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Background Data comparing outcomes in heart failure ( HF ) across Asia are limited. We examined regional variation in mortality among patients with HF enrolled in the ASIAN ‐HF (Asian Sudden Cardiac Death in Heart Failure) registry with separate analyses for those with reduced ejection fraction ( EF ; <40%) versus preserved EF (≥50%). Methods and Results The ASIAN ‐ HF registry is a prospective longitudinal study. Participants with symptomatic HF were recruited from 46 secondary care centers in 3 Asian regions: South Asia (India), Southeast Asia (Thailand, Malaysia, Philippines, Indonesia, Singapore), and Northeast Asia (South Korea, Japan, Taiwan, Hong Kong, China). Overall, 6480 patients aged >18 years with symptomatic HF were recruited (mean age: 61.6±13.3 years; 27% women; 81% with HF and reduced r EF ). The primary outcome was 1‐year all‐cause mortality. Striking regional variations in baseline characteristics and outcomes were observed. Regardless of HF type, Southeast Asians had the highest burden of comorbidities, particularly diabetes mellitus and chronic kidney disease, despite being younger than Northeast Asian participants. One‐year, crude, all‐cause mortality for the whole population was 9.6%, higher in patients with HF and reduced EF (10.6%) than in those with HF and preserved EF (5.4%). One‐year, all‐cause mortality was significantly higher in Southeast Asian patients (13.0%), compared with South Asian (7.5%) and Northeast Asian patients (7.4%; P <0.001). Well‐known predictors of death accounted for only 44.2% of the variation in risk of mortality. Conclusions This first multinational prospective study shows that the outcomes in Asian patients with both HF and reduced or preserved EF are poor overall and worst in Southeast Asian patients. Region‐specific risk factors and gaps in guideline‐directed therapy should be addressed to potentially improve outcomes. Clinical Trial Registration URL : https://www.clinicaltrials.gov/ . Unique identifier: NCT 01633398.

Introduction: Dual responsibility of women as home maker and mother intensifies stress with respect to childcare and rearing in working mothers leading to lower quality of parent -child relationship, influencing the mental health of parents and children during their developing years. Objective: (1) To determine and compare parenting stress among working and non-working mothers (2) To determine and compare coping strategies adopted by working and non-working mothers to combat parenting stress (3) Assess association of socio-demographic variables with parenting stress between the two groups. Methodology: It is a Cross-sectional study, conducted among working and non-working mothers attending immunization clinic. Data on socio-demographic variables, parenting stress (parenting stress scale) and coping strategies (cope inventory) adopted was obtained through a self-administered, validated questionnaire and analyzed using SPSS V.24. Results: 13% of non-working women and 26% of working women experienced high stress and apart from working status of the mother, there was no significant statistical difference seen between the parenting stress scores with respect to any other socio-demographic variables under consideration. Significant difference was seen with respect to the scores of Religious coping (p = 0.020), Behavioural disengagement (p = 0.003) and Acceptance (p = 0.05) as coping strategies between the working and non-working mothers Conclusions: Significant proportion of working mothers in comparison to non-working mothers had parenting stress, necessitating interventions in the form of promotion of mental health and provision of creche facility at work place.

Tobacco use is one of the biggest public health threats the world has ever faced and leads not only to human loss, but also heavy social and economic costs. It is claiming the lives of nearly 5.4 million people a year worldwide. 1 Burden in South East Asia region is one of the highest among WHO regions. 1 Tobacco is one of the major causes of death and disease in India, accounting for nearly 0.9 million deaths and 12 million people fall ill due to tobacco every year. 2 Nearly 275 million adults (15 years and above) in India (35% of all adults) are users of tobacco, according to the Global Adult Tobacco Survey India, 2009-10. Tobacco use is a major risk factor for many chronic diseases including lung diseases, cardiovascular diseases and stroke. Among other diseases, tobacco use increases risk for lung and oral cavity cancers. 3 Tobacco use accounts for one in six deaths due to non-communicable diseases (NCDs). In India tobacco consumption pushes approximately 150 million people in poverty. 3 India is the second largest consumer and third largest producer of tobacco and a plethora of tobacco products are available at very low prices. Tobacco products are made entirely or partly of leaf tobacco as raw material, ABSTRACT Background: Tobacco use is one of the important preventable causes of death and a leading public health problem all over the world. Tobacco is killing half of the people who use it. Globally, it kills nearly 6 million people. If current trends continue, by 2030 tobacco use is estimated to kill more than 8 million people worldwide each year. Present study carried out to determine prevalence and pattern of tobacco usage among urban slum dwellers. Methods: A cross sectional study conducted in urban slum of the urban health training center area of VIMS & RC, Bengaluru. Among adults aged 18 years and above, sample size of 370 selected by simple random sampling and interviewed by using semi structured questionnaire. Results: Prevalence of current tobacco users is 84.3% of which 28.9% are daily users. The commonest cause for starting tobacco use was due to offering in occasions (31.2%) and for maintenance was addiction (57.4%). Cigarettes (15.1%) and beedis (15.1%) were common smoking forms of tobacco and Betel quid with tobacco (40.3%) and pan masala (28.6%) were most common smokeless forms. Among the subjects 45.7% are exposed to second hand smoke in their homes, 63.2% are aware of health hazards, 95.71% are willing to quit tobacco at some point of time. Conclusions: Prevalence of tobacco use is high in the urban slums and many more are exposed to second hand smoke. Many want to quit tobacco but are unable to get proper assistance.

Background: Health insurance is a rapidly emerging social security instrument for the rural poor, for whom, chronic health problems, arising due to prevalence of diseases and inaccessibility to an affordable health care system is a major threat to their income earning capacity. Insurance is one of the risk management strategies.The need for an insurance system that works on the basic principle of pooling of risks of unexpected costs of persons falling ill and needing hospitalization by charging premium from a wider population base of the same community. There is a need to increase the awareness of health insurance among rural population therefore this study was undertaken. Objective: (1) To study the socioeconomic and demographic characteristics of study population; and (2)to analyze the awareness of health insurance of study population. Materials and Methods: A pretested semi-structured questionnaire was used for collecting data on sociodemographic and economic characteristics of the study population and their awareness of the benefits and purpose of taking health insurance. Study was from October 2015 to December 2015. The data were analyzed using percentages and proportion. A total of 1084 sample houses were visited and among them 399 were interviewed. Result: Of the 399 respondents, 302 (75.7%) of them were aware of health insurance. Among 302 only 202 (66.9%) had procured health insurance. Of these,187(95.5%) had government insurance and 15(7.5%) of them had private health insurance. Awareness of health insurance was associated with socioeconomic status and education (p < 0.05). Conclusion: The determinants of awareness of health insurance were education and socioeconomic status. Though this study shows increased prevalence of awareness of health insurance there is still an alarming need to improve the awareness with regard to their knowledge about health insurance covering the medical expenses in the rural communities.