Assessing the current knowledge, attitude and behaviour of adolescents and young adults living with haemophilia.

INTRODUCTION: There is significant incidence of Haemophilia in India, with second largest number of persons with Haemophilia A. 20,778 patients registered with Haemophilia Foundation of India in 2018. Research in India includes diagnostic studies, complications and co-morbidities, prenatal diagnosis, inhibitor development and gene therapy. Limited is known about quality of life of these patients. Since Haemophilia leads to the loss of 'normal lifestyle' in young people resulting in emotional distress and depression, it is important to analyse Knowledge, Attitude and Behaviour of persons with Haemophilia. AIM: The aim of the study is to focus on exploring the status of Haemophilia and knowledge, attitude, behaviour of adolescents and youths with haemophilia with the objectives to study 1) the current medical status of haemophilia amongst target population; 2) the knowledge, attitude and behaviour of patients with haemophilia towards their condition. METHODS: Respondents in the age group of 15-30 years, who were registered with the Hemophilia Treatment Centers of Government Hospitals/Hemophilia Societies, were interviewed. Data were collected using a structured questionnaire. The study was conducted in two different states and with respondents of two different age groups. FINDINGS: Most respondents suffered from severe haemophilia and co-morbidities such as anxiety, stress, chronic pain and head-ache. All of them felt that haemophilia interferes in leading a normal life and perceive a grim future. CONCLUSION: Young people in India need technical, financial and psychological support to prevent complications related to haemophilia. While most of them take responsibility for their health, more behavioural changes need to be inducted to improve quality of life.

Ultrabrief Electroconvulsive Therapy for Manic Episodes of Bipolar Disorder.

Right unilateral ultrabrief-pulse electroconvulsive therapy (RUL-UB ECT) is gaining popularity and is being used for the treatment of severe major depression. Though brief pulse-width ECT has shown to have robust antimanic effects, the efficacy of UB ECT for mania has not been studied, and there are very few reports on its use in mania. A brief case series of 3 patients with manic episode of bipolar disorder who were treated with RUL-UB ECT is presented here. The successful treatment of 2 patients in this report suggests that some manic episodes can be rapidly and effectively treated with RUL-UB ECT.

Quality differentials and reproductive health service utilisation determinants in India.

PURPOSE: This paper seeks to establish relationships between women's reproductive health service use, assessed longitudinally and by facility type, with service quality perceptions related to public or private health facilities. DESIGN/METHODOLOGY/APPROACH: The study was mainly secondary and quantitative in nature. It included analysing data collected by the International Institute for Population Sciences (IIPS) and The Johns Hopkins University (JHU) as a follow-up study to the 1998-1999 National Family Health Survey (NFHS-2). The follow-up survey was carried out in Tamil Nadu, Maharashtra, Bihar and Jharkhand. In 2002-2003, these four states were selected to capture socio-economic and demographic variations. Analysis includes composite indices and logistic regression analysis. A scale was constructed to measure utilisation levels. Dimensions include: service proximity, doctor availability, waiting time, medicines, facility cleanliness, dignified treatment, privacy, service affordability and treatment effectiveness. FINDINGS: Findings indicate that doctor availability, waiting time, cleanliness, privacy and affordability at private health facilities enhance the probability that a health facility will be used for any reproductive health purpose. At the combined states level, medicine availability and treatment effectiveness at public health facilities enhances service use. RESEARCH LIMITATIONS/IMPLICATIONS: The major limitation is that the study includes only selected Indian states. PRACTICAL IMPLICATIONS: The findings may enhance Indian service-quality policy. ORIGINALITY/VALUE: The paper's main contribution is that seemingly for the first time in India, healthcare service use has been measured longitudinally and then explained through service quality variables by comparing public and private health facilities.

Cognition related to domestic violence in India: implications for reproductive health programme.

In India, the nature of interdependency between wife and husband is regarded as different from what it is in the west. It is observed that in Indian state of Bihar, there is co-existence of memory of domestic violence and attitudinal justification of domestic violence on all the dimensions of domestic violence. However, In Tamil Nadu, demographic transition is likely to create the differentiation and therefore significant co-existence of certain forms of attitude (attitudinal justification of beating for household chores, contraceptives, and sex refusal) and 'memories related to domestic violence' are not present there. Attitudinal assertion against domestic violence in the name of 'unfaithfulness' seems to be helping women both in Bihar & Tamil Nadu. However, in Tamil Nadu, if women raise her voice against beating by husband for sex refusal; her chance of facing domestic violence gets increased here. These kind of connect between violence and attitude is not present in Bihar. In Bihar, attitudinally if women assert their voice against violence for contraceptive decision making; it makes them to feel lesser amount of constant strain. The study shows the implications for reproductive health programme in India.