Depressive Disorders among People with Chronic Illness in an Urban Area of South India

Over the past decades, twin demographic and epidemiological transitions have been reflected an increase in the burden of chronic diseases. Although public health practitioners have recognized the increasing burden, the socioeconomic and overall health impact is to be adequately researched. Depressive disorders are considered an important correlate, for appropriate management of chronic disease but have been given relatively less importance. Hence, this study was taken up in an urban slum of Bengaluru city to explore the associations between depressive disorders and chronic diseases.Methodology: The cross-sectional community-based study was conducted in an urban slum of Bengaluru city using a modified cluster sampling technique. All persons who were ill or on long-term medication or were hospitalized for a period more than 3 weeks in the past 1 year were interviewed. A semi-structured pre-tested questionnaire incorporating Hamilton Depression Rating Scale was used. Results: He overall prevalence of chronic illness was 10% among the study population with 10.9% having mild depression, and 1.2% having mild-moderate depression, and none severe depression. None of them were taking any treatment for their depression. The mean age of those with mild depression was 53.9 years and was greater among females (males 5.0% and females 16.7%). The latter was highly statistically significant. Of the 91 persons with symptoms of mild depression, nearly two-thirds (58.2%) belonged to Class IV of Modified B G. Prasad’s classification. Factor analysis showed that HAM-D scores to have a significant relation with chronic illness. Discussion: Depressive disorders among those with chronic disorders are hitherto unrecognized in routine clinical practice. Middle ages, females and those lower down in the socioeconomic hierarchy are at greater risk. There is a need to establish a mechanism for appropriate management of these disorders.

Morbidities of Employees in a Biscuit Factory of Bengaluru City

The employees working in biscuit factories are exposed to various factors such as noise, heat, odor, flour dust, sugar dust, biscuit dust. At the individual level, flour induced rhinitis and asthma are frequently severe enough to cause considerable inconvenience, discomfort, and even abandonment of the trade. Methods: A cross-sectional study involving all the employees working at a biscuit manufacturing factory of Bengaluru city, was conducted from January to March 2015 after obtaining informed consent from each one of them. Medical pro forma form 16 as per factories act was used to assess the health status of the study population. The data were entered and compiled in Microsoft Excel sheet. Analysis was done using SPSS software version 20.0. Results: It was observed that 6.7% of the study population had hypertension, 5.7% of them were found to have skin problems , 6.5% had decreased visual acuity and 4% of the workers showed symptoms of respiratory morbidity. Discussion: A strong health surveillance system has to be devised for regular monitoring of the employees’ health and facilitate early detection of various morbidities.

Commentory on “Live, Orally given Poliovirus Vaccine - Effects of Rapid Mass Immunization In Population Under Conditions of Massive Enteric Infection with other Viruses".

The following is a commentary on the article “Sabin AB, Ramos-Alvarez M, Alvarez-Amezquita J, Pelon W, Michaels RH, Spigland I, et al. Live, orally given poliovirus vaccine: effects of rapid mass immuniza-tion on population under conditions of massive enteric infection with other viruses. Jama. 1960;173(14):1521-6.” Abstract (of the original article): The phenomenon of viral interference must be taken into account in planning the use of live poliovirus vac-cine in areas where conditions favor the extensive dissemination of naturally occurring polioviruses. Expe-rience with feeding a trivalent vaccine to 26,033 children in a tropical city of 100, 000 population led to the conclusion that interference was overcome by mass feeding of vaccine to 86% of all children under 11 years within a period of about four days, and that, because dissemination of the poliovirus was self-limited, a second feeding of trivalent vaccine was necessary to achieve immunization of almost all children. Recom-mendations are here formulated for the eradication of poliomyelitis, but they apply only to subtropical and tropical regions with extensive dissemination of various enteric viruses and not to temperate zones with good sanitation and hygiene during certain periods of the year and under conditions of low or absent dis-semination of enteric viruses.

Commentory on “LIVE, ORALLY GIVEN POLIOVIRUS VACCINE - EFFECTS OF RAPID MASS IMMUNIZATION IN POPULATION UNDER CONDITIONS OF MASSIVE ENTERIC INFECTION WITH OTHER VIRUSES.

The following is a commentary on the article “Sabin AB, Ramos-Alvarez M, Alvarez-Amezquita J, Pelon W, Michaels RH, Spigland I, et al. Live, orally given poliovirus vaccine: effects of rapid mass immunization on population under conditions of massive enteric infection with other viruses. Jama. 1960;173(14):1521-6.” Abstract (of the original article): The phenomenon of viral interference must be taken into account in planning the use of live poliovirus vaccine in areas where conditions favor the extensive dissemination of naturally occurring polioviruses. Experience with feeding a trivalent vaccine to 26,033 children in a tropical city of 100, 000 population led to the conclusion that interference was overcome by mass feeding of vaccine to 86% of all children under 11 years within a period of about four days, and that, because dissemination of the poliovirus was self-limited, a second feeding of trivalent vaccine was necessary to achieve immunization of almost all children. Recom-mendations are here formulated for the eradication of poliomyelitis, but they apply only to subtropical and tropical regions with extensive dissemination of various enteric viruses and not to temperate zones with good sanitation and hygiene during certain periods of the year and under conditions of low or absent dis-semination of enteric viruses.

Self-rated health as a measure of health status among people with chronic illness in an Urban area of South India.

Background: Rising burden of chronic illnesses across the globe necessitates the assessment of needs of persons suffering from these illnesses. Self-rated health has been found to be a valid and reliable tool in population health surveys. Material and methods: A cross-sectional study using modified cluster sampling technique was undertaken in the urban field practice area of M S Ramaiah Medical College, Bangalore. A semi-structured pre-tested questionnaire was used for data collection, which was done by interview method through house-house visits. Self- rated health was assessed using a 5-point scale ranging from Very Good -Good –Fair- Poor- Very poor. This rating was crosschecked by an assessment by the investigator. Descriptive statistics and factor analysis were used for the purpose of analysis of data and weighted kappa statistic was used to test agreement between self-rated health and health assessed by investigator. Results and Conclusions: Overall prevalence of chronic illness in the study population was 10.0% and significant difference was observed between males and females. In the study population, 72.0% (293) rated their health as fair. 13.0% rated their health as poor while the investigator assessed the health status of the study pop-ulation as fair in 72.0% of the study population and as poor in 4.9% of the study population. Weighted Kappa statistic showed 33% agreement between the two ratings. Factor analysis of 32 variables included in the study explained 67% of the total variance. Principal component analysis of these factors yielded 12 factors of which 3 were considered major depending on the number of variables included and percentage variance explained by that factor. Major factor 1 contained 11 variables including self-rated health and explained 14.3% of the variance, which signifies the role of self-rated health as a measure of health status.