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Purpose: Glaucoma is the second leading cause of blindness worldwide, affecting more than 64 million people aged 40–80. The best way to manage primary open?angle glaucoma (POAG) is by lowering the intraocular pressure (IOP). Netarsudil is a Rho kinase inhibitor, the only class of antiglaucoma medications that reorganizes the extracellular matrix to improve the aqueous outflow through the trabecular pathway. Methods: An open?label, real?world, multicentric, observation?based 3?month study was performed for assessing the safety and ocular hypotensive efficacy of netarsudil ophthalmic solution (0.02% w/v) in patients with elevated IOP. Patients were given netarsudil ophthalmic solution (0.02% w/v) as a first?line therapy. Diurnal IOP measurements, best?corrected visual acuity, and adverse event assessments were recorded at each of the five visits (Day?1: screening day and first dosing day; subsequent observations were taken at 2 weeks, 4 weeks, 6 weeks, and 3 months). Results: Four hundred and sixty?nine patients from 39 centers throughout India completed the study. The mean IOP at baseline of the affected eyes was 24.84 ± 6.39 mmHg (mean ± standard deviation). After the first dose, the IOP was measured after 2, 4, and 6 weeks, with the final measurement taken at 3 months. The percentage reduction in IOP in glaucoma patients after 3 months of once?daily netarsudil 0.02% w/v solution use was 33.34%. The adverse effects experienced by patients were not severe in the majority of cases. Some adverse effects observed were redness, irritation, itching, and others, but only a small number of patients experienced severe reactions, as reported in a decreasing order: redness > irritation > watering > itching > stinging > blurring. Conclusion: We found that netarsudil 0.02% w/v solution monotherapy when used as the first?line treatment in primary open?angle glaucoma and ocular hypertension was both safe and effective.
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Background: The majority of children with pneumonia are managed as outpatients. Pneumonia is indeed an acute respiratory illness that mostly affects the lungs. When a healthy individual breathes, the lungs are made up of little sacs called alveoli, which fill with air. Pneumonia can occur at any age, and it is much more common in children under the age of five. Pneumonia accounts for 13% of all infectious diseases in babies under the age of two. Pneumonia in newborns is characterized by poor feeding and respiratory distress, as well as tachypnea, retractions, grunting, and hypoxemia. In contrast, the majority of published material on pneumonia, particularly bacterial pneumonia, has come from hospitalized patients. This circumstance implies a lack of straightforward, accurate ways of establishing a bacterial illness diagnosis in the outpatient context. The aim of the study was to observe the possible causes and clinical manifestations of pneumonia among pediatric patients.Material & Methods:This cross-sectional observational study was conducted at the Department of Pediatrics, Abdul Malek Ukil Medical College, Noakhali, Bangladesh. The study duration was August 2021- July 2022. A total of 76 infants and children with WHO ARI classified pneumonia were included in the study.Results:Among the participants, over half [61.84%] of participants had been less than 1 year of age, and 59.21% of the participants were male. All the participants presented with cough, and fever was also extremely common among the participants. 36.84% of the participants also had convulsions, while respiratory infections, headaches, and feeding problems were each present in 22.37% of the participants. 40.79% had crepitation in the lung, 42.11% had rhonchi or wheezing sounds, and 10.53% had both crepitation and rhonchi. Among the symptoms present in the participants, all 100 had a cough, 94.74% had a fever alongside cough, and 39.47% had fast breathing. Among the participants, 18.42% had respiratory rates of 41-50 per minute, 52.63% had a respiratory rate of 51-60, and 28.95% had a rate of over 60 per minute. The mean heart rate was 91.69 among the participants. 71.05% had grade 1 protein-energy malnutrition, 53.95% were breastfed, 38.16% were bottle-fed, and 7.89% had discontinued feeding. Poor sanitation was observed in 44.74%. 14.47% had LPG cooking gas being used in their home, while 85.53% had used non-LPG gas.Conclusion:The study showed that the majority of the children were under 1 year of age, and male prevalence was observed among participants. Cough and fever were extremely common clinical presentations and symptoms of pneumonia, and rhonchi and crepitation were common signs of symptoms. Grade 1 protein malnutrition, unsanitary living space, and use of non-LPG gas might have a hand in the incidence of pneumonia among the participants. Among the different types of pneumonia, bacterial and viral were the most prevalent among children.
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Background and Objectives : Routine surveillance and monitoring studies pose a constant need to update clinicians on prevalent pathogens and rational and empirical treatment in Urinary Tract Infection (UTI). Escherichia coli (E coli) is the most commonly isolated uropathogen globally. Extended-Spectrum ?-Lactamase (ESBL) production and ?-Lactamase Inhibitor Resistance (BLIR) among these pathogens together with their uro-virulence determinants further complicate treatment approaches. This study investigated the clinico-microbiological pattern of UTI and determined the antibiotic sensitivity pattern, the phylogenetic background, and virulence determinants of E coli, the most commonly isolated uropathogen. Methods : Uropathogens isolated by urine culture from community and hospitalized patients were biochemically speciated. Antibiotic susceptibility was tested by Kirby-bauer disk diffusion method. Phylogenetic background and virulence determinants of E coli isolates were identified by PCR. SPSS 16.0 was used for statistical interpretation. Results : 45% of the urine samples showed growth positivity. 44% amongst them were E coli. All isolates were multidrug-resistant. 50% and 40% were ESBL producers and BLIR respectively. Former showed highest resistance to quinolone, fluoroquinolones, cotrimoxazole, and latter were resistant against all drugs tested except nitrofurantoin. Significant correlation existed between the ?-lactams, quinolone, fluoroquinolones, cotrimoxazole (p<0.05) resistance pattern. BLIR and ESBL E coli recorded highest prevalence of pathogenic phylogroup B2 and D respectively. Varied prevalence of fimbrial (fimH, papC, papEF, papG, GII) and toxin genes (iroN, hlyA, cnfI, i ucD, cdtBU) in ESBL, BLIR and non-ESBL isolates were observed. Their distribution was statistically significant (p=0.05). Interpretation and Conclusions : Nitrofurantoin is the drug of choice in empirical treatment of uncomplicated UTI. Aggressive and consistent investigation and health education are highly recommended for effective clinical management in UTI.
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Traditionally, fermented food and beverages are prepared by adding a mixture of plant residues as a starter or source of microbes. Most of the conventional fermented foods use a local starter which contains a mixture of herbs or old ferment or otherwise cereal dust-coated tablet. In this study, we have made an attempt to prepare a rice-based fermented food with the herbal starter (0.5% w/w) of Elephantopus scaber L. rhizome, and also examined its microbial and nutrient profiles. The food product is fortified with organic acid and titratable acidity of 0.58% and also contained an excellent source of microbes (LAB and Bifidobacterium sp.). The fermented food contains significant amount of fat, protein, minerals, vitamins, oligosaccharide, unsaturated fatty acids (?3, ?6, ?7 and ?9) and a pool of free amino acids. The presence of phytochemical contents in the fermented rice was also exhibited significant effects against commercially available free radicals (DPPH, ABTS, FRAP and OH-radicals). Thus, food-grade microbes containing newly formulated fermented food would provide essential macro-and micro-nutrients to the individuals and convey the sustainability of good health. Therefore, the mentioned plant part would be used as an effective starter for aiding rice-based food products.
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Fungal biomass, being organic waste, could be an excellent source of protein, carbohydrate and minerals. However, it has not been exploited fully until now. Efficient management of this waste can not only address the environmental impact on its disposal but also yield value-added metabolites. In the present study, in order to explore its potential, we subjected dead fungal biomass of Aspergillus niger SKN1 as substrate for both fermentative and enzymatic biodegradation, respectively by potent proteo-chitinolytic bacteria Alcaligenes faecalis SK10 and its enzyme cocktail. The results revealed that reasonable amount of protease and chitinase could be biosynthesized by the fermentative mode of utilization, while a mixture of amino acid, peptides and low-molecular weight amino-sugar (mono and oligomeric form of N-acetylglucosamine) could be generated through enzymatic hydrolysis. The physicochemical condition of both the bioprocess was subsequently optimized through statistical approach. The projected utilization of waste zero-valued fungal biomass offer a sustainable and environmentally sound method for production of microbial metabolites and large scale execution of the same could be proficient and in tune with the principle of circular economy.
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Background: Hyperbilirubinemia is a common neonatal problem. Phototherapy and exchange transfusion is the conventional treatment for indirect hyperbilirubinemia. In the treatment of cholestatic liver disorders, Ursodeoxycholic acid (UDCA) is a bile acid widely used. Few studies have been conducted using UDCA in indirect hyperbilirubinemia. Aim of the study: This study was planned to assess the additive effect of UDCA on reducing indirect hyperbilirubinemia in neonates receiving phototherapy. Material & Methods:This prospective randomized controlled trial was conducted among neonates with indirect hyperbilirubinemia in the neonatal wards of Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh from June 2018 to July 2020. Finally, 140 neonates were included in the study. Eligible cases were randomized into two groups by the lottery method. Group A (n=70) received phototherapy and Group B (n=70) received UDCA at a dose of 10 mg/kg/day orally twice daily in addition to phototherapy. Total serum bilirubin levels were measured every 12 hours until serumbilirubinlevel falls below 10 mg/dl and then phototherapy was stopped. Demographic data, clinical features, laboratory parameters, outcome variables, and complications were recorded in a pre-format sheet. CBC with PBF, Total and indirect bilirubin, Blood grouping and Rh and typing, CRP, Reticulocyte count, and Coombs test were obtained at enrolment. Comparison of parameters among themselves was done by unpaired t-test and chi-square test. Analyzed outcomes were: time for resolution of jaundice, total duration of phototherapy, length of hospital stays, and adverse effects of the drug. The two groups did not differ statistically in age, sex or weight. The mean total serum bilirubin level measured at 12, 24, 36, 48, and 60 hours of treatment in group A was 16.10±1.43, 14.76±1.45, 13.34±1.68, 11.84±1.35, and, 10.57±0.74 respectively, and in the group, B was,15.18±1.63, 13.18±2.25, 11.39±1.56, 9.84±0.81 and, 9.44±0.46 respectively (p<0.001). The mean duration of phototherapy (64.11±10.8 vs. 47.18±7.51 hours, p<0.001) and length of hospital stay (2.80 ±0.40 vs. 2.19±0.39 days, p=<0.001).Conclusion:The inclusion of UDCA as an adjuvant to phototherapy is more effective in reducing indirect hyperbilirubinemia in neonates.
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Background: Acute bronchiolitis is the most common lower respiratory tract infection in young infants and young children. The respiratory syncytial virus is the commonest cause of bronchiolitis. Recently the role of nebulized 3% saline has come into focus. Nebulized adrenaline has also been suggested as another treatment option, its primary role being the reduction of mucosal edema, which is an important part of the disease pathology in bronchiolitis. Objective: To see the effects of nebulized adrenaline in comparison to nebulized 3% hypertonic saline in the treatment of acute bronchiolitis. Material & Methods:This was a randomized controlled trial, carried out in the Department of Pediatrics, Bangladesh Shishu Hospital and Institute from October 2017 to March 2020. A total of 90 children from 1 month to 2 years of age of either sex who were diagnosed and admitted with acute bronchiolitis were enrolled. After enrollment, they were randomly assigned to either 3% nebulized hypertonic saline (group A=45) or to the nebulized adrenaline-1:1000 group (group B=45). Monitoring was done by respiratory distress assessment instrument (RDAI) score at 12 hours interval for 1st 24 hours and then 24 hourly till the patient was ready for discharge. The efficacy was determined by assessing clinical severity score/RDAI score and length of hospital stay. Data were analyzed using SPSS version-23.Results:The mean age was found 6.34±3.89 months in group A and 6.06±3.55 months in group B. The majority of patients were males in both groups. All patients had a cough, breathing difficulty, Ronchi, and chest indrawing in both groups. Changes in heart rate were 5.68±6.61/min in group A and 2.86±5.87/min in group B, which was significantly decreasing in group A than in group B. Mean clinical severity scores at 12 hours and at 24 hours were statistically significant (p<0.05). However, mean clinical severity scores at baseline, at 48 hours, at 72 hours, and at 96 hours were not statistically significant. The mean duration of oxygen therapy was found 15.00±5.36 hours in group A and 24.63±11.64 hours in group B. Which indicates that the duration of oxygen therapy was significantly higher in group B than in group A. Majority of the patients of group A and group B were discharged within 72 hours 39(86.7%) and 28(62.2%) respectively, which was statistically significant.Conclusions:Nebulization with 3% hypertonic saline significantly reduced clinical severity score and length of hospital stay in case of acute bronchiolitis in comparison to nebulized adrenaline.
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Background: Seizure is a common cause of childhood hospitalization. Neuroimaging studies help in identifying etiologies, including the rare ones, and planning management. Purpose: The aim of this study is to determine the etiology of seizures in pediatric patients and the utility of neuroimaging in the same. Materials and Methods: A prospective study was carried out on 100 children who were admitted with seizures (including recurrent episodes) in our tertiary care institute. The sociodemographic profile, clinical features, neuroimaging findings, and findings of other investigations were documented and analyzed, to classify the type and etiology of seizures. Results: The male–female ratio among patients was 1.94: 1. Seizures of generalized onset were most common (95%), affecting mostly the age group of 1–5 years (50.53%), followed by the 5–18 years (29.47%) and the 1 month to 1 year (20%) groups. The etiologies were simple febrile seizure (51%), seizure disorder (8%), cerebral palsy (8%), acute viral meningoencephalitis (7%), pyogenic meningitis (6%), and complex febrile seizure (5%). Neuroimaging was carried out in 30 children, in which 14 showed abnormal reports, and abnormal electroencephalogram (EEG) report was found in 6 out of 10 patients. The analysis of the distribution of the types of seizures concerning age, gender, family history of seizure, history of seizure, socioeconomic status, and developmental milestones did not reveal any statistically significant relationships (P > 0.05). Conclusion: Seizure of generalized onset was the most common type, and the most common etiology was a simple febrile seizure. Abnormal neuroimaging/EEG findings were more pronounced in patients with focal seizures.
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Introduction: Awareness regarding Gestational Diabetes Mellitus (GDM) among antenatal women is necessary for early diagnosis and management of the disease for ensuring a safe motherhood and a healthy child. Objective: This study envisaged to assess the awareness regarding GDM and its determinants among antenatal women attending healthcare facilities in a rural area of West Bengal and to explore the perspectives of health workers with regard to gaps in proper awareness generation activities among antenatal women. Method: This mixed-method study was conducted from April 2021 to July 2021 at 4 health facilities in Singur, West Bengal. Quantitative data were collected from 195 antenatal women using a pretested questionnaire which were analysed using SPSS software. Qualitative data were collected via in- depth interviews among 6 health workers working in the health facilities and were analysed thematically. Results: Overall, 75.4% of participants were not aware of GDM. Multivariable logistic regression analysis showed that secondary education and below (AOR=3.48, 95% CI=1.63-7.42), no history of GDM among family & relatives (AOR=7.24, 95% CI=2.12-24.66), lesser number of antenatal visits (AOR=3.48, 95% CI=1.63-7.42) and non-receipt of counselling regarding GDM during antenatal visits (AOR= 3.09, 95% CI =1.45–6.58) had a significant association with poor awareness. From health workers' perspectives, lack of reorientation training, shortage of supplies for testing, and overburdening with other responsibilities were the major gaps identified in proper awareness generation activities. Conclusion: Present study revealed majority of study participants possessed poor knowledge regarding GDM. Reorientation training of health workers, organizing awareness campaigns at the community level, and relevant counselling regarding GDM during each antenatal visit should be given utmost priority for improving knowledge about the disease
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Background: Bronchiolitis, caused mostly by Respiratory syncytial virus (RSV) virus is the leading cause of lower respiratory tract infection in infants. The disease is mostly presents with cough runny nose, fever, breathing difficulties and respiratory failure This infection usually affects children up to age of 24 months, with younger infants often more severely affected and is the most prevalent cause of hospitalization in infants under the age of 12 months. The treatment is supportive; therefore, epidemiology, clinical, laboratory, and radiologic findings can help to ensure appropriate diagnosis and proper treatment.Methods:This descriptive cross-sectional observation study was conducted at Paediatrics department of Sher-E-Bangla Medical College & Hospital (SBMCH), Barishal, Bangladesh between October 2018 to March 2019To find out the clinico-epidemiological and radiological profile of Bronchiolitis. Children below 24 months of age diagnosed as bronchiolitis were studied.Results:200 children were evaluated, including 150 boys and 50 girls; Infants below 6 months accounted for the highest proportion (60%). All the bronchiolitis patients had cough or cold with respiratory distress. Other symptoms were fever (98.0%), restlessness (63.0%), poor feeding (60%) and fast breathing. On examination lower chest indrawing and rhonchi were found in all cases. Hyperinflation was the most prevalent radiological finding (60%) and more than half (55%) patients had lymphocytosis on CBC.Conclusion:Most children present with typical clinical and radiological feature of bronchiolitis which can help the clinicians to clinically identify this disease more efficiently.
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Background: Heavy menstrual bleeding (HMB) poses threat to the quality of life among women. To prevent HMB, the levonorgestrel-releasing intrauterine system (LNG-IUS) is a well-known nonsurgical, long-performing, and alternative method. Objectives: The objective of this study was to determine the efficacy of LNG-IUS in women with HMB through an analytical observational study. Materials and Methods: This study was performed among 60 patients who visited the gynecology and obstetrics outpatient department (OPD) at the Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital (IPGMER and SSKMH), Kolkata, West Bengal, India from May 2019 to April 2020 due to HMB. The mean demographic and clinical profiles were evaluated, and comparative analysis was performed for hemoglobin (Hb), spotting, pain, and endometrial thickness on day 0 and follow-up 3 months, 6 months, and 12 months. Results: The mean age of patients was 37.77 ± 4.58 years was obtained. The Hb level was significantly (P < .001) increased, whereas pictorial blood loss assessment chart (PBAC) score, endometrial thickness, spotting, and pain were significantly (P < .01 and P < .001) reduced. The majority of patients had pallor, but the rates of spontaneous expulsion and hysterectomy were observed lower after using LNG-IUS among studied patients. Conclusion: the usage of LNG-IUS is potential in the treatment of HMB in women, which may lead to a better quality of life. This can be the alternative to hysterectomy and oral pills for long-term use. It is suggested in a future study with larger sample size and multicentric approach to minimize hospital biasness.
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The present case study discuss about the therapeutic management of prolonged postpartum anoestrus in a crossbred Jersey cattle without any hormonal intervention. A three and half years old cattle having approximate 250 kg body weight was presented to an animal health camp held on Burdhaman district in West Bengal state (India) with a history of postpartum anoestrus. According to the cattle owner the animal hasn’t shown any symptoms of estrus cycle even after five months of first calving. On per-rectal examination the animal failed to reveal distinctly palpable corpus luteum in the ovaries with apparently normal uterus. In this case, at first the cattle was dewormed then managed with supportive therapy by giving vitamins and minerals supplements. For better result ovarian massage was given also. The owner informed that animal came to heat after one month of treatment and now the animal is three months pregnant after conceiving through artificial insemination
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Background: The population of the elderly has been on the rise in recent years and this demographic trend is likely to continue. Depression tends to be common in the elderly. Further it is possible that cognitive abilities start deteriorating as a result of depression and even more so due to several changes that are already occurring. This may impact an individual’s cognition, functionality, and autonomy, may progress from a subclinical level to a pathological level if not intervened early. Medications work to reduce symptom severity but sometimes patients become resistant to it and other interventions have to be used. CBT techniques have been found to be effective to treat depression and further efficacy of reminiscence therapy for older adults with mild to moderate depression has been established. Method: The present study was undertaken with the objective of establishing the efficacy of a comprehensive psychotherapy program for an elderly woman, aged 66 years, who presented with a diagnosis of chronic depression, along with chronic pain and sub clinical cognitive limitations. Techniques of CBT, reminiscence therapy and cognitive training was carried out for 8 weekly sessions. Results: The outcome of the intervention showed improvements in overall functioning along with generalization of the training, thereby implicating the effectiveness of the intervention. Conclusion: Thus, it is important to promote active aging, fostering healthy mental functioning and training the cognitive capabilities, to avoid pathological aging or reducing its impact
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It is of essential importance to identify clinical conditions of childhood and adolescence that present a high risk to evolve any kind of Personality Disorder. Personality disorder does not suddenly come out at age eighteen years old. Early sighs of some pathological behaviour that evolves before 19 years predict long term deficits in functioning and a higher chance is there these patients continue to present some symptoms up to 20 years. Some childhood and early adulthood predictive factors are responsible for excellent recovery of Personality disorder. Unfortunately, PD diagnosis and treatments both gets delayed. Adolescence represents a sensitive and vulnerable phase for the development of any kind of Personality Disorder. There is a dearth of information about emerging personality development in childhood and in adolescence. The present study attempts to explore the role of Dialectical Behavioural Therapy in the management of a 14 years old Female, Hindu, Bengali speaking, Unmarried, hailing from an urban neutral family with a diagnosis of emerged personality disorder with prominent features of impulsivity, interpersonal relationship problems, self-harm behaviours, anger outbursts. Thus the aim of the present study is to reduce these behaviours which is having an impact in her life and improving overall well-being of the individual. She was treated with DBT approach, bringing in improvement after 14 sessions.. The execution of DBT for suicidal adolescent has been presented by a case study.
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Traumatic brain injury (TBI) is a one of occurrence with multiple possible neuropsychiatric symptoms, including problems with cognition, emotion, and behavior and deficits in social skills (Hartley 1995). Traumatic brain injury refers to a physiologically significant disruption of brain function resulting from the application of external physical force, including acceleration/deceleration forces (Marr et. al 2002). Severity level of traumatic brain injury can be classified as mild, moderate, and severe. In this context we wanted to study the cognitive functions, social deficits, and state of mood in an individual aftereffect of TBI frequent problems of cognitive, emotional, behavioral, physical, and psychosocial were reported in various studies and substantial source of at least temporary disability and stress to TBI survivors and their families. Hence, we have planned psychological and cognitive management for them. Therefore, in present study, a male of 26 years resident of Jaipur city was studied, the neuropsychological and behavioral functioning was assessed, and findings suggest that impairment in attention and concentration, visual motor functioning, and visuo- spatial functioning, anger, confusion-bewilderment and fatigue state and poor social relationship. Post psychological intervention improvement was observed
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Primary cilia are non-motile, microtubule-based, antennae-like organelle that protrude out from the cell surfaceand perform sensory function or transduce physiological signals in majority of the vertebrate cells. Cilia areassembled on basal bodies that are transformed centrioles. The assembly-disassembly of primary cilia maypose an additional measure on regulating cell cycle in vertebrate cells. While primary cilia are commonly foundin differentiated or quiescent cells that are not cycling, disassembly of primary cilia may promote re-entry ofthese cells into the mitotic cycle, and support proliferation. Many cancer tissues or cancer-derived cells exhibitloss of primary cilia. However, primary cilia may also promote tumorigenesis in some contexts throughgrowth-promoting signalling. This review will shed light on recent advancements of temporal coordination ofciliary disassembly and cell cycle progression, with a focus on how cilia loss may support tumorigenesis invarious epithelial cancers
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Aim of Study: The present study was planned to analyze serum heme oxygenase-1 levels in osteosarcoma patients. Materials and Methods: Twenty five histopathologically confirmed cases of osteosarcoma localized without metastasis of all the ages attending the Orthopedic Clinics were included in the study group and twenty five patients having musculoskeletal pain (age and sex matched) served as control. Five ml of venous blood was collected aseptically from antecubital vein and serum was be separated by centrifugation and analyzed the same day. Routine biochemistry investigations were performed as per standard enzymatic methods by autoanalyzer. Serum Heme oxygenase-1 was analyzed by enzyme-linked immunosorbent assay. Results: In osteosarcoma patients, serum HO-1 levels were increased as compared to patients having musculoskeletal pain (P < 0.05). Workers have found that HO-1 induction in prostate cancer cell lines (PC3) cells restored the proliferation of osteoblasts, which was inhibited during co-culture with parental prostate cancer cell line PC3 cells. However, no concrete data are available on blood levels of HO in osteosarcoma. Major role of HO-1 is the protection against oxidative injury, additionally, it regulates cell proliferation, modulates inflammatory response and facilitates angiogenesis. Conclusion: Findings of the present study suggests that pharmacological agents that regulate HO activity or HO-1 gene silencing may become powerful tools for preventing the onset or progression of various cancers and sensitize them to anticancer therapies
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Cognitive behaviour therapy (CBT) has been proved to be one of the most well-researched and effective therapy. It has been found effective in many clinical conditions in children and adolescents as well. Application of therapeutic processes gets complicated by the facts that childhood and adolescent problems do not come in neat packages and tend to overlap and/or coexist. For instance, there is much overlap among clinical problems like anxiety, depression, behavioural problems, and between reading and writing difficulties, and attention and hyperactivity. Many behavioural and emotional disturbances in children are also associated with specific medical conditions. The relationship between physical and/or medical conditions and emotional and behavioural disorders in children and adolescent has been documented in various studies. This demands attention to the therapeutic intervention to the childhood problems with greater monitoring and modulation. Use of CBT in childhood and adolescent problems for efficiency and convenience may be grouped into externalising and internalising disorders, and the management techniques may be formulated and tailored to meet the two opposing dimensions. In this case study, index client was an eight years old girl who presented with compulsive behaviour along with anxiety and fear, and the application of CBT techniques, its adaptability and efficacy in this case of obsessive-compulsive disorder (OCD), with specific phobia would be discussed.
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Introduction: The first Nipah Virus (NiV) outbreak occurred in India in the year 2001 at Siliguri. The second outbreak happened at Nadia in 2007. Nipah Virus exhibits neurological and pneumonic tropism with the predominant clinical presentation being encephalitis in humans. Material and Methods: The present study was a record based prospective study on 67 cases admitted with pyrexia of unknown origin in North Bengal Medical College during the period from 18.02.2001 to 30.02.2001 and a parallel study on epidemiological record carried out by PSM department also taken into account. All necessary investigations including autopsy examination, pathological, and microbiological study were done. Results: There was a clustering of cases around Bhaktinagar. There was a strong H/O Medinova Nursing Home Contact among the patients. 18 out of 20 cases were staff of that Nursing Home. Serum samples tested show NiV specific IgM and IgG in 9 out of 17 samples with one sample which was positive for IgG only suggesting past infection. The cases were admitted with predominant neurological symptoms (53.73% cases) but about 80% recovered with no residual neuro deficit. The natural reservoir of NiV is present in Bangladesh and in Northern India. Conclusion: When NiV infection is suspected, infection control practices must be strengthened to avoid an outbreak in a hospital setting. Here the present study is presenting the experience in the first outbreak of the Nipah virus in India at Siliguri for awareness of clinical personnel to control further outbreak at the very beginning.
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Obstructed labour is the situation where in spite of adequate uterine contraction the progressive decent of presenting part is arrested due to mechanical obstruction. Obstructed labour contributes to around eight percent of maternal deaths in India. It is also one of the leading causes of perinatal morbidity and mortality in developing countries. We wanted to study the risk factors and fetomaternal outcome in obstructed labour at Chittaranjan Seva Sadan College of Obstetrics, Gynaecology and Child Health. This will help us to assess obstetric near miss cases and to develop strategies to decrease the complications arising from obstructed labour.METHODSThis was a three year retrospective observational study conducted by reviewing the records of obstructed labour during the period April 2014 - March 2017. The study was approved by Institutional Ethics Committee. All the mothers who were admitted in the labour room with signs and symptoms of obstructed labour were included in this study. All the relevant information such as age, parity, socioeconomic status, risk factors, complications, mode of delivery, and fetomaternal outcome were collected.RESULTSThere were 219 cases of obstructed labour among a total of 23,815 deliveries. Most common cause for obstructed labour was cephalopelvic disproportion (77%) followed by malposition/malpresentation (17.3%). Majority of the patients (69.2%) belonged to poor socioeconomic group. Sepsis (10.6%) and pyrexia (9.6%) were the common complications. Neonatal mortality was 30.8% and maternal morbidity was 5.8%.CONCLUSIONSLack of health education, antenatal care, low socioeconomic condition, poor referral system and demographic factors are important contributory factors leading to adverse outcome of obstructed labour. This can be sorted out by proper antenatal care, improving health care delivery system and by timely referral of cases according to partograph monitoring.