Appropriateness of Hospital Admission and Length of Stay in the Pediatric Department of a Tertiary Care Hospital in West Bengal.

Background: Appropriateness of admissions and inpatient length of stay (LOS) are important factors controlling health-care expenditure. The current study was conducted to assess the proportion of appropriate admissions among 29-day to 12-year--old aged patients admitted to pediatric wards of a tertiary health-care center in one month and evaluate inappropriate LOS among them. Materials and Methods: An observational longitudinal study was carried out for two months among patients admitted to the pediatric inpatient department using Pediatric Appropriateness Evaluation Protocol (PAEP)-II tool. All patients admitted to the institution during the study period were included in the study. Results: Among 495 children, 438 (88.5%) were appropriately admitted. Inappropriate admission was mostly found in children aged 1 to 5 years (29, 16.6%), those who lived >5 km from the hospital (45, 15.2%), and those who presented with other systemic illnesses (13, 31.7%). Among the appropriately admitted children, 333 (76%) met the criteria of appropriate LOS during their hospital stays. Multivariable logistic regression showed that the age of the children (AOR = 0.99; 95% CI = 0.98, 0.99), age-appropriate feeding (AOR = 2.12;95% CI = 1.30,3.47), and hematological disorder (AOR = 0.16; 95% CI = 0.05, 0.52) were found to be associated with the children being kept at the hospital inappropriately. Conclusions: The current study observed a high proportion of appropriate admission in children. However, a higher proportion of inappropriate LOS among them was seen. The younger age group, age-appropriate feeding, and type of illness were found as the primary predictors for inappropriate LOS.

Occupational Ventilatory Defects Among Workers Employed in Tea Gardens, A Cross-Sectional Study in Siliguri Subdivision of Darjeeling District, West Bengal.

Introduction: During the refining and packing of tea, a very fine dust is formed which is called the tea fluff. Exposure to this fluff has been reported to cause ventilatory defects on chronic exposure. Objective: To determine the association between air quality of the different work sections of tea gardens and the ventilatory functions of the workers. Methodology: An observational analytical study with cross sectional design was conducted on 400 apparently healthy individuals working in different sections of 4 tea gardens. Data on sociodemographic characters of the population, particulate matter (PM) and air quality (AQI) was recorded. All participants underwent spirometric evaluation. Results: The mean (SD) age of the study population was 37.8 (8) years. Most (67%) of the study participants were females. The participants were engaged in the job for a mean (SD) of 4.7 (2.7) years. The median distribution of PM2.5, PM 10 and AQI are progressively higher from the garden section to the dry section. A significant correlation between FVC and PM2.5 and PM10 is seen. FEV1 and FEV1/FVC shows a significant correlation with all air quality parameters while FEF25-75 is correlated to none of them. Comparison of the three models to predict the spirometric variables show that even after adjustments, the FEV1 is significantly associated with air quality parameters, FEV1/FVC is significantly associated with the air quality parameters and age while the FEF25-75% is dependent on the age of the participant. Conclusion: There is a strong correlation between the ventilatory parameters and the cumulative exposure of PM2.5, PM10 and AQI, which persists even after adjustment for confounders.

Evaluation of Multiple-Choice Questions by Item Analysis, from an Online Internal Assessment of 6th Semester Medical Students in a Rural Medical College, West Bengal.

Background: Properly constructed single best-answer multiple choice questions (MCQs) or items assess higher-order cognitive processing of Bloom's taxonomy and accurately discriminate between high and low achievers. However, guidelines for writing good test items are rarely followed, leading to generation and application of faulty MCQs. Materials and Methods: During lockdown period in 2020, internal assessment was taken through online mode using Google Forms. There were 60 'single response type' MCQs, each consisting of single stem and four options including one correct answer and three distractors. Each item was analyzed for difficulty index (Dif I), discrimination index (DI), and distractor efficiency (DE). Results: The mean of achieved marks was 42.92± (standard deviation [SD], 5.07). Dif I, DI, and DE were 47.95± (SD 16.39) in percentage, 0.12± (SD 0.10), and 18.42± (SD 15.35), respectively. 46.67% of the items were easy and 21.66% were of acceptable discrimination. Very weak negative correlation was found between Dif I and DI. Out of total 180 distractors, 51.66% were nonfunctional one. Conclusion: Item analysis and storage of MCQs with their indices provides opportunity for an examiner to select MCQs of appropriate difficulty level as per the need of assessment and decide their placement in the question paper.

Pulmonary Involvement in Systemic Lupus Erythematosus Patients in a Tertiary Care Hospital.

INTRODUCTION: In half of the individuals with systemic lupus erythematosus (SLE), over the course of the disease, pulmonary involvement occurs frequently and is one of the parts in the array of presenting symptoms. But the published research and information on SLE have historically concentrated on renal, central nervous system (CNS), and dermatological manifestations, while the pulmonary effects of SLE have received very less attention. OBJECTIVE: To know the extent and pattern of pulmonary involvement in SLE patients in a tertiary care hospital. MATERIALS AND METHODS: A cross-sectional observational study was conducted among 70 diagnosed SLE [who fulfilled the revised American College of Rheumatology (ACR) criteria for the classification of SLE] patients attending a tertiary care center. Seventy diagnosed SLE patients who met the updated ACR criteria for the classification of SLE and were enrolled in a tertiary care facility in West Bengal participated in a cross-sectional observational study. After informed consent, clinical examinations, general survey, respiratory examination, cardiovascular examination, and relevant investigations [chest X-ray, pulmonary function test, echocardiography and electrocardiography, and high-resolution computed tomography (HRCT)/chest computed tomography (CT) scan] were performed. RESULTS: The majority of the study subjects belonged to the 21-30 years of age-group (45.7%) and were females. Most of the study subjects were treatment-naïve as they were newly diagnosed. Among the chief presenting complaints, the most common was cough followed by dyspnea and pleuritic chest pain. Chest X-rays showed pleural pathology in 37% of study subjects and pulmonary function tests were found to have a restrictive pattern in 4.3%. Echocardiography documented that 19.6% had pulmonary artery hypertension. HRCT revealed that 19.4% of subjects had definitive findings of interstitial lung diseases (ILD). CONCLUSION: A substantial contributor to morbidity and death, SLE is a potentially fatal, commonly debilitating autoimmune illness with pulmonary symptoms. Cough was the most common presenting complaint, and the most common radiological abnormality detected was pleural effusion. Spirometry revealed, as expected, a restrictive pattern in most of the cases. Around 29% of cases revealed features suggestive of or confirmatory evidence for intestinal lung disease. As a whole, the prevalence of lung involvement in SLE in the study was 67%. But this being a study with only 70 participants, a further longitudinal is recommended to study disease activity correlation with the incidence of early pulmonary involvement in SLE disease course.

Study on intimate partner violence against rural tribal women of reproductive age group in siliguri subdivision of Darjeeling District, West Bengal.

Background: Since the early 1990s, several milestone international declarations have recognized violence against women as a violation of human rights. Intimate partner violence (IPV), often used synonymously with domestic abuse or domestic violence against women, is a big burden to our society which manifests itself in many forms and it has its existence in every corner of the world irrespective of all the boundaries. Objectives: The objective of this study was to find out the prevalence of IPV against reproductive age group tribal women in Siliguri subdivision of Darjeeling district. Methodology: A cross-sectional study was carried out among 360 tribal women aged between 15 and 49 years residing at selected villages across Siliguri subdivision. Data regarding IPV were collected using the Indian Family Violence and Control Scale questionnaire. The data were analyzed using SPSS version 20 and multi-variable logistic regression was done to find out factors associated with domestic violence. Results: The study revealed that 70.3% of women had experienced domestic violence in any form in their lifetime. Logistic regression revealed that IPV was significantly associated with: age between 30 and 49 years, education above primary school, unskilled occupation, ₹ 2500 and above per-capita monthly income, and participants who are separated/broken up. Among the factors related to the male partner, literacy above primary school level was associated with experience to domestic violence. Conclusion: Domestic violence in all its manifestations was found to be present in the study population. The report may offer policymakers fresh perspectives on how to allocate funds for the complete elimination of domestic violence against women.

Prevalence of Risk Factors of Non-communicable Diseases among Adolescents of a Rural Area in Darjeeling District of West Bengal.

INTRODUCTION: Adolescence is the transitional period between childhood and adulthood when new health behaviors are laid down, which may track in to adulthood and have lifelong impact. Global trends show that these NCD-related behaviors are gradually rising among young people, and that they establish patterns of behavior that persist throughout life and are often hard to alter. OBJECTIVE: To find out the prevalence and socio demographic predictors of risk factors of non communicable diseases among adolescents of a rural area Methods: A community based cross sectional study was conducted among 365 adolescents residing in a rural area of Siliguri subdivision. They were interviewed and measurements were taken using standard procedure. RESULTS: The prevalence of behavioural factors for NCDs like tobacco use, alcohol use, unhealthy diet, physically inactivity was 18.4%, 4.7%, 87.1% and 23.0% respectively; metabolic risk factors like overweight, hypertension, and abdominal obesity 28.5%, 17.5%, 1.4% respectively. After adjustment, the odds of behavioural and metabolic risk factors were found highest among the males, participants whose mothers were not working and those who belonged to Hindu families and lower socioeconomic class. CONCLUSION: The proportion of risk factors of non communicable diseases among the rural adolescents was quite high'. Given the associated health problems and costs, non communicable diseases have become an issue of serious concern.

Identifying emotional Facial Expressions in Practice: A Study on Medical Students.

BACKGROUND: Successful identification of emotional expression in patients is of considerable importance in the diagnosis of diseases and while developing rapport between physicians and patients. Despite the importance of such skills, this aspect remains grossly overlooked in conventional medical training in India. This study aims to explore the extent to which medical students can identify emotions by observing photographs of male and female subjects expressing different facial expressions. METHODS: A total of 106 medical students aged 18-25, without any diagnosed mental illnesses, were shown images of the six universal facial expressions (anger, sadness, fear, happiness, disgust, and surprise) at 100% intensity with an exposure time of 2 seconds for each image. The participants marked their responses after each image was shown. Collected data were analyzed using Statistical Package for the Social Sciences. RESULTS: Participants could identify 76.54% of the emotions on average, with higher accuracy for positive emotions (95.6% for happiness) and lower for negative emotions (46% for fear). There were no significant variations in identification with respect to sex of the observers. However, it was seen that participants could identify emotions better from male faces than those from female faces, a finding that was statistically significant. Negative emotions were identified more accurately from male faces, while positive emotions were identified better from female ones. CONCLUSIONS: Male participants identified emotions better from male faces, while females identified positive emotions better from female faces and negative ones from male faces.

Risk factors for pneumonia mortality in under-five children in a tertiary care hospital of Darjeeling district of West Bengal: A prospective case-control study.

BACKGROUND: Among children admitted with pneumonia, several modifiable predictors have been identified for deaths in children in hospitals. Despite the presence of a several national programs designed to address most of the risk factors directly or indirectly it is surprising that they continue to be common in children with pneumonia. OBJECTIVES: The objective is to determine the risk factors for pneumonia mortality in under-five children in a tertiary care hospital of Darjeeling district of West Bengal. METHODS: An analytical study with case-control design was conducted between May 2016 and October 2017. Children aged 2-59 months admitted with the diagnosis of pneumonia were followed up after admission and who died were recruited as cases and two consecutive age- and sex-matched controls were recruited among children who were declared cured and discharged. A total of 95 cases and 190 controls were studied and the risk factors were compared in the pair matched groups by the conditional logistic regression. RESULTS: Factors influencing childhood pneumonia mortality were severely underweight (adjusted odds ratio [AOR]: 3.66 [1.28,10.46]) unimmunized child (AOR 4.18 [1.53, 11.41]), lack of exclusive breast feeding (AOR: 3.12 [1.23, 7.91]), past history of diarrhea or acute respiratory infection in the last 3 months (AOR: 7.27 [3.68, 14.36]), hypoxemia on admission (AOR: 2.53 [1.14, 5.61]), sub-center as the first contact health facility (AOR: 6.49 [2.15, 19.67]), and antibiotic not received at first contact (AOR: 3.18 [1.36, 7.43]). CONCLUSIONS: Most of the risk factors for death in children between 6 and 59 months of age are directly or indirectly related to health service delivery and can be ameliorated through proper structural and administrative measures.

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 0-14 years in the Siliguri city of West Bengal. METHODS: A cross-sectional study was conducted among 780 children aged 0-14 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.

Prevalence of soil-transmitted helminth infestations among children attending Integrated Child Development Service centers in a tea garden area in Darjeeling.

INTRODUCTION: Helminths infestations are common in children in the tea garden areas of Darjeeling, which present unique social, cultural, and environmental conditions. The present study was conducted to determine the proportion of soil-transmitted helminth (STH) infestations and association of STH to sociodemographic variables among children attending Integrated Child Development Services centers of a tea garden area in Darjeeling. METHODOLOGY: A cross-sectional descriptive study was conducted at Kiran Chandra Tea Estate, a tea garden in Naxalbari, Darjeeling, between August and September 2016. Stool samples were collected from children attending ICDS centers in the area and examined using the direct and concentration methods. A pretested and predesigned questionnaire was used to collect data on the sociodemographic profile of the children's families. RESULTS: Stool samples could be collected from 52 (45%) of the 115 eligible children. The children were predominantly male (61.5%), from families with an income between Rs. 2000 and 4000 per month, had mothers with no formal education (75.0%) and came from households with no sanitary toilets (33.5). The proportion of children with STHs was 9.6%; with Ascaris found in 7.7% and Trichuris in 1.9%. No statistically significant differences were found in selected variables between the worm-positive and worm-negative children. CONCLUSIONS: The proportion of STH infestation is low among children <6 years of age attending ICDS in the study area probably because of the mass de-worming strategy of the government of India. Some differences in infestations among groups might suggest a clustering effect.

Behavioral and biological risk factors of noncommunicable diseases among tribal adults of rural siliguri in Darjeeling District, West Bengal: A cross-sectional study.

BACKGROUND: The increasing burden of noncommunicable diseases (NCDs) urges continuous survey of risk factors in different population groups. Objectives: The study was conducted to assess the prevalence and determinants of behavioral and biological risk factors of NCDs, in rural tribal population. METHODS: A community-based cross-sectional study was conducted from June 2014 to May 2015, in rural Siliguri, among 172 tribal people aged 25-64 years selected by multistage cluster random sampling using WHO-STEPS instrument. Study participants were interviewed for sociodemographic and behavioral risk factors, and biological measurements were taken. Descriptive and logistic regression analyses were performed to explore the determinants of risk factors. RESULTS: Among the study participants, the prevalence of current tobacco use and alcohol use were 69.8% and 40.7%, respectively; 96.5% consumed unhealthy diet and 2.9% were physically inactive. The prevalence of abdominal obesity and overweight were 26.2% and 12.2%, respectively. Odds of tobacco use were significantly raised among men (adjusted odds ratio [AOR]: 47.7 [95% confidence interval (CI) 11.1, 203.9]) and increased age of the participants. Men showed higher odds of alcohol consumption (AOR: 13.4 [95% CI 4.6, 38.9]). Odds of abdominal obesity were higher among older participants, whereas lower odds were found among men (AOR: 95% CI 0.11 [0.0, 0.5]) compared to women. CONCLUSIONS: Most of the behavioral and biological risk factors of NCDs were quite high among tribal population of rural Siliguri except physical inactivity. Increasing awareness about NCDs through locally accepted and culturally appropriate strategies need to be implemented in the study area.

Determinants of infant mortality in rural India: An ecological study.

BACKGROUND: Long-term reductions in infant mortality (IM) are possible only by addressing the distal determinants. OBJECTIVES: The objective of the present study was to determine the relationship between IM and its major distal determinants in rural India. METHODS: The dependent variable used in the study was state wise IM rate (IMR), the values of which were obtained from the Sample Registration System, 2015. State level literacy rate in females, unemployment rates of females, GINI index, and round-the-clock neonatal services in primary health centers in the rural areas and the per capita gross state domestic product at purchasing power parity (GSDP at PPP) of the states, were used as the predictor variables for IM. Relationship between the variables was obtained by the Pearson's correlation coefficient. Bivariate and multivariable linear regressions were used to identify the magnitude and direction of the predictors on IM. RESULTS: Correlation statistics showed none or weak positive correlation between the Gini coefficient and 24 × 7 primary health-care services and IMR. There was a strong negative correlation between female literacy rate and IMR, while the unemployment rates and per capita gross state domestic product (GSDP) were moderately negatively correlated to IMR. Bivariate analysis revealed that, for unit increase in unemployment rates in females, proportion of literate women, and 1000$ increase in the GSDP at current prices, IMR decreased by 0.07, 0.763, and 1.702, respectively. However, after adjustment, only the female literacy rates showed significant association with IMR. CONCLUSIONS: Of the major determinants included in the study, rural female literacy is the most important distal determinant of IM in rural areas of India.

Vaccine hesitancy for childhood vaccinations in slum areas of Siliguri, India.

BACKGROUND: Despite evidence regarding the beneficial effects of vaccines, vaccination uptake has not been up to the mark across the globe in various sociocultural and sociodemographic groups. Logistics and workforce have been issues of concern to public health managers, but the latent issue of vaccine hesitancy leading to vaccine delays and refusals has not been widely addressed particularly in the Indian context. OBJECTIVES: The present study was conducted to find out the proportion and factors contributing to vaccine hesitancy for childhood vaccinations in slums of Siliguri, India. METHODS: A cross-sectional study was carried out among 194, 0-59 months' children residing in slums of Siliguri in 2016. Data were collected at the household with interviews of mothers/primary caregivers using a predesigned pretested interview schedule developed based on the validated version of vaccine hesitancy survey questionnaire originally developed by the World Health Organization Strategic Advisory Group of Experts working group on vaccine hesitancy. Associations were analyzed using logistic regression. RESULTS: Majority 161 (83%) of the families were vaccine-hesitant and only 33 (17%) were not hesitant. Nuclear families and mothers of lower educational status had significantly higher odds of vaccine hesitancy. Reluctance to vaccinate (26.1%) and to be unaware/having no reliable information (20.5%) were the major reasons cited for vaccine hesitancy. CONCLUSION: Most of the families of the children were vaccine-hesitant in the area. Uniformity in schedules in different health facilities in slum areas, appropriate antenatal information, and counseling regarding childhood vaccinations, widespread awareness, and improving mothers' education can address the issue of vaccine hesitancy.

A Randomized Controlled Trial Comparing the Efficacy of a Combination of Rifaximin and Lactulose with Lactulose only in the Treatment of Overt Hepatic Encephalopathy.

Background: Hepatic encephalopathy (HE), or portosystemic encephalopathy, represents a reversible decrease in neurologic function caused by liver disease, and treatment has traditionally been with non-absorbable disaccharides along with antibiotics and supportive measures. The present study was undertaken to evaluate if their combination therapy were superior to the established therapy in management of HE. Methods: Ninety six (96) patients of hepatic encephalopathy were randomly assigned to receive either lactulose and rifaximin in standard dosage or lactulose only and their response to therapy was monitored using standard assessment tools. The statistical analysis was done using Kaplan- Meier methods to estimate the percentage of patients maintaining survival over time. Results: The patients who were on lactulose and placebo revealed to have lower mortality than those on lactulose and rifaximin. Also, improvement in neurological status was of Grade 1 or more was more in patients on lactulose and placebo when compared to those on lactulose and rifaximin. Although survival analysis revealed no statistical difference between two groups, the mean survival in the placebo group was higher. Conclusions: The present study reveals that improvement in neurological status of the group treated with lactulose only was that of a higher percentage than that of the group being treated with lactulose and rifaximin, which reiterates the recommendation that lactulose be used as a first line therapy in overt hepatic encephalopathy (OHE). Also the outcome was better in patients who had a lower grade of encephalopathy on admission.

Usage of Online Social Networking Sites among School Students of Siliguri, West Bengal, India.

BACKGROUND AND OBJECTIVE: Social networking sites (SNSs) are online platforms that provide individuals with an opportunity to manage their personal relationship and remain updated with the world. The primary objective of the present research was to find the pattern of school students' SNS usage and its influence on their academic performance. MATERIALS AND METHODS: The setting was an English medium school situated in the metropolitan city of Siliguri in West Bengal. A pretested and predesigned questionnaire was self-administered anonymously by 388 randomly selected students. The data were analyzed using appropriate statistics. RESULTS: Three hundred thirty-eight (87.1%) students used SNS and spent an increased amount of time on these networks. Addiction was seen in 70.7% and was more common in the age group of 17 years and above. CONCLUSION: There is a need to educate students about the ways of using SNS and the perils associated with it, to help them understand that though very much in trend, they should be used cautiously.

Utilization of safe drinking water and sanitary facilities in slum households of Siliguri, West Bengal.

BACKGROUND: With the rapid expansion of urban population, provision of safe water and basic sanitation is becoming a challenge; especially in slums. This is adversely affecting the health of the people living in such areas. OBJECTIVES: The study was conducted to measure the proportion of households using improved drinking water and sanitation facilities and to determine the association between diarrhea in under-five children with water and sanitation facilities. METHODS: A community-based, cross-sectional study was conducted among 796 slum households in Siliguri from January to March 2016 by interviewing one member from each household using a predesigned and pretested questionnaire based on the WHO/UNICEF Joint Monitoring Program Core questions on drinking water and sanitation for household surveys. RESULTS: A majority 733 (92.1%) of slum households used an improved drinking water source; 565 (71%) used public tap. About two-thirds (65.7%) household used improved sanitation facilities. About 15.8% households had reported diarrheal events in children in the previous month. Unimproved drinking water sources (AOR = 4.13; 1.91, 8.96), houses without piped water supply (AOR = 4.43; 1.31, 15.00), and latrines located outside houses (AOR = 3.61; 1.44, 9.07) were significantly associated with the diarrheal events in children. CONCLUSION: The utilization of improved drinking water source was high but piped water connection and improved sanitary toilet used was low. Association between diarrheal events and type of drinking water sources and place of sanitation might suggest fecal contamination of water sources. Awareness generation through family-centered educational programs could improve the situation.

Nomophobic behaviors among smartphone using medical and engineering students in two colleges of West Bengal.

BACKGROUND: Growing smartphone usage among global and Indian college students has resulted in considerable issues of "nomophobia" (NMP) or feelings of discomfort or anxiety experienced by individuals whenever unable to use their smartphones. This significantly impacts their health, work, and study. OBJECTIVE: The objective of this study is to find out the prevalence of NMP among smartphone using medical and engineering undergraduates of West Bengal and to compare the nomophobic behaviors, its predictors, and smartphone usage among them. METHODS: A cross-sectional study was conducted among 303 medical and 305 engineering undergraduates in West Bengal using a validated NMP questionnaire consisting of four factors. Comparison of means of individual questions and factor scores was done. Nomophobic clusters among the two groups were identified using two-stage cluster analysis. Binary logistic regression was used for comparison of predictors of NMP. RESULTS: Engineering students showed a higher proportion of nomophobics (44.6%) than medical students (42.6%). Significant higher means was observed among engineering students for the factor "giving upconvenience" and individual variables like "scared due to running out of battery," "nervous due to disconnection from online identity," "uncomfortable when unable stay up-to-date with social media" and "anxious when unable to check E-mails." A Higher proportion of nomophobics among both groups were females, those owning smartphone beyond 2 years, having monthly mobile bill above Rs. 200 and spending over 4 h daily on smartphone. CONCLUSION: NMP has emerged as a significant cause of concern among both the groups. Standardized measures for identification and appropriate psychobehavioral therapy for those seeking help might alleviate the problem.

Depression in cancer patients undergoing chemotherapy in a tertiary care hospital of North Bengal, India.

BACKGROUND: Detection of cancer and subsequent chemotherapy can lead to clinical depression in many cancer patients. OBJECTIVES: The study was conducted to find out the extent of depression in cancer patients undergoing chemotherapy and determine the factors associated with depression. METHODS: A cross-sectional descriptive study was conducted at the Chemotherapy Day Care Centre of North Bengal Medical College and Hospital from May to June 2013. A total of 174 cancer patients were selected and interviewed after obtaining informed consent and Institutional Ethics Committee Clearance. Brief Edinburgh Depression Scale was used to find out depression with a score of 6 and above indicating depression. Data obtained was analyzed using SPSS software version 20. Logistic regression was used to see the relative importance of multiple contributing factors toward depression. RESULTS: Out of 174 cancer patients, 97 (55.7%) were found to be depressed. Depression was comparatively higher in patients ≥50 years; in males; those belonging to religion other than Hindus; who received higher education; had monthly family income ≥5000 rupees and were involved in moderate or heavy work. Nearly 70.6% of blood cancer patients; 64.3% of those who had been receiving chemotherapy for ≥6 months and 56.9% of those in their 4th or less cycle of chemotherapy were found to be depressed. CONCLUSION: The study revealed depression is substantially high among cancer patients undergoing chemotherapy in this area. Diagnosis and treatment of cancer patients need to be complemented by psychological support for the cancer patients.