North Bengal Medical College Research Articles

Demographic Study on Enteric Fever: A Single Centre Experiences

Background: Typhoid fever, caused by Salmonella typhi and Salmonella paratyphi, infects various organs after entering the bloodstream. It typically presents with headache, fever, splenomegaly, abdominal pain, and leucopenia, among other symptoms. Globally, it affects 11-21 million people annually, causing 120,000-160,000 deaths, with Southeast Asia being the most impacted region. Improved water, sanitation, and hygiene (WASH) practices are crucial for prevention, alongside targeted public health strategies in endemic regions like Bangladesh. Aim of the study: The study aims to identify demographic risk factors associated with typhoid fever in Bangladesh. Methods: This cross-sectional observational study was conducted at the Department of Medicine, North Bengal Medical College Hospital, Sirajganj, Bangladesh, over 12 months. We included 72 patients presenting with fever, headache, and abdominal pain, with positive blood culture reports for Salmonella typhi and Salmonella paratyphi, aged 18 years and above, who provided informed consent. Excluded were patients on antibiotics and those with multiple blood culture samples. A short questionnaire, validated through a pilot study, captured demographic and clinical data. Result: Mostly 76.39% of participants were aged 18-45. Males comprised 58.33% of participants, and females 41.67%. Occupationally, 48.61% were civil servants, 16.67% housewives, 13.89% students, 12.50% businessmen, and 8.33% farmers. Socio-economically, 16.67% were upper class, 37.50% middle class, and 45.83% lower class. Urban residents made up 40.28% and rural residents 59.72%. All participants had a fever, with other symptoms including headache (69.44%), abdominal pain (48.61%), vomiting (20.83%), coated tongue (27.78%), and constipation (61.11%). Conclusion: This study examines factors influencing enteric fever in Bangladesh, noting higher prevalence among males aged 18-45 due to occupational risks. Lower socio-economic status and rural living also increase risk, highlighting healthcare disparities. Common symptoms included fever, headache, and abdominal pain. Improving sanitation and targeting high-risk groups can reduce incidence.

Exploring the Role of Serum Hydrogen Sulphide (H2S) Levels in Manic Depressive Psychosis in Terms of Its Association, Diagnostic Ability, and Severity Prediction: Findings From a Tertiary Care Center in North Bengal.

Manic depressive psychosis (MDP) or bipolar disorder, a prevalent psychiatric condition globally and in the Indian population, has been attributed to various pathological mechanisms. Hydrogen sulphide (H2S), a member of the gasotransmitter family, may be linked to the development of bipolar disorder because it plays a crucial role in maintaining proper neuronal function in terms of excitability, plasticity, and homeostatic functions. There is very little data regarding the role of the gasotransmitter H2S in MDP in terms of its association, diagnostic ability, and severity prediction, which led us to conduct this study among MDP patients in the Sub-Himalayan region of West Bengal. This was an observational case-control study performed in the Department of Biochemistry, North Bengal Medical College and Hospital, Siliguri, West Bengal, India, from January 2022 to December 2022. Fifty diagnosed MDP patients and 50 healthy age- and sex-matched control subjects satisfying the inclusion and exclusion criteria were studied. The H2S level in the blood was assayed using the standardised spectrophotometric methylene blue method. The severity of depression was assessed by Hamilton Depression Rating Scale (HAM-D) scoring. Of the 50 MDP patients, 45 (90%) were in the depressive phase, and five (10%) were in the manic phase. Of the 45 depressive patients, eight (17.8%) had mild depression, 12 (26.7%) had moderate depression, 19 (42.2%) had severe depression, and six (13.3%) had very severe depression. The mean H2S level in MDP patients (41.98±18.88 μmol/l) was significantly (P<0.05) lower than that in control subjects (99.20± 15.20 μmol/l). It was also observed that the mean H2S level in MDP patients decreased with the duration of the disease but was not statistically significant. The mean H2S levels in the different depression severity groups were found to be significantly different (P<0.001). Receiver operating characteristic (ROC) curve analysis revealed that a cut-off value of H2S <78.5 μmol/l was associated with MDP, with a sensitivity of 96%and a specificity of 88%,and a cut-off value of H2S < 53 μmol/lpredicted the severity of depression with a sensitivity of 89.3% and a specificity of 76.5%. The significant association of the gasotransmitter H2S in MDP patients and its role as a diagnostic and severity predictive marker can help us to employ proper measures for better management of MDP and improving quality of life.

Correlation Between Thyroid Profile and Glycated Haemoglobin (HbA1c) in Type 2 Diabetes Mellitus Patients

Diabetes mellitus is a global health problem affecting major populations worldwide. It is a group of metabolic disorders characterized by absolute or relative deficiencies in insulin secretion with chronic hyperglycaemia and disturbances of carbohydrate, lipid, and protein metabolism. Thyroid hormones are secreted from thyroid gland. Thyroid hormone replacement is associated with a decrease in Glycated Hemoglobin (HbA1c) level. The present study was undertaken to study correlation between thyroid profile and glycated Haemoglobin (HbA1c) in Type 2 Diabetes Mellitus patients. A hospital based case control study was carried out in Dept. of Biochemistry, North Bengal Medical College, Sirajganj, Bangladesh from July to December 2022. 100 participants were in the study group and 100 participants in control groups were enrolled by following procedure. Patients aged 30 years or more who came to routine health check-up were taken for the study. Basic information, clinical history was taken from the record files. 50 cases of Type 2 Diabetes mellitus and 50 healthy controls were taken. Blood samples were collected and analyzed for thyroid profile, HbA1c, Fasting Blood Sugar and Renal Function Test. We found that there was a positive correlation between TSH (Thyroid stimulating hormone) and HbA1c levels, and a negative correlation between Thyroid hormones [Triiodothyronine (T3) &amp; Thyroxine (T4)] and Glycated Haemoglobin (HbA1c) in cases of type 2 Diabetes Mellitus. There is a significant decrease in TT3 (Total Triiodothyronine) and TT4 (Total Thyroxine) and significantly increased TSH in cases of Diabetes mellitus as compare to healthy Controls. We found that out of 50 cases of type 2 Diabetes Mellitus, 31% patients showed thyroid disorders. There is a high prevalence of thyroid disorders in Diabetic patients. If not diagnosed early, it could negatively affect diabetes and its complications. Therefore, routine screening of thyroid profile in diabetic patients is advisable to improve quality of life and reduce morbidity rate.

Efficacy of Foley Catheter Bulb with Intracervical Dinoprostone Gel versus Dinoprostone Gel Alone for Cervical Ripening and Induction of Labour: An Observational Study

Introduction: One of the most common obstetrical interventions is the induction of labour. Cervical ripening drugs are typically used before conventional methods of induction since they are linked to an increased risk of protracted labour, chorioamnionitis, and Caesarean Sections (CS) during labour induction when an unfavourable cervix is present. The two major techniques for cervical ripening are mechanical interventions, such as the insertion of balloon catheters, and the application of pharmacologic agents, such as prostaglandins. It is widely accepted that the induction of labour, which ultimately leads to vaginal delivery, is largely dependent on the condition of the uterus’ cervix. Aim: To compare the efficacy of a combination of Foley bulb catheter and intracervical Dinoprostone and intracervical Dinoprostone alone for the induction of labour. Materials and Methods: A prospective observational study was performed over 150 pregnant mothers from May 2018 to April 2019. in the labour room of North Bengal Medical College and Hospital, a tertiary care institution in Darjeeling, West Bengal, India. The pregnant women were divided into two groups: intracervical Dinoprostone gel alone (Group-1) and a combination of intracervical Foley catheter and intracervical Dinoprostone gel (Group-2) with n=75 patients in each group. Group-1 received intracervical Dinoprostone gel 0.5 mg, which was repeated every 6 hours, a maximum of three doses, or until she went into active labour, whichever occurred earlier. In Group-2, a 16 F Foley catheter was inserted into the cervix, inflated, and a single dose of intracervical Dinoprostone gel 0.5 mg was given alongside it. Participant demographic characteristics, medical and pregnancy history, indication for labour induction, labour course, and outcomes were collected. The collected data were analysed with the mean and standard deviation for numerical variables and counts and percentages for categorical variables. Odds ratio was calculated where deemed relevant. Results: The induction to delivery time was considered the primary outcome and was shorter in Group-2 by 28 minutes (p=0.342). Among the secondary outcomes, the duration of the latent phase of labour was shorter in Group-2 by 57 minutes, and the proportion of patients delivering within 12 hours was also higher (28%) but statistically insignificant (p&gt;0.05). The rates of CS were unaffected by the mode of induction. None of the two methods were found to be inferior to the other in respect to neonatal outcomes or complications of labour like chorioamnionitis and postpartum haemorrhage. Conclusion: The combination of Foley catheter with intracervical Dinoprostone gel did not prove to be more efficient than intracervical Dinoprostone alone for labour induction in the current study

Mortality Risk Assessment by SNAP-II and SNAPPE-II among Very Low Birth Weight Newborns- An Observational Study

Introduction: Very Low Birth Weight (VLBW) babies are those with a birth weight of less than 1500 gm and require special care, attention, and resources. However, despite all efforts, their mortality rate remains high. Proper assessment of these neonates is crucial to identify high-risk cases and take early steps to reduce mortality. In addition to technical advances in neonatal care, severity scores have been developed to predict neonatal mortality. Richardson developed the Score for Neonatal Acute Physiology (SNAP-II) and SNAP with Perinatal Extension (SNAPPE-II) as scoring systems for predicting mortality in the Neonatal Intensive Care Unit (NICU). Aim: To assess the usefulness of SNAP-II and SNAPPE-II as predictors of mortality in VLBW neonates. Materials and Methods: This was an observational cross-sectional study involving 145 VLBW neonates admitted to the NICU of North Bengal Medical College and Hospital (NBMCH) from May 2019 to April 2020. Relevant data were collected to assess the mortality risk scores SNAP-II and SNAPPE-II. The outcome of discharge or death was recorded. Data entry was performed using MS excel and analysed using Statistical Package for Social Sciences (SPSS) version 20.0. The relationship between newborn survival and SNAP-II or SNAPPE-II final scores was determined using the Mann- Whitney U test, and the relationship between survival and various SNAP-II and SNAPPE-II score categories was determined using Fisher’s-Exact Test. A p-value of less than 0.05 was considered statistically significant. An ROC curve was generated to determine the best cutoff score for predicting mortality. Results: The mean scores of SNAP-II and SNAPPE-II were higher in babies who expired compared to those who survived. The mean (±SD) SNAP-II scores were 8.96 (±13.865) for survived newborns and 41.08 (±23.174) for expired newborns. The mean (±SD) SNAPPE-II scores were 20.01 (±14.54) for survived newborns and 48.85 (±25.02) for expired newborns. The optimal cutoff values for SNAP-II and SNAPPE-II in predicting mortality were 31.5 and 36, respectively. The sensitivity and specificity of SNAP-II were 83.0% and 89.1%, while for SNAPPE-II they were 69.8% and 89.1%, respectively. Conclusion: The mean SNAP-II and SNAPPE-II scores were higher among expired VLBW neonates compared to those who survived. A SNAP-II score of 31.5 and SNAPPE-II score of 36 were associated with higher mortality, indicating that both scores are effective predictors of mortality regardless of Gestational Ages (GA) and birth weight.

A Study of Correlation between Tear Film Break - Up Time (TBUT), Pterygium and Pinguicula on Patents Attending a Tertiary Centre, North Bengal Medical College &amp; Hospital, Darjeeling, Sub Himalayan Region, India

Introduction: Degenerative changes in conjunctive are quite common in India, especially after 40 years of age. Degenerative changes like Pterygium and Pinguicula occurs especially due to prolonged exposure to ultra violet rays who lives in dry windy area and having pre-existing dry eye syndrome. Pterygium is a elastotic degeneration of the subconjunctival tissue approaches towards the cornea in a triangular fashion. Pterygium is mostly prevalent on the palpebral aperture mostly in the nasal side. It is thought that the predominantly nasal location is related to reflection of light from the nasal bridge on to the nasal conjunctiva. The ultraviolet light may be mediated by mutation in the P53 gene.

The Prevalence of Diabetic Retinopathy and Associated Risk Factors among Diabetic Patients in a Tertiary Care Hospital

Background: One of the most serious complications of diabetes that places an enormous strain on the patient, the healthcare system, and the world economy is diabetic retinopathy (DR). It includes long-term exposure to the metabolic changes linked to diabetes, which cause damage to the retina's microvasculature. Objectives: The aim of the study was to assess the prevalence of diabetic retinopathy and associated risk factors among diabetic patients in a tertiary care hospital. Methods: This cross-section observational study was carried out in the Department of Ophthalmology, North Bengal medical College. Convenience sampling technique was followed. Face to face interview was done to collect data with a semi-structured questionnaire. After collection, the data were checked and cleaned, followed by editing, compiling, coding and categorizing according to the objectives and variable to detect errors and to maintain consistency, relevancy and quality control. Statistical evaluation of the results used to be obtained via the use of a window-based computer software program devised with Statistical Packages for Social Sciences (SPSS-24). The duration of the period from July 2018 to July 2022. A total of 120 patients were participate in the study. Results: About 58.33% respondents were male and 41.67% were female. Majority (33.33%) of the respondents were within the age group of 50-59. 33.33% were service holder, 41.67% were businessman, 12.5 were day labor, 6.67% were farmer. 75% were from urban area and 25% from rural area. The prevalence of DR in this study was 41.1%. About 90% had DM of &lt;5 years, 55% had 6-10 years, 40% had 15-20 Years, 30% had 16-20 years and only 7% had &gt;21 years. About 50% had normal grade of diabetic retinopathy in the worse eye, 15% had Mild NPDR, 8.33% had Moderate NPDR, 6.67% had Mild to moderate NPDR with non-CSME, 2.5% Moderate NPDR with CSME, Severe NPDR with non-CSME Severe NPDR with CSME and Advanced PDR respectively. Mean FBS (mg/dl) was 160.86±70.6, Total cholesterol (mg/dl) was 183.2 ± 2.1, Triglycerides (mg/dl) was 161.2 ± 2.6, Systolic BP was 130.56±15.7 and Diastolic BP was 80.86±13.4. Patients with baseline age of &lt;60 years were three times (AOR = 3.2:95% CI: 1.19–8.63) more likely to develop DR. The odds of DR is about 3 times (AOR = 2.91:95% CI: 1.01–8.35) higher for patients with disease duration of ≥6 years as compared to disease duration of &lt;6 years. Systolic blood pressure also had statistically significant association with patients having blood pressure of &lt;140 mmHg being about 3.6 times (AOR = 0.28:95% CI: 0.09–0.82) less likely to have DR as compared to hypertensive patients with systolic blood pressure of ≥140 mmHg. The other cofactors, history of hypertension, and total cholesterol level were not independent significant factors for the development of DR in our study. Conclusion: Systolic hypertension, being on insulin alone or in combination with OHA, and having diabetes for a longer period of time were all independently linked to the occurrence of DR. The significant DR prevalence our study suggests that routine patient care, including treatment facilities, has to be improved. Healthcare practitioners must make a consistent effort to educate diabetic patients about the importance of blood sugar control and hypertension management in lowering the risk of the start and progression of DR. It is advised that diabetic patients get health education regarding the importance of routine eye exams for the early detection and treatment of diabetes-related eye problems.

Low Dose Aspirin for Primary Prevention of Adverse Pregnancy Outcome

Background: Pregnancy is associated with various complications such as pre-eclampsia, SGA, preterm birth etc. Low dose aspirin is a possible medication to minimize these adverse outcomes. The aim of this study was to evaluate the use of low dose aspirin for primary prevention of adverse pregnancy outcome. Material Methods: This cross-sectional study was conducted in department of Gynaecology, North Bengal Medical College Hospital, Mirjapur Bkash Hospital, Mirjapur, Tangail, Bangladesh, during the period from June 2021 to August 2022. Total 200 pregnant women were included in this study. Results: In this study, the mean (±SD) age of the study subjects were 25.12 ± 5.49 years and 25.00 ± 4.83 years in LDA group and control group, respectively. There was no statistically significant (p&gt;0.05) difference in age between the groups. The rate of caesarean section was higher in control group (68%) compared to LDA group (59%) but there was no statistically significant (p&gt;0.05) difference among the groups. In our study, 8% pregnant women in LDA group and 19% pregnant women in control group had gestational hypertension, pre-eclampsia was seen in 6% and 13% pregnant women in LDA group and control group, respectively, preterm birth was seen in 8% and 17% pregnant women in LDA group and control group, respectively, SGA was seen in 19% and 32% pregnant women in LDA group and control group, respectively, and fetal distress was seen in 2% pregnant women in both LDA group and control group. There were statistically significant (p&lt;0.05) differences in complications except fetal distress. Mean (±SD) neonatal birth weight was 2.88±1.03 kg and 2.74±0.85 kg in LDA group and control group, respectively and there was no statistically significant (p&gt;0.05) difference. Conclusion: We found that low dose aspirin could significantly reduce the risk of adverse outcomes, especially for pre-eclampsia, SGA and preterm birth.

Clinical Profile Analysis of Tuberculosis Patients Attended in a Tertiary Care Hospital in Bangladesh

Background: Despite noteworthy socio-economic development and advances in medical science, tuberculosis (TB) remains a major public health problem. Although it is a curable disease, still millions of people suffer and a large number of patients die from this infectious disease. Now a day, the prevalence and nature of tuberculosis are not in a consistent stage. So we need more current information regarding this issue. Aim of the study: The aim of this study was to assess the clinical profile of tuberculosis patients attended in a tertiary care hospital in Bangladesh. Methods: This was a prospective, observational study which was conducted in the department of Medicine, North Bengal Medical College, Sirajgonj, Bangladesh during the period from January 2020 to June 2022. In total 87 diagnosed patients with tuberculosis, treated in the mentioned hospital were selected as the study subjects. Before data collection, proper written consents were taken from all the participants. For data collection a predesigned questionnaire was used in data collection. Collected data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. Results: In this study, the male-female ratio of the participants was 1.7:1. The highest number of participants were from the 41-50 years’ age group which was 27.59%. BMI (Kg/m2) was found ≥18.5 in 61% and &lt; 18.5 was found in 39% of patients. Majority (56%) of the cases were ‘non- smoker’. As the types of TB, pulmonary Koch’s, CNS tuberculosis, abdominal Koch’s, and TB lymphadenitis were found in 43% 21%, 14%, and 13% of participants respectively which was noticeable. In this study, among all the participants, cough and fever were found as two most frequent symptoms which were found in 93% and 84% of patients respectively. Conclusion: Fever and cough are the two most frequent symptoms in tuberculosis patients. Although the death rate among TB patients is not alarming, the treatment success rate of the first treatment attempt is not satisfactory among tuberculosis patients.

Frequency of Metabolic Syndrome and Lipid Profile Analysis among Patient with Type 2 Diabetes: A Single Center Study

Background: Diabetes mellitus is associated with various metabolic disorders, which leads to the progression of the disease and its complications. Dyslipidemia has been noted to play an integral role in the pathogenesis and progression of micro and macro vascular complications in diabetes mellitus (DM) patients. Lipid profile is the indicators of dyslipidemia. Aim of the Study: The aim of this study was to accumulate the frequency of metabolic syndrome and lipid profile among patient with type 2 diabetes. Methods: This hospital based descriptive type of observational study was conducted in the Department of Medicine, North Bengal Medical College and Hospital, Sirajgonj, Bangladesh during the period from January 2022 to December 2022. In total 97 diagnosed patients with type 2 diabetes mellitus were enrolled in this study as the study subjects. Proper written consents were taken from all the participants before data collection. All demographic as well as clinical data were recorded. Data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. Results: The highest number (37%) of our participants was from 41-50 years’ age group and the female participants were dominating in number. Majority of the patients (63%) were obese: ≥30. In this current study, the frequency of metabolic syndrome was found as 71%. The mean± SD total cholesterol, triglyceride, LDL cholesterol and HDL cholesterol of the respondents were found as 179.88±42.81, 179.88±42.81, 109.74±46.69 and 44.75±7.68 mg/dL respectively. Among the majority of our patients (72%) normal (≥40 mg/dL) HDL level was found. Conclusion: The higher frequency of metabolic syndrome among type 2 diabetes patients demands more attention from health professionals as well as the policy makers. There may not have any significant correlation of metabolic syndrome or type 2 diabetes with lipid profile but aged people may be prone to those diseases.

Computer-Assisted Learning versus Conventional Methods for Pathology Tutorials: A Longitudinal Interventional Study

Introduction: One of the important objectives of undergraduate pathology teaching is to enable the student to correlate the normal and altered morphology of different organ systems in common diseases. The conventional chalk and board method of tutorials for imparting this training is not free of disadvantages. ComputerAssisted Learning (CAL) is the trend of the day worldwide. Aim: The present study aimed to compare the effectiveness of CAL with the conventional method for pathology tutorials, with special emphasis on the retention of knowledge in students. Materials and Methods: The present study was a longitudinal interventional study involving 110 students of the second Professional MBBS batch of the Department of Pathology at North Bengal Medical College, Darjeeling, a rural area Medical College, for a period of six months from December 2017 to June 2018. The students were divided into an intervention group taught by the CAL method and a control group taught by the chalk and board method. On the day of teaching and one month after that, assessment was done by histopathology slide spotting. Focus Group Discussion (FGD) and a pre-tested and validated questionnaire completion were also undertaken. Paired t-test was used for comparison in both groups. Results: Those instructed by the CAL Method scored significantly higher than the control group students in both Spotting-1 and Spotting-2. In Spotting-1, the average score of group A (interventional group) and group B (control group) students was 71.11±27.67 (SD) and 38.89±24.75, respectively (p-value 0.01). In Spotting-2, the average score of group A and group B students was 67.78±28.52 (SD) and 29.44±28.85 (SD), respectively (p-value-0.01). Conclusion: The present study concluded that the CAL method is acceptable to both students and facilitators. It resulted in a significantly improved performance of students in the diagnosis of histopathology slides assessed immediately after teaching and one month after teaching. Hence, CAL also assists in the retention and recall of information.

Platelet-Rich Plasma Therapy for Hair Loss Treatment in North Bengal Medical College, Sirajganj, Bangladesh

Platelet-Rich Plasma Therapy for Hair Loss Treatment in North Bengal Medical College, Sirajganj, Bangladesh

Outcome predictors of meningoencephelitis due to Orienta tsutsugamushi in children: a retrospective study in tertiary care hospital in the terai region of West Bengal

Background: Childhood infection by Orienta tsutsugamushi is endemic in India and central nervous system invasion by this organism is exceedingly high which is difficult to diagnose. Meningoencephelitis is a life-threatening manifestation of febrile illness caused by orienta tsutsugamushi that can cause significant morbidity and case fatality. Early diagnosis of mortality indicators and judicious intensive treatment accordingly can reduce mortality.Methods: A retrospective study was conducted with 22 patients of meningoencephelitis due to Orienta tsutsugamushi to find out the mortality predictors in the department of pediatrics of North Bengal medical college, Darjeeling, West Bengal, IndiaResults: It was seen that Pneumonitis, raised SGPT, Oedema and raised creatinine were found to be poor prognostic indicators of orienta tsutsugamushi meningoencephelitis.Conclusions: Identification of those predictors and early initiation of intensive management accordingly will be salutary to reduce mortality in orienta tsutsugamushi meningoencephelitis.

A COMPARATIVE STUDY BETWEEN 0.5% BUPIVACAINE (HEAVY) AND 2- CHLOROPROCAINE (PRESERVATIVE FREE) FOR SPINAL ANAESTHESIA IN ELECTIVE SHORT SURGICAL PROCEDURES

Background: Spinal anaesthesia is the preferred anaesthetic technique in lower abdominal surgeries but in case of short surgeries (&lt; 60 min), appropriate choice of local anaesthetic is of prime importance to prevent problems like prolonged motor block, delayed ambulation and delayed micturition postoperatively. Preservative free 2-Chloroprocaine has recently come up as a good alternative as compared to commonly used local anaesthetics. Aim: The aim of this study was to compare the efcacy between 1% 2-Chloroprocaine and 0.5% Bupivacaine (heavy) in terms of early block resolution and early ambulation. Material And Methods: This prospective, randomised, double blinded, comparative study was conducted in the Department of Anaesthesiology, North Bengal Medical College and Hospital. One hundred and ten (110) patients of ASA physical status I or II and age of 18-60 yrs undergoing lower abdominal surgeries under spinal anaesthesia were chosen and randomly divided into two groups, Group A and Group B. Group A received 40 mg (4ml) of intrathecal 1% preservative free 2-Chloroprocaine and Group B received 12 mg (2.4ml) of intrathecal 0.5% Bupivacaine (heavy). After administration of intrathecal drugs, vital parameters were monitored and any intraoperative complications recorded. Onset and height of sensory block were monitored by pinprick method and degree of motor block was monitored by modied Bromage Scale – (0-3). Time to reach readiness for surgery, duration of sensory block and motor block, time to ambulation and micturition, any supplementation required and any complications were recorded. The data were analysed using appropriate statistical tests. Results: The patients in Group A had a lower duration of motor block in comparision to those in Group B [81 ± 11 min vs 142 ± 29 min (P&lt;0.001)]. The duration of sensory block was also signicantly lower in Group A as compared to Group B [100 ± 14 min vs 188 ± 39 min (P&lt;0.001)]. Also patients in Group A had lower time to ambulation than those in Group B[142 ± 24 min vs 280 ± 51 min (P&lt;0.001)] as well as lower time to micturition as compared to those in Group B[204 ± 37 min vs 365 ± 57 min (P&lt;0.001)]. Conclusion: For spinal anaesthesia in lower abdominal short surgical procedures, intrathecal 2-Chloroprocaine produces a satisfactory surgical block and is a better drug in comparison to hyperbaric bupivacaine with respect to faster block resolution and ambulation.

Common Microorganisms Present in Diabetic Foot Infection and It’s Spectrum of Antibiotic Sensitivity

Introduction: Diabetic patients have foot problems secondary to neuropathy, micro-vascular changes and impaired resistance to infection. They are at increased risk of infection and ulceration. Diabetic ulcers are frequently involved in both aerobe and anaerobe microorganisms. It is important to culture the specimen on several different media. The Gram stain can provide valuable information regarding the range of organisms under consideration. The aim of this study is to identify the sensitive antibiotics to the specific aerobic bacteria, to prevent the random misuse of broad spectrum antibiotics and make awareness about diabetic foot care. Materials and Methods: This study was a retrospective analysis and was carried out in general surgery and diabetic wards at North Bengal Medical College Hospital (NBMCH), Sirajganj, Bangladesh from August, 2019 to July, 2020. To identify common aerobic microorganism and spectrum of antibiotic sensitivity from 54 cases of diabetic foot ulcers, wound swabs taken and cultured using standard aerobic microbiological techniques. Antibiotic sensitivity testing to different antimicrobial agents were carried out using the disc diffusion method. Result: Among 54 aerobic bacterial isolates, Gram negative bacteria 41(75.9%) and Gram positive bacteria 13(24.1%). Escherichia Coli 28(51.9%), Proteus spp 09(16.7%), Pseudomonas 03(5.6%), Klebsiella spp 01(1.9%) were isolated Gram negative bacteria. Staphylococcus aureus 13(24.1%) was only Gram positive bacteria. Gram negative bacterial isolates were sensitive to Imipenem, while Vancomycin showed good activity against Gram positive bacteria. Conclusion: The antibiogram results of this study suggest that bacteria remain sensitive to a limited number of used agents, while found resistant to a number of widely used agents. Imipenem was most effective against Gram negative bacilli and also effective against Gram positive cocci. Medicine Today 2022 Vol.34(1): 65-69

Obstetric Violence and Its Correlates: A Pilot Study in North Bengal Medical College, Darjeeling District, West Bengal, India

Obstetric Violence and Its Correlates: A Pilot Study in North Bengal Medical College, Darjeeling District, West Bengal, India

Anxiety and Depression among Caregivers of the Children with Thalassemia, Attending at Thalassemia Control Unit of a Rural Tertiary Care Medical College, Darjeeling, West Bengal

Background of Study: Caregivers of the children with thalassemia often experienced a life with varied degree of anxiety and depression due the chronic illness like of their children. Mothers as the main caregivers for most of the thalassemic children suffers with different forms of psychological problems. Objectives: The aim of this study was to assess the levels of anxiety and depression of the caregivers of children with Thalassemia and also to find out sociodemographic factors associated with their anxiety and depression. Materials and Methods: Descriptive cross-sectional study conducted in Thalassemia Control Unit (TCU) of North Bengal Medical College (NBMC) from December 2018 to April 2019. Complete enumeration method was used to include 136 caregivers of children (≤12 years) with thalassemia. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) was used to assess the levels of anxiety and depression. Collected data were entered into MS-Excel and analyzed by using SPSS software program, version 22.0. Results: Mean age of caregivers was 34.3 (SD ± 1.4 years). Most of caregivers were female (89%) and had educational qualification up to primary school (45.6%). Majority (70.6%) of the caregivers were the mothers of the children. Most of the study participants (54.4%) had moderate depression followed by 30.1% with mild mood disturbances. Majority (69.9%) of the study participants had mild anxiety and 30.1% moderate anxiety. The median (IQR) of BDI score was 21(23–18) and median (IQR) of BAI score was 20(22–18). Conclusions: Early counseling, psychotherapy, appropriate treatment should be prioritized. Social support, community involvement with their full participation should be emphasized.

OUTCOME OF TUBERCULOSIS IN HIV INFECTED PATIENTS WITH SPECIAL REFERENCE TO CD4 COUNT IN AN ART CENTRE, WEST BENGAL

Background: Opportunistic Infections in HIV are major determinants of mortality in HIV patients. Tuberculosis is a leading cause of mortality. Tuberculosis is a public health challenge specially in developing countries like India. The incidence of TB HIVco-infection is gradually increasing. Methods: This was institution based, retrospective study. Study was conducted at ART Centre, North Bengal Medical College &amp; Hospital, Sushruta Nagar, Darjeeling, West Bengal from January 2015 to January 2020 including 105 HIV-TB co-infected patients. Data was collected and template was generated in MS excel sheet and analysis was done on SPSS software. Results: 105, HIV-TB co-infected patients were registered with majority being male (n=79), mean age for male and female patients were 36.78 years and 35.73 years respectively.. The number of patients diagnosed with Extra-pulmonary tuberculosis (EPTB) and Pulmonary tuberculosis (PTB) were almost equal. Majority of patients (34.3%) had CD4 counts &lt;200 whereas (33.3%) had CD4 counts between 200-349. Favourable outcome in terms of cured patients were 82.85% with a statistically signicant pre-treatment and post-treatment improvement in body weight (p value&lt;0.0001) and CD4 count (p value&lt;0.002. Conclusions: There is a strong association between incidence of TB and HIV infection. Early diagnosis and treatment are essential to reduce mortality and morbidity in people living with HIV. Strict adherence to treatment and dedicated counseling for drug compliance is the need of the hour.

Quality of life among caregivers of thalassaemic children, attending at Thalassaemia control unit of a rural tertiary care hospital, in a sub-Himalayan district of West Bengal

Thalassaemia is a disease of abnormal development of red blood cells which manifests as anaemia. This chronic disease may cause mental, social, financial burdens on the families, care givers and also on health care system.To assess the quality of life (QOL) of the caregivers of thalassaemic children and to identify the predictors of quality of their physical and mental health.Institution based descriptive cross-sectional study conducted in the Thalassaemia Control Unit (TCU) of North Bengal Medical College (NBMC) from December 2018 to April 2019. Total 136 caregivers of children (≤12 years) with thalassaemia were included by complete enumeration method. Physical and mental health of the caregivers were reported in Short Form-36 (SF-36) Health Survey. Collected data were entered into MS-Excel, analysed with the help of SPSS (Version 22).Mean age of caregivers was 34.3 (SD ± 1.4 years). Most of caregivers were female (89%) and had educational qualification up to Primary school (45.6%). Majority (70.6%) of the caregivers were the mothers of the children. Most of the study participants (60.3%) had favourable Physical health Component Summary (PCS) but 64.7% of the caregivers had unfavourable Mental health component Summary (MCS). Educational status was found to be the predictor for PCS but age and relationship with the child were the predictors for MCS.Counselling, psychotherapy, social support for family members or caregivers of the thalassaemic children and community involvement with their full participation should be emphasized to reduce stigma related to thalassaemia.

COVID-19 pandemic and its influence: Case study in North Bengal Medical College, Darjeeling district, West Bengal, India

COVID-19 pandemic will be the most dreaded public health challenge world has ever faced and health-care workers play a crucial role in combating it, risking their own lives. Health workers serving COVID faced discrimination. Many new set up like COVID-19 screening clinics with complete new set of rules and logistics were set up. In North Bengal Medical College (NBMCH), it was functional round the clock since its inception. Our case that was a chronic smoker, alcoholic, and had records of defiant behavior was posted as a guard here. The anguish and pan of the patients attending, an increased job responsibility thrust on him along with the dependence of patients on his behavior brought about a change. Witnessing able tireless fearless leaderships from major wards, supportive supervision, empathy, and regular counseling sessions are thought to herald the positive behavioral change in him. The role of self-actualization theories and adoption of behaviors with effective health communications and theories of ergonomics were reinstated. Using health belief models, a deep understanding of the preventive behaviors was tried.