Gap Analysis in Workforce and Infrastructure in the Subcenters for Upgradation to Health and Wellness Center in a Community Development Block of Purba Bardhaman District, West Bengal.

CONTEXT: The government of India has recently decided to upgrade subcenters (SCs) to health and wellness centers (HWCs) for providing comprehensive quality services. AIMS: The present study was undertaken to determine workforce- and infrastructure-wise gaps in the SCs for upgradation to HWCs and assess knowledge of the auxiliary nurse midwives (ANMs) regarding services to be delivered through HWCs. SETTINGS AND DESIGN: This cross-sectional study was conducted in Bhatar block of Purba Bardhaman district between August and October 2019. SUBJECTS AND METHODS: Workforce and infrastructure availability was assessed using a checklist in 38 SCs and knowledge was assessed using a questionnaire among ANMs. STATISTICAL ANALYSIS USED: Data entry and analysis was done in Microsoft™ Excel™. RESULTS: No Subcentre had Community Health Officer and 23.7% of Subcentre were without second ANM. 28.9% of the ANMs had adequate knowledge about services to be delivered through HWCs. Infrastructurally, lack of staff residential facility (76.3%), water supply (34.2%), and inadequate civil construction (34.2%) were major barriers. CONCLUSIONS: Adequate recruitment of HCWs, infrastructure upliftment, and proper training of HCWs in the SCs are the need of the hour.

Community Based Assessment of Unintentional Injuries in a Community Development Block of Purba Bardhaman District, West.

BACKGROUND: Injuries are a focus of public health practice because they pose a serious health threat and are preventable. Currently, injury accounts for 14% of all Disability Adjusted Life Years (DALYs) losses for the world's entire population. In India, unintentional injuries within the home environment have not so far been recognized to the same extent as traffic and work-related injuries among all age groups. With this background, a community based epidemiological study was conducted with the aim to find out the prevalence and epidemiology of unintentional injuries. METHODS: A cross-sectional study was conducted during July 2018 - June 2019 in Bhatar block of Purba Bardhaman District. Cluster random sampling was applied to select required sample of 555 individuals from 24 villages. The study tools used were a predesigned and pretested schedule developed by the researchers with the help of Guidelines for conducting community surveys on injuries by World Health Organization (WHO) and a checklist for assessing household level injury hazard. The study had approval from Institutional Ethics Committee. Chi square test and multivariable logistic regression were performed using SPSS V16. RESULTS: Prevalence of unintentional injury was 8.8 % in the preceding three months. Multivariable logistic regression revealed that those who were below 18 years of age, severely vulnerable to unintentional injuries and belonged to nuclear families had significantly higher odds of developing unintentional injuries at home. CONCLUSION: Unintentional injury is prevalent in West Bengal. Dissemination of injury prevention information with special focus on household modification is an effective strategy to prevent unintentional injuries.

Sleep Quality and its various correlates: A community-based study among geriatric population in a community development block of Purba Bardhaman district, West Bengal.

BACKGROUND: In the elderly population, sleep problems are prevalent and have known to be associated with many factors. There are many adverse consequences of decreased sleep such as heart disease, diabetes, depression, accidents, impaired cognition, and poor quality of life. Correlates of poor sleep quality have not been well explored in Indian research. OBJECTIVES: The present study aimed to measure prevalence of poor sleep quality among elderly and its association with different factors. METHODS: A cross-sectional study was conducted during June-November 2018 in a randomly selected block of Purba Bardhaman district. Cluster random sampling was applied to select required sample of 180 elderly people (≥60 years) from 30 villages. Study tools used were Pittsburgh Sleep Quality Index (PSQI), 5-Item Geriatric Depression Scale (GDS), Generalized Anxiety Disorder 7-item scale (GAD-7), Global Physical Activity Questionnaire (GPAQ), and a pretested schedule for sociodemographic and other variables. The study had approval from Institutional Ethics Committee. Chi-square tests and multivariable logistic regression were performed using SPSS V16. RESULTS: Prevalence of poor sleep quality (GPSQI ≥5) was 68.89%. Median Global PSQI (GPSQI) score was 7.00 (4.00-11.00). Multivariable logistic regression revealed that marital status, vital events in past one month, anxiety status, and depression were significantly associated with sleep quality. Those who were unmarried/widowed, having vital events in past one month in the family, and severe anxiety and depression were having significantly higher odds of developing poor sleep quality. CONCLUSION: Poor sleep quality is high among elderly and measures toward the significant correlates are thus emphasized.

Health-related quality of life of hemophilics and its possible correlates: A perspective in health promotion and disability prevention.

BACKGROUND: Clinical evaluations are not sufficient to adequately characterize the morbidity associated with hemophilia. Quality of life (QoL) of hemophilics and associated factors is not well explored in Indian research. The present study aimed to measure the QoL in hemophilics and its association with socio-demographic characteristics and other characteristics. MATERIALS AND METHODS: A cross-sectional study was conducted during June-November 2018. Two hundred and one hemophilics (age ≥ 4 years) were interviewed with a pre-tested schedule for sociodemographic and other relevant variables. QoL was measured by Haemo-QoL questionnaire for different pediatric age groups and Haem-A-QoL questionnaire for adults and assigned health-related QoL scores. Score achieved in each dimension as well as total scores were transformed on scales ranging from 0 to 100, high values indicate high impairment of QoL. Hemophilic arthropathy was assessed using the World Federation of Hemophilia Joint Scores. One-way ANOVA, independent t-test, Kruskal-Wallis test, and Spearman correlation analyses were performed using SPSS version 16. RESULTS: Mean Haemo-QoL scores for 4-7 years, 8-12 years, 13-16 years, and >16 years were 43.92 ± 8.09, 37.37 ± 8.62, 32.79 ± 6.66, and 45.92 ± 6.30, respectively. Significant difference was noted for QoL scores across different age groups, grades of severity, educational, occupational categories, socioeconomic status classes, marital status, and presence or absence of target joint. Total QoL scores, as well as scores in some of the dimensions, showed a significant positive correlation with the World Federation of Hemophilia joint scores by Spearman correlation analysis. CONCLUSIONS: Improvement of the joint health status by regular physiotherapy is needed to improve the QoL of hemophilics.

Depression among nursing students in an Indian government college.

BACKGROUND: Depression is a major public health threat that can affect anyone including health professionals and nursing students. OBJECTIVES AND METHODS: This analytical, cross-sectional study was conducted among 180 students of a nursing college to find out the burden of depression on them and possible contributing factors using the Beck Depression Inventory. RESULTS: 63.9% of the students were found to be depressed, the majority being mild in grade. First-year students were found to be significantly more affected (P=0.008). Binary logistic regression showed that familial disharmony, disinterest in the course and insecurity about future placement were statistically significant factors behind the development of depression. CONCLUSION: It is imperative that the psychological condition of nursing students be viewed as an important aspect to be considered, particularly within the Indian population and others in which there is a paucity of data.

Clinico-laboratory profile of severe Plasmodium vivax malaria in a tertiary care centre in Kolkata.

BACKGROUND: Vivax malaria is the most widely distributed human malaria and is responsible for up to 400 million infections every year. Recently, it has become evident that Plasmodium vivax monoinfection could also result in multiple organ dysfunction and severe life-threatening disease as seen in Plasmodium falciparum infection. MATERIALS AND METHODS: The aim of this study was to note the different clinical and biochemical profiles of adult patients with the severe vivax malaria with regards to complications and outcome. This was a prospective observational study carried out at a tertiary care hospital in Kolkata over 9 month's period. Detailed history and examination findings were noted in all patients. Their clinical presentations, complications, course in ward until discharge or death was noted. RESULTS: A total of 900 cases of vivax malaria were included in the study. Severe disease was present in 200 (22.2%) cases of malaria. There were 108 (54%) patients with single complication (SC) and 92 (46%) patients with the multiple complications (MC). Patients with SC had jaundice (48.1%) followed by cerebral involvement (25.9%), renal failure (7.4%), and pulmonary involvement (3.7%). The MC was found in various combinations and the majority (47.8%) had constellation of two different complications. The mortality rate of patients with the SC and MC was 7.4% and 34.8%. The overall mortality observed in severe vivax malaria was 20% (40/200). CONCLUSIONS: In recent years, the clinical pattern of vivax malaria has changed. Severe vivax malaria is now very common with increasing mortality. Not only the number, but also the type of complication influences the outcome of complicated malaria.

A study on socio-demographic characteristics of alcoholics attending the de-addiction center at Burdwan medical college and hospital in West Bengal.

Prevalence of alcohol use in India is reported to be 21.4% and there is increasing alcohol intake among the young people. The present study was undertaken to study the socio-demographic characteristics of patients having alcohol-related disorders attending the de-addiction center at Burdwan Medical College in West Bengal and to find out some factors responsible for that. A clinic-based descriptive cross-sectional study was conducted among 187 patients with the help of pre-tested pre-designed schedule after obtaining informed consent. Data analysis was carried out with the help of Epi info software version 6. Majority of the patients were male, in productive age group and married. Age of initiation and amount of alcohol intake were significantly associated with positive family history of alcoholism. Children having family history of alcoholism should be counseled to prevent development of alcoholism.

Skin rash as a surrogate marker of clinical response of targeted therapy using gefitinib in advanced or metastatic non-small-cell lung cancer--a retrospective study.

This retrospective review of a single institution case series study was conducted to correlate the objective response and skin rash of gefitinib in patients with advanced or metastatic non-small-cell lung cancer(NSCLC). One hundred and forty-nine patients with advanced or metastatic NSCLC were treated with gefitinib (250 mg/day) as second line systemic therapy. Baseline patient characteristics were: More than 75% patients were above 50 years of age, males 64%; adenocarcinoma 52%. Sixty-one patients were excluded from the analysis due to varying reasons; only 88 remaining in the analysis. Partial response was observed in 15 patients (17%), and 34 patients (38.6%) had stable disease. The rest 39 patients (44.3%) had progressive disease on gefitinib therapy. There was a significantly longer median time to progression (TTP) of 7 months in females as compared to 5 months in males (p = 0.001). A highly significant association (p = 0.001) was observed between the grade of skin toxicity and the median time to disease progression, with the median TTP being 4 months in patients experiencing no skin toxicity as compared to 7 months with those grade 2 skin toxicity and 12 months with grade 3 skin toxicity. Gender (p = 0.003), and presence of skin toxicity (p = 0.0001) were having significant difference in median overall survival. On multivariate testing of the same using Cox regression analysis only presence of skin toxicity (p = 0.012) and gender (p = 0.003) was found to significant factors. Thus it can be concluded that occurrence of skin rash and female gender were associated with improved survival with gefitinib for recurrent NSCLC patients.