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Biomedical subjects

R Balarajan

Publications and source records attributed to R Balarajan.

51 records · Page 3Linked to original sources
PubMed1983

Trends in primary care in the United Kingdom.

Trends in primary care in the United Kingdom were studied using the diagnostic information available at Intercontinental Medical Statistics Ltd (IMS) for 1969-80. Total consultation rates overall showed an increase until 1978 when they started to decline. Diseases of the respiratory system showed a decline for first consultations. Diseases of the musculoskeletal and connective tissue and diseases of the nervous system and sense organs showed an increase. Diseases of the respiratory system, circulatory system, and mental disorders accounted for 15.4%, 11.2%, and 9.6% respectively of the total consultations in 1980. Neuroses and personality disorders accounted for the highest consultation rates in general practice. This study identifies areas for further research in general practice and the potential of this data base, if expanded, for the continuous monitoring of morbidity in primary care.

Family Practice↗
PubMed1983

Malignant lymphomas in road transport workers.

The relative risks of malignant lymphomas among road transport workers were investigated using the National Cancer Registry in England and Wales. Drivers of buses and coaches (OCC unit 120) had increased risks for both Hodgkin's and non-Hodgkin's lymphomas and the drivers of other road passenger vehicles (OCC unit 121) for Hodgkin's lymphomas only. Although the increased risks did not show statistical significance, they corresponded to and reinforced previously described findings based on occupational mortality.

Adolescent↗
PubMed1983

Certification of death and the clinician.

Patterns of certification of death and the subsequent selection of an underlying cause of death are analysed. The need for awareness among certifying practitioners of the issues and the rules for the selection is demonstrated. There is scope for further improvement in certifying practice among medical practitioners and coroners.

Death Certificates↗
PubMed1982

Mortality and cause of death in Down's syndrome.

Mortality in sufferers from Down's syndrome over the age of 1 year in the 1970s was analysed using the Wessex Mental Handicap Register linked to the NHS Central Register. Of the 1045 subjects, 37 died during the period of the study; the standardised mortality ratio based on England and Wales mortality was 5.39. Mortality ratios were high between the ages of 1 and 14 compared with older ages. Bronchopneumonia and congenital heart disease were the main causes of death. Problems with certification and selection of underlying cause of death showed the potential value of multiple-cause coding.

Adolescent↗
PubMedDate not supplied

Perinatal and postneonatal mortality in England and Wales among immigrants from the Indian subcontinent.

Perinatal and postneonatal mortality among immigrants to England and Wales from India, Pakistan and Bangladesh (Asians) for the years 1982-85 showed significant differences not only between the immigrant and indigenous populations, but also among the different groups from the Indian subcontinent. Compared with the perinatal mortality rate of 10.1 per 1000 total births in UK born mothers, rates in infants of mothers born in India, Bangladesh, and Pakistan were 12.5, 14.3 and 18.8 respectively. In contrast, postneonatal mortality in infants of Indian and Bangladeshi origin (3.9 and 2.8 per 1000 live births respectively) was lower than in the indigenous population (4.1), with Pakistani infants experiencing the highest rate (6.4). Excess perinatal mortality in infants of Asian origin was apparent at most maternal ages and parities. Pakistani infants had the highest rates of perinatal and postneonatal mortality in all age, parity and birth weight groups. The Asian groups showed higher mortality from congenital anomalies in both the perinatal and the postneonatal period, the rates in Pakistani infants being almost double those in Indian and Bangladeshi infants. A significant finding was the lower rates of sudden infant death in all the groups of Asian origin.

Bangladesh↗
PubMedDate not supplied

Patterns of mortality among Bangladeshis in England and Wales.

OBJECTIVES: To investigate the patterns of mortality among Bangladeshis living in England and Wales. METHODS: An analysis of national mortality data, classified by country of birth, for the latest period (1988-1992), using the method of indirect standardization for deriving standardized mortality ratios (SMRs) with the age- and sex-specific rates for England and Wales as the standard (= 100). The SMRs were derived for Bangladeshi-born men and women aged 20-69 years for major disease entities. RESULTS: The mortality among Bangladeshi men was significantly higher (SMR 118 and 95% CI 111-126) than the levels prevalent in England and Wales. In contrast, the mortality among Bangladeshi women was significantly lower (SMR 71 and 95% CI 61-82). The cancer mortality overall was lower than expected in both sexes, with the exception of cancer of the liver and gall bladder. The mortality from breast cancer (SMR 16 and 95% CI 6-34) and cervical cancer (SMR 51 and 95% CI 14-131) was lower than expected. Bangladeshi men experienced high mortality from diabetes (SMR 685 and 95% CI 529-874), coronary heart disease (SMR 148 and 95% CI 134-163) and cerebrovascular disease (SMR 267 and 95% CI 222-319); they also experienced excess deaths from cirrhosis of the liver (SMR 254 and 95% CI 175-357). CONCLUSIONS: The findings establish significant variations in the recent health experiences of Bangladeshi men living in England and Wales, posing a major challenge for purchasers of care. If the Health of the Nation strategy is to ensure that equity in health and health care is to apply to all those living in this country, the Bangladeshi population needs special targeting.

Adult↗
PubMedDate not supplied

Cirrhosis and primary liver cancer amongst first generation migrants in England and Wales.

OBJECTIVE: To examine mortality from cirrhosis of the liver and primary liver cancer among first generation migrants to England and Wales. DESIGN: Comparison of standardised mortality ratios (SMRs) for cirrhosis of the liver and primary liver cancer in men and women aged 20-69, by country of birth for the five year period 1988-1992. SETTING: England and Wales. RESULTS: There was a statistically significant two-fold excess of mortality from cirrhosis of the liver among male migrants from East Africa (SMR 286), India (SMR 261) and Bangladesh (SMR 254) as well as men born in Scotland (SMR 253) and Ireland (SMR252). Among women, only those born in Scotland (SMR 254) and Ireland (SMR 237) showed significant excess mortality. For liver cancer, significant excess mortality occurred among men born in the Caribbean (SMR 312), Bangladesh (910) and the African Commonwealth other than East Africa (1014), with Scottish and Irish born men showing more moderate excesses (136 and 170, respectively). SMRs were elevated also in all groups of foreign-born women but, probably owing to the small numbers of deaths, none of the findings reached statistical significance. CONCLUSIONS: Of public health concern is the excess mortality from cirrhosis in first generation immigrants to England and Wales from Scotland and Ireland (men and women) and in male migrants from India, Bangladesh and East Africa. Of equal concern is increased mortality from liver cancer in all foreign-born groups of both sexes, particularly among Bangladeshis, and African-Caribbeans. As well as promoting sensible drinking among immigrant men, specific preventive measures for those of Bangladeshi, African-Caribbean origin may include selective screening for hepatitis B and C and other tumour markers. Screening for liver cancer using imaging techniques needs further investigation. The benefit/cost ratio should be assessed by the Screening Committees of the UK Departments of Health. At local level, variation in incidence and prevalence of hepatic disease and feasible prevention programmes should be assessed within developing health improvement programmes.

Adult↗
PubMedDate not supplied

Ethnicity and variations in the nation's health.

The variations in the Health of the Nation (HoN) key areas among ethnic minorities living in England and Wales are examined, based on a national mortality study by country of birth for the latest possible period (1988-1992). It addresses the 10 mortality indicators in the HoN White Paper (covering coronary heart disease [CHD] and stroke, cancers, mental illness and accidents), using age-standardised rates adjusted to the European Standard Population. The findings establish variations in the recent health experience of ethnic minorities born outside England and Wales who are now living in England and Wales. CHD among persons aged under 65 years was highest in those born in the Indian Subcontinent, 55% above the normal rate in England and Wales. Caribbeans, and African groups experienced the lowest rates. Stroke mortality under 65 years-of-age was highest in Bangladeshis, followed by other Commonwealth Africans, and then by Caribbeans. Patterns of cancer deaths also varied, with breast cancer mortality rates being lower in all ethnic groups, and lowest in those born in the Indian Subcontinent. By contrast, lung cancer deaths were higher in Irish men and women; lung cancer mortality among Bangladeshi men was significantly higher than Indians and Pakistanis, being only 15% less than that of the rates in England and Wales. Suicides were lowest in Bangladeshis and Pakistanis and highest among Indians and the Irish. Accidental deaths in children were highest in Pakistanis followed by the Irish, who also experienced higher rates among young persons. It is suggested that the HoN strategy should consider setting appropriate and achievable targets, including ones in new areas of relevance to these groups. The National Health Service purchaser/provider framework should respond to the needs of its populations, including ethnic groups.

Accidents↗