RESUMO
Background: Substance abuse disorder is among the leading public health problems in modern day world as they cause enormous human suffering in terms of morbidity, mortality and economic loss; and threatens the very social fabric of almost all communities around the world and as such is a great threat to the global health, economy and peace. Like most social behaviours the etiology of substance abuse is complex, varying through time, geographical regions and by demographic characteristics. Among young people, students are the most vulnerable group as the initiation into substance abuse first starts during this period. Aims & Objective: To find out the prevalence and pattern of substance abuse and its association with various sociocultural and demographic variables. Material and Methods: Multi-stage random sampling method was adopted to select the study subjects. The study subjects were asked about the substance abuse and related socio-demographic variables by means of WHO model core questionnaire format and results were subjected to statistical analysis. Results: The overall life-time prevalence of for substance abuse among college students was found to be 31.3%. Male students had significantly higher prevalence of substance abuse as compared to female counterparts(37.5% versus 19.6% respectively).The most common substance being abused was Tobacco products(22.5%) followed by solvents (10.0%), alcohol (6.2%), sedatives (5.9%), cannabis (4.4%), amphetamine products (2.1%), hallucinogens (0.5%) and cocaine (0.3%). Age, gender and family type were found to be strongly associated with substance abuse (p<0.001). Conclusion: Prevalence of substance abuse among college students is high and causes significant problems in this population; therefore there is necessity of targeted interventions to reduce this huge burden.
RESUMO
Late onset sepsis [LOS] [onset of sepsis >72 hours of age or nosocomial sepsis] is an important cause of morbidity and mortality in the neonatal intensive care unit [NICU]. Thrombocytopenia is an important complication of sepsis. We investigated the incidence of thrombocytopenia in LOS patients and studied the influence of various parameters on platelet response. Infants born in the level 3 neonatal intensive care unit between January 2002 and December 2006 with documented LOS were included in this prospective study. Multiple hemograms with platelet counts, bacterial blood culture and fungal blood culture were obtained in all patients. Demographic and clinical data were compared between patients without thrombocytopenia and with mild, moderate and severe thrombocytopenia. Duration of thrombocytopenia in relation to type of organism and mortality with respect to degree of thrombocytopenia were also studied. Of 200 patients with culture-proven nosocomial sepsis, 119 [59.5%] patients developed thrombocytopenia [platelet count <150x10[9]/L]. In our series Klebsiella pneumoniae was the most frequently isolated organism [125/200, 62.5%] and the incidence of thrombocytopenia was 60.0% [75/125]. However, the incidence of thrombocytopenia was highest among patients who had concurrent bacterial and fungal sepsis [28/31, 90.3%] Coagulasenegative staphylococcal [CoNS] sepsis was present in 21 [10.5%] patients and the incidence of thrombocytopenia was 33.3%. Isolated fungal sepsis was present only in 6 [3%] patients and the incidence of thrombocytopenia was 66.0%. The incidence of thrombocytopenia was highest among preterm babies and low-birth weight [LBW] babies. Twenty-seven percent [54/200] of babies presented with mild thrombocytopenia, 20% [40/200] presented with moderate thrombocytopenia, and 12.5% [25/200] developed severe thrombocytopenia. Severity of thrombocytopenia was also directly related to the presence of necrotizing enterocolitis [NEC] and disseminated intravascular coagulation [DIC]. The mortality rate was significantly associated with the degree of thrombocytopenia. LOS sepsis is an important risk factor for thrombocytopenia in the NICU. Fungal and gram-negative sepsis are frequently associated with a decreased platelet count. Sepsis-induced thrombocytopenia is more common among LBW babies and preterm babies. The mortality rate is significantly related to degree of thrombocytopenia