Indranil Saha

Overweight, obesity and influence of stress on body weight among undergraduate medical students.

Obesity is emerging as a serious problem throughout the world, not only among adults, but also children, teenagers and young adults. Of the factors contributing to obesity, stress seems to be particularly important as stressful condition leads to irregularity in diet, lack of exercise and addiction, each being considered independent factors leading to obesity.(1) Medical education is stressful throughout the whole course of training. The amount of material to be absorbed, social isolation, pressure of examination, discrepancies between expectation and reality all can be anticipated to bring psychological stress.(2) Hence, this study was undertaken to find out the prevalence of overweight and obesity among undergraduate medical students. An attempt was made to find out the significance of presence or absence of factors influencing body weight.

Gender differences in notification rates, clinical forms and treatment outcome of tuberculosis patients under the RNTCP

Introduction: An increased notification rate of tuberculosis (TB) in men is seen in the SAARC region. In India, the Revised National Tuberculosis Control Programme (RNTCP) detects nearly three times more male than female TB patients. Gender differences have also been reported in the clinical forms of tuberculous disease and in treatment adherence and cure rates in patients undergoing treatment for tuberculosis. The present study was undertaken to find out the sex differences in the notification rates and treatment outcomes of TB patients registered under the RNTCP in a rural tuberculosis unit (TU) in West Bengal. Materials and Methods: A retrospective record-based study was carried out among a total of 3605 cases registered under the RNTCP between January 1999 and June 2005. Notification rates of TB, clinical forms of TB and disease treatment outcomes recorded in the registers were analyzed based on genders. Outcomes were defined in accordance with the standard RNTCP definitions. The Z-test for proportion (for comparing differences in proportions), Student t-test (for comparing mean), and χ2 test (to see association) were performed for statistical analysis. Results: Among the total of 3605 patients, 2498 (69.3%) were male and 1107 (30.7%) were female with a male female ratio of 2.25:1. In patients less than 20 years of age, the notification rates among males and females were similar. In the other age groups, males were more likely to be notified compared to females and the difference was statistically significant. While new smear positive and retreatment cases were significantly more than in males, among females, new smear negative and new extrapulmonary cases were significantly higher. Among the new smear positive patients 89.4% of females were cured compared to 85.8% of males which was again significant statistically (Z=1.70, P<0.05). Male patients outnumbered females in all the unfavorable outcomes like death, failure, and default although none of the differences were statistically significant (P>0.05). Conclusion: The present study demonstrates a gender difference in the notification rates, clinical presentations and treatment outcomes of patients with tuberculosis. Integrated research is necessary to find the reasons for these differences. Such studies will be helpful in improving the efficacy of the RNTCP.

PITYRIASIS VERSICOLOR: A CLINICOMYCOLOGICAL AND EPIDEMIOLOGICAL STUDY FROM A TERTIARY CARE HOSPITAL

Background: Pityriasis versicolor is a mild, chronic, usually asymptomatic superficial fungal infection of the stratum corneum, caused by Malassezia yeasts. The purpose of the present study is to assess the clinical profile of a group of patients with pityriasis versicolor and to find out the epidemiological characteristics in this part of India as well as any association, if any, with other diseases. Materials and Methods: For this purpose, 110 consecutive patients of pityriasis versicolor were evaluated clinically and diagnosis was confirmed mycologically at a tertiary care hospital in Kolkata. All data were recorded in a predesigned, pretested semi-structured schedule. The total duration of study period was 12 months. Results: Majority of the patients were young adults. Most of the patients were asymptomatic. There is prominent seasonal variation of the patients with a peak in August and September months. Most of the lesions were hypopigmented scaly macules and were KOH positive. Most commonly involved sites were chest, face and back. Seborrheic dermatitis sometimes coexisted with pityriasis versicolor and a number of patients also had diabetes mellitus and immunosuppressive conditions. Conclusions: Overall, the clinicomycological and epidemiological profile of pityriasis versicolor infection as observed in a tertiary care setting in eastern India does not differ significantly from those observed by previous workers elsewhere.

The role of long-term doxycycline in patients of idiopathic pulmonaryfibrosis: The results of an open prospective trial

Objective: To evaluate the effect of long term use of doxycycline in IPF patients. Materials and Methods: Patients of IPF, selected randomly from out patient services and diagnosed on the basis of HRCT chest, were put on doxycycline in an open prospective trial. They were followed up with monitoring of subjective well being along with measurement of pulse rate and arterial oxygen saturation at rest and after a fixed and certain exercise, forced vital capacity, six minutes walk test, St Georges Respiratory questionnaire, and serial chest X-rays. Results: Out of seven patients put on doxycycline, six of them continued the drug for a mean period of 531.43 (± 328.88 days). All the patients tolerated the drug well and had shown uniform subjective and overall objective improvement in all the parameters concerned; the change in the radiological parameter being statistically significant. Conclusion: Doxycycline merits an appropriate clinical trial in the management of idiopathic pulmonary fibrosis. This widely used and relatively safe drug can add a new dimension to the therapeutic regimen. However, further in-depth studies will be required to evaluate its role in the management of IPF.

Mucocutaneous and demographic features of systemic sclerosis: A profile of 46 patients from Eastern India

Background: Systemic sclerosis (SSc) is a multisystem connective tissue disorder of uncertain etiology. The clinical picture is frequently dominated by prominent cutaneous manifestations that have diagnostic and prognostic significance. The objective of the present study was to find out the demographic profile and the relative frequencies and characteristics of different mucocutaneous features of SSc in a group of patients from eastern India. In addition, we sought to compare the frequency and pattern of the findings in the limited versus the diffuse variety of the disease. Materials and Methods: This was a cross-sectional, clinical observational study. Consecutive patients of SSc attending the dermatology O.P.D. of a tertiary care hospital of eastern India over 3 years were enrolled to the present study. Results: A total of 46 patients (41 females and 5 males; mean age 29.6±12.3 years) of SSc were evaluated. Among mucocutaneous manifestations Raynauds phenomenon was present in 39 (84.8%) patients. Other cutaneous features included dyspigmentation (40, 86.9%), sclerodactyly (38, 82.6%), inability to open the mouth (38,82.6%), mat-like telangiectasia (11,23.1%), fingertip ulceration and scarring (29,63%), cutaneous calcinosis (1,2.2%), digital gangrene in (2,4.3%), generalized pruritus (4,8.7%), cutaneous small vessel vasculitis (2,4.3%), chronic urticaria (2,4.3%), flexion contractures of the fingers (13,28.3%), and amputation of the digits (3,6.5%). Mucosal changes were observed in 10 (21.7%) patients and nail changes were seen in 13 (28.2%) patients. Diffuse cutaneous SSc was noted in 27 (58.7%) patients and limited cutaneous SSc was seen in the remainder. Thirty-six (78.2%) patients tested positive for ANA. Conclusion: The present study provides a snapshot of the spectrum of the demographic and mucocutaneous manifestations of SSc in the eastern Indian population. We have not observed any statistically significant differences between dcSSc and lcSSc in terms of mucocutaneous manifestations in the studied population.

Ocular morbidity among children at a tertiary eye care hospital in Kolkata, West Bengal.

Eye diseases in childhood are important causes of medical consultation and it affects learning ability, adjustment in school and personality. To determine the pattern of ocular morbidity a cross-sectional observational study was conducted among 714 children, attending Ophthalmology department at a tertiary eye care center in Kolkata, West Bengal. All the children less than 15 years of age, attending in Unit II outpatient department were selected by complete enumeration method for duration of one year (January-December 2010). Distribution of association was analyzed by Chi-square test and difference between two proportions was calculated by z test for proportions. The common ocular morbidity were refractive errors (23.67%) followed by allergic conjunctivitis (17.23%), infection of the eye and adnexa (15.13%), ocular trauma (12.74%), and congenital eye diseases (13.59%). Majority of ocular morbidity is treatable and need early attention through eye screening cum intervention program beginning right from the childhood.

Morbidity pattern of low-birth-weight infants in an urban slum of Kolkata, India

BACKGROUND Low birth weight (birth weight<2500 g) is one of the major determinants of neonatal morbidity as well as mortality and these are known to be significantly higher in these infants. OBJECTIVE To study the morbidity pattern of low-birth-weight (LBW) infants in an urban slum in Kolkata, India. MATERIALS AND METHODS A follow-up community-based study was undertaken in 2004-2005 in an urban slum of Chetla (Kolkata, West Bengal, India), among 126 singleton live-born babies, who were followed up for 9 months at 15±5 days interval by home visits. RESULTS Incidence of LBW was 28.6%. Morbidity episodes and hospitalization rate were more in LBW than in normal-birth-weight infants. Overall, gastrointestinal infection and acute respiratory infection were predominant in both LBW and normal-birth-weight babies. CONCLUSION AND RECOMMENDATIONS Although morbidity episodes as well as hospitalization rate were lower compared with other studied slums of India, there is still room for further improvement of health status of these babies. Adequate care, exclusive breast-feeding, and proper nutrition of the LBW infants must be ensured to have healthy lifestyle free from morbidity.

Awareness and perception of mothers about functioning and different services of ICDS in two districts of West Bengal

Integrated Child Development Services, a national programme of the Government of India has health, nutrition, and pre-school education components of services. To ascertain awareness, perception of mothers about functioning and different services of ICDS a cross-sectional community based study was conducted between June to September 2007 in Howrah and Purulia districts of West Bengal. A total of 1235 mothers were included as study subjects. As per opinion of the mothers 73% AWCs opened regularly, behaviour of the AWWs was friendly (71.6%) and 63% mothers opined that ICDS is beneficial to their children. 84.2% mothers were aware of any ICDS services. Quantity and quality of supplementary food was acceptable to 88% and 72.7% mothers respectively. 79.2% and 87.5% mothers did not receive any advice on child feeding and growth chart. Making beneficiaries aware about services by targeted interventions will ensure better utilization of ICDS.

Goitre prevalence, urinary iodine and salt iodisation level in a district of West Bengal, India.

Objectives: We carried out a study to assess the prevalence of goitre, measure urinary iodine excretion (UIE) levels and to estimate salt iodine content at the household level in Howrah district of West Bengal, India. Methods: Study Design: This is a Cross-sectional descriptive study conducted in September–December 2006. Setting: Primary schools located in 30 clusters (villages and wards) randomly selected through <5001>30 cluster<5002> sampling methodology. Participants: 2400 school children, aged 8–10 years. Indicators: The indicators used in this study to assess for IDD were recommended by the WHO/UNICEF/ICCIDD. Goitre was assessed clinically by the standard palpation technique. The urinary iodine excretion level was analyzed by the wet digestion method. Salt samples consumed at the household level were collected and tested by the spot iodine testing kit to measure iodine content. Results: The Total Goitre Rate (TGR) was 13.7% (95% CI = 12.3–15.1%). Grade 1 was 11.4% and Grade 2 (visible goitre) was 2.3%. The TGR was influenced by the age and sex factors but not by religion and residence. The median urinary iodine excretion level was 13 μg/dL (normal range: 10–20 μg/dL) and none had a value less than 5 μg/dL. There was significant negative correlation between UIE levels and the age and place of residence factors. Almost 80% of salt samples tested had adequate iodine content (≥ 15 ppm). Consumption of iodized salts was lower among Hindus and in rural area. Conclusion: In conclusion, the Howrah district is in a transition phase from iodine deficiency to iodine sufficiency.

Research submission: Some technicalities and vital links

Publishing allows the author to share with the world his original findings, reasoning, important breakthroughs and it also creates the avenue for mandates of promotion and career upliftment. In an endeavour to publish an article, the first vital technicality that the authors face is selection of an appropriate journal. There has been steady increase in the number of predatory publishers and journals. Knowledge of the different publication models, websites to check valid open access journals and reliance on certain reputable publishing houses may actually guide the authors in selecting legitimate journals. Open Researcher and Contributor ID (ORCID ID) or Researcher ID is required during submission of articles. ResearchGate, Mendeley or Scholar Universe are useful sites to collaborate and disseminate research publication in an effective manner. Search Engine Optimization (SEO) is another vital technicality that needs to be adopted by the authors before submission of the research work for publication to ensure higher visibility of the published research article in the academic community and increase citations. Thorough understanding of the publication process, following simple technicalities of manuscript submission and establishing vital links in the post publication phase is some of the useful guidelines for shaping up the success story of the research.