Morbidity pattern and health-care seeking among women domestic workers: Perspective from an Indian metropolis.

Background: Domestic work being unrecognized as a formal form of occupation in India, workers are often deprived of basic social security, including access to proper health care. Self-negligence coupled with societal neglect makes them vulnerable to injury and a variety of illnesses. Objectives: We aimed to study the morbidity pattern of women domestic workers residing in a slum area of Kolkata, West Bengal, India. Materials and Methods: An observational descriptive cross-sectional study was carried out by interviewing and clinically examining 106 randomly selected women domestic workers. Results: The majority (82.08%) had health complaints: heart burn being most common (40.57%). Musculoskeletal and dermatological issues were common. Anemia (31.25%) was a common prediagnosed morbidity. Pallor (33.96%) and dental caries (31.13%) were common; 50.94% reported workplace injury. Of those having complaints, 77.36% sought health care, 59.43% of whom relied on health facilities. Lack of time (54.05%), felt need (35.14%) and money (21.62%) affected adequate care seeking. Participants with cardiorespiratory complaints tended to visit health facilities significantly more (P < 0.05). Conclusion: Health vulnerabilities and neglectful behavior among domestic workers are evident, making the need to sensitize them about their health risks and ways to overcome such issues very vital. Awareness should also be generated about government health schemes to encourage timely health checkup and necessary intervention.

How Covid-19 Affected the Work Prospects and Healthcare-Seeking of Women Domestic Workers in Kolkata City, India? A Longitudinal Study.

Background: Self-negligence, societal neglect, and lack of access to adequate health care make domestic workers vulnerable to ill-health. COVID-19 has adversely affected the work prospects of people across social classes and their health care-seeking opportunities as well. We studied the impact of COVID-19 pandemic on work prospects and health care-seeking behavior of a vulnerable section of the society - the women domestic workers. Methods: A longitudinal analysis on 292 randomly selected women domestic workers residing in slums of "Kalikapur" locality of Kolkata city, West Bengal (India). Data were collected using a predesigned and pretested schedule twice: in early-2020 (before severe impact of COVID-19) and mid-2020 (during the pandemic ravaging India). Paired t-test and McNemar's test were used to check for significant changes. Result: Of all the participants, 57.2% lost jobs partially while 2.7% were completely jobless in mid-2020; the average daily work-hour decreased by 25.7%. Their average monthly pay significantly reduced (P < 0.05); mean family income in mid-2020 was lesser as well, compared to earlier (P < 0.05). Compared to early-2020, 15.8% more participants were sole bread-winners for their families during COVID-19. Number of participants visiting health practitioners significantly reduced (P < 0.05) in mid-2020. Rise in over-the-counter medicine use (P < 0.05) and increased tendency to ignore symptoms (P < 0.05) during COVID-19 was noted. Conclusion: The COVID-19 pandemic has affected work prospects and health care-seeking behavior of women domestic workers negatively. Most of them faced wage reduction, many becoming sole-earners for their families. This necessitates continued formulation and implementation of strategies ensuring social benefits including healthcare. Awareness about affordable healthcare and ill-effects of bad practices like self-medication should also be built.

Cumulative Noise Exposure and Perceived Effects: A Comparative Study Among Different Occupational Groups in Kolkata.

Background: Adverse short-term and long-term health effects following a high level of noise have been established. The current study aims to find the relationship of these effects with an environment-specific level of noise exposure. Materials and Methods: A comparative cross-sectional study was conducted among 50 auto-rickshaw drivers and 51 age-matched service-sector employees. The peak average noise exposure in decibels (dB) was measured. The duration of exposure and response regarding perceptions following noise exposure was assessed through a pre-designed pre-tested semi-structured questionnaire. Results: The mean age of the participants was 42.24 (±13.72) years. Among the auto-rickshaw drivers, 82% perceived stress, 64% had hearing difficulty, and 74% complained of lack of sleep following exposure to a high level of noise. However, the perceptions were comparable among the comparison group and the differences were not statistically significant. The mean average peak level of noise exposure among drivers and their comparison group was 91.64 (±7.37) dB and 91.98 (± 8.06) dB, respectively, but were not different statistically. Around 52.94% of the service-sector respondents and 48% of the drivers were exposed to the lower cumulative noise levels. Those having a higher level of cumulative noise exposure, had a higher odds of feeling irritated (Odds ratio [OR]: 2.182, 95% confidence interval [CI]: 0.845-5.636), feeling stressed (OR: 5.805, 95% CI: 1.552-21.708), having palpitation (OR: 3.694, 95% CI: 1.264-10.793), and lack of sleep (OR: 3.020, 95% CI: 1.006-9.066). Conclusion: Stress and lack of sleep were the most important perceived effects of noise exposure. The exposures to the higher cumulative noise level in specified groups were more important in relation to quantifying perceived symptoms than the average peak noise level.

Epidemiological profile of snake bite in south 24 Parganas district of West Bengal with focus on underreporting of snake bite deaths.

BACKGROUND: Snake bite is a neglected public health problem in India. Very few community based epidemiological studies in India have been published so far on this issue. Most of the studies were carried out on hospital data. Previous community-based survey in the state revealed that only 22% snake bite victims attended hospitals. OBJECTIVES: The objective of the present study is to find out the epidemiological profile of snake bite in eight blocks of the South 24-Paraganas district of West Bengal and to explore the under reporting of snake bite deaths in health facilities in that area during the study period. MATERIALS AND METHODS: A retrospective analysis of snake bite data was carried out from a community-based epidemiological survey on 1.9 million populations. This survey was done door-to-door from January 2009 to October 2010 to get epidemiological profile of snake bite of the previous 2 years. The data of direct survey was compared with the official report of the same area to evaluate the hospital-based data with focus on underreporting of snakebite deaths. RESULTS: A total number of snake bite cases as found in the survey in the study area was 4871. There was a huge gap between the two data (direct survey and official data). Only 7.23% snake bite deaths were officially reported. Only 22.19% of the snake bite victims attended the hospitals. Nearly 65.7% of the snake bite deaths were due to common krait bite, most of them occurring in the months of June to September. CONCLUSIONS: Official reporting system is still having a huge deficiency in India. Snake bite needs to get more attention from the health authority.

Critical appraisal of mass DEC compliance in a district of west Bengal.

A cross sectional study was carried out to assess drug compliance after Mass Drug Administration of DEC and the factors responsible for poor compliance among the population of Murshidabad district of West Bengal during Jan 2009. Total study unit were 120 families covering 3 villages and one municipality ward area (30 families from each area). As a part of Revised Filaria control strategy, MDA programme was implemented in Murshidabad district from 29th-31st December 2008. Result revealed that total covered population were 601, out of which 571 were eligible population for Mass drug administration (6 Pregnant women and <2 years age groups (24) were excluded). Drug distribution rate was 91.8%. Overall drug compliance was 42.3%. Total number of defaulters was 330 (57.7%). Non compliance was highest (75.5%) in urban area. Defaulters was more among male than female. Factors responsible for defaulters were no motivation (24.7%), drugs not supplied (22.5%), absence at home (13.5%), no faith (10.1%), fear of side effects (10.1%) and others (Forgotten, lack of prior IEC etc), illness, wrong information were 7.8%, 7.3%, 3.9% respectively. Majority has no side effects, only dizziness (3.3%), headache (1.7%), vomiting and others (4.1%) were experienced by the people after consumption of drugs. On an average 40% families were aware about ELF & transmission of disease. Only 43.7% of community members were informed about MDA by Health Workers prior to the implementation of MDA programme.

The profile of visual loss in children--a retrospective study in a referral hospital in India.

A retrospective study of 8772 children's records at the department of ophthalmology, North Bengal Medical College, Sushrutanagar, Darjeeling, West Bengal, India was conducted to collect the data on visual loss relating age, gender, degree and aetiology with an object of delineation of the profile of visual loss in children of particular area encircling that referral centre. Out of 8772 children, 126 children were detected to be suffering from visual loss. Of these 126 children, 88(69.84%) were males, 38(30.16%) were females, 75 children (59.52%) had low vision, 51(40.48%) had blindness. The causes of visual loss were cataract in 42 cases (33.33%), corneal pathology in 30(23.80%), high refractive error in 15(11.90%), glaucoma in 14(11.11%), retinal disease in 12(9.52%), global anomalies in 10 (7.94%) and lesion in the higher visual pathway in 3 cases (2.38%). Information obtained from the study possesses a definite role in understanding the background of visual loss in children of a particular area and planning the strategy to control childhood blindness by identification of preventable and treatable causes of blindness.

Effect of Withania somnifera glycowithanolides on a rat model of tardive dyskinesia.

Withania somnifera glycowithanolides (WSG) were investigated for their preventive effect on the animal model of tardive dyskinesia (TD), induced by once daily administration of the neuroleptic, haloperidol (1.5 mg/kg, i.p.), for 28 days. Involuntary orofacial movements (chewing movements, tongue protusion and buccal tremors) were assessed as TD parameters. WSG (100 and 200 mg, p.o.), administered concomitantly with haloperidol for 28 days, inhibited the induction of the neuroleptic TD. Haloperidol-induced TD was also attenuated by the antioxidant, vitamin E (400 and 800 mg/kg, p.o.), but remained unaffected by the GABA-mimetic antiepileptic agent, sodium valproate (200 and 400 mg/kg, p.o.), both agents being administered for 28 days like WSG. The results indicate that the reported antioxidant effect of WSG, rather than its GABA-mimetic action, may be responsible for the prevention of haloperidol-induced TD.

Effect of bioactive tannoid principles of Emblica officinalis on ischemia-reperfusion-induced oxidative stress in rat heart.

The tannoid principles of the fruits of Emblica officinalis have been reported to exhibit antioxidant activity in vitro and in vivo. In the present study, an emblicanin-A (37%) and -B (33%) enriched fraction of fresh juice of Emblica fruits (EOT) was investigated for antioxidant activity against ischemia-reperfusion (IRI)-induced oxidative stress in rat heart. Vitamin E (VE) was used as the standard antioxidant agent. IRI was induced in isolated rat heart by perfusing it with modified Kreb-Hensleitt's solution for 5 min, followed by a period of ischemia (stoppage of perfusion) for 10 min and then restoring the perfusion (reperfusion) for 15 min. IRI induced a significant decrease in the activities of cardiac superoxide dismutase, catalase and glutathione peroxidase, with a concomitant increase in lipid peroxidation. These IRI-induced effects were prevented by the administration of EOT (50 and 100 mg/kg body wt.) and VE (200 mg/kg body wt.) given orally twice daily for 14 days prior to the sacrifice of the animals and initiation of the perfusion experiments. The study confirms the antioxidant effect of E. officinalis and indicates that the fruits of the plant may have a cardioprotective effect.