Relationship between inter-arm blood pressure differences and predicted future cardiovascular risk in hypertensive patients

Background: Hypertension stands as a widely recognized significant risk factor for cardiovascular disease. In clinical practice, it is advisable to measure blood pressure (BP) in both arms. The increasing attention on inter-arm blood pressure difference (IABPD) stems from its association with cardiovascular disease. This study aimed to assess the relationship between inter-arm blood pressure differences and predicted future cardiovascular risk in hypertensive patients. Methods: This cross-sectional study was conducted at the department of cardiology, Chittagong Medical College Hospital from July 2020 to June 2021. The study included 428 cases of previously or newly diagnosed hypertension, selected through convenient sampling. Data analysis was conducted using Microsoft Office tools and statistical package for the social sciences (SPSS) version 23.0. Results: In this study, 8.2% of patients exhibited noteworthy systolic IAD, and 2.3% demonstrated notable diastolic IAD. Median 10-year cardiovascular risk, assessed by Framingham and ASCVD calculators, was 21% and 11% respectively. A positive correlation was observed between sIAD and 10-year cardiovascular risk (p=0.003) and sIAD and 10-year ASCVD risk (p=0.041). Patients with significant sIAD had a higher incidence of ischemic heart disease compared to those without (p=0.041). Multiple regression analysis revealed a significant correlation between 10-year Framingham cardiovascular risk and sIAD (p=0.003). Conclusions: A significant difference in systolic blood pressure between arms is linked to a higher 10-year cardiovascular risk and the presence of cardiovascular disease in well-managed hypertensive patients. So, monitoring sIAD could be an additional factor in predicting future cardiovascular events in patients receiving hypertension treatment.

Influence of Seed Storage and Priming on Naturally Aged Seeds of Aromatic Joha Rice

Joha is a fine grain aromatic rice of Assam, well known in the world market. This rice is protected and tagged as a geographical indication. This study evaluated priming effects on naturally aged seeds of two varieties, Kon Joha and Keteki Joha, after 0, 3, 6 and nine months of storage under ambient conditions. Seeds were hydro-primed, osmo-primed with 5% and 10% PEG, halo primed with 1% and 2% KCl and primed with 5 ppm and 10 ppm GA3 for 12 and 24 hours. Seed moisture percentage, germination percentage, germination index, mean germination time, seedling length and dry weight, seed vigour index, field emergence, seed reserve utilization rate, seed reserve use efficiency, seed reserve depletion percentage, and biochemical parameters like electrical conductivity, lipid peroxidation and ?-amylase were observed. Seed quality was gradually deteriorating due to ageing over the storage period. The rate of deterioration was faster for seedling vigour traits than germination parameters. There was a varietal difference in the rate of deterioration; it was slower in Kon Joha, an indigenous variety which also showed dormancy. The priming treatments were able to ameliorate the effect of seed ageing on seed germination, seedling growth and biochemical parameters in Kon Joha. Treatments with 1% KCl, 10 ppm GA3 and 5% PEG enhanced the germination parameters and vigour indicators. KCl (1%) priming was the best priming agent; 24 hours of priming for all agents was better than 12 hours.

Impact of Climate Variables on Occurrence of Rice Earhead Bug, Leptocorisa oratorius (F.) (Hemiptera: Alydidae)

Rice earhead bug, Leptocorisa oratorius (F.) (Hemiptera: Alydidae) is one of the major sucking pests of rice, causing significant yield losses worldwide. The population fluctuation and infestation of earhead bug is influenced by different meteorological parameters. A field experiment was conducted at the ICR (Instructional Cum Research) Farm, Assam Agricultural University, Jorhat with a view to study the occurrence of L. oratorius on rice crop during Ahu (Autumn rice) season, 2018 and 2019. The population of L. oratorius was first observed in the field during the month of May and attained its peak population (2.66 and 1.56 adult per hill) on second and third week of June in 2018 and 2019, respectively. The occurrence of L. oratorius was also correlated with the different climate variables viz., temperature, relative humidity, rainfall and bright sunshine hour (BSSH). The correlation analysis revealed no significant impact of climatic variables on the occurrence of L. oratorius population during 2018, while all the variables except rainfall showed significant correlation with the occurrence of L. oratorius population during 2019. In 2019, a significant best fit multiple regression model was developed for L. oratorius to predict their seasonal occurrence under agro-climatic condition of Jorhat, Assam. The per cent grain infestation was also recorded during 2018 and 2019, which was found to be 39.34 and 37.11 per cent, respectively.

Correlation of lipoprotein (a) level with severity of coronary lesion in coronary heart disease patients

Background: Cardiovascular diseases (CVDs) are the leading cause of death in developing nations, especially in low and middle-income countries (LMICs). Bangladesh has been undergoing an epidemiological transition from communicable to non-communicable diseases. This study aimed to investigate the association of risk factors with coronary heart disease (CHD) in patients from Bangladesh. Methods: This cross-sectional observational study was conducted in the department of cardiology, Chattogram Medical College and Hospital, Chattogram, Bangladesh from July 2018 to June 2019. A total of 100 patients were enrolled. Results: This cross-sectional study enrolled 100 CHD patients with a mean age of 53.21±10.29 years. The majority were obese (64, 64.0%), and hypertension was the most prevalent risk factor (77, 77.0%), followed by smoking (65, 65.0%) and dyslipidemia (58, 58.0%). Most patients had triple vessel disease (53, 53.0%), and significant CHD (81, 81.0%). Patients with severe CHD had higher levels of blood LDL-C, triglycerides, and Lp(a). Lp(a) levels, history of dyslipidemia, and LDL-C were independently associated with a Gensini score ?20. These findings emphasize the independent association between Lp(a) and CHD severity, warranting greater attention to patients with elevated Lp(a) levels. Conclusions: This study suggested that Lp(a) is an independent risk factor for CHD in patients from Bangladesh. More attention should be paid to such patients with elevated Lp(a) level.

Association between neutrophil to lymphocyte ratio with the severity of coronary artery diseases

Background: Coronary artery disease is a type of heart disease where the arteries of the heart cannot deliver enough oxygen-rich blood to the heart. This study aimed to evaluate the association between neutrophil to lymphocyte ratio (NLR) with the severity of coronary artery diseases. Methods: This cross-sectional study was conducted in the Department of Cardiology, Chittagong Medical College Hospital, Chattogram, Bangladesh during the period from 1 July 2020 to 31 June 2021. 160 patients undergoing elective coronary angiography with the symptoms of coronary artery disease were enrolled in this study. A purposive sampling technic was used. The association between NLR and Gensini score was assessed using Pearson’s or Spearman’s correlation analysis as appropriate. All data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. Results: The mean (±SD) Gensini score of our participants was 42.75 (±29.50) and the mean (±SD) NLR (Neutrophil-lymphocyte ratio) was 2.38 (±1.11). In this study, the AUROC for NLR was found as 0.851 with a P-value of <0.001, indicating a statistically significant association of NLR with the severity of CAD. The scatter dot diagram showed the correlation between NLR and Gensini score. Both the variables were positively correlated and the degree of correlation was found statistically significant (r=0.44; p<0.001) by Pearson’s correlation test. The multivariate logistic regression analysis showed that a high level of NLR had an independent association with severe CAD (with OR being 3.308) along with dyslipidemia. Conclusion: High blood NLR is associated with the severity of CAD and it may be useful for predicting angiographically severe disease.

A retrospective observational study on incidence and clinico-epidemiological features of COVID-19 associated pulmonary aspergillosis among cancer patients hospitalized with COVID-19 in a tertiary care cancer centre of India

Background: COVID-19 associated pulmonary aspergillosis (CAPA) is an emerging complication among patients with COVID-19 but hasn’t been well studied in cancer patients. This study, we try to find out important aspects associated with CAPA among cancer patients with regards to clinico-epidemiological factors. Methods: In this retrospective observational study, we included 198 consecutive patients COVID-19 between April 2020 and February 2021. CAPA cases were classified according to CAPA-European Confederation of Medical Mycology criteria (2020 ECMM/ISHAM consensus criteria). Results: The overall incidence of CAPA was found to be 10.1% in our study population. The incidence among hematological malignancies was 11.25% and solid tumors was 10%. In-hospital mortality was significantly high among patients with CAPA as compared to that among without CAPA (40% versus 16.85%; p<0.012695). Significant number of patients with CAPA had received chemotherapy in last 3 months before diagnosis of COVID-19 (50% versus 28.09%, p=0.043222) and had evidence of culture positive bacterial infection (30% versus 5.62; p=0.000888). Significantly more patients having CAPA were on steroids, required oxygen and/or ventilator support as compared to those without CAPA. Conclusions: CAPA is a significant cause of mortality and length of hospital stay (16 versus 7 days; p=0.00001) among cancer patients with COVID-19. Cancer patients with COVID-19 were at increased risk of CAPA as compared to non-cancer patients.

Effect of megaloblastic anemia on hemoglobin A2 and diagnosis of ?-thalassemia trait

Context: ?-thalassemia trait is usually diagnosed by raised hemoglobin A2 (HbA2). The presence of megaloblastic anemia can cause an increase in HbA2 and create a diagnostic dilemma. Here, we have analyzed the effect of vitamin B12 and folic acid supplementation on HbA2 and diagnosis of ?-thalassemia trait in cases of megaloblastic anemia with raised HbA2. Materials and Methods: Cases of megaloblastic anemia with raised HbA2 on high-performance liquid chromatography (HPLC) were supplemented with vitamin B12 and folic acid. Post-treatment evaluation was done after 2 months. Cases showing adequate hematological response were subjected to statistical analysis. Based on post-treatment HbA2 value, the cases were diagnosed as normal, borderline raised HbA2, or ?-thalassemia trait. Pre- and post-treatment values of red cell parameters and HbA2 were analyzed. Results: There was a significant decrease in HbA2 value after vitamin B12 and folic acid supplementation. The diagnosis was changed in 70.97% of the cases after treatment. The chance of inconclusive diagnosis was decreased from more than 50% to less than 10%. Pre-treatment mean corpuscular volume (MCV) and HbA2% showed a significant difference between the thalassemic and normal groups. Conclusions: Megaloblastic anemia can lead to false-positive diagnosis of ?-thalassemia trait on HPLC. Repeat HPLC should be done after adequate supplementation of vitamin B12 and folic acid in cases of megaloblastic anemia with raised HbA2. Red cell parameters are not helpful to suspect ?-thalassemia trait in presence of megaloblastic anemia. However, HbA2% on HPLC can be a useful parameter to suspect or exclude ?-thalassemia trait in cases of megaloblastic anemia.

Association of serum uric acid level with angiographic severity of coronary artery disease: a study in a tertiary care hospital, Chittagong, Bangladesh

Background: Coronary artery disease (CAD) is a major global health issue. Serum uric acid (SUA), a byproduct of purine metabolism, is linked to CAD development and progression. Elevated SUA levels are an independent risk factor for cardiovascular mortality and may indicate endothelial dysfunction. The aim of the study was to the observed associate serum uric acid level with the angiographic severity of CAD. Methods: This observational study was conducted at Chittagong medical college hospital in Bangladesh from October 2020 to September 2021. It included 130 patients and used unpaired t-tests to analyze the association between serum uric acid level and angiographic severity of CAD patients. Ethical clearance was obtained from the institutional review board of Chittagong medical college and hospital. Results: A study of 130 patients found a significant relationship between serum uric acid (SUA) levels and CAD (CAD), vessel involvement, and CAD severity (p=0.001). Patients with CAD had higher SUA levels (mean 5.26±1.32 mg/dL) compared to those without CAD (mean 4.22±1.03 mg/dL). A SUA level range of 3.94-6.58 mg/dL was associated with CAD presence. Gender also showed a highly significant association with SUA levels (p=0.001), while age, BMI, and smoking status did not show significant differences. Conclusions: A strong positive association has been found between serum uric acid level and the severity of CAD. The findings of this study approve the effectiveness of hyperuricemia as an emerging risk factor for CAD.

Association of serum uric acid level with angiographic severity of coronary artery disease: a study in a tertiary care hospital, Chittagong, Bangladesh

Background: Coronary artery disease (CAD) is a major global health issue. Serum uric acid (SUA), a byproduct of purine metabolism, is linked to CAD development and progression. Elevated SUA levels are an independent risk factor for cardiovascular mortality and may indicate endothelial dysfunction. The aim of the study was to the observed associate serum uric acid level with the angiographic severity of CAD. Methods: This observational study was conducted at Chittagong medical college hospital in Bangladesh from October 2020 to September 2021. It included 130 patients and used unpaired t-tests to analyze the association between serum uric acid level and angiographic severity of CAD patients. Ethical clearance was obtained from the institutional review board of Chittagong medical college and hospital. Results: A study of 130 patients found a significant relationship between serum uric acid (SUA) levels and CAD (CAD), vessel involvement, and CAD severity (p=0.001). Patients with CAD had higher SUA levels (mean 5.26±1.32 mg/dL) compared to those without CAD (mean 4.22±1.03 mg/dL). A SUA level range of 3.94-6.58 mg/dL was associated with CAD presence. Gender also showed a highly significant association with SUA levels (p=0.001), while age, BMI, and smoking status did not show significant differences. Conclusions: A strong positive association has been found between serum uric acid level and the severity of CAD. The findings of this study approve the effectiveness of hyperuricemia as an emerging risk factor for CAD.

Community based cross-sectional survey to assess the conditions of refractive error by eye-screening program in remote area of Saifai, Etawah

Background: Refractive error is a state where an optical system of the eye fails to bring parallel light rays on a point focus at the fovea, due to increase or decrease of the size of the eyeball through any reasons, changes in the refractive index of the component of the eyes or the age related factors. Methods: A community-based cross-sectional survey was conducted in the systemic random sampling without repetitions (SRSWOR) method at the circumference area of 5 km of the Saifai Medical University UPUMS Saifai, Etawah (Uttar Pradesh). The data was collected through the rural program for the control of blindness. Among 1032 samples, for the refractive error, total 237 individuals were registered for the study through the screening programme. Results: The age group 0-19 years concludes 22 (9.28%), for 20-39 concludes 71 (22.95%), for 40-59 years concludes 101 (18.14%) and for the age group above 60, it was 43(48.94%) respectively. Among all the age groups a total of 22.96% responders were diagnosed for the prevalence of refractive error and it was observed more for females 50.63% as compared to males 49.36%. Conclusions: The prevalence of refractive errors refers to the age group of 40-59 years, so for early diagnosis eye care must be included at a particular time difference at a community level through an eye screening program for all the age groups with the main intention to give special cover to the age group of 40-59 years.

An epidemiological study on assessment of dementia and general health pattern among geriatric population in the rural field practice area of medical college and hospital, Kolkata

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.

COVID-19 Pandemic and the Role of Control Room in the Tertiary Care Hospital

COVID-19 has been labeled a serious public health emergency globally. Due to its high infectivity it has led to an increased burden to the Medical Fraternity as well as the Government. Therefore, the need for preparedness as well as conventional intervention strategies became integral during such health emergencies. To monitor the implementation of proper activities and to manage the patient load with adequate safety of the staff, COVID control rooms were established in the hospital premises. The main objective of the Control Room is risk mitigation, planning strategies, alleviating concerns and addressing issues associated with the health emergency across the hospital and further delegating the information to the higher authorities and the Ministry. Hereby in this review we have tried to summarize the administrative structure, functions and limitations of the 24x7 Control Room established in Tertiary Care Hospital, New Delhi.

Gastrointestinal tract involvement in patients with potential celiac disease beyond the small intestine: An early proof with IgA anti-tissue transglutaminase-2 antibody deposits

Background: IgA anti-tissue transglutaminase-2 antibody (anti-TG2Ab) deposits in intestinal and extraintestinal organs have been used to link the respective pathological changes in these organs with celiac disease (CeD). Aims: To know if parts of intestine other than the duodenum, such as esophagus, stomach, and colon, have any pathology related to potential CeD or have mucosal IgA anti-TG2 Ab deposits. Settings and Design: A prospective case–control study conducted from April 2018 to December 2019. Materials and Methods: Nine patients with potential CeD and 27 age- and gender-matched patients with irritable bowel syndrome were recruited as cases and controls, respectively. Mucosal biopsies were collected from esophagus, stomach, duodenum, and rectosigmoid regions, histological changes were evaluated, and IgA anti-TG2 Ab deposits were analyzed in these regions by two-color immunohistochemical staining. Statistics: Data were analyzed using statistical software Stata 14.0. Results: No distinct difference in mucosal lymphocytosis were identified between biopsies of patients with potential CeD and controls at the following sites: esophagus (11.1% vs 0%, P = 0.079), stomach (14.3% vs 7.7%, P = 0.590), and rectum (20% vs 0%, P = 0.067). Co-localized IgA anti-TG2Ab deposits were observed more in potential CeD than in controls at esophagus 22.2% (2/9) vs 0%, P = 0.012; stomach 66.7% (6/9) vs 11.5% (3/26), P < 0.001; and duodenum 66.7% (6/9) vs 0%, P < 0.001 but not at rectum 0% (0/4) vs 0% (0/25). Conclusion: Although histological changes are not distinct, a subset of subjects with potential CeD has pan-intestinal involvement other than in the duodenum.

A cross-sectional study to determine the cognitive impairment and depression among elderly in a rural area of West Bengal

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.

Correlation between red cell distribution width and coronary artery disease in patients undergoing elective coronary angiography

Background: Coronary artery disease (CAD) is the primary cause of death in developed countries and is one of the leading causes of disease burden in developing countries. Methods: This descriptive cross-sectional study included 124 purposively selected patients who underwent elective CAG in the department of cardiology, Chittagong medical college hospital, Chattogram, from July 2020 to June 2021. SPSS 23.0 software was used for processing and analysis at the end of the data collection period. Results: According to the Gensini score, patients were categorized into two groups (score <30 and ?30). There were no significant differences between the two groups concerning BMI, smoking, hypertension, DM, F/H of CAD, statin or beta-blocker use, or the levels of hemoglobin, hematocrit, MCV, MCH MCHC, and creatinine. However, the mean age was older, and there were more males in the severe CAD group. The percentage of dyslipidemia was significantly higher in patients with Gensini score ?30 than in patients with <30. RDW (OR: 2.629; 95% CI: 1.425-4.484; p=0.002) and age (OR: 1.058; 95%CI: 1.00-1.111; p=0.027) were independently correlated with the severity of CAD. The AUROC for red cell distribution width (RDW) was 0.915 with a p<0.001 for predicting CAD on CAG. It indicated a statistically significant association of RDW with the presence of CAD. A cut-off value of 13.65% RDW had a sensitivity of 80% and specificity of 84.2% for the prediction of CAD. There were no significant differences between patients with and without angiographic CAD for BMI, hypertension, DM, statin, or beta-blocker use, or of the levels of hemoglobin, hematocrit, MCV, MCH, MCHC, and creatinine. However, the mean age was older, and there were more males in the CAD group. The percentage with dyslipidemia, smoking, and F/H of CAD was significantly higher in patients with CAD than in patients without CAD. The data indicate that only RDW was independently correlated with the presence of CAD (OR: 2.593; 95% CI: 1.347-4.989; p=0.004). Conclusions: RDW is associated with the presence of CAD and suggests that it might be a readily available test for predicting coronary artery diseases.

A study of growth pattern of school going children of Kolkata, India

Background: In our society only, a few peoples have good physiological status from their childhood. Health status of children and adolescents is important factor for young society. This present study highlights the peoples’ state of health and nutrition. Change in height with respect to age can be seen during puberty and adolescence. Growth can also be dependent upon the geographical regions. Methods: In this study included 230 adolescent students (boys- 146, girls- 84) in the age group of between 12-18 years. So many related growth parameters were measured using by an anthropometric rod, weighing machine, and slide calliper. BMI, p value was obtained by performing t-test at 0.05 level of significance. Statistical software SPSS version 20 was used. Results: Growth parameter was found to be increasing with age and it was more pronounced between 16 and 17 years. Interestingly the increment of all the growth parameter was found to be more in urban and less in rural. Conclusions: The findings of this study showed a progressively increasing of growth-related parameters with ages and the progress vary, indicating a nutritional supplementation are unequal (unequal growth pattern), as it was evident from different growth parameters percentile values of CDC and IAP values. This study will certainly help to create among the children and their parents about the physical growth and health.

A cross-sectional study on assessment of physical activity and dietary consumption pattern among geriatric population attending geriatric outpatient department of Medical College and Hospital, Kolkata

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.

A study on assessment of sleep pattern and perceived stress among geriatric patients in Medical College and Hospital, Kolkata

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.

High-grade mixed neuroendocrine non-neuroendocrine neoplasm of the gastroesophageal junction: A rare case report and review of literature

Mixed neuroendocrine non-neuroendocrine neoplasm (MiNeN) is a recently described entity of the esophagus in the latest (fifth) edition of WHO Classification of Digestive System Tumors. It is often a difficult pathological diagnosis, especially in small preoperative biopsies. We herein report a case of high-grade MiNeN of gastroesophageal junction diagnosed as a squamous cell carcinoma in preoperative biopsy and subsequently as a high-grade MiNeN in esophagogastrectomy specimen comprising areas of mucoepidermoid carcinoma and large-cell neuroendocrine carcinoma (NEC). This report accentuates the importance of deeper multisite preoperative biopsies as the management is completely different in a MiNeN from esophageal squamous cell carcinoma.

Knowledge regarding child rearing among teenage pregnant women in a rural area of West Bengal: A cross-sectional survey

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.