RESUMEN
Background: Hospital costs are the largest component of health expenditure and they have therefore been a key focus in the drive for increased efficiency in the health sector.1With the simultaneous menace of ever increasing price rise and population explosion there is dearth of the existing meagre resources and thereby it becomes necessary to allocate and utilise the available resources to the fullest with provisions for minimum wastage. The objective of this study is to find out the pattern of diseases with their ICD-10 codes and the hospital performance indicators in patients admitted at the surgery ward of North Bengal Medical College during the study period.Methods: A descriptive epidemiological study with cross-sectional design was done by complete enumeration of all patients admitted in surgery ward of North Bengal Medical College and Hospital in Darjeeling district of West Bengal from July 2016 to September 2016.Results: A total of 2227 patients were admitted during the study period with intra-cerebral haemorrhage (I61) being the most common cause of admission followed by abdominal injury (S36) and burn (T29). The bed occupancy rate was 144.21%, bed turn-over rate 14.26 and average length 9.1. Scatter plot indicates hospital utilisation at Region IV as per Pabon Lasso Model of Hospital Utilisation.Conclusions: A high bed occupancy rate and low bed turn-over rate indicates scarcity of hospital beds, preponderance of severe and chronic cases and unnecessary stay in hospital.
RESUMEN
Leprosy is an infectious disease, which may lead to disability before, during or after treatment. Leprosy is associated with social stigma and discrimination because of disability and disfigurement and recognized as a disease of major public health significance. As factors associated with occurrence and management of disabilities may vary from area to area, it is important to generate this information in affected populations. This study has been carried out to determine the extent and pattern of disabilities among newly diagnosed leprosy cases, factors associated with disability, provision and utilization of disability preventive services. This cross-sectional study was conducted in Siliguri subdivision of Darjeeling district, West Bengal. All newly diagnosed and registered leprosy cases in a reference year (April 2013 - March 2014) were included. Detailed medical examination and interviews was carried out to assess the disability and to study the relevant aspects. The entire collected data was analysed using SPSS software and chi-square, binary logistic regression were applied to test association between disability and other epidemiological correlates. It was observed that all the disabilities were in multibacillary (MB) cases only. Child leprosy rates of 5.5% appears to be promising statistics. Among 110 new leprosy cases studied, overall proportion of disability was 15.5%; grade 1 and grade 2 disabilities were 9.1% and 6.4% respectively. Hand was the commonest site of involvement, whereas grade 2 disability was highest in feet (2.7%). Disability status was found to be significantly associated with number of nerve involvement and history of treatment interruption. Utilization of disability preventive services was found very poor. Significantly the proportion of disability was highest among leprosy cases aged 60 years or more (37.5%). As no disability was noted in patients below 15 years, march towards achieving one of the targets of Global Leprosy Strategy 2016-20 appears to be closing to goal. Though the situation may be better comparably to some other parts of country, yet the overall proportion of disabilities as well as grade 1 and grade 2 disabilities among newly diagnosed leprosy cases is unacceptably high in the studied area. Community based studies and appropriate interventions can help in achieving the targets pertaining to leprosy situation in general and access to quality services in particular
RESUMEN
Background: High risk pregnancies in intra-partum period are vulnerable, and if not appropriately attended, may roll on to maternal death or dreaded maternal near-miss cases. Despite the presence of a number of standard treatment guidelines designed to address most of the high risk conditions, their adherence and implementation continues to be uncommon. To assess the adherence to recommended guidelines during referral of high risk pregnancies in labour in mothers of the difficult terrains of eastern Himalaya. Methods: A descriptive epidemiological study with cross-sectional design was conducted among mothers with high risk pregnancies admitted in the labour ward, North Bengal Medical College Hospital, Darjeeling. 433 subjects were studied using complete enumeration technique. Results: Anaemia in pregnancy (22%), obstructed labour (19%), pre-term rupture of membranes (15%) and pregnancy induced hypertension (15%) were the high risk conditions identified. Referral linkage existed in most (70.7%) but no pre-referral treatment was given to 61.4% of the intra-partum mothers. Multivariate analysis shows mothers with age more than 35 years (AOR 4.97), bad obstetric history (AOR 2.40) & not attended by doctors (AOR 5.02) were found to be having more odds of missing the pre-referral treatment. About 86% of the gaps in pre-referral treatment were due to doctors not attending patients, lack of referral communication, not providing JSSK facilities and non-maintenance of Partograph as per Pareto analysis. Conclusions: Most of the non-adherence to standard treatment guidelines in high risk intra-partum mothers are related to health service delivery and can be ameliorated through proper administrative measures.
RESUMEN
Impact of fishing methods and gears used on fish faunal diversity in spring–fed torrential river Relli in Darjeeling hill area of West Bengal was investigated in the present study. The fish species available in the river provide nutrition and recreation (rarely income generating) for a large number of people residing along the river bank and nearby villages and towns. The fishing methods observed therein have been categorized as, i) Scientific fishing methods, that is, collection of required number and size of fish so that sufficient population of fish remains balanced in the nature. ii) Unscientific fishing methods, that is, indiscriminate killing of large number of fish which adversely affect the water quality of rivers. Ten types of fishing methods are practiced in this area, for example, diversion of river channel, cast netting, scoop netting, angling, fish spearing, rock striking or hammering, dynamiting, electric fishing, river poisoning and traps utilized. Over the years uncontrolled and often indiscriminate fishing in the unmanaged hill-stream has resulted in a sharp decline in fish resources. The study gives a clear picture on the anthropogenic pressure on the river Relli and provides baseline data which may be helpful for conservation and management of the fish species and also formulating new fishery policy.