Self-care practices and quality of life of filariasis patients in a gram panchayat of Paschim Burdwan district, West Bengal, India.

Background & objectives: Self-care management is one of the important components in the goal of elimination of lymphatic filariasis (LF) and Quality of Life (QoL) has become an important deliverable in the present day health care system. The objective was to assess the self-care management of the affected limb and to find out the quality of life who were suffering from lymphoedema. Methods: This was a community-based cross-sectional epidemiological study conducted during 2019-2020 in a Gourbazar gram panchayat area of Paschim Burdwan district of West Bengal, India. QoL was assessed by Lymphatic Filariasis Specific Quality of life Questionnaire (LFSQQ). Results: Total 115 LF patients were identified with a mean age of 53.9 years. About 26.1% correctly knew the management of the affected area. Out of the 33 patients having cracked skin, around 39.4% used to take care of the affected skin. Overall, median quality of life score was found to be 77.84 (65.90-89.20). Age-wise, median score gradually decreased with increase in age except in the age group of 50-60 years. Males had higher score compared to females (79.54 vs. 76.13). Activity domain score was found to be lowest followed by mobility score, while social and psychological domain score was found to be good. Interpretation & conclusion: Self-care practice is not known to the affected patients. Time has also come to integrate measures like rehabilitation, psychological intervention, social assistance in addition to self-care management to put up a holistic approach of the existing program.

Cardiac paraganglioma: clinical presentation, diagnostic approach and factors affecting short and long-term outcomes.

BACKGROUND: We describe our experience of the case of a young female who presented with chest pain and was found to have an intra-pericardial mass that was later confirmed to be a paraganglioma. Although preoperative magnetic resonance imaging (MRI) did not show any left atrial invasion, the patient died in the peri-operative period due to irreparable damage of the cardiac structures from extensive neoplastic invasion. We then performed a retrospective analysis of the available literature to find the factors associated with adverse surgical and long-term outcomes in patients with cardiac paraganglioma. METHODS: We found 93 case reports of cardiac and/or pericardial paragangliomas in the literature. After exclusions, 82 cases were included in the final analysis. The patients were divided into two groups based on the outcome of surgical management. Univariate analysis was performed using SPSS software (Chicago, IL version 18), and the statistical significance was defined as a p-value<0.05. RESULTS AND CONCLUSIONS: The comparison of available demographic, clinical, pathological and laboratory parameters between the deceased and the surviving patients revealed that only the intra-cardiac location (p-value=0.021) and the development of metastases (p-value<0.001) were independently associated with increased surgical and long-term mortality, respectively. The size of a paraganglioma, its functional status or invasion into the surrounding structures does not appear to affect short-or long-term survival in these patients. The Kaplan-Meier survival curve showed excellent long-term prognosis for patients with a complete surgical removal of the neoplasm. Based on our experience, we also suggest preoperative imaging with a three dimensional cardiac CT and evaluation for cardiac transplantation before embarking on the surgical resection of these tumors.