LetterTo Editor

Editorial

Background and Objective: Loss of appetite (LOA) during illness impacts individual well-being and quality of life. An epidemiological survey was conducted on the prevalence of LOA. Methodology: Multi-centre, non-interventional, cross-sectional, survey of LOA in Indian participants recuperating from various health disorders. Results: A total of 15914 participants were enrolled into the study. Of the 15914 participants enrolled, 63.5% were men and 36.5% were women, with a mean age of 38.5 years and majority of participants (68.7%) had infectious diseases. Of which, 80.3% participants were reported with infections and infestations disorders as the most frequent infectious condition. The prevalence of LOA was 93.1% (95% CI: 92.7%, 93.5%) with 33.8% participants having mild, 47.7% had moderate and 11.6% had severe to very severe LOA problem. The prevalence of fatigue was 91.1% (95% CI, 90.5, 91.4) of which, 44.4% had mild, 36.8% had moderate, and 9.8% had severe to very severe fatigue. LOA and fatigue was highest in participants with infections and infestations (93.8% and 91.7% respectively), with typhoid being the most common cause. The risk of LOA was 1.5 times more in participants with a past history of any medical condition and 1.31 times more in subjects with infectious diseases (p<0.0001). The risk of fatigue was 1.19 times more in participants aged >40 years and 1.27 times more in participants with family history of any medical condition (p<0.0001). Conclusions: The survey observed that about 93% and 91.1% of Indian participants with various health conditions suffered from LOA and fatigue respectively. Infectious disease especially typhoid was the commonest cause of LOA and fatigue. This is the first study documenting the extent of the problem in pan-Indian participants.

Aim: : To evaluate the causes of increased incidence of strokes in winter as compared to summer in the city of Kolkata, India Protocol: 25 hypertensive middle aged patients, attending the Medical OPD were selected randomly for the study. Keeping there blood pressure under control with suitable therapy, Arterial BP readings were recorded monthly for 12 consecutive months. ResultsMean Arterial BP (Systolic) of the patients was 134.12 mm.Hg.±1.86 in summer and 149.24 mm. Hg.±2.17 in winter. The Mean Arterial Blood Pressure (Diastolic) was 83.40 mm. Hg.±0.88 in summer and 88.76 mm. Hg.±1.10 in winter. Both the differences were statistically significant. Overweight patients (BMI>25) showed almost similar seasonal variation in BP when compared with the standard weight patients (BMI up to 25) Conclusion: Blood Pressure level is greatly influenced by the environmental temperature generally irrespective of the body weight. This fact should be considered in the management of hypertensive patients in a long follow up period.

Introduction: Diarrhea Alleviation through Zinc and ORS Therapy (DAZT) project was started in six demonstration districts of Gujarat in 2011. The aims of the research were to understand prescription practices for childhood diarrhea, assess knowledge and practice about zinc therapy among health care providers in the government/private sectors and among caretakers. Methodology:It was a cross-sectional study conducted in six DAZT demonstration districts of Gujarat. Information was collected on structured questionnaires by interviewing 127 care providers & 43 care takers in six districts. In addition, case records were reviewed for 228 prescriptions – all from the government sector. Results: Government functionaries dispensed ORS in 97% & Zinc in 90% cases of diarrhea while, private providers prescribed it in 79% & 71% respectively. Antibiotics were prescribed in 24% & 59%, anti-amoebic in 20.2% & 64.7% in public and private sectors respectively. Knowledge of dosage and duration of zinc therapy was better among public sector providers than private sector ones. Amongst caretakers, 74.4% gave correct dose of zinc to their children but was given for 14 days in 67.4% of cases. Conclusions:For all the parameters studied, responses were better amongst government providers than those from the private sector

Background: Stigma has long been found to be present among caregivers of persons with psychiatric disorders, but there is a lack of studies examining this issue, especially from India. Aims: To measure stigma among caregivers of persons with psychiatric disorders, to correlate stigma with various sociodemographic and clinical variables and to compare stigma among caregivers of persons with psychiatric disorders and substance dependence. Materials & Methods: 202 caregivers of persons with schizophrenia and other psychotic disorders, depression, obsessive compulsive disorder and substance dependence were included. They were assessed on various sociodemographic and clinical variables. Stigma was measured using the stigma scale translated and adapted in Hindi. Results:Caregivers experience higher stigma if the patient or caregiver were less educated. Parents experienced higher stigma than the siblings and spouses. The stigma experiences were highest among caregivers of persons with substance dependence. In addition, stigma experiences among caregivers were higher if the patient was ill for a longer duration, was not in remission or was ever admitted to psychiatry ward. Conclusions:In addition to the burden of caring for the patient, family members face stigma and discrimination in various areas. The psychosocial interventions planned for the family members should deal with these experiences

Beta Thalassemia major is a hereditary disease known long back in areas where malaria is endemic. In India more than 20000 children are born each year with this disease. Though regular blood transfusion is an effective treatment for the disease but has acted as double edged sword. One side it has given long term survival benefit to the patient on the other hand patient also has to face problem of iron overload. To combat this problem we already have a well-known chelating agent –Deferoxamine. Now newer agents are also being used like deferiprone, deferasirox and wheatgrass. Most of the studies for these agents are largely done in India and found satisfactory results. Deferoxamine still remains single most effective chelating agent. Studies on combination therapy are showing better results than any single agent alone.

LetterTo Editor