Evaluation of changes in the cognitive, affective, and psychomotor domains of learning following an interprofessional intervention for malaria and its control among the Bedia tribe, a particularly vulnerable tribal group, in rural Eastern India.

Background: The "Bedia" tribal people are found all over India; they are poor, illiterate, and confined culturally. In many parts of India, malaria, a disease caused by mosquitoes, is becoming more common. Raising awareness and educating people about it is the best method to stop disease and maintain good health. Objective: This study aimed to determine the perception, attitudes, and practices of a particularly vulnerable tribal group-the "Bedia"-in the rural region of eastern India. Methods: A questionnaire with 19 structured questions has been created. The Bedia participants received the questionnaire from us. They had already responded. The intervention took the form of several health education workshops that were created in response to the deficiencies identified in the pre-test assessment's replies. The identical questionnaire used for the pre-test evaluation was given to each participant for the post-test who attended the training sessions. Results: The current study found that while the first cognitive domain question on malaria transmission was not statistically significant, changes in malaria breeding grounds, regions with higher mosquito numbers, and the source of information about malaria are. Their knowledge of the treatment for malaria and the agent used to treat it is statistically significant in the current study, but the fifth question on the most common symptom of malaria was not statistically significant. The answers to the questions about "What you will do if you see someone suffering from malaria," "How much time was spent in the malaria control program," "Malaria detection," and "Regular usage of bed-nets" in the affective and psychomotor domains all had statistical significance. Conclusions: Our research on interventions to raise awareness of malaria in this tribal region of northern West Bengal, eastern India, bordering Bangladesh, was published for the first time to our knowledge. In the majority of the items from the cognitive, psychomotor, and affective learning domains, we have seen significant changes.

Perception of Doctor-Patient Relationship in the Present Time from the Viewpoint of Doctors: A Qualitative Study at a Tertiary Health-Care Center in Eastern India.

CONTEXT: Doctor-patient relationship has gone through some troubled times in the recent past. Quality data regarding this is lacking in the Indian setting. AIMS: The study aim was to find the perception of doctors regarding doctor-patient relationship. SETTINGS AND DESIGN: The study was conducted at a tertiary health-care center in West Bengal. It was a qualitative study including in-depth interviews and focus group discussions (FGDs). SUBJECTS AND METHODS: The study comprised of in-depth interviews (IDI) of thirty residents and three FGDs, involving 33 residents. STATISTICAL ANALYSIS USED: Data analysis was performed manually by deductive approach. Descriptive "codes" of the text information were done. The consolidated criteria for reporting qualitative research guidelines were followed. RESULTS: Doctor-patient relationship was perceived as of mutual trust and respect. Overburdened doctors, impatient patients, unrealistic expectations from the treatment, and lack of infrastructure were some of the agreed-upon factors for the strained relationship. A combined corrective effort is needed to salvage the current situation. CONCLUSIONS: A healthy doctor-patient relationship is instrumental in the holistic picture of health care. Doctors, patients, administration, and media have shared causation to the problem and have equal responsibility for its amendment.

Intervention on malaria awareness among 'Bedia' tribal community in West Bengal, India.

BACKGROUND: Tribals have a vulnerable health status because of malarial morbidities, yet they ignore their illnesses and do not go to physicians during sickness for several reasons including poverty. OBJECTIVE: This qualitative research project attempted to create awareness among 'Bedia' tribal to initiate preventive and other personal protective measures against malaria. METHODS: Initially, efforts were made to create malaria awareness by literate 'Bedia' volunteers who were trained to do so; however, their tribal fellows were reluctant to receive awareness efforts from them. After thorough analysis and interaction, a novel "interprofessional team" of composer, vocalist, and instrumentalists approach was made to impart malaria awareness by composing songs in the language of the aborigine. Then health education was imparted to the 'Bedia' participants by the trained 'Bedia' through theme songs with their rustic music instruments and group dance performances in the intermingled media from the team. An evaluation was done to assess usefulness of the health education intervention by the researchers. RESULTS: Overall, 137 adult 'Bedias' in 42 families (M = 74; F = 63) participated in our study. In the informal feedback session, only 51 adult males and 46 adult females could furnish expected results. Out of the 42 families residing in the village, 11 houses consistently used mosquito bed nets before the awareness program; after the awareness program, it became 15 as was demonstrated by using social mapping. CONCLUSIONS: Our project activities on the Bedia tribes could unearth required interventions of awareness about malaria. However, it was possible to create awareness and confidence among them so that they could themselves take necessary preventive measures and positive approaches toward malaria.

Post-traumatic seizure: a multicentric epidemiological study.

Post-traumatic seizure (PTS) is the development of recurrent seizures following head trauma and has a high clinical relevance. We tried to understand the epidemiology of PTS in a multicentric pro- spective study during the period May 2010 to April 2012. We included 320 patients excluding poor Glasgow coma scale (GCS) ie, <4 and history of previous epilepsy. At a median follow-up of one year, 49 patients (15.31%) developed PTS. Incidence of immediate, early and late onset seizures were 27 (8.4%), 14 (4.4%), 9 (2.8%) respectively. In this study incidence of PTS was high in patients of the age group 20-30 years, with road traffic accident, with poor GCS ie, < 9. High incidence of PTS was associated with x- ray findings of skull fracture and abnormal CT findings. Early use of anticonvulsants is ineffective in preventing early post-traumatic epilepsy.

New onset paediatric epilepsy in 1-5 years age group children--approach to management in a tertiary care centre with newer anti-epileptic levetiracetam.

Epilepsy is a common paediatric neurologic disorder that is difficult to manage in a substantial portion of children, highlighting the continued need for more effective and better tolerated drugs. A multicentric study was conducted from August, 2011 to July, 2013 using levetiracetam (LEV) in newely diagnosed epilepsy in 122 young children of 1-5 years age group to find its role in practical scenario depending upon the knowledge from prior literature available. It has been demonstrated effective as adjunctive therapy as well as monotherapy for new-onset partial seizures and generalised tonic-clonic seizures (GTCS) but it acts better as adjunctive therapy than the monotherapy. When LEV was used as adjunctive therapy 15.4% children with partial seizure were seizure-free as compared to 11.12% in GTCS and when LEV was used as monotherapy 16.17% children with partial seizure were seizure-free as compared to 15.38% in GTCS. When LEV was used as add on therapy 16.67% children < 2 years were seizure-free as compared to 17.85% in > 2 years. When LEV was used as monotherapy 25.00% children < 2 years were seizure-free as compared to 18.18% > 2 years. So, it was found more efficacious in partial group of seizures than the GTCS variety. It also shows more efficacy in older age group (> 2 years) than the younger ones (< 2 years). Somnolence and behavioural changes were noted as ad- verse effects in a few cases. So, LEV is an important addition to the treatment of paediatric epilepsy.

ECG manifestations in acute organophosphorus poisoning.

A cross-sectional study was conducted to evaluate the electrocardiographic changes in 107 patients of acute organophosphorus poisoning admitted at casuality ward of MGM Medical College, Kisanganj from June 2007 to June 2010. Electrocardiographic changes were recorded before the administration of atropine. Prolonged Q-Tc interval was the commonest ECG abnormality, found in 67 patients (62.6%), followed by sinus tachycardia in 36 patients (33.6%). Sinus bradycardia was found in 33 patients (30.8%). Elevation of ST segment was seen in 27 patients (25.2%). T wave inversion was seen in 21 patients (19.6%). First-degree heart block (P-R interval >0.20 seconds) occurred in 9 cases (8.4%). Atrial fibrillation was seen in 5 patients (4.6%). Ventricular tachycardia was seen in 6 cases (5.6%) and ventricular premature complexes in 3 patients (2.8%). Of these 6 cases of ventricular tachycardia 1 responded to intravenous lignocaine, and the other 5 developed ventricular fibrillation leading to death despite other resuscitative measures. All the electrocardiographical abnormalities returned to normal before the patients were discharged. Seventeen patients died. The cause of death was ventricular fibrillation in 5 patients and non-cardiogenic pulmonary oedema in others. In conclusion it can be said that ECG should be carefully recorded and analysed in all patients of acute organophosphorus poisoning, and depending upon these changes and other clinical and biochemical parameters, the patients should immediately be shifted to well equipped ICU for better care which will reduce the mortality rate caused by these highly lethal poisons.

Prevalence of diabetic foot ulcers in newly diagnosed diabetes mellitus patients.

Foot ulcer is one of the most common and dreadest complication of diabetes mellitus.This is also a frequent cause of hospitalisation and disability. Most of the patients with diabetic foot ulcers living in developing countries present to healthcare facilities fairly late with advanced foot ulcers because of poor economic status, inadequate knowledge of self-care, sociocultural reasons and poor and inadequate diabetes healthcare. To determine the prevalence of diabetic foot ulcers amongst the newly diagnosed diabetes mellitus patients (n = 1674) a cross-sectional study was carried out during the period January 2010 to January 2011 in the department of medicine, NRS Medical College, Kolkata. Diabetic foot ulcers were found in 4.54% newly diagnosed diabetes mellitus patients. Neuropathic type of foot ulcer was present in 46.06% of patients (52.5% in male and 38.88% in female). Ischaemic type of foot ulcer was present in 19.74% of patients (22.5% in male and in 16.66% females). Neuroischaemic type of foot ulcer was present in 34.2% of patients (25% in males and 44.44% in females). Neuropathy occurred most frequently either singly or with peripheral vascular disease. General awareness about the disease, early diagnosis and proper management will prevent this dreaded complication.

A study on clinical and biochemical profile of low body weight type 2 diabetes mellitus.

Low body weight type2 diabetes mellitus (T2DM) is a distinct entity in T2DM having different clinical presentation, morbidity and mortality patterns as well as biochemical profile when compared with classical T2 DM. This study was aimed at comparing three subtypes of T2 DM-overweight (BMI>25), normal weight (BMI>18.5 but <25) and low body weight or lean type2 DM (BM1<18.5). Seventy-five cases of T2 DM (25-lean, 25-normal weight and 25-overweight) were selected. The present study revealed that normal C-peptide level with basal hyperglycaemia is an important characteristic of lean T2 DM. Lower prevalence of hypercholesterolaemia and higher level of triglycerides were found in low body weight T2 DM.Lower prevalence of macrovascular and higher prevalence of microvascular complications are also noted.