Showing papers by "North Bengal Medical College published in 2019"

Behavioral and biological risk factors of noncommunicable diseases among tribal adults of rural siliguri in Darjeeling District, West Bengal: A cross-sectional study.

Abstract: Background: The increasing burden of noncommunicable diseases (NCDs) urges continuous survey of risk factors in different population groups. Objectives: The study was conducted to assess the prevalence and determinants of behavioral and biological risk factors of NCDs, in rural tribal population. Methods: A community-based cross-sectional study was conducted from June 2014 to May 2015, in rural Siliguri, among 172 tribal people aged 25–64 years selected by multistage cluster random sampling using WHO-STEPS instrument. Study participants were interviewed for sociodemographic and behavioral risk factors, and biological measurements were taken. Descriptive and logistic regression analyses were performed to explore the determinants of risk factors. Results: Among the study participants, the prevalence of current tobacco use and alcohol use were 69.8% and 40.7%, respectively; 96.5% consumed unhealthy diet and 2.9% were physically inactive. The prevalence of abdominal obesity and overweight were 26.2% and 12.2%, respectively. Odds of tobacco use were significantly raised among men (adjusted odds ratio [AOR]: 47.7 [95% confidence interval (CI) 11.1, 203.9]) and increased age of the participants. Men showed higher odds of alcohol consumption (AOR: 13.4 [95% CI 4.6, 38.9]). Odds of abdominal obesity were higher among older participants, whereas lower odds were found among men (AOR: 95% CI 0.11 [0.0, 0.5]) compared to women. Conclusions: Most of the behavioral and biological risk factors of NCDs were quite high among tribal population of rural Siliguri except physical inactivity. Increasing awareness about NCDs through locally accepted and culturally appropriate strategies need to be implemented in the study area.

Kimura's disease involving bilateral lacrimal glands and extraocular muscles along with ipsilateral face: A unique case report.

Abstract: A 23 year female presented with bilateral recurrent swelling of eyelids along with ptosis and proptosis for last 3 years. She also had swellings over the right cheek, parotid gland, and retro auricular area along with regional lymphadenopathy. Systemic laboratory workup revealed raised serum IgE and a high peripheral eosinophil count. Computed tomography and magnetic resonance imaging showed bilateral enlargement of extraocular muscles, lacrimal glands, and ipsilateral parotid gland. Excision biopsy of the retro-auricular lymph node was suggestive of Kimura's disease (KD). The patient responded well to systemic corticosteroid. KD rarely affects orbit, but it should be included in the differential diagnosis of inflammatory diseases of the orbit. To our knowledge, this is the first reported case of KD from India involving the orbit, lacrimal gland, extraocular muscles, parotid gland and buccal area.

Ultrasound detected changes in joint cartilage thickness in juvenile idiopathic arthritis.

Abstract: AIM The purpose of this study was to investigate the changes in joint cartilage thickness in different subtypes of juvenile idiopathic arthritis (JIA) using ultrasound, comparing them with healthy children and to evaluate the relationship with disease duration and inflammatory markers. METHODS We conducted a cross-sectional study comprising of 27 cases of JIA and 54 age- and sex-matched healthy children. Bilateral wrist, knee and ankle joint cartilage thicknesses were measured by ultrasound as per European League Against Rheumatism standard guidelines and compared them between JIA subtypes as well as between cases and control. RESULTS Descriptive analysis of the whole cohort revealed the mean age of the study population was 8.3 ± 3.2 years with mean cartilage thicknesses at the wrist, knee and ankle being 1.40 ± 0.89 mm, 1.57 ± 0.78 mm and 1.41 ± 0.85 mm, respectively. The median cartilage thicknesses of wrist, knee and ankle joints of JIA cases (n = 27) and healthy controls (n = 54) were 1.01, 1.35, 1.05 and 1.95, 2.00, 1.95, respectively. The joint cartilage thickness was significantly reduced in JIA in comparison to the healthy cohort (P < 0.01). Diseased boys suffered greater cartilage damage in knee joints compared to girls; the polyarticular variety of cases had thinner knee cartilage in comparison to the oligoarticular subtype. Further, it was found that joint cartilage destruction is independent of inflammatory markers and disease duration. CONCLUSION Significant cartilage thinning in addition was found in JIA children, particularly in the polyarticular subtype, and more in boys than girls, which is independent of disease duration and inflammatory markers, using ultrasound as a primary investigative tool.

Oleander Stem and Root Standardized Extracts Mitigate Acute Hyperglycaemia by Limiting Systemic Oxidative Stress Response in Diabetic Mice

Abstract: The extracts of different parts of Nerium oleander L. are used as antidiabetic remedy in the traditional medicinal systems of different parts of the world. Despite these uses in ethnomedicinal system, the antihyperglycemic potentials of oleander stem (NOSE) and root (NORE) extracts have not been pharmacologically evaluated. Therefore, we aimed at evaluating the antidiabetic ethnomedicinal claims of NOSE and NORE, primarily focusing on glucose homeostasis and associated metabolic implications. Alloxan-treated mice with hyperglycaemia (blood glucose >200 mg/dL) were treated with oleander 70% hydromethanolic extracts (200 mg/kg) for 20 consecutive days, and the results were compared with positive control glibenclamide. Blood glucose level was 52–65% lowered ( ) in oleander treated groups, which was otherwise 4.62 times higher in diabetic mice, compared to control. Insulin resistance was lowered 51–36% irrespective of any significant ( ) changes in insulin sensitivity throughout the treatments. Improved serum insulin remained associated with lowered glucose level (rP = −0.847 and −0.772; ). Markers of hyperglycaemia-related hepatic glycogen, glycated haemoglobin (HbA1c), hyperlipidaemia, hepatic injury, and diabetic nephropathy were normalized as well. Improvement of systemic intrinsic antioxidant enzymes (catalase and peroxidase) were correlated (rP = −0.952 to −0.773; ) with lower lipid peroxidation by-product malondialdehyde (MDA) in the circulation. Principal component analysis coupled with hierarchical cluster analysis represented shift in metabolic homeostasis in diabetic mice, which was further normalized by oleander and glibenclamide treatment. Additionally, molecular docking studies of the phenolic acids measured by HPLC with intracellular cytoprotective transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) revealed strong molecular interactions. The results collectively support the ethnomedicine antidiabetic claims of oleander stem and root and suggest that the oleander mediated elevation of systemic antioxidant status is likely responsible for the improved glycaemic control.

Frontal assessment battery in Parkinson's disease: A study on 170 patients.

Abstract: Background: Frontal assessment battery (FAB) was devised as a specific study design to assess frontal lobe dysfunction. Since Parkinson's disease (PD) is often associated with cognitive and other higher mental function complications, FAB test has been carried out by a number of workers to assess the integrity of the frontal lobe. On the other hand, the other frequently conducted test, performed in order to evaluate the mental status, is the Mini Mental State examination of Folstein (MMSE), but its reliability has been questioned in PD, since it does not assess the functions of the frontal lobe alone. Material and Methods: The present study was undertaken in order to assess the suitability of application of the FAB test in Indian patients and to perform its comparative analysis with the MMSE scale. Results and Conclusions: It was observed that the FAB test correlated with the age and the level of education of the patient. The results also correlated with that of the MMSE study, in spite of the fact that the latter is not considered to be a test which can assess exclusively the status of the frontal lobe. To the best of our knowledge, this is first study undertaken in India in this regard.

Phakomatosis Pigmentovascularis: A Clinical Profile of 11 Indian Patients.

Abstract: Introduction: Phakomatosis pigmentovascularis (PPV) is a rare congenital syndrome characterized by the simultaneous presence of capillary malformation and pigmentary nevi. The objective of our study was to describe the clinical characteristics of a series of Indian patients presenting with this rare entity. Materials and Methods: It was a record-based descriptive case series. Results: A total of 11 patients with PPV (9 females, 2 males, age range: 7 days to 45 years; mean 11.6 years) were studied. Port wine stain was present in 10 (91%) patients and one patient (9%) had cutis marmorata telangiectatica congenita. Isolated nevi of Ota and Mongolian spots were seen in 4 (36%) patients each. Simultaneous presence of both Mongolian spots and nevus of Ota was present in 1 (9%) patient. The combination of Mongolian spots and bilateral palatal hyper-melanosis was noticed in 2 (18%) patients. Cafe au lait macule was present in one patient. Bilateral ocular melanosis was found in 3 (27%) patients. Unilateral ocular melanosis was noticed in 4 (36%) patients. Two patients (18%) had history of seizure disorder and intracranial vascular anomalies on MRI imaging. Two patients (18%) had features of Klippel-Trenaunay syndrome. According to the traditional classification, three patients had PPV type 2b, one patient had PPV type 5b, and seven patients had PPV type 2a. According to the Happle's classification, 10 patients had PPV of cesio flammea type, and one patient had PPV of cesio marmorata type. Limitations: We could not perform genetic study of the patients. Conclusion: Our findings emphasize the importance of detailed systemic evaluation including ocular examination and brain imaging in every patient of PPV.

Determinants of infant mortality in rural India: An ecological study.

Abstract: Background: Long-term reductions in infant mortality (IM) are possible only by addressing the distal determinants. Objectives: The objective of the present study was to determine the relationship between IM and its major distal determinants in rural India. Methods: The dependent variable used in the study was state wise IM rate (IMR), the values of which were obtained from the Sample Registration System, 2015. State level literacy rate in females, unemployment rates of females, GINI index, and round-the-clock neonatal services in primary health centers in the rural areas and the per capita gross state domestic product at purchasing power parity (GSDP at PPP) of the states, were used as the predictor variables for IM. Relationship between the variables was obtained by the Pearson's correlation coefficient. Bivariate and multivariable linear regressions were used to identify the magnitude and direction of the predictors on IM. Results: Correlation statistics showed none or weak positive correlation between the Gini coefficient and 24 × 7 primary health-care services and IMR. There was a strong negative correlation between female literacy rate and IMR, while the unemployment rates and per capita gross state domestic product (GSDP) were moderately negatively correlated to IMR. Bivariate analysis revealed that, for unit increase in unemployment rates in females, proportion of literate women, and 1000$ increase in the GSDP at current prices, IMR decreased by 0.07, 0.763, and 1.702, respectively. However, after adjustment, only the female literacy rates showed significant association with IMR. Conclusions: Of the major determinants included in the study, rural female literacy is the most important distal determinant of IM in rural areas of India.

Prevalence of soil-transmitted helminth infestations among children attending Integrated Child Development Service centers in a tea garden area in Darjeeling.

Abstract: Introduction: Helminths infestations are common in children in the tea garden areas of Darjeeling, which present unique social, cultural, and environmental conditions. The present study was conducted to determine the proportion of soil-transmitted helminth (STH) infestations and association of STH to sociodemographic variables among children attending Integrated Child Development Services centers of a tea garden area in Darjeeling. Methodology: A cross-sectional descriptive study was conducted at Kiran Chandra Tea Estate, a tea garden in Naxalbari, Darjeeling, between August and September 2016. Stool samples were collected from children attending ICDS centers in the area and examined using the direct and concentration methods. A pretested and predesigned questionnaire was used to collect data on the sociodemographic profile of the children's families. Results: Stool samples could be collected from 52 (45%) of the 115 eligible children. The children were predominantly male (61.5%), from families with an income between Rs. 2000 and 4000 per month, had mothers with no formal education (75.0%) and came from households with no sanitary toilets (33.5). The proportion of children with STHs was 9.6%; with Ascaris found in 7.7% and Trichuris in 1.9%. No statistically significant differences were found in selected variables between the worm-positive and worm-negative children. Conclusions: The proportion of STH infestation is low among children

Profile of firecracker injuries of the eye during Diwali: A tertiary eye-care center study

Abstract: Aims and Objectives: The aim was to study the demographic pattern, clinical features, management, and prognosis of the patients with firecracker-related ocular injuries during Diwali. Materials and Methods: This institution-based prospective study was done in 30 patients who attended eye emergency and outpatient department (OPD) of Calcutta National Medical College and Hospital, West Bengal, during the period of 1 week of Diwali in 2016 and 2017. The parameters studied were the age and sex of the patients, type of firework (crackers and sparklers), eye involved, severity of injury with respect to active and passive participants, management, severity of injury, and visual outcome with respect to type of firecrackers. Results: A total of 30 patients attended eye OPD and emergency during our study period, of which 23 (76.7%) were male and 7 (23.3%) were female. All of them were in the pediatric age group (1–15). All patients were examined on the day of injury. Patients between 6 and 10 years of age were most commonly affected. Four cases (13.3%) were open-globe injuries and 26 (86.7%) cases were closed-globe injuries. Visual acuity varied from 6/9 to no perception of light. The most common firework involved was the crackers. Conclusions: Careless and indiscriminate use of firecrackers may sometimes lead to serious ocular damage. In India, use of fireworks is quite common during various festivals, particularly during Diwali, thus fireworks-related ocular injuries are important causes of blindness. This prospective study revealed the presentation and outcome of ocular injuries due to firecrackers in this area of mixed culture during this festive week.

A Study on Deliberately Self-Poisoned In-Hospital Patients in a Tertiary Health Care Center in Northeast India: A Cross-Sectional Review

Abstract: Background The nature and profile of different modes of poisoning vary significantly in different parts of India. The assessment of the magnitude of suicidal poisoning is an area of paramount importance not only for appropriate management but also for raising social awareness and framing government policies for the prevention of same. Objectives We aimed to determine the pattern of poisoning, the sociodemographic profile of patients who poison themselves, and the in-hospital outcome of self-poisoned patients over a 1-year period. Methods This was a cross-sectional observational study conducted between May 2015 and April 2016 that included 492 patients >12 years of age who were admitted to our hospital after consuming poison with the intention of deliberate self-harm. Relevant history with respect to the nature and amount of poison ingested were taken and recorded, and the patients’ sociodemographic profiles and outcome (as either discharge or death) were noted. Results Most of the patients were 13–28 years of age (69%). Males (n = 293 [59.55%]) predominated over females and the majority were farmers (n = 193 [39.23%]). Rural cases (n = 373 [75.81%]) outnumbered urban cases. The major causes of deliberate self-harm attempts were impulsive actions (n = 442 [89.84%]). Pesticides (n = 393 [79.88%]) were the most commonly consumed poison. The overall mortality rate was 12%, with paraquat (94.74%) topping the list of fatal substances. Conclusion Young adults and males constitute majority of the population in this study. Agricultural poisons made up the bulk of the cases, mostly taken by rural population. Paraquat, an herbicide banned in several countries, had the highest mortality rate in this study.

Profile of nutritional anemia and its correlation with serum iron, Vitamin B12, and folic acid level among the tribal population of northern districts of West Bengal, India

Abstract: Background and Objective: Nutritional anemia is the most common and easily preventable cause of anemia. No comprehensive data regarding the magnitude of this problem are available in the literature in northern regions of West Bengal where a significant number of tribals inhabit. The present study was undertaken to assess the magnitude of anemia and the status of iron, Vitamin B12, and folic acid deficiency in tribals of North Bengal and to analyze their red blood cell (RBC) morphology. Materials and Methods: A descriptive study done on the individuals during a period of 1 year at North Bengal Medical College. Serum iron, ferritin, total iron-binding capacity, Vitamin B12, and folic acid were measured along with other relevant investigations. Results: Forty-eight out of 88 (54.51%) of the cases were found to be anemic. Thirty-four out of 48 (70.83%) of them had at least one of the nutritional deficiencies. Iron deficiency was most common, seen in 18 (37.5%) of cases. Abnormal hemoglobin was seen in 7 (14.58%), two of which also had nutritional deficiency. In combined iron and folate deficiency, 7 out of 10 (70%) showed microcytic hypochromic morphology and 3 (30%) were dimorphic. Conclusion: Iron and folic acid deficiency is quite common among the tribals of northern region of West Bengal. RBC morphology alone lacks the specificity for the diagnosis of causes. Furthermore, nutritional deficiencies may coexist with abnormal hemoglobin variants, complicating their diagnosis further. A proper clinical, hematological, and biochemical correlation is required for the accurate diagnosis and effective treatment of anemia, highlighting the need for a screening for the causes of anemia in this population.

Assessment of anti-malarial drug prescribing pattern in pediatric and adult malaria patients in a tertiary care hospital in Eastern India

Abstract: Background: Kolkata, one of the major metropolitan cities of India, is also the capital of the state West Bengal, contributes largest number of malaria cases reported from West Bengal. The present study was undertaken to assess the anti-malarial prescribing pattern in a tertiary care teaching hospital in Kolkata. Methods: This was an observational, prospective, cross-sectional study for a period of one year (from March 2017 to February 2018) in which prescriptions of diagnosed pediatric and adult malaria patients were scanned and reviewed for anti-malarial use pattern. Core drug use indicators were also analyzed to assess the rational prescribing pattern. Results: During one-year study period, 122 adult and 24 child malaria patient encounters were screened. Among adult patients, 48(39.3%) patients had P. falciparum and 74(60.7%) patients had P. vivax malaria; in children, 9(37.5%) patients had P. falciparum and 15(62.5%) patients had P. vivax malaria. All adult and pediatric P. vivax malaria patients were treated with chloroquine. Artemisinin derivatives were prescribed to 91.67% of adult and 88.88% of pediatric falciparum malaria patients, 77.09% of adults and 66.67% of children received ACT. Artemether- lumefantrine was the most commonly prescribed ACT (33.34% in adults and 55.56% in children). Prescriptions were usually in generic name and from National EDL. Percentage of encounters with antibiotics was high in both age group but percentage of encounters with injections was low in adults and children. Conclusion: Chloroquine was used rationally for treatment of P. vivax malaria patients. Artemether-lumefantrine was the most common ACT used for treatment of P.falciparum malaria cases though the National guideline for treatment of malaria does not recommend Artemether-lumefantrine for this state and region for treatment of falciprum cases.

Developmental delays and its predictors among infants- a cross sectional study in rural areas of siliguri subdivision, darjeeling district, west bengal.

Abstract: Background & objectives: Developmental delay is a condition where a child fails to reach the different developmental domains at the expected age. Children who are developmentally delayed are less likely to be productive adults. The present study is aimed to determine the prevalence and predictors of global developmental delay among the infants of rural areas of Siliguri sub division, Darjeeling district, West Bengal Methods: A descriptive epidemiological study with cross- sectional design was carried out among 780 infants in Siliguri subdivision, Darjeeling district, West Bengal. Thirty cluster sampling technique was used to select the study subjects. Data were collected by interviewing the respondents using a pre-designed and pre tested schedule. Development status was assessed using ASQ-3 scale and delay in more than one domain was defined as global developmental delay. Logistic regression was applied to find out the association between global development delay and different predictors. Results: Overall prevalence of global developmental delay was 38.2%. Neonatal factors like birth weight (p=.000), h/o neonatal infection (p=.001) and neonatal jaundice (p=.000) was found to be significantly associated with global developmental delay. No statistical significance was observed with sociodemographic and maternal factors. Conclusion: Developmental delay is high among the infants of the studied area and associated with some of the neonatal factors. Field based studies using appropriate screening tools from different parts of India including West Bengal will be helpful to find out the hidden cases and related factors. Key words: Developmental delay, Predictors, Infants, ASQ-3, Darjeeling

Use and relevance of modified alvarado scoring system in diagnosis of acute appendicitis: a cross sectional study from West Bengal, India

Abstract: Background: For successful management of acute appendicitis, early diagnosis and intervention is needed. Incorrect diagnosis may allow significantly increased morbidity and mortality. Several studies across the globe shows that Modified Alvarado Scoring System (MASS) does not need high end instrument and can be done in emergency situation for accessing acute appendicitis and reducing the chances of unnecessary surgery. To access the efficacy of MASS for diagnosis of acute appendicitis in remote areas with primary health care facilities, present study was done at Siliguri of Darjeeling district of West Bengal which was 580 km distant from state capital (Kolkata). Methods: A cross sectional study over a period of 16 months was conducted among the patients admitted at North Bengal Medical College and Hospital suspected to have acute appendicitis. The diagnosis was confirmed by histopathological examination. Written consent was obtained from the patients before commencement of the study. MASS was applied to the patients and the results were compared with histopathological findings. Appropriate statistical analysis has been done by SPSS (version 16.0). Results: A total of 75 patients (44 males and 31 females) were considered. The sensitivity and specificity of MASS in this study were 75.86% (71.43% for males and 80% for females) and 82.61% (80% for males and 87.5% for females) respectively. Study revealed statistically significant (p<0.000) association between Histopathological report and MASS. Conclusions: To reduce the chances of negative appendectomy and for better diagnosis of appendicitis, MASS may be more useful at primary health care centres those are located in remote areas as it was very simple, easy and cost effective.

Occurrence and predictors of abortion among women of the reproductive age group in a block of Darjeeling District, West Bengal, India.

Abstract: Background: Despite being a sensitive and less explored issue, abortion is a major preventable cause of maternal morbidity and mortality affecting millions of women in developing countries. Objectives: The study aimed to determine the occurrence, nature, and predictors of abortion among women in the reproductive age group in Naxalbari block of Darjeeling district. Methods: A community-based cross-sectional study was conducted in Naxalbari block of Darjeeling district, West Bengal, India, from May 2015 to April 2016, among 420 women aged 15–49 years selected from 30 villages by cluster sampling technique. A predesigned, pretested interview schedule validated in the local vernacular was used. Binary logistic regression was used for finding out predictors of abortion among ever-pregnant women. Results: Lifetime occurrence of abortion was 33.6%. Among total 178 events of abortion, 51.7% were spontaneous and 48.3% induced. Majority of spontaneous abortions events were attended by a doctor (73.9%). About 59.3% of induced abortions were illegal, and unwanted pregnancy was major reason (62.4%) for induced abortion. Private facilities and over the counter drugs were preferred. Lower education, nuclear family, number of children <2, not having male child, domestic violence during pregnancy were significant predictors of abortion. Conclusions: Illegal abortions were highly prevalent in the area. Unwanted pregnancies hint toward unmet needs of family planning. Stigma and poor awareness were the root cause of not visiting a health facility in case of abortions. Building up of better infrastructure, better orientation of frontline workers, non-judgemental and confidential services will attract women to in government facilities.

Electrocardiographic Parameters in Indian Newborns.

Abstract: To generate data of electrocardiogram (ECG) parameters according to gestational age in Indian newborns. An observational study was carried out over 7 months in neonatology unit of a tertiary care teaching hospital. Following auscultation, ECG parameters were recorded simultaneously in 12 leads, on third day of life, in hemodynamically stable neonates. Data from 364 babies were analyzed, keeping at least 30 records for each gestational age between 30 to 42 weeks. There was no difference in mean heart rate recorded through auscultation and ECG traces. The mean (SD) values recorded were: P wave duration 0.04 (0.01) s, P wave amplitude 1.3 (0.4) mm, T wave duration 0.07 (0.02) s, T wave amplitude 1.1 (0.6) mm, PR interval 0.09 (0.02) s, QRS duration 0.04 (0.01) s, QT interval 0.26 (0.02) s, QTc 0.4 (0.03) s and QRS axis 127 (22) degree. Gestation age-wise percentile charts of different ECG parameters were generated. These gestational age-wise percentile charts of different ECG parameters for Indian newborns can be used as reference for neonatal ECG.

Closure of sino-orbital fistula using glabellar rotation flap: A case report.

Abstract: BACKGROUND Sino-orbital fistulas (SOF) are a well-reported complication of orbitalexenteration and sinonasal carcinoma resection. Despite repair, however, complete fistula closure may be difficult. CASE A 79 -years-old man had undergone total exenteration of right orbit for spreading sqamous cell carcinoma of conjunctiva. Subsequently he developed two large sinoorbitalfistulae medially to the ethmoid sinus wall of the orbit. Post- operatively good socket hygiene was maintained but the fistulae increased in size. At 3 month follow-up, closure of the fistulae using glabellar rotation advancement flap was done. The defects have remained closed at follow-up with excellent cosmetic results. There is no recurrence of fistula or malignancy till date. Patient was cosmetically rehabilitated with spectacle prosthesis. CONCLUSION Glabellar rotation flap for closure of medially situated sino- orbital fistulae is a good option with excellent cosmetic result.

Pro-life or pro-abortion – Women's attitude toward abortion in Darjeeling, India

Abstract: Background and Objective: Despite liberal abortion law in India, majority of abortions are unsafe. Behavioral theory suggests that women's attitudes may influence their abortion decisions. The present study was conducted to find out women's attitude toward abortion and its predictors. Materials and Methods: A community-based cross-sectional study was conducted in Naxalbari block of Darjeeling district, West Bengal, India, among 420 women aged 15–49 years using a predesigned, pretested interview schedule. The women's attitude regarding abortion practices was determined based on Likert's three-point scale. Two-stage cluster analysis was used to classify the overall attitude of women. Binary logistic regression was used for finding out predictors of abortion attitude. Results: More than half (53.5%) of the women had an overall pro-life attitude and 46.5% women had an overall pro-abortion attitude. Women who were less educated with

Abandoned Babies at Tertiary Care Rural Medical College Hospital: The Indian Scenarios.

Abstract: In India, girls are sex-selectively abandoned. The abandoned babies are brought to the nearest hospital under the jurisdiction of the administration. The authors aimed to study the demographic data and disease profile of those babies. In this hospital-based, retrospective, descriptive study, authors studied all the abandoned babies who were admitted to the Department of Pediatrics as “unknown” and cared for over the last 3 y. Their case records were analyzed with an appropriate statistical measure. Out of 11 babies, girl-boy ratio was 2.6:1, 73% being abandoned in the neonatal period with a survival rate of 91%. Six babies (54.5%) required emergency intervention at admission. Hospital stay was higher in girls with mean discharge time being 106 d, although the mean fit for discharge time was 6.5 d. This study is the first of its kind on abandoned babies demographic data and disease profile, highlighting the burden of abandoned babies in the hospital.

Retrospective analysis of clinical profile of pediatric proptosis in a tertiary care hospital of Eastern India

Abstract: Background: Pediatric proptosis can often present with puzzling clinical features and needs a systematic approach to avoid diagnostic dilemma. Aims and Objectives: To study the clinical and etiological profile, management, and outcome of pediatric proptosis. Materials and Methods: This retrospective noncomparative study involved the analysis of record files of 41 cases of childhood proptosis, who presented in the eye outpatient department and oculoplastic clinic between January 2013 and December 2016. Results: There were a total of 41 children, age varied from 6 months to 15 years. The maximum number of cases 25 (61%) were in the age group of 0–5 years. Male:female ratio was 1.77:1. Unilateral cases were found to be 31 (76%) and bilateral cases be 10 (24%). Neoplastic lesions constituted 22 (54%) of which benign lesions were 3 (14%) and malignant were 19 (86%). Among malignant, primary were 11 (58%) and secondary were 8 (42%). Inflammatory/infective lesions were 8 (20%). Conservative/medical management was given to 11 cases (27%). Surgery with pre- or post-operative chemo- or radio-therapy was the treatment of choice. Conclusion: Neoplastic lesions were found to the most common cause of proptosis in this study. Apart from detail ocular and systemic examination, final etiological diagnosis is possible in certain cases only after investigations such as peripheral smear, bone marrow examination, histopathological examinations, ultrasonography B-scan, computed tomography scan, and magnetic resonance imaging. Timely diagnosis and management can save the vision and many a times lives.

Comparative evaluation of microleakage after root-end resection by erbium, chromium: Yttrium-scandium-gallium-garnet (Er, Cr:YSGG) laser and carbide bur with or without placement of mineral trioxide aggregate: An in vitro study.

Abstract: Background: Root-end resection followed by retrofilling is one of the prime requisites to avoid apical microleakage. Aim: It comparatively evaluated the microleakage after root-end resection by erbium, chromium:yttrium, scandium, gallium, and garnet laser and carbide bur with or without placement of mineral trioxide aggregate (MTA). Materials and Methods: In this study, 60 maxillary central incisors were decoronated and biomechanically prepared. Out of 60 samples, 48 were included in the experimental group while the rest 12 were in the control group. The samples in the experimental group were obturated, whereas the samples in the control group were not obturated. The experimental group samples were divided into two: one group resected with the laser and the other half resected with carbide bur. These groups were further subdivided into two – one group retrofilled with MTA and the other half without MTA. The control group had both laser- and carbide bur-resected samples with positive and negative controls. All the samples were dyed, decalcified, and cleared. Digital photograph of each sample was taken, and the area of dye penetration was measured with the help of ImageJ software. Statistical Analysis: Analysis of variance and Tukey's test were done. Results: The highest microleakage was seen in carbide without MTA and the least was seen with laser with MTA. Conclusion: Laser-resected MTA-retrofilled samples showed minimum leakage.

A study on awareness of HIV/AIDS among adolescent school girls in an urban area of North Bengal, India

Abstract: Background: HIV/AIDS has recognized throughout the world as the important public health problem and adolescents are at greater risk of having this infection because of varying behavior pattern. Adolescents need correct information to prepare them to make better choices in sexual behavior. The present study was conducted to find out the existing knowledge regarding the causes, modes of transmission, prevention and social impact of AIDS. Methods: Setting based cross-sectional study done in the secondary and higher secondary students of Siliguri Girls School during July-September 2018. A self-administered, well designed pretested semi structured questionnaire with anonymity of the respondent was used for data collection with the help of interview. Results: 66.2% of girls knew sexual intercourse as the primary route of transmission whereas 22.9% knew airborne as the method. 60.8% of them thought isolation could prevent HIV/AIDS and safe sex can prevent transmission 59.4%. All the correct four routes of transmission were known by only 14.2% of students.12.55 of them knew about AIDS vaccine. Working with AIDS patient, using same toilet or sharing meals or swimming were the common myths among them to contract HIV/AIDS. Conclusions: Prevention being the only strategy available for HIV/AIDS is of utmost importance that knowledge regarding its various aspects should be dispersed among the adolescents through addition of chapter of AIDS and sex education in school curriculum.

Quality of life among menopausal women in an urban area of Siliguri, West Bengal, India

Abstract: Background: Women who lay the foundation of the whole society are most neglected in our society, especially in their mid-life. Physical and psychosocial symptoms among post -menopausal women had a positive relation with the quality of life. Methods: A total of 110 women of an urban area of North Bengal region of West Bengal, India were interviewed with help of schedule to obtain information regarding the personal characteristics and MENQOL tool to assess four domains means on the basis of 29 symptoms. Results: The mean menopausal age was 44.58±3.11 years. The means and standard deviation found in different domains are, vasomotor domain (5.35±2.94), physical domain (27.95±10.25), psychosocial domain (13.81±4.70) and sexual domain (1.99±2.91). In the vasomotor domain, muscles ache, joint ache and low back ache were the common symptoms. In psycho-social domain, 99% of the women suffered from poor memory and 97.2% of them felt depressed or down/blue. In sexual domain, 33.6% were bothered by changes in their sexual desires and avoided intimacy. In physical domain, age category, financial and decision autonomy had significant association. In the sexual domain, age category, literacy status, money and sexuality had a significant difference. Conclusions: Post-menopausal women are vulnerable group for whom appropriate and practical measures should be provided in their post-menopausal age in order to have a contented and pleasant life till they die.

Role of plaster of paris cast immobilization of skeletal pin following skeletal traction abstract

Abstract: BACKGROUND: Application of skeletal traction, requires insertion of skeletal pin which inflicts an open skin wound around the pin, impending portal for entry of microbes into the pin tract. Associated notable complications are metal reactions and secondary infection, subsequently leads to pin change or removal, failure of fracture union, septic arthritis, osteomyelitis etc. Aim of the present study was to compare the pin tract infection grade of elderly patients having open pins with antiseptic dressing and cases immobilized with plaster of Paris (POP) cast. MATERIALS AND METHODS: The study population consists of 88 patients treated with upper tibial skeletal traction, of whom 44 persons followed up by regular antiseptic dressing of open percutaneous pin would (Group 1) and the rest 44 persons having pin covered with POP cast (Group 2). Pin tracts of both groups were evaluated after 6 weeks by Checketts-Otterburn’s grading system. Primary outcome variables of infection gradation and outcome measures was compared by NNT with 95% confidence interval, proportion and percentage. RESULTS: Mean age of patients of group 1 was 69.75, SD 7.185 and group 2 was 68.95, SD 8.177. Skeletal pin had to be removed (Grade 4 in Checketts-Otterburn’s grading system) in 10 (66.7%) of group 1 compared to only 5 (33.3%) cases of group 2. No case of osteomyelitis (Grade 6) has been seen in any group. The difference in grade of pin tract infection in the two groups was statistically significant (p =0.001). DISCUSSION High morbidity in conservative treatment is vastly the result of continuous pain, infection and discomfort. The present study compellingly documented non-operative management by skeletal traction is far from being the lethal procedure if the the rate of pin tract infection is reduced by covering with POP cast. In institutes that cater to a significant number of elderly population, skeletal traction with appropriate control of pin site infection is an effective alternative to more aggressive operative method. Keywords: Skeletal Traction, Pin Tract Infection, Elderly Patients, Plaster of Paris (Pop) Cast.

Study of feeding practice and factors influencing it among preterm babies getting Kangaroo mother care in a Tertiary Care Hospital

Abstract: Background: Kangaroo mother care (KMC) is an effective way to reduce mortality and morbidity of low-birth-weight babies. KMC feeding aims at the establishment of exclusive breastfeeding (EBF) for every baby. This study was conducted to analyze the actual feeding pattern and factors influencing it. Methods: Babies getting KMC were prospectively observed and the data related to feeding practice were collected. At discharge, the babies were divided into two groups: EBF and non-EBF. Different factors were compared between these groups. Results: Among 387 babies, 63.56% were on EBF. Postnatal counseling, early contact and initiation of feeding, early expression of breast milk, and first feeding with EBM played a pivotal role behind the establishment of EBF (P

Evaluation of curettage, synthetic bone grafting and fixation with implant in benign osteolytic and cystic lesions of long bones in children and young adults

Abstract: Background: Curettage is one of the most common treatment options for benign lytic bone tumors and cystic lesions. In children and young adults, the resultant defect is usually filled with synthetic bone graft, which is a natural calcium phosphate hydroxyappatite (HA) in crystalline ceramic form. Methods: Sixteen cases of benign lytic and cystic lesions of bone were managed by simple curettage and grafting using hydroxyappatite blocks. Displaced pathological fractures or impending peritrochanteric fractures were fixed by implant. Commercially available HA was used for this purpose. Mean duration of follow up was 17.5 months (range 12 –30 months). Mean patient age was 11.2 years (range 6–20 years). Radiological staging of graft incorporation was done as per criteria of Irwin et al. Results: Among 16 cases, 2 patients presented with non-ossifying fibroma and 2 patients with simple bone cyst, 12 cases were aneurysmal bone cyst. 5 patients had pathological fracture. Healing of lesion and graft incorporation is seen in all of the cases. At 6 months of follow up 3 cases were in Irwin stage III, 9 cases were in Irwin stage II and 4 cases were in Irwin stage I. At final follow up 10 cases were in Irwin stage III and rest was in Irwin stage II. No recurrence seen till date. Conclusions: We conclude that meticulous curettage and filling of bone cavity by calcium phosphate hydroxyappatite and fixation with implant in displaced pathological fracture or impending fracture is the procedure of choice of management of benign lytic lesions of bone.

Combination of critical care pain observation tool and face, legs, activity, cry, consolability scale in assessment of postoperative pain severity in postanesthesia care unit: A prospective cross-sectional analytical study

Abstract: Context: Effective post-operative pain assessment is mandatory to exclude overdose of analgesics and avoid adverse effects. Patients in PACU have impaired ability to communicate making pain assessment challenging. This study aims to establish agreement between two pain scales, CPOT (Criticalcare Pain Observation Tool) and FLACC (Face, Legs, Activity, Cry, Consolability) and to find out specificity of combination of scales. Methods: Taking sample size of 50 patients of either sex, aged 18-80 years, ASA-PS I-III, undergoing elective surgeries were chosen, study period being June-September 2017. Adequately reversed, extubated patients not receiving sedatives, analgesics and local anaesthetics within 15 minutes before end of operation were included while patients with ASA-PS more than III or on ventilator were excluded. Assessment was done upto 2 hours at 30 minutes interval using CPOT tool and FLACC scale simultaneously by two observers, both being blinded about study. Results: Combination of two scales show high odds ratio (41%) and kappa coefficient (0.78) suggesting excellent agreement. Specificity of combination of scales is very high (95.2%) than individual test. Conclusion: CPOT and FLACC scale together has excellent agreement and their combination are more specific to assess the severity of post-operative pain than when used individually.

Author's Reply for article "Vaccine Hesitancy for Childhood Vaccinations in Slum Areas of Siliguri: A Critical Commentary".

Abstract: Indian Journal of Public Health ¦ Volume 63 ¦ Issue 2 ¦ April-June 2019 161 Sir, We appreciate that the readers have taken great interest in our topic of research.[1] It would be beneficial for all of us to clarify some aspects of the methodology in a point-wise manner. 1. We agree to the point raised by readers here. However, in the backdrop of the slum area, and our study covering grossly all childhood vaccinations, responses solely based on mothers’/caregivers’ responses could not be relied on. Hence, we used immunization cards for validating the responses. The World Health Organization Strategic Advisory Group of Experts on immunization has defined vaccine hesitancy as “delay in acceptance or refusal of vaccination despite the availability of vaccination services.” Vaccine hesitancy occurs along a continuum between full acceptance and outright refusal of all vaccines, i.e., when there is acceptance of some and delay or refusal of some of the recommended vaccines[2] 2. In the present study, birth doses are operationally defined as vaccines given within 14 days.[1] Moreover, there needs a minimum gap of 4 weeks between the primary doses.[3] Hence, if a child is vaccinated after 4 weeks of the scheduled period, he is already late for the next dose. In the sociocultural context of the area, she might be even out of the cascade of immunization. Hence, based on previous studies[4] and experts’ opinion, we used this operational definition 3. In a widely promoted and structured routine immunization delivery system in India, forgetfulness can be a proxy indicator for hesitancy. Further exploration in this regard was beyond the scope of our study 4. Within limitations of our study, we have explored few aspects of this emerging problem. Further researches could be done for in-depth exploration of “reluctance.”

Different methods of fixation of semitendinosus grafts in arthroscopic reconstruction of anterior cruciate ligament

Abstract: BACKGROUND: The Anterior Cruciate Ligament (ACL) is the most commonly injured ligament in the human body. Earlier treatment of ACL injury was mainly restricted to sportsmen, but has increased over the years because of awareness and accessibility to treatment facilities. Arthroscopic reconstruction is now the gold-standard for the treatment of ACL tear. MATERIALS AND METHODS: This study was conducted at IPGME & R, Kolkata in the department of Orthopaedics, where forty patients with single knee injury were taken into consideration, the injury being more than two months old, in the age group 20-50 years, with clinically significant knee instabilities and confirmed on MR imaging. RESULTS: This was a prospective randomised study where 95% of the patients were male. The outcome was based on regaining pre-injury status and recovery was based on pre- and post-operative clinical and radiological findings and marked according to Tegner- Lysholm scale. CONCLUSION: Clinical and radiological (MRI) proved knee instabilities due to standardised Anterior Cruciate Ligament injury were best treated by arthroscopic repair using semi-tendinosus graft, which provided to be the gold-standard treatment protocol. Keywords: ACL Injury, Knee Instability, Arthroscopic Repair, Semitendinosus Graft.