Monkeypox, a global health concern: A study on awareness and adherence to preventive measures among medical students in a tertiary care hospital, Kolkata

Background: The re-emerging Monkeypox disease is spreading worldwide, thus if prevention measures are not followed or awareness is not raised, chaos could result. Aims and Objectives: The present study aimed to assess the awareness and preventive measures of Monkeypox among medical students in a tertiary care hospital of Kolkata. Materials and Methods: A hospital-based, descriptive, observational, and cross-sectional study was conducted over 6 weeks, among final year MBBS students of Medical College Kolkata. Convenience sampling was done. Minimum sample size calculated was 110. A pre-designed, pre-tested, semi-structured, and self-administered questionnaire which was face and content validated by experts used as the study tool in this study. Questionnaire was answered while keeping their identities confidential. Data were collected and entered in a coded manner in MS Excel. Using SPSS version 25, tabulation, the necessary tables, and diagrams were created. The Institutional Ethics Committee of the Medical College in Kolkata was consulted for ethical approval. Results: The students lacked sufficient information. Majority of them responded well when asked about the disease’s cause, incubation period, natural host signs and symptoms, mode of transmission, preventive measures, and treatment, but it was clear that they were unsure about identification of a suspected, probable, or confirmed case and definitive diagnosis. Conclusion: The present study reported that the students had limited knowledge about Monkeypox disease.

Knowledge on prevention and management of snake bite among adults in rural area of West Bengal

Background: Snake bite and its consequences may be largely prevented with adequate knowledge. Better knowledge can lead to positive attitude and subsequently good practices. Hence, it is of utmost need that people should have adequate knowledge regarding snake bite and its management. Aims and Objectives: The aims of this study were to assess the knowledge regarding prevention and management of snake bite among adults in a rural area of West Bengal and to find out any association between sociodemographic profile and knowledge on prevention as well as management of snake bite among the study participants. Materials and Methods: A community-based and observational descriptive study was conducted in the rural field practice area of Medial College, Kolkata, West Bengal for of 2 months. The study participants who were willing to participate in the study and gave written informed consent were included in the study. A pre-designed, pre-tested, and semi-structured data collection form was used. It was developed based on similar type of previous studies and was modified according to the local culture. The data collection form comprised sociodemographic profile of the study participants, their knowledge regarding snake bite, and its prevention and availability of first aid management. Results: A total of 134 participants were included in the study. The mean age was 45.81 ± 8.00 years. It was observed that majority of the study subjects believed in the knowledge that all types of snakes are poisonous (93.2%) and leads to death (90.3%). First aid measures such as application of tourniquet that was seen in only 4.4% of the cases. However, more than half of the study subjects (71.6%) believed in sucking the venom out of the wound. It was noted that higher education status, improved social class had better knowledge score of snake bite prevention and management as compared to their counterparts and this association was found to be statistically significant (P < 0.001). Conclusion: Knowledge of the study subjects on snake bite and its prevention is good, but still a large number of participants have inadequate knowledge on snake bite and its prevention. Community-based awareness program on prevention and management of snake bite, use of personal protective measures, and training of peripheral health workers ware specifically recommended.

A qualitative study on perceptions of COVID-19 vaccine among health care worker in a rural area of West Bengal, India

Background: COVID vaccines have been rolled out all over the world after emergency use authorization in the prevailing pandemic situation. However, hesitancy about its safety and efficacy exists among beneficiaries. Vaccine hesitancy can be a barrier to adequate immunization coverage. Aims and Objectives: This qualitative study was undertaken among health care workers in the rural field practice area of a tertiary care hospital, to find out their perceptions about COVID vaccines, and reasons behind hesitancy toward the same. Materials and Methods: Six focused group discussions (FGD) were held with the help of moderator. Each FGD had five members, so 30 members were included in the study. Health care workers included doctors, nurses, ANM/ASHAs, and other health care workers. Results: There were 17 males and 13 females. Doctors had a positive attitude toward vaccination, but other health care workers had mixed perception regarding vaccination. Most grass root level workers were sceptical about the efficacy of the vaccine. Conclusion: Mostly positive attitude toward COVID vaccines was observed in the present study. Hesitancy toward vaccines was observed in some health care workers, and it likely rooted from their inadequate knowledge about the vaccine.

An observational study on utilization of blood and blood components in a tertiary care hospital of Kolkata, West Bengal

Background: Blood is essential for human survival though it is a scarce and precious resource. Blood Transfusions also have some risks, like immunomodulation in the recipients, transmission of infectious agents, and may lead to serious adverse reaction. Hence, it is necessary to make an efficient use of blood and blood products. Aims and Objectives: With this background, the present study was carried out at the blood bank of Medical College and Hospital, a tertiary care hospital of West Bengal, India to evaluate the utilization pattern of blood and blood components. Materials and Methods: Facility based, observational, descriptive, and cross-sectional epidemiological study was conducted on the basis of secondary data collected from records of blood bank, medical college, Kolkata, regarding blood and blood component transfusion pattern of patients who were admitted in medical college and hospital and received blood and blood components from blood bank medical college, Kolkata during period from September 1, 2021, to September 15, 2021. Results: Total number of transfusion recipients during the study period was 1339. Total 2621 no of blood and blood components were issued. About 66.84% (895) of all recipients were transfused with single unit of blood or blood component. Packed red blood cells were the maximum utilized blood component. The most common diagnosis for patients requiring blood and blood components was anemia. Conclusion: A large proportion of patients were transfused with single unit of blood or blood component, which might not be beneficial. Training, regular meeting with clinicians and periodic assessment of blood usage are recommended to prevent inappropriate transfusion.

An epidemiological study on assessing patients' satisfaction with services obtained from Medical College and Hospital, Kolkata

Background: Patient satisfaction has been defined as the degree of congruency between a patient’s expectations of ideal care and his/her perception of the real care he receives. It is a multidimensional aspect, represents a vital key marker for the quality of health care delivery and this is an internationally accepted factor which needs to be studied repeatedly for smooth functioning of the health care systems. It has been an important issue for health care managers. Patient satisfaction level is an important and useful indicator for measuring quality in healthcare. Aims and Objectives: This study was planned to assess patient satisfaction with services provided in the study area and to find out whether there is any association between the socio-demographic characters with the satisfaction level from the services provided. Materials and Methods: The study is an observational, descriptive study with cross-sectional study design. An exit interview of 162 adult patients, selected by convenience sampling attending various out-patient department of medical college, Kolkata was conducted over a period of 2 months; using a pre-designed pre-tested semi-structured data collection form. Statistical analyses were done using Chi-square tests, at P ? 0.05 level of significance. Results: The study highlighted that majority (60.5%) of the study participants belonged to 31–60 years age group. It was also noted that majority of the patients were satisfied with overall services available except for ventilation and toilet facilities. Lower educated participants were satisfied with overall behavior of the healthcare providers. Rural participants and those from lower socio-economic status were satisfied with overall availability of general basic facilities. Lower educated participants were less satisfied with overall satisfaction level at various service windows. Gainfully employed participants were satisfied compared to unemployed participants. There was a statistically significant association between the education status and occupation of the study subjects with overall satisfaction level at various service windows. It was found that lower educated participants were less satisfied with overall satisfaction level at various service windows, compared to higher educated participants (P < 0.05). Conclusion: The present study revealed that majority of the patients were satisfied with the overall services provided at medical college, Kolkata.

A study on gender preference among pregnant mothers attending antenatal clinic of a tertiary care hospital, Kolkata

Background: A balanced sex ratio is needed to stabilize India, a patriarchal subcontinent. Aim and Objective: The study aims to find out whether there is any association between the socio-demographic characters and perceived gender preference among the study subjects. Materials and Methods: The study is an observational, descriptive study with cross-sectional study design. An exit interview of 80 pregnant mothers, both primi and multigravida, selected by systematic random sampling attending antenatal clinic of Medical College, Kolkata for 1st time was conducted for 1 month, using a pre-designed pre-tested semi-structured data collection form after ethics committee approval. Statistical analyses were done using Chi-square tests, at P ? 0.05 level of significance in Statistical Package for Social Sciences. Results: Mean age of study participants was 24.15 ± 4.38 years. The majority (77.5%) of them belonged to age group 20–29 years. 58.8% mothers were nulliparous, 53.8% from rural areas, 63.7% followed Islam, 52.5% from joint family, 31.3% belonged to middle class. 95% of the mothers had no history of abortion. Regarding education, the majority (32.5%) of the study participants were educated till secondary level. Among their husbands, 28.7% were educated till middle level. 40% study participants had no any gender preference, 40% had male preference and 20% had female preference. Main reason behind male preference was an earlier female child. Some preferred daughters due to their earlier male child. Nulliparous mothers had no gender preference while lesser-educated mothers had gender preference. Conclusion: The majority of the study participants had gender preference. Male preference was more than female preference.

Chikungunya virus infection in West Bengal, India.

Background: Chikungunya virus has recently re-emerged in India. Objectives: Assess prevalence of Chikungunya. Materials and Methods: Study conducted from April 2011 to September 2011. Two hundred and six patients (206) of both sexes (100 males and 106 females) of all age groups studied. Serum separated and CHIKV MAC IgM ELISA and Hemagglutination inhibition assay done. Results: 76 cases (36.89%) sero-positive by both the methods. Conclusion: Re-emergence and resurgence of the Chikungunya virus requires continuous monitoring.

Familial Brachydactyly in an Indian Family: A case report.

Brachydactyly or short digit is a rare deformity involving fingers and toes. We present a rare family with 6 known members affected with similar pattern of brachydactyly, affecting only bilateral index fingers. The knowledge of this entity is important and a thorough clinical and radiological evaluation is mandatory for any patient with digital deformities.

A study of pulmonary tuberculosis in the elderly.

The incidence of tuberculosis (TB) is increasing globally. The diagnbsis of TB in elderly is often delayed due to the atypical presentation. There is also therapeutic problems because of presence of comorbidity, nutritional and socio-economic factors and increased incidence of adverse drug reactions and mortality. A prospective study was conducted among patients presenting with pulmonary tuberculosis at the department of TB and respiratory medicine in a tertiary care hospital between January, 2006 to July, 2006. Thirty patients aged more than 65 years were studied for their clinical characteristics, comorbid illnesses, sputum status, radiological features and adverse drug reactions. They were contrasted against the same parameters in 40 patients aged 65 years or less. The study showed that pulmonary TB in the elderly is characterised by (a) atypical symptoms, (b) more extensive radiological lesion with lower zone preponderance, (c) higher sputum positivity, (d) more frequent comorbidity, (e) more frequent side-effects and (f) higher mortality.

Variations in fat and fatty acid intakes of adult males from three regions of India.

Fat and fatty acid intakes of 25 healthy adult urban males from Ghaziabad, U.P.; Goa and Kolkata, W.Bengal, respectively were studied. Fat intakes were estimated using dietary records, food frequency questionnaires and chemical analysis of the diets consumed. Fatty acid intakes were estimated by gas chromatography. Total fat intakes ranged from 26.9 g/day to 163.2g/ day. Percent subjects having intakes above the desirable level were 72% in Kolkata, 36% in Ghaziabad, U.P. and only 10% in Goa. Visible fat constituted more than 60 percent of total fat. In all 3 areas, SFA intakes were higher and MUFA lower than desirable levels. Palmitic acid constituted at least 50% of SFA intakes. In Goa, lauric acid, in Ghaziabad and Kolkata, stearic acid and myristic acid were major dietary SFAs, In Kolkata, erucic acid was 17.3+/-8.3%. Overall 60% of subjects had n-6:n-3 intakes close to the desirable ratio. Linoleic acid constituted almost the entire n-6 intake. Alpha linolenic acid constituted most of the n-3 intakes in Ghaziabad, U.P. and Kolkata. The ratios of SFA:MUFA--PUFA vaned widely and percent subjects with intakes close to the desirable ratios were 12% in Goa, 23% in Ghaziabad and 40% in Kolkata. The data highlights the need for limiting fat intakes and modifying diets to provide fatty acids in desirable ratios.

Epidemiology of HIV infection among brothel-based sex workers in Kolkata, India.

A cross-sectional study was carried out during January-June 2004 to assess the status of HIV infection among brothel-based sex workers in Kolkata city, India. Six hundred and twenty-two sex workers, selected from six brothels, were included in the study to assess their HIV status, and 362 sex workers, a subset of the above population, were interviewed to study their risk behaviour and practices. Blood samples were collected from each sex worker for testing HIV by an unlinked anonymous method. The prevalence of HIV infection was 9.6%, but was much higher among younger sex workers aged 20 years or less (27.7%) compared to the older age group (8.4%). This difference was statistically significant, indicating an association of younger ages with HIV infection [p = 0.006 and odds ratio (OR) = 4.18; (95% confidence interval (CI) 1.2-13.8)]. HIV was not associated with duration of sex work, average number of clients entertained per day, condom use, practice of sex during menstruation, pre-coital examination of penis for visible ulcer/discharge, suffering from sexually transmitted infections, and entertaining clients outside the brothel. There was a big gap between the reported and the evaluated condom use by sex workers. The results suggest that there is a need to develop suitable HIV intervention strategies, considering the socioeconomic and cultural aspects of city sex workers, with a provision for continuous monitoring and evaluation.

Improvement of dry matter digestibility of water hyacinth by solid state fermentation using white rot fungi.

Feeding value of water hyacinth biomass colonized by three species of white rot fungi during solid-state fermentation was investigated. All three organisms proved to be efficient degraders and enhanced dry matter digestibility. Loss of organic matter was maximum (23.6+/-0.1% dry wt) after 48 days by P. ostreatus. C. indica showed maximum cellulose degradation (18.5+/-0.1% dry wt) than other two fungi after 48 days of incubation. In all cases, an extensive removal of hemicellulose at the initial growth period and a delayed degradation of lignin were observed. Hemicellulolysis was maximum (46.3+/-0.1% dry wt) by C. indica, but delignification (14.2+/-0.2% dry wt) by P. sajor-caju after 48 days. The amount of reducing sugar in the degraded biomass decreased at early stages, but increased as degradation progressed in all three cases (maximum 1.1+/-0.05% dry wt after 48 days by C. indica). Soluble nitrogen content increased only during 16-32 days of incubation (highest 1.1+/-0.1% dry wt after 32 days by P. sajor-caju). Crude protein of the bioconverted biomass increased gradually up to 32 days but decreased thereafter (maximum 10.3+/-0.1% dry wt after 32 days by P. sajor - caju). Per cent change in in vitro dry matter digestibility of degraded substrates enhanced gradually after 8 days and reached maximum after 32 days but thereafter decreased (highest + 20.4+/-0.3% dry wt by P. sajor-caju). The results demonstrated the efficient degrading capacity of the test fungi and their potential use in conversion of water hyacinth biomass into mycoprotein-rich ruminant feed, more so by P. sajor-caju.

Hepatoprotective effect of Himoliv, a polyherbal formulation in rats.

The effect of Himoliv (HV) was evaluated in carbon tetrachloride or paracetamol induced hepatotoxicity in rats. Liver necrosis was produced by administering single dose of either carbon tetrachloride (CCl4, 1 ml/kg, 50% v/v with olive oil, s.c.) or paracetamol (PC, 1 g/kg, p.o.). The liver damage was evidenced by elevated levels of serum glutamate oxaloacetate transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT) and serum alkaline phosphatase (ALP) and hepatic thiobarbituric acid reacting substances (TBARS) and superoxide dismutase (SOD). HV pretreatment (0.5 and 1.0 ml/kg, p.o.) significantly (P < 0.001) reduced CCl4 or PC-induced elevations of the levels of SGOT, SGPT, ALP and TBARS, while the reduced concentration of SOD due to CCl4 or PC was reversed. Silymarin (25 mg/ kg, p.o.), a known hepatoprotective drug showed similar results.

Induction of lepromin positivity by a candidate anti-leprosy vaccine Mycobacterium w in lepromin negative healthy contacts of multibacillary leprosy patients.

In a hospital based study, 362 household contacts of multibacillary leprosy patients were screened for evidence of leprosy and 54 (14.9%) were found to be having leprosy. The remaining 308 apparently healthy contacts were lepromin tested and 109 (35.4%) were observed to be negative to Mitsuda lepromin. M.w vaccine was administered intradermally to 95 of these 109 lepromin negative contacts. Sixty eight of them could be retested for lepromin A reactivity. Fifty six (82.35%) manifested lepromin conversion. The twelve subjects who did not show lepromin conversion, received a second dose of the vaccine, and eleven subsequently became lepromin positive. The overall lepromin conversion rate was thus 98.5% (67 out of 68). Follow-up of these contacts upto a period of 30 months did not demonstrate reversion of lepromin positivity back to negativity status. No untoward effects of vaccination were observed except for local ulceration at the site of vaccine administration.

Silanized silica bound trypsin as analytical probe.

Trypsin immobilized by covalent coupling to silanized silica shows significant activity (30-38%) and greater thermostability as compared to soluble trypsin. Proteolytic processing of albumin at varying periods suggest that the enzyme matrix can be used efficiently for limited proteolysis. Repeated use of the immobilized enzyme in protein digestion produces similar products as seen by electrophoretic analysis. Also, digestion of albumin by the immobilized enzyme follows similar pattern as that by soluble enzyme. The enzyme matrix can be easily removed from the incubation mixture. The results indicate the possibility of the immobilized enzyme for its effective application as analytical tool in peptide mapping and limited proteolytic processing.

Ultrastructural study of mouse dorsal root ganglion cultures infected long term with M. leprae.

Ultrastructural changes in the mouse dorsal root ganglion cultures infected long-term with viable M.leprae were studied. Subtle cytomorphological changes and loss of neurites noted in the long-term infected cultures were correlated to early events in the nerve damage.

Virulence of nonpathogenic zymodemes of Entamoeba histolytica isolates from asymptomatic subjects in Calcuta, India

The zymodene and virulence of 31 Entamoeba histolytica isolates obtained from asymptomatic human subjects in Calcuta, India are described. Virulence was measured by the extent of lesion diameter (mm) induced by each isolated in the liver of golden hamsters and resistance of isolates to non-immmune hamster sera in vitro. Two nonpathogenic zymodemes, III (N=17) and IV (N=14), were detected among 31 isolates by isoenzyme electrophoresis. Most of the zymodeme III isolates were moderately to highly virulent while a quarter of the zymodeme IV were invasive although with low virulence. The virulence of the isolates was found to have a significant positive correlation (r=0.96, P<0.001) with their greater resistance to complement-mediated lysis. The data suggest that the virulence of E. histolytica is probably not related to its zymodeme

Experimental hepatic amoebiasis in inbred mice.

A model of hepatic amoebiasis in two inbred strains of mouse (Swiss and BALB/c, has been developed by introducing Entamoeba histolytica-infected hamster liver tissue in between the adjacent liver lobes of mouse. It is expected that this model might be useful in studying various parameters of host-parasitic interactions and experimental chemotherapy of amoebiasis with relative ease.

Management of a case of lagophthalmos by Gillies' method (a case report).

A case of facial palsy with lagophthalmos with exposure keratitis was corrected surgically by a method of temporalis transfer. When the slings were tightened leaving 1 cm gap in the palpebral aperture, lagophthalmos persisted. A secondary tightening procedure causing overlap of the upper lid over the lower yielded good results.