Samir Dasgupta

Domestic violence among ever married women of reproductive age group in a slum area of Kolkata

BACKGROUND Domestic violence has serious impact on womens health and well-being. A nationwide survey conducted in India observed that 37.2% of women experienced violence after marriage. OBJECTIVES To assess the prevalence of domestic violence among the ever married women in reproductive age group and to find out the types of domestic violence and factors associated with it. MATERIALS AND METHODS The study was a community based cross-sectional study, conducted in a slum area of Kolkata. RESULTS AND CONCLUSION Overall prevalence of domestic violence was 54%, of which 41.9% suffered from both current and lifetime physical and psychological violence. Presence of property, higher per capita income and social support were protective factors against domestic violence, whereas alcohol addiction and multiple sex partners were the important contributory factors for it. The study recommended more social support, awareness and income generation for women in the slum areas.

Gender preference and awareness regarding sex determination among antenatal mothers attending a medical college of eastern India

Aim: There are many women “missing” due to an unfavourable sex ratio in India,, which has strong patriarchal norms and a preference for sons. Female gender discrimination has been reported in health care, nutrition, education, and resource allocation due to man-made norms, religious beliefs, and recently by ultrasonography resulting in lowered sex ratio. Methods: The present study attempts to find out the level of awareness regarding sex determination and to explore preference of gender and factors associated among antenatal mothers attending a medical college in eastern India. Interviews were done by predesigned pretested proforma over 6 months. The data were analysed by SPSS 16.0 software for proportions with chi-squared tests and binary logistic regression analysis. Results: Most women who were multigravida did not know about contraceptives; 1.8% of mothers knew the sex of the fetus in present pregnancy while another 34.7% expressed willingness; 13.6% knew of a place which could tell sex of the fetus beforehand; 55.6% expressed their preference of sex of the baby for present pregnancy while 50.6% of their husbands had gender preference. Gender preference was significantly high in subjects with: lower socioeconomic status (p=0.011); lower level of education of mother (p=0.047) and husband (p=0.0001); multigravida (p=0.002); presence of living children (p=0.0001); and husband having preference of sex of baby (p=0.0001). Conclusions: Parental education, socioeconomic background, and number of living issues were the main predictors for gender preference. Awareness regarding gender preference and related law and parental counselling to avoid gender preference with adoption of small family norm is recommended.

Healthcare-seeking behavior of patients with epileptic seizure disorders attending a tertiary care hospital, Kolkata

Introduction: Neurological diseases are very important causes of prolonged morbidity and disability, leading to profound financial loss. Epilepsy is one of the most important neurological disorders Healthcare seeking by epilepsy patients is quite diverse and unique. Aims and Objectives: The study was conducted among the epilepsy patients, to assess their healthcare-seeking behavior and its determinants. Materials and Methods: Three hundred and fifteen epilepsy patients, selected by systematic random sampling, in the neuromedicine outpatient department of a tertiary care hospital were interviewed with a predesigned, pretested, semi-structured proforma. Results and Conclusion: More than 90% sought healthcare just after the onset of a seizure. The majority opted for allopathic medicine and the causes for not seeking initial care from allopaths were ignorance, faith in another system, constraint of money, and so on. A significant association existed between rural residence and low social status of the patients with initial care seeking from someone other than allopaths. No association was found among sex, type of seizure, educational status of the patients, and care seeking. The mean treatment gap was 2.98 ± 10.49 months and the chief motivators were mostly the family members. Patients for anti epileptic drugs preferred neurologists in urban areas and general practitioners in rural areas. District care model of epilepsy was proposed in the recommendation.

Study comparing the management decisions by IMNCI algorithm and pediatricians in a teaching hospital for the young infants between 0 to 2 months.

Integrated management of neonatal and childhood illness (IMNCI) was already operational in many states of India, but there were very few studies in Indian scenario comparing its validity and reliability with the decisions of pediatricians. The general objective of the study is to compare the IMNCI decisions with the decisions of pediatricians and the specific objectives are to assess the agreement between IMNCI decisions and the decisions of pediatricians, to assess the under diagnosis and over diagnosis in IMNCI algorithm in comparison to the decisions of pediatricians and to assess the significance of multiple presenting symptoms in IMNCI algorithm. The study was conducted among the sick young infants presenting in pediatric department from January to March 2009. The IMNCI decision was compared with pediatricians decisions by percent agreement, Kappa and weighted Kappa with the aids of SPSS version 10. The overall diagnostic agreement between IMNCI algorithm and pediatricians decisions was 55.56%, (Kappa 0.32 and weighted Kappa 0.41) with 33.33% over diagnosis, and 11.11% under diagnosis. 71.88% young infants with multiple symptoms and 40% with single symptom were classified as red by IMNCI algorithm, which is statistically significant (P=0.004) whereas 56.25% young infants with multiple and 31.76% with single symptom were considered admissible by pediatricians, which is not statistically significant (P=0.052).

A comparative study of the management decisions by IMNCI algorithm and by pediatricians of a teaching hospital for the children between 2 months to 5 years

Background: Integrated management of neonatal and childhood illness (IMNCI) is already operational in many states of India, but there are very few studies in Indian scenario comparing its validity and reliability with the pediatricians’ decisions. Objectives: 1) To compare the IMNCI decision with the decision of pediatricians; 2) to assess the significance of multiple presenting symptoms in the IMNCI algorithm. Materials and Methods: The study was conducted among the sick children between 2 months to 5 years presented in pediatric department from January to March 2009. The IMNCI decision was compared with pediatricians decisions by percent agreement, Kappa and weighted Kappa with the aids of SPSS version 10. Results: The overall diagnostic agreement between IMNCI algorithm and pediatricians decisions was 36.64%, (Kappa 0.16 and weighted Kappa 0.29) with 51.15% over diagnosis and 12.21% under diagnosis. The importance given by IMNCI algorithm in cases of multiple presenting symptoms was also reflected as it was evident that 37.50% children presented with three symptoms were categorized as red, whereas it was 28.57% and 11.67% for those presented with two and one symptom, respectively, (P < 0.0001). Pediatricians also gave importance for presence of multiple symptoms by considering 50% as admissible in the group presented with three symptoms, 30.16% in the group presented with two symptoms, and 16.67% in the group presented with only one symptom. The association was also statistically significant (P = 0.018). Conclusion: Diagnostic discordance is seen mainly due to over diagnosis of all fever cases as malaria. Importance of presence of comorbidities was also reflected.

Monitoring of mass measles campaign in AILA-affected areas of West Bengal.

A mass measles campaign was organized in AILA-affected areas of West Bengal in July-August 2009. The present cross-sectional study was conducted with the objectives to monitor and assess the cold chain maintenance, safe injection practices, IEC methods adopted, and to observe the conduction of the sessions in the campaign. All the cold chain points at the block level had adequate vaccines and equipments, twice monitoring of temperature which was in optimal range. 82% sessions had team according to microplan, AWW was present and team members were actively mobilizing the children in 83% sessions, puncture proof container was used and vaccines were given in correct sites in more than 95% sessions. The study observed satisfactory conduction of the whole campaign, still the injection safety procedures should be strengthened considering the potential harm to the health care providers.

Suspected anthrax outbreak: Investigation in a rural block of west Bengal and public health response

Anthrax is one of the top 10 diseases reported in India and also one of the major causes of death in livestock. This study was conducted to confirm the outbreak of suspected anthrax, determine the transmission mechanism, and implement control measures in Bhatar block of Burdwan district, West Bengal, India. A cross-sectional descriptive study was conducted through house-to-house visits in Oregram and Kathaldanga villages during the period from May 30, 2013 to June 8, 2013. Out of the 93 persons exposed to anthrax, 11 persons had history of slaughtering, while 82 consumed the meat. All of the 7 cases of suspected anthrax were male (mean age 41.14 ± 10.04 years) and involved in slaughtering the animal. Most cases presented with papule and vesicle over the upper extremity and the trunk. One patient among the suspected cases died. The outbreak was labeled as a suspected anthrax outbreak. A health awareness camp was organized to improve awareness of anthrax among villagers.

Assessment of validity and reliability of IMNCI algorithm in comparison to provisional diagnosis of senior pediatricians in a tertiary hospital of Kolkata

Background: Integrated management of childhood illness (IMNCI) is already operational in many states of India, but there are only limited studies in Indian scenario comparing its validity and reliability with the decisions of pediatricians. Aims and Objectives: To assess the validity and reliability of the IMNCI algorithm with provisional diagnosis of senior pediatricians for each IMNCI classifications. Materials and Methods: The present study is done with all the young infants between 0-2 months presented during the study period with a fresh episode of illness to test the validity and reliability of the algorithm in comparison to provisional diagnoses of senior pediatricians. The study was done in a tertiary care hospital. Validity characteristics such as sensitivity, specificity, positive predictive value, negative predictive value, and reliability characteristics such as percent agreement and Kappa were assessed for individual IMNCI classifications. Results: The sensitivity of possible serious bacterial infection, local bacterial infection, jaundice, no dehydration and possible serious bacterial infection, not able to feed were 88.89, 14.29, 66.67, 25 and 44.44% respectively. The specificities for the same conditions were 71.72, 99.09, 99.07, 94.50 and 86.87%. Percent agreements for similar conditions were 74, 94, 97, 90 and 80% respectively and the Kappa ratios were 0.38, 0.20, 0.73, 0.19 and 0.29 respectively. Conclusion: It could be concluded that IMNCI is quite a sensitive strategy and could identify severe illnesses of young infants requiring referral to higher facility. Further studies, particularly in primary health care setting, are required.

A study on mental distress among MBBS students in a Medical College, Kolkata, India

Background: The undergraduate medical training period is a stressful period. In the recent years, due to growing competitiveness and aspiration for achievement the pressure on the students has increased manyfolds and makes the medical students more vulnerable for developing mental distress and thus contributes to poor academic performance and substance use. So an observational, cross-sectional study was conducted among the undergraduate students in a medical college to study the prevalence of mental distress among the undergraduate students of Medical College, Kolkata, India and to find out the correlation between mental distress and explanatory variables among the study population. Materials and Methods: It was a cross-sectional, observational study among the undergraduate students in a medical college, Kolkata, India and used SRQ-20 for the assessment of mental distress. Result: The prevalence of mental distress was 14.5%. Present occupancy, parents occupation, attempt in MBBS entrance examination, students who could not cope with the situation, socioeconomic status, and place of residence were found as risk factors of mental distress. A total of 78% of the explanatory variables could be explained by binary logistic regression analysis. Conclusion: Considering these risk factors, preventive measures should be undertaken to reduce the mental distress and its consequences.

Utilization of safe drinking water and sanitary facilities in slum households of Siliguri, West Bengal

Background: With the rapid expansion of urban population, provision of safe water and basic sanitation is becoming a challenge; especially in slums. This is adversely affecting the health of the people living in such areas. Objectives: The study was conducted to measure the proportion of households using improved drinking water and sanitation facilities and to determine the association between diarrhea in under-five children with water and sanitation facilities. Methods: A community-based, cross-sectional study was conducted among 796 slum households in Siliguri from January to March 2016 by interviewing one member from each household using a predesigned and pretested questionnaire based on the WHO/UNICEF Joint Monitoring Program Core questions on drinking water and sanitation for household surveys. Results: A majority 733 (92.1%) of slum households used an improved drinking water source; 565 (71%) used public tap. About two-thirds (65.7%) household used improved sanitation facilities. About 15.8% households had reported diarrheal events in children in the previous month. Unimproved drinking water sources (AOR = 4.13; 1.91, 8.96), houses without piped water supply (AOR = 4.43; 1.31, 15.00), and latrines located outside houses (AOR = 3.61; 1.44, 9.07) were significantly associated with the diarrheal events in children. Conclusion: The utilization of improved drinking water source was high but piped water connection and improved sanitary toilet used was low. Association between diarrheal events and type of drinking water sources and place of sanitation might suggest fecal contamination of water sources. Awareness generation through family-centered educational programs could improve the situation.