Tertiary Care Centre In Eastern India Research Articles

A Randomized Controlled Study Comparing the Efficacy of 75mg Versus 150mg Aspirin for the Prevention of Preeclampsia in High-Risk Pregnant Women.

Background Preeclampsia is a major factor in both maternal and fetal morbidity and mortality. The most widely investigated preeclampsia prevention medication is low dose Aspirin. However, guidelines differ considerably regarding the prophylactic dose of Aspirin for preeclampsia. Objective The objective is to compare the efficacy of 150mg versus 75mg Aspirin for the prevention of preeclampsia in pregnant women at high risk of preeclampsia. Methodology This was a parallel, open-label, randomized control trial carried over a period of one year and three months at a tertiary care center ofEasternIndia. Block randomization was done and block sizes of 2 and 4 were used to ensure balanced distributions within the study arms. Primary outcome was the development of preeclampsia and secondary outcomes were fetomaternal complications in both groups. Results The present clinical trial was conducted on 116 pregnant women with a risk factor of preeclampsia andthey were randomly assigned to receive either 150mg or 75mg of Aspirin daily beginning from 12 to 16 weeks of gestation till 36 weeks' gestation. A significantly greater number of pregnant females who received Aspirin 75mg (33.92%) developed preeclampsia in contrast to those who received Aspirin 150mg (8.77%), p=0.001, OR = 5.341, 95%CI = 1.829-15.594. There was an insignificant difference in fetomaternaloutcome among both the groups ofwomen. Conclusion Among womenwho are at high risk of developing preeclampsia, Aspirin 150 mg once a day at bedtime is more effective than Aspirin 75 mg once a day at bedtime in preventing preeclampsia with similar fetomaternal outcomes (NICU admission, IUGR, neonatal death, still birth, eclampsia, HELLP syndrome, placental abruption and pulmonary edema).

Sexual dysfunction in female patients of reproductive age group with recurrent urinary tract infection—a cross-sectional study

Sexually active female patients often present with urinary tract infection. Recurrent urinary tract infections negatively affect a patient's social and sexual life, leading to deterioration of overall life quality. This study aimed to determine the prevalence of sexual dysfunction in recurrent urinary tract infection patients of reproductive age, and the association between recurrent urinary tract infections and sexual dysfunction. A total of 697 women of reproductive age with urinary tract infection attending a urology outdoor patient department in a tertiary-care center in eastern India were evaluated with a comprehensive history (including a validated questionnaire), physical examination, and relevant investigations. To assess sexual dysfunction and sexual distress profiles, the Female Sexual Function Index scale and the revised Female Sexual Distress Scale were used. Recurrent urinary tract infection was found in 143 of 697 (20.5%) patients. Women with recurrent urinary tract infection had a lower Female Sexual Function Index score (<26.55) and a higher Female Sexual Distress Scale score (>11), suggestive of sexual dysfunction, in 59.4% and 58.1% of cases, respectively (P<.001), whereas such scores were found among 22.6% and 19.1% of patients without recurrent urinary tract infection, respectively (P<.001). Relationship status and bowel history were independent predictors of Female Sexual Distress Scale score of >11. Nearly 60% of sexually active women of reproductive age with recurrent urinary tract infection had low Female Sexual Function Index and high Female Sexual Distress Scale scores, which are suggestive of sexual dysfunction. Thus, every patient with recurrent urinary tract infection should be evaluated for sexual dysfunction to improve quality of life.

Study of Knowledge, Attitude and Practice among the Nursing Students Regarding COVID-19 Preparedness in A Rural Tertiary Care Center in Eastern India

The present pregression of the highly contagious novel coronavirus [COVID-19] has been testing thehealthcare system globally pressing the medical staff everywhere. Present and future healthcare workers’updated knowledge, proper attitude towards the pandemic and adequate preventive practices are ofparamount importance for the combat effectiveness of the healthcare burden.This study assessed theknowledge, practice and attitudes regarding COVID-19 among the nursing students of a tertiary care centerin Eastern India. KAP scores were compared with their socio-demographic variables. Inter-relation betweenknowledge, attitude and practice was also assessed.Out of the 131 students participated in the study the KAPparameters were not significantly different based on the socio-demographic factors. Though knowledgeand attitude parameters were positively correlated among them, it was found that practice was negativelycorrelated to both knowledge and attitude. This finding can be attributed to them being non-exposed andinexperienced in the regular healthcare activities as well to the fact that Indian population was to some extentunprepared to cope up with this type of epidemic for a long time. Training on the updated knowledge alongwith exposure to simulated environment with scheduled supervision to reflect the behavior of the studentsis of great importance so that in extreme situation, the trainee students can also come handy into utilizationif needed.

Estimation of Femoral Neck Anteversion in Adults: A Comparison Between Clinical Method, Radiography, and Computed Tomography at a Tertiary-care Center in Eastern India.

IntroductionFemoral anteversion is the anterior inclination of the femoral neck and head in relation to the shaft of the femur. Femoral anteversion provides torsional stability of the hip - an important clinical factor for conditions such as trauma, arthroplasty, developmental dysplasia of the hip, and Legg-Calve Perthes disease. Precise measurement is important to avoid instability in pathological conditions of the hip. Computed tomography (CT) measures the angle more accurately as compared to plain radiography and is considered the gold standard procedure for measurement. Patients are exposed to significantly more ionizing radiation in CT, especially the pediatric population, which is more susceptible.Material and methodsA prospective study of 25 individuals was undertaken wherein the femoral anteversion angle was comparatively measured by clinical, radiographic, and CT methods.ResultsThe radiological evaluation depicted mean values that were far from those of the CT evaluation as compared to the clinical evaluation.ConclusionThe clinical method (trochanter prominence angle test) can be used to measure femoral anteversion to avoid exposure to ionizing radiation and cases where CT is unavailable.

Apolipoproteins AI/B/E gene polymorphism and their plasma levels in patients with coronary artery disease in a tertiary care-center of Eastern India

The present study was designed to investigate whether the three-apolipoprotein (AI, B, E) gene polymorphisms were related to alter their plasma protein levels and hence associated to coronary artery disease (CAD). We determined distribution of MspI apo AI, EcoRI apo B, HhaI apo E gene polymorphisms, plasma apolipoproteins and lipids levels among 150 patients having CAD admitted to the Department of Cardiology, N.R.S. Medical College & Hospital, Kolkata, India during June 2010-June 2012 and 150 age sex matched healthy controls. We found that ApoAI concentration of studied population was significantly different in each genotypes of -75 G/A apo AI (p<0.0001) gene polymorphism. A significant association was found in multivariate analysis for the genotypes with apo E4 allele [odds ratio (OR): 3.639; 95% confidence interval (CI): 1.019-12.995, p=0.040] with four conventional risk factors (i.e. smoking, low-density lipoprotein, ApoAI and ApoB) with CAD. In contrast E2 allele has reverse effect, but the genotypes with apo E2 allele was no longer significant in the multivariate model (OR: 1.788; 95% CI: 0.400-8.001, p=0.447) where as being significant in univariate analysis (OR: 0.219; 95% CI: 0.087-0.552, p=0.001). Our findings suggest that the polymorphisms apo AI MspI and apo B EcoRI do not seem to affect CAD. But the genotype with E4 allele of apo E gene independent of other risk factors is associated with this disease.

Congenital adrenal hyperplasia: An Indian experience

Data regarding the presentation and course of patients with congenital adrenal hyperplasia (CAH) is scarce in South Asia. We aimed to fill that gap by collating our experience with CAH and comparing it with findings from few other centres around the world for pertinent differences. We retrospectively analysed the records of 86 CAH patients seen at our tertiary care centre in Eastern-India from 1996 to 2010. Forty-five patients (52.3%) had classic disease and 41 (47.7%) had non-classic disease (NC CAH). In the classic CAH group, 18 (20.9%) had salt wasting CAH (SW CAH) while 27 (31.4%) had simple virilising disease (SV CAH). Ten (11.6%) had a 46,XY karyotype. Patients with SW CAH were diagnosed earlier in infancy at a median age of 0.5 year, than those with SV type, who were diagnosed at 9 years (P < 0.05). The NC CAH patients were diagnosed still later, at 20.4 years. In patients with SW CAH, boys were diagnosed at an earlier median age of 0.1 year than girls who were diagnosed at 6.4 years (P < 0.05). Sixteen girls (21% of the girls) underwent vaginoplasty of whom four required additional clitoroplasty. One girl needed bilateral laparoscopic adrenalectomy. One NC CAH patient had a successful assisted pregnancy. Hypothyroidism, found in seven (8.1%) was the commonest coexisting abnormality. The skewed male : female ratio suggested that a substantial proportion of males were being missed and consequently may die. Majority of the diagnosed patients (n= 55, 64%) have been lost to follow-up. Remaining patients could be reasonably controlled with standard therapy.