Prevalence of iodine deficiency disorders among school student of Purba Medinipur, 2018: a cross sectional study

Background: Iodine deficiency disorder is one of the preventable public health diseases in India. Prevalence of goiter is also still prevalence at sub-Himalayan region of West Bengal. Study was conducted to assess prevalence of goiter among school students between 6 and 12 years age, to find out urinary excretion of iodine and iodine content in salt sample and to recommend for consuming iodized salt.Methods: We conducted the study among the school students aged 6 to 12 years during the month of June 2018 in Purba Medinipur district, West Bengal, India. Multistage cluster sampling method was conducted for selecting the study population. Clinical examination was done by medical officer to detect goiters. Salt and urine samples were taken from the selected students and were sent to State Iodine Monitoring Laboratory, Kolkata for examination of iodine content in household salt samples and urine samples.Results: Total 2821 students were examined for survey. Over all prevalence of goiter was 3.75% (109/2821). Girls had more prevalence 4.63% than boys 3.18%. Average urinary iodine excretion (UIE) level is 184.74% in 30 clusters of 339 urine samples. Only 5.60% showed UIE level ≤100 microgram/liter. Total 541 household salt samples were tested for iodine and average iodine content was 22.85%. Among them 91.5% (495) had iodine ≥15 ppm indicating adequate iodine contents in salt samples.Conclusions:Purba Medinipur may be considered a non-endemic district. We recommended continuing use of iodized salt.

Prevalence and predictors of metabolic syndrome with comparison of myoinositol and metformin in PCOS women

Background: The objective is to determine the prevalence of metabolic syndrome (MBS) and the effects of insulin sensitizers to improve the clinical and hormonal milieu for better reproductive outcome in PCOS women.Methods: This prospective cross-sectional study was conducted on 50 PCOS women and 50 age matched control to determine the prevalence of the MBS in two tertiary hospitals over one year. Diagnosis of PCOS was based on at least two of ESHRE/ASRM criteria and diagnosis of MBS was based on at least three of NCEPATPIII criteria. Patients already diagnosed as PCOS were treated with insulin sensitizers myoionositol and metformin which were compared.Results: The study revealed that the prevalence of MBS was 40 % (20/50) nearly 4-fold higher than that of control groups. Among PCOS women, the most prevalent MBS factors were high BMI (52%) and low serum HDL-C (42%). The least prevalent factor was high fasting serum glucose level (16%). The resumption of spontaneous regular menstrual cycle and pregnancy rate in infertile groups of PCOS patients with myoionositol and metformin were 61% vs. 26% and 50% vs.91% respectively. The myoionositol group did not require any extra ovulating agents for pregnancy, while 7 out of 11 patients in metfromin group needed clomiphen citrate for ovulation induction to achieve pregnancy.  With myoinositol there is significant reduction of weight, BMI, LH/FSH ratio and fasting insulin level; whereas metformin shows decrement of weight and BMI only.Conclusions: The prevalence of MBS in PCOS is nearly 4 times in present study and there is significant improvement of symptom profile, weight, BMI and change of hormonal pattern in myoinositol group.

Dengue fever in a rural area of West Bengal, India, 2012: an outbreak investigation.

Background: During September 2012, an increased number of fever cases was reported from Ramnagar-II block, Purba Medinipur district. This study investigated the outbreak, with the following objectives: to describe the distribution of fever cases, to determine the risk factors and to recommend preventive measures. Materials and Methods: The clinical features, date of onset and outcome of all cases of fever were listed. Blood specimens were collected from affected patients and sent for serological examination. An epidemic curve was plotted and environmental and entomological surveys were carried out. Results: There was a total of 100 cases, of which 56% (56/100) were men. Among the four villages studied, the highest number of cases was from Gopalpur 37% (37/100), followed by Badalpur 26% (26/100); 19% (19/100) of cases had a history of migration from dengue-endemic areas. The majority of cases were in age group 15–45 years – 52% (52/100), followed by the age group >45 years – 28% (28/100). All the cases had history of fever (100%), followed by myalgia – 82%, headache – 78%, and retro-orbital pain – 73%. The outbreak started on 7 September 2012, peaked on 18 September, then gradually declined and no further cases were noted after 28 September 2012. Seventy-nine per cent (79/100) of cases were NS1 test positive (non-structural antigen-1) and 72% (13/18) cases were positive on a dengue monoclonal antibody (IgM) capture enzyme-linked immunosorbent assay (MAC-ELISA) test. All recovered except one (case-fatality ratio: 1%). The values for Household Index, Container Index and Breteau Index of the four villages were: Badalpur, 3%, 10% and 5%; Gopalpur, 13%, 23% and 18%; Ramchandrapur, 9%, 11%, and 13%; and Tajpur, 2%, 2% and 2%. Conclusion: The outbreak was probably due to dengue fever. The study led to a recommendation to destroy water containers and use mosquito nets. The outbreak was controlled.

An outbreak of pandemic influenza A (H1N1) in Kolkata, West Bengal, India, 2010.

Background & objectives: An increased number of cases with influenza like illness (ILI) were reported in Greater Kolkata Metropolitan Area (GKMA) during July and August 2010. We investigated these cases to confirm the outbreak, describe the distribution of patients and propose control measures. Methods: A suspected case of influenza like illness (ILI) was defined as acute onset of fever (>38°C) with cough or sore throat and a confirmed case as ILI case with throat swab positive for influenza A (H1N1) on RT-PCR. The demographic and clinical details were collected from patients attending the swine flu OPD of Infectious Disease Hospital, Kolkata, during July 5 to August 16, 2010. Results: Overall 440 patients with ILI attended the swine flu OPD of Infectious Disease and Bengal General hospital during the study period, of which 129 were positive for influenza A (H1N1). Four patients died (case fatality ratio: 0.90%). Besides fever, common symptoms included cough (73%), running nose (54%), sore throat (43%), respiratory distress (25%) and diarrhoea (4%). Forty seven (11%) patients (including the four who died) had co-morbidities. The outbreak started on July 10, peaked on July 24 and subsided by August 14, 2010. A total of 372 (85%) patients were from GKMA. Majority (n=168, 45%) of the cases from GKMA were from 6 boroughs of Kolkata Municipal Areas. Interpretation & conclusions: An outbreak of influenza A (H1N1) occurred in Kolkata predominantly affecting young and middle aged population. State health authorities implemented several interventions to limit the outbreak including training of health care providers in case management and infection control, vaccination of health care workers, creation of isolation wards and administration of oseltamivir to ILI patients, and community health education about social distance and personal hygiene measures.

Outdoor air pollution and emergency room visits at a hospital in Delhi.

Several reports from large metropolitan cities have indicated significant association between acute morbidity and mortality from cardio-respiratory disorders and daily levels of major pollutants in the ambient air. Despite the wide-spread public concern about the adverse health effects of air pollution, there is substantial uncertainty regarding the effects of these pollutants at a concentration typical of Delhi, which is one of the ten most polluted cities in the world and the most polluted city in India. This study was undertaken to correlate the daily levels of various pollutants with the number of patients visiting the All India Institute of Medical Sciences (AIIMS, New Delhi) casualty for aggravation of certain defined cardiorespiratory disorders. Daily counts of patients visiting the emergency room of the AIIMS for acute asthma, acute exacerbation of chronic obstructive airway disease (COAD) and acute coronary event was obtained in prospective manner from January 1997 to December 1998. Daily mean levels of ambient CO, NOx and SO2 were monitored along with temperature and humidity. Data was analysed using one day time lag for events of interest. Time series analysis was undertaken using Poisson regression and population averaged general estimation equation, correcting for auto-correlation, days of the weak and season. The ambient levels of pollutants exceeded the national air quality standards on most of the days, over the two year period. Further, emergency room visits for asthma, COAD and acute coronary events increased by 21.30%, 24.90% and 24.30% respectively on account of higher than acceptable levels of pollutants. It is concluded that there is considerable burden of cardiorespiratory diseases in Delhi due to high levels of ambient air pollution.