Prevalence and correlates of psychological distress among cancer patients in a tertiary care hospital in northern India

Background: Patients diagnosed with cancer are usually exposed to high level of mental stress and hence invariably lend in psychological distress. This study aimed to estimate the prevalence of psychological distress amongst cancer patients and determine its association with socio-demographic factors. Methods: This hospital based cross-sectional study was conducted at a cancer research institute of district Dehradun. Purposive sampling was used to select the hospital and recruiting patients. All eligible patients, giving written consent for the study were interviewed and distress related information was gathered using the Hospital Anxiety and Depression Scale (HADS). The data were collected for two months and sample size of 208 was achieved. Data was entered in SPSS 22.0 and association of different variables with psychological distress was determined by chi-square test.. Results: The mean age of the surveyed cancer patients was 51.05±15.68 years and the male female ratio was 1.7. Prevalence of psychological distress was found to be 38.5% and significantly more female patients than male patients (47.4% and 33.3% respectively) had distress. The association between psychological distress and increasing age, sex, literacy and employment status was found to be significant. Conclusions: Approximately 39% of cancer patients had psychological distress (anxiety/ depression/ both). The prevalence of psychological distress was found to be significantly higher in female patients, older age, patients with no formal education, unemployment and lower socio-economic status. Appropriate psychiatric interventions/ counselling following diagnosis and during therapy may be effective in reducing distress and improving quality of life in cancer patients.

Prevalence And Bio- Social Predictors Of Hypertension In Rural Dehradun.

Abstract: Background and Objectives: Cardiovascular diseases account for a large proportion of all deaths and disability worldwide. Hypertension is directly responsible for 57% of all stroke deaths and 24% of all coronary heart disease deaths in India. Studies have shown a high prevalence of hypertension in both urban and rural areas. Although there is generally a lower prevalence of hypertension in rural Indian population, there has been a steady increase over time in this rural population as well. Methodology: This observational cross sectional study was conducted in a randomly chosen block in district Dehradun. Overall 457 people were interviewed and measurements were taken to know the prevalence of hypertension and related risk factors. The collected data was entered and analysed in SPSS software (21.0 version ). Results: The prevalence of hypertension was 23.9% and male subjects had higher prevalence than females (26.2% and 21.5%respectively). With increasing age, prevalence of hypertension increased significantly. Age, sex, marital status, family type and occupation were found as important bio-social predictors of hypertension. Conclusion: Increasing prevalence of hypertension in rural areas and in younger age groups is of concern to the public health. In developing countries like India, preventive strategies should be directed towards masses with focus on behaviour change communication.

Assessment of Awareness and Presence of Risk Factors for Cancer in a Rural Community Of Uttarakhand, India.

Background: Cancer has become one of the major threats to public health in the developed world and increasingly in the developing world. Cancer rates in India are lower than those seen in western countries, but are rising with increasing migration, increase in life expectancy and changes in lifestyles. This study was planned to elicit the presence of risk factors for cancer in a rural community and to assess the awareness of people about risk factors of cancers. Methods and Material: This cross sectional study was conducted in a randomly chosen block in district Dehradun. Overall 1731 people were interviewed by trained personnel and data was entered and analysed in SPSS software (21.0 versions). Results: Overall 9.7 % respondents reported presence of the warning symptoms of different cancers. Regular smokers were 7.3% (16.3 % males and 1.4 % females), while 8.3 % respondents (males-18.6%, females-1.4%) accepted regular use of smokeless tobacco. 87 % of the surveyed people had the knowledge that cancer can be prevented by changing the lifestyle. Conclusions: Increasing incidence of various cancers is of concern to the public health. In developing countries like ours, preventive programs should be directed towards masses with focus on behaviour change communication.

Epidural Steroid Injection in Lumbar Disc Herniation.

Low back pain is a problem that is common and costly to society and its effective management remains a challenge. Major cause of morbidity due to low back pain is prolapsed intervertebral disc which mostly affects young adults in their fourth decade of life. Epidural steroid injection (ESI) is a low-risk alternative to surgical intervention in the treatment of lumbar disc herniation. This follow up study was planned to know the results of epidural injections with corticosteroids in symptomatic patients of lumbar disc prolapse. Out of 159 patients who were evaluated before and after the ESI for pain relief, 78% had positive response. No major post-injection complications were reported in this study. Carefully administered epidural steroid injection is a safe and effective modality in the treatment of pain in lumbar disc herniation.

Socio-Demographic Characteristics of Substance Abusers Among Intercollege Students in a District of Uttarakhand.

Substance abuse by children and adolescents is a major health problem. The use of illicit substances frequently starts among school children during adolescence. Concern with the use of harmful habit forming substances in students appears to be a very natural reaction; as they constitute a vital part of the society. Their age and often sudden wide exposure to new environments may render them extremely vulnerable for substance abuse. To find out the association of socio-demographic factors with substance abuse among intercollege students, a Cross-sectional study was conducted among intercollege students of district Dehradun. Multistage random sampling was used for the selection of two intercolleges (one rural and one urban). Overall 1094 students from 9th to 12th classes were included in the study. Statistical analysis was done by entering the data in SPSS software. The prevalence of substance abuse was found to be maximum in the students belonging to the middle slab of income group (socio-economic classes II, III and IV). Nonvegetarian dietary habits, Hindu religion and fathers in professional jobs were also found to be major risk factors for substance abuse behaviour among students.

Clinico-radiological profile of new smear positive pulmonary tuberculosis cases among young adult and elderly people in a tertiary care hospital at Deheradun (Uttarakhand).

SETTING: Patients of pulmonary tuberculosis (TB) attending the out and in patient department of pulmonary medicine, Himalayan Institute of Medical Sciences (HIMS), a post graduate institute and a large tertiary care center in Dehradun. OBJECTIVE: To compare the clinico-radiological pattern of pulmonary tuberculosis in the young adult (18-59 years) and elderly (> or = 60 years) patients. DESIGN: Prospective observational study of pulmonary and associated extra pulmonary tuberculosis cases, diagnosed between October 2005 to September 2006 in pulmonary medicine department of HIMS. RESULT: Mean age of young adult and elderly patients was 35.71 +/- 5.7 years and 68.57 +/- 3.03 years respectively. Elderly patients had a higher number of co-morbidities like diabetes mellitus, hypertension, and malignancy. Tuberculin positivity was less among elderly patients (36.0%) as compared to young adults (65.9%). Hemoptysis (29.5% vs. 6%), fever (95.4% vs. 76%) and night sweats (54.5% vs. 18.0%) were significantly higher in the young adult patients than the elderly. As for roentgenographic abnormalities, a higher involvement of lower zone (24.0% vs. 7.9%) and far advanced lesions (32.0% vs. 14.7%) were seen in the elderly patients as compared to young adults. The elderly showed a higher frequency of TB related mortality (8% vs. 1.1%) and associated extra pulmonary involvement (40% vs. 7%). CONCLUSION: Young adults are more likely to have hemoptysis, night sweats and positive PPD response while lower lung field involvement is more common in elderly.

Morbidity Profile of Elderly Persons

This cross-sectional study was conducted to know about the morbidity status of the geriatric population reporting at RHTC. A total of 285 elderly persons (>=60 yrs.) had reported at RHTC during the study period. All the subjects underwent personal interview and clinical examination. Hypertension was the commonest morbidity (41.4%) followed by musculoskeletal problems (36.8%) and respiratory problems (36.1%). The prevalence of psychosocial problems among patients was found to be 28.8 % (males-16.9%, females-48.1%). With the changing pattern of family, migration and other socio-demographic factors; there is a continuous rise in the health problems of elderly in developing countries. It makes a greater demand on the health services of a community.