Disorders Proforma (SDP)]. Methods: One thousand and fifty apparently healthy bystanders of patients' (mean age 35.1±8.7 years; M:F:29:21) attending the Neurology outpatient services were recruited between April 2006 to February 2007. [ABSTRACT FROM AUTHOR]

Epilepsy is a common neurological disorder whose consequences are influenced socially and culturally, especially in India. This review (second of the two part series) was carried out to understand the social impact and economic burden to develop comprehensive program for control and prevention of epilepsy. Epilepsy is known to have adverse effect on education, employment, marriage, and other essential social opportunities. Economic burden associated with epilepsy is very high with treatment and travel costs emerging as an important contributing factor. A vicious cycle between economic burden and poor disease outcome is clear. There is no significant change in the perception, stigma, and discrimination of epilepsy across the country despite improvement in educational and social parameters over the time. The huge treatment gap and poor quality of life is further worsened by the associated comorbidities and conditions. Thus, a multidisciplinary response is needed to address the burden and impact of epilepsy which calls for an integrated and multipronged approach for epilepsy care, prevention, and rehabilitation. Service delivery, capacity building, integration into the existing program, mobilizing public support, and increasing public awareness will be the hallmarks of such an integrated approach in a public health model.

Of the 70 million persons with epilepsy (PWE) worldwide, nearly 12 million PWE are expected to reside in India; which contributes to nearly one-sixth of the global burden. This paper (first of the two part series) provides an in-depth understanding of the epidemiological aspects of epilepsy in India for developing effective public health prevention and control programs. The overall prevalence (3.0-11.9 per 1,000 population) and incidence (0.2-0.6 per 1,000 population per year) data from recent studies in India on general population are comparable to the rates of high-income countries (HICs) despite marked variations in population characteristics and study methodologies. There is a differential distribution of epilepsy among various sociodemographic and economic groups with higher rates reported for the male gender, rural population, and low socioeconomic status. A changing pattern in the age-specific occurrence of epilepsy with preponderance towards the older age group is noticed due to sociodemographic and epidemiological transition. Neuroinfections, neurocysticercosis (NCC), and neurotrauma along with birth injuries have emerged as major risk factors for secondary epilepsy. Despite its varied etiology (unknown and known), majority of the epilepsy are manageable in nature. This paper emphasizes the need for focused and targeted programs based on a life-course perspective and calls for a stronger public health approach based on equity for prevention, control, and management of epilepsy in India.