Care Hospital In Eastern India Research Articles

A study on knowledge, attitude, and practice about eye donation among medical students and healthcare professionals at a tertiary hospital in Eastern India.

To assess and analyze the rate of knowledge, attitude, and practice patterns about eye donation among medical and healthcare professionals in a tertiary care hospital in eastern India. This was a cross-sectional, descriptive study conducted on medical students, resident doctors, and nursing and paramedical staff at a tertiary institute in the year 2020. A pretested, structured questionnaire consisting of 28 questions in the three subsections based on knowledge and awareness, attitudes and beliefs, and practice patterns mainly willingness to donate eyes by pledging, was noted. All the responses were individually scored, and the total scores were calculated. Univariate analysis was done to find out the factors that had a positive or negative influence on the knowledge and willingness about eye donation. Around 270 participants responded to this survey. The majority of the respondents (206, 76.3%) were below 30 years and 64.4% were males. Awareness about eye donation was 95.6% but a willingness to pledge was observed in 51.5% of participants. The total practice score was lower among nonmedicos compared with medicos (3.33 ± 1.22 vs 3.74 ± 0.64), (P < 0.001). On univariate analysis, the Crude Odds Ratio with a 95% confidence interval was 25.787 (5.18-128.33) in the occupational category (P < 0.001). The study reported an adequate knowledge level among doctors and healthcare workers. The practice pattern among the nursing staff and paramedical workers needs to be improved as they can play a pivotal role in strengthening the hospital corneal retrieval program. They can also be the key messengers during public awareness campaigns for eye donations in our country.

Effect of Tourniquet Deflation on Intracranial Pressure Measured by Ultrasound of the Optic Nerve Sheath Diameter in Patients Undergoing Orthopedic Surgery Under Spinal Anesthesia: An Observational Study.

Background Orthopedic surgeries of the lower extremities frequently require exsanguination and the use of pneumatic tourniquets. However, the deflation of the tourniquet is accompanied by predominant metabolic changes such as an increase in PaCO2. Prior studies have reported the existence of a correlation between tourniquet deflation and an increase in intracranial pressure in patients undergoing surgery under general anesthesia. However, there is a dearth of literature demonstrating such relationships among patients undergoing surgery under subarachnoid block in the Indian setting. The present research was conducted to study the variations in intracranial pressure after the deflation of the tourniquet by measuring the optic nerve sheath diameter (ONSD) using ultrasound among patients undergoing orthopedic surgery of the lower limb under spinal anesthesia at a tertiary care hospital in eastern India. Methodology After obtaining clearance from the Institutional Ethics Committee, this prospective observational study was conducted among 45 patients undergoing orthopedic surgeries of the lower limb using a pneumatic tourniquet. Changes in intracranial pressure following tourniquet deflation were recorded by measuring ONSD by ultrasound in these patients. Heart rate (HR), mean arterial pressure (MAP), SpO2, EtCO2, and ONSD were noted 15 minutes before administration of subarachnoid block (T0), just before tourniquet deflation (T1) and at 5, 10, and 15 minutes after tourniquet deflation (T5, T10, and T15, respectively). Results The ONSD varied significantlyat each point of observation (p < 0.05). The ONSDs at 5 and 10 minutes after the deflation of the tourniquet were significantly greater than that at T0 (p = 0.002). EtCO2 showed a significant increase compared to baseline values at every point of observation intraoperatively whereas MAP showed a significant decrease (p < 0.05).For all parameters (ONSD, HR, systolic blood pressure, diastolic blood pressure, MAP, and EtCO2), the most significant change in observation was noted at T10, i.e., 10 minutes after the deflation of the tourniquet. Conclusions The significant findingin thisstudy was that the ONSD measurements recorded by ultrasound were increased after the deflation of the tourniquet and that this change can be attributed to an increase in EtCO2. However, the results obtained cannot be validated outside the present research owing to the observational nature of the study and limited sample size. Thus, it is difficult to arrive at a definitive conclusion. Further large-scale multicentric studiesmaybe needed to substantiate the findings of thisstudy.

Association of Early Pregnancy Values of Glycosylated Hemoglobin and the Development of Gestational Diabetes Mellitus.

Introduction There is no consensus regarding screening and diagnostic methods for gestational diabetes mellitus (GDM). The present study aimed to evaluate the association between early pregnancy values of glycosylated hemoglobin and the development of gestational diabetes mellitus among pregnant women in a tertiary care hospital in eastern India. Methods The prospective cohort study included 200 pregnant women aged between 18 and 35 years in their first trimester (gestational age eight to 13 weeks) attending the antenatal clinics of the study hospital. A glycatedhemoglobin (HbA1c) test and a 75-g oral glucose tolerance test (OGTT) test were done in all study participants in their first trimester. Pregnant women with HbA1c ≥6.5% and OGTT ≥140 mg/dl were excluded from the study. In other women, the second trimester (24-28 weeks) and the third trimesterOGTT (32-34 weeks) were done to detect gestational diabetes mellitus. Data collection was initiated after the approval of the Information, Education, and Communication (IEC) and relevant authorities. Receiver operating characteristic(ROC) analysis was done to identify the cut-off value of HbA1c that predicted the development of GDM. Results The incidence of GDM was 33% among our study participants. The mean HbA1c was significantly higher among women who had GDM (5.4 ± 0.4%) as compared to those who did not develop GDM (4.9 ± 0.2%) (p<0.001). On ROC analysis of HbA1c values to predict the development of GDM, a cut-off value of HbA1c ≥5.25%, irrespective of risk status, was calculated to have 84.8% sensitivity and 62.7% specificity, and among the high-risk group, HbA1c ≥5.15% had 83.3% sensitivity and 97% specificity in predicting GDM. On stratified analysis, a moderately strong positive correlation was demonstrated between HbA1c values and OGTT in the second trimester in both high-risk and low-risk cohorts (p<0.05). Conclusion Based on the findings of the present study, HbA1c can be proposed to be a suitable biomarker for GDM prediction, probably not independently but rather as a component of a multi-marker approach for high- and low-risk pregnant groups.

A retrospective observational study of injury patterns associated with powered circular saw in subjects presenting to the emergency department of a tertiary care hospital.

Powered circular saw-related injuries (PCSRIs) are responsible for a sizable proportion of occupational injuries presented to the emergency department (ED). The present study portrays the mechanisms, injury patterns, epidemiological parameters, and outcomes among subjects presenting with PCSRI to the ED. This retrospective observational study was conducted in the ED of a tertiary care hospital in eastern India. Clinical records of subjects with PCSRI from June 2019 to June 2022 were reviewed. Data pertaining to patients' demographic profiles and the patterns and mechanisms of injury were retrieved. The Modified Hand Injury Severity Score (MHISS) and the Injury Severity Score (ISS) were calculated. Statistical analysis was performed using R version 4.1.0. A total of 175 subjects' data were analyzed. The median age was 34.5 years, and all subjects were men. The mean year of experience of the subjects was 6.2. The most common job category was carpentry (n = 63 [36%]), followed by "do it yourself work" (n = 26 [14.8%]). One hundred twenty-two (69.7%) subjects had hand injuries (HIs), and the left hand was involved in 85 (69.6%) subjects. The index finger was involved in 36 (29.5%) subjects, followed by the thumb (n = 31 [25.4%]). Laceration (n = 155 [88.5%]) was the most common injury pattern. The subjects' mean ISS and mean MHISS were 8.52 and 45, respectively. PCSRI is associated with moderate-to-severe HIs that are most common in occupational settings. Young male carpenters involved in wood and plywood work are more prone to injuries.

Epidemiology and outcome of acute kidney injury in hospitalized children: experience from a tertiary care hospital in Eastern India

Background: The aim of the study was to assess the etiology, clinical profile and short-term outcome of acute kidney injury in hospitalized children. Methods: A single centre prospective observational study conducted at a tertiary care hospital in eastern India. Consecutive hospitalized children aged between one month to twelve years who developed AKI according to AKIN criteria were included in the study. Relevant clinical and laboratory parameters as guide by clinical condition along with outcome of patients were recorded at the time of discharge and at one month and three months after discharge. Results: 116 hospitalized children who developed AKI were included in the study; 63 (54.3%) participants are above 5 years of age with male to female ratio of the study population was 1.07:1. Infections (46.5%), acute glomerulonephritis (19.8%), snake bite (11.2%) and post-surgery (8.6%) were the common causes of AKI. 43.1% of them had AKIN stage 3. 66.4% had oliguria, 33.6% had shock. 72.4% required admission at Pediatric Intensive Care Unit support, 32.4% required ionotrop support, 44.8% required mechaicanical ventilator support. Around 65% requrired dialysis support; of which 75% recieved hemodialysis and 25% requied peritoneal hemodialysis. Mortality rate was 44%. At discharge, 41.6% (n=27) of the patients had complete renal recovery from AKI. Percentage of partial renal recovery at the time of discharge, 1 month and 3 months after discharge were respectively 53.8%; 47.7% and 10%. 3 patients at the time of discharge and 2 patients after 3 months required persistent dialysis support. Number of factors are associated with poor outcome especially higher acute kidney injury state, critically ill patients and low serum albumin at admission. Conclusions: Infection is the leading cause of acute kidney injury in hospitalized children in this part of world. Mortality in critically ill children with acute kidney injury is high. Various clinical parameters at presentation are associated with poor short term renal outcome.

Molecular Detection of Upper Respiratory Tract Viral Infection with RSV, HPIV &amp; Adenovirus among SARS-CoV2 Negative patients with respiratory illness admitted in tertiary care hospital in Eastern India

Molecular Detection of Upper Respiratory Tract Viral Infection with RSV, HPIV &amp; Adenovirus among SARS-CoV2 Negative patients with respiratory illness admitted in tertiary care hospital in Eastern India

A study on the multidisciplinary diagnostic approach of leprosy: Can we prevent the recrudescence in the post-elimination Indian scenario?

Leprosy also widely known by the name Hansen's disease is a chronic disease caused by Mycobacterium leprae affecting mankind with various clinico-pathological forms. It remained a major public health issue due to associated case load, morbidity and stigma attached to it. India declared elimination of leprosy in the year 2005. However, it is surprising to see that in some parts of the country, the prevalence is still significant. The objective of the study is to describe the spectrum of histopathological profile of leprosy and compare its correlation with clinical diagnosis in this post elimination era. A 24-months prospective study was conducted with clinically diagnosed leprosy cases in a tertiary care hospital in eastern India. Lesions were graded and the histopathological slides along with its bacteriological index (BI) on slit skin smears where possible was reviewed and analyzed. Agreement of histopathological finding with clinical finding was established. A total of 220 cases were included in the study. On histopathology, borderline category was the most frequently reported with borderline tuberculoid the most common subtype. Most common clinical feature was hypopigmented plaque, followed by erythematous skin lesions, nodules, macules etc. Bacteriological index was studied in 192 slit skin smears. Moderate agreement between clinical and histopathological diagnosis with kappa measure of inter-rater agreement as 0.457 was noted. Clinico-histopathological correlation is pivotal in the accurate diagnosis of leprosy to prevent, treat, and control the resurgence of the disease in the post-elimination era.

Efficacy of Interventions Based on WHO Multimodal Hand Hygiene Improvement Strategy in a Tertiary Care Hospital in Eastern India: A Quasi-Experimental Study.

The study aimed to evaluate the efficacy of the World Health Organization (WHO) multimodal hand hygiene improvement (WHO-5) strategy in enhancing hand hygiene compliance among health care workers at a tertiary care hospital. The interrupted time series study included preintervention, intervention, and postintervention phases, with 2 points of observation each during the pre- and postintervention phases. The baseline hand hygiene compliance was 16%, which improved to 43.9% after the intervention. Health care workers were 4 times more likely to adhere to proper hand hygiene postintervention (odds ratio [OR], 4.117). Independent predictors of hand hygiene compliance included the week of observation (week 3: adjusted odds ratio [AOR], 0.872; week 5: AOR, 3.427; and week 7: AOR, 4.713), health care worker type (consultants: AOR, 0.964; residents: AOR, 2.187; and interns: AOR, 6.684), daytime (AOR, 1.232), and "after" type of hand hygiene opportunity (AOR, 1.577). No significant differences were found in knowledge, attitude, and practices pre- and postintervention, and the interventions' effect was sustained and increased over time, supporting implementation in hospitals across India.

An Observational Study of Candida auris Infections with Special Reference to the Clinicomicrobiological Problems Faced in Day-to-Day Practice at a Tertiary Care Hospital in Eastern India

An Observational Study of Candida auris Infections with Special Reference to the Clinicomicrobiological Problems Faced in Day-to-Day Practice at a Tertiary Care Hospital in Eastern India

Trends in Pediatric Malignancy Cases at a Tertiary Care Center in Bihar, India: A Retrospective Study

Background and aim: Pediatric malignancies constitute a significant proportion of cancer cases in India, and yet, there is a dearth of information on the distribution of these cancers in the state of Bihar. To address this knowledge gap, we conducted this study to analyze the pattern of pediatric malignancies. Materials and Methods: This was a cross-sectional observational study conducted in a tertiary care hospital in eastern India. The study was conducted at the Department of Radiotherapy where we enrolled patients between the ages of 0-18 years who were referred to our department. Result: We analyzed the data of 306 patients, of which 22 (7.19%) were diagnosed with benign tumors and 284 with malignancies. Of the 284 patients with malignancies, 208 (73.24%) had solid tumors, and 76 (26.76%) had hematological malignancies. The most common hematological malignancy was acute lymphoblastic leukemia (32.89%), followed by Hodgkin lymphoma (30.27%) and non-Hodgkin lymphoma (27.63%). Among solid malignancies, sarcoma was the most prevalent (31.25%), followed by germ cell tumors (17.79%) and Wilms’ tumor (16.83%). Conclusion: Lymphoblastic leukemia and Hodgkin’s lymphoma are the most prevalent pediatric hematological malignancies, while sarcoma is the most common pediatric solid tumor, followed by germ cell tumors and Wilms’ tumor. In summary, our study highlights the distribution of pediatric malignancies in Bihar, India, and underscores the need for further research in this area.

Knowledge-practice gap in breastfeeding and the factors influencing it among the urban mothers attending the immunization clinic under a tertiary care hospital in eastern India

Background: Breast milk is a complete food for the newborn. Timely introduction of breast milk and exclusive breast feeding till 6 months of age of a newborn, with proper positioning and adequate attachment to mother’s breast is encouraged as Initiation of breast feeding within the first hour after birth, prevents the newborn from the risk of morbidity and mortality. An effective improvement in mother’s self efficacy and understanding on breast feeding will be useful in meeting the nutritional goals of the child. Aim of study was to assess the knowledge, perception and practice among the mothers on breast feeding and the factors influencing their practice and to determine probable association of ideal infant weight with exclusive breast feeding. Methods: Descriptive cross-sectional study among 390 mothers attending the Immunization Clinic of Kalinga Institute of Medical Sciences, Bhubaneswar. They were assessed if they breast fed infant by following the ideal positioning and proper attachment to breast and for their knowledge, perception and practices of breast feeding. Analysis was done using STATA-17. Results: Good knowledge, perception and practice of breast feeding was present among 88.2%, 83.5% and 69.8% mothers, respectively. Association between ideal weight of baby and proper breast feeding technique was found. Knowledge was more positively related to practice, than to perception. Conclusions: Children who have been exclusively breast fed, had the right weight for age. Mother and other family members must be aware of proper technique, adequacy and frequency of breast feeding for the best nourishment of the newborn.

Outcome of preventive interventions on the prevalence of constipation in hip fracture patients admitted in orthopaedic ward of a tertiary care hospital in eastern India

Background: Orthopedic patients admitted with hip fractures are prone to developing constipation due to pain and immobility in bed. The reported incidence for constipation in orthopaedic patients varies from 44 % after thoracolumbar fusion surgery to 18-72% after hip replacement surgery to 39-43%. Methods: This study was conducted for the admitted patients with hip fracture in orthopaedic ward of a tertiary care hospital. The study period was divided into first 3 months where prevalence was measured while administering the present standard nursing care, without any active preventive interventions and next 3 months where the prevalence was measured after adding implementation of active preventive interventions. Results: The study had 78 % incidence of constipation in the former group compared to 26 % in intervention group. This was found to be significant statistically. Conclusions: It was safely concluded that implementation of our preventive intervention protocol in all our admitted patients with hip fractures the prevalence of constipation could be significantly reduced.

CLINICO-TRICHOSCOPIC EVALUATION OF HIRSUTISM TREATED WITH INTENSE PULSED LIGHT IN A TERTIARY CARE HOSPITAL IN EASTERN INDIA

Objective: The objective of this study is to determine the effectiveness of Intense Pulsed Light in treating hirsutism after three sittings, as evaluated through clinical and trichoscopic assessments, in patients attending a tertiary care hospital in Eastern India. Methods: This was a Descriptive Longitudinal study conducted at the Dermatology Outpatient Department (OPD), Government Medical College, Kolkata, from March 2019 to February 2020. The study included 40 cases of Dermatology OPD attendees who complained of hirsutism. Trichoscopy was used to evaluate treatment response. Data were analyzed using Medcalc. Results: Seventy percent had functional while 30% had organic hirsutism; 65% patients had PCOD and 27.5% had idiopathic hirsutism. All the patients had significant improvement with intense pulsed light with regard to terminal-vellus hair ratio and Terminal hair density observed with trichoscopy irrespective of their medical treatment. The mean modified visual analog score was 6.75±1.1209. According to the modified visual analog score, 57.5% had good reduction while the rest had a moderate reduction. Conclusions: The majority had functional hirsutism. Polycystic ovarian disease and idiopathic hirsutism are the most common causes of hirsutism. Intense pulsed light is an effective and safe method of hair removal, regardless of medical treatment, and trichoscopy can be used to evaluate treatment response.

Assessment of Post-operative Complications in Patients Undergoing Thyroid Surgery in a Tertiary Care Hospital in Eastern India.

Background Thyroid surgeries, among the most common surgical procedures globally, present with varied complications. This study is aimed at identifying the complications and selected variables associated with thyroid surgery. Methods In this cross-sectional, retrospective, record-based study, a total of 107 patients who underwent thyroidectomies and satisfied the inclusion criteria, were recruited using convenience sampling technique. This study was conducted at a tertiary care hospital from January 2021 to December 2021. Data were collected from medical records using a researcher-created data extraction form after ethical approval from the institutional ethics committee. The data were analyzed using Epi Info software (Atlanta, GA: Centers for Disease Control and Prevention), with a p-value of <0.05 considered to be statistically significant. Results Of the 107 patients who underwent thyroidectomies, 92 (85.9%) reported one or more complications. Complications were most common (90.2% of patients) in the 25-34 years age group and among females (83.3%). The most common complications were dysphagia (30.84% of patients), voice change (21.50%), and respiratory obstruction (8.41%). Temporary hypocalcemia developed in 3.74% of these patients, while tracheal injury and hematoma were documented in 3.74% and 1.87%, respectively. Tobacco users (14.9%), alcohol users (16.8%), those eating a non-vegetarian diet (61.9%), and those eating saturated fats (13.0%) suffered more complications. Family history (p=0.03) was found to be significantly associated with complications. Conclusion The most common post-thyroidectomy complications in this group of patients were dysphagia and voice change, while hypocalcemia, tracheal injury, and hematoma were rare complications. Tobacco users and alcohol users reported more complications. Complications were more common in those with a family history of thyroid disease and those who were underweight.

Scrub Typhus in Children: A Prospective Observational Study in a Tertiary Care Hospital in Eastern India.

Background Scrub typhus is a reemerging, acute, undifferentiating febrile illness and one of the most neglected tropical diseases, calling for an in-depth investigation into its clinical diversity, complications, and mortality, which drives us to carry out this research work. Methods Over a year, prospective observational research was carried out after gaining parental consent and institutional ethical clearance, 206 children of either gender aged between one month and 12 years who had been hospitalized with a fever for at least five days and subsequently tested positive forOrientia​​​​tsutsugamushiwere included in the study. Basic demographic information, clinical characteristics, laboratory findings, complications, related coinfections, and results were gathered and analyzed.A P-value of 0.05 was set as the statistical benchmark. Results The current study found that boys outnumbered girls. The ratio of boys to girls was 1.22:1, and the average age was 5.18 years. All had a fever (100%), and the other most frequently occurring clinical signs and symptoms were abdominal pain (16.99%), vomiting (22.33%), hepatosplenomegaly (49.51%), facial puffiness (39.32%), edema (27.18%), lymphadenopathy (19.90%), eschar (19.90%), macular-erythematous rash (17.96%), cough (21.84%), conjunctival congestion (25.24%), and headache (13.59%). Anemia (81.55%), leucocytosis (20.39%), leucopenia (6.8%), thrombocytopenia (49.51%), thrombocytosis (2.43%), and elevated serum levels of alanine aminotransferase (ALT, 57.28%) and aspartate aminotransferase (AST, 63.59%) were characteristic laboratory results. The coinfections were dengue, enteric fever, urinary tract infections, and malaria.Children who also had dengue were more likely to develop thrombocytopenia, which was statistically significant (P-value = 0.008). With doxycycline medication, early defervescence of fever occurred earlier than with azithromycin, and it was statistically significant (P-value = 0.000). The complications were hepatitis (63.59%), lower respiratory tract infections (LRTIs, 22.82%),scrub typhus meningoencephalitis (STME, 3.88%), acute kidney injury (AKI, 2.91%), myocarditis (1.46%), and acute disseminated encephalomyelitis (ADEM, 0.49%). Except for one who had ADEM, everyone was sent back home after receiving the best care possible. The average duration of hospital stay was 6.89 days. Conclusions Even in the absence of eschar, scrub typhus should be suspected in any febrile child who experiences clinical signs of meningoencephalitis syndrome, capillary leakage, skin rash, conjunctival congestion, LRTI, AKI, lymphadenopathy, hepatosplenomegaly, thrombocytopenia, and liver dysfunction in the post-monsoon season. Strong clinical suspicion and prompt anti-scrub drug administration go a long way in preventing or decreasing the morbidity and mortality of the same.

PATTERN OF NON-VENEREAL GENITAL DERMATOSES IN ADULT MALE- A CLINICAL STUDY IN A TERTIARY CARE CENTRE

Objectives: Non-venereal genital dermatoses are genital dermatoses that are not sexually transmitted. It causes extreme anxiety in patients because venereal disease is often their primary concern. The aim was to study the clinical pattern of various non-venereal genital dermatoses in males aged 18–60 years. Methods: A cross-sectional clinical study was done among male patients between 18 and 60 years of age with non-venereal genital dermatoses attending the dermatology outpatient department of a tertiary care hospital in Eastern India. Patients clinically diagnosed with non-venereal genital dermatoses were included in the study after signing the informed consent thorough examination of the genital lesion was done with special relevance to the morphology, number, tenderness, regional lymph node involvement, etc. A complete physical and systemic examination was done. Associated skin lesions were noted. Investigations such as blood sugar, Tzanck smear, KOH mount, Gram stain, and histopathological examination were done in relevant cases. At the Venereal Diseases Research Laboratory, HIV tests were done to rule out STDs. Statistical analysis was done using the necessary software. Results: A total of 133 patients were included in the study. The commonest age group was 18–30 years. The most common [35%] disease was Candidal Balano-Posthitis. Married people were more affected. Diseases predominant in rural areas were LSA. Non-STD genital dermatoses are less more common in Muslims. Diabetes is common in both personal and family histories. Conclusion: For the differentiation of non-venereal genital dermatoses, apart from history and investigations, the clinical study such as age, residence, religion, and morphology of the lesions are very important. A clinician should have an unbiased approach towards genital conditions.

Health system factors related to COVID-19 mortality in Eastern India: Hospital-based cross-sectional study.

Mortality from coronavirus disease 2019 (COVID-19) pandemic has left footprints across all ages and socio-economic strata. The deaths because of COVID-19 are usually multi-factorial. The study aimed to assess the health system factors related to COVID-19-related deaths. A hospital-based retrospective study was conducted at a tertiary care hospital of eastern India. A total of 272 COVID-19 deaths that occurred between April and November 2020 were investigated. Data were extracted from Medical Record Department, and telephonic interviews were conducted to assess the different delays related to death. Data were analysed using Statistical Package for Social Sciences. Travel time, travel distance, delay in testing, and delay in receiving quality care were presented as median with inter-quartile range. Complete information could be collected from 243 COVID deaths of the 272 deaths (89.3%). The duration of hospital stay was 1-7 days for 42% of the deceased. The median travel time was 120 min, and the median distance travelled was 60 km. The median time to receive first attention of health care workers was 10 minutes. There was hardly any delay in reporting of test results, whereas the median time from symptoms to test and the median time from symptoms to admission were 4 days each. Health system factors related to death of COVID-19 need to be addressed to avoid the avoidable deaths during the pandemic situation. The resilience of the health system can be helpful in reducing death toll in a low-resource country like India.

Prevalence of microalbuminuria in patients with type 2 diabetes mellitus having diabetic retinopathy in a tertiary care hospital in eastern India: A cross-sectional study

Diabetic retinopathy is a common microvascular complication of diabetes mellitus and one of the leading causes of acquired blindness. Microalbuminuria reflects a pathophysiological state of vascular dysfunction and organ damage. It is noticed that a rise in urinary albumin excretion is seen in the early phase of diabetic retinopathy. The concordance of microalbuminuria and diabetic retinopathy has been well reported in type 1 diabetes; however, for type 2 diabetes, there is a paucity of data. To estimate the prevalence of microalbuminuria in diabetic retinopathy patients with type 2 diabetes attending the out-patient department (OPD) in a tertiary care center in eastern India and also to find out any association between microalbuminuria and severity of diabetic retinopathy. : The study included 200 patients with type 2 diabetic patients having diabetic retinopathy. The study populations were selected by thorough clinical examination and as per inclusion–exclusion criteria. Estimation of urinary albumin and albumin creatinine ratio was done by using Konelab 20 Autoanalyzer machine by the immunoturbidimetry method. Diabetic retinopathy was classified as per the International Clinical Diabetic Retinopathy Severity Scales into mild, moderate, severe, very severe non-proliferative as well as proliferative diabetic retinopathy. Data were analyzed with ratio, rate, percentage, and statistical significance was considered if p&amp;#60;0.5. : The prevalence of microalbuminuria was found in 36% (72 patients). The highest number of patients (88.24%) with microalbuminuria was found in severe NPDR. 93.06% of patients with microalbuminuria had clinically significant macular edema. A statistically significant correlation (p&amp;#60;0.001) was found between microalbuminuria and the degree of retinopathy in mild, moderate, and severe NPDR. A significant correlation was found between urinary microalbumin and the severity of diabetic retinopathy.

Knowledge, Attitude, and Practices of Diabetic Patients toward Diabetic Retinopathy in a Tertiary Care Hospital of Eastern India: A Cross-Sectional Study

Abstract Background: To document knowledge, attitude, and practice (KAP) patterns of diabetic patients regarding diabetic retinopathy (DR), to determine associations between them, and to identify barriers to compliance with follow up and treatment regimes. Method: This is a cross-sectional study including 504 participants who attended the outpatient department (OPD) of a tertiary care hospital in eastern India. The participants included diabetic patients and questionnaires were completed to collect information about their sociodemographic and healthcare characteristics. A Chi-square test and Pearson correlation test were performed to analyze the data. Results: A total of 504 participants were enrolled in the study, with a mean age of 62.84 ± 7.62 years and a mean diabetes duration of 12 ± 4.42 years. The majority (65.07%) of the participants had higher secondary education or above. Good knowledge, a positive attitude, and poor DR practices were observed in 56.34%, 68%, and 66.6% of participants, respectively. The most common barrier to complying with regular follow-up despite having knowledge were domestic issues (no family support, lack of transport). Conclusion: The study reported good knowledge and attitude about DR among type 2 diabetics with relatively poor eye-care practices. Therefore, it is recommended that a collaborative approach amongst primary care providers, ophthalmologists, diabetologists, and health policy makers is necessary to transform this good knowledge and attitude into good practices.

Maternal food insecurity and low birth weight: A hospital-based case–control study in Eastern India

Abstract Background: As household food insecurity is directly connected with the amount and quality of nutrition available to a person, maternal food insecurity, therefore, might have a role to play in poor pregnancy outcomes such as low birth weight (LBW). Objectives: To find out whether maternal food insecurity was associated with LBW among infants born between May and June of 2020 in a tertiary care hospital of Eastern India. Materials and Methods: The study was a case–control design, conducted among a set of sex-matched cases and controls. 105 LBW infants were taken as cases and 105 infants with birth weight ≥2500 g were taken as controls. Multivariable logistic regression analysis was done to ascertain the relationship between the independent and dependent variables and crude and adjusted odds ratios (AOR) were calculated to find out the association between the exposure and the outcome. Results: The cases and controls were statistically comparable with respect to baseline characteristics. Univariable analysis showed that the odds of LBW were 7.77 (95% confidence interval [CI]: 3.73–16.16) times more in food-insecure households. After adjusting for other variables included in the analysis, the AOR for food insecurity was 8.04 (95% CI: 3.81–16.94). Conclusion: The odds of giving birth to a LBW infant were higher in mothers belonging to food-insecure households. Addressing the prevalent barriers to accessibility, affordability, and adequacy of nutrition can be effective in mitigating this problem.