ABSTRACT
Background: Enquiry into unnatural deaths with all its manners being, suicidal, accidental or homicidal depends on circumstantial evidences for acceptable judgment in court of law. Objectives were to study socio-demographic characteristics of the study and to find out influencing factors, if any, behind these sudden, suspicious, undesirable deaths.Methods: A record-based, descriptive study with cross-sectional design was conducted for first six months of 2017 in NRS medical college hospital among 1603 unnatural deaths undergone police inquest. Besides the records obtained from medical record section, findings were corroborated from mortuary. Data were analyzed in SPSS 22.0 and Epi Info 7.0.Results: Mean age of the deceased was 37.18±17.42 years. Regarding cause of injury, more than 1/3rd (36.6%) was attributed to poisoning, followed by burn injury (24.8%), road traffic accidents (22.8%), fall from height (6.9%) and others the rest. Majority (68.3%) died within twenty hours of reaching the health care facility. More than half of the deceased committed suicide followed by accident and suicide the least. Binary logistic regression revealed, unnatural deaths inflicted by selves or others, i.e. suicide or homicide respectively, had statistically significant (p<0.05) association to productive age, urban residence, burn and RTA, longer survival and conservative nature of management.Conclusions: As suicide was found to comprise lion share of unnatural deaths, development and implementation of addressing the issue at all the levels, starting from individual to community is the need of the hour.
ABSTRACT
Background: The national program for prevention and control of cancer, diabetes, cardiovascular diseases and stroke (NPCDCS) has been rolled out in West Bengal, with its implementation initiated through state-wide training of Medical Officers (M.O). For attaining requisite competency for meeting NPCDCS objectives, MOs have been trained at their respective district levels. Present study aimed to assess the training need, training efficacy and need for further training.Methods: A repeat cross-sectional study was conducted from May-July 2018 for M.Os of six randomly chosen districts of West Bengal, out of those whereat NPCDCS was launched in first phase. 40-45 M.Os were randomly selected from each district in liaison with district level health authorities. The total sample size was 352 with Finite population correction. On the days of training, pre and post training surveys were conducted with an identical semi-structured, pre-tested and validated questionnaire (Cronbach’s alpha >0.8) covering different levels of cognitive domain, with a maximum possible score of 100 marks. No negative marking was done for incorrect responses. Training was imparted by the Principal Investigator (accredited trainer). Ethical clearance was granted by the State Health Directorate. Informed consent from each participant was obtained.Results: Dependent sample t-test revealed significant increment (p<0.0001) in post-test scores (t=63.134) & one-way repeated measure general linear model (GLM) also revealed F=29.617 (p<.0001). The “Effect Size” was classified as “Huge” (Cohen’s D=63.134/√(352)= 3.365), as was noted between pre-test and post-test scores, based on Cohen’s convention and Sawilowsky’s addition. It was further noted that even after six hour training sessions there was 27.44% knowledge gap (p<0.0001) after adjusting for Bonferroni.Conclusions: Imperativeness of training coupled with periodic refresher training has been established as a pre-requisite for successful implementation of NPCDCS.