Care Hospital In Kolkata Research Articles

Clinico-bacteriological profile of lower respiratory tract infections in a tertiary care hospital in Kolkata – A cross-sectional and observational study

Clinico-bacteriological profile of lower respiratory tract infections in a tertiary care hospital in Kolkata – A cross-sectional and observational study

Drug-resistant Pantoea agglomerans Causing Bacteremia at a Tertiary Care Hospital in Kolkata, India: First Report of Carbapenem Resistance Mediated by OXA-181.

The spread of antibiotic resistance (ABR) in uncommon human pathogens endangers global public health, escalating morbidity, death, and healthcare expenditures. Pantoea agglomerans, a member of the Erwiniaceae family that rarely infects humans, is emerging as a drug-resistant nosocomial pathogen. Seven P. agglomerans isolates were recovered from bacteremia patients at a tertiary care hospital in Kolkata, West Bengal, between March 2022 and October 2022. The isolates were evaluated for phenotypic resistance, β-lactamase and plasmid-mediated quinolone resistance (PMQR) genes, plasmid profiling, and clonality assessment. All isolates were resistant to fluoroquinolones and third-generation cephalosporins, with four resistant to carbapenems. The following β-lactamases and PMQR genes were identified: blaOXA-1 (n = 1), blaTEM (n = 1), blaCTX-M-1 (n = 2), blaNDM (n = 5), blaOXA-181 (n = 1), qnrB (n = 2), and qnrS (n = 4). Six isolates carried up to seven plasmids ranging in size from 2kb to > 212kb. IncFI, FII, HI, and X3 plasmid types were detected in three isolates, while the rest remained untypable. Four different genetic patterns were noted. Four isolates were clonally related, with three being clonal. The swap of environmental isolates to human pathogens exacerbates the ABR dilemma, periling patient care and outcomes. This is the first report in India of a carbapenem-resistant P. agglomerans blood isolate carrying blaOXA-181. In-depth genomic research of drug-resistant microbes adapted to the environment-human interfaces might underpin the source-route-containment of ABR.

Blood Culture Contamination in a Busy Emergency Ward of a Tertiary Care Hospital in Kolkata

Blood Culture Contamination in a Busy Emergency Ward of a Tertiary Care Hospital in Kolkata

Clinical characteristics and analysis of treatment outcome at one year of rhino-orbito-cerebral mucormycosis cases during the second wave of the Covid-19 pandemic (2<sup>nd</sup> wave); experiences from a tertiary care hospital in Kolkata, India

Clinical characteristics and analysis of treatment outcome at one year of rhino-orbito-cerebral mucormycosis cases during the second wave of the Covid-19 pandemic (2<sup>nd</sup> wave); experiences from a tertiary care hospital in Kolkata, India

Immunofluorescence Patterns of Antinuclear Antibodies in the Indian Population

Autoimmune diseases are chronic hypersensitive diseases that occur due to an inability of the immune system to recognize self-antigens as part of its system. Antinuclear autoantibodies (ANA) are antibodies that target the proteins located in the nucleus, mitotic spindle, nuclear membrane, and cytoplasmic substructures. Detection of ANA is done using either the ANA-IIF or by ELISA method; the latter might be slightly more sensitive as compared to the ANA-IIF but the specificity is however low. ANA patterns such as nuclear, cytoplasmic, and mitotic can be important to clinical practice because they suggest the significance, as well as the nature of autoimmune Connective Tissue Disorder (CTDs). ANA is a predictor of autoimmune diseases, and the risk is greater in female individuals. The specific objective of this study was to assess the prevalence of ANA and the detection of demographic correlations with them; thereby it would help in the identification of the various autoantibody subclasses in the Indian people. The present cross-sectional descriptive study included 351 patient records from a tertiary care hospital in Kolkata, India expounds on the association of multiple ANA patterns with certain autoantibodies, and demography of the ANA-positive patients. Knowledge of such regional variations of autoimmune diseases would be useful to formulate a strategy for proper diagnosis of systemic autoimmune rheumatic diseases (SARDs) in India.

Socio-demographic and Clinical Profile of Cervical Cancer Patients Undergoing Chemotherapy or Radiotherapy Attending the Department of Radiotherapy of a Tertiary Care Hospital in Kolkata

Socio-demographic and Clinical Profile of Cervical Cancer Patients Undergoing Chemotherapy or Radiotherapy Attending the Department of Radiotherapy of a Tertiary Care Hospital in Kolkata

Prevalence of Onychomycosis by Non Dermatophyte Molds in a Tertiary Care Hospital in Kolkata , West Bengal, India

Prevalence of Onychomycosis by Non Dermatophyte Molds in a Tertiary Care Hospital in Kolkata , West Bengal, India

Do Sleep Time and Duration Affect the Development of Prehypertension in Undergraduate Medical Students? An Experience from a Tertiary Care Hospital in Kolkata

Abstract Introduction and Objective Hypertension is an evolving public health challenge at present, and it is preceded by a prehypertensive stage. Irregular sleep duration and pattern have been found to be linked with cardiovascular diseases. Medical students are highly vulnerable to low quality sleep due to pressure regarding the academic curriculum and poor lifestyle. The present study aimed to estimate the prevalence of prehypertension, describe the risk factors and sleep patterns of undergraduate medical students, and determine the association, if any, involving sleep time and duration and prehypertension. Materials and Methods Data was collected from 254 undergraduate medical students via the Pittsburgh Sleep Quality Index (PSQI) questionnaire and a self-structured questionnaire. The frequency of events was established and the Chi-squared and t-tests were applied to determine the association. Finally, regression analysis was performed to determine the correlation. Results Male sex, high body mass index (BMI), poor sleep quality, and night sleep duration shorter than 5 hours were found to be significant risk factors for the development of prehypertensive condition (prevalence of 42.5%). However, there were no statistically significant associations regarding prehypertension and family history, junk food and salt intake, physical activity and daytime napping, bedtime, and wake-up time. Night sleep duration shorter than 5 hours presented an odds ratio of 4.713 (p = 0.010) for the development of prehypertension after adjusting for other risk factors, such as male sex, sleep quality, and high BMI. Discussion and Conclusion A high prevalence of prehypertension (42.5%) was noted among undergraduate medical students. Night sleep duration shorter than 5 hours was a significant risk factor for the development of prehypertension, whereas sleep time was not significantly associated with prehypertension.

An Observational Study to Find the Association of Viral Load, NS1 Antigen, IgG Antibody, and Other Laboratory Parameters With the Outcome of Dengue Patients in Eastern India.

Background Dengue, the mosquito-borne febrile disease caused by the dengue virus, has become one of the major concerns of public health. It may present with only fever, or there may be a hemorrhagic manifestation or septic shock. As there is no specific treatment for dengue, early detection of the disease, assessment of progression, and prediction of outcome by studying the laboratory markers will help guide the management of cases and lower morbidity and mortality. Methodology This clinico-observational study was conducted at the Department of Microbiology in a tertiary care hospital in Kolkata, India, from February 2020 to August 2022 to determine the outcome of dengue patients in correlation with viral load, NS1 antigen, IgM and IgG antibodies, ferritin level, platelet count, and other laboratory parameters. Results Out of 316 samples from fever patients, 103 (32.5%) were NS1 antigen reactive. We followed up the dengue patients (n = 103) for 15 days and divided them into three groups according to their duration of symptoms (group A suffered for ≤5 days, group B for 5 to 10 days, and group C for >10 days) and per the WHO classification of disease severity, namely dengue without warning signs (DOS), dengue with warning signs (DWS), and severe dengue (SD). Based on severity, 65 (63.1%) patients had DOS, whereas 31 (30.09%) patients had DWS, and seven (6.79%) patients had SD. Secondary infection was present in 83.33% of patients in group C, 71% of DWS cases, and 57% of SD cases, which positively correlates with liver enzymes, viral load (mean value 102195 in secondary infection vs. 1195 copies/10 µl in primary infection), and negatively correlates with platelet counts (mean value 60,213 in secondary infection vs. 1,25,516 in primary infection). Patients in group C had higher liver enzymes, a lower platelet count, and a higher initial viral load than groups A and B. Similarly, SD cases had a higher ferritin level (9215 ug/l), a lower platelet count (mean value 23,250), and a higher initial viral load (mean value 2,74,257 copies/10 µl). An increase in hematocrit value considering the peak value and its baseline value is an important marker for disease severity rather than its absolute value. Conclusion Poor outcome of dengue infection, i.e., an increase in the duration of symptoms and disease severity depends on concurrent associations between high serum ferritin, increased hematocrit level, thrombocytopenia, secondary infection, increasing liver enzymes, and increased initial viral load.

Prominent early adulthood hyperferritinemia in scrub typhus

Background: Scrub typhus is an acute infectious disease, caused by Orientia tsutsugamushi. It is endemic to a geographically distinct region of Japan, Taiwan, China, and South Korea, known as the tsutsugamushi triangle, as well as in Nepal, Pakistan, and Papua New Guinea. In India, the incidence of this disease varies from 4-46% with high morbidity and mortality. Methods: In this cross-sectional study at a tertiary care hospital in Kolkata, India we analysed ferritin blood levels along with different demographic and laboratory test parameters of 60 suspected scrub typhus patients who were also scrub typhus IgM antibody positive during a one-year study period. Results: It was found that serum ferritin levels were unusually high in 21-40 years age group patients along with mildly increased urea and creatinine levels. Other important findings were below 40 years of age males were mostly affected, but above 40 years of age, females were generally affected. Haemoglobin and platelet levels were normal in all age groups. Although WBC count and neutrophils were normal in the 21-40 years age group, in other age groups increased levels were observed. CRP, SGPT, and SGOT levels were uniformly high above 20 years of age. Electrolytes were mildly decreased. Conclusions: It appears that oxidative stress-induced acute kidney injury may be an important reason for the rising ferritin levels in the 21-40 years age group. These important findings may be helpful to clinicians in management of these patients.

A comparative study of clinical symptoms, demographic characteristics and laboratory parameters among primary and secondary dengue cases in a tertiary care hospital in Kolkata

A comparative study of clinical symptoms, demographic characteristics and laboratory parameters among primary and secondary dengue cases in a tertiary care hospital in Kolkata

Out-of-pocket Expenditure and its Impact on the Quality of Life among Patients Attending the Anti-retroviral Therapy Centre of a Tertiary Care Hospital in Kolkata

Introduction: Out-of-pocket expenditure (OOPE) has a negative impact on Quality of life (QoL) of People Living with HIV (PLHIV)which can increase the risk of slipping into poverty. Objectives: Primary Objective of this study was to estimate the burden of OOPE in seeking health care among HIV patients attending the Anti-retroviral therapy (ART) centre of a tertiary care hospital; and secondary objectives were to assess their QoL, to identify the association of socio-demographic characteristics with the OOPE & QoL and to find out the correlation between OOPE and QoL. Method: A cross-sectional study was conducted among 232 patients attending ART centre of a tertiary care hospital in Kolkata using a pre-designed, pre-tested, structured schedule. Multivariable binary logistic regression was done to identify the association of their socio-demographic characteristics and clinical profile with the OOPE and QoL. Results: About 41.4% of the study population rated their QoL as neither poor nor good, 18.9% as ‘good’. All the participants reported OOPE; 20.7% in the form of direct health expenditure. Participants belonging to the age group 18-39 years, residing in a joint family, had family member infected with HIV and had associated co-morbidity were statistically significant covariates of direct health expenditure; whereas participants belonging to the age group ≥40 years, living in a joint family, involved in an unskilled occupation, and belonging to middle and lower middle were statistically significant covariates of poor QoL. Conclusion: OOPE was experienced by all participants. As per the study findings Qol was neither poor nor good among participants. With increase in OOPE, the QoL worsened.

A hospital-based cross-sectional study on parental self‑medication among children in a tertiary care hospital in Kolkata

Introduction: Self-medication/self-prescription, the practice of using measures to treat and handle diseases, without consulting appropriate authority, has been significantly inculcated in modern society. Parental self-medication is today a significant paediatric public health problem contributing to global rise of antimicrobial resistance.Objectives: To assess the magnitude and determinants of parental self-medication among children attending a tertiary care hospital in Kolkata. Method: This cross-sectional study was conducted on parents of 105 children attending the paediatric clinic of a tertiary care hospital in Kolkata. Universal sampling was employed. Parents were surveyed by face-to-face interview using a pre-tested semi-structured interview schedule validated by subject experts. Information on pattern, reasons, and perception of parental self-medication were elicited from the schedule. Microsoft Excel and STATA MP16 were used for statistical analysis. Results: Mean ages of the parents and their children were 31.79±5.6 years, and 5.3±2.9 years respectively. Prevalence of parental self-medication was 78.1% (95% CI: 69-85%). Analgesic-antipyretics were the most common type of medicine used during self-medication (77.1%), whereas prior experience in dealing with similar illness was the most common reason (42%) for practising self-medication. Higher educational levelof respondent parent and increased age of child (>3 years) were significantly associated with the practice of self-medication in bivariate analysis.Conclusions: Prevalence of parental self-medication was 78.1%. Analgesic-antipyretics were used during self-medication in 77.1% cases. Prior experience in dealing with similar illness was the reason for practising self-medication in 42% cases. Higher educational level of the respondent parent and increased age of child (>3 years) were significantly associated with the practice of self-medication.

A Cross-sectional Study on Awareness and Utilisation of Government Health Insurance Schemes among Patients at a Tertiary Level Hospital in Kolkata, India

Introduction: Despite the presence of multiple Government Health Insurance (GHI) schemes in West Bengal, the National Family Health Survey report (NFHS-5) has indicated that only 29.3% of households are covered by a health scheme. Awareness of health insurance schemes increases their utilisation. The absence of health insurance coverage results in increased out-of-pocket health expenditures, pushing families into debt. Therefore, there is a need to determine whether this lack of awareness among patients contributes to the issue. Aim: To estimate the awareness level, enrollment in GHI schemes, experiences of their utilisation, and to determine the contributory factors of awareness and enrollment among patients attending the Outdoor Patient Departments (OPDs) at a tertiary care hospital in Kolkata. Materials and Methods: An observational cross-sectional study was conducted from April 2023 to June 2023 at Medical College, Kolkata, West Bengal, India. A total of 390 respondents were chosen using a systematic random sampling technique and were interviewed using a predesigned, pretested, and semistructured questionnaire. Data were analysed using R Studio version 4.3.0. A p-value <0.05 was considered statistically significant. Results: Awareness about Swasthya Sathi was found to be present in 318 (81.54%) patients, but only 109 (34.28%) of them were enrolled. Awareness of Sishu Saathi and Rashtriya Bal Swasthya Karyakram (RBSK) was 12 (3.08%) and 10 (2.57%), respectively, and none were enrolled. The major source of information (11.03%) regarding health insurance among respondents was informal sources such as friends, relatives, and neighbours. The age of the respondents, type of family, occupation, and economic status were found to have a significant association with the right awareness (p=0.008, 0.012, 0.0005, and 0.029, respectively). The patient satisfaction level after utilising Swasthya Sathi was found to have a significant positive correlation with the right awareness (Spearman’s ρ=0.322, p-value <0.01). The determinants of enrollment in Swasthya Sathi were female gender, rural residence, and right awareness (p<0.001). The commonest reason for not enrolling in any GHI among the non subscribers was a lack of awareness (82.56%). Conclusion: Correct awareness was found to be a determinant of enrollment in GHI. In order to bridge the gap between awareness and utilisation of GHI, there is a need to focus on Information, Education, and Communication (IEC) activities involving mass media and frontline health workers.

Knowledge, Attitude, and Practice of COVID-19 in Adolescents Attending Covid Vaccination Center in a Tertiary Care Hospital in Kolkata, India: A Cross-sectional Study

Introduction: This study aimed to assess the knowledge, attitudes, and practices related to coronavirus disease 2019 (COVID-19) among adolescents in India, recognizing the vital role this demographic plays in pandemic control. Materials and Methods: Conducted at the Medical College, Kolkata COVID-19 vaccination center from June to August 2022, this web-based prospective cross-sectional study included individuals aged 13–19 years. Data collection involved a structured questionnaire in multiple languages, ensuring broad accessibility. Ethical standards were upheld with online informed consent and rigorous data confidentiality measures. Results: The study revealed balanced gender representation among participants, with most enrolled in the 10th or 12th standard. Parents’ educational backgrounds varied, but a significant proportion had family members employed in the health-care sector (66.7%). Knowledge about COVID-19 in India was surprisingly limited: only 3.7% knew about oxygen saturation and its utility. 18.75% considered depression as a comorbidity of COVID-19. 73.8% of the participants relied on social media for information about COVID-19. A majority (66.25%) of the participants believed 2 doses of the vaccine would protect them from the disease. Twice as many women believed in the protection offered by vaccines. Conclusion: This research, distinct from conventional scoring-based studies, emphasized uncovering misconceptions and knowledge gaps. Importantly, many adolescents lacked awareness of the true COVID-19 situation in India, potentially undermining the pandemic gravity perception and preventive measures. Although participants showed awareness of common COVID-19 symptoms and preventive measures, knowledge about comorbidities’ influence on mortality rates was limited.

Role of HER2/neu in Colorectal Carcinoma: A Cross-sectional Study from a Tertiary Care Centre in West Bengal, India

Introduction: In many tumours, Human Epidermal Growth Factor Receptor 2 (HER2) expression and HER2 amplification are studied as therapeutic and prognostic factors. The incidence of HER2/neu expression and its consequences in patients with colorectal carcinoma has shown conflicting evidence. Aim: To evaluate the utility of HER2/neu expression in colorectal carcinoma and to find any association between HER2/neu expression, histological grade, and stage of the tumour. Materials and Methods: This cross-sectional study was conducted on 50 cases of colorectal carcinoma. Patients undergoing surgery for colorectal tumours were selected over an 18-month period (January 2020 to June 2021) in a tertiary care hospital in Kolkata, West Bengal, India. Various clinical and demographic parameters were obtained from the patients, and the specimens were subjected to Immunohistochemical (IHC) staining for HER2/neu. The results were analysed using Statistical Package for the Social Sciences (SPSS)software version 25.0 (IBM, Armonk, New York, USA). Results: On HER2/neu IHC examination, 30 cases (60%) showed a 3+ score, 4 cases (8%) showed a 2+ score, 7 cases (14%) showed a 1+ score, and the remaining 9 cases (18%) showed a score of 0. HER2/neu expression was found in 30 cases (60%) of colorectal carcinoma. HER2/neu expression showed a significant association with the histological grade of the tumour (p-value=0.020). HER2/neu expression also showed a significant association (p-value<0.001) with histological subtypes of the tumour. Conclusion: This study revealed a significant association between HER2/neu expression and histological subtypes and grade of the tumour. Moderately differentiated adenocarcinoma showed the highest expression, while mucinous adenocarcinoma and undifferentiated carcinoma showed minimal or absent HER2/ neu expression. Thus, HER2/neu can serve as a prognostic and therapeutic marker in colorectal carcinoma. In conclusion, surgery alone is not curative for patients with colorectal cancer, and additional forms of management may be required to improve patient survival. In such cases, HER2/neu expression can guide new adjuvant therapy.

A comparative analysis of serum phosphorus levels and mineral metabolic markers in non-dialysis and dialysis chronic kidney disease patient: a cross-sectional study

Background: Chronic kidney disease is a major public health problem worldwide. As kidney function declines, it leads to several metabolic abnormalities including dysregulation of mineral metabolism. It is also reported that hyperphosphatemia in patients with advanced kidney disease is associated with an increased risk of mortality and cardiovascular events, and is higher in dialysis-dependent chronic kidney disease (CKD) patients compared to non-dialysis CKD. However, data in the Indian context is limited. Objectives were to evaluate and compare serum phosphorus levels and associated factors in non-dialysis and dialysis CKD patients. Also, the impact of dietary phosphate restriction and the use of phosphate binders on serum phosphorus is analysed. Methods: A cross-sectional study was conducted at a tertiary care hospital in Kolkata, India, with 100 CKD patients: 50 non-dialysis CKD patients and 50 dialysis-dependent CKD patients. Relevant demographic, clinical and laboratory parameters including serum phosphorus, calcium, parathyroid hormone (PTH), alkaline phosphatase, albumin and estimated glomerular filtration rate (eGFR) were collected. Data was analyzed using appropriate statistical tests. Results: Mean serum phosphorus was significantly higher in the dialysis CKD group (6.12±0.34 mg/dl) compared to the non-dialysis CKD group (4.56±0.80 mg/dl). Serum calcium and PTH were also higher while eGFR and albumin were lower in the dialysis CKD group. Serum phosphorus levels increased with advancing CKD stages in the non-dialysis group. Phosphate binder helped phosphorus control in dialysis CKD patients. Conclusions: Our study is in confluence with other reports and dietary phosphate restriction and the use of phosphate binders help optimize phosphorus levels in CKD patients.

Effect of School Closure During COVID-19 Lockdown on ADHD Symptoms Among Students.

Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder among children, with an estimated prevalence of 1.3 per 1000 in India. The nationwide lockdown imposed due to the COVID-19 pandemic has led to the closure of schools for an indefinite period. After the reopening of schools, the lockdown period was feared to have caused a deterioration in symptoms of existing mental health conditions among school-going children. This field study aimed to probe the association of school closures due to lockdown with any change in symptoms of ADHD in aged 6-15 years in the largest tertiary care hospital in Kolkata. A longitudinal observational study was conducted involving 34 prediagnosed ADHD patients attending the Clinical Psychology outpatient department (OPD) of a tertiary hospital for follow-up. Data was collected by face-to-face interviews with the patients' parents using a predesigned, pretested structured study schedule. Conners' Parent Rating Scale (CPRS) was used to assess the ADHD symptoms. Twenty-three (67.65%) patients were observed to have worsened ADHD symptoms after lockdown. Significant worsening was observed in the ADHD indicator and the mood disorder indicator. Significant contributing factors were rural residence, nuclear family, non-attendance at school, and knowledge inadequacy among parents. There was a significant worsening of symptoms of ADHD owing to the school closure due to the lockdown.

Psychological Impact of COVID-19 and Its Influence on Parental Willingness to Vaccinate Children: A Cross-Sectional Study at a Tertiary Care Hospital in Kolkata.

Background COVID-19 has affected the physical and mental health of people globally, and vaccination is seen as a crucial tool in controlling the pandemic. However, the readiness to vaccinate children remains a concern, particularly in India. Aim The study aimed to investigate the association between the psychological impact of COVID-19 and willingness to vaccinate their children among attendees of the COVID-19 vaccination clinic at Nil Ratan Sircar Medical College, Kolkata. Method The study used an observational, cross-sectional design and collected data from 356 participants between August and September 2022. The COVID-19 Perceived Stress Scale-10 was used to assess participants' psychological impact, and willingness to vaccinate was determined using a survey. Results Approximately 64% (n=227) and 71% (n=253) of the participants exhibited a high level of perceived stress and willingness to vaccinate their children. The vaccine acceptance was significantly associated with perceived stress level and other factors such as family type, presence of chronic illness, and history of acquaintances suffering from COVID-19. Conclusion The study highlights the importance of addressing parental stress and anxiety to enhance vaccination rates among children. To achieve this, population-level awareness of vaccine safety measures and benefits should be raised to alleviate stress and increase vaccine uptake.

Prospective Study to Evaluate the Effect of Optimal Medical Therapy on Iron Profile in Patients of Chronic Heart Failure in Tertiary Care Hospital in Kolkata

Prospective Study to Evaluate the Effect of Optimal Medical Therapy on Iron Profile in Patients of Chronic Heart Failure in Tertiary Care Hospital in Kolkata