Background: Deliberate self-harm (DSH) is a major public health concern. Gender differences in suicide methods are a controversial realm with various regional and cultural variations. This study compared and assessed the methods used in DSH attempters as undertaken by men and women, and investigated the possible role of gender and other clinical variables in the selection of suicide method. Materials and Methods: Two hundred subjects fulfilling the inclusion and exclusion criteria were recruited in the study. The sociodemographic details were recorded in the semi-structured pro forma. Detailed assessment of psychiatric morbidity and DSH was done by clinical interview and validated by Mini International Neuropsychiatric Interview-Plus 5.0 and Beck Suicide Intent Scale. Data were analyzed using SAS version 9.2 and SPSS version 17.0. The sample was disaggregated by gender to compare the known correlates of suicide risk on the two most common methods of suicide – poison consumption and drug overdose using multivariate analyses. Results: The analysis revealed that majority of the attempters were in the age group of 11–40 years (91%). Females (63%) outnumbered males (37%); poisoning was the most common type of method (50.5%), followed by drug overdose (35%). There were no statistical differences between the two genders with respect to other sociodemographic variables. Males from urban/semi-urban background (odds ratio [OR] = 4.059) and females living alone (OR = 5.723) had high odds ratio of attempting suicide by poison consumption. Females from urban/semi-urban background (P = 0.0514) and male subjects from nuclear families had an increased odds ratio (OR = 4.482) to attempt suicide by drug overdose. There were no statistical differences when the two genders were compared for other variables such as intentionality, lethality, impulsivity, and number of attempts. Conclusions: It appears that gender differences among DSH attempters appear less pronounced in the Indian setting compared to the worldwide literature on the subject. Nevertheless, the unique, gender-specific characteristics pertaining to DSH attempters in our population emphasize the need for gender-specific interventions in future clinical treatment.

Introduction: Anxiety disorders are one of the frequently encountered psychiatric disorders in psychiatric clinics which have significant impact on the psychosocial well-being of the patient as well as their caregivers. Study Design and Aims: This study is a non- invasive, cross sectional study of 91 patients with anxiety disorder (except obsessive compulsive disorder) aimed to assess the burden of care on their key-relatives and to study various socio demographic and clinical variables of the patient in relation to burden of care on key-relatives. Methodology: Patients diagnosed with anxiety disorders other than obsessive compulsive disorder and their key relatives satisfying the selection criteria were enrolled in the study. Assessment was done on semi-structured proforma, ICD 10 DCR, SCAN (Schedules for Clinical Assessment in Neuropsychiatry), International Personality Disorder Examination (IPDE), Burden assessment schedule, Hamilton Anxiety Rating Scale (HAM-A). Result: Total adjusted burden score in our study was 40.41 which is suggestive of mild burden. It was found that the burden of care was higher in male gender, married individuals, in joint families, among spouses, urban background, in the age group 41 to 50 years, low income group particularly on farmers and laborers. Generalized anxiety disorder was associated with more burden of care in comparison to other anxiety disorders. Conclusion: Key relatives of patients with anxiety disorder have significant burden of care in different domains along the socio-demographic strata.

Background: Gender differences can be in any stage in the life cycle including before birth (feticide/sex selective abortions) which have been objectively documented. This study tries to identify the gender differentials among the children which is a basic step in cascade process of female discrimination in the society. Objective: To study the gender differentials among children under 6 years in households of rural Ballabgarh, Haryana in terms of nutrition, health care seeking, social aspects and to see whether they differ by socio economic status. Methods: Two hundred households were selected purposively from four villages (50 households each) by multi stage sampling during Mar – June 2010. Pre tested interview schedule was used to assess gender differences in nutrition (breast feeding, 'z' score); in health care seeking and in social aspects (Expenditure on birth related ceremonies and toys and dresses). Differences are measured in means or proportions. Determinants of Gender differentials were identified by logistic regression. Results: Girls were breast fed for five months lesser than boys (P < 0.02). Even though occurrences of common childhood illnesses were equal between the two, expenditures incurred to treat these illnesses were more among the boys (Boys Vs girls: Rs 181.3 Vs Rs 123.9). Proportion of illnesses treated from health facilities located outside the villages was higher among the boys [boys (22.2%), girls (11.4%)]. Expenditures incurred during birth related social ceremonies were higher for boys (Rs 20311 and Rs 2487.5 respectively for boys and girls). Conclusion: In this patriarchal society, socio cultural norms have produced the gender gap which can have adverse impact on health of the female children.

Background and Objective: In spite of newer sensitive screening techniques, blood transfusion is still associated with a small risk of transmitting infectious diseases. A very important and efficient method of curtailing transfusion transmitted infections (TTIs) is notifying and counseling the TTI reactive donors. Materials and Methods: Totally, 4281 donations were screened for TTI, namely, human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis, by serology. All TTI reactive donors were retested and notified of their status by telephone or letter and called for repeat testing followed by face-to-face counseling and referral for treatment. Results: We evaluated 116 (2.7%) donors with reactive screening test results, i.e., 41 (1%) HBV, 61 (1.4%) HCV, 12 (0.3%) HIV, and 2 (0.05%) reactive for both HIV and HCV while none of donors were syphilis reactive. Only 35.34% (41) of donors responded to notification. The response from voluntary donors was comparatively less as compared to the replacement donors (34.6% vs. 41.7%). Around 22 (53.7%) of counseled reactive donors revealed history of high-risk behavior/factors which were not disclosed during donor registration and screening. Conclusion: In spite of strict donor screening and self-exclusion option, donors conceal their high-risk behaviors and continue to donate blood. It reflects the need to implement predonation counseling to extract the history of high-risk factors from the donors. Maintenance of privacy during donor screening, predonation education and counseling and postnotification counseling of reactive donors are recommended. National guidelines for notification of reactive donors need to be formulated.

Background: Chronic periodontitis is an inflammatory disease of the supporting structures of the tooth. One of the important non-oral risk factors for periodontitis is psychosocial stress and depression. Depression affects oral health by affecting the immune system through its effects on hypothalamic pituitary axis system. Periodontal inflammatory surface area (PISA) is a system used to assess inflammatory burden in the periodontal tissue. Aim: The aim of this study is to assess the relationship between PISA and depression. Settings and Design: The design of the study is case-control study. Materials and Methods: The study design is a case-control study with forty patients each in case and control groups. The periodontal inflammatory level was assessed by PISA system and the levels of depression was assessed by using Beck's Depression Inventory (BDI). Statistical Analysis: Student's t-test was used to compare PISA and BDI scores. The BDI score (mean ± standard deviation [SD]) for controls was 12.75 ± 6.82 compared to 22.73 ± 4.40 for the cases. The comparison (t = 7.78) was statistically significant at P < 0.0001. The PISA score (mean ± SD) for controls was 210.47 ± 76.80 compared to the PISA score of 1069.50 ± 204.21 for cases which was statistically significant (t = 24.90; P < 0.0001). Results: Significantly higher BDI scores were observed in patients with chronic periodontitis than healthy controls. Conclusion: This study clearly reveals a significant association between the severity of depression and inflammatory burden.

Background: The belief that jinn can cause mental illness in human through afflictions or possession is widely accepted among Muslims. Belief about jinn in Muslim medical professionals, especially medical doctors has not been studied till date. Aim: To explore the belief among Muslim doctors regarding jinn and psychiatry. Materials and Methods: We conducted a cross-sectional study among Muslim doctors using a study questionnaire. Results: Majority of the participants believed in the existence of jinn and a significant proportion of the sample believed in jinn possessing humans and jinn causing mental illness in humans and recommended treatment by doctor and religious figures together for jinn afflictions. Conclusion: The belief in jinn and jinn causing mental illness are common among Muslims and remain intact even after medical education. It deserves attention from practitioners in the field of mental health care and demand strengthening of liaison between religious leaders and mental health services.

Background: Spirituality is considered one of the determinants of health. Various studies have documented its role in the management of psychological illnesses such as schizophrenia, and anxiety disorders. Doctors often lack skills to do spiritual assessment of the patients. Aim: The current study was conducted among the 1^st year undergraduate medical students to find out their ideas and thoughts about spirituality using self-administered questionnaire. Methodology: This was a college based cross sectional study wherein 168 students were interviewed using semistructured, self administered questionnaire. Ethical clearance was obtained from Institutional ethical committee.Results: Most of the students (93.5%) believed in spirituality, but only about half (49%) of them had complete knowledge about it. Only psychological disorders and chronic diseases were labeled by students who need spirituality as a modality of treatment. Girls linked spirituality with God more than boys. A formal training in spirituality is not essential according to 43% of the subjects. Conclusion: The undergraduates need to understand the importance of this dimension of health. A mere gain in knowledge about spiritual strength available in some of the textbooks would not be able to orient doctors sufficiently to apply it in their practice. Future Direction: Skill building and practicing the culture of spiritual counseling among health workers is the need of hour.

Aim: This study was aimed to investigate the role of internet usage on social behavior of the students. Methods: This cross-sectional descriptive study was conducted among 175 university students. The samples were selected randomly from 333 Arabic students and divided into low (<8 h a week) and high (>8 h a week) internet user groups. The data were collected via social behavior and demographic questionnaires. To analyze the data, t-test was used. Results: The findings indicated that social behavior and subscales, i.e. participation, interpersonal interaction, social positive and negative consequences of students are significantly different in low and high internet user groups (P < 0.05). Conclusion: Internet is the strongest communication tool, which affects all aspects of human life. This technology is also related with social behavioral aspects of students who participated in this study. Therefore, in social studies, the effects of internet usage in people's behavior could be considered as an effective variable.

Introduction: Substance use and dependence has been a part of Indian society for centuries. However, abuse of more hazardous drugs including intravenous use, younger age of initiation, and high prevalence has made it a major public health issue. Community-based interventions for drug/alcohol use are often hindered by a lack of community participation, which is the result of stigma associated with drug/alcohol use and its treatment. We describe our attempt to address this issue of lack of community participation in a particular community of Dhanas, Chandigarh, using an ethnography approach. Methodology: Despite drug/alcohol use being rampant in their community, the leaders of the community (Sarpanch and Medical Officer of Primary Health Centre) not only denied the problem, but also refused to support community outreach team. In the absence of facilitation by community leaders and prevalent stigma, drug/alcohol users from the Dhanas village did not seek treatment even when the treatment was offered close to their homes. Using an ethnography approach, a 6 point questionnaire was developed to investigate the severity of the problem as well as to engage the community leaders in the delivery of community-based treatment. Results: The questionnaire highlighted that key leaders chose to deny existing drug/alcohol problem whereas those who were aware of the problem did not have a say in the decision-making process. The questionnaire facilitated a thorough understanding of the sociocultural and political ethos of the community which in turn helped in chalking out an action plan in this village. Conclusion: With the help of various individuals such as former and current healthcare workers, community leaders, drug users, and their family members, the community outreach team successfully mobilized the community from denial to activism. This was evident in the number of individuals seeking treatment for drug/alcohol use that showed an increasing trend over the months.

Background: Pattern of substance use, profile of substance users, and treatment-seeking differ across cultures and continents. These differences could potentially affect the pattern and perhaps prevalence of dual diagnosis. However, the study of dual diagnosis from de-addiction clinics in India is limited in number and methodology. In this study, we report the prevalence and patterns of psychiatric disorders in subjects attending a de-addiction clinic in a teaching hospital in Srinagar, Kashmir. Methodology: In this cross-sectional study, 300 subjects (>18 years of age) seeking treatment for substance use disorders were screened with Mini International Neuropsychiatric Interview Plus for the presence of psychiatric comorbidity. Subjects were assessed after 4 weeks of complete abstinence from psychoactive substances. Results: Cannabis (26%) was the most common single-use substance. It was followed by polysubstance use (22.3%) and opioids (21.3%). Among the 300 subjects assessed for the purpose of the study, 174 (58%) were found to have dual diagnosis. Psychotic disorders (34%) were the most common psychiatric comorbidity, and it was followed by major depressive disorder (16%) and bipolar affective disorder (16%). Posttraumatic stress disorder (PTSD) was present in 20 (11.5%) subjects. When the groups with or without dual diagnosis were compared, cannabis and benzodiazepine dependence was found to be significantly common in the dual diagnosis group. Conclusions: A high prevalence of dual diagnoses, especially psychotic disorders and also PTSD, in our predominantly cannabis-using subjects attending hospital located in a distinct sociocultural setting in India, highlights the importance of taking into consideration the sociocultural context in which substance use as well as dual diagnoses should be understood.