Multimedia education program on knowledge and attitude regarding management, prevention of complication and side-effects of drugs on hepatitis-B among hepatitis patients: a pre-experimental study

Background: Hepatitis is considered a public health challenge on the Asian continent. However, due to the paucity of the data, the exact burden of the condition has not been established. Better disease-related knowledge will help to improve attitudes toward managing the complications and side effects and also prevent the further spread of infection. Methods: A hospital-based pre-experimental study was undertaken with 60 hepatitis B patients. Knowledge and attitude were assessed using demographic data, a 30-item knowledge questionnaire, and 16-item Likert scale responses, respectively. SPSS V20.0 was used for data analysis and interpretation. To do the analysis, a paired t-test and descriptive statistics, along with chi-square analysis were done to check the association level. Results: The result showed that in the pre-test, 41 (68.3%) of the participants had inadequate knowledge, 19 (31.7%) had moderate knowledge, and none of the study participants had adequate knowledge. Furthermore, 60 (100%) participants had a neutral attitude, and none of the participants had an unfavorable and favorable attitude toward hepatitis B patients. The paired “t” test value was found to be 18.67 for knowledge level and 25.25 for attitude level, which was highly significant at p<0.05 level. Also, we have observed a strong positive linear correlation between knowledge and attitude, and the calculated “r” value is 0.741*. Conclusions: The findings of the study indicate that hepatitis B patients have a lack of knowledge and attitude which may lead to the further spread of infection in the community and hospital itself. Extensive health education, community reach, and health workers participation can have a rational control over the management of the disease.

Assess Life Skills, Self-Esteem, and Self-Reported Lifestyle Practices Among Adolescents: A Descriptive Correlational Study.

Background: Life skills are essentially those abilities that help to promote mental wellbeing and competence in adolescents as they face the realities of life. Life skills education is to educate the young people in schools and beyond to develop an organized, acceptable, and beneficial lifestyle. Objectives: The current study aimed to assess life skills, self-esteem, and self-reported practices among adolescents in Kolkata and to find out the correlation between life skills and self-esteem. Methods: Descriptive study was conducted from January to March 2020 among 422 adolescents between the age group 13 years to less than 18 years from three selected schools under Bidhannagar Municipal Corporation, Kolkata, using the multistage cluster sampling technique. The data were collected by self-reporting questionnaire and analyzed using SPSS software (version 20.0). Results: Most of the adolescents had low life skills (52.4%) and average self-esteem (64%). About self-reported lifestyle practices among adolescents that they do physical exercises daily in the form of walking (52.6%), cycling (52.1%), swimming (21.8%), and yoga (17.8%). Most of the adolescents responded that they spend leisure time listening to music (43.4%), watching television (43.1%), drawing (36.3%), reading (40.5%), surfing mobile (46.7%), 51.9% of adolescents had smartphones, and that they are using for academic purpose (55.7%), playing games (35.5%), entertainment (19.9%), and to read the news (19.2%). Only 5.2% of adolescents were using substances (tobacco). Conclusion: There is a need for ongoing life skills training program for adolescents in school to increase their self-esteem which helps them to face the challenges of changing life situations.

Prevalence and pattern of childhood injuries in Siliguri City, West Bengal, India

Background: Children are vulnerable to injuries, and childhood injury is a complex phenomenon precipitated by a set of factors. In India, the magnitude and nature of childhood injury are not clearly known owing to the absence of a proper injury surveillance system. However, in recent days few studies demonstrated a substantially high burden of childhood injury. Objectives: To find out the prevalence, pattern, and the factors associated with injury among children of 0� years in the Siliguri city of West Bengal. Methods: A cross-sectional study was conducted among 780 children aged 0� years residing in the Siliguri Municipal Corporation area selected through cluster sampling technique (30 clusters [wards] with a cluster size of 26). Relevant data were collected by interviewing the mothers of children as respondents and was analyzed using SPSS software, binary logistic regression was applied to test the association between injury and other risk factors. Results: Of total 780 children, 165 had reported a total of 220 injury events with an overall period prevalence of 21.2% and a mean of 0.28 injury events per child. Majority of injuries were superficial in nature (53.2%); due to fall (56.4%), extremities were mostly involved (62.3%), and 12.8% cases were moderate-to-severe grade. Under-five children were most vulnerable. Injury was significantly related to socioeconomic status, presence of siblings, outdoor activities, and the presence of supervising person during travelling. Conclusions: Childhood injury is still highly prevalent in the area with its unique pattern and few preventable risk factors requiring a multifaceted comprehensive approach.

Occurrence and predictors of abortion among women of the reproductive age group in a block of Darjeeling District, West Bengal, India

Background: Despite being a sensitive and less explored issue, abortion is a major preventable cause of maternal morbidity and mortality affecting millions of women in developing countries. Objectives: The study aimed to determine the occurrence, nature, and predictors of abortion among women in the reproductive age group in Naxalbari block of Darjeeling district. Methods: A community-based cross-sectional study was conducted in Naxalbari block of Darjeeling district, West Bengal, India, from May 2015 to April 2016, among 420 women aged 15–49 years selected from 30 villages by cluster sampling technique. A predesigned, pretested interview schedule validated in the local vernacular was used. Binary logistic regression was used for finding out predictors of abortion among ever-pregnant women. Results: Lifetime occurrence of abortion was 33.6%. Among total 178 events of abortion, 51.7% were spontaneous and 48.3% induced. Majority of spontaneous abortions events were attended by a doctor (73.9%). About 59.3% of induced abortions were illegal, and unwanted pregnancy was major reason (62.4%) for induced abortion. Private facilities and over the counter drugs were preferred. Lower education, nuclear family, number of children <2, not having male child, domestic violence during pregnancy were significant predictors of abortion. Conclusions: Illegal abortions were highly prevalent in the area. Unwanted pregnancies hint toward unmet needs of family planning. Stigma and poor awareness were the root cause of not visiting a health facility in case of abortions. Building up of better infrastructure, better orientation of frontline workers, non-judgemental and confidential services will attract women to in government facilities.

Polypoidal choroidal vasculopathy: Pearls in diagnosis and management

Polypoidal choroidal vasculopathy (PCV) is increasingly recognized as an important cause of exudative maculopathy in Asians as against Wet age-related macular degeneration in Caucasians. A panel of retinal experts methodically evaluated pertinent updated literature on PCV with thorough PubMed/MEDLINE search. Based on this, the panel agreed upon and proposed the current consensus recommendations in the diagnosis (clinical and imaging), management and follow-up schedule of PCV. Diagnosis of PCV should be based on the gold standard indocyanine green angiography which demonstrates early nodular hyperfluorescence signifying the polyp with additional features such as abnormal vascular network (AVN). Optical coherence tomography is an excellent adjuvant for diagnosing PCV, monitoring disease activity, and decision-making regarding the treatment. Current treatment modalities for PCV include photodynamic therapy, anti-vascular endothelial growth factor agents, and thermal laser. Choice of specific treatment modality and prognosis depends on multiple factors such as the location and size of PCV lesion, presence or absence of polyp with residual AVN, amount of submacular hemorrhage, presence or absence of leakage on fundus fluorescein angiography, visual acuity, and so on. Current recommendations would be invaluable for the treating physician in diagnosing PCV and in formulating the best possible individualized treatment strategy for optimal outcomes in PCV management.

An epidemiological study of low birth weight newborns in the district of Puruliya, West Bengal.

BACKGROUND: A community-based epidemiological study on birth weight of newborns was undertaken in the rural domain of a backward district of West Bengal. OBJECTIVES: To find out the magnitude of low birth weight (< 2.5 kg.) newborns and to highlight association, if any, of the socio-demographic, maternal and obstetric factors with birth weight of newborns. METHODS: The study was undertaken in 30 sub-centre areas (cluster), selected by '30 clusters sampling technique', in the rural area of Puruliya district. An adequate sample of 512 newborns (466 plus 10% extra allowance) delivered in those selected clusters (17 consecutive deliveries in each cluster) were to be studied. But, due to inability to record birth weight within 48 hours (in home deliveries) and other reasons, 487 newborns were included in assessing magnitude of the LBW problem. In-depth information on several variables was obtained from 439 mothers of the newborns. Health Workers (F), Anganwadi Workers, Trained dais and Health Supervisors -(F), specially trained for the survey, collected information by using pre-designed and pre-tested proforma. RESULTS & CONCLUSION: The incidence of LBW was 31.3%. Among different variables studied, statistically significant association was found in case of educational level of mothers and also place of delivery of newborns. More such community-based studies should be conducted

Impact of zinc supplementation on subsequent morbidity and growth in Bangladeshi children with persistent diarrhoea.

This study was conducted to explore whether supplementation of zinc to children during persistent diarrhoea has any subsequent effect on morbidity and growth. A prospective follow-up study was conducted among children, aged 3-24 months, with persistent diarrhoea, who participated earlier in a double-blind randomized placebo-controlled trial. During persistent diarrhoea, children were randomly allocated to receive either zinc in multivitamin syrup or only multivitamin syrup for two weeks. After recovering from diarrhoea, 76 children in the multi-vitamin syrup and 78 children in the zinc plus multivitamin syrup group were followed up for subsequent morbidity and growth. Weekly morbidity and two-weekly anthropometric data were collected for the subsequent 12 weeks. Data showed that episodes and duration of diarrhoea were reduced by 38% and 44% respectively with supplementation of zinc. There was no significant difference in the incidence or duration of respiratory tract infection between the zinc-supplemented and the non-supplemented group. Improved linear growth was observed in underweight children (weight-for-age <70% of the National Center for Health Statistics standard) who received zinc compared to those who did not receive.

A study on drug use in a district hospital of West Bengal.

A cross-sectional study at Howrah General Hospital, West Bengal for prescription analysis and assessment of drug dispensing in 341 patients revealed that the average number of drugs prescribed per encounter was 2.98 +/- 1.69, 38.2% drugs were in generic name and majority were from essential drugs list. 18.6% and 5.2% encounters used antibiotics and injections respectively. Average consultation and dispensing time were short. Majority of drugs were dispensed but unlabeled. 46.8% patients knew correct dosage of drugs. Only 4.7% patients were treated without drugs. Average drug cost per encounter was Rs. 31.32+30.89 where antibiotics and injections shared 36.5% and 4.6% respectively.

A study on bed utilization in the gynaecological ward of a district hospital in West Bengal.

A study was conducted in a non-paying gynaecological ward of the district hospital, South 24 Parganas, West Bengal to assess different bed efficiency indicators. Total 331 patients were admitted in 23 study beds (12 OPD beds and 11 emergency beds) during an observation period of six months. Overall average number of admissions were 14.4 and average length of stay 14.7days. Bed turnover rate was 13.8 and was higher for emergency beds (22.1) compared to OPD beds (9). Bed occupancy rate was 61.3% with significant difference between OPD beds (57.5%) and emergency beds (65.4%).

Study of KAP of the private medical practitioners about national disease control programmes.

This study was carried out among the Private Allopathic Medical Practitioners (PMPs) at Khardah Municipal area (West Bengal) to find out their perception & practice about management protocol of diseases like acute respiratory infections and diarrhoel diseases in children, malaria and tuberculosis. Data was collected by interviewing the PMPs with pre-designed open-ended questionnaire. It was supplemented by analysing sample prescriptions of the same diseases. The study revealed that PMPs knowledge and practice were not at par with national guidelines. The need for periodic sensitization of PMPs regarding national disease control programme was emphasized.

Reproductive tract infection: an experience in rural West Bengal.

A community based cross-sectional study was conducted in the villages of Singur block, Hooghly district, West Bengal during September 2000 to February 2001. The objectives of the study were to find out the magnitude of Reproductive Tract Infections (RTI) among reproductive age group women, their knowledge about RTI and utilization of service available locally. Out of an estimated 896 women of reproductive age group in the study area, 186 women were selected by multistage random sampling technique. The study revealed that 66.1% respondents experienced one or more symptoms of RTI in four weeks recall period of this study. There was significant association (p < 0.01) between literacy status and their experiences of reproductive illness. 57% had knowledge about RTI. This increased gradually with increase of their ages (p < 0.01); literacy status (p < 0.01) and their socio-economic condition (p < 0.05). 27.6% of RTI patient did not receive any treatment, and majority of those received treatment (41.5%) sought advice from private practitioners.

A study of compliance status of diabetes mellitus patients.

A clinic based descriptive (case series) study was conducted among 106 study subjects with poor glycaemic control in a tertiary care hospital, Kolkata. Poor compliance was observed in 89.62% and 10.38% had good/acceptable compliance. Compliance was better in above 60 years age group, in males, in married and educated persons. Non-compliance factors acted mostly in combination.

Utilisation pattern of blood in a teaching hospital of Kolkata.

An annual utilisation of blood transfusion services at several depts. of R.G. Kar Medical College and Hospital, Kolkata were assessed among a sample of 3122 patients selected by Systematic Random Sampling Technique from the register made available in the blood bank there. Record analysis revealed that overall 79.4% of supplied blood units were actually transfused, wastage of 21.6%. Wastage was maximum in the Department of Gynae & Obstetrics (33.11%) and Surgery (32.87%). Only single unit of blood was requisitioned and transfused for 5.44% & 30.90% of the patients respectively. Most common indications of blood transfusion were for surgical cases (37.92%), followed by anaemia (34.80%) and haemorrhage (26.92%). The use of blood and blood products merit attention, appraisal and instructional guiding accordingly.

An evaluation of routine immunization coverage in some districts of West Bengal and Assam.

A coverage evaluation survey was carried out in the five districts of West Bengal and Goalpara district of Assam during the period from November 2002 to April 2003 through 40 clusters sampling technique. Results revealed that highest coverage with routine immunization was in Paschim Medinipur (82.5%) followed by Kolkata (71.6%), Malda (65.3%), 24 Parganas South (61.9%) districts of West Bengal. Murshidabad district of West Bengal had only 41.3% coverage while poorest coverage was observed in Goalpara district (27.2%) of Assam. "Not aware of the need for routine immunization" was the main reason for not being vaccinated with all the UIP vaccines. Vaccination was given mainly through government hospitals in Kolkata while it was administered mainly through subcentres in the other rural districts.

Evaluation of pulse polio immunization in some districts of West Bengal & Assam.

A cross-sectional non-interventional survey was carried out in 5 districts of West Bengal and one district of Assam to find out the extent of coverage during IPPI. It was observed that in the recent rounds of IPPI, more than 95% coverage was observed in all the surveyed districts excepting in 24 Parganas South where coverage was around 92%. Situation at the Goalpara district further needed attention, as the coverage during February 03 as well as in the past two rounds were 90.13%, 88.13%, and 91.04% respectively. In all these districts booths were the main sites for IPPI dose though 1/3rd to 1/4th of the beneficiaries received immunization at home also. It was also observed that around 10% of the beneficiaries were not administered any PPI dose in the either of the rounds, in 24 Parganas (south) & Murshidabad districts, from where maximum number of Poliomyelitis cases were reported. At Goalpara it was 19%. Main reason for not being covered with PPI doses in either of the rounds in all the districts excepting Kolkata was "Not aware of the need for additional doses". In Kolkata "child sick" was the main reason. Health workers were main source of information of PPI in South 24 Parganas (67.13%), Malda (58.25%) & West Midnapur (54%). At Murshidabad "announcement through mike" (61.25%) was the main source of information while in Kolkata, TV was the main source (67.13%). Miking (56.38%) was the main source of information for PPI at Goalpara district of Assam. It was observed that involvement of multiple methods & media of communication was helpful in disseminating dates & other information of PPI.

A study on arsenical dermatosis in rural community of West Bengal.

The spatial distribution of chronic arsenicosis due to consumption of arsenic contaminated tube well water in different districts of West Bengal was gradually unfolding since 1983. Arsenical dermatosis was found to be the commonest and earliest manifestation of chronic arsenic toxicity. This study was conduct in Baruipur block of South 24 Parganas district of West Bengal. Total 313 people selected from three randomly selected villages with reported arsenic contamination in tube well water and 342 people living three randomly selected villages without such evidence of contamination were examined as control population. 5.97% of exposed population and 2.05% of unexposed population showed melanosis (p < 0.01). Moreover, 5.11% of exposed population and 0.88% of unexposed population showed keratosis (p < 0.01). The prevalence of dermatosis among exposed population was also seen to have increased with increasing age, from 7.19% in 0-19 year age group to 37.50% in above 40 year group (p < 0.001). Prevalence was also found to be more with increase in level of contamination. The prevalence rate of dermatosis among unexposedgroup was 2.92%. But age adjusted prevalence rate among exposed group was 19.08% at arsenic contamination level of 0.487 ppm. Mean arsenic concentration in nail and hair samples of exposed group was also found higher than the prescribed limit.

Development of a training programme for school teachers on school health service.

A training programme was developed and implemented for 56 primary school teachers of Barasat II block in North 24 Parganas district as per their recommended roles and responsibilities in School health service. The methodology consisted of development of learning objectives, evaluation parameters (questionnaire and check list) and teaching-learning materials. This was followed by pre-training assessment, implementation of training and re-training and evaluation of the outcome 7 days and 3 months after initial training and re-training. One way analysis of variance revealed significant overall improvement of the cognitive, affective and psychomotor domain of learning of school teachers. The need of periodic re-inforcement training with adequate scope of practice under supervision were emphasized.