Mausumi Basu

Assessment of future physicians on biomedical waste management in a tertiary care hospital of West Bengal.

Background: One-fourths of the biomedical waste (BMW) is regarded as hazardous with the potential for significant health concern for both medical personnel and general community. So, awareness about various aspects of BMW management is required and it was assessed among junior doctors in a tertiary care hospital. Objectives: To assess the knowledge and awareness about various aspects of BMW management among junior doctors (future physicians) and thus help the authority to develop the strategy for improving the situation in future. Materials and methods: In this descriptive observational study, we interviewed 200 junior doctors of a tertiary care hospital of Kolkata using a pre-designed pre-tested self-administered, semi-structured, anonymous questionnaire. Results: Majority of the participants were in the age group of 22 to 24 years (62%), males (66.5%), hostelites (70.2%), belonged to nuclear family (80.1%), and had per capita monthly family income in the range of Rs 5 000 to 20 000 (61.4%). Almost all respondents (99.1%) heard about BMW, 94.4% heard about the BMW rule 1998, and 67.9% knew about the Bio Hazard symbol. Only 55.9% respondents could remember the ten category of BMW. Segregation at source (the golden rule of BMW) was known by 78.8% of the junior doctors, only 29.5% had the knowledge of various methods of final disposal of BMW. Though 98.8% of the study population was aware that improper management of BMW causes different health problems, only 76.4% knew about various types of color-coded bags for collection of BMW. All the junior doctors were trained in all these essential aspects of BMW in their undergraduate curriculum. Conclusion: Still, intensive training program and monitoring at regular time interval is needed for all staff, with special emphasis on junior doctors.

Role of family and peers in the initiation and continuation of smoking behavior of future physicians

Background: Globally researchers have long back noted that the trend of substance use was on the rise particularly in the student population. Objective: To find out the prevalence and determinants of smoking practices among undergraduate medical students. Materials and Methods: A cross-sectional study was conducted among undergraduate medical (MBBS) students of a tertiary care medical college using a predesigned and pretested semi-structured self-administered anonymous questionnaire. Results: Among 182 participants, 55 (30%) were smokers; 85.45% were regular smokers; majority in the age group 20-22 years (70%); mostly males (98%). No significant difference was observed among urban and rural students, and religion had no association. The practice of smoking for last 6 months to 1 year was in 43.6% and 40% smoked less than 6 months. Half of them (50.9%) smoked 5-9 cigarettes per day. Peer pressure was significantly high in smokers (83.6%); 42% had other addictions. The effect of parental smoking on smoking habits of the participants was quite evident among smokers (82%), which was significantly higher than nonsmokers (χ2 = 63.49, P < 0.05). Peer pressure was the most important risk factor (57.69%) of initiation of smoking habit followed by parental influence (16.49%). Among morbidities of smokers, 60.6% were suffering from regular cough, 6% from bronchitis, and 2% had asthma. Conclusions: Our survey conducted on budding doctors surprisingly showed that undergraduate medical students smoke so much.

Prevalence and determinants of diabetes mellitus in Puducherry, South India

Background: Diabetes mellitus is an emerging global health problem. It is a chronic, noncommunicable, and expensive public health disease. Aims and Objectives: To determine the prevalence and the risk factors of type 2 diabetes mellitus among the adult population of Puducherry, South India. Materials and Methods: This was a population-based cross-sectional study carried out during 1st May 2007–30th November 2007 in the rural and urban field practice area of Mahatma Gandhi Medical College and Research Institute, Puducherry. Simple random sampling technique was used for the selection of 1370 adult 20 years of age and above. Main outcome measures were the assessment of the prevalence of prevalence and correlates of diabetes among the adult population. Predesigned and pretested questionnaire was used to elicit the information on family and individual sociodemographic variables. Height, weight, waist, and hip circumference, blood pressure was measured and venous blood was also collected to measure fasting blood glucose, blood cholesterol. Results: Overall, 8.47% study subjects were diagnosed as diabetic. The univariate analysis and multivariate logistic regression analysis showed that the important correlates of diabetes mellitus were age, blood cholesterol, and family history of diabetes. The findings were found to be statistically significant. Conclusions: In our study we observed that adults having increased age, hypercholesterolemia, and family history of diabetes mellitus are more likely to develop diabetes mellitus.

Perception of tuberculosis among general patients of tertiary care hospitals of Bengal.

Introduction: Tuberculosis is a public health problem in India. The patients of Tuberculosis hide their disease from family, relatives, and community due to the presence of stigma. This study was conducted to assess the knowledge, awareness, and perception regarding social variables of tuberculosis among patients and to associate the awareness with their literacy status. Materials and Methods: Type of study was observational, descriptive, and epidemiological. Study design was cross-sectional. Study setting was general out-patient department of tertiary care hospitals of West Bengal. Sample size was 464 (Four hundred sixty four) patients. The collected data were tabulated, analyzed, and interpreted by proper statistical methods (by percentage and Z test). Results: 60.34% of study population was male. More than one third was illiterate (37.93%). Majority (91.38%) had heard about tuberculosis (TB). Correct answer on cause (infection) was responded by 16.81% patients. About 72.41% had heard about TB from an informal contact. The correct response on mode of spread of TB was told by 31.47% patients. About 62.07% correctly answered that cough was the commonest symptom. 82.76% knew about curability of the disease. Isolation of patient (08.62%) and avoidance of sharing of food (06.03%) were reported as preventive measures. The literacy status had a significant influence on awareness about TB. Conclusion: An attempt could be made in future to improve awareness among illiterates to remove myths and misconceptions, to allay the social stigma attached with it, to decrease TB transmission.

Spectrum of visual impairment among urban female school students of Surat.

Aim: Eye morbidities with or without symptoms delineate a significant morbidity among adolescent schoolgirls in India. The study was undertaken to assess the extent of visual impairment and ocular morbidity to identify influencing factors and the impact on scholastic performance. Materials and Methods: A population-based cross-sectional study was undertaken among 3002 urban girl students of Surat in Gujarat, India. Overall prevalence of refractive error was found to be 15.22%; myopia affected 91.47%, hyperopia 4.60%, and astigmatism 0.04%. The prevalence of myopia and astigmatism was more in higher age groups, while hyperopia was more in lower age groups; even students with good vision reported ophthalmic symptoms. Of all spectacle users, in 29.73% cases the eyesight was not found to be with the best possible corrections. Refractive error was observed to be higher among the general caste (50.98%) and among Muslims (54.05%). Still, among those with problems of eyesight, 75.93% students had good academic performance. Associated ocular morbidity was noted in 20.35% participants along with the refractive error. Conclusion: This study highlighted the load of eye morbidities of adolescent Indian urban girls.

Sociodemographic variables of contraceptive practice in Sikkim

Objectives: The objective was to assess sociodemographic characteristics of men who use contraceptive and to compare them with men whose wives use contraceptive. Materials and Methods: Study design: A population-based cross-sectional study was performed. Study setting: It was performed in rural setting of the Sang PHC and Pakyong PHC service areas in Sikkim, India. Study participants: A total of 596 currently married men enrolled in the eligible couple registers. Interventions: No interventions occurred. Measurements: Sociodemographic correlates of contraceptive use were analyzed: occupation, religion, ethnicity, literacy, age, loss of children, and distance from health facility. Results: The use of contraceptive was high among the cultivators - men (44.45%), spouse (36.01%) followed by persons in Government service, respectively, 31.49% and 31.55%. Hindu men (55.42%), women (69.25%), and other backward communities (OBC) men (47.53%) and their wives (52.31%) were the majority users. A significantly higher number of users of contraceptive were literate men (72.33%) and their wives (86.17%) (χ2=0.021, P> 0.05). Highest use was found in men and women (44.47%) in the 35 years and above (43.83) age group. But this difference was not significant. With the increase in the number of losses of children the contraceptive use declined among men and their spouses. Contraceptive users were higher at distances 1 hour and above from the health center compared to others. Conclusions: The finding of the research indicated that sociodemographic correlates determine the magnitude of the contraceptive use among couples in a rural community. A research agenda should define factors at both macro and micro levels that interact to adversely impinge on reproductive health outcomes.

Nutritional status and morbidity profile of school-going adolescents in a district of West Bengal

Background: In India, adolescent age group (10-19 years) constitutes 21.4% of the total population. The health and nutritional status of the adolescents is an index of its future manpower. It is well recognized worldwide that anthropometric measurements are indispensable in diagnosing undernutrition. Objective: To assess the nutritional status and morbidity pattern among school-going adolescents. Materials and Methods: A descriptive cross-sectional study was carried out in three randomly selected co-educational schools of Burdwan District of West Bengal in May 2013 among 424 adolescents in the age group of 10-19 years from class V to class XI (except class X), using a predesigned pretested proforma. Results: The prevalence of underweight and stunting were 53.31% and 47.41%, respectively, which was significantly higher in early adolescence than in late adolescence and more in boys than in girls. About 55.18% had pallor, 40.33% had dental caries, 33.49% were suffering from refractive errors, 23.11% had history of worm infestation, 38.90% had skin problems, and 68.61% adolescents had ENT problems. Conclusion: The health and nutritional status among the school-going adolescents was found to be poor.

The pattern of needle stick injury among health care workers at West Bengal

Introduction: Health care workers (HCWs) are at increased risk of infection with blood-borne pathogens; because of occupational exposure. Objectives: The objective of the following study is to assess the occurrence of needle stick injury (NSI) among HCWs, various factors responsible for NSI, the circumstances under which they occur and explored the responses of the HCWs after an injury. Materials and Methods: A descriptive hospital based observational epidemiological study, cross-sectional in design was conducted in indoor and Out-patient Departments of Surgery, Medicine and Gynaecology and Obstetrics of Burdwan Medical College and Hospital from June 2012 to August 2012 using a pre-designed pre-tested semi-structured self-administered anonymous questionnaire among senior residents, junior residents, house-staffs, internees, nursing staff and nursing students and laboratory technicians. Results: 132 (53.0%) reported NSI in the preceding 1 year in the health care facility. Nurses and nursing students had the highest percentage (42.4%). Only 40.2% HCWs were wearing gloves at the time of NSI. Recapping of needles was the most common cause implicated in causing NSI. 49.2% HCWs took action instantly after an NSI. Conclusion: Occurrence of NSI among the HCWs in West Bengal was high. Information, education and communication materials should be displayed prominently at the places of work.

Clinico-pathological correlates of incidentally revealed thyroid swelling in Bihar, India.

Background: Global prevalence of thyroid cancer has been on the rise in recent decades. Objectives: To study the clinical presentations to reach an agreement for diagnosis and optimal management of incidentally revealed thyroid swellings for early diagnosis. Materials and Methods: A prospective study was carried out on 178 cases of incidentally detected thyroid swelling attending a tertiary care teaching institute of Kishanganj Bihar. All the cases were subjected to a thorough clinical examination followed by evidence-based interventions. Fine needle aspiration cytology was done in all the cases preoperatively as out-patients basis and histopathologically confirmed postoperatively. Results: The highest incidence of thyroid swelling (75.84%) was found in the age group of 20-40 years; a female preponderance was noted in the ratio 4:1. The duration of swelling ranged from six months to three years. Difficulty in swallowing and breathing was complained by 23 (12.9%) and 18 (10.1%) of the patients respectively. Typically the swellings were located in the right lobe. Commonly the subjects in our study were in euthyroid state (90%) and were with firm swellings (66.7%). Follicular and anaplastic carcinoma was important postoperative cytological findings. Majority of surgical intervention was hemithyroidectomy (55.06%). Conclusion: Incidentally revealed thyroid swelling was quite high in eastern India for which we need a consensus line of intervention.

Prevalence and determinants of delay in diagnosis of pulmonary tuberculosis in Darjeeling district of West Bengal

Background: Delayed diagnosis of tuberculosis (TB) is a significant problem both in individual as well as community level. Different studies around globe revealed that these diagnostic delays are attributed to both patient delay and health system-related delay. Aims: This study aims to assess the magnitude of delay in diagnosis and the association with sociodemographic profile among new sputum-positive pulmonary TB patients in Darjeeling district. Materials and Methods: A cross-sectional study was conducted among 374 TB patients from October 2011 to March 2012 using a predesigned pretested schedule by face-to-face interview. Statistical Analysis: Logistic regression analysis, odds ratios (OR), adjusted ORs. Results: Patient delay, health system delay and total diagnostic delay were 27 days, 20.1 days, and 20.6 days; mean delays were 23.64, 5.71, and 29.46 days, and median delays were 25, 5, and 32 days, respectively. Risk factors associated with patient delay were female gender, rural residence, illiteracy, smoking, alcohol consumption, taking two, or more alternate treatments; for health system delay were female sex, rural residence, time to reach health facility, time spent per visit; and for total diagnostic delay were female sex, alcoholism, and seeking more than two alternate treatment. Conclusions: The risk factors for delay identified may be the subject of future interventions.