Sero-prevalence of Rubella Antibodies in Pregnant Women with Bad Obstetric History Attending A Rural Tertiary Care Hospital in West Bengal, India

Background: Rubella infection in pregnant mothers is of great concern as it acts as a teratogen causing abortions, still births, intra-uterine foetal deaths and multiple birth defects. In India, rubella causes significant bad obstetric pregnancy outcome including congenital deformities due to lack of proper surveillance and immunization coverage with rubella vaccination. Aim: To determine Sero-prevalence of rubella IgM and IgG antibodies in Bad Obstetric History (BOH) pregnant women in Tertiary Rural Medical College in Eastern India. Materials and Methods: Cross sectional study was conducted from 1st January 2017 to 31st March 2017 on sera of 100 antenatal mothers with bad obstetric history aged between 20-40 years of age group with pregnancy of ≥18 wks. Rubella IgM and IgG antibodies were assessed by ELISA. Statistical Analysis: Percentage, proportions and ᵡ2 test were applied. Results: Eleven per cent (11%) sero-prevalence for IgM antibodies and 54% for IgG antibodies was observed with maximum sero-positivity among 20-25 years mothers. Repeated abortions were the commonest pregnancy outcome. Conclusion: All antenatal cases should be routinely screened for rubella, so that early diagnosis will help in proper management and foetal outcome and strong recommendation for universal coverage of MMR in early age group of children.

Sero-prevalence of Rubella Antibodies in Pregnant Women with Bad Obstetric History Attending A Rural Tertiary Care Hospital in West Bengal, India

Background: Rubella infection in pregnant mothers is of great concern as it acts as a teratogen causing abortions, still births, intra-uterine foetal deaths and multiple birth defects. In India, rubella causes significant bad obstetric pregnancy outcome including congenital deformities due to lack of proper surveillance and immunization coverage with rubella vaccination. Aim: To determine Sero-prevalence of rubella IgM and IgG antibodies in Bad Obstetric History (BOH) pregnant women in Tertiary Rural Medical College in Eastern India. Materials and Methods: Cross sectional study was conducted from 1st January 2017 to 31st March 2017 on sera of 100 antenatal mothers with bad obstetric history aged between 20-40 years of age group with pregnancy of ≥18 wks. Rubella IgM and IgG antibodies were assessed by ELISA. Statistical Analysis: Percentage, proportions and ᵡ2 test were applied. Results: Eleven per cent (11%) sero-prevalence for IgM antibodies and 54% for IgG antibodies was observed with maximum sero-positivity among 20-25 years mothers. Repeated abortions were the commonest pregnancy outcome. Conclusion: All antenatal cases should be routinely screened for rubella, so that early diagnosis will help in proper management and foetal outcome and strong recommendation for universal coverage of MMR in early age group of children.

Nutritional Status of Rural Govt. Primary School Children in Khammam District, Andhra Pradesh, India.

Background: Rural school children are more vulnerable victims of undernutrition and its consequences. On that ground, rural govt. primary school children were examined on the basis of height, weight and few background variables to find real picture of nutritional status. Objective: To assess nutritional status of govt. rural primary school children in Khammam district, Andhra Pradesh, India. Materials and Methods: A cross sectional study adopting a multistage random sampling technique was conducted among 600 govt. primary school children of rural communities of Khammam district, Andhra Pradesh. Anthropometric measurement like weight for age and height for age was recorded to assess nutritional status. Data were collected by interview and physical examination and were analyzed with SPSS10.0 Results: Among 600 children, 36.0% were in Grade I malnutrition, 37.7% in Grade II malnutrition, 6.3% in Grade III and 19.0% of children were stunted and 4.0% were severely stunted. Girls (20.1%) were more stunted than boys (17.9%). Conclusions: The study concluded that despite adoption of several measures to curb the malnutrition, still high prevalence of undernutrition was observed in govt. rural primary school children in India and to be addressed properly immediately.

Evaluation of Role of Ultra Sound Guided Fine Needle Aspiration Cytology for Diagnosis of Ovarian Lesions with Particular References to Diagnostic Pitfalls.

Background: Ovarian lesions are quite common among females of all age groups. Ovarian cancers account for 6% of female malignancy. ULTRASONOGRAPHY(USG) can help in proper identification and categorization of these lesions. Fine needle aspiration cytology (FNAC) under USG guidance can be an effective modality for early diagnosis of ovarian masses. Aims And Objectives: To evaluate the role of USG guided FNAC over ovarian space occupying lesions (SOLs) for proper categorization into non-neoplastic, benign & malignant variants and to identify possible underlying causes of cytological misdiagnosis, if any, in comparison to histopathological diagnosis. Materials and Methods: FNAC under USG guidance were performed over one hundred and sixteen cases with radiologically proved ovarian SOLs during a period of five years. Aspirated materials were interpreted as non- neoplastic, benign or malignant lesions. Histopathological study was possible in 47 of these cases. Results: Out of 116 aspirations, non neoplastic, benign and malignant diagnosis were given in 51, 42 &23 cases, respectively. During histopathological correlation 41 out of 47 cases(87.2%) show exact cytohistological parity.Rest six cases with cytological misdiagnosis were discussed in detail. Conclusion: USG guided FNAC can effectively diagnose ovarian lesions in more than 87% cases. Scrutiny about failed diagnosis will help to improve accuracy in future.

A rare case of microfilaria in thyroid aspirate.

Filariasis is a major health problem in the Indian Subcontinent. Due to its nocturnal periodicity it may be difficult even to demonstrate in the blood. In heavy parasitic load they may appear in the blood, urine with chyle and at times in scrotal aspirates. It is very rare and unusual to find microfilaria in thyroid aspirate. This case report of presence of microfilaria in thyroid aspirate suggest that careful screening is important for thyroid lesions as patients may present with thyroid enlargement other than usual thyroid lesions

The Adverse Effects of Wealth on Cardiovascular Health: A Scientific Statement of the International College of Cardiology.

Background and Aims: Increase in economic status may be associated with increased consumption of Western type of foods and sedentary behaviour. In the present review, we discuss that increase in wealth may be associated with adverse effects on health behaviour Study Design and Methods: Internet search and discussion with colleagues. Results: Review of studies indicate that with increase in wealth, there is increased consumption of high fat, ready prepared foods and decrease in physical activity in most of the countries resulting in obesity and metabolic syndrome, leading to cardiovascular diseases (CVDs) and other chronic conditions. Many experts during the United Nations High Level Meeting in Sept 2011, misinterpreted the WHO estimates and proposed that, of total deaths, 22·4 million arise in the poorest countries, and 13.7 million in high-income and upper-middle-income countries and therefore poverty may be the major cause of deaths due to non-communicable diseases (NCDs). A recent study shows that 57.0 % of deaths in adults (aged 25-64 years) were due to CVDs and other chronic diseases, 25.5% due to communicable diseases and 15.9% due to injury and accidents. The deaths due to NCDs were highly prevalent among higher social classes compared to lower social classes who had greater deaths due to communicable diseases. It is interesting to know from new data from United States, that there is ‘Wealth’ without cardiovascular health in America. The whole world is likely to have the same scenario in the near future. Conclusions: Increase in wealth may be associated with altered health behaviour; greater consumption of unhealthy foods, tobacco consumption, mental load and sedentary behaviour resulting in increased risk of deaths due to CVDs and other chronic diseases which may change with knowledge about health education. Wealth may cause extension in life by buying of expensive drug therapy, intervention and surgery which are known to add income and employment in the west.

Disseminated lipogranulomatosis.

Farber disease or disseminated lipogranulomatosis is a rare inherited disorder of lipid metabolism resulting from a defect in ceramide degradation. Because of the feature of nodular swellings around various joints, this may sometimes be confused with juvenile idiopathic arthritis. We report a 4-year-old boy with Farber disease who presented with nodular swellings around the joint, angle of the mouth and conjunctiva, and was subsequently diagnosed to be a case of Farber Disease.

Ghosal type hemato-diaphyseal dysplasia: a rare variety of Engelmann's disease.

Ghosal type hemato-diaphyseal dysplasia is a recently described clinical entity. The authors describe such a case with severe anemia requiring transfusions and with clinical and radiological evidence of diaphyseal dysplasia. Very few such cases are reported in world literature.

Uncomplicated falciparum malaria complicated by salmonella septicaemia: cause not coincidence.

A male patient of 10-year-old presented with fever, headache and vomiting for last few days. He was being treated with antimalarial drugs. On 14th day of illness he again showed rise of temperature. His blood culture showed growth of Salmonella typhi. He was treated with ceftriaxone and responded favourably. Here uncomplicated falciparum malaria developed a secondary infection with salmonella during hospital stay. This uncommon association was noted rather than a mere coincidence, which rarely reported in literature.

Jervell-Lange Nielsen syndrome in a family with the long QT Syndrome (LQTS).

A child with Jervell-Lange Nielsen syndrome is presented from Kolkata. Family study showed that the other family members are suffering from long QT syndrome. The child had frequent syncopal attack and very prolonged QT interval requiring left cardiac sympathetic denervation and beta-blocker therapy as patient could not afford implantable defibrillator and cardiac pacing.

Hemiconvulsion, hemiplegia, epilepsy syndrome and inherited protein S deficiency.

A nine-year-old Nepalese girl developed hemiconvulsion, hemiplegia, epilepsy syndrome (HHE syndrome) after an episode of right-sided focal status epilepticus following acute gastroenteritis. She had left middle cerebral artery (MCA) territory infracts due to inherited protein S deficiency.

Virchows node: rare presentation of childhood hepatocellular carcinoma.

Cervical (supra-clavicular) lymphadenopathy may not always be due to tuberculosis in children. Hepatocellular carcinoma in children even may present as supra clavicular lymphadenopathy (Virchow's node).

Epidemiological aspects of acute childhood poisoning among patients attending a hospital at Kolkata.

A retrospective study from a tertiary care teaching hospital in Kolkata revealed 3.6% of total paediatric admissions were due to poisoning. Majority of the cases included oral/chemical poisoning followed by biological/envennomation. Kerosene was the commonest among all poisoning. Most of the cases were accidental.

Prominence of symptoms and level of stigma among depressed patients in Calcutta.

A pilot study of 29 patients for research on clinical depression employed the framework of cultural epidemiology to examine illness-related experience, meaning, behaviour with a Bengali version of the explanatory Model Interview Catalogue (EMIC). This report examined patterns of distress and stigma with reference to the most troubling patient-specified symptom. All subjects were psychiatric outpatients in the Institute of Psychiatry, Calcutta, and met Diagnostic and Statistical Manual (DSM)-IV criteria for a major depressive episode. Only 5 patients (17.2%) identified sadness as the most troubling problem, and 48.3% specified pains and other somatic symptoms instead. An internally consistent stigma scale with Cronbach's alpha of .67, comprised 13 items, was used to assess stigma. In addition to the scale score for each subject, the contribution of each item was reported and compared. A suggestive, though not significantly lower value of the stigma score for patients reporting somatic symptoms as most troubling, compared with sadness, was consistent with findings from prior studies showing a positive relationship between the magnitude of depression and stigma. These findings are discussed with reference to their impact on recognition and help seeking among patients, and recognition and management of depression by general practitioner. Culturally distinctive presentations and social contexts of depression and other mental illnesses should be addressed in professional training and public health communications.