Birth defects in India: Hidden truth, need for urgent attention.

Birth defects (structural, functional and metabolic disorder present from birth, may be diagnosed later) rising up as an important cause of infant mortality even in developing countries where infant mortality has been reduced to much extent. Seventy percent of birth defects are preventable through the application of various cost effective community genetic services. Indian people are living in the midst of risk factors for birth defects, e.g., universality of marriage, high fertility, large number of unplanned pregnancies, poor coverage of antenatal care, poor maternal nutritional status, high consanguineous marriages rate, and high carrier rate for hemoglobinopathies. India being the second most populous country with a large number infant born annually with birth defects should focus its attention on strategies for control of birth defects. Many population based strategies such as iodization, double fortification of salt, flour fortification with multivitamins, folic acid supplementation, periconceptional care, carrier screening and prenatal screening are some of proven strategies for control of birth defects. Strategies such as iodization of salt in spite of being initiated for a long time in the past do have a very little impact on its consumption (only 50% were using iodized salt). Community genetic services for control of birth defects can be easily flourished and integrated with primary health care in India because of its well established infrastructure and personnel in the field of maternal and child health care. As there is wide variation for infant mortality rate (IMR) in different states in India, so there is a need of deferential approach to implement community genetic services in states those had already achieved national goal of IMR. On the other hand, states those have not achieved the national goal on IMR priority should be given to management of other causes of infant mortality.

Depression Among the Elderly Population in a Rural Community : A Study of its Prevalence and Correlates.

Background: The next few decades are expected to see an unprecedented increase in the number of older people needing mental health interventions in India. The elders living in rural areas represent a special risk group. Objective: To assess the magnitude of depression and its significant sociodemographic correlates among elderly. Setting: Rural community of Delhi, India. Participants: Elderly aged above fifty years, selected by cluster sampling. Tool: Geriatric Depression Scale (GDS). Statistical Analysis: Proportions, Chi square test. Results: Mean age of the sample population was 61.7 ± 8.2 years and included 58% females. It was found that 45 (35.7%) of the subjects had a score suggestive of depression. Poor sleep at night and tension at home, poor perception of own health, not receiving any financial support in the form of pension for self or spouse and poor nutritional indicators were found to be associated with depression. Depression was less common among those who had a positive approach, including doing some exercise daily (p=0.03) and doing yoga daily (p=0.026). Conclusion: The present study found a significant proportion of the rural elderly population to having depressive symptoms and several important risk factors were found to be associated with depression. Identification of these risk factors among the elderly population at higher risk for depression can help to plan for better care of the elderly.

Doing meta-analysis in research: A systematic approach.

Meta-analysis is an objective, systematic review that employs statistical methods to combine and summarize the results of several studies. It is a quantitative synthesis of all the unbiased evidence, meant for summarizing large volume of data, establishing and determining the magnitude of an effect, and to increase power and precision of studies. The steps to performing a meta-analysis include making a hypothesis and defining the domain of research, defining inclusion/exclusion criteria, literature search, selecting the final set of studies, extracting data on variables of interest, coding procedures, calculating effect sizes and interpretations, selecting potential moderators and examine their relationships, report writing, and critical evaluation. Meta-analysis has several strengths as well as weaknesses.