Metabolic syndrome and its socio demographic and behavioral correlates: a cross sectional study among adult patients attending medicine outpatient department in a tertiary care hospital, West Bengal

Background: Metabolic syndrome (MS) is a pre-condition for cardiovascular diseases and type 2 diabetes mellitus (T2DM) which are major contributors to morbidity and mortality worldwide.Methods: The cross-sectional, observational study was conducted to estimate the proportion of MS and to explore crucial risk factors for MS among adult patients attending medicine OPD in a tertiary care hospital in West Bengal. The estimated final sample size was 315. Baseline socio demographic information and information on risk factors for MS, such as dietary habit, physical activity status, substance use, intake of related drugs, and presence of co-morbidities were collected by interviewing the patients with the help of a predesigned, pretested, structured schedule. Anthropometric measurements such as weight, height, waist circumference recordings were taken, and blood pressure was measured.Results: About 64% of the final study population (210/330) suffered from MS. On bivariate analysis, significant association between female gender (df=1, Pearson chi-square=5.06, p=0.024), weekly frequency of consumption of junk foods (df=3, Pearson chi-square=10.40, p=0.015) and obesity according to BMI (independent samples Mann-Whitney U test, p=0.010) at 5% level of significance were observed. Performing binary logistic regression analysis, obesity according to BMI (AOR=1.388, 95% CI=1.064-1.810) was found to be significant.Conclusions: Majority of the population suffered from MS who were mostly female, obese and consumers of junk foods. Appropriate interventional measures in terms of life style modification both at community and at tertiary care level are the need of the hour.

Goiter Prevalence, Urinary Iodine, and Salt Iodization Level in Sub-Himalayan Darjeeling District of West Bengal, India.

National iodine deficiency disorders control program needs to be continuously monitored. Hence, a cross-sectional study was conducted during the period from April-May 2011 to assess the prevalence of goiter, status of urinary iodine excretion (UIE) level and to estimate iodine content of salts at the household level in Darjeeling district, West Bengal. Study subjects were 2400 school children, aged 8-10 years selected through “30 cluster” sampling methodology. Goiter was assessed by standard palpation technique, UIE was estimated by wet digestion method and salt samples were tested by spot iodine testing kit. Overall goiter prevalence rate was 8.7% (95% confidence intervals = 7.6-9.8) and goiter prevalence was significantly different with respect to gender. Median UIE level was 15.6 mcg/dL (normal range: 10-20 mcg/dL). About 92.6% of the salt samples tested had adequate iodine content of ≥15 ppm. Findings of the present study indicate that the district is in a transition phase from iodine-deficiency to iodine sufficiency.

Assessment of stress & related albuminuria in caregivers of severe mentally ill persons.

Background & objectives: The family caregivers of patients with chronic diseases are known to undergo psychiatric stress leading to oxidative damage to glomerular membrane of kidney resulting in proteinuria. This study was aimed to compare current anxiety, depression levels and urinary albumin:creatinine ratio between primary caregivers of chronic mental patients and matched controls, and also whether the urinary albumin : creatinine ratio is correlated with stress factors (state and trait anxiety level, depression and caregiver burden) amongst caregivers. Methods: The present cross-sectional study included 131 subjects (93 primary caregivers of patients with major mental illness as cases and 38 normal controls). They completed the Burden Assessment Schedule of SCARF, State Trait Anxiety Inventory and Beck’s Depression Inventory. A spot urine sample was tested for urinary albumin : creatinine ratio from all study subjects. Results: Mean values of current State and Trait anxiety, depression, urinary albumin:creatinine ratio were significantly higher in caregivers than controls (P<0.001). Urinary albumin : creatinine ratio was significantly correlated (P<0.001) with State and Trait anxiety level, depression as well as caregiver burden. Interpretation & conclusions: The study demonstrated depression , anxiety and albuminuria amongst primary caregivers of patients with mental illness. Increase in the caregivers’ burden, depression and anxiety resulted in an increase in the urinary albumin: creatinine ratio. This indicates that psychological stress is one of the determinants of albumin excretion rate in otherwise healthy subjects.

Assessment of perception of first professional MBBS students in India about a teaching learning activity in Biochemistry.

Objectives: To obtain feedback from the 1st Professional MBBS students on their perception of the existing method of lecture classes in Biochemistry. Method: A semi-structured questionnaire based study was conducted at the Department of Biochemistry, Medical College and Hospital, Kolkata, West Bengal, India, under the West Bengal University of Health Sciences. The subjects were the 1st Professional MBBS students in the 1st semester of the academic year 2008 – 2009. Results: Three items with the highest and least Satisfaction Index were segregated and compared against an ‘average satisfaction’ of 66.67%. The summary of the consolidated observation on the most appreciated and least appreciated aspects and suggestions for improvements were taken into consideration and discussed. Further, Interpretation of the feedback reflected that the learners still preferred to be taught in a predominantly individualized care-based environment. Conclusion: Feedback from the students facilitates a change in preconceived notions about teachinglearning principles on the part of the faculty. At the same time, it is evident from the feedback obtained that the students still prefer to be taught in an individualized care-based environment which reflects their lack of or incomplete attitudinal shift towards the more institutionalized care-based environment of a medical education institution.

Iodine deficiency disorders among the pregnant women in a rural hospital of West Bengal.

BACKGROUND & OBJECTIVES: Iodine deficiency disorder (IDD) is a major nutritional problem in India. The pregnant women and their neonates have been important target groups for study of the prevalence of IDD in a community. No such study was available to assess the prevalence of IDD among the pregnant women and neonates in the state of West Bengal. The present study was undertaken to assess the status of IDD in the pregnant women and its effect on the neonatal thyroid function in Burdwan district of West Bengal. METHODS: The present study was a hospital-based, cross-sectional, non-interventional study among 267 full term pregnant mothers, and the neonates born to them. One hundred non pregnant healthy women were selected as controls. The overall iodine status of the pregnant and non pregnant women was estimated by measuring the urinary iodine excretion (UIE) and the serum thyroid stimulating hormone (TSH) levels. The neonatal thyroid function was estimated by measuring the TSH levels in their cord blood. RESULTS: A total of 78.4 per cent pregnant women showed UIE > 10 mug/dl with 7 per cent having a UIE < 5 mug/dl. The median UIE and the serum TSH values in the pregnant women were found to be 14.4 mug/dl and 4.1 mIU/l, respectively. No statistically significant difference was found when compared with the control values. Only 2.9 per cent of the neonates showed a cord blood TSH value > 5 mIU/l which is just below the recommended criteria for mild endemicity for IDD in the study population. INTERPRETATION & CONCLUSION: Pregnant women of the study area were iodine repleted. The neonatal thyroid function was also within normal range. The findings of the present study indicates that the iodine supplementation of the salt should be maintained in the area with periodical surveillance.

Prevalence of iodine deficiency disorders among schoolchildren in three blocks of Bardhaman District and Bardhaman Municipal area of West Bengal, India: a comparative study.

Urinary iodine levels in children (6-12 years) living in three rural blocks and in the municipal urban area of Bardhaman District, West Bengal, were analyzed to compare the status of recent iodine nutrition in the rural and urban population of the district. Goiter, indicating previous iodine status, was simultaneously estimated. Iodine levels in salt samples, that provide insight into the usage of iodized salt, were estimated. Data indicated that 56.6% of urban children and 51.1% of rural children were biochemically iodine repleted and had urinary iodine excretion (UIE) levels > or = 10microg/dl. Urban children (29.4%) and rural children (37.1%) were found to have goiter. Eighty percent and 50% of the rural and urban salt samples, respectively, were found to have iodine levels below 10 ppm; with significant urban-rural differences. The results indicate that iodine repletion in the surveyed area needs continuous surveillance of the proper distribution and use of iodized salt.

Role of clinical biochemistry laboratory in the diagnosis of diabetes mellitus.

Clinical biochemistry and laboratory help is needed at all stages of diagnosis of diabetes. Laboratory plays a key role in the management of diabetes and its complications like renal, metabolic, and others. Monitoring of treatment is also guided by regular blood sugar estimation and self-monitoring of blood glucose level.

Iodine deficiency disorders among school children of Malda, West Bengal, India.

A community-based, cross-sectional study was conducted among 2,392 school children, aged 8-10 years, in Malda district of West Bengal, India, in January 2001 to assess their iodine status. The children were selected through a multistage 30 cluster-sampling technique to determine the status of iodine deficiency disorders (IDD) using recommended quantifiable indicators. The prevalence of goitre was assessed clinically using the standard palpation method by the teachers of Community Medicine, and a total goitre rate of 11.3% was found with no significant gender difference (p>0.05). Urinary iodine excretion (UIE) levels of 341 study subjects, selected through systematic random sampling, were analyzed by the wet digestion method to determine biochemical iodine deficiency by the teachers of Biochemistry Department. The median UIE was 15 mcg/dL, and no child had UIE value less than 5 mcg/dL. Iodine content of 1,060 salt samples tested with spot-testing kit revealed 85.1% with adequate iodine content of > or = 15 ppm. The finding of 11.3% of total goitre rate but with no evidence of current iodine deficiency (median UIE 15 mcg/dL) indicates that the Malda district is in the transition phase from iodine-deficient to iodine-sufficient.