How Indians Die ?

The Office of the Registrar General and Census Commissioner of India has this week released the results of the 2010-2013 data on causes of death collected from the Sample Registration System. The study used the verbal autopsy tool and was done in the entire SRS area and had recorded 1,82,827 deaths during this period  .  The top 10 causes of death during this period in India and the previous round of study in 2004-06 is shown below  :

(Image copyrighted by ORGI , GoI and used for informational purpose only)

While the top 10 causes overall has remained the same, their relative positions have changed quite a lot (except for Cardiovascular diseases and the ill defined category ).

In terms of age-distributions the commonest cause of deaths are :
1. preterm birth and low birth weight in Infants
2. Pneumonia in the 1- 5 years age group
3. Suicides in the young (15-29 years)
4. Cardiovascular deaths in middle age(30-69 years) and the old.

The report also presents data dis-aggregated into sex (male / female),area of residence (rural /urban) and  states (EAG and non-EAG)

Detailed Report is available here:

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Another reason to not work more !

A systematic review and meta-analyses published yesterday in The Lancet , containing data from more than 25 studies from 24 cohort studies across three continents found that  those who work long hours have a higher risk of stroke as well as coronary heart disease than those working standard hours. The association is stronger for stroke when compared to coronary heart disease but both the associations fulfill many of the criteria’s for causation as per Bradford Hill Criteria- strength, consistency, temporality, dose response, reverse causation and of course plausibility !

However your boss may not trust this results and allow you to go back home at standard hours in case he decides to take into consideration that a large proportion of the unpublished individual-participant data that was used
in this study was from the IPD-Work Consortium which had done on convenience sampling. Read the full paper here (Click: Open Access)


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Cochrane goes Open Access

Cochrane reviews , widely considered as ‘gold standard’ for systematic reviews and used in formulation of evidence based clinical guidelines and policy making has declared that it will follow the Open Access route. As a part of its committment to become open access by 2020 from early 2016 all Cochrane Protocols will become open access and Reviews automatically deposited in PubMed Central after one year embargo.

This is a positive step towards open access on part of the Cochrane. Cochrane Library is freely available in India has the Indian Council of Medical Research has been buying nation-wide licenses , but many poor nations continue still do not have access to the Cochrane Library.

More details here:

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Nobel prize 2015 : drug therapy for River Blindness ,Lymphatic Filariasis & Malaria

The Nobel Prize of Medicine for 2015 was awarded for discovery of Avermectin , used for the treatment of River Blindness and Lymphatic Filiariasis to William C. Campbell and Satoshi Ōmura and to Youyou Tu for the discovery of Artemisinin, which is used for the treatment of Malaria.

Both the drugs are first-line therapies for the respective diseases and have saved millions.

If you fancy reading the Nobel-Prize Winning papers they are here , here and here. The first two papers are open access but the third is in Chinese and not available in public domain.


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Top 5 Public Health India Twitter Persona to Follow 1.0

Here is my pick for the must-follow super smart twitter accounts for those interested about Public Health in India. Not ranked and completely biased but worth checking out . Not following either of these might mean you miss an awful lot . Here it goes :

  • @epigiri    Curates Epi Times – a daily dose of interesting published work in public health globally . Tweets 234px-Twitter_Logo_Mini.svgabout public health issues in India particularly in policy circles .
  • @AnantBhan   The most avid twitter person in the list. Ethics, Health Policy, Latest Public Health Updates and activism. Nothing escapes the eagle eye.
  • @scepticemia  Tweets about anything that catches his fancy- Public Health , Medical History and Humanities, Zoonoses and Emerging Infections. He is the ‘original’ RxStar of the public health blogging microcosm in India.
  • @tribalnevin  Equity, tuberculosis . smoking and health systems are his favorite, but there is more on everything all the time
  • @trished  Strictly should not fill the bill as the tweets do not originate from India. But the list would have been incomplete if I did not mention this. A lot that happens from India (or for that matter most parts of the world) feature in the feed.

Did I miss someone interesting on twitter ? Drop me in comments below so that I can add it in future versions.

P.S You might consider following me too at @DrSoumyadeepB

Image Courtesy : Wikimedia under  Creative Commons CC0 1.0 Universal Public Domain Dedication

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​Primary closure versus delayed or no closure for traumatic wounds due to mammalian bite

Mammalian bite wounds are a very common clinical problem across the world. Systematic reviews have been conducted to address the role of education in preventing dog bite injuries in adolescents and children (Duperrex 2009) and antibiotic prophylaxis for mammalian bites (Medeiros 2001). However local wound management, one of the most important aspects in management of mammalian bites has not been evaluated by systematic reviews. The issue of primary closure versus delayed closure for non-bite traumatic wounds has been studied previously (Eliya-Masamba 2013), but this systematic review did not include mammalian bites. The issue of primary closure of animal bites remains controversial (Garbutt 2004), and a systematic review in this regard will help to make an objective assessment of this important question, and enable evidence-based clinical decision-making and guideline development.

A Cochrane Review on this is being conducted by Dr. Soumyadeep B and his colleagues. The protocol for the same has been published and is available here  (Open Access in India by ICMR grant )

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Health and beyond…strategies for a better India: using the “prison window” to reach disadvantaged groups in primary care

…Politicians, policy makers and the general public in India are prejudiced by the traditional notion that “sinners deserve neither mercy nor money.” Owing to this mind-set policy makers tend to allocate the resources “as per law” rather than “as per needs.” Even this is provided only after significant lobbying by pressure groups like human/prison rights activists. Sadly the media too presents prison health as a human rights issue and not an issue of public health concern. The very fact that almost all prisoners return back to the community makes it imperative to link prison health with the public health system and bring them under the coverage of primary health care. Policy makers as well as the general public need to understand that the prison and the community are at continuum. The much needed overhaul of the prison health system by linking it with public health cannot be achieved without a sustained campaign aimed at changing these dogmas. Historical data from nations which have separate health systems for prisons clearly indicate very poor quality of services. …Read the full article published at Journal of Family Medicine & Primary Care here.(Click: Open Access)

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