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Background: As our age increases, different pathophysiological changes occur, which leads to geriatric syndromes in the elderly. Along with other bodily changes, psychological changes and dementia start emerging that affects day-to-day activities of the elderly people. These symptoms often get undetected due to lack of care or awareness among the geriatric population or their caregivers. Aim and Objectives: This study aims to measure the prevalence of psychiatric disorders and onset of dementia among the geriatric population in a rural area of West Bengal. Materials and Methods: An observational, descriptive, community-based, and cross-sectional study was conducted by interviewing persons aged 60 years and above residing in Banspole village during the months of April–May, 2022, using General Health Questionnaire-12 and dementia assessment by rapid test questionnaire. The data were analyzed with the Statistical Package for the Social Sciences. Results: A total of 104 respondents were interviewed (62.5% male and 37.5% female). Most commonly found comorbidity was hypertension (48.08%), followed by chronic obstructive pulmonary disease (26.92%) and hypothyroidism (25.97%). Significant psychological morbidity was found in 49 (47.11%) persons, whereas, different levels of dementia was found in 72 (69.23%) participants. Significant associations were found between psychiatric morbidity with age and socioeconomic status, and dementia with age and marital status. Significance level was at P < 0.05. Conclusion: As it can be seen that in psychiatric morbidity is present in almost half of the participants, and dementia in almost 70% participants, but most of the times, these get undetected or overlooked. Early detection and management are the need of the hour, as these conditions causes huge economic burden on the caregivers, as well as on the government concerned.
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Neuroendocrine neoplasms are derived from the epithelial lineages mainly of respiratory tract, with predominant neuroendocrine differentiation. There are only a handful of documented cases of paranasal small cell neuroendocrine carcinomas (SNEC) with primary orbital involvement. Here, the authors describe a 33-year-old male patient with rapidly progressive swelling of the right lower lid with proptosis since 4 weeks. On contrast-MRI orbit, an ill-defined multilobulated mass measuring 3.6 × 3.1 cm with intense homogenous enhancement was seen in the right retrobulbar space involving the right ethmoid sinus. On incisional biopsy, a poorly differentiated mass containing numerous small round blue cells and scanty intervening stroma with prominent necrosis and apoptosis was seen. Immunohistochemistry was strongly positive for synaptophysin. He was diagnosed as a case of SNEC and received chemotherapy, with good response till date of 9 months of follow up. The authors present a literature review and describe challenges in management of a primary orbital SNEC.
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Intraocular cysticercosis with central nervous system involvement is not that rare. We report a male child with a right-sided painful blind eye who had intraocular cysticercosis and granuloma in the left frontal lobe of the brain. There was an incidental finding of chronic inflammation in the choroid of that eye supported by histopathology. Immunohistochemistry for T-cells marker and B-cells marker was variable. The patient was treated with antiparasitic, anti-epileptic medications, and oral steroids subsequently.
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Background: The increase in worldwide life expectancy among the elderly is contributing to an increase in cognitive impairment (CI). A more complicated etiology makes CI an essential clinical concern for elderly patients with depression. Ageing populations as a result of demographic change have accelerated the development of certain geriatric conditions, including CI and depression. Aims and Objectives: The objective was to identify the prevalence and contributing factors of CI and depression in the elderly rural community. Materials and Methods: A descriptive, cross-sectional, and community-based study was conducted in rural field practice area of Medical College, Kolkata, among 133 geriatric people during time period of March–June, 2022. The prevalence of CI was measured using the Mini-Mental State Examination (MMSE) scale and depression was assessed using the geriatric depression scale. Data were analyzed in SPSS software version 16. Results: Mean age of the participants was 65.68 (±6.03) years. The prevalence of CI was 86.5%, with a mean MMSE score of 19.27 ± 4.34, and the depression was 77.5% and 7.07 ± 3.39. Conclusion: Almost two-third of the geriatric population is suffering from depression and CI. To handle the issue of CI, depression, and its resulting effects, new and modified geriatric health policies are very much needed.
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Background: Anemia is a very important preventable nutritional disorder affecting pregnant ladies which may have some adverse effects on the neonatal survival and development. Birth weight was correlated with changes in maternal hemoglobin concentration in various trimesters as it is important for determining child survival and development. Aims and Objectives: The aim of the study was to assess the correlation between maternal hemoglobin levels in various trimesters and neonatal birth weight. Materials and Methods: The study enrolled all pregnant women within age group 15–35 years who gave birth at Agartala Government Medical College and GBP Hospital from June 15, 2017 to August 15, 2017. Pregnant women were included into the study following delivery by simple random sampling into cases (Pregnant women who delivered low birth weight babies <2500 g) and control group (Pregnant women who delivered normal birth weight babies ?2500 g). Antenatal data were collected from hospital case sheet and labor room register. Data were analyzed using descriptive statistics and presented as Mean + SD. P < 0.05 (P < 0.05) was considered statistically significant. Results: Mean hemoglobin concentration was normal (?11 g/dl) in all three trimesters among the controls but it is found to be <11 g/dl in second and third trimesters of the case group. The mean birth weight of the babies was 2.151(± 0.2386) kg in case group and 3.047(± 0.3666) kg in control group. Conclusions: It was found that maternal hemoglobin concentration has a positive correlation (r > 0) with neonatal birth weight in all three trimesters in both cases and controls which is statistically significant (P < 0.05).
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Background: A lot of comorbid conditions and health problems result from unhealthy dietary habit and sedentary lifestyle in all age group, but more among geriatric population. Due to progressive fragility, weakness, and comorbidities, there is gradual decrease in overall physical activity in elderly which again leads to different health problems and this vicious cycle is going on. There was scarcity of evidences related to dietary pattern and physical activity of elderly population particularly in West Bengal. Aim and Objectives: The present study was conducted for estimating the physical activity level of the study participants and to determine its relationship with the sociodemographic profile and dietary consumption pattern. Materials and Methods: Observational descriptive cross-sectional epidemiological study was conducted in Geriatric Outpatient Department of Medical College and Hospital, Kolkata, from August 1, 2022, to October 31, 2022, among 124 participants aged 60 years and above attended OPD in first 2 months of study period. IPAQ-SF questionnaire was used for assessment of physical activity. Analysis was done in Microsoft Excel and SPSS (version 20) software. Results: Larger proportion (52.4%) participants belonged to HEPA active (Category 3) according to physical activity status. Age of the participant, place of residence and socioeconomic status and consumption of green leafy vegetables, other vegetables, fruits, flesh food and egg, milk and milk products, and sugar and jaggery were significantly associated with physical activity. Conclusion: In the present study, significant proportion (32.3%) was minimally active which should be dealt properly. Physical activity should be promoted to all elder persons as a part of healthy lifestyle.
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Background: Menstrual disorders are a common clinical problem due to multiple causes. Hyperprolactinemia, is disorders of hypothalamic-pituitary axis in young women, is usually associated with amenorrhea, oligomenorrhea, anovulation, and ovulatory cycles with short or inadequate luteal phase, and galactorrhoea. Menstrual disorder affects physical and mental health of every woman. Aims and Objectives: The aim of the study was to know hyperprolactinemia among the patients of menstrual disorders in a tertiary care hospital. Materials and Methods: Women with menstrual irregularities attending Gynae outpatient department and admitted initially checked clinically and their serum prolactin level were measured. Women in reproductive age group (15–45 years) with complain of abnormal uterine bleeding were included in the study. Menopausal women, women with organic diseases in uterus and cervix, and pregnant women were excluded from the study. Results: Prolactin level is statistically significant with age (P = 0.011). The patients from age group of 20 to 35 years had high proportion (14.4%) of hyperprolactinemia followed by age group <20 years. (12.9%) and >35 years (12.9%). The women presenting with menstrual disorders enlisted in the study were evaluated on the basis of their sociodemographic parameters. About (15.5%) were below 20 years. About (27%) were above 35 years and majority of the women (57.5%) enrolled in the study were from age group of 2035 years of age. Serum prolactin level was observed in 15.4% in patients with frequent menses, 9.1% in patients with metrorrhagia and 7.7% in patients with heavy menstrual bleeding. That result was statistically significant with P = 0.039. Conclusion: Serum prolactin level should be evaluated in every patient of menstrual disorders.
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Background: In addition to risk of developing different non-communicable diseases, chronic diseases, and disabilities with increases of age, elderly people are more likely to suffer from mental and psychological distress and sleep disturbances which are again very much related to other physical problems of elderly. However, these two issues are often neglected and also were not addressed by research work adequately. Aims and Objectives: In above backdrop, our present study was conducted to determine sleep pattern and perceived stress among elderly population and their relationship with sociodemographic parameters. Materials and Methods: An observational descriptive cross-sectional study was conducted in Geriatric Outpatient Department (OPD) of Medical College and Hospital, Kolkata, from August to October 2022, among 161 geriatric OPD patients. A semi-structured questionnaire was used for eliciting sociodemographic information. Pittsburgh Sleep Quality Index and perceived stress scale were used for assessing sleep quality and perceived stress of participants respectively. Data were analyzed in the Statistical Package for the Social Sciences (version 20). Results: About 41.2% participants suffered from poor sleep pattern. About 41.2% of geriatric participants had low level of stress and rest had moderate stress. Age and marital status were significantly associated with both sleep pattern and perceived stress. Socioeconomic status was related to sleep score, whereas perceived stress was associated with education of elderly participants. Conclusion: Poor quality of sleep and stress has an impact on other physical health problems of elderly such as diabetes, hypertension, and cardiovascular diseases. Hence, awareness generation among general population and provision of adequate management in elderly health clinics regarding these two issues is required.
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Background: Child rearing practices are very important determinants of overall growth and development of child. As mother is primary caregiver of child, her knowledge regarding child rearing is very important. Unfortunately, till today, in India, teenage marriage and teenage pregnancy are very common. These adolescent mothers are not only underprepared physically and psychologically for giving birth and rearing a child successfully, but also it is assumed that have no proper knowledge. However, there was no sufficient research study for assessing knowledge regarding child rearing among teenage pregnant women in West Bengal, especially in rural area. Aims and Objectives: Assessing the knowledge regarding child rearing practice and its relationship with the determinants among teenage pregnant women in rural area of West Bengal. Materials and Methods: A descriptive community-based cross-sectional epidemiological study was conducted in rural field practice area of Medical College, Kolkata among 99 adolescent pregnant women during time period of July–December 2021. Data were analyzed in SPSS software version 20. Results: Mean age of the respondents was 17.60 (±1.23) years. Among the participants 58% being school dropout and 46% were homemaker. Maximum number of participants was married and got pregnant within age group of 15–17. Only 59.6% had good knowledge about child rearing. Number of child and perceived social pressure was statistically significant with the CRK score. Conclusions: The government should give more emphasis to improving maternal education and preventing teenage marriage and teenage pregnancy as a long-term strategy for improving child health.
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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.
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1 Background: Geriatrics refers to people aged 60 years and above. In India, the absolute number of elderly people increased from 76 million in 2001 to 100 million in 2011(8.6% of total population) and 138 million in 2021 (10.1% of total population). Common morbid conditions in older age include hypertension, diabetes, hearing loss, cataracts and refractive errors, back and neck pain and osteoarthritis, chronic obstructive pulmonary disease, diabetes, dementia, and complex health states commonly called the “Geriatric Syndromes.” Aims and Objectives: The present study described the morbidity pattern, quality of life and their relationship among geriatric patients attending Medical College and Hospital, Kolkata. Materials and Methods: An observational, descriptive, cross-sectional study was conducted with a semi-structured data collection form having “OPQOL-Brief questionnaire” among 110 older subjects in a systematic manner who have attended the Geriatric Medicine OPD of Medical College, Kolkata, during the months of March–April, 2021. The data were entered into Microsoft Excel spreadsheet (version 10) and analyzed with the help of SPSS (version 25). Results: About 59.1% of study subjects were male. The most common morbidity was hypertension (47.27%), followed by diabetes mellitus (39.1%), bronchial asthma (27.3%), and heart diseases (19.1%). About 50.9% of the patients (49.23% of male and 53.33% of female) had a good quality of life. Conclusion: This study showed that these patients’ quality of life had significant relationship with their socioeconomic status and number of comorbidities present. It was advisable to adopt policies for affordable solutions for diagnosis and management of geriatric comorbidities overall.
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Background: Rabies is a fatal but preventable zoonotic disease and prevention of rabies following exposure is largely dependent on proper wound care and timely initiation and completion of post-exposure prophylaxis (PEP) which again dependent on awareness of general population regarding prevention of rabies and economic burden related to PEP. Aims and Objectives: With this background, the present study was carried out to estimate the economic burden, knowledge, and practice regarding prevention of rabies and to determine predictor of practices. Materials and Methods: Facility-based, observational, descriptive, and cross-sectional epidemiological study was conducted in Rabies Immunization Clinic, Medical College, Kolkata, among 110 animal bite victims (>18 year age) who are attending for PEP during study period (January 2022 to June 2022). Results: About 48.2% study participants had poor knowledge score related to prevention of rabies. Although direct economic burden for all participants was nil, 53.6% participants faced heavy indirect economic burden. Only 62.7% study participants cleaned wound properly following exposure. About 73.6% of study participants had history of timely initiation as well as completion of PEP with regularity. Proper wound care following exposure was mainly determined by awareness level of study participants regarding prevention of rabies, whereas timely initiation as well as completing PEP with regularity was mainly predicted by economic burden incurred by the participants. Conclusion: For achieving zero human deaths due to dog-mediated Rabies by 2030, more emphasis to be given on awareness generation among general population and combating economic burden related to PEP.
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Background: Pneumococcal conjugate vaccine (PCV) had been introduced in National Immunization Schedule recently in West Bengal in view to prevent pneumococcal diseases mainly pneumonia and meningitis, which was a leading cause mortality and morbidity particularly in under 5 age group. Like all other health program, success of this initiative would be dependent on awareness level of beneficiaries. Aim and Objective: The present study aimed at estimating parenteral awareness level related to pneumococcal diseases and PCV. Materials and Methods: The observational and analytic study was conducted among parents of 404 children (who were eligible for PCV-1) attended in Immunization Clinic, Medical College, Kolkata. Sociodemographic parameters of families of study participants were elicited. Parenteral knowledge regarding pneumococcal diseases and PCV was assessed. Results: About 58.4% of parents neither had any awareness regarding pneumococcal diseases, nor had any idea related to PCV. Only 30.7% of parents had any knowledge regarding pneumococcal diseases and 31.7% had any awareness related to PCV. Maternal education, social class, and residence were found to significant predictor of parenteral knowledge both in unadjusted model as well as when adjusted with sociodemographic variables. Conclusion: As parenteral knowledge level in the present study was not satisfactory, more stress to be given in conducting awareness generation campaign for newly introduced PCV vaccine throughout the state in general, and in vulnerable urban areas particularly, where awareness among beneficiaries was significantly poorer.
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A 15-month-old child was brought to the ophthalmology outpatient department with his parents complaining of a large mass located on the nasal side of his right eye since birth. On examination, an irregular mass was seen to be located on the nasal side of his right orbit, obscuring the visual axis. On a contrast-enhanced computed tomography scan, a heterogenous lesion was seen to be located on the bridge of the nose and the medial aspect of the right orbit without any bony defect or communication with the brain or sinuses. In view of the possibility of developing amblyopia, the lesion was surgically removed. On histopathological examination, a diagnosis of extranasal glial heterotopia was made. To the best of our knowledge, this is the largest extranasal glial heterotopia in the orbit to be ever reported.
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Background: Development in early childhood is an important determinant of health status in future life and any damage to brain in that period may affect quality of life. Reliable data regarding prevalence and predictors of developmental delay among under-5 children are required for combating this problem. Aim and Objective: Our study aimed at estimating proportion and determining predictors of developmental delay among 0–6-year-old children. Materials and Methods: An observational analytic study was conducted among 173 children (<6 years) attended in immunization clinic, medical college, Kolkata. Developmental status of children was assessed by Trivandrum Development Screening Chart. Sociodemographic parameters of children and their families were studied. Maternal morbidity and care during antenatal period as well as child morbidity and care during neonatal period were also assessed. Results: Proportion developmental delay among <6-year-old children was 26%. Maternal morbidity during antenatal period was revealed as significant predictor [AOR = 9.835 with 95% CI: 3.089–31.314]. Childhood morbidity and hospitalization during neonatal period were also found to be significant determinants of developmental delay [AOR = 28.041 with 95% CI: 8.826–89.089 and AOR = 28.286 with 95% CI: 8.790–91.023, respectively]. Conclusion: Improvement of neonatal care resulted in much reduction in neonatal mortality rate at the cost of increase in prevalence of developmental delay. Hence, more emphasis is now to be given on early detection and intervention of developmental abnormalities. It is mandatory to focus not only on care during newborn period for reducing mortality but also on “care beyond survival” which is the sixth pillar of India Newborn Action Plan.
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Background: Domestic work being unrecognized as a formal form of occupation in India, workers are often deprived of basic social security, including access to proper health care. Self‑negligence coupled with societal neglect makes them vulnerable to injury and a variety of illnesses. Objectives: We aimed to study the morbidity pattern of women domestic workers residing in a slum area of Kolkata, West Bengal, India. Materials and Methods: An observational descriptive cross‑sectional study was carried out by interviewing and clinically examining 106 randomly selected women domestic workers. Results: The majority (82.08%) had health complaints: heart burn being most common (40.57%). Musculoskeletal and dermatological issues were common. Anemia (31.25%) was a common prediagnosed morbidity. Pallor (33.96%) and dental caries (31.13%) were common; 50.94% reported workplace injury. Of those having complaints, 77.36% sought health care, 59.43% of whom relied on health facilities. Lack of time (54.05%), felt need (35.14%) and money (21.62%) affected adequate care seeking. Participants with cardiorespiratory complaints tended to visit health facilities significantly more (P < 0.05). Conclusion: Health vulnerabilities and neglectful behavior among domestic workers are evident, making the need to sensitize them about their health risks and ways to overcome such issues very vital. Awareness should also be generated about government health schemes to encourage timely health checkup and necessary intervention.
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Background: Domestic work being unrecognized as a formal form of occupation in India, workers are often deprived of basic social security, including access to proper health care. Self‑negligence coupled with societal neglect makes them vulnerable to injury and a variety of illnesses. Objectives: We aimed to study the morbidity pattern of women domestic workers residing in a slum area of Kolkata, West Bengal, India. Materials and Methods: An observational descriptive cross‑sectional study was carried out by interviewing and clinically examining 106 randomly selected women domestic workers. Results: The majority (82.08%) had health complaints: heart burn being most common (40.57%). Musculoskeletal and dermatological issues were common. Anemia (31.25%) was a common prediagnosed morbidity. Pallor (33.96%) and dental caries (31.13%) were common; 50.94% reported workplace injury. Of those having complaints, 77.36% sought health care, 59.43% of whom relied on health facilities. Lack of time (54.05%), felt need (35.14%) and money (21.62%) affected adequate care seeking. Participants with cardiorespiratory complaints tended to visit health facilities significantly more (P < 0.05). Conclusion: Health vulnerabilities and neglectful behavior among domestic workers are evident, making the need to sensitize them about their health risks and ways to overcome such issues very vital. Awareness should also be generated about government health schemes to encourage timely health checkup and necessary intervention.
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Background. Xpert-MTB/RIF assay or Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) helps in rapid diagnosis of tuberculosis (TB). Methods. Specific samples were collected and carried to Regional Medical Research Centre where these were taken up for CBNAAT and culture in Lowenstein-Jensen media. Appropriate samples were sent to the Designated Microscopy Centre (DMC) of our institute for acid-fast bacilli (AFB) smear examination. Diagnostic measures, such as sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Xpert-MTB/RIF were reported considering mycobacterial culture and a composite reference standard (CRS) as Gold standard. Results. We studied 335 samples. Lymph node fine needle aspirate was the most common sample (32.5%) followed by pleural fluid (29.3%). The overall sensitivity and specificity of Xpert-MTB/RIF was determined to be 26.5% (95% CI [confidence interval] 20.8�.8) and 100% (95% CI 96.8�0), respectively. The sensitivity and specificity of CBNAAT in relation to mycobacterial culture, however, was 78.8% (95% CI 61.1�.0) and 89.1% (95% CI 85�.4), respectively. Both were highest for pus, cerebrospinal fluid and lymph node fine needle aspirate samples. Conclusions. Xpert-MTB/RIF may be useful for samples, like cold abscess and lymph node fine needle aspirate or biopsy specimens. However, its routine use in case of serosal fluids is not recommended because of its lower sensitivity.