ABSTRACT
Background: Disaster and mental health preparedness are inseparable domains highlighted during all the major disasters in India. To build Disaster-Mental health Preparedness (Disaster MHP), one has to understand the existing strategies, systemic efforts, and ground-level implementation. In this scoping review, we have analyzed the mental health preparedness efforts during major disasters in India. Methodology: We followed the Peters MDJ et al framework for scoping review named ‘Guidance for conducting systematic scoping reviews. This included the searching relevant articles on PubMed and google Scholar, and concept-context of the review. Results: The review identified major efforts taken during ten disasters in past 40 years and mapping of the potential areas for development of sustainable efforts towards Disaster MHP. Conclusion: This is the first systematic scoping review from India that provides insight into strength and sustainability of disaster mental health preparedness in India. The mapping of the review focuses on the models emerged from Bhopal, Odisha, Tamilnadu and NIMHANS for the future infrastructure, capacity building, and environment required for Disaster-MHP in India.
ABSTRACT
Abstract: Background: Diabetes accelerates the atherosclerotic process in blood vessels, leading to micro- and macro vascular complications, stroke being one of these. Carotid artery atherosclerosis in patients with Diabetic nephropathy is found to be associated with Silent cerebral infarction (SCI). Present study was carried to found any relationship between carotid intima media thickness and silent cerebral infarction in patients with type 2 diabetic nephropathy.Methods: The study was done in 50 DN patients admitted in medicine ward of tertiary care hospital. Subjects were evaluated based on detailed clinical data like symptoms, signs, and associated illnesses, general and systemic examination. Subjects were diagnosed with silent cerebral infarct based on MRI Findings. Each subject had undergone MRI to find out incidence of SCI.Results: Maximum (54%) was in age group of 61-70yrs and very few (6%) were below age of 50yrs. M: F was 1.6:1. Around 44% had duration of diabetes in 1-5yrs of duration and very few (6%) had diabetes >15yrs. On USG scan of carotid vessels it was found that 86% had increased carotid intimal media thickness either or side of vessel. On MRI brain there was incidence of silent cerebral ischemia among 30% study subjects.Conclusion: Both CIMT and SBI showed rise in incidence with corresponds to increase in age, duration of diabetes and urine albumin level among study subjects.
ABSTRACT
To determine the incidence of hypoglycaemia in children suffering from severe falciparum malaria, 23 patients from Rourkela (Orissa), were investigated. Plasma glucose and immunoreactive insulin were estimated before and at hourly intervals during quinine infusion. No child had hypoglycaemia at the time of admission. Correlation between parasite count and prequinine plasma glucose was not significant. In the period of quinine infusion, 20 patients showed fall in plasma glucose during all the three hours (P less than 0.05, P less than 0.01, P less than 0.01 at the end of 1st, 2nd, and 3rd h respectively) but the decrease to hypoglycaemic level (plasma glucose less than or equal to 40 mg/dl) was observed in only one child. Concomitant increase in plasma insulin was noticed in 18 of these patients. Decrease in plasma glucose and increase in plasma insulin was found to correlate well (r-0.78, P less than 0.001). Hypoglycaemia was found to be an infrequent complication of severe falciparum malaria in children from the area studied. Though decrease in plasma glucose was observed after quinine infusion, it was less severe and did not reach the hypoglycaemic level.