Poverty, undernutrition and morbidity: The untold story of tea-garden workers of Alipurduar district, West Bengal.

Background: There is a paucity of information on health and nutritional status of tea-garden workers of West Bengal, which is crucial to meet their health needs by formulating appropriate public health interventions. Objectives/Aims: The objective of this study is to assess the morbidity pattern and nutritional status of tea-garden workers of West Bengal, India. Materials and Methods: The present cross-sectional study was conducted among 463 tea-garden workers of randomly selected three tea gardens of Alipurduar district of West Bengal, India, chosen by multi-stage sampling. Pre-designed and pre-tested questionnaire was used to collect information on socio-demographic and other variables by means of interview. Physical examination and anthropometric assessment were performed. The haemoglobin was estimated by the 'filter paper cyanmethemoglobin method'. Morbidities were assessed on the basis of history, clinical examination, evaluation of medical records if any and relevant laboratory investigations and classified and coded as per the 10th revision of the international classification of the diseases. Morbidity profile and nutritional status were assessed through history taking, clinical examination, review of medical records if any, anthropometric assessment and laboratory investigations. Statistical Analysis: Simple proportion was used for interpretation of point prevalence. Chi-square test was applied as the test of significance wherever applicable. Results: Out of total 463 tea-garden workers, majorities (76%) were female and from backward social class (81.2%). More than half (55.9%) were illiterate and three-fourth (67.2%) belonged to lower income quartile. Anaemia was found widespread (87.9%) and more than one-third (36.1%) of the tea-garden workers were found undernourished. Also 43.8% of the workers had airway obstruction as measured by peak expiratory flow rate. Majority (69.8%) of the garden workers had any form of morbidity. Non-communicable diseases (24.2%), musculoskeletal disorders (17.9%), skin disorders (17.7%), respiratory morbidities (16.2%), febrile illness (12.3%), gastro-intestinal disorders (8.6%), ocular problems (8.4%), vitamin and micronutrients deficiencies were found the common morbidities among tea-garden workers. Scheduled tribe caste, undernutrition and anaemia were found independent determinants of any morbidity among the tea-garden workers. Conclusions: Morbidities, anaemia and under-nutrition were found very much prevalent among tea-garden workers of West Bengal, which necessitates urgent public health interventions through multi-disciplinary approach in a focussed manner with an aim to improve the overall quality of life of the tea-garden workers.

Metabolic syndrome is not uncommon among lean non-alcoholic fatty liver disease patients as compared with those with obesity.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is associated with obesity, which is known to be associated with metabolic syndrome (MS). However, the risk factors for NAFLD in absence of obesity (leanness) is not well-studied. This study aimed to investigate and compare the clinical characteristics, metabolic associations, and cardiovascular risk factors among patients having NAFLD with (body mass index [BMI] ≥ 23 kg/m2) or without obesity (BMI < 23 kg/m2). METHODS: The cross-sectional study was conducted among the outdoor and indoor patients diagnosed as NAFLD by ultrasonography in a tertiary care teaching hospital in eastern India. Relevant anthropometric measurements, laboratory investigations, and imaging were performed. Metabolic syndrome was classified by the "International Diabetes Federation, 2005" criteria. RESULTS: Among 120 NAFLD patients, 37 (30.8%) were lean, while 83 (69.2%) were obese. The components of MS such as systolic blood pressure (lean, 138.0 ± 17.6 mmHg; obese, 137.9 ± 15.3 mmHg), diastolic blood pressure (lean, 88.9 ± 6.5 mmHg; obese, 87.3 ± 6.1 mmHg), fasting blood sugar (lean, 127.8 ± 30.8 mg/dL; obese, 135.1 ± 29.5 mg/dL), and serum triglyceride (lean, 170.5 ± 34.2 mg/dL; obese, 186.4 ± 43.8 mg/dL) were comparable among patients with obese and lean NAFLD and were more often abnormal among both the groups of NAFLD as compared with controls. CONCLUSION: The overall prevalence of MS among NAFLD study population was 64.2%. Lean NAFLD was also associated with the component of MS like obese NAFLD.

Gender preference and awareness regarding sex determination among antenatal mothers attending a medical college of eastern India.

AIM: There are many women "missing" due to an unfavourable sex ratio in India, which has strong patriarchal norms and a preference for sons. Female gender discrimination has been reported in health care, nutrition, education, and resource allocation due to man-made norms, religious beliefs, and recently by ultrasonography resulting in lowered sex ratio. METHODS: The present study attempts to find out the level of awareness regarding sex determination and to explore preference of gender and factors associated among antenatal mothers attending a medical college in eastern India. Interviews were done by predesigned pretested proforma over 6 months. The data were analysed by SPSS 16.0 software for proportions with chi-squared tests and binary logistic regression analysis. RESULTS: Most women who were multigravida did not know about contraceptives; 1.8% of mothers knew the sex of the fetus in present pregnancy while another 34.7% expressed willingness; 13.6% knew of a place which could tell sex of the fetus beforehand; 55.6% expressed their preference of sex of the baby for present pregnancy while 50.6% of their husbands had gender preference. Gender preference was significantly high in subjects with: lower socioeconomic status (p=0.011); lower level of education of mother (p=0.047) and husband (p=0.0001); multigravida (p=0.002); presence of living children (p=0.0001); and husband having preference of sex of baby (p=0.0001). CONCLUSIONS: Parental education, socioeconomic background, and number of living issues were the main predictors for gender preference. Awareness regarding gender preference and related law and parental counselling to avoid gender preference with adoption of small family norm is recommended.

Hysterectomy ..Which route?

OBJECTIVE: We designed this study to focus on women with mobile uteri benign no larger than 14 weeks, who would ordinarily be considered candidates for vaginal hysterectomy and compare the outcomes when abdominal routes were chosen. We also compared the intra and post operative complications, requirement for blood transfusion, length of hospital stay, between abdominal and vaginal route of hysterectomy. METHOD: In a simple randomized prospective comparative study 200 consecutive patients requiring hysterectomy for benign uterine conditions were analysed over a period of 2 years. (June 2006-May 2008). Group A (n = 100) underwent vaginal hysterectomy (non descent vaginal hysterectomy, NDVH) which was compared with group B (n = 100) who had abdominal hysterectomy. RESULTS: As far as duration of operation, duration of i.v. drip, mobilization in post operative ward, duration of hospital stay, P value was significant. Regarding blood loss P value was insignificant. CONCLUSION: The accessibility of the vaginal passage, disease confined to the uterus and the surgeons experience are the major determining factors for the choice of the route of hysterectomy.

Monitoring of mass measles campaign in AILA-affected areas of West Bengal.

A mass measles campaign was organized in AILA-affected areas of West Bengal in July-August 2009. The present cross-sectional study was conducted with the objectives to monitor and assess the cold chain maintenance, safe injection practices, IEC methods adopted, and to observe the conduction of the sessions in the campaign. All the cold chain points at the block level had adequate vaccines and equipments, twice monitoring of temperature which was in optimal range. 82% sessions had team according to microplan, AWW was present and team members were actively mobilizing the children in 83% sessions, puncture proof container was used and vaccines were given in correct sites in more than 95% sessions. The study observed satisfactory conduction of the whole campaign, still the injection safety procedures should be strengthened considering the potential harm to the health care providers.