Sexual dysfunction among men in secondary care in southern India: Nature, prevalence, clinical features and explanatory models.

BACKGROUND: Sexual dysfunction, common in general medical practice, is under-recognized and inadequately managed resulting in significant morbidity and reduction in quality of life. We examined the nature, prevalence, clinical features and explanatory models of illness among men with sexual dysfunction in a general healthcare setting. METHODS: We recruited 270 consecutive men attending a general health clinic. Participants were evaluated using a structured interview. The International Index of Erectile Function-5, the Chinese Index of Premature Ejaculation-5, Short Explanatory Model Interview and the Revised Clinical Interview Schedule were used to assess sexual dysfunction, explanatory models and psychiatric morbidity. RESULTS: Premature ejaculation and erectile dysfunction were reported by 43.0% and 47.8% of men, respectively. The most common perceived causes were loss of semen due to masturbation and nocturnal emission. Popular treatments were herbal remedies and resources used were traditional healers. The factors associated with erectile dysfunction were diabetes mellitus, financial stress, past history of psychiatric treatment and common mental disorders such as depression and anxiety; those associated with premature ejaculation were common mental disorders, older age and financial debt. Sexual dysfunctions and concerns were under-diagnosed by physicians when compared to the research interview. CONCLUSION: There is a need to recognize sexual problems and effectively manage them in general medical settings. The need for sex education in schools and through the mass media, to remove sexual misconceptions, cannot be under-emphasized.

Risk factors for suicide in rural south India.

BACKGROUND: The relative contributions of psychosocial stress and psychiatric morbidity to suicide are a subject of debate. AIMS: To determine major risk factors for suicide in rural south India. METHOD: We used a matched case-control design and psychological autopsy to assess 100 consecutive suicides and 100 living controls matched for age, gender and neighbourhood. RESULTS: Thirty-seven (37%) of those who died by suicide had a DSM-III-R psychiatric diagnosis. Alcohol dependence (16%) and adjustment disorders (15%) were the most common categories. The prevalence rates for schizophrenia, major depressive episode and dysthymia were 2% each. Ongoing stress and chronic pain heightened the risk of suicide. Living alone and a break in a steady relationship within the past year were also significantly associated with suicide. CONCLUSIONS: Psychosocial stress and social isolation, rather than psychiatric morbidity, are risk factors for suicide in rural south India.

An experimental method for calibration of the plasmon mean free path.

Transmission electron microscopy specimens in the form of elongated, conical needles were made using a dual-beam focused ion beam system, allowing the specimen thickness to be geometrically determined for a range of thickness values. From the same samples electron energy loss maps were acquired and the plasmon mean free path (lambda) for inelastic scattering was determined experimentally from the measured values of specimen thickness. To test the method lambda was determined for Ni (174 +/- 17 nm), alpha-Al(2)O(3) (143 +/- 14 nm), Si (199 +/- 20 nm) and amorphous SiO(2) (238 +/- 12 nm), and compared both to experimental values of lambda taken from the literature and to calculated values. The calculated values of lambda significantly underestimate the true sample thickness for high accelerating voltages (300 kV) and large collection angles. A linear dependence of lambda on thickness was confirmed for t/lambda < 0.5-0.6, but this method also provides an approach for calibrating lambda at sample thicknesses for which multiple scattering occurs, thus expanding the thickness range over which electron energy loss spectroscopy can be used to determine the absolute sample thickness (t/lambda > 0.6). The experimental method proposed in this contribution offers a means to calibrate lambda for any type of material or phase that can be milled using a focused ion beam system.

Sexual Dysfunction among Men in Rural Tamil Nadu: Nature, Prevalence, Clinical Features, and Explanatory Models.

BACKGROUND AND AIM: There is a dearth of community data on nature, prevalence, clinical features, and explanatory models related to sexual dysfunction among men, particularly from rural India. This study attempted to examine different aspects of male sexual dysfunction and misconceptions in the community. MATERIALS AND METHODS: Villages in Kaniyambadi Block, Vellore district were stratified, and four were randomly selected. Men living in these villages were recruited for the study. The following instruments were administered: (i) International Index of Erectile Function, (ii) Chinese Index of Premature Ejaculation (iii) Short Explanatory Model Interview, and (iv) Revised Clinical Interview Schedule. The data were analyzed using standard bivariate and multivariate statistics. RESULTS: A total of 211 men were recruited. The majority were middle-aged (mean 40.73 years), literate (84.8%), married, and with children (72%), from nuclear families (99.6%), followed the Hindu religion (87.7%), reported satisfaction with their marriage (51.2%), had a single sexual partner (99.5%), and practised contraception (88.2%). A minority reported erectile dysfunction (29.9%), premature ejaculation (19.4%), and depression/anxiety (30.8%). Erectile dysfunction was associated with single marital status (P < 0.001), premature ejaculation (P < 0.001), worry about nocturnal emission and loss of semen (P < 0.02), and punishment by God as causal beliefs (P < 0.001). Premature ejaculation was associated with diabetes mellitus (P < 0.05), alcohol use (P < 0.05), anxiety and depression (P < 0.01), guilt about masturbation (P < 0.001), and belief that nocturnal emission is causal (P < 0.001) and erectile dysfunction (P < 0.05). CONCLUSION: Sexual misconception and dysfunction in men are significant problems in rural communities in India. They mandate the need for sex education in schools and the empowerment of physicians in primary and secondary care to manage such problems.

Correlates of self-reported, autobiographical, and mini-mental status examination defined memory deficits following electroconvulsive therapy in South India.

BACKGROUND: Cognitive deficits, self-reported or found following electroconvulsive therapy (ECT), and their correlates are diverse. Despite the characteristics of people receiving ECT in Asia differ widely from the west, pertinent research from Asia remains sparse. METHODS: We investigated the correlates of self-reported, mini-mental status examination (MMSE) defined, and autobiographical memory deficits in a cohort that received ECT in a south Indian tertiary-care setting. 76 consecutive consenting people were recruited within seven days of completing their ECT course. Memory was assessed by a subjective Likert scale, MMSE, and an autobiographical memory scale (AMS). Psychopathology was assessed by brief psychiatric rating scale, and serum cortisol levels were estimated by chemi-luminescence immunoassays. Relevant sociodemographic and clinical data were collected from the participants, and their medical records. The correlates were analysed using generalised linear models after adjusting for the effects of potential confounders. RESULTS: Self-reported, MMSE-defined, and autobiographical memory deficits were present in 27.6% (95%CI 17.6-37.7%), 42.1% (95%CI 31.0-53.2%), and 36.8% (95%CI 26.0-47.7%) of participants, respectively. Agreement between the memory deficits was poor. Age, less education, duration of illness, hypothyroidism, and past history of another ECT course were significantly associated with MMSE-defined deficits. Age, anaemia, past ECT course, and pre-ECT blood pressure were significantly associated with autobiographical memory deficits, while residual psychopathology and cortisol levels were significantly associated with self-reported memory deficits. CONCLUSION: Self-reported, MMSE-defined, and autobiographical memory deficits are common at the completion of ECT course, and their correlates differ. All service users receiving ECT need periodic cognitive assessments evaluating multiple cognitive domains.

ZnO/Ag nanocomposite: an efficient catalyst for degradation studies of textile effluents under visible light.

Degradation of model organic dye and industry effluent was studied using different weight percentages of Ag into ZnO as a catalyst. In this study, the catalysts were prepared by thermal decomposition method, which was employed for the first time in the preparation of ZnO/Ag nanocomposite catalysts. The physical and chemical properties of the prepared samples were studied using various techniques. The specific surface area, which plays an important role in the photocatalytic degradation, was studied using BET analysis and 10 wt.% Ag into ZnO showed the best degrading efficiency. The optical absorption (UV-vis) and emission (PL) properties of the samples were studied and results suggest better photocatalytic properties for 10 wt.% Ag sample compared to other samples.

National suicide rates and mental health system indicators: an ecological study of 191 countries.

PURPOSE: The relative contributions of psychiatric morbidity and psychosocial stress to suicide, and the efficacy of mental health systems in reducing population suicide rates, are currently unclear. This study, therefore, aimed to investigate whether national suicide rates are associated with their corresponding mental health system indicators. METHODS: Relevant data were retrieved from the following sources: the World Health Organization, the United Nations Statistics Division and the Central Intelligence Agency World Fact book. Suicide rates of 191 countries were compared with their mental health system indicators using an ecological study design and multivariate non-parametric robust regression models. RESULTS: Significant positive correlations between suicide rates and mental health system indicators (p<0.001) were documented. After adjusting for the effects of major macroeconomic indices using multivariate analyses, numbers of psychiatrists (p=0.006) and mental health beds (p<0.001) were significantly positively associated with population suicide rates. CONCLUSIONS: Countries with better psychiatric services experience higher suicide rates. Although these associations should be interpreted with caution, as the issues are complex, we suggest that population-based public health strategies may have greater impact on national suicide rates than curative mental health services for individuals.

Nature, prevalence and factors associated with depression among the elderly in a rural south Indian community.

BACKGROUND: Depression in old age is an important public health problem causing considerable morbidity and disability worldwide. There is a dearth of community studies from India investigating geriatric depression and its associated risk factors. This study aimed to establish the nature, prevalence and factors associated with geriatric depression in a rural south Indian community. METHODS: We recruited 1000 participants aged over 65 years from Kaniyambadi block, Vellore, India. We assessed their socio-demographic profile, psychiatric morbidity, cognitive functioning, anthropometrics and disability status using the following structured assessment tools: Geriatric Mental State, Community Screening Instrument for Dementia, Modified CERAD 10 word list learning task, History and Aetiology Schedule Dementia Diagnosis and Subtype, WHO Disability Assessment Scale II, and Neuropsychiatric Inventory. We adopted a case control framework to study the factors associated with geriatric depression. RESULTS: Prevalence of geriatric depression (ICD-10) within the previous one month was 12.7% (95% CI 10.64-14.76%). Low income (OR 1.78; 95% CI 1.08-2.91), experiencing hunger (OR 2.58; 95% CI 1.56-4.26), history of cardiac illnesses (OR 4.75; 95% CI 1.96-11.52), transient ischemic attack (OR 2.43; 95% CI 1.17-5.05), past head injury (OR 2.70; 95% CI 1.36-5.36) and diabetes (OR 2.33; 95% CI 1.15-4.72) increased the risk for geriatric depression after adjusting for other determinants using conditional logistic regression. Having more confidants (OR 0.13; 95% CI 0.06-0.26) was the significant protective factor. Age, female gender, cognitive impairment and disability status were not significantly associated with geriatric depression. DSM-IV diagnosis of major depression was significantly correlated with experiencing hunger, diabetes, transient ischemic attack, past head injury, more disability and less nourishment; having more friends was protective. CONCLUSIONS: Geriatric depression is prevalent in rural south India. Poverty and physical ill health are risk factors for depression among elderly while good social support is protective.

Surface modification of CdS quantum dots using thiols-structural and photophysical studies.

This study is aimed at identifying a suitable organic thiol for CdS by studying its structural, thermal and photophysical characteristics. Quantum dots of the II-VI semiconductor CdS, in the size regime of 2.0-3.3 nm, were prepared in the cubic phase by a wet chemical method. Five organic thiols were used for capping: (i) 1,4-dithiothreitol (DTT), (ii) 2-mercaptoethanol (ME), (iii) cysteine (Cys), (iv) methionine (Meth), and (v) glutathione (GSH). Structural studies were carried out by x-ray diffraction (XRD) and transmission electron microscopy (TEM), which revealed the cubic phase of CdS. Optical properties were studied by FT-IR, UV-visible and fluorescence spectroscopic techniques, and a comparison was made between uncapped and capped CdS. FT-IR studies suggested two different bonding mechanisms of the capping agents with the CdS. GSH and DTT capped CdS showed significant decrease in absorption wavelengths. An increase in band gap was observed in two cases: when (i) capped and (ii) decreased in size. The band gap was increased from 2.50 eV for the uncapped to 2.77 eV for the DTT capped CdS. DTT was found to be the best capping agent for CdS among these five organic thiols in two aspects: (i) yielding lower grain size in cubic phase, and (ii) good fluorescence properties with efficient quenching of the surface traps.

Nonlinear I-V characteristics of nanocrystalline SnO2.

Current versus voltage characteristics (I-V) of nanocrystalline SnO2 materials have been investigated in air at room temperature. The samples were prepared by the inert gas condensation technique (IGCT) as well as by chemical methods. X-ray diffraction studies showed a tetragonal rutile structure for all the samples. Microstructural studies were performed with transmission electron microscopy. All the samples exhibited nonlinear I-V characteristics of the current-controlled negative resistance (CCNR) type. The results show that the threshold field (break down) voltage is higher for the samples prepared by the IGCT method than for those prepared by the chemical method due to the formation of a tin oxide layer over the crystalline tin. It is also found that the threshold field increases with the decrease in grain size.