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Introduction: In half of the individuals with systemic lupus erythematosus (SLE), over the course of the disease, pulmonary involvement occurs frequently and is one of the parts in the array of presenting symptoms. But the published research and information on SLE have historically concentrated on renal, central nervous system (CNS), and dermatological manifestations, while the pulmonary effects of SLE have received very less attention. Objective: To know the extent and pattern of pulmonary involvement in SLE patients in a tertiary care hospital. Materials and methods: A cross-sectional observational study was conducted among 70 diagnosed SLE [who fulfilled the revised American College of Rheumatology (ACR) criteria for the classification of SLE] patients attending a tertiary care center. Seventy diagnosed SLE patients who met the updated ACR criteria for the classification of SLE and were enrolled in a tertiary care facility in West Bengal participated in a cross-sectional observational study. After informed consent, clinical examinations, general survey, respiratory examination, cardiovascular examination, and relevant investigations [chest X-ray, pulmonary function test, echocardiography and electrocardiography, and high-resolution computed tomography (HRCT)/chest computed tomography (CT) scan] were performed. Results: The majority of the study subjects belonged to the 21–30 years of age-group (45.7%) and were females. Most of the study subjects were treatment-naïve as they were newly diagnosed. Among the chief presenting complaints, the most common was cough followed by dyspnea and pleuritic chest pain. Chest X-rays showed pleural pathology in 37% of study subjects and pulmonary function tests were found to have a restrictive pattern in 4.3%. Echocardiography documented that 19.6% had pulmonary artery hypertension. HRCT revealed that 19.4% of subjects had definitive findings of interstitial lung diseases (ILD). Conclusion: A substantial contributor to morbidity and death, SLE is a potentially fatal, commonly debilitating autoimmune illness with pulmonary symptoms. Cough was the most common presenting complaint, and the most common radiological abnormality detected was pleural effusion. Spirometry revealed, as expected, a restrictive pattern in most of the cases. Around 29% of cases revealed features suggestive of or confirmatory evidence for intestinal lung disease. As a whole, the prevalence of lung involvement in SLE in the study was 67%. But this being a study with only 70 participants, a further longitudinal is recommended to study disease activity correlation with the incidence of early pulmonary involvement in SLE disease course.
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Background: Since the early 1990s, several milestone international declarations have recognized violence against women as a violation of human rights. Intimate partner violence (IPV), often used synonymously with domestic abuse or domestic violence against women, is a big burden to our society which manifests itself in many forms and it has its existence in every corner of the world irrespective of all the boundaries. Objectives: The objective of this study was to find out the prevalence of IPV against reproductive age group tribal women in Siliguri subdivision of Darjeeling district. Methodology: A cross?sectional study was carried out among 360 tribal women aged between 15 and 49 years residing at selected villages across Siliguri subdivision. Data regarding IPV were collected using the Indian Family Violence and Control Scale questionnaire. The data were analyzed using SPSS version 20 and multi?variable logistic regression was done to find out factors associated with domestic violence. Results: The study revealed that 70.3% of women had experienced domestic violence in any form in their lifetime. Logistic regression revealed that IPV was significantly associated with: age between 30 and 49 years, education above primary school, unskilled occupation, ? 2500 and above per?capita monthly income, and participants who are separated/broken up. Among the factors related to the male partner, literacy above primary school level was associated with experience to domestic violence. Conclusion: Domestic violence in all its manifestations was found to be present in the study population. The report may offer policymakers fresh perspectives on how to allocate funds for the complete elimination of domestic violence against women.
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Background: Children are vulnerable to injuries, and childhood injury is a complex phenomenon precipitated by a set of factors. In India, the magnitude and nature of childhood injury are not clearly known owing to the absence of a proper injury surveillance system. However, in recent days few studies demonstrated a substantially high burden of childhood injury. Objectives: To find out the prevalence, pattern, and the factors associated with injury among children of 0� years in the Siliguri city of West Bengal. Methods: A cross-sectional study was conducted among 780 children aged 0� years residing in the Siliguri Municipal Corporation area selected through cluster sampling technique (30 clusters [wards] with a cluster size of 26). Relevant data were collected by interviewing the mothers of children as respondents and was analyzed using SPSS software, binary logistic regression was applied to test the association between injury and other risk factors. Results: Of total 780 children, 165 had reported a total of 220 injury events with an overall period prevalence of 21.2% and a mean of 0.28 injury events per child. Majority of injuries were superficial in nature (53.2%); due to fall (56.4%), extremities were mostly involved (62.3%), and 12.8% cases were moderate-to-severe grade. Under-five children were most vulnerable. Injury was significantly related to socioeconomic status, presence of siblings, outdoor activities, and the presence of supervising person during travelling. Conclusions: Childhood injury is still highly prevalent in the area with its unique pattern and few preventable risk factors requiring a multifaceted comprehensive approach.
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Background: The increasing burden of noncommunicable diseases (NCDs) urges continuous survey of risk factors in different population groups. Objectives: The study was conducted to assess the prevalence and determinants of behavioral and biological risk factors of NCDs, in rural tribal population. Methods: A community-based cross-sectional study was conducted from June 2014 to May 2015, in rural Siliguri, among 172 tribal people aged 25–64 years selected by multistage cluster random sampling using WHO-STEPS instrument. Study participants were interviewed for sociodemographic and behavioral risk factors, and biological measurements were taken. Descriptive and logistic regression analyses were performed to explore the determinants of risk factors. Results: Among the study participants, the prevalence of current tobacco use and alcohol use were 69.8% and 40.7%, respectively; 96.5% consumed unhealthy diet and 2.9% were physically inactive. The prevalence of abdominal obesity and overweight were 26.2% and 12.2%, respectively. Odds of tobacco use were significantly raised among men (adjusted odds ratio [AOR]: 47.7 [95% confidence interval (CI) 11.1, 203.9]) and increased age of the participants. Men showed higher odds of alcohol consumption (AOR: 13.4 [95% CI 4.6, 38.9]). Odds of abdominal obesity were higher among older participants, whereas lower odds were found among men (AOR: 95% CI 0.11 [0.0, 0.5]) compared to women. Conclusions: Most of the behavioral and biological risk factors of NCDs were quite high among tribal population of rural Siliguri except physical inactivity. Increasing awareness about NCDs through locally accepted and culturally appropriate strategies need to be implemented in the study area.
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Background: Long-term reductions in infant mortality (IM) are possible only by addressing the distal determinants. Objectives: The objective of the present study was to determine the relationship between IM and its major distal determinants in rural India. Methods: The dependent variable used in the study was state wise IM rate (IMR), the values of which were obtained from the Sample Registration System, 2015. State level literacy rate in females, unemployment rates of females, GINI index, and round-the-clock neonatal services in primary health centers in the rural areas and the per capita gross state domestic product at purchasing power parity (GSDP at PPP) of the states, were used as the predictor variables for IM. Relationship between the variables was obtained by the Pearson's correlation coefficient. Bivariate and multivariable linear regressions were used to identify the magnitude and direction of the predictors on IM. Results: Correlation statistics showed none or weak positive correlation between the Gini coefficient and 24 � 7 primary health-care services and IMR. There was a strong negative correlation between female literacy rate and IMR, while the unemployment rates and per capita gross state domestic product (GSDP) were moderately negatively correlated to IMR. Bivariate analysis revealed that, for unit increase in unemployment rates in females, proportion of literate women, and 1000$ increase in the GSDP at current prices, IMR decreased by 0.07, 0.763, and 1.702, respectively. However, after adjustment, only the female literacy rates showed significant association with IMR. Conclusions: Of the major determinants included in the study, rural female literacy is the most important distal determinant of IM in rural areas of India.
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Chronic Kidney failures are progressive diseases and are divided into stages 1 to 5 based on the severity. Glomerular filtration rate (GFR) falls as the severity of kidney failure increases. Hypothyroidism was found to be present along with chronic renal failure and a presence of Low T3 was associated with increased chance of mortality due to cardiovascular complications. Significant association was known to exist in between thyroid dysfunction and chronic kidney disease progression. Aims & objectives: To study the pattern of thyroid dysfunction in chronic kidney disease population (who are not dialyses dependent) admitted at a tertiary care hospital of Tripura & to evaluate the correlation existing in between severity of kidney failure and thyroid dysfunction. Methods: 260 chronic kidney disease patients were included in the study. Diagnosis of chronic kidney failure was performed as per criteria laid down by Kidney Disease Outcome Quality Initiative. Blood was drawn for estimation of serum creatinine, GFR and thyroid profile. Data collected were analysed statistically and P≤0.05 was considered statistically significant. The statistical software namely SPSS 15.0 were used for statistical data analysis. Results: Among 260 individuals 138 were male and 122 female with age ranging from 20 to 82 years with mean age of 60.08±11.35 years. Calculation of GFR showed a mean GFR of 35.37±26.20 & mean serum creatinine level of 2.74±1.61mg/dl. Of the 260 patients, 68(26.1%), 74(28.5%), 74(28.5%), 31(11.9%) & 13(5%) patients belonged to CKD Stages 5,4,3,2 & 1 respectively. Low T3 is the most common thyroid dysfunction & the earliest abnormality noticed in CKD patients. The prevalence of low T3 syndrome in this study was 41.5 %( n=108). Increasing trend for Low T3 prevalence with increasing severity of CKD was noticed in this study and was statistically significant(P<O.001). The prevalence seen for LowT3 was CKD1-7.7%; CKD2-16.1%; CKD3-29.7%; CKD4-50% & CKD5- 63.2%. Statistically significant correlation was also seen with increasing prevalence of hypothyroidism & fall in GFR as the severity of kidney dysfunction increased (P<0.001). Conclusion: The present study was done to study the correlation of thyroid dysfunctions and chronic kidney diseases. It was observed that hypothyroidism both subclinical and overt exist with CKD and the most early and common dysfunction was lowT3 syndrome. The prevalence of thyroid dysfunction increase significantly as kidney failure progress .Low T3 is associated with increased chance of mortality due to cardiovascular complications and serves as a prognostic indicator in CKD individuals.
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Background: Despite evidence regarding the beneficial effects of vaccines, vaccination uptake has not been up to the mark across the globe in various sociocultural and sociodemographic groups. Logistics and workforce have been issues of concern to public health managers, but the latent issue of vaccine hesitancy leading to vaccine delays and refusals has not been widely addressed particularly in the Indian context. Objectives: The present study was conducted to find out the proportion and factors contributing to vaccine hesitancy for childhood vaccinations in slums of Siliguri, India. Methods: A cross-sectional study was carried out among 194, 0–59 months' children residing in slums of Siliguri in 2016. Data were collected at the household with interviews of mothers/primary caregivers using a predesigned pretested interview schedule developed based on the validated version of vaccine hesitancy survey questionnaire originally developed by the World Health Organization Strategic Advisory Group of Experts working group on vaccine hesitancy. Associations were analyzed using logistic regression. Results: Majority 161 (83%) of the families were vaccine-hesitant and only 33 (17%) were not hesitant. Nuclear families and mothers of lower educational status had significantly higher odds of vaccine hesitancy. Reluctance to vaccinate (26.1%) and to be unaware/having no reliable information (20.5%) were the major reasons cited for vaccine hesitancy. Conclusion: Most of the families of the children were vaccine-hesitant in the area. Uniformity in schedules in different health facilities in slum areas, appropriate antenatal information, and counseling regarding childhood vaccinations, widespread awareness, and improving mothers' education can address the issue of vaccine hesitancy.
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OBJECTIVES: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) adversely impacts food security in households of people living with HIV/AIDS (PLWHA). Little research has focused on food insecurity among PLWHA in India. The purpose of this study was to identify the prevalence of and factors relating to food security in households of PLWHA in the Siliguri subdivision of Darjeeling, West Bengal, India. METHODS: A cross-sectional community-based study was carried out among 173 PLWHA residing in Siliguri and registered at the Anti-retroviral Therapy Centre of North Bengal Medical College & Hospital. Data was collected at the household level with interviews of PLWHA using a food security survey instrument. We analyzed the associations using logistic regression. RESULTS: The prevalence of household food security among the participants was 50.9% (88/173). Five years or more of schooling, higher socioeconomic class and males were found to be significantly associated with a higher likelihood of food security. A later stage of the disease and the presence of other family members with HIV/AIDS were significantly associated with a lower likelihood of food security. The major coping strategies to deal with food insecurity in the acute phase HIV infection included borrowing money (56.1%), followed by spousal support, loans from microfinance institutions, banks, or money lenders, borrowing food, or selling agricultural products. CONCLUSIONS: The present study revealed that only about half of households with PLWHA were food secure. Prior interventions relating to periods of food and economic crisis as well as strategies for sustaining food security and economic status are needed in this area.
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Humanos , Masculino , Estudios Transversales , Composición Familiar , Abastecimiento de Alimentos , VIH , Infecciones por VIH , India , Modelos Logísticos , PrevalenciaRESUMEN
BACKGROUND: This study aimed to assess the whole-body vibration (WBV) exposure among large blast hole drill machine operators with regard to the International Organization for Standardization (ISO) recommended threshold values and its association with machine- and rock-related factors and workers' individual characteristics. METHODS: The study population included 28 drill machine operators who had worked in four opencast iron ore mines in eastern India. The study protocol comprised the following: measurements of WBV exposure [frequency weighted root mean square (RMS) acceleration (m/s2)], machine-related data (manufacturer of machine, age of machine, seat height, thickness, and rest height) collected from mine management offices, measurements of rock hardness, uniaxial compressive strength and density, and workers' characteristics via face-to-face interviews. RESULTS: More than 90% of the operators were exposed to a higher level WBV than the ISO upper limit and only 3.6% between the lower and upper limits, mainly in the vertical axis. Bivariate correlations revealed that potential predictors of total WBV exposure were: machine manufacturer (r = 0.453, p = 0.015), age of drill (r = 0.533, p = 0.003), and hardness of rock (r = 0.561, p = 0.002). The stepwise multiple regression model revealed that the potential predictors are age of operator (regression coefficient beta = -0.052, standard error SE = 0.023), manufacturer (beta = 1.093, SE = 0.227), rock hardness (beta = 0.045, SE = 0.018), uniaxial compressive strength (beta = 0.027, SE = 0.009), and density (beta = e1.135, SE = 0.235). CONCLUSION: Prevention should include using appropriate machines to handle rock hardness, rock uniaxial compressive strength and density, and seat improvement using ergonomic approaches such as including a suspension system.
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Aceleración , Vértebra Cervical Axis , Fuerza Compresiva , Dureza , India , Hierro , Análisis Multivariante , VibraciónRESUMEN
Piper betle Linn. is a Pan-Asiatic plant having several beneficial properties. Protein glycation and advanced glycation end products (AGEs) formation are associated with different pathophysiological conditions, including diabetes mellitus. Our study aims to find the effect of methanolic extract of P. betle leaves on in vitro protein glycation in bovine serum albumin (BSA)-glucose model. The extract inhibits glucose-induced glycation, thiol group modification and carbonyl formation in BSA in dose-dependent manner. It inhibits different stages of protein glycation, as demonstrated by using glycation models: hemoglobin-d-gluconolactone (for early stage, Amadori product formation), BSA-methylglyoxal (for middle stage, formation of oxidative cleavage products) and BSA-glucose (for last stage, formation of AGEs) systems. Several phenolic compounds are isolated from the extract. Considering their relative amounts present in the extract, rutin appears to be the most active antiglycating agent. The extract of P. betle leaf may thus have beneficial effect in preventing protein glycation and associated complications in pathological conditions.
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Animales , Bovinos , Glicosilación/efectos de los fármacos , Fenoles/análisis , Piper betle/química , Extractos Vegetales/química , Extractos Vegetales/farmacología , Hojas de la Planta/química , Albúmina Sérica Bovina/metabolismo , Factores de TiempoRESUMEN
Aim: Mentha spicata (L.) is popularly used as herbal remedy for various ailments. But the scientific basis for its medicinal use especially in pain and inflammation remains unknown. Therefore, the present study was aimed to investigate the analgesic, anti-inflammatory and antipyretic effects of whole plant of Mentha spicata in laboratory animals. Materials and Method: The methanol extract of Mentha spicata (MEMS) was used to investigate the acute effect on analgesia by Hot-plate test and acetic acid induced writhing method (By acetic acid) in mice and on inflammation in rats by carrageen induced paw edema method. Subcutaneous injection of 20% aqueous suspension of Brewer’s yeast in wistar rats leads to pyrexia. Results: The extract showed a significant (p<0.001) dose dependent increase in reaction time in mice in the hot-plate test at the doses of 250 mg/kg and 500 mg/kg body weight. The extract showed a significant (p<0.05) dose dependent increase in reaction time in mice in writhing method at the doses of 250 and 500 mg/kg body weight. The extract also exhibited promising anti-inflammatory effect as demonstrated by statistically significant (p<0.05) inhibition of paw volume by 42.58% at the dose of 250 mg/kg body weight and 45.10% at the dose of 500 mg/kg body weight at the sixth hour of study. Intraperitoneal administration of MEMS showed dose dependent decrease in body temperature in brewer’s yeast induced hyperthermia in rats at both doses. However, MEMS significantly decreased body temperature (p<0.05) at 500mg/kg compared to control. Conclusion: This study suggests that the methanol extract of Mentha spicata have analgesic, anti-inflammatory and antipyretic activity in a dose dependent manner which supports its use as an analgesic, anti-inflammatory and antipyretic drug in folk medicine.
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Type 1 neurofibromatosis is a common neurocutaneous syndrome with various common and uncommon associations. The present case represents an uncommon association of type 1 neurofibromatosis and pheochromocytoma, which is probably due to mutation of NF-1 gene.
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Organophosphate poisoning is an important cause of suicides in hospital admission. The present case is of a female presenting with loss of power in all four limbs two weeks following a suicidal attempt. Nerve conduction velocity test revealed axonal type of motor neuropathy in bilateral median and ulnar nerve and peroneal and tibial nerves were unexcitable bilaterally. Therefore, in all cases of neuropathy, ingestion of organophosphate, either accidental or suicidal should be looked for even if the initial phases of intoxication are not clinically well defined.
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A cross sectional study was conducted from February - May 2009 with the objectives to find out profile of injuries among municipal primary school children in Siliguri, West Bengal and to identify the related factor associated with injury. 20% of total primary schools under municipal corporation of the town were selected and a pre-designed, pre-tested schedule was used to assess the profile of injury and associated factors. The Chi square test was usedto determine statistical significance at the 0.05 significance level. Out of 956 participants, a significantly higher injury was observed among males (68%). Open wound injuries were commonest (59.6%) occurring mainly at the extremities. Falls were mainly responsible for overall injuries. Injury at home (41.8%) was also found to be more. Mother education, number of siblings and presence of caregiver were significant related factors to injury.
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Background: Poor nutritional status during adolescence is an important determinant of health outcome. The adolescents have different needs and have diverse problems. This study was conducted to assess the nutritional status and find out the morbidity pattern of the school going adolescents. Methods: A cross-sectional study was conducted among school going adolescents, 11-19 years studying in various schools of Naxalbari block of Darjeeling district in 2007. A two stage sampling design was used to draw representative sample. Participants were clinically examined, anthropometric measurements were made and pre-tested questionnaire was dispensed. BMI-forage and height-for-age were considered as the indicators. Results: The study population comprise of 420 participants [39% girls]. 40% of the adolescents were under nourished. Severe malnutrition was found in 27% of male and 29% of female population. 44% of the study participants were stunted and 14% were severely stunted. Pallor was present in 40% participants. One fourth of the adolescents complained of psychological problems. Conclusion: There is an urgent need to intensify efforts to improve the nutritional profile of children to optimize human resource development
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Chemically made enamel is a dynamic substance rather than inert. Trace elements of enamel take active part in demineralisation, remineralization, ionic exchange, various physiological and pathological conditions.
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Esmalte Dental/química , Humanos , Espectrofotometría Atómica , Oligoelementos/análisisRESUMEN
In 58 patients with acute recurrent or persistent flank pain, straight x-ray (kidney, ureter, bladder region) detected stones in the urinary tract in 50 cases (86.2%), whereas ultrasonography detected stones in the urinary tract in 55 patients (94.8%). Ultrasound also detected unilateral hydronephrosis in 20 patients (34.48%). The presence of calculus was subsequently proved by intravenous urography/surgery or spontaneous passage. Ultrasonography is safe, quick, reliable and most effective diagnostic tool in such cases in rural areas. Intravenous urogram should be reserved for cases which need surgical intervention.
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Adulto , Diagnóstico Diferencial , Femenino , Humanos , Hidronefrosis/diagnóstico por imagen , Dolor de la Región Lumbar/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Cálculos Ureterales/diagnóstico por imagen , Cálculos Urinarios/diagnóstico por imagenRESUMEN
A high frequency vaginal probe with improved resolution offers a remarkable sharp clear image of pelvic organs. This is possible because of its closed proximity with target organ and non-intervention by gut or omentum. Study of ovarian follicular dynamics (folliculometry), identification of proliferative, secretory and decidual changes of endometrium (endometrial dating) in different phases of menstrual cycle and imaging of mucus secretion in the cervical canal (cervical mucus study) in the pre-ovulatory phase is possible by transvaginal probe. It is non-invasive, acceptable to patients, and thus can be repeated any number of times. A close serial monitoring offers immense wealth of information about the anatomical as well as reproductive endocrinal status of the patient. Ovulation can be predicted in advance. The case of dysovulation can be identified in first cycle of study; corrective therapy can be started in another two or three cycles, aiming at achieving perfect folliculogenesis. Once well tuned synchronised cycle is restored, the pregnancy outcome is remarkable. Thus transvaginal sonography offers one of the best reproductive endocrinology evaluation in the hand of a modern gynaecological sonologist and infertility specialist.