North Bengal Medical College

About: North Bengal Medical College is a other organization based out in Darjeeling, India. It is known for research contribution in the topics: Population & Cancer. The organization has 624 authors who have published 691 publications receiving 5492 citations.

Study of etiological and clinical profile of pericardial effusion in a tertiary care hospital in Kosi region of Bihar, India -

Abstract: Background: Pericardial effusion is one of the common diseases presenting in emergency and outpatient departments of a tertiary care center. Pericardial effusion can cause significant symptoms and diminished quality of life, but more importantly, is associated with increased risk of cardio respiratory failure, mortality and death. The etiology of pericardial effusion varies in different parts of the world and is related to the relative prevalence of different diseases. Methods: This is a retrospective where data from all the cases diagnosed with pericardial effusion in the medicine department of KMCH from July 2014 to July 2015 were included. Altogether 66 cases diagnosed with pericardial effusion were established by Echocardiograpy. Evaluation for the cause of pericardial effusion included complete blood count with ESR, Blood urea, serum creatinine, tuberculin skin test, Chest X-ray, ECG, Thyroid profile, ANA, Rheumatoid factor, CT chest / MRI and pericardiocentesis. Pericardial fluid was analysed for cells, proteins, LDH, malignant cells, ADA, PCR (for mycobacterium tuberculosis), gram staining, AFB staining and cultures. Iatrogenic (cardiac surgery, catherterization) and post-traumatic cases and age <15 years were excluded. Results: Majority of patients ware aged between 56-75 years. Thirty-five patients (53.03%) were male and 31 patients (46.96%) were female. Most common etiology of pericardial effusion was tuberculosis 27.27% followed by Idiopathic 19.69% then Uremia 16.66%, and Malignant 13.63%. The least common etiology of pericardial effusion was HIV infection 1.51%.The most common clinical feature was Tachycardia 69.69%, followed by Breathlessness 60.60% and fever was 54% of patients. Conclusions: By this study, we have observed various presenting feature for pericardial effusion are tachycardia, shortness of breath, fever, heaviness of chest, cough, chest pain etc. The important disease factor for the occurrence of pericardial effusion such as tuberculosis, idiopathic/viral, uremic, neoplastic, CCF, hypothyroidism, post MI, etc.

Working environment and morbidities of child laborers in an urban slum of kolkata.

Abstract: Sir, According to the World Health Report (1995), 15% of children aged 10–14 years old were working in Asia and India has the largest percentage of child laborers in the world.(1) Child labor contributes to about 20% of India's GNP(1) and mostly operates in the unorganized, informal, and unregulated sectors of the economy and is not being adequately reported. The most powerful force driving children into labor is exploitation of poverty. They begin to work at a very young age. These child laborers are engaged in various types of working situations in unorganized urban sectors. Poor and unsafe working conditions adversely affect these children and they may suffer from poor physical, mental, and social development. They have to work in an unkind, uncomfortable, and often physically hazardous environment for long hours. This study was carried out to assess the working conditions and environment of child laborers and to determine their morbidity pattern. A cross-sectional, observational study was conducted for a period of 3 months from October to December 2003 in the service area of the Urban Health Centre (UHC), Chetla, Kolkata under the All India Institute of Hygiene and Public Health, Kolkata. Of the four sectors catered by this UHC, Sector I and III were selected randomly for the study. Children working in two lanes of each sector, chosen randomly, were considered for the study. The study units were selected based on the definition given by the Operation Research Group, Baroda i.e., children between 5–14 years old, full-time workers, and on remunerative work.(2) The children working in commercial establishments were considered for the study. Based on this, the sample size came to be 45. Data was collected using a pretested and predesigned schedule. The children were interviewed in their working places. The adult workers were interviewed to judge the validity of information. Observation was done to assess the working place environment such as, the type of construction, ventilation, lighting, availability of drinking water, latrine facility, etc. The current morbidity pattern was recorded based on 2 weeks recall. The study revealed that a majority (86.6%) of the child laborers were male and most of the children (84.4%) were between the ages of 11 and 14 years old. The average age of the child laborers was 11.9 years old. Among the working children, 73.3% were Hindus and the rest were Muslims. A majority (84.4%) of the children were from nuclear families. For 6.7% of the children, both the parents were dead and in the case of 17.7% of the children, the father was either dead or had left the family. A total of 48.9% of the children had not been to school, 46.7% of the children received primary education, and only 4.4% of the children had gone to middle school. A total of 5 out of 45 children were still trying to pursue their education. Among the study population, 42.3% worked in a garage, 35.5% were rag pickers, 13.3% worked in hotels and food stalls, and 8.9% were shop helpers. None of the children were engaged in so-called hazardous occupations as described by the Indian Child Labor (Prohibition and Regulation) Act, 1986. Children working in garages, hotels, and shops were all males and the females were rag pickers. The Indian Child Labor (Prohibition and Regulation) Act, 1986 had recommended that the child workers would work for a maximum of 6 hours a day with 1 hour rest after 3 hours of work and they would get a weekly holiday. The present study showed [Table 1] that most of the child laborers (71.2%) worked for more than 6 hours a day and about one third of them did not get any rest in between their work. All the child laborers included in the study get one weekly holiday except the hotel boys who are allowed leave after one or two months of continuous work or when they are sick. Table 1 Distribution of child laborers according to working hours and remuneration It was found that 26.6% of the child laborers were paid less than Rs 300 per month. Among the laborers working, 21 (46.7%) received food, mainly hotel and some garage workers and 6 (13.3%) received tips. Financial support in medical care was available to 20 (44.4%) of the workers. The majority of the working children had to spend almost all of their income to support their family. A total of 32 (71%) of the working children were satisfied with their working conditions, 17.8% felt tired during work, and 11.1% considered the remuneration to be very low. As laid down in the Child Labour Act, it is the responsibility of the appropriate government agencies to make rules to provide safe and healthy environmental conditions for child laborers such as disposal of wastes and effluents, ventilation, temperature, lighting, cleanliness, drinking water, latrine, urinals, fencing of machinery, etc. Among the study population, 35.5% of the children worked totally exposed to the sun and rain and 31% had to work partly under open air. Almost all the working places were adequately ventilated and illuminated. A total of 44.4% had no latrine facilities at their work places although arrangements for drinking water were present in most (84%) of the places. Being fragile physically, children are more susceptible than adults to various work-related injuries and illnesses. Also, because they are not yet matured mentally, they are less aware, even completely unaware, of the potential risks involved in their specific occupations or at the work place itself. About 40% of the children said that they had no health problems in last 2 weeks but 31% complained of respiratory infections, 24% had skin infections, and 13.3% had toothaches and caries tooth. A total of 42.2% had pallor and 11.1% had signs of vitamin B deficiency. Physical injury while working had been sustained by 6 (13.3%) children. Morbidities were more in children who worked in the sun and rain (87.5%) than those who were not exposed (44.08%) and the difference is statistically significant. It is now evident that child labor cannot be totally eradicated by legislation alone. Implementation of such laws and detection of violations, especially regarding working hours, rest period, holidays and to supervise the working environment are necessary. We should try to provide these children with education, supplementary nutrition, health care, and vocational training to improve their living conditions.

Polyarticular tuberculosis missed diagnosed as juvenile idiopathic arthritis

Abstract: We report a child with multiple joint swellings, being treated as a case of poly-articular juvenile idiopathic arthritis subsequently turned out to be tubercular origin. Development of overlying sinuses, lytic lesions on radiographs, synovial fluid analysis showing tubercular infection and demonstration of epitheloid granulomas on bone biopsy confirmed the diagnosis of tubercular poly-arthritis with dactylitis. Child was asymptomatic after two months of starting antitubercular treatment. The case highlights the need to consider the possibility of tuberculosis as aetiology of poly-arthritis, at least in endemic areas, even in the absence of a tuberculosis contact history and overt pulmonary symptoms.

Virilising adrenocortical carcinoma.

Abstract: A 16-year-old, Hindu, female presented with rapidly growing abdominal lump for 6 months, primary amenorrhoea and non-development of secondary sex characters. Her BP was 180/120 mmHg. There was an excessive hirsutism involving face, neck, shoulders, abdomen and thighs. A lump was felt at left lumbar region extending on to left hypochondrium and part of umbilical region. Her serum testosterone level was 224 ng/dl and cortisol level was 15 microg/dl. Ultrasonography revealed a solid mass arising from the upper pole of left kidney. Exploratory laparotomy revealed a huge left adrenal tumour which was removed completely. Histopathology of the resected mass showed sheets of large round to polyhedral cells with hyperchromatic nuclei and eosinophilic granular cytoplasm with numerous giant cells. The case was diagnosed as virilising adrenocortical carcinoma.

CD8-positive Mycosis Fungoides Masquerading as Pyoderma Gangrenosum.

Abstract: Mycosis fungoides (MF), a primary cutaneous T-cell lymphoma, accounts for <1% of non-Hodgkin lymphomas. The diagnosis of classic MF is based on a constellation of typical clinical presentation, histopathology, immunohistochemistry, and T-cell monoclonality detected by molecular studies. Rarely, atypical clinical presentation may occur. The typical immunohistochemical phenotype is, CD2 +ve, CD3 +ve, CD5 +ve, CD4 +ve, and CD8 - ve. Here, we report a rare case of CD8 +ve MF in a 43-year-male patient who was clinically diagnosed as pyoderma gangrenosum initially. The atypical presentation and rarity of such case have prompted this report.