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Food and waterborne outbreaks are a neglected public health problem in India. However, it is important to identify the source of infection and the causative pathogen to curb the outbreak quickly and minimize mortality and morbidity. A retrospective descriptive study was conducted with a line list of 130 diarrheal cases. Epidemiological investigation and laboratory investigation were done. Data were collected from hospital case report forms as well as interviewed affected cases. A case of acute diarrheal disease was reported among the people in the village with abdominal pain, vomiting, and diarrhea from December 31, 2022 to January 3, 2023. Out of a total of 130 recorded cases, 33 stool samples were collected and were positive for Enteroaggregative Escherichia coli, Shigella flexneri 3a, and Shigella sonnei by cultural and molecular tests. The presumptive fecal pollution indicator assay indicated high coliform counts in the water samples (most probable number [MPN]-05) and the presence of Escherichia coli. The identified pathogens showed susceptibility to gentamicin and meropenem. People who used public drinking water were found to be infected with acute diarrheal disease (ADD). Quick identification of the causative pathogens and their antimicrobial resistance pattern helped correct antibiotic prescriptions and quick recovery of the patients without any deaths. Thus, a timely implementation of food and waterborne outbreak investigation is crucial to saving lives and preventing the spread of infection.
RESUMO
Background: Musculoskeletal manifestations of diabetes are common and not life threatening, but these are an important cause of morbidity, pain and disability among diabetic patients. In 2004, the National Health Interview Survey determined that 58% of diabetic patients would have musculoskeletal functional disability. This study was designed to estimate the proportion of musculoskeletal manifestations among Type 2 diabetic patients attending a tertiary care hospital in Tripura and also to determine the association of various musculoskeletal manifestations with glycaemic status, body mass index and duration of diabetes mellitus. Methods: This hospital-based cross-sectional study was carried out in a tertiary care hospital in a northeastern state of India from December 2020 to November 2021. All the diabetic patients attending diabetes nutrition clinic of a tertiary care hospital for a period of one year were considered for this study. Diagnosis of musculoskeletal disorder was made based on history, physical examination, laboratory test and imaging test. Quantitative data were expressed as mean and standard deviation. Descriptive data was expressed in percentages and frequencies using charts and tables. Chi-square test was applied to explore any association between variables. Ethical approval for the study was obtained from the institutional ethics committee. Results: Out of four hundred and forty-two diabetic cases and two hundred and thirty-four (52.9%) patients were found with musculoskeletal manifestations, 55% of which belong to 45-59 age group. Conclusion: Physicians treating diabetic patients should be encouraged for regular examination for musculoskeletal complaints. Early diagnosis will facilitate appropriate treatment and thus prevents further complications.
RESUMO
Introduction: Healthcare workers (HCWs) are at increased risk of acquiring the COVID-19 disease, if there is a breach in the personal protection while managing patients. Objectives: 1. To estimate the pattern of risk exposure among healthcare workers exposed to confirmed cases of COVID-19 working in non-COVID zones of a Teaching Hospital, North-East India. 2. To determine the association between pattern of exposure with their COVID-19 status. Materials and Method: This was a hospital-based cross-sectional study conducted among all HCWs who had occupational exposure to laboratory confirmed COVID-19 cases between July and September 2020 in-non COVID zones of a major tertiary care hospital in Tripura. Results: The present study showed that 215 HCWs were exposed to confirmed cases of COVID-19 while working in non-COVID zones of the hospital. Among the exposed, 39.5% of HCWs had high-risk exposure and 8.8% of HCWs were detected as COVID-19 positive. A majority of the study subjects experienced exposure in the hospital wards (66.0%), in surgical departments (19.5%), had close contact (less than one meter distance) with positive COVID-19 cases (73.5%), and had an exposure of more than 15 minutes (51.2%). The COVID status of the exposed HCWs was significantly associated with no source control (P = 0.016), close contact with COVID-19 positive cases (P = 0.026), more duration of exposure (P < 0.05), use of any PPE (P = 0.000). COVID status was also significantly associated with the high-risk exposure of the participants (P = 0.000). Conclusion: Strict enforcement of the infection control measures like universal precautions should be practiced by HCWs to prevent hospital-acquired infections.
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BACKGROUND: Viswanathan Mohan and his team have developed "Indian Diabetes Risk Score" (IDRS) for identifying the Indians at risk for developing diabetes and prediabetes. Due to heterogeneity of Indian population, this risk score needs further validation in different parts across the country. OBJECTIVES: The objective is to estimate the sensitivity, specificity, positive, and negative predictive values of IDRS for screening prediabetes in West Tripura District. METHODOLOGY: It was a community-based cross-sectional study conducted in West Tripura district during January 1, 2018-December 31, 2019 among 325 self-declared nondiabetic individuals, selected by multistage sampling. Fasting blood sugar value was used as the gold standard to validate IDRS. Data were collected using a validated and pretested interview schedule. Data entry and analysis were performed in computer using SPSS-24. Receiver operating characteristic (ROC) curve was constructed to validate IDRS. RESULTS: Among the study individuals, 19% and 6.5% were identified as prediabetic and diabetics, respectively. Optimum sensitivity of 83.13% and specificity of 82.64%, with positive and negative predictive values 62.16% and 93.45%, respectively, were observed at an IDRS score of ≥60 for identifying prediabetes and diabetes in this study population. IDRS showed good accuracy with an area under ROC curve of 0.832 (95% confidence interval: 0.77-0.88). CONCLUSION: IDRS is found to be a valid tool for screening prediabetes at community level in West Tripura district of India.
RESUMO
BACKGROUND: In India 66% of blindness among individuals aged 50 yrs and above is attributable to cataract. Cataract has multiple etiologies and many of them are modifiable. But data regarding burden and correlates of cataract among OPD attendees in Northeast India are insufficient. OBJECTIVES: To estimate the proportion of cataract among the attendees of ophthalmology OPD of a teaching hospital of Northeast India and to study the factors associated with it. METHODS: This hospital based cross-sectional study was conducted during 7th February to 6th March 2020, using a pre-tested structured interview schedule, among 330 adults attending ophthalmology OPD of Agartala Government Medical College, chosen by consecutive sampling. RESULT: Proportion of cataract among the attendees was 36.7% and it was 51.5% among the subjects aged ≥50 years. Age, family type, literacy, diabetes mellitus and hypertension had significant associations with cataract (P < 0.05). Logistic regression model has identified age ≥ 50 yrs (OR: 5.57, 95% CI: 2.98-10.43) and illiteracy (OR: 2.67, 95% CI: 1.55-4.59) as the significant predictors for developing cataract (P < 0.05) in the study population. CONCLUSION: Proportion of cataract among OPD attendees is 36.7%, which is higher than the community prevalence of cataract in Tripura. Promoting literacy, reducing family size, blood sugar and blood pressure may bring down the proportion of cataract in this population.
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Background: India is currently in need of large number of public health specialists to combat the double burden of communicable and non-communicable diseases. But it was seen that medical students are less interested in a career as a public health specialists. This study aimed to assess the preferences of subjects for future specialization among medical students and to understand their attitude towards Community Medicine as a future career. Methods: A cross-sectional study was done among 200 MBBS students selected by stratified random sampling at Agartala Govt. Medical College of Tripura during April to May 2018. Data were analyzed using SPSS (version 25.0). Results: Medicine was the most preferred subject (35%) for specialization followed by obstetrics and gynecology (16%) and surgery (15%). About 4% of the participants opted Community Medicine for future specialization. Lack of personal satisfaction, lack of future career prospective and lack of opportunity to earn name and money ranked top most cause for not choosing Community Medicine as a career. Conclusions: Preference of Community Medicine for future specialization was very limited among medical students. Interest on Community Medicine as a career among MBBS students can be improved by proper counseling and modification of curriculum.