Effectiveness of a program designed to expose medical student to the rural community and support system in healthcare, in a medical college.

Background: It is felt that medical training should largely be made in close proximity of public health & social environment compared to a tertiary care hospital. The package of training could include an exposure to the rural community because a fresh graduate doctor does not have concept of broad community healthcare needs. Aims & Objectives: The aim of the study was to assess the effectiveness of a program designed to expose medical student to the rural community and support system in health. Methods: The study was conducted in December 2008 among 96 medical student of 7th semester. This was a quasi- experimental design with before and after intervention assessment. Assessment was made based on presentations on comparisons of mock village scenario Vs real village experience. A structured questionnaire was used to assess change in knowledge. Results: The mean of the test scores in communication skill and knowledge (based on presentations) in average mock village scenario were 45.94 and improved to 53.56 after real village stay. There was an improvement of 7.62(16.6 %, p<0.001).The mean pre and post village stay score in knowledge based on questionnaire was 56.02 and 67.12 respectively with an improvement of 11.1 (19.81%, p<0.001). The programme was also found to be interesting to the students and villagers. Conclusions: A village stay programme to teach undergraduate student in a field setting to expose them to various parameters of practice of primary health care can help them understand the contextual needs of the society.

Perinatal mortality in eclampsia in relation to drug therapy.

Fifty-nine babies were born to eclamptic mothers among 7500 deliveries giving incidence of occurrence of 0.77 percent. The perinatal mortality in eclamptic babies was 32.7%, whereas the total perinatal mortality rate amongst all the deliveries was 10.5%. The mothers were treated within Group I--diazepam, Group II i chlorpromazine (largactil), phenargan and diazepam and Group III--largactil, phethidine and phenargan. The mortality rate was 23.8%, 18.8% and 66.6% respectively. The highest number of still-born i.e. six out of 8 occurred in Group III. Hundred percent still-born was noted in 28-32 weeks of gestation and birth weight less than 1.5 kg irrespective of drug regimes. Iargactil potentiates the respiratory depressant effect of pethidine and may cause high rate of still-birth and death after birth.

Value of Mantoux Test in diagnosis of tuberculosis in chronic illness.

Total 240 cases of 2-12 years age group who had contact of tuberculosis indirectly or directly and had chronic illness were screened for tuberculosis. Out of 240 cases, 180 cases were diagnosed as tuberculosis. Special emphasis was given on Mantoux Test (M.T.), though the battery of tests were done to diagnose tuberculosis. Out of 180 cases of Tuberculosis, M.T. was Positive in 97 cases (40.41%) and repeat M.T. was done after 3 weeks and was converted to Positive in 20 cases (8.33%). Thus only M.T. help in diagnosis of Tuberculosis in almost 50% of the cases.

Utilization of maternal services in west Bengal.

A study was conducted in selected blocks of West Bengal to assess the utilization of available maternal health services specially immunization, antenatal care and other services. Coverage with two doses of tetanus toxoid levels varied between 58.6 to 86.7% but it fell far short of Universal Immunization Programme target of 100%. Drop out rates were slightly higher in the rural areas. It was observed that in 5 out of 7 blocks more than 55% of the deliveries were conducted either at hospital or Primary Health Centre by health personnel. However, untrained dais predominated over the trained dais in conducting deliveries in most of the areas. This indicates the poor availability or utilization of the latter.

Epidemiology of Japanese encephalitis.

Seven hundred and sixty-two cases of Japanese Encephalitis (JE) were studied during the last 5 years (1985-1989) in relation to age, sex, religion, nutritional status, living habits, exposure to domestic animals and mosquitos, clinical profile, seasonal variation and mortality pattern. The maximum occurrence was in 1987-1988 and it showed a preponderance in males (51-82%). The disease is progressively decreasing in Muslims (3-7%) and gradually increasing in tribes (25-60%). Children in the age-group of 6-7 years (19-25%) were maximally affected and the disease was rare in infancy. The common features were coma, convulsions, neck rigidity and fever (88-97%). Gastrointestinal manifestations were rare (3.6%) but were associated with the highest mortality. About 80-95% had exposure to domestic animals directly or indirectly and 95% of the patients were not using mosquito nets. The CSF protein and sugar content were normal, with or without slight leucocytosis while the lymphocyte count was variable. The CSF and blood picture had no significant relation with clinical presentation and prognosis.

Mortality pattern in babies delivered by cesarean section and vaginal delivery.

A total of 7077 cases of delivery were studied in a rural based hospital where most of the mothers come without any antenatal care, from November, 1979 to December, 1980 to observe the mortality pattern in different types of delivery. Only live born babies were included in the study in which the mortality rate in elective cesarean section was found to be nearly equal to that in vaginal delivery. The percentage of mortality was higher (5.4%) in emergency cesarean section-the chief causes being asphyxia neonatorum, low gestational age and low birth weight.

Sialic acid in human semen.

Sialic acid of seminal fluid of eighty two human subjects has been studied in relation to infertility. Normozoospermic group had highest sialic acid content (94 mgm/100 ml of the fluid) and was significantly different from other groups. The lowest sialic acid level was observed in necrozoospermic group (54 mgm/100 ml of the fluid). Azoospermic (62 mgm/100 ml) and vasectomised group (73 mgm/100 ml) had 33 and 22 percent less sialic acid level respectively than normozoospermic group. For the pooled observation sialic acid was found to be correlated (r = 0.282, significant at 5 percent level) with the total sperm count.