Forhad Akhtar Zaman

Evaluation of Ondansetron-induced QT interval prolongation in the prophylaxis of postoperative emesis

Background: To avert nausea and vomiting the 5-Hydroxytryptamine3 (5-HT3) antagonists have become the first line of treatment ifassociated with cardiovascular effects andappear to cause QT prolongation. Objective: Evaluate the effect of 1 mg, 4 mg, and 8 mg bolus doses of intravenous Ondansetron, relative to placebo, in prevention of postoperative nausea and vomiting (PONV) and to find out the changes of QT interval corrected for heart rate (QTc). Materials and Methods: This prospective randomized, placebo-controlled, double-blind study was carried out among 136 adult participants of both sexes in a tertiary care postgraduate teaching institute at Kolkata. mg, 4 mg or 8 mg inj. Ondansetron was diluted to 10 ml with normal saline, was infused 30 min before extubation in relation with a control group. Time to first rescue antiemetic medication and in QTc interval at different time intervals, in each group was noted in different in the various surgical operation theaters (OTs). Results: Requirement of the first rescue antiemetic in the postoperative period between 60 to 120 min in the mg, 4 mg or 8 mg Ondansetron groups was in 28%, 24% and 7% participants respectively; between 120 to 240 min in 63%, 72% and 57% respectively; and within 360 min in 9%, 4% and 36% respectively. Significant and maximal QTc prolongation was observed in the participants with mg or 8 mg Ondansetron 3 and 5 min of drug administration. Conclusions: One mg Ondansetron in healthy adult participants can effectively prevent PONV causing no or insignificant prolongation of QTc interval.

Configuring two-algorithm-based evolutionary approach for solving dynamic economic dispatch problems

A dynamic economic dispatch (DED) problem is a complex constrained optimization problem that has the objective of economically allocating power demands to the available generators for a certain period. Although, over the last few decades, different evolutionary algorithms (EAs) for solving different types of DED problems have been proposed, no single EA has consistently been the best for a wide range of them. In this paper, to solve a wide range of DED problems, a general EA framework which automatically configures the better EA from two considered during the evolutionary process is proposed. In it, a real-coded genetic algorithm and self-adaptive differential evolution are performed under two sub-populations, in which the number of individuals of a sub-population is dynamically varied in each generation based on each algorithms performance during previous generations. Moreover, a heuristic technique is employed to repair infeasible solutions towards feasible ones to enhance the convergence rate of the proposed algorithm. The effectiveness of the proposed approach is demonstrated on a number of DED problems, with the simulation results, which are compared with those from recent state-of-the-art algorithms, revealing that it has merit in terms of solution quality and reliability. A self-configured evolutionary algorithm is proposed.A new repairing method to deal with infeasible solutions is developed.Thermal, hydro-thermal, wind-thermal and solar-thermal DED problems are solved.The performance of the algorithm is superior to that of existing approaches.

Obesity in Kolkata children: Magnitude in relationship to hypertension.

Background: Limited data is available from India regarding the distribution and profile of childhood obesity and hypertension. Materials and Methods: A population based cross-sectional study was conducted in the urban schools of Kolkata. Using stratified random sampling method, 979 participants were selected. Body mass index (BMI) status and blood pressure (BP) were estimated using standard protocol and their various correlates regarding sociodemographic characteristics were looked into. Results: Majority (38.92%) of the study population were in the preadolescent group followed by adolescent group (33.40%). Male constituted 52.09%, overweight was more prevalent among preadolescent age group (22.57%). Overall 27 cases of prehypertension were found of which 19 (70.37%, n=27) were in the adolescent age group. There was no significant association between ages with increased BMI status. We detected total 15 cases (1.53%) of hypertension in our study population and three-fourths of them were from adolescent age group. However, significant association was seen between high BP with increasing age. Average fast food intakes and screen time was higher in obese as compared to their normal peers. Upper and upper-middle social status contributed to higher number of obese/overweight and hypertensive children and was the significant risk factor. Conclusion: Childhood obesity and hypertension were found to be common in the city of Kolkata which suggest the need for greater public awareness programs on these morbidities.

Hand washing practices in two communities of two states of Eastern India: An intervention study

BACKGROUND Public health importance of hand washing as well as its importance in reduction of communicable diseases such as diarrhea and acute respiratory infections have been highlighted in many studies worldwide. OBJECTIVE This study was designed to study the hand washing practices followed in two urban slums as well as to assess and compare the status of different components of hand washing at the pre- and post-intervention phases. MATERIALS AND METHODS A community-based cross-sectional intervention study on hand washing practices was carried out at two urban slums situated in two states of Eastern India with similar sociocultural and linguistic background. The study was carried out by using an interview technique as well as observation of hand washing practices. Interpersonal communication for behavioural change was chosen as a method of intervention. RESULTS The majority (>90%) practiced hand washing after defecation in both the study areas. However, hand washing following all six steps and for stipulated time period was seen to be poor before intervention. Significant improvement was observed in all the aspects of hand washing after intervention in both the areas. The poor practice of hand washing was observed in some situations and needed attention. Use of soap and clean material for drying hands after hand washing was poor initially followed by improvement after intervention. CONCLUSION Based on the findings of the study, it could be suggested that Behaviour Change Communication program should be further planned with emphasis on different components of hand washing with a final objective to bring down the incidence of target diseases.

Glucose indices, frank and undetected diabetes in relation to hypertension and anthropometry in a South Indian rural population.

Diabetes has emerged as one of the worlds biggest health problems and its prevalence is increasing at an alarming rate. This study was conducted to find out the magnitude of frank and undetected diabetes mellitus, including impaired glucose tolerance (IGT) among persons in rural Karnataka, and its relationship with associated risk factors like hypertension and anthropometry. This was a population-based, cross-sectional study on 1370 participants in the field practice area of KBN Medical College, conducted from April 2009 to March, 2010. Diabetes mellitus was noted among 19.78% of the participants, with an additional 12.04% with impaired glucose tolerance. Hypertension observed among participants with diabetes and impaired glucose tolerance was 65.13 and 53.94%, respectively. Effective primary prevention strategies have to be intensified among high-risk population groups, to promote awareness through behavior change communication.

An application of Indian public health standard for evaluation of primary health centers of an EAG and a Non-EAG state.

National Rural Health Mission (NRHM) has provided the opportunities to develop a standard for Sub centers, PHCs and CHCs in the country, popularly known as Indian Public Health Standards (IPHS). The study was carried out to find out and compare to what extent the IPHS were followed by the PHCs in the selected districts of both the Empowered Action Group (EAG) state of Assam and non EAG state of Karnataka. It was a Cross sectional observational study conducted during September-October 2008 where the quality of care and services provided in the selected PHCs as per the IPHS norms was assessed. All the PHCs in both the studied districts were rendering the assured services of OPD, 24hrs general emergency service and referral services while 24 hour delivery services were being provided by 80% of the PHCs of the selected districts of both the states. Functional labor rooms were available only in 80% and 90% of the studied PHCs in Assam and Karnataka respectively. Basic laboratory facilities, for routine blood, urine and stool examination were available in 80% of the studied PHCs in the non-EAG state of Karnataka while it was only in 20% of the studied PHCs of the EAG state of Assam. The findings of the present study revealed important deficiencies as per IPHS norms in the studied PHCs of both Assam and Karnataka.

Solving an economic and environmental dispatch problem using evolutionary algorithm

For successful operation of any power system, an effective scheduling of power generation is crucial. In this paper, we consider a power system with two types of generators, thermal and hydro. The characteristics of these generators vary with respect to the cost, emission to the environment, input source, capacity limit, and technological constraints. The mathematical model considering two objectives, such as minimization of the operating cost and minimization of total emissions, for a hydrothermal system is discussed. A solution approach has been proposed, based on evolutionary computation concept, for solving a benchmark problem for both single and bi-objective version of the problem. In the approach, an initial population of solutions is generated based on a heuristic and the population is then evolved using two well-known evolutionary search algorithms. The solutions of our approaches are compared with another approach from the literature. The analysis of the results reveals that the heuristic enhanced the performance of the evolutionary algorithms considered in this paper.

Prevalence of diabetes mellitus amongst rural hilly population of North Eastern India and its relationship with associated risk factors and related co-morbidities.

Context: Diabetes has emerged as pandemic health problem and its prevalence is increasing at an alarming rate. Aims: The aim of the following study was carried out to understand the prevalence of diabetes mellitus, its associated risk factors and related co-morbidities amongst persons residing in rural hilly terrain of Upper Siang district of Arunachal Pradesh, India. Settings and Design: Population based cross-sectional study on 1370 participants in the field practice area of a private Nursing School in Yingkion in Upper Siang district of Arunachal Pradesh, India was conducted during April 2009-March, 2010. Materials and Methods: The clinico-social data related to diabetes was gathered by personal interview. Body weight, height, waist circumference and blood pressure were measured and blood glucose was estimated in fasting venous blood samples. Results: Diabetes mellitus was observed among 19.78% of the participants with additional 12.04% patients with impaired glucose tolerance (IGT). Diabetes mellitus was most prevalent among 50-59 years age group (32.10%). Hypertension was observed among participants with diabetes and IGT was 65.13% (hypertensive diabetics) and 53.94% (diabetics only). Mean body mass index and associated family history was added risk factors in prevalence of diabetes. Conclusions: Effective primary prevention strategies are to be intensified among the high-risk population groups to promote awareness through behavior change communication.

Fine needle aspiration cytology as the primary diagnostic tool in thyroid enlargement

Background: In the preoperative decision-making of the thyroid swellings, fine needle aspiration cytology (FNAC) is becoming an ever more vital tool. Objectives: To compare the advantage of preoperative FNAC of thyroid swellings with postoperative histopathology to reach a consensus protocol as a simple procedure for diagnosis and optimal management of thyroid swellings. Materials and Methods: A prospective study of preoperative FNAC was carried out on 178 incidental thyroid swellings attending a tertiary care centre in Kishanganj, Bihar. Evidence-based surgical interventions were done, irrespective of FNAC findings and diagnosis was confirmed by histopathological examination (HPE) postoperatively in all the cases. Results: In the FNAC, preponderance of the cases (75.84%) was colloid goitre followed by granulomatous thyroiditis; follicular carcinoma was noted in 7.30 percent and anaplastic carcinoma in 3.37 percent of cases. Histopathological examination showed colloid goitre predominantly (76.97%), followed by follicular carcinoma (8.99%). The overall prevalence of malignancy was 11.24 percent diagnosed by HPE and 9.55 percent by FNAC. In our FNAC series sensitivity of was 90 percent while specificity was 100 percent; accuracy was 98.88 percent. Predictive value of a positive test and negative tests was 100 percent and 98.75 percent respectively. Conclusion: The study highlights that FNAC should be treated as a first-line diagnostic test for thyroid swellings to guide the management though this is not a substitute for HPE as a need to improve primary healthcare in India.

Comparative risk of type 2 diabetes mellitus among vegetarians and non-vegetarians.

Sir, The prevalence of type 2 diabetes in vegetarians was compared to that in non-vegetarians in 724 people in the Bijapur district of Karnataka in a hospital-based survey. The type of vegetarian diet was categorized based on a food-frequency questionnaire. A vegetarian diet, in the broad sense, is defined as the one that does not include meat, fish, or fowl. An ovolactovegetarian is a vegetarian who does not eat beef, lamb, pork, poultry, fish, shellfish, or animal flesh of any kind, but is willing to consume dairy and egg products. Pescetarianism, also called pescovegetarianism, is the practice of a diet that includes seafood and excludes mammals and birds. In addition to fish or shellfish, a pescetarian diet typically includes some or all of vegetables, fruit, nuts, grains, beans, eggs, and dairy. Vegetarian diets offer a number of nutritional benefits including lower levels of saturated fat, cholesterol, and animal protein as well as higher levels of carbohydrates, fiber, magnesium, potassium, folate, antioxidants such as vitamins C and E, and phytochemicals.(1)Vegans tend to be thinner, have lower serum cholesterol, and lower blood pressure, reducing their risk of heart diseases and diabetes mellitus. However, eliminating all animal products from the diet increases the risk of certain nutritional deficiencies. Micronutrients of special concern for the vegans include vitamins B12and D, calcium, and long-chain n-3 (omega-3) fatty acids.(2)On the other hand, the omission of meat and fish from the diet increases the risk of certain nutritional deficiencies.(3)There is convincing evidence that vegetarians have lower rates of coronary heart disease, largely explained by low LDL cholesterol, probable lower rates of hypertension and diabetes mellitus, and lower prevalence of obesity.(4)In our study, mean BMI was lowest in vegans (23.9 kg/m2) and incrementally higher in ovolactovegetarians (25.9 kg/m2), pescovegetarians (26.4 kg/m2), semivegetarians (27.36 kg/m2), and non-vegetarians (29.2 kg/m2). The prevalence of type 2 diabetes increased from 3.1% in vegans to 8.2% in non-vegetarians; the prevalence was intermediate in ovolactovegetarians (3.6%), pescovegetarians (4.9%), or semi-vegetarians (6.4%). After adjustment for age, sex, ethnicity, education, income, physical activity, television watching, sleep habits, alcohol, and BMI, vegans (OR 0.53 [95% CI 0.36–0.60]), ovolactovegetarians (0.55 [0.47–0.64]), pescovegetarians (0.68 [0.61–0.78]), and semi-vegetarians (0.79 [0.64–0.88]) had a lower risk of type 2 diabetes than non-vegetarians. The results show that increased conformity to vegetarian diets protected against risk of type 2 diabetes.