Hospital In Kolkata Research Articles

A Retrospective Analysis of Factors Influencing Maintenance Hemodialysis Adequacy: A Single-center Study in Eastern India.

Quality of life in maintenance hemodialysis (MHD) patients is dependent on adequate hemodialysis. Kt/V, which gauges urea clearance, serves as the standard metric for assessing the effectiveness of MHD. According to the 2006 guidelines from the NKF-KDOQI, a spKt/V exceeding 1.2 or a urea reduction ratio (URR) of 65% is advised for maintenance hemodialysis conducted three times weekly. This study was aimed at determining the adequate hemodialysis sessions and their associated factors for patients undergoing maintenance hemodialysis sessions at our center. The study was conducted over a 1-year period at Medica Hospital in Kolkata, focusing on patients receiving maintenance hemodialysis three times per week. Kt/V levels were assessed using the Online Clearance Monitoring (OCM) technique. The study included 251 participants, consisting of 170 (67.72%) men and 81 (32.28%) women, with a mean age of 59.09 ± 13.00 years. Diabetes was the most frequently observed underlying condition, affecting 138 patients (55.4%), while fistula was the predominant type of vascular access, utilized in 198 patients (79%). Hemodialysis adequacy was achieved in 81.08% of MHD sessions. Patients on high-flux dialyzers achieved a higher average Kt/V compared to patients on low-flux dialyzers. Dialyzer clotting was associated with a decline in Kt/V. The study found that MHD adequacy was inversely related to both age and predialysis systolic blood pressure, while it showed a direct correlation with the duration of hemodialysis. Additionally, females attained higher Kt/V values compared to males. Logistic regression analysis identified male gender and blood flow as independent determinants of hemodialysis adequacy. MHD adequacy is determined by a combination of factors rather than a single variable. Our findings indicate that achieving MHD adequacy requires a combination of sufficient treatment duration, appropriate rate of blood flow, effective anticoagulation for prevention of clotting, stable blood pressure management, and the use of hemodialyzers with a surface area exceeding 1.2 m2.

Central protection act: Urgency or emergency in India?

Very recently, another history was made with one of the most gruesome crimes Indians and the world could ever imagine. A 31-year-old doctor was sexually assaulted and murdered in RG Kar Hospital in Kolkata, West Bengal. Why, being a healthcare professional, are we facing this frequent workplace violence? We don’t have the right to feel safe and secure in our workplace. There have been multiple acts and provisions for the safeguarding of healthcare professionals. The matter of concern is whether these provisions implemented are working or are just feeble and defenceless. Is this growing violence against healthcare professionals just a State Government issue, or do we need an amendment to a centralized established act for uniformity and justice?

DUAL TARGET REVERSE TRANSCRIPTION POLYMERASE CHAIN REACTION FOR SARS-COV-2 FOR ENHANCING ACCURACY WITH E GENE AND ORF1B GENE: A CROSS-SECTIONAL STUDY

Objectives: The pandemic of the recently emerged 2019- novel coronavirus infection was a challenge to public health. The current gold standard for the molecular diagnosis of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is the reverse transcription polymerase chain reaction (RT-PCR) for the qualitative and quantitative detection of viral nucleic acids. However, superior combination of gene targets for SARS-CoV-2 detection is underexplored. To find out the possible combination of target genes for maximizing RT-PCR accuracy in SARS-CoV-2 detection. Methods: This study is an observational, cross-sectional study conducted at a tertiary care hospital in Kolkata. Study population included all SAR-CoV-2-infected patients attended either inpatient or outpatient department in a tertiary care hospital in eastern India. 870 patient’s respiratory tract samples with the clinical diagnosis of COVID-19 were collected. E gene, N gene, RNA dependent RNA polymerase (RdRp) (open reading frame [ORF1ab]) gene, ORF1b gene, and human RNase P (Internal control) gene targets were detected. Results: Among all the genes, E gene was the most frequently detected (n=665; 86.70%) closely followed by N gene (n=429; 83.30%). ORF1b could be detected in 69.73% (n=159). RdRp was least frequently detected in only 44.64% (n=175). The E gene and ORF1b could simultaneously be detected in 85.12% samples when tested together. E gene and N gene could be detected together in 71.16% and E gene and RdRp could be detected in only 53.41%. Conclusion: Our study found that the combination of E gene and ORF1b gene as optimal targets for assay design as these two genes are expressed simultaneously, that will minimize inconclusive results and maximize diagnostic yield.

Genomic epidemiology and genetic characteristics of clinical Campylobacter species cocirculating in West Bengal, India, 2019, using whole genome analysis.

Campylobacter species are the most common pathogens responsible for foodborne gastroenteritis worldwide. India is a region with frequent diarrheal infections and a high level of Campylobacter infection incidence, but the detailed genomic information is limited. This study aimed to characterize 112 isolates of Campylobacter from diarrhea patients at two hospitals in Kolkata, West Bengal, by whole genome analysis. The Campylobacter isolates consisted of 90 C. jejuni, 20 C. coli, and 2 C. lari isolates. Multilocus sequence typing analysis revealed that the largest sequence type (ST) populations were ST-2131 in C. jejuni and ST-830 in C. coli and seven novel STs were found in C. jejuni and one in C. coli. Notably, ST-2131, which is rarely seen elsewhere, was positive for a sialylated LOS-related gene (wlaN +neuA + cstIII) associated with Guillain-Barré syndrome. Antibiotic resistance factors predicted from the genome sequence included blaOXA variants (58.9%), tet(O) (54.5%), tet(W) (0.9%), ant(6)-Ia (0.9%), mutation in GyrA (T86I, T86I+D90N, T86I+P104S, T86I+D90N+P104S) (79.5%), and mutation in 23S rRNA (A2075G) (12.5%). In addition to the high drug resistance of Campylobacter in Kolkata, Campylobacter pathogens were circulating that may be associated with Guillain-Barré syndrome. This study indicates the importance of genomic analysis in the surveillance of pathogens, which provides genomic information on genetic diversity, virulence mechanisms, and determinants of antimicrobial resistance.

Study on antifungal usage in patients with vaginal itching and discharge at a private hospital in Kolkata using the National Accreditation Board for Hospitals and Healthcare Providers and the World Health Organization prescribing criteria

Abstract Introduction: One in every 10 women presents with abnormal vaginal discharge in Gynaecology and Obstetrics Department, with the most common cause being candidiasis. Irrational use of antifungal for treatment of this condition leads to antifungal resistance and increase morbidity. Materials and Methods: This retrospective study was conducted at the Department of Pharmacology in collaboration of Department of Obstetrics and Gynaecology of the private medical college hospital in Kolkata. One hundred and forty outpatient department prescriptions were screened and included in this study from March 2024 to April 2024, and the prescriptions of the previous 6 months were collected. Results: The average number of drugs per prescription was 1.1. Antifungals were prescribed in 89.3%, out of which only 8.6% were in accordance with the standard treatment guidelines of management of vaginal candidiasis. The dose of the drug was written in 11.5% of the prescriptions while the duration of treatment was written in 84.9% of the prescriptions. The fungal culture and sensitivity testing was documented in only 10.7% of the prescriptions. 29.5% of the prescriptions had the generic name of the medicines whereas the complete diagnosis was written in only 13.7% of the prescriptions. Conclusion: This study highlights the commonly encountered errors in prescribing of antifungal drugs in a tertiary care teaching hospital. These errors may lead to irrational prescribing of antifungal and development of antifungal resistance in the long run. Active surveillance in the form of regular prescription audit and organizing regular training workshop for the prescribers will improve the prescribing practice.

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

Rotator Cuff Repair by All-Arthroscopic Versus Mini-Open Technique: A Comparison of Clinical and Functional Outcome.

Rotator cuff tears can lead to debilitating shoulder function and impairment. Rotator cuff repair aims to eliminate pain and improve function with increased shoulder strength and range of motion. This study evaluated the differences between all-arthroscopic (AA) and mini-open (MO) repair procedures for rotator cuff tendon tears regarding clinical and functional outcomes. This was a prospective study conducted at a tertiary care government Hospital in Kolkata, India, between March 2015 and September 2016 which evaluated 25 patients who had undergone all-arthroscopic surgery and 25 patients who underwent mini-open repair (total of 50 patients) for rotator cuff tear with a minimum one-year follow-up. The UCLA score was used to assess the functional outcome of these patients. The mean age of all patients included in this study was 45.32 years. 86% of patients were male. The two groups had similar demographic characteristics, pre-operative baseline parameters, and intra-op findings. The average UCLA score showed significant improvement from 13.92 pre-operatively to 29.76 at the final follow-up. The patients in the all-arthroscopic surgery group experienced a notable decrease in pain within the first three months compared to the mini-open group. However, at the time of the final follow-up, no significant difference was noted between both groups when comparing the University of California at Los Angeles (UCLA) score, Visual Analogue Scale (VAS) score for pain, and active or passive glenohumeral motion. The outcomes of all-arthroscopic and mini-open rotator cuff repair surgery are equivocal in terms of both clinical and functional results, with no significant difference in post-operative pain, shoulder joint strength range of motion, or patient satisfaction over the long term.

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.

Correlation of Biochemical Markers with Chest CT Severity Index and Oxygen Saturation in Moderate to Severe COVID-19 Patients: A cross-sectional study

Introduction: COVID-19, a global pandemic, has been linked to biochemical parameters such as Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), Total Leucocyte Count (TLC), Neutrophil/Lymphocyte Ratio (NLR), Lactate Dehydrogenase (LDH), and liver function tests, which correlate with disease severity. Prothrombotic markers like D-Dimer and Fibrinogen levels, along with the CT Severity Index (CTSI) indicating lung involvement, are associated with clinical worsening. This study aims to observe biochemical and chest radiological profiles in moderate to severe COVID-19 patients and explore any correlations between them. Methodology: A hospital-based cross-sectional observational study was conducted at a Medical College and Hospital in Kolkata, involving 80 symptomatic COVID-19 patients with SpO₂ ≤94%. Patients with liver, kidney, chronic inflammatory diseases, COPD, malignancy, or asthma were excluded. Results: Out of 80 patients, 29 had moderate and 51 had severe illness. Statistically significant differences were observed in TLC, ESR, CRP, AST, ALT, A:G ratio, LDH, Fibrinogen, and D-Dimer between moderate and severe cases. The CTSI correlated significantly with TLC, NLR, CRP, AST, ALT, A:G ratio, LDH, Fibrinogen, and D-Dimer. CTSI values also differed significantly between moderate and severe COVID-19 cases. Conclusion: Biochemical markers such as ESR, TLC, CRP, liver enzymes, LDH, D-Dimer, and Fibrinogen can help predict disease severity. These markers also correlate with radiological severity in COVID-19.

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

A Study to Assess the Knowledge and Practice about Radiation Safety among Nursing Personnel working in Radiation Exposure Area in Selected Hospital in Kolkata, WB, India

A Study to Assess the Knowledge and Practice about Radiation Safety among Nursing Personnel working in Radiation Exposure Area in Selected Hospital in Kolkata, WB, India

Enhancing Diagnostic Accuracy in Radiology: The Role of Efficient Radiology Staff at Eskag Sanjeevani Hospital, Kolkata, India

Diagnostic imaging is a cornerstone of modern medical diagnosis and treatment, yet missed diagnoses remain a significant issue within radiology, often resulting in delayed treatment and adverse patient outcomes. This article examines the pivotal role of radiology technicians in mitigating missed diagnoses and enhancing diagnostic accuracy. Through a detailed analysis of practices at Eskag Sanjeevani Hospital in Kolkata, India, the article highlights how the radiology team's comprehensive approach to imaging encompassing rigorous adherence to protocols, pattern recognition, and thorough communication contributes to superior diagnostic precision. The discussion includes case studies illustrating the team’s proactive identification of incidental findings, such as abnormalities in paranasal sinuses during a brain CT and posterior abnormalities detected during an abdominal CT, which led to additional diagnostic procedures and timely intervention. These practices demonstrate the significant impact of efficient radiology staff on reducing diagnostic errors, improving patient outcomes, and optimizing healthcare delivery.

Adolescent Pregnancy and Anemia: A Descriptive Analysis in a Tertiary Care Hospital in Kolkata, West Bengal

Adolescent pregnancy is a major public health problem in India due to its deleterious consequences on maternal and child health outcomes. A secondary data analysis was performed to assess the proportion of adolescent pregnancy and its association with maternal anemia among pregnant women attending a tertiary care hospital in Kolkata, West Bengal. The secondary data captured in the labor room logbook was analyzed after obtaining permission from the concerned authority. The data were anonymized and checked for completeness, and only complete responses were used for analysis. Among the women who were admitted during the study period, 11.5% were adolescents. Among them, 17.4% were multigravida during their current pregnancy. The prevalence of anemia in teenage pregnancies was higher compared to its adult counterpart (46.4% vs. 40.7%), and this difference was statistically significant. As adolescent pregnancy was found to be significantly associated with maternal anemia, this group needs special attention to prevent adverse consequences.

Mental health problems raise the odds of cognitive impairment in COVID-19 survivors.

COVID-19 survivors around the globe are suffering from mental health issues. While mental health problems can be an early warning sign of dementia, they may also increase the chances of developing the disease. In this study, we examined the mental health of COVID-19 survivors and mapped its associations with cognitive and demographic variables. COVID-19 survivors listed in the databases of three tertiary care hospitals in Kolkata were contacted sequentially. 376 willing patients were interviewed over the telephone. 99 COVID-19 patients and 31 matched controls participated in the in-person interviews that were arranged for a more detailed investigation. The participants were administered standardized tests that are widely used for the assessment of cognitive functioning and mental health status. 64.89% of COVID-19 survivors reported a deterioration in physical functioning. 44.95% reported a decline in mental health, whereas 41.49% reported a drop in cognitive performance. Detailed investigations revealed that they had an increased risk of having depression, anxiety, and poor sleep quality by 91%, 68%, and 140%, respectively. 6.1% of the patients had mild cognitive impairment, and 4% had dementia. COVID-19 patients who had depression and anxiety were 8.6 and 19.4 times more likely to have cognitive decline, respectively. Compared to the matched controls, COVID-19 patients had greater depression (p<.001), anxiety (p<.001), stress (p =.003), and insomnia (p <.001). They also scored significantly lower on Addenbrooke's Cognitive Examination-III (p =.009) and Picture Naming Test (p =.005) and took significantly longer to complete Trail Making Test-A (p =.002). COVID-19 survivors in this study had major mental health issues even one year after contracting the virus. They had significant cognitive deficits that might progress into dementia. Strict monitoring and systematic treatment plans should be implemented as soon as possible.

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&lt;sup&gt;nd&lt;/sup&gt; 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&lt;sup&gt;nd&lt;/sup&gt; 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

Smoking and the Risk of Type 2 Diabetes: A Cross-sectional Analytical Study.

India is undergoing epidemiological transitions with the increase in noncommunicable disease (NCD) burden. Targeting the modifiable risk factors through lifestyle changes in the early years of life remains the most effective strategy for decreasing the prevalence of type 2 diabetes mellitus (T2DM). To determine the association between cigarette smoking and T2DM. An analytical cross-sectional study was conducted among the patients attending the outpatient department of a tertiary care teaching hospital in Kolkata, West Bengal, India. Patients aged more than 35 years were enrolled, and details regarding sociodemography, clinical status, and NCD risk factors were collected using pretested semistructured questionnaires after obtaining IEC approval. Data collected were entered in MS Excel and analyzed using SPSS software. Simple logistic regression and multivariable logistic regression analysis were used to calculate the crude and adjusted odds ratio with 95% confidence interval. Out of 434 participants, 37.3% had diabetes mellitus, 51.6% were males, and 28.6% had alcohol consumption. Univariate logistic regression analysis revealed age, BMI, systolic BP, diastolic BP, and cigarette smoking were significantly associated with increased risk of T2DM. Multivariable logistic regression analysis revealed cigarette smoking, systolic BP, age, and female gender were significant risk factors for T2DM. Our study reported cigarette smoking and systolic BP are modifiable risk factors associated with T2DM. Early identification of smoking through screening and appropriate control of hypertension in T2DM patients will decrease the morbidities and mortalities in T2DM cases.

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.