Frequency of Psychiatric Disorders in Suicide Attempters: A Cross-Sectional Study from Low-Income Country

Background: The burden of Diabetes in South Asia is alarming as the prevalence is higher compared to other region, living cost is low after Sub Saharan Africa and health care system are in state of expanding to be more accessible and adequate. Objectives: The objective of the study was to assess the direct cost of illness among diabetic patient regularly visiting at outpatient department (OPD) in BPKIHS. Methods: This was a cross sectional study done in year 2018. 142 patients with at least nine visit per year were enrolled. The direct cost were calculated from the pattern of prescription of medications and laboratory investigations carried out over a year of the individual patient. The data were tabulated and analyzed. Results: Among the 142 patients on 37.5% were in mono-therapy and 62.5% were in poly-therapy. The direct cost of illness was USD 103 per annum that includes drug and investigation cost expensed at OPD visit. The average indirect cost was USD 102 per annum including travel and food. Among 142 patient the cost of illness on inpatient due to DM was USD 85.47 per event. Conclusion: The financial burden of being a diabetic in Nepal is high. Comprehensive quality care by expansion of health system and service with nominal charges to patient seems to be one of the challenges in Nepal.

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Factors influencing depression in individuals with traumatic spinal cord injury and caregivers’ perceived burden in a low-income country: a cross-sectional study

Spinal Cord ◽

10.1038/s41393-020-0451-5 ◽

2020 ◽

Vol 58 (10) ◽

pp. 1112-1118

Author(s):

Shambhu P. Adhikari ◽

Geetu Gurung ◽

Barsha Khadka ◽

Chanda Rana

Keyword(s):

Spinal Cord ◽

Low Income ◽

Cross Sectional Study ◽

Traumatic Spinal Cord Injury ◽

Sectional Study ◽

Cross Sectional ◽

Low Income Country ◽

Factors Influencing ◽

Perceived Burden ◽

Cord Injury

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Screening of Biochemical Abnormalities in Suicide Attempters Irrespective of Psychiatric Diagnosis: A Cross-sectional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/45810.14933 ◽

2021 ◽

Author(s):

Ashwini Kamble ◽

Vishwak Reddy Vatte ◽

Bheemathati Ranga Rao ◽

Sourya Reddy ◽

C Pradyumna ◽

...

Keyword(s):

Psychiatric Disorders ◽

Psychiatric Diagnosis ◽

Cross Sectional Study ◽

Sectional Study ◽

Serum Electrolytes ◽

Cross Sectional ◽

Suicide Attempters ◽

Complete Blood Counts ◽

Low Cholesterol ◽

Biochemical Abnormalities

Introduction: Empirical studies have documented the impact of membrane cholesterol on serotonergic function which might influence the suicidality in various psychiatric disorders. Most studies in last two decades demonstrated low cholesterol as potential predictor of suicidality in depression but trends of metabolic disorders and current status of hypercholesterolemia and biochemical abnormalities in suicidal spectrum population is scarce. Aim: The present study was aimed to comprehensively evaluate the blood levels of cholesterol and other biochemical abnormalities (serum electrolytes, proteins, blood pH etc.,) irrespective of any psychiatric disorders in suicide attempters. Materials and Methods: A cross-sectional study was conducted on a total of 202 patients who visited our emergency hospital services with the suicidal attempt from 1st January 2019 till 31st December 2019 for a period of 12 Months. Blood evaluation and analysis were done on the same day of hospitalisation for complete blood counts, serum electrolytes, proteins and cholesterol levels. Clinical and standardised psychological evaluations for psychiatric diagnosis were performed. The results were analysed and compared using descriptive and inferential statistics based on SPSS software 21.01. Results: Out of 202 total suicide attempters, 120 (59.4%) were males and 82 (40.6%) were females with most patients 111 (54.9%) falling in the age range of 20-29; while 175 (86.6%) of patients had their first ever suicide or deliberate harm. A total of 169 (83.7%) of patients had normal complete blood counts but 106 (52.5%) showed acidic pH (<7.3) while only 5 (2.5%) of the patients had alkalosis. Serum potassium was abnormal in 43 (21.3%) patients. Further serum chloride was deranged in 13(6.4%) while serum albumin was deranged in 17 (8.4%). About 27 (13.4%) found to have increased serum cholesterol and none of them had low cholesterol. Conclusion: Excessive and dampened reactivity of biomolecular parameters including hypercholesterolemia may modulate the neurobiological stress system associated with increased suicidality. This may be one of the predictors irrespective of the underlying psychiatric disorders.

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Representative estimates of COVID-19 infection fatality rates from four locations in India: cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2021-050920 ◽

2021 ◽

Vol 11 (10) ◽

pp. e050920

Author(s):

Rebecca Cai ◽

Paul Novosad ◽

Vaidehi Tandel ◽

Sam Asher ◽

Anup Malani

Keyword(s):

Low Income ◽

Tamil Nadu ◽

Large Population ◽

Cross Sectional Study ◽

High Income ◽

Income Country ◽

Secondary Outcome ◽

Sectional Study ◽

Cross Sectional ◽

Increased Risk

ObjectivesTo estimate age-specific and sex-specific mortality risk among all SARS-CoV-2 infections in four settings in India, a major lower-middle-income country and to compare age trends in mortality with similar estimates in high-income countries.DesignCross-sectional study.SettingIndia, multiple regions representing combined population >150 million.ParticipantsAggregate infection counts were drawn from four large population-representative prevalence/seroprevalence surveys. Data on corresponding number of deaths were drawn from official government reports of confirmed SARS-CoV-2 deaths.Primary and secondary outcome measuresThe primary outcome was age-specific and sex-specific infection fatality rate (IFR), estimated as the number of confirmed deaths per infection. The secondary outcome was the slope of the IFR-by-age function, representing increased risk associated with age.ResultsAmong males aged 50–89, measured IFR was 0.12% in Karnataka (95% CI 0.09% to 0.15%), 0.42% in Tamil Nadu (95% CI 0.39% to 0.45%), 0.53% in Mumbai (95% CI 0.52% to 0.54%) and an imprecise 5.64% (95% CI 0% to 11.16%) among migrants returning to Bihar. Estimated IFR was approximately twice as high for males as for females, heterogeneous across contexts and rose less dramatically at older ages compared with similar studies in high-income countries.ConclusionsEstimated age-specific IFRs during the first wave varied substantially across India. While estimated IFRs in Mumbai, Karnataka and Tamil Nadu were considerably lower than comparable estimates from high-income countries, adjustment for under-reporting based on crude estimates of excess mortality puts them almost exactly equal with higher-income country benchmarks. In a marginalised migrant population, estimated IFRs were much higher than in other contexts around the world. Estimated IFRs suggest that the elderly in India are at an advantage relative to peers in high-income countries. Our findings suggest that the standard estimation approach may substantially underestimate IFR in low-income settings due to under-reporting of COVID-19 deaths, and that COVID-19 IFRs may be similar in low-income and high-income settings.

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