Soumyadeep Bhaumik

Diagnosis and management of preeclampsia in community settings in low and middle-income countries

Hypertensive disorders of pregnancy contribute significantly to maternal mortality and morbidity. Preeclampsia belongs to the spectrum of hypertensive disorders of pregnancy and if undiagnosed and/or untreated leads to fatal consequences for both the mother and the baby. Early detection and prevention of preeclampsia is limited by uncertainty in the knowledge about its etiopathogenesis. While much work has been done in establishing clinical guidelines for management of preeclampsia in the hospital or tertiary care settings, there is considerable lack of work in the domain of evidence-based guidelines for screening, identification and management of preeclampsia at the community-level. The article reviews these issues with special considerations and to challenges faced in low and middle-income countries. There is a need to focus on low-cost screening and interventions in the community to achieve a significant impact on preventable maternal and fetal mortality in order to control the burden of preeclampsia significantly as well as investing on more research at primary care level to improve the evidence base for community-level interventions.

Identifying gaps in research prioritization: The global burden of neglected tropical diseases as reflected in the Cochrane database of systematic reviews.

Background: Neglected tropical diseases (NTDs) impact disadvantaged populations in resource-scarce settings. Availability of synthesized evidence is paramount to end this disparity. The aim of the study was to determine whether NTD systematic reviews or protocols in the Cochrane Database of Systematic Reviews (CDSR) reflect disease burden. Methods: Two authors independently searched the CDSR for reviews/protocols regarding the NTDs diseases. Each review or protocol was classified to a single NTD category. Any discrepancy was solved by consensus with third author. NTD systematic review or protocol from CDSR were matched with disability-adjusted life year (DALY) metrics from the Global Burden of Disease 2010 Study. Spearmans rank correlation coefficient and associated P values were used to assess for correlation between the number of systematic reviews and protocols and the %2010 DALY associated with each NTD. Results: Overall, there was poor correlation between CDSR representation and DALYs. Yellow fever, echinococcus, onchocerciasis, and schistosomiasis representation was well-aligned with DALY. Leprosy, trachoma, dengue, leishmaniasis, and Chagas disease representation was greater, while cysticercosis, human African trypanosomiasis, ascariasis, lymphatic filariasis, and hookworm representation was lower than DALY. Three of the 18 NTDs had reviews/protocols of diagnostic test accuracy. Conclusions: Our results indicate the need for increased prioritization of systematic reviews on NTDs, particularly diagnostic test accuracy reviews.

Polio eradication: Current status and challenges

For more than two decades mankind has been dreaming of a “polio-free world.” However the dream is yet to be realized owing to various problems related to transmission of wild polio virus transmission as well as vaccine-derived polio virus. These problems are as much scientific as human. The article briefly discusses the current status of polio control across the globe, and various challenges associated with it in a nation-wise manner.

Are interventions to reduce sitting at workplace effective

CLINICAL SCENARIO It is common for family physicians in developing nations like India to encounter patients whose profession demands sedentary lifestyle. Such patients present with back problems, obesity, cardiovascular diseases and diabetes and ask doctors for advice on how to decrease sitting. Workplaces need to address this issue by inculcating strategies to decrease sitting and improve health of their employees. Occupational physicians too need to suggest evidence-based strategies to employers. This article provides an evidence based summary about what interventions are actually effective for decreasing sitting at workplace.

Impact of entertainment media smoking on adolescent smoking behaviours

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the influence and impact of exposure to tobacco use in entertainment media among non-smoking adolescents (13 to 18 years).

Misplaced priorities in the Union Health Budget 2015.

The Union Budget presented on 28 February 2015 in the Indian parliament has allocated only INR 33,000 crores for health. It allocates more funds for building newer tertiary care hospitals and increases income tax exemptions for buying health insurance. The article explains that model that is being followed, as indicated by these measures, will create havoc to the lives of Indians and make them sicker and healthcare costlier. The budget is not in line with the actual priorities of Indias health system and nor paves the road map for Universal Health Coverage. The Government of India needs to gets its priorities right.

Is intermittent short-course anti-TB regimen as efficient and safe as daily anti-TB regimen for treating childhood TB?

Childhood tuberculosis (TB) is a common clinical condition in low- and middle-income nations like India where TB is endemic. Different guidelines vary in the recommendations on treatment regimes for childhood TB. Apart from clinical outcomes the decision to use one regimen over another also has an implication in the form of health system burden. The evidence summary presents the comparison between the intermittent regimens with the daily anti-TB regimen for childhood TB.

Health and beyond…strategies for a better India: using the "prison window" to reach disadvantaged groups in primary care.

As of 2013, the latest statistics available, more than 400,000 individuals are lodged in Indian prisons. Prisoners represent a heterogeneous population, belonging to socially diverse and economically disadvantaged sections of society with limited knowledge about health and healthy lifestyles. There is considerable evidence to show that prisoners in India have an increased risk of mental disorders including self-harm and are highly susceptible to various communicable diseases. Coupled together with abysmal living conditions and poor quality of medical services, health in prisons is a matter of immense human rights concern. However, the concept and the subsequent need to view prison health as an essential part of public health and as a strategic investment to reach persons and communities out of the primary health system ambit is poorly recognized in India. This article discusses the current status of prison healthcare in India and explores various potential opportunities the “prison window” provides. It also briefly deliberates on the various systematic barriers in the Indian prison health system and how these might be overcome to make primary healthcare truly available for all.

Representation of women as editors in the Cochrane collaboration.

There is considerable gender disparity in editorial boards of medical journals. Being an editor in a Cochrane review group (CRG), like being an editor in a medical journal, is an indirect representation of ones reputation and leadership abilities in a particular specialty. The aim of the study was to analyze the representation of women editors on the editorial teams of CRGs and the Central Editorial Unit (CEU) of the Cochrane Collaboration.