Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Prevalence of suicidal behaviour among students living in Muslim-majority countries: systematic review and meta-analysis(Royal College of Psychiatrists, 2023) Arafat, S.M.Y.; Baminiwatta, A.; Menon, V.; Singh, R.; Varadharajan, N.; Guhathakurta, S.; Mahesar, R.A.; Rezaeian, M.BACKGROUND: Assessing suicidal behaviours among students would help to understand the burden and enhance suicide prevention. AIMS: We aimed to determine the prevalence of suicidal behaviour among students living in Muslim-majority countries. METHOD: We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search was conducted in Medline, EMBASE and PsycINFO. Meta-analyses were performed to pool the lifetime, 1-year and point prevalence rates for suicidal ideation, plans and attempts. RESULTS: From 80 studies, 98 separate samples were included in this analysis. The majority (n = 49) were from the Eastern Mediterranean, and 61 samples were of university students. The pooled prevalence of suicidal ideation was 21.9% (95% CI 17.4%-27.1%) for lifetime, 13.4% (95% CI 11.1%-16.1%) for the past year and 6.4% (95% CI 4.5%-9%) for current. The pooled prevalence of suicide plans was 6.4% (95% CI 3.7%-11%) for lifetime, 10.7% (95% CI 9.1%-12.4%) for the past year and 4.1% (95% CI 2.7%-6.2%) for current. The pooled prevalence of suicide attempts was 6.6% (95% CI 5.4%-8%) for lifetime and 4.9% (95% CI 3.6%-6.5%) for the past year. The lifetime prevalence of suicidal ideation was highest (46.2%) in South-East Asia, but the 12-month prevalence was highest (16.8%) in the Eastern Mediterranean. CONCLUSIONS: The study revealed notably high rates of suicidal behaviours among students living in Muslim-majority countries. However, the quality of studies, differences in regional and cultural factors, stages of studentship and methods of measurement should be considered when generalising the study results.Item Academic psychiatry journals in South Asian countries: most from India, none from Afghanistan, Bhutan and the Maldives(Global Psychiatric Association, 2022) Arafat, S.M.Y.; Ali, S.A.Z.; Saleem, T.; Banerjee, D.; Singh, R.; Baminiwatta, A.; Shoib, S.Objective: As journals play a crucial role in the dissemination of knowledge, reviewing the psychiatry journals would illustrate the current status of mental health research. Aims: We aimed to identify and assess the academic journals within South Asia that focus on psychiatry. Methods: We searched on Google to identify the currently functioning psychiatry journals from South Asian countries. We used “psychiatry journals in South Asia” and “mental health journals in South Asia” as search terms. We also searched by individual country names (Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan and Sri Lanka). Results: A total of 20 psychiatry journals were identified and reviewed from five countries; one each from Bangladesh, Nepal, Pakistan and Sri Lanka, while 16 journals were from India. Only three journals (15%) are indexed in PubMed, four journals (20%) in Scopus, and one in Web of Science inclusively. Major indexation was only found in the journals from India. The Indian Journal of Psychiatry appears to be the oldest and currently leading mental health journal in the region. Conclusion: The review revealed that South Asia has a noticeable deficit in a high-quality academic research publishing system in psychiatry despite the region holding about a quarter of the global population.Item Depression and suicidal behavior in South Asia: a systematic review and meta-analysis(Cambridge University Press, 2022) Arafat, S.M.Y.; Saleem, T.; Menon, V.; Ali, S.A.Z.; Baminiwatta, A.; Kar, S.K.; Akter, H.; Singh, R.Background. Estimates of depression in suicidal behavior in South Asia would help to formulate suicide prevention strategies in the region that hasn’t been assessed yet. Objectives. We aimed to systematically assess the prevalence of depression in fatal and nonfatal attempts of suicide in eight South Asian countries. Methods. We searched Medline, Embase, and PsychINFO by specific search terms to identify articles assessing depression in fatal and non-fatal attempts of suicide in South Asian countries published between 2001 and 2020. Two separate meta-analyses were conducted for fatal and non-fatal attempts. Due to the high heterogeneity of studies (96–98%), randomeffects models were used to calculate pooled prevalence rates. Results. A total of 38 studies was identified from five south Asian countries (India [27], Pakistan [6], Sri Lanka [3], Nepal [1], and Bangladesh [1]). The majority of studies (n = 27) were published after 2010. Twenty-two studies reported non-fatal attempts, and sixteen reported suicide. The prevalence of depression among non-fatal attempts ranged from 14% to 78% where the pooled prevalence rate was 32.7% [95% CI 26–39.3%]. The prevalence of depression among suicides ranged from 8% to 79% where the pooled prevalence estimate was 37.3% [95% CI 26.9–47.6%]. Conclusions. This review revealed the pooled prevalence of depression among fatal and nonfatal suicidal attempts in South Asian countries, which seems to be lower when compared to the Western countries. However, a cautious interpretation is warranted due to the heterogeneity of study methods, sample size, and measurement of depression.Item Chinese medicine neuroaid efficacy on stroke recovery: a double-blind, placebo-controlled, randomized study(Lippincott Williams and Wilkins, 2013) Chen, C.L.; Young, S.H.; Gan, H.H.; Singh, R.; Lao, A.Y.; Baroque, A.C.; Chang, H.M.; Hiyadan, J.H.; Chua, C.L.; Advincula, J.M.; Muengtaweepongsa, S.; Chan, B.P.; de Silva, H.A.; Towanabut, S.; Suwanwela, N.C.; Poungvarin, N.; Chankrachang, S.; Wong, K.S.; Eow, G.B.; Navarro, J.C.; Venketasubramanian, N.; Lee, C.F.; Bousser, M.G.; CHIMES Study InvestigatorsBACKGROUND AND PURPOSE: Previous clinical studies suggested benefit for post stroke recovery when MLC601 was administered between 2 weeks and 6 months of stroke onset. The Chinese Medicine Neuroaid Efficacy on Stroke recovery (CHIMES) study tested the hypothesis that MLC601 is superior to placebo in acute, moderately severe ischemic stroke within a 72-hour time window. METHODS: This multicenter, double-blind, placebo-controlled trial randomized 1100 patients with a National Institutes of Health Stroke Scale score 6 to 14, within 72 hours of onset, to trial medications for 3 months. The primary outcome was a shift in the modified Rankin Scale. Secondary outcomes were modified Rankin Scale dichotomy, National Institutes of Health Stroke Scale improvement, difference in National Institutes of Health Stroke Scale total and motor scores, Barthel index, and mini-mental state examination. Planned subgroup analyses were performed according to age, sex, time to first dose, baseline National Institutes of Health Stroke Scale, presence of cortical signs, and antiplatelet use. RESULTS: The modified Rankin Scale shift analysis-adjusted odds ratio was 1.09 (95% confidence interval, 0.86-1.32). Statistical difference was not detected between the treatment groups for any of the secondary outcomes. Subgroup analyses showed no statistical heterogeneity for the primary outcome; however, a trend toward benefit in the subgroup receiving treatment beyond 48 hours from stroke onset was noted. Serious and nonserious adverse events rates were similar between the 2 groups.CONCLUSIONS:MLC601 is statistically no better than placebo in improving outcomes at 3 months when used among patients with acute ischemic stroke of intermediate severity. Longer treatment duration and follow-up of participants with treatment initiated after 48 hours may be considered in future studies. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00554723.