Introduction
Suicide is the act of deliberately killing oneself. It is a leading cause of mortality worldwide. Each year, more than seven lakh people end their lives globally. India is the worst-affected country in Southeast Asia. Both the genders and all age groups are affected. The COVID pandemic has led to the disruption of routine life and business. The proportion of deaths due to suicide was 9.4% among all deaths reported for autopsies by a study in the same mortuary over a seven-year period. Increased stress and anxiety have been postulated to lead to suicide. Our study objective is to describe the epidemiology of suicide during the early COVID pandemic (lockdown period).
Methods
This is a record-based cross-sectional study. We have analyzed the post-mortem reports for six months starting from April 1, 2020. Descriptive analysis was performed with Epi Info version 7 (Centers for Disease Control and Prevention, CDC, Atlanta, GA, USA).
Results
During the study period, 340 cases were classified as deaths due to suicide, out of a total of 891 mortalities. The median age for females was 26.5 and for males, it was 30. The male to female ratio was 1.8:1. Most of the deceased (39.8%) were in their third decade, followed by the fourth decade (18.9%), second decade (15%), and fifth decade (12.98%), respectively. Poisoning was the leading method used for suicide, accounting for 238 (70.1%) deaths, followed by hanging (11.8%), burns (6.8%), jumping from a height (6.5%), and jumping in front of the train (4.13%). Self-immolation (burning) was a common mode of suicide for females. Most of the suicides (71.4%) took place from the evening to midnight.
Conclusion
There was a fourfold rise in suicides during the period compared to previous data. Productive age groups are affected more. A large-scale multi-centric study in community settings for estimation of the true burden is the need of the hour. A multi-sectorial public health approach is needed to prevent untimely death due to suicide.
One of the problems among Women of Reproductive Age (WRA) group has been lack of effective programs whose benefits are not reaching WRA group. Another problem is the prevalence of monotonous diet based on starchy staple food, which lacks essential micronutrients and contribute to the burden of malnutrition and micronutrient deficiency. The objectives of the study was to assess household dietary diversity and nutritional status of non-pregnant non-lactating women of reproductive age in urban field practice area in Burla as a way of comparing food security situation. It was a cross sectional study. Data were collected from urban field practice area in Burla and were analysed to assess the dietary diversity among “women of reproductive age (WRA)” group. One third (about 29%) of them was malnourished. On application of logistic regression, those aged ≥25years had better odds of having Minimum Dietary Diversity (MDD) score of 5 and above (OR=1.777). Subjects with BMI range ≥21.5 Kg/mt2 also had better odds of having MDD score of 5 and above (OR=3.371). Women of reproductive age are nutritionally more vulnerable because of pregnancy, lactation and menstruation requiring nutrient dense quality food. Monotonous diet based on starchy staple lacks essential micronutrients and contribute to the burden of malnutrition and micronutrient deficiency. Intake of diverse diet is a cost effective strategy to overcome this problem. From our survey we conclude that more than half of WRA failed to achieve MDD. Based on findings, Information Education and Communication (IEC) activities are recommended with an emphasis on locally available, low-cost nutrition diet.
Keywords: Minimum Dietary Diversity, Women of Reproductive Age, Micronutrients
BACKGROUND Maternal near miss is higher in developing countries and causes are similar to those of maternal mortality namely haemorrhage, hypertensive disorders and sepsis. Objectives-1. To estimate the burden of maternal near miss in O and G Dept. of VIMSAR, Burla in terms of proportion and near miss indicators. 2. To assess the foetal outcome of patients with maternal near miss. MATERIALS AND METHODS It was a record-based cross-sectional study conducted in the Department of O and G, VIMSAR, Burla from July 2017-Dec 2017. Cases were defined based on WHO criteria. Relevant data was collected from case records of maternal near miss patients. RESULTS Out of 1406 deliveries, near miss cases were 89. Total live births during the study period were 1349 and there were 8 maternal deaths. Maternal mortality ratio was 593/ 100,000 live births. Maternal near miss incidence ratio was 65.95 and Mortality index was 8.2. Preeclampsia was the leading cause (40.4%) of morbidity of near miss cases followed by severe anaemia (29.2%) and eclampsia (19.1%). CONCLUSION Near miss approach helps to evaluate and improve the quality of care provided by health system by identifying the pattern of severe maternal morbidity and mortality, strengths and weaknesses in the referral system and the way in which improvement can be made.
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