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Objective: To evaluate the incidence and pattern of cardiac involvement in children postCOVID (coronavirus disease) infection in a tertiary care referral hospital in India. Methods: A prospective observational study was conducted including all consecutive children with suspected MIS-C referred to the cardiology services. Results: Of the 111 children with mean (SD) age 3.5 (3.6) years, 95.4% had cardiac involvement. Abnormalities detected were coronary vasculopathy, pericardial effusion, valvular regurgitation, ventricular dysfunction, diastolic flow reversal in aorta, pulmonary hypertension, bradycardia and intracardiac thrombus. The survival rate post treatment was 99%. Early and short-term follow-up data was available in 95% and 70%, respectively. Cardiac parameters improved in the majority. Conclusion: Cardiac involvement post COVID-19 is often a silent entity and may be missed unless specifically evaluated for. Early echocardiography aids in prompt diagnosis, triaging, and treatment, and may help in favorable outcomes.
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Background: Yoga therapy can be a promising adjunct to antiretroviral therapy. However, evidence on the ef-fectiveness of Yoga therapy is scanty. The proposed trial will estimate the effect of integrated yoga practice for six months on immune parameters (CD4 (cluster of differentiation 4), viral load) among adult people living with HIV (PLWH) and its cost-effectiveness from the healthcare system’s perspective. Methods: In this randomized open-label parallel-group trial, 110 PLWH in stage 2 HIV, between 18 and 49 years in the intervention arm and 220 PLWH in the same stage will be recruited by block randomization. Inte-grated yoga practice will be given for six months in the intervention arm, and health education on yoga prac-tice in the control arm, besides antiretroviral therapy. After six months, the difference in immune parameters, cardio-metabolic indicators and quality of life (QOL) will be assessed. Besides, an economic evaluation will be done with sensitivity analysis. If found useful, the intervention can be tested at large scale for further confir-mation of the outcomes. Irrespective of the study's outcome, the results will be disseminated through peer-reviewed journals.
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Background: Containing expenditure and efficient resource use is essential to limit the increasing costs of health research. Electronic data collection (EDC) is thought to reduce the costs compared to paper-based data collection (PDC). Objectives: As economic evidence in this area is scanty, especially in low- and middle-income countries, the objectives of the study are to perform an economic evaluation and compare the cost between EDC and PDC. Methods: A cost-comparison study was conducted to compare between EDC and PDC from the institutional perspective for the year 2018, based on a community?based survey. Step?down cost accounting was adopted with a bottom?up approach for cost estimation. Total and unit costs were estimated with the base case comparison between EDC and PDC while using SPSS software (e?SPSS and p?SPSS, respectively). We conducted scenario analyses based on the usage of different software, R and STATA for both EDC and PDC (e-R, p-R, e-STATA, and p-STATA, respectively). One-way and probabilistic sensitivity analysis (PSA) was performed to examine the robustness of the observed results. Results: In the base-case analysis, total costs of EDC and PDC were ?72,617 ($1060.9) and 87,717 ($1281.5), respectively, with estimated cost reduction of ?15,100 ($220.6). In other scenarios, the estimated cost reduction for e?R, e-STATA, p-R, p-STATA was ??274 ($4.0), 98 ($1.4), 14826 ($216.6), and 15,002 ($219.2), respectively, when compared to EDC?SPSS. On one-way and PSA, the results of the cost-comparison analysis were robust. Conclusion: EDC minimizes institutional cost for conducting health research. This finding will help researchers in efficiently planning for the budget for their research.
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Good quality health, nutrition and demographic survey data are vital for evidence-based decision-making. Existing literature indicates system specific, data collection and reporting gaps that affect quality of health, nutrition and demographic survey data, thereby affecting its usability and relevance. To mitigate these, the National Data Quality Forum (NDQF), under the Indian Council of Medical Research (ICMR) - National Institute of Medical Statistics (NIMS) developed the National Guidelines for Data Quality in Surveys delineating assurance mechanisms to generate standard quality data in surveys. The present article highlights the principles from the guidelines for informing survey researchers/organizations in generating good quality survey data. It describes the process of development of the national guidelines, principles for each of the survey phases listed in the document and applicability of them to data user for ensuring data quality. The guidelines may be useful to a broad-spectrum of audience such as data producers from government and non-government organizations, policy makers, research institutions, as well as individual researchers, thereby playing a vital role in improving quality of health, nutrition and demographic data ecosystem.
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Background: To become lifelong learners, it is essential for medical students to develop self-directed learning (SDL) skills from early medical schools. Aim and Objective: The present study was conducted to compare the outcome of traditional lecture classes (LCs) and SDL sessions among the first MBBS students in the department of physiology. Materials and Methods: This pilot study was conducted over a period of 1 year in the department of physiology among the first MBBS students to compare the outcome of traditional LCs with SDL sessions. The first 12 traditional LCs were conducted among Group A (roll no. 1–100) and the first 12 SDL sessions were conducted among Group B (roll no. 101–200). For the rest 13 traditional LCs and SDL sessions, crossover of two groups was done, that is, traditional LCs were conducted among Group B and SDL sessions were conducted among Group A. Results: Students performed significantly better in the 3rd, 7th, 10th, 11th, 12th, 13th, 15th, 18th, 19th, 21st, and 22nd SDL sessions as compared to LCs in post-test sessions. Students performed significantly better in the 4th, 6th, 8th, 16th, 23rd, 24th, and 25th LCs as compared to SDL sessions in posttests. Students performed significantly better in post-test sessions as compared to pre-test sessions. Students were highly satisfied with the program (as per evaluation done by Kirkpatrick model: Level 1). Conclusions: The students were highly satisfied with the teaching-learning program implemented by the department of physiology and their performance was better following SDL sessions as compared to traditional LCs.
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Context/Background: Malnutrition among children is a major public health problem in India. The objective of the study is to assess the nutritional status of pre-school children and to identify the so-cio-demographic determinants of malnutrition. Methodology: In this community-based cross-sectional study, 194 under-five children were recruited from rural and urban areas of Chittoor district, Andhra Pradesh. Anthropometric measurements were measured and age standardized weight-for-age (WAZ), height-for-age (HAZ), and weight-for-height (WHZ) were calculated. The proportion of under nutrition (WAZ <-2 standard deviation (SD)), stunt-ing (HAZ <-2SD), and wasting (WHZ <-2SD) were calculated along with the determinants. Results: The mean age of the participants was 40.5 months (SD- 9.1 months), 101 (52.1%) were from rural areas, and 96 (495%) females. The HAZ values were significantly low in- urban children (-0.81; 95%CI: -0.4, -1.21), among the non-Hindu children (-0.92; 95%CI: -0.35, -1.5). The overall prevalence of underweight, stunting, and wasting were- 13.4% (95%CI: 8.5%, 18.3%), 23.7% (95%CI: 17.6%, 29.8%), and 19.6% (95%CI: 11.9%, 25.3%) respectively. Urban residence (OR 6.75; 95% CI: 3.03 – 15.04) was a strong predictor of stunting. Conclusion: Malnutrition remains to be a public health problem in this area. Strengthening of existing programs should be the key strategy in combating malnutrition.
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An observational study was performed at Purba Medinipur District Hospital, West Bengal, from April 1, 2018, to December 31, 2020, with an aim to find out the magnitude of maternal mortality and near miss cases and to assess the utilization of available maternal health care services by the deceased women and near miss cases. Result showed 4.5% women developed potentially life?threatening condition (PLTC) of which 21% women developed LTC. Maternal Near Miss (MNM) ratio was 9.46/1000 live birth and the MNM?to?Maternal Mortality ratio was 8.3:1 and the leading causes of MNM and maternal death were hemorrhage, pregnancy induced hypertension/eclampsia. The utilization of maternal health?care services revealed that there is a scope to increase the service delivery. Study finding indicates that health?care programs need to enhance the existing efforts to improve timely health seeking behavior of women
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Context: Oral antidiabetic drug (OAD) failure is an indication for starting insulin therapy, but there is still a dilemma as to whether basal insulin or a premixed/co-formulation analog should be the choice. Aim: To compare the safety and efficacy of once daily (OD) insulin degludec/insulin aspart (IDegAsp) to OD insulin glargine (IGlar U100) in insulin-naïve Indian subjects with type 2 diabetes mellitus (T2DM), inadequately controlled with OADs alone. Setting and design: Retrospective study. Methods and material: Data was retrieved from the author’s clinic database of OAD failure patients (18-80 years), who were started either with (IGlar U100, n = 120) or IDegAsp (n = 89) OD over and above the standard of care. Data of fasting plasma glucose (FPG), postprandial plasma glucose (PPG) and glycated hemoglobin (HbA1c) from baseline and at last follow-up visits were collected. Statistical analysis used: Baseline characteristics and change in study parameters during the follow-up period were computed between two groups (IGlar U100 vs. IDegAsp) by unpaired t-test and paired t-test, respectively. ANCOVA test was used to compute percentage reduction in body weight, body mass index (BMI), FPG, PPG and HbA1c in between two groups (IGlar U100 vs. IDegAsp). Results: IDegAsp caused a significantly greater reduction in FPG, PPG and HbA1c as compared to the IGlar U100 arm. There was no significant difference in the proportion of patients with hypoglycemia between IDegAsp and IGlar U100 groups (p = 0.208). No episodes of severe hypoglycemia were reported. Conclusion: Comparison of IDegAsp and IGlar U100 OD in T2DM patients indicated that both were relatively safe but the former controlled FPG and PPG levels more effectively.
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Background: Social mapping, though an old approach in public health education and research, not prac-ticed much in nursing education. This study was conducted to describe the social mapping process in a semi-urban area in the Chittoor district of Andhra Pradesh in India and to describe the implications of such social mapping from the students' perspective. Methods: This participatory rural appraisal was conducted for the Bachelor of Nursing Students in a semi-urban settlement in the state of Andhra Pradesh in India. The social mapping process was conduct-ed in three broad steps- classroom-based teaching of social mapping, conducting social mapping in the community and a debriefing session with the students. The major outcome of this educational activity was the social map. In addition, we also came up with the students’ implications through group discus-sion. Results: A facility map was constructed by the community members which was replicated by the teach-ers. The map was triangulated by the teachers through a transect walk in that area. The students came out with various academic, clinical, and administrative implications from this educational session. Conclusion: Social mapping can be used as a potential tool in nursing education. More evidence is re-quired on this learning approach before recommending it in the Community Nursing curriculum.
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Background : Substance abuse is an important health hazard and also a major preventable cause of morbidity and mortality. This habit not only affects health, education and occupational career, but also incurs huge financial and social burden to the society specially when the doctors are involved in it. Aims and objectives : To estimate the prevalence of substance abuse, its pattern and causes among the MBBS students of West Bengal. Methods : A questionnaire based cross-sectional retrospective study was designed to collect data from the Medical Officers of the State to record their experience of substance abuse during their MBBS course. Results : The prevalence of substance abuse was 22% among the study participants. Smoking Tobacco was most common (16.67%). 76% of the subjects with substance abuse spend Rs1000 or less per month. The prevalence was 25% in upper class and 22.22% among those who belonged to lower class of socio-economic status as per BG Prasad Classification. Curiosity was the reason as per 34.5% of the subjects followed by depression (23.25%), peer pressure (13%) study pressure by 15%; media influence by 11%; to cope with home problems by 10.75% and parental influence by 2.25% of the study subjects. Conclusion : The institution should keep a Psychological Counselor who can guide the students who suffer from problems related to Depression, Peer pressure, Study pressure that may lead to substance abuse. Allotting, hobbies, sports and recreation would help in keeping away from substance abuse
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Dual concept has been recognized in appreciation of Kaala or time employing the scholars of Ayurveda. Saambatsara or Nityaga Kaala denotes the year and climate changes throughout the year and Atura Avastha or Avastika Kaala stands for the health repute along with ailment prevalence and their control about the weather changes. The weather change can steer the earth’s biological structures. Developing countries with restricted assets are expected to face a host of health consequences because of weather change, along with vector-borne and water-borne diseases. The distribution of infectious ailment includes complex social and demographic factors. Global climate change is a phenomenon this is now taken into consideration strongly associated with health and hazards. The outcomes of climate change on exposed biological incidences, in addition to societies prone to expose with disease, are a challenge for the complete scientific community. Rising temperatures, warm waves, floods, tornadoes, hurricanes, droughts, fires, lack of forest, and glaciers, in conjunction with the disappearance of rivers and desertification, can directly and circuitously concern with human pathologies which can be physical and mental.
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Background: Studies have established that Theory of Mind (ToM) is impaired in patients with depression, but few studies have investigated the status of ToM in breast cancer patients who often suffer from depression. Our objective was to compare the ToM deficits in women with breast cancer with and without depression with a control group. Methods: The study was conducted at the Oncology department of a multi-speciality hospital in Kolkata. It was a cross sectional matched control study. We compared the ToM performance of women with breast cancer and depression (N=39), breast cancer without depression (N=63) and a healthy control group (N=34) using the widely used ToM task, Reading the Mind in the Eyes test (Eyes Test). Depression was diagnosed using Mini - International Neuropsychiatric Interview following International Classification of Diseases - 10th edition guidelines. Chi-square and one-way analysis of variances was done. Results: Both groups of patients had greater impairment in ToM compared to healthy controls (p<0.05). Among breast cancer patients, presence of depression predicted even greater impairment of ToM (p<0.05). Lower income, less education and not being in any occupation other than homemaking were associated with greater ToM impairment across all groups (p<0.05). Conclusion: Breast cancer patients suffering from depression may have an additional burden of impaired social cognition, which may reduce their ability to shore up social support when it is most required. This needs to be addressed urgently to ensure better quality of life.
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Background: The epidemiological and mycological patterns of superficial mycoses across various geographic regions of India across the last few years are changing. Objective: This study was performed to evaluate the epidemiological and mycological profile of superficial mycoses in India between 2015 and 2021. Methods: In this systematic review, the PubMed database was searched for all observational studies published between January 1, 2015, and December 31, 2021, which had evaluated the clinico‑mycological profile of superficial mycoses among outpatients from various parts of India. Descriptive statistics was used to represent the results. Results: Forty studies(21 from the north, three from the northeast, five from the east, seven from the south, one from the west, and three from multiple regions of India) were included. Male patients and those of the age group of 21–40 years were most commonly affected. The proportion of dermatophytes as causative organisms was consistently high across all regions and throughout the study period (23.6%–100%). Among dermatophytes, the proportion of Trichophyton mentagrophyte (14.0%–97.2%) and Trichophyton rubrum (0%–69.1%) was consistently high across all regions. The prevalence of T. mentagrophyte showed a rising trend, while that T. rubrum showed a declining trend from 2015 to 2021. Conclusions: The epidemiological and mycological pattern of superficial mycoses showed a fairly similar trend across various regions of India from 2015 to 2021. Dermatophytes were the main causative agents of superficial mycoses; the most common species were T. mentagrophyte and T. rubrum. A rising trend of T. Mentagrophyte infection was found.
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Ahara is as old as the history of humanity as the body is originated and subsequently maintained by food. Historically, by the fundamental methods as looking and accumulating and agriculture humans secured their food from nature. As agricultural technologies elevated, humans settled into agriculture existence with diets fashioned through the agriculture possibilities of their geographical environment. Geographic and cultural variations have caused creation of numerous cuisines and culinary arts, which includes a big selection of components, herbs, spices, techniques, and dishes. With engorgement of rapid transferring lifestyles, fashions of assimilation of various subculture and way of life the food become very venerable for life expectancy. In Ayurveda, proper style of partaking food or Ahara has been mentioned by different treatise in a holistic approach. In the present study the holistic measure regarding Ahara is stipulated in five common rights as the Right Quantity, Right Time, Right Quality, Right Method, and Right Place
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Denaturation of proteins plays a crucial part in cellular activities. In this study, we have investigated the folding unfolding pathways of zebrafish dihydrofolate reductase (zDHFR) in presence of different chemical denaturants which were found to be an influential factor for the refolding yield by UV-visible spectrophotometric analysis. The activity change of zDHFR has been observed in presence of three different denaturants like Acetic Acid (AcOH), Sodium Dodecyl Sulphate (SDS), and Ethanol (C2H5OH). Spectrophotometric analysis reveals that protein unfolded completely at different concentrations and times by these denaturants. The spontaneous refolding experiments of chemically denatured zDHFR were also conducted to verify the spontaneous refolding yield. These investigations have helped us to decipher a picture about the denaturants contributing to achieving the refolding yield. We observed that acetic acid is a stronger denaturant among all, and the spontaneous refolding yields were higher from SDS denaturation. In the light of the above findings, higher spontaneous refolding yields were obtained from the low concentration of denaturants.
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Introduction : Deaths of Healthcare Workers (HCWs) from COVID-19 infection were reported from various parts of West Bengal months after rolling out of Vaccines for them. Empirical data suggested that those HCWs who died due to COVID- 19 were either not vaccinated or partially vaccinated. which points to Vaccine hesitancy among them. Objectives : (1) To study the perception of HCWs of West Bengal about COVID-19 Vaccine. (2) To determine the level of vaccine hesitancy and its causes among the study population. Methods : A cross sectional exploratory survey was conducted on 400 HCWs. A prevalidated questionnaire was administered which contained questions on profile of the study population, perception about COVID-19 Vaccine, Vaccine hesitancy. Results : 70% of the study population were nurses and only 13% were trained in COVID-19 Vaccination. 44% chose Mask as the most effective strategy to prevent COVID infection followed by Vaccination (36%), social distancing and sanitization. 37% HCWss were hesitant to take Vaccine when offered. Causes of Vaccine hesitancy as admitted by the study population - doubts about Vaccine effectiveness (56%), concern about side effects (30%), difficulty in availability of Vaccine (9%) and confusion about Vaccination strategy (5%). Conclusion : Vaccine confidence among HCWs can inspire the general public for a better coverage of Vaccine among all. The findings of this study will help the program managers to effectively plan strategies to enhance risk perception and Vaccine confidence among General Public.
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Background: Stressful life events may lead to insomnia, a very common sleep disorder. Aim and Objectives: The aim of the study was to study the correlation of perceived stress levels and sleep quality among physicians during the coronavirus disease-19 Pandemic. Materials and Methods: Physicians working in Burdwan Medical College were selected as a study group and age, sex-matched controls were selected from other non-medical workers. This online survey was conducted using Google Forms. The form was shared with participants using emails and WhatsApp. In the first section of the form the importance of the study was explained and informed consent was taken from the participants. In the second part of the form, subjects were asked to fill up demographic details and relevant history; in the third part, participants were asked to fill up two scales: Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI). Results: 128 doctors and 114 other staff participated in the present study. Doctors had significantly higher PSS and PSQI levels as compared to the other group. Doctors’ PSQI: Mean ± SD = 7.59 ± 4.37 and other staff PSQI: Mean ± SD = 5.77 ± 2.75; P: 0.00013**. Doctors’ PSS: 18.43 ± 4.04 and other staff PSS: 15.14 ± 1.7; P < 0.0001**. PSS and PSQI levels were positively correlated in both groups with r values of 0.975 for Doctors and 0.544 for other staff, respectively. Conclusions: Doctors were found to have higher PSS and PSQI levels as compared to the control group. PSS levels were found to be positively correlated with PSQI levels and more so among doctors.
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@#Introduction: Vitamin D deficiency and frequent infections are the two common worldwide phenomenon among elderly. Recent studies have demonstrated that vitamin D regulates the expression of specific endogenous antimicrobial peptides like cathelicidin LL-37 of macrophages and neutrophils, which is active against a broad spectrum of infectious agents. Therefore, the objective of the present study was to determine the level of cathelicidin LL-37 in macrophages of elderly women (classified according to serum 25(OH)D level) after exposure to Vibrio cholera infection and to find out the effect of 1,25(OH)2D added in vitro. Methods: This study was conducted among 40 randomly selected rural elderly women aged between 60 to 70 years of age. Their vitamin D status was assessed by the estimation of serum 25(OH)D and classified into three groups viz. sufficient (14 members), insufficient (13 members), and deficient (13 members). Later, their peripheral blood mononuclear cells (PBMC) were isolated and cultured from fresh blood. 1,25(OH)2D supplementation was given selectively at a dose of 10 ×10-8 M for 72 hours in the culture media; then exposed to infection and screened according to the objectives of this study. Results: Macrophages in all groups, except vitamin D deficient group, responded significantly in terms of LL-37 release during exposure to Vibrio cholera infection. Considering in vitro 1,25(OH)2D, supplementation responded significantly (p<0.05) in all three groups. Conclusion: Vitamin D can be used as a prophylaxis to enhance cathelicidin LL-37 release for all three groups as in the present study.
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Objective: Primary central nervous system lymphoma (PCNSL) is a rare form of aggressive extranodal non-Hodgkin lymphoma. This study attempts to delineate the clinicopathological and radiological profile of PCNSL cases at our center. Materials and Methods: All the pathologically confirmed PCNSL cases between January 2007 and July 2016 were analyzed retrospectively. The influence of potential prognostic parameters and therapeutic strategies on survival was investigated by log-rank test and Cox regression analysis. Results: Of the 53 PCNSL patients, 34 (64%) patients were males. Median age at diagnosis was 44 years (range 22–65 years). The most common location in the brain was the cerebral hemispheres in 32 patients (60%), and 16 patients (30%) had multiple intracranial lesions. Histologically, all patients were diffuse large B-cell lymphomas, except one case of anaplastic large-cell lymphoma. The median survival of the patients received whole-brain radiation alone ( n = 6), standard CHOP chemotherapy + radiation ( n = 14), and DeAngelis protocol ( n = 31) was 8 months, 13 months, and 23 months, respectively. Among the 31 patients treated with DeAngelis protocol, Memorial Sloan Kettering Cancer Center Class 1 ( n = 23) and Class 2 ( n = 8) patients had a median overall survival (OS) of 25 months and 13 months, respectively. The incidence of treatment-related neurotoxicity was significantly higher with DeAngelis protocol, in comparison to CHOP + whole-brain radiation therapy (26% vs. 14%, P < 0.05). Conclusion: None of the potential prognostic factors had a statistically significant influence on OS in our patients. High-dose methotrexate-based chemotherapy combined with radiation was the only factor, which had a significant impact on survival (log-rank P = 0.000) but at the cost of increased neurotoxicity
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Aim: The aim of the present study was to understand the physico-chemical changes during vermicomposting of terrestrial weeds, Mikania micrantha and leaf litters of Acacia auriculiformis and Bambusa polymorpha mixed with cowdung.Methodology: Vermicomposting was done in 2.5 l earthen pot, each having 300 g waste materials [cowdung alone (300g) and different litter wastes mixed with cowdung in 7:3 ratio]. Based on our pilot study using cowdung and plant wastes in different ratios, it was observed that earthworm thrived well and acted better in 7:3 (plant wastes: cowdung) compared to other ratios. Each pot was inoculated with 30 adult earthworms, Perionyx excavatus [cumulative weight (g) 9.99±0.09] after 21 days of pre-composting of wastes. Samples from vermicomposting pots were collected on 0, 15, 30 and 45th day for physico-chemical analysis of wastes. Results: Vermicomposting brought about changes in pH values near to neutral at the end of the experiment in all the treatments. Significant increase (p<0.05) in the electrical conductivity, total nitrogen (%), available phosphorus (mg 100g-1), available potassium (mg 100g-1) and a significant decrease (p<0.05) in total organic carbon (%) and C:N ratios from initial feed mixtures to final product in all the vermicomposting treatments were observed. The maximum rise in electrical conductivity, nitrogen, available phosphorus, and available potassium were recorded in the vermicompost obtained from Mikania-cowdung-mixtures. Interpretation: Vermicompost derived from Mikania-cowdung mixtures may be considered as suitable organic resource. Addition of carbonaceous materials such as leaf litters, sawdust, straw etc. with Mikania-cowdung mixtures is recommended for vermicomposting to increase the C:N ratio of vermicompost for slow release of nutrients.