A study on knowledge, attitude, and practice regarding mental health illnesses in Amdanga block, West Bengal.

BACKGROUND: The discourse of mental health is getting its due attention after all these years in India. A major threat to the mental health system is the demand side factors, namely, knowledge, attitude, and practice (KAP) of the general population toward this. In spite of growing concern regarding mental health in India, this kind of study to assess the mental health status has been very few in India, more so in West Bengal. OBJECTIVES: With this background, this study was carried out with the objectives to validate the Community Attitude to Mental Illness (CAMI), to assess the different sociodemographic factors among the study population, to assess the KAP regarding mental illness among the study population. METHODS: It was an observational, descriptive study with cross-sectional design done at Amdanga Community Development Block, North 24 Parganas, West Bengal, India, in 2015-16. Questionnaire validation to assess the KAP was the primary objective with obtaining the descriptive data were the second one. CAMI questionnaire was used which was validated for the given area by validation methods such as Cronbach's alpha and structural equation modeling. The resultant questionnaire was used in the field on adult population after a single-stage survey design to collect 730 samples. RESULTS: The test statistics showed that the questionnaire was reasonably valid after a few tweakings. SEM identified well-define domains in the attitude part. 94.9% says that they are willing to live with a people with mental illness. 14.9% has actually done so. Health-care seeking behavior shows that 19.2% will go to a GP in case of any mental illness. Furthermore, attitude toward mental illness showed mixed picture as also knowledge. This study correlated with various studies of developing countries and it was seen that these population showed markedly different attitudes for probability of the patients getting cured than many other countries. Furthermore, stigma was gradually decreasing, as evident from various other studies. CONCLUSION: This study will provide valuable insights into the cognitive and affective aspect of mental illness among these population and thus help in implementing better policies in this regard, as this is fast becoming the talk of the day.

Tetralogy of Fallot Presenting with Superior Vena Cava Syndrome - A Rare Presentation.

Tetralogy of Fallot (TOF) presenting with superior vena cava (SVC) syndrome is an exceedingly rare scenario. The diagnosis of this condition is still a difficult task due to its unspecific clinical features and unclear recommendations for the best diagnostic tools. We report an interesting case of a 23-year-old male who was found to have TOF with the presentation of SVC syndrome after a sequential diagnosis. The timely diagnosis helped in the successful management of the patient. Through this case, we want to make clinicians aware of such a rare association and its diagnosis.

Synergistic effect of anti and pro-inflammatory cytokine genes and their promoter polymorphism with ST-elevation of myocardial infarction.

BACKGROUND: The single-gene approach in association studies of polygenic diseases such as acute myocardial infarction (AMI) is likely to provide limited value. Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) plasma levels may be genetically influenced. AIM: We evaluate the impact of single nucleotide polymorphism of the promoter region of these genes, as well as reciprocal interaction of these genes with ST-elevation of myocardial infarction (STEMI). METHODS: In a case-control study 500 STEMI patients and 500 age- and sex-matched controls were studied. Three single-nucleotide polymorphism genotypes were evaluated by polymerase chain reaction and restriction enzyme analysis and assessed their association with STEMI. The synergistic effects of IL-6, TNF-α and IL-10 gene polymorphisms were evaluated by using logistic regression analysis. RESULTS: We found that IL-6 and TNF-α concentrations of studied population were significantly different (p<0.0001) in each genotype of IL-6 -174G>C and TNF-α -308G>A gene polymorphisms respectively. A significant association was found in multivariate analysis for the IL-6 -174G>C [odds ratio (OR): 0.390; 95% confidence interval (CI): 0.176-0.865, p=0.020] and TNF-α -308G>A [OR: 0.372; 95% CI: 0.171-808, p=0.012] gene polymorphisms with STEMI. In contrast, IL-10 -592C>A gene polymorphism was no longer significant in the multivariate model (OR: 0.678; 95% CI: 0.288 to 1.594, p=0.373) whereas significant in univariate analysis (OR: 0.697; 95% CI: 0.523-0.929, p=0.014). CONCLUSIONS: Our findings suggest that IL-6, TNF-α and IL-10 gene polymorphisms all contribute in the association with STEMI whereas the association persisted only for IL-6 and TNF-α but not for IL-10 gene polymorphism with this disease in the multivariate analysis.