Neuropsychiatric disorders in Rural and Urban areas of district Dehradun

Background: Neuropsychiatric disorders are quite prevalent in the community and are on the rise due to changing lifestyles and lack of social support. Most of the published data is from hospital, which calls for more community-based studies to measure the actual burden of this menace. Aim & Objective: To estimate the prevalence of neuropsychiatric disorders in district Dehradun and to find out association of socio-demographic correlates with neuropsychiatric disorders Settings and Design: This community based cross-sectional survey was conducted in selected rural and urban areas of district Dehradun. Methods and Material: Study areas and households were selected by multistage stratified and systematic random samplings respectively. Participants were chosen from the selected households by Kish method. Respondents were screened for neuropsychiatric disorders by using MINI-6. Statistical analysis used: data was entered in SPSS 20.0 version and analysed by using percentages, chi-square test and logistic regression. Results: About one fifth of the respondents had a lifetime diagnosis of at least one neuropsychiatric disorder. Age, male gender, higher education, joint family and upper socio-economic status were found to be significantly associated with neuropsychiatric disorders. Conclusions: Factors determining psychological wellbeing are deeply rooted in socio-demographic environment and individual characteristics. Many of the respondents had one or more lifetime neuropsychiatric disorder and most of them were not diagnosed. More community-based research is required to determine the exact magnitude and responsible factors of neuropsychiatric disorders, so that a focused strategy may be developed to address its preventable aspect

Study of epidemiology of road traffic accidents

Background: Road traffic accidents (RTAs) have emerged as an important public health issue which needs to be tackled by a multi-disciplinary approach. The trend in RTA injuries and death is becoming alarming in countries like India. The number of fatal and disabling road accident happening is increasing day by day and it is a real public health challenge for all the concerned agencies to prevent it. This article is intended to create awareness among the health professionals about the various modalities available to prevent road accidents and also to inculcate a sense of responsibility towards spreading the message of road safety. Materials and methods: This was a prospective study of 230 patients between April 2016 to December 2017 reporting at General surgery, Orthopedics and Neurosurgery Department in Government Doon Medical College, Dehradun. Both indoor and OPD patients were included in this study. Data was gathered using a self-administered questionnaire with closed ended questions being addressed to the participants. Results: Total of 230 accident victims was included in this study. Among them, 195 (85%) were males and 35 (15%) were female. Out of 230 respondents, 180 (78.26%) were involved in the accidents on normal working days, 30 (13.04%) of the accidents occurred during weekends and 4 (8.70%) on public holidays, Speeding 50 (21.74%) was one of the most significant personal factor associated with RTAs. Alcohol intoxication 35(15.22%), reckless driving 45 (19.57%) and tiredness of the driver 30 (13.04%) are the important personal factors associated with RTAs. Mohit Goyal, Dhananjay Dobhal, Ashutosh Sayana, Salyl Dobhal, Aditya Goyal. Study of epidemiology of road traffic accidents. IAIM, 2018; 5(4): 23-28. Page 24 Conclusion: Most countries have a multidisciplinary approach to traffic planning and road design. It is done by psychologists, engineers, doctors, sociologists, vehicle experts, etc., in India; road traffic is still a civil engineering issue. Lessons can be learnt from the eminent guidelines and good practices for good behavior on the roads practiced in developed countries where safety, orderliness, and discipline are ingrained in the citizens, come what may. Mere celebration of the annual Road Safety Week during the first week of January does not serve any purpose. Drivers should learn to show consideration and respect to co-vehicle drivers and pedestrians so that our roads become safer.

Clinical Profile of Vivax Malaria among Children in a Tertiary Care Hospital.

Malaria is endemic in India. Vivax malaria has been traditionally described as benign tertian malaria but recent reports from many centers have revealed that it can cause life threatening disease as seen in case of falciparum malaria.There is paucity of data on this topic from this region. Objective: The present study is aimed to find out the clinical features, complications, response to treatment and outcome of patients suffering from vivax malaria in children. The study has also tried to focus on the severe illnesses associated with P. vivax infection. Material and Methods: The study was performed at a tertiary care hospital of Uttrakhand. The study period was of two years, from August 2011 to July 2013. Patients of 18 years of age or below it who were smear positive or antigen positive were included in the study. All such patients who were admitted in the hospital underwent detailed investigation. The data analysed to find out their clinical profile, laboratory manifestations and outcome. Result: 72 patients were identified as suffering from plasmodium vivax malaria. Splenomegaly, hepatomegaly, hepatosplenomegaly, were common findings. Renal, hepatic and cerebral dysfunctions were noted, severe malaria was observed in 28(38.9%). Thrombocytopenia was the commonest hematological abnormality. 5(6.9%) patients died. Cerebral malaria, shock and ARDS were associated with high mortality. Conclusion: Vivax malaria, in its severe form, may cause life threatening complications. The clinical profile in such patients is similar to those which have been traditionally described with falciparum malaria.

A comparative study of complications of vivax and falciparum malaria in Dehradun, India.

Background: Traditionally Plasmodium falciparum has been considered to cause severe malaria while Plasmodium vivax is known to cause benign malaria. However many recent studies have shown that Plasmodium vivax is also responsible for many cases of severe malaria. There is scarcity of data on this topic from this region. The present study was conducted to find out clinical and pathological manifestations of vivax and falciparum malaria in Dehradun. Methods: The study period was of one and half years, from January 2012 to June 2013. Patients of 18 years of age or above it who were smear positive or antigen positive were included in the study. Results: one hundred and thirty nine patients were found to be suffering from malaria. 90 (64.7%) had vivax malaria, while 49 (35.3%) patients suffered from falciparum. The study of morbidity profile showed that the complications related to severity, earlier attributed to only falciparum is equally seen in vivax case. Low platelet count was the commonest finding in both groups. Other complications seen in both groups were those of severe anemia, cerebral malaria, ARDS, renal failure, hepatitis, leucocytopenia, pancytopenia, and shock. Mortality in the two groups was of the same order. Conclusions: Vivax malaria causes significant mortality and morbidity. The morbidity and patterns are almost similar in both vivax and falciparum malaria.