Summary Background A systematic understanding of suicide mortality trends over time at the subnational level for India's 1·3 billion people, 18% of the global population, is not readily available. Thus, we aimed to report time trends of suicide deaths, and the heterogeneity in its distribution between the states of India from 1990 to 2016. Methods As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016, we estimated suicide death rates (SDRs) for both sexes in each state of India from 1990 to 2016. We used various data sources for estimating cause-specific mortality in India. For suicide mortality in India before 2000, estimates were based largely on GBD covariates. For each state, we calculated the ratio of the observed SDR to the rate expected in geographies globally with similar GBD Socio-demographic Index in 2016 (ie, the observed-to-expected ratio); and assessed the age distribution of suicide deaths, and the men-to-women ratio of SDR over time. Finally, we assessed the probability for India and the states of reaching the Sustainable Development Goal (SDG) target of a one-third reduction in SDR from 2015 to 2030, using location-wise trends of the age-standardised SDR from 1990 to 2016. We calculated 95% uncertainty intervals (UIs) for the point estimates. Findings There were 230 314 (95% UI 194 058–250 260) suicide deaths in India in 2016. India's contribution to global suicide deaths increased from 25·3% in 1990 to 36·6% in 2016 among women, and from 18·7% to 24·3% among men. Age-standardised SDR among women in India reduced by 26·7% from 20·0 (95% UI 16·5–23·5) in 1990 to 14·7 (13·1–16·2) per 100 000 in 2016, but the age-standardised SDR among men was the same in 1990 (22·3 [95% UI 14·4–27·4] per 100 000) and 2016 (21·2 [14·6–23·6] per 100 000). SDR in women was 2·1 times higher in India than the global average in 2016, and the observed-to-expected ratio was 2·74, ranging from 0·45 to 4·54 between the states. SDR in men was 1·4 times higher in India than the global average in 2016, with an observed-to-expected ratio of 1·31, ranging from 0·40 to 2·42 between the states. There was a ten-fold variation between the states in the SDR for women and six-fold variation for men in 2016. The men-to-women ratio of SDR for India was 1·34 in 2016, ranging from 0·97 to 4·11 between the states. The highest age-specific SDRs among women in 2016 were for ages 15–29 years and 75 years or older, and among men for ages 75 years or older. Suicide was the leading cause of death in India in 2016 for those aged 15–39 years; 71·2% of the suicide deaths among women and 57·7% among men were in this age group. If the trends observed up to 2016 continue, the probability of India achieving the SDG SDR reduction target in 2030 is zero, and the majority of the states with 81·3% of India's population have less than 10% probability, three states have a probability of 10·3–15·0%, and six have a probability of 25·1–36·7%. Interpretation India's proportional contribution to global suicide deaths is high and increasing. SDR in India is higher than expected for its Socio-Demographic Index level, especially for women, with substantial variations in the magnitude and men-to-women ratio between the states. India must develop a suicide prevention strategy that takes into account these variations in order to address this major public health problem. Funding Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.

Gender differentials and state variations in suicide deaths in India: the Global Burden of Disease Study 1990–2016

COVID-19 and domestic violence against women.

Intimate partner violence claims millions of victims worldwide leading to infringement of fundamental human rights, serious physical and mental heath consequences and leading behind in its wake broken relationships and affected children. Despite its prevalence, its is not a well understood phenomenon. Through this article, we briefly review the literature on this subject; emphasizing on epidemiology and typologies of IPV, perpetuating factors and outcomes, the relevant legislations in India and the screening and intervention steps.

Intimate partner violence: Wounds are deeper.

Domestic violence (DV) is reported by 40% of married women in India and associated with substantial morbidity. An operational research definition is therefore needed to enhance understanding of DV epidemiology in India and inform DV interventions and measures. To arrive at a culturally-tailored definition, we aimed to better understand how definitions provided by the World Health Organization and the 2005 India Protection of Women from Domestic Violence Act match the perceptions of behaviors constituting DV among the Indian community. Between September 2012 and January 2013, 16 key informant interviews with experts in DV and family counseling and 2 gender-concordant focus groups of lay community members were conducted in Pune, India to understand community perceptions of the definition of DV, perpetrators of DV, and examples of DV encountered by married women in Pune, India. Several key themes emerged regarding behaviors and acts constituting DV including 1) the exertion of control over a woman’s reproductive decision-making, mobility, socializing with family and friends, finances, and access to food and nutrition, 2) the widespread acceptance of sexual abuse and the influences of affluence on sexual DV manifestations, 3) the shaping of physical abuse experiences by readily-available tools and the presence of witnesses, 4) psychological abuse for infertility, dowry, and girl-children, and 5) the perpetration of DV by the husband and other members of his family. Findings support the need for a culturally-tailored operational definition that expands on the WHO surveillance definition to inform the development of more effective DV intervention strategies and measures.

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How Well Does the World Health Organization Definition of Domestic Violence Work for India

Background: No nation is untouched by domestic violence, and it is well-known that domestic violence has serious impact on women's health and well-being. The present study aimed to assess the prevalence and characteristics of domestic violence and injuries owing to domestic violence among currently married women. Materials and Methods: This was a community-based, cross-sectional study conducted in the rural and urban areas of Haryana. In total, 880 currently married females of the reproductive age group were interviewed using the Women's Questionnaire (used in National Family Health Survey-3) which is according to the Modified Conflict Tactics Scale. Results: Totally, 37% of the females had ever experienced domestic violence and 28.9% currently experienced domestic violence. All types of violence (except sexual violence) were significantly more common in the rural area than the urban area. Injuries owing to domestic violence were reported by more than half (55.4%) of the women. Among spousal violence, emotional violence was the most common type of violence followed by physical violence. Only 0.1% and 4.5% of females had ever initiated physical and emotional violence respectively, against their husbands, and in rest of the cases, it was the husband who initiated violence. Conclusion: Awareness regarding domestic violence needs to be made, and law enforcement regarding it needs to be made stringent. Rehabilitation of victims of domestic/spousal violence should also be considered on priority.

https://journals.sagepub.com/doi/pdf/10.4103/IJPSYM.IJPSYM_62_18

Study of Domestic Violence among Currently Married Females of Haryana, India

The protection of women from domestic violence act 2005 its implementation in the aligarh district

Abstract: Objectives: The purpose of conducting the present study was to determine the frequency of PIMs among medication charts of hospitalized elderly patients based on Beer’s Criteria, 2019. Materials and Methods: In a tertiary care hospital, a descriptive, observational cross-sectional study was conducted over the course of six months. The study comprised both male and female in-patients aged 65 years and above. A pre-structured data collection form was used to gather information from the patient case files. Results: A total of 100 prescriptions were included. The most prevalent disease among the elderly was found to be hypertension (15.51%) followed by type 2 diabetes mellitus (14.4%) and sepsis (6.92%). The most commonly prescribed medications among the elderly in the present study were insulin followed by proton-pump inhibitors, atorvastatin, aspirin, and furosemide. A total of 216 potentially inappropriate medications were identified in 87 prescriptions. The use of proton-pump inhibitors was found to be the leading PIM to be avoided followed by insulin. The most common PIM to be used with caution was found to be diuretics followed by aspirin. Conclusion: The study findings show that the frequency of prescribing PIMs is high among hospitalized elderly patients. The use of such medications can be controlled by adhering to the updated Beers criteria. Keywords: Geriatrics, Polypharmacy, Beer’s criteria, Potentially inappropriate medications, Observational study. 

https://ijopp.org/sites/default/files/InJPharPract-16-2-110.pdf

Gouhar Sultana

Papers

The protection of women from domestic violence act 2005 its implementation in the aligarh district

Analysis of Medication Charts of Hospitalized Elderly Patients: A Cross-sectional Study