A cross-sectional survey on burden of caregivers of pediatric leukemia patients attending a tertiary care hospital in Kolkata, India

Background: Care giving of children with leukemia involves considerable stress and anxiety on the part of family caregivers. Although caregivers’ burden is a crucial predictor of the health of both the child and the caregiver, it is often overlooked. Aim and Objectives: The present study aimed to assess the burden faced by caregivers of pediatric leukemia patients attending a tertiary care hospital in West Bengal, to elicit their sociodemographic characteristics and patients’ profile, and to find out relationship among these, if any. Materials and Methods: The study was descriptive observational type with cross-sectional design. It was conducted among caregivers of pediatric leukemia patients. Data were collected from 38 caregivers using predesigned, pretested, semi-structured schedule, and patients’ records. Burden was measured using Zarit Burden Interview, which is a 22 item 5-point Likert scale. Data were compiled and analyzed in Microsoft Excel and Statistical Software for the Social Sciences 20.0 for statistical analysis. Sociodemographic and clinical variables were expressed as number, percentages, mean, and standard deviations. To find out the association between different factors and caregiver burden, a logistic regression model was used. P < 0.05 was considered as statistically significant. Results: Majority of the caregivers were the mothers of the patients (68.42%), and most of the families of caregivers belonged to lower middle class according to modified BG Prasad Scale. Half of the caregivers (50%) experienced moderate–to-severe burden according to Zarit Burden Interview. Association was found between burden experienced and duration of disease and treatment. However, socioeconomic status was found to be the most significant determinant of burden as per multiple logistic regression by ENTER method. Conclusions: Majority of the caregivers were having moderate to severe and severe burden, which was significantly more among people coming from lower socioeconomic status. Prolonged disease duration and treatment were also found to be associated with increased burden of the caregivers.

An epidemiological study on body perception imaging and lifestyle behaviors among adolescents during COVID-19 pandemic in a rural area of West Bengal

Background: Adolescence is the intermediary linking phase from childhood to adulthood. Physical, sexual, psychological and social developmental changes during this period. Adolescence is a period of increased awareness of bodily cues and self-reflection, including evaluation of one’s own body and appearance. Body misconception and body dissatisfaction, two very important potential causative factors of bad nutritional status of adolescents, have not been adequately investigated in rural India. Aims and Objectives: The present study on adolescents was conducted to assess the lifestyle factors and degree of dissatisfaction and misconception of their body. Materials and Methods: An observational, descriptive, and community-based cross-sectional study was conducted by interviewing adolescents residing in the field practice area of the Department of Community Medicine, Medical College, Kolkata, during the months of March–April, 2022. The data were analyzed with the Statistical Package for the Social Sciences. Results: A total of 239 respondents were interviewed (74.1% male and 25.9% female). About 47.3% were early adolescents, 46.4% were middle adolescents, and rest 6.3% were late adolescents. About 56.5% was indulged in some kind of exercise. According to the total adolescent body image satisfaction scale score, 66.5% seemed to be satisfied with their body image. Body image dissatisfaction was associated with participants’ age, gender, socio-economic status, and type of family. Conclusion: It is evident from the study that girl children, adolescents of the lower socio-economic status group, and middle, and late adolescents are more prone to be dissatisfied with their body image. Hence, they need to be given extra focus for restoration of their mental health.

A qualitative study on perceptions of COVID-19 vaccine among health care worker in a rural area of West Bengal, India

Background: COVID vaccines have been rolled out all over the world after emergency use authorization in the prevailing pandemic situation. However, hesitancy about its safety and efficacy exists among beneficiaries. Vaccine hesitancy can be a barrier to adequate immunization coverage. Aims and Objectives: This qualitative study was undertaken among health care workers in the rural field practice area of a tertiary care hospital, to find out their perceptions about COVID vaccines, and reasons behind hesitancy toward the same. Materials and Methods: Six focused group discussions (FGD) were held with the help of moderator. Each FGD had five members, so 30 members were included in the study. Health care workers included doctors, nurses, ANM/ASHAs, and other health care workers. Results: There were 17 males and 13 females. Doctors had a positive attitude toward vaccination, but other health care workers had mixed perception regarding vaccination. Most grass root level workers were sceptical about the efficacy of the vaccine. Conclusion: Mostly positive attitude toward COVID vaccines was observed in the present study. Hesitancy toward vaccines was observed in some health care workers, and it likely rooted from their inadequate knowledge about the vaccine.

Comparison Of In-Hospital Mortality Of COVID-19 Patients Between Those Who Were Vaccinated And Who Were Not

Background:We compared the mortality rate of patients with moderate to severe COVID-19 who were vaccinated and who were not. Material And Methods:In this retrospective observational study, we collected data of patients who were admitted with moderate to severe COVID-19.The vaccination status and co morbidities of the patients were documented. The incidence and in-hospital mortality of COVID-19 patients was assessed.Univariate analysis was performed to determine the risk factors of in-hospital mortality.Result:Of 294 patients, 5.1% (n=15) received Covaxin™and 26.5% (n=78) received Covishield™;68.4%(n=201) patientswere unvaccinated.Of patientswho were vaccinated and contracted COVID-19, 24.8%(n=73) had taken the first dose and 6.8%(n=20) had taken the second dose of either vaccine.The in-hospital mortality rate was 13.6% (n=40). No significant association was found with the type of vaccine and the in-hospital mortality (p=0.23). Significant associations with in-hospital mortality were found with the interval before COVID-19 disease andvaccination (OR, 3.02; p=0.01); and the presence ofdiabetes mellitus (OR, 2.13; p=0.02), cardiovascular diseases (OR, 2.11; p<0.001), and malignancy (OR: 2.33; p=0.0325).Conclusion:The mortality rate of unvaccinated patients with moderate to severe COVID-19 was high. There was no significant difference in the effectiveness of Covaxin™ and Covishield™ in terms of the incidence of COVID-19 and in-hospital mortality. Diabetes mellitus, cardiovascular diseases, and malignancies had a significant association with in-hospital mortality in patients with moderate to severe COVID-19.

Diversity and management of plant species in an Eri silkworm agroforestry system by Mishing tribe of Assam, India

Aim: The present study was conducted to investigate the status and diversity of plant species used for rearing of Eri silkworm and their traditional management in the homegardens of Mishing tribe.Methodology: A total of 45 homegardens from three villages were surveyed randomly which were primarily associated with rearing of Eri silkworm. Vegetation was studied using quadrat method. The data on traditional knowledge associated with the management of plants species for rearing of Eri silkworm were collected using semi structured questionnaires. Results: The average size of studied homegardens was 0.35 ha. A total of 243 plant species were recorded from the studied homegardens of which six species were used as food plants for rearing of Eri silkworm and 10 species were used in construction of mountage. Trees related to Eri culture contributed to 37.47% of the total importance value index (IVI) in the studied homegardens. Heteropanax fragrans (Roxb.) Seem and Ricinus communis L. were the primary food plants of Eri silkworm and were found to be dominant in the homegardens. Activities such as land preparation, sowing, pruning, weeding and watering are carried out for the management of Eri silkworm food plant species and were found to vary for different species. Interpretation: There is an urgent need to document the indigenous knowledge and traditional practices associated with the management of host and food plants used in the rearing of Eri silkworm in the present day context as it is a part of their cultural heritage and should be reoriented through integration of modern farming technique.

A novel standardized reproducible method to calculate the area of internal limiting membrane peeled intra-operatively in macular hole surgery by using a video overlay桝 long-term study in cases of idiopathic macular holes

Purpose: To calculate AIP and to find correlation between hole closure pattern with AIP in idiopathic full thickness macular hole (FTMH) cases. Methods: In this prospective, non-randomized, interventional single blind study, 105 eyes of symptomatic FTMH (<6 month duration) were operated. Minimal diameter of macular hole (MDMH) was calculated on OCT, divided into Group I (>400?, n = 75) and Group II (<400?, n = 30). 23G vitrectomy with ILM peeling and gas injection were done in all and recorded. Final area of ILM peeled (AIP) was calculated using Adobe Photoshop CS2 (PSD format) in disc diameters (DD) from still frame. Follow up was done at 6 monthly interval up to a maximum of 5 years after surgery. Results: Macular holes were closed in 92.38% eyes. In Group I, mean pre-operative BCVA was 1.14 � 0.39 log MAR and was improved to 0.79 � 0.26 log MAR post-operatively at 6 months. In Group II, mean pre-operative BCVA was 0.95 � 0.44 log MAR and was improved to 0.60 � 0.24 log MAR after surgery. When AIP was more than 3DD, Type I and Type II closure were 72.77% and 27.27% in Group I (P value <0.01) and 84.21% and 15.79% in Group II (P value <0.01). Conclusion: AIP can be calculated using Adobe Photoshop CS2. Type I closure was significantly high with AIP >3DD in both groups. Intra-operatively using video overlay, surgeons can increase the diameter of AIP to get better closure pattern.

Primary chondromyxoid fibroma of the orbit: An orbital mass with calcification

Primary orbital chondromyxoid fibroma is a rarely reported entity. A 34-year-old lady presented with painless, non-axial proptosis of the left eye of 6 months duration. Orbital imaging showed a supero-temporal mass with calcific foci and bone erosion. The mass caused globe compression resulting in choroidal folds. Anterior orbitotomy with complete mass excision was performed. The histopathology revealed a chondromyxoid fibroma. At 12-months follow-up, the patient is doing fine with no clinical recurrence. Chondromyxoid fibroma is an important differential diagnosis for bony orbital tumors.

Adaptation Approaches for Direct Seeded Rice to Reduce Greenhouse Gas Emission in the Perspective of Climate Change

A field experiment was conducted at research farm, Bihar Agricultural University, Sabour, India during 2017 and 2018 to gain insight crop phonology mediated greenhouse gas emission under different tillage and nitrogen management practices in direct seeded rice (DSR). The experiment was conducted in split plot design with two tillage viz. zero tillage (ZT) and conventional tillage (CT) as main plot and four nitrogen management practices viz. 100% nitrogen through neem coated urea (S1), SPAD based nitrogen management (S2), 75% through neem coated urea + 25% nitrogen through vermicompost, (S3) and ¼ nitrogen as basal and rest in equal three splits at 20, 40, 60 DAS (S4) as sub plot, in three replication. The highest yield (4.69 t ha-1), net return (Rs 46440 ha-1) and B:C ratio (1.44) were recorded from zero tilled DSR. Further, highest yield (4.82 t ha-1), net return (Rs 44880 ha-1) and B:C ratio (1.36) was obtained under split application of nitrogenous fertilizers among other subplot treatments. The range of methane (0.57- 1.47 mg m-2 hr-1) carbon dioxide (0.32- 0.61 mg m-2 hr-1) and nitrous oxide (19.58- 38.79 µg m-2 hr-1) emission was recorded lowest in zero tilled plots and split application of nitrogenous fertilizer also emitted lowest values of 1.59 mg m-2 hr-1 methane, 0.86 mg m-2 hr-1 carbon dioxide and 46.76 µg m-2 hr-1 nitrous oxide at maximum tillering stage of crop growth. Moreover, methane and nitrous oxide emission was gradually decreased from maximum tillering to harvesting stage. Zero tilled DSR with split nitrogen fertilizer application ascribed lowest greenhouse gas intensity among the other crop establishment and nitrogen management options. Thus, zero tilled method of crop establishment with split application of nitrogenous fertilizer could be a remunerative and environmentally stable method for direct seeded rice cultivation.

Eye donation in north India: Trends, awareness, influences and barriers

Purpose: To understand trends, awareness, influences and barriers to eye donation in Indian society. Methods: This cross sectional study was conducted in Delhi from March 2017 to February 2018. About 10 hospitals collaborated with the Eye Bank under Human Cornea Retrieval Program (HCRP). Eye Bank recruited Eye Donation Counselors (EDCs) to approach family members of the deceased. A pretested questionnaire was used for this study. Irrespective of whether the next of kin of the deceased consented for eye donation or not, the option of participating in the survey was given. Results: Out of 473 potential donors identified, 407 (86%) next of kin consented to participate in the study. Of these, 388 (95.3%) were males and 19 (4.7%) were females. About 168 (41%) consented for eye donation and were assigned to donor group, while 239 (59%) participants refused eye donation and were assigned to non-donor group. Majority of the participants were siblings 170 (41.8%) of the deceased and the mean age of the deceased was 42.71 ± 17.56 years. The foremost concern before decision-making was transparency in how the cornea would be used (32.25%). The concern with regards to whether the body would remain intact after eye donation significantly decreased the probability of consent for eye donation. Conclusion: The study highlights that barriers to eye donation in India are not cultural or religious but more due to misinformation and proper utilization of the donated tissue. This study also emphasizes the pivotal role of EDC's in facilitating the eye donation movement.

Induced breeding of Catla catla carried out at low temperature in FRP carp hatchery of Arunachal Pradesh, India

Aim: The present study was undertaken to find out the possibilities of induced breeding of Catla catla, at low water temperature using fibre reinforced (FRP) tanks in a carp hatchery. Methodology: Brood fish of C. catla was maintained in 0.1 ha pond with proper feeding and pond management. Six induced breeding programmes: 3 in April (pre-monsoon) and 3 in June (monsoon) of 2017 were conducted with C. catla using synthetic hormone, Ovasis intra-peritoneally. The relationship between temperature variation and latency period, effective spawning period, fecundity, hatching start time, hatching duration and spawn production with its recovery was observed. Results: The latency period (time gap between injection and first egg release) was very high and ranged between 653.3 and 721.6 min for breeding in the pre-monsoon and ranged between 446.6 and 480 min for monsoon period. In pre-monsoon, the effective spawning period between 86.6 and 116.6 min and in monsoon between 53.3 and 73.3 min; both varied significantly (p˂0.05). In pre-monsoon period, the average water temperature during larval incubation in hatching pool ranged between 21.58 and 22.58ºC, whereas during monsoon period it ranged between 30.1 and 30.4ºC. The spawn production was 0.13 to 0.22; and 0.47 to 0.65 (lakh kg-1 b. wt. of female) in pre-monsoon and monsoon period, respectively, and showed a significant difference (p˂0.05). Interpretation: This report on breeding of C. catla in the temperature range of 18.6-24.7oC indicates the possibility of spawn production of Indian Major Carp in the north east hilly region states of India

A morphometric study of adult human trachea in West Bengal population

Background: Keeping in view the great variations in different dimensions of the human trachea and its remarkable clinical importance, the present work was undertaken. It included the study of dimensions of adult trachea of both sexes in West Bengal population. In addition, an effort was made to establish their relationship with selected external measurements. Methods: This was a cross-sectional, observational study on 60 cadavers. Relatively disease-free fresh adult cadavers were selected from West Bengal population. Study variables were tracheal length, internal transverse diameter and internal anteroposterior diameter. Selected external measurements were height and sternal length. Results: In males, the highest correlation was observed between tracheal length and height (r = 0.800), and tracheal length and sternal length (r = 0.799). In females, the highest correlation coefficient was found between tracheal length and height (r = 0.809). Conclusion: Different formulae were obtained by linear regression with all measurements being in centimeters. Therefore, it is possible to predict the tracheal dimensions from simple external measurements.

A curious case of Lepromatous Leprosy Developing Complete loss of Pigmentation, followed by Reappearance of Pigmentation with Multi Drug Therapy (MDT) alone - A Support for Neural Theory of Vitiligo Pathogenesis?

Lepromatous leprosy is a multisystem disease characterized by a decline in delayed hypersensitivity to Mycobacterium leprae antigens, causing multiplication of bacilli in huge numbers. We herein report a case of an adult male with lepromatous leprosy who was started on adult multibacillary multi-drug therapy. With treatment, the surface of lesions developed depigmented macules and patches. However, on continuation of antileprotic drugs, there was progressive perifollicular as well as inter-follicular re-pigmentation. This case clinically depicts re-pigmentation of depigmented skin following multidrug therapy for leprosy supporting the role of neural system in the homeostasis of melanocytes.

Quality indicators for eye bank

Purpose: The aim of this study is to identify quality indicators of the eye bank and validate their effectivity. Methods: Adverse reaction rate, discard rate, protocol deviation rate, and compliance rate were defined as Quality Indicators of the eye bank. These were identified based on definition of quality that captures two dimensions – “result quality” and “process quality.” The indicators were measured and tracked as part of quality assurance (QA) program of the eye bank. Regular audits were performed to validate alignment of standard operating procedures (SOP) with regulatory and surgeon acceptance standards and alignment of activities performed in the eye bank with the SOP. Prospective study of the indicators was performed by comparing their observed values over the period 2011–2016. Results: Adverse reaction rate decreased more than 8-fold (from 0.61% to 0.07%), discard rate decreased and stabilized at 30%, protocol deviation rate decreased from 1.05% to 0.08%, and compliance rate reported by annual quality audits improved from 59% to 96% at the same time. In effect, adverse reaction rate, discard rate, and protocol deviation rate were leading indicators, and compliance rate was the trailing indicator. Conclusion: These indicators fulfill an important gap in available literature on QA in eye banking. There are two ways in which these findings can be meaningful. First, eye banks which are new to quality measurement can adopt these indicators. Second, eye banks which are already deeply engaged in quality improvement can test these indicators in their eye bank, thereby incorporating them widely and improving them over time.

Histological differentiation of human fetal kidney.

Introduction: The description of development of human kidney given in various textbooks doesn’t include detail microscopic appearance of kidney at various fetal ages. So an attempt was made in this study to gather information on this topic. Material and methods: The present study was carried out on 15 human fetuses of known gestational age (GA). The sections of kidney were processed and were stained using Hematoxylin and Eosin. Results: At 12th week of GA various stages of developing glomeruli were observed in the substance of the kidneys. In the cortex, various cut sections of the tubules were observed without any differentiation as proximal (PCT) and distal tubules (DCT). The second trimester section showed well differentiated the PCT and DCT by 16th week. Distinct brush border was observed in PCT by the 16th week. Immature duct system was observed in the medulla. The nephrogenic zone was appreciated till 36 weeks. By 28 th week the sections of DCT were observed adjacent to the renal corpuscles indicating the developing juxtaglomerular apparatus. Conclusion: As it is essential to know the developmental morphology of kidney, the present study explains every component of it in detail.

Femoral Neck Anteversion and Neck Shaft Angles: Determination and their Clinical Implications in Fetuses of Different Gestational Ages

Precise anatomical assessment of femoral neck anteversion (FNA) and the neck shaft angles (NSA) would be essential in diagnosing the pathological conditions involving hip joint and its ligaments. The present study was undertaken on 48 fetal femurs to calculate the NSA and FNA in fetuses digitally. End on images of upper end of the femurs were taken for the estimation of FNA and a photograph in a perpendicular plane was taken to calculate the NSA. Microsoft Paint software was used to mark the points and Image J software was used to calculate the angles digitally. The FNA ranged from 17.08º to 33.97 º on right and 17.32 º to 45.08 º on left. The NSA ranged from 139.33 º to 124.91 º on right and 143.98 º to 123.8 º on left. Unpaired t test showed the FNA and NSA of femur did not vary significantly during the third trimester.

Anthropometric Status between Tribal and Non Tribal School Children.

A descriptive cross sectional study named "Anthropometric status between tribal and non tribal school children" was conducted on Guimara primary school, Matiranga, Kharagrachari and Thana primary school, Sitakund, Chittagong to assess the difference in nutritional status between tribal and non tribal school children aged 6 to 10 years in terms of selected indicators. The indicators were height for age Z score, weight for height Z score, and weight for age Z score. Data were collected by interview from mother of the child through semi-structured questionnaire and measuring height and weight of 128 children. Among them 63 were selected from tribal community and 65 from non tribal area. The study revealed that 9.2% non tribal and 7.9% tribal children were severely stunted, 12.3% non tribal and 1.6% tribal were moderately wasted and 9.2% non tribal and 1.6% tribal children were moderately underweight. In relation to sex among tribal children 12.9% tribal boys and 3.1% tribal girls were severely stunted, only 3.2% tribal boys were both moderately wasted and underweight. In case of non tribal children 17.9% boys and 2.7% girls were severely stunted, 17.9% boys and 8.1% girls were moderately wasted and 17.9% boys and 2.7% girls were moderately underweight. According to the age group of 6 to 7 years it was found that, only 4.2% non tribal children were severely stunted and 29.2% were moderately stunted where as 12% tribal children were moderately stunted. In both case of moderately wasting and underweight non tribal were 8.5% more than tribal children and among 8 to 10 years age group it was 12.2% and 7.3% more respectively and in case of severely stunted tribal children were 1% more than non tribal. Improper dietary practice was also found among the two group of study population. Information and health education should be provided to the parents of the children by community participation regarding proper use of sanitary latrine, provision of safe drinking water and proper dietary practice.

Synchronous primary cancers of the head and neck region and upper aero digestive tract: Defining high-risk patients

Background: Patients with cancers in the head and region are at increased risk of developing synchronous primary cancers. Aim: To see the epidemiology of synchronous cancers of the head and region and identification of high-risk factors for the development of synchronous primary in the head and neck cancers. Materials and Methods: Data of head and neck cancer patients from January 2010 to December 2011 were obtained from the hospital cancer registry for retrospective analysis of patients with synchronous cancers. All synchronous malignancies were analyzed for distribution of sites, association with smoking history, stage of index head, and neck tumor and the average age of patients at presentation with synchronous cancers. The Chi-square test for association of upper aero digestive tract (UADT) and smoking and statistical formula of median for calculating the average age have been employed for analysis. Results: Incidence of synchronous primaries has been found to be 1.33%, majority were seen at the oropharynx (39.2%) and 60.7% synchronous occurred at the esophagus, 0.81% of all head and neck cancers developed synchronous primary at the esophagus. Approximately, 65% of all synchronous primaries were in Stage III and Stage IV disease and 88.2% esophageal synchronous had Stage II disease. Association of UADT synchronous cancers with smoking is highly significant, relative risk = 1.95 95% confidence interval for relative risk 1.05-3.64 P = 0.00010981 (P < 0.05) and the average age is 62.4 years in males and 57.8 years in females. Conclusion: Patients who are at the high-risk for the development of synchronous primary tumors in the cancers of the head and neck region are patients with oropharyngeal carcinoma, smoking population, patients over the age of 62 years in males, and 57 years in females and in patients with higher staged index tumor.