Tertiary Care Hospital In Kolkata Research Articles

Knowledge, attitude, and practices toward COVID-19 vaccination among patients attending OPD of a tertiary care hospital in Kolkata: A descriptive cross-sectional study

Knowledge, attitude, and practices toward COVID-19 vaccination among patients attending OPD of a tertiary care hospital in Kolkata: A descriptive cross-sectional study

A cross-sectional survey on burden of caregivers of pediatric leukemia patients attending a tertiary care hospital in Kolkata, India

Background: Care giving of children with leukemia involves considerable stress and anxiety on the part of family caregivers. Although caregivers’ burden is a crucial predictor of the health of both the child and the caregiver, it is often overlooked. Aim and Objectives: The present study aimed to assess the burden faced by caregivers of pediatric leukemia patients attending a tertiary care hospital in West Bengal, to elicit their sociodemographic characteristics and patients’ profile, and to find out relationship among these, if any. Materials and Methods: The study was descriptive observational type with cross-sectional design. It was conducted among caregivers of pediatric leukemia patients. Data were collected from 38 caregivers using predesigned, pretested, semi-structured schedule, and patients’ records. Burden was measured using Zarit Burden Interview, which is a 22 item 5-point Likert scale. Data were compiled and analyzed in Microsoft Excel and Statistical Software for the Social Sciences 20.0 for statistical analysis. Sociodemographic and clinical variables were expressed as number, percentages, mean, and standard deviations. To find out the association between different factors and caregiver burden, a logistic regression model was used. P < 0.05 was considered as statistically significant. Results: Majority of the caregivers were the mothers of the patients (68.42%), and most of the families of caregivers belonged to lower middle class according to modified BG Prasad Scale. Half of the caregivers (50%) experienced moderate–to-severe burden according to Zarit Burden Interview. Association was found between burden experienced and duration of disease and treatment. However, socioeconomic status was found to be the most significant determinant of burden as per multiple logistic regression by ENTER method. Conclusions: Majority of the caregivers were having moderate to severe and severe burden, which was significantly more among people coming from lower socioeconomic status. Prolonged disease duration and treatment were also found to be associated with increased burden of the caregivers.

Hematological Parameters: Manual vs Automated Method; Among the β-Thalassemia and other Haemoglobinopathies in a Tertiary Care Hospital in Kolkata

Background: According to a report of WHO in 2007, 7% of world populations are carrier for Haemoglobindisorder and accurate and timely detection of various Hb variants including beta thalassemia trait can preventoccurrence of more serious disorders like thalassemia major in new-borns. But in a developing country like ususe of high pressure liquid chromatography (HPLC) is limited, manual testing is done and accurate assessmentis quite impossible. So, an observational cross-sectional study was done among 117 β-thalassemia and otherHemoglobinopathies cases and carriers.Objective: To find out the variation between the results of haematological tests obtained by automated countingchamber and manual method.Materials & Methods: This Observational, cross-sectional study was done at Thalassemia control unit and Physiologydepartment of R G Kar Medical College and Hospital, Kolkata. β-thalassemia and other Hemoglobinopathies casesand carriers detected by complete blood count with HPLC from Thalassemia Outpatient Department (OPD) andantenatal mothers from antenatal clinic (ANC) were the population of this study. Findings and variations of thefeatures of different hematological parameters amongst the β-thalassemia and other hemoglobinopathies werereviewed. A finding by HPLC was HbA, HbA2, HbF, HbD, and HbE.Results: Result of only Hb% obtained from HPLC and manual method was significantly different inβ- THALASSEMIA Trait (p=0.0001), HbE Trait (p=0.0001), HbS trait (p=0.0001) and not significant in HbE diseaseand no other Red cell indices were significantly different in two methods. Conclusion: As hematological featureslike TC of RBC or PCV results by manual method shows no significant differences with HPLC/Automated counter assessment, such methods can be utilized even at primary level cost effectively for assessment of hematologicaldisorders. But significant difference is seen in estimating Hemoglobin percentage in between Shalli‘s method andHPLC/Automated counter assessment. So some alternate method may introduce at lower level of health systemother than Shalli’s method

Study on spectrum of nephrotic syndrome in adults in a tertiary care hospital of eastern India

Background: Nephrotic syndrome is a very common yet perplexing kidney disease whose spectrum has undergone a gradual change globally over time. Within various Asian countries, the spectrum of adult nephrotic syndrome varies according to the place of origin. Aims and Objectives: The purpose of this study is to know the clinical presentation, laboratory abnormalities, histopathological spectrum of adult nephrotic syndrome, and its changing trends compared to previous studies. Materials and Methods: This observational cross-sectional study includes 50 cases of biopsy proven nephrotic syndrome admitted under general medicine department of a tertiary care hospital of Kolkata from March 2020 to February 2021. Proper history taking, clinical examination, and relevant laboratory investigations were done. Results: The mean age of presentation was 34.56±12.033 years with 27 males and 23 females. Oliguria was the most common presentation. Facial puffiness was the most predominant clinical finding closely followed by generalized swelling, pedal edema and ascites. 44 (88%) patients had serum albumin level ≤3 g/dl and all 50 (100%) patients had serum cholesterol values >200 mg/dl. 46 (92%) patients had a 24 h urinary protein level >3.5 g whereas 33 (66%) patients had 3+grade and 8 (16%) patients had 4+grade albuminuria. The most predominant renal biopsy variety was found to be focal segmental glomerulosclerosis (FSGS), seen in 27 (54%) patients followed by minimal change disease in 14 (28%) patients. 44 (88%) patients had primary glomerular disease (PGD) and 6 (12%) patients had secondary glomerular disease (SGD). The most common type of PGD and SGD was FSGS (59.09%) and lupus nephritis (4%), respectively. Conclusion: Widely varying etiology and clinical presentation makes early diagnosis by renal biopsy critical to properly categorize the disease and direct subsequent clinical approach in adults.

Changing Paradigms in Antibiotic Resistance in Salmonella Species with Focus on Fluoroquinolone Resistance: A 5-Year Retrospective Study of Enteric Fever in a Tertiary Care Hospital in Kolkata, India.

Enteric fever, a potentially fatal multisystem disease that is caused by Salmonella enterica serovar Typhi and Paratyphi, poses a significant risk in low- and middle-income countries. A retrospective study to understand the prevalence and evolving patterns of antibiotic resistance in Salmonella Typhi and Paratyphi was undertaken from June 2017 to June 2022. A total of 4051 blood samples were collected from patients attending inpatient and outpatient departments of the School of Tropical Medicine (Kolkata, India) hospital. Blood samples were cultured, and culture positive samples were further processed for identification using conventional and automated systems. Antibiotic susceptibility test was performed using both the Kirby-Bauer disc diffusion method and VITEK2 (bioMerieux). Forty-five (1.1%) Salmonella species were isolated among the number of total (n = 4051) samples that were tested. Out of the 45 Salmonella isolates, 35 were Salmonella Typhi (77.77%) and 10 were Salmonella Paratyphi A (22.23%). We found pronounced fluoroquinolone resistance of 100% in the recent years (2019–2022) in both of the S. Typhi and S. Paratyphi A isolates. We found that 1 Salmonella Typhi and 2 Salmonella Paratyphi A isolates were resistant against multiple antibiotics (cefixime, ceftriaxone, ciprofloxacin and nalidixic acid), and 1 multidrug-resistant (MDR) Salmonella Paratyphi A isolate was found in a recent study year (2020) and it showed resistance against different classes of antibiotics (cephalosporins, fluoroquinolones and carbapenems). There was no resistance that was detected to the 3rd generation cephalosporins in the final years of the study. The emergence of Salmonella isolates that are resistant to multiple antibiotics poses a serious health problem. The antimicrobial resistance patterns that were detected in the study thus warrant further studies to understand the antibiotic susceptibility and resistance pattern of Salmonella against the major classes of antibiotics.

P442 Bacterial and fungal infection in COVID-19 diagnosed cases in a tertiary care ICU setting in the wake of second wave in Kolkata, India

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PMFungal and bacterial infections increase the mortality rate of COVID-19-positive patients. In addition to the risk factors that we cannot change, invasive procedures should be avoided, constant blood sugar regulation should be applied, and unnecessary antibiotics use should be avoided. To investigate the incidence of bacterial and fungal infection of hospitalized patients intensive care units with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in this retrospective observational study in a tertiary care hospital in Kolkata in the wake of second-wave in India. A retrospective study of hospitalized patients with confirmed SARS-CoV-2 by PCR was analyzed study in a tertiary care hospital in Kolkata in the wake of second-wave from February 2021 to October 2021. The records of 327 patients hospitalized in ICU with the diagnosis of COVID-19 were investigated from electronic health records and hospitalization files. The demographic characteristics (age, gender), the number of ICU hospitalization days and mortality rates, APACHE II scores, accompanying diseases, antibiotic-steroid treatments taken during hospitalization, and microbiological results (blood, urine, tracheal aspirate samples) of the patients were recorded. Blood cultures, respiratory samples, pneumococcal or Legionella urinary antigens, and respiratory viral PCR panels were obtained from COVID-19 patients, respectively. The average APACHE II score of the patients was 28 ± 6. A positive blood culture was identified in 60 patients (7.1%), of which 39 were classified as contaminants. Bacteremia resulting from respiratory infection was confirmed in two cases (one each community-acquired Klebsiella pneumoniae and ventilator-associated Enterobacter cloacae). Line-related bacteremia was identified in six patients (three Candida, two Enterococcus spp., and one Pseudomonas aeruginosa). All other community-acquired bacteremias (n = 16) were attributed to non-respiratory infections. Zero concomitant pneumococcal, Legionella or influenza infection was detected. A low yield of positive respiratory cultures was identified; Staphylococcus aureus was the most common respiratory pathogen isolated in community-acquired coinfection (4/24; 16.7%), with pseudomonas and yeast identified in late-onset infection. Invasive fungal infections (n = 3) were attributed to line-related infections. Opportunistic fungal infection was detected in 58 patients (17.37%) of 327 patients monitored in ICU with a COVID-19-positive diagnosis. Candida albicans was the opportunistic fungal agent isolated from most blood samples taken from COVID-19-positive patients. The mortality rate of COVID-19-positive patients with candidemia was 80%. While 2/3 patients (66.6%) for whom fungi were grown from their tracheal aspirate died, one patient (33.3%) was transferred to the ward. Prolonged mechanical ventilation support was associated with the development of nosocomial candidemia and bacteremia. Parallel to the developments in the field of diagnosis and treatment, an increase in the incidence of fungal infections and the number of patients who are in the risk group for the development of opportunistic fungal infections have been observed in recent years. Among the hospitalized patients, those most at risk in terms of fungal infections are intensive care unit (ICU) patients. The rate of Candida infections amongst critical care patients is very and may pose severe mortality if not diagnosed, treated, and handled effectively, and promptly.

Pediatric Stroke: The Clinical and Etiological Spectrum: An Observational Study from a Tertiary Care Stroke Clinic, Kolkata, India

In different geographical regions, the clincoetiological spectrum of childhood stroke varies widely and studies from Eastern India is lacking. To determine the clinicoetiological spectrum of childhood stroke and their outcome. This study was conducted in a stroke clinic of a tertiary care hospital of Kolkata over a period of 18 months. All children below 12 years diagnosed as stroke were included. On the basis of clinical examination, relevant laboratory investigations and radioimaging etiologies were determined. Appropriate statistical methods were used to analyze the data gathered from these patients using a preformed proforma. Among the 70 pediatric stroke patients, the most common clinical presentation was found to be hemiparesis (61.42%) followed by seizure (30.00%) and aphasia (25.71%), respectively. Vasculopathies (30.00%) were found to be the most common etiology of childhood stroke followed by infective meningoencephalitis and craniocervical trauma (14.28% each). Ischemic stroke comprised 71.4% of cases. During discharge, 20 cases (28.57%) showed complete recovery, whereas 40 cases (57.14%) had persistent neurodeficit [Pediatric Stroke Outcome Measure (PSOM) score >1], 12 cases (17.14%) had recurrent stroke, 8 cases (11.42%) died, and only 2 (2.85%) patients were lost to follow-up. Out of those 40 cases having persistent neurodeficits during discharge had recovered too at follow-up at 18th month. At presentation PSOM score in 40 cases (57.14%) was >5 and at follow-up at 18th month, only 8 cases (11.42%) had PSOM score of >5. The commonest etiologies of stroke in pediatric patients presenting at our hospital were found to be intracranial vasculopathies, infection, and trauma. Ischemic stroke was the predominant type. Eighteen-month follow-up showed complete recovery from acute neurological deficits in most of the patients. Dubey S, Ghosh R, Chatterjee S, et al. Pediatric Stroke: The Clinical and Etiological Spectrum: An Observational Study from a Tertiary Care Stroke Clinic, Kolkata, India. Indian J Phys Med Rehab 2019;30(3):74–80.

A 10-year experience of hydatid cysts of lung in association with other extrathoracic system involvement in a tertiary care hospital in Kolkata, India

Background: The metacystode of tapeworm Echinococcus causes hydatid disease. Infection in man is mainly caused by Echinococcus granulosus. Surgical intervention to treat complicated hydatid cyst (HC) is different from uncomplicated HC. Aims and Objectives: The present study was performed with an aim to review 82 cases of pulmonary HCs and associated HCs in other locations. We analyze and evaluate our experience in the surgical treatment and complication. Materials and Methods: In a 10-year period, from August 1, 2005, to July 31, 2015; 82 patients were operated on in our hospital for HCs in pulmonary as well as other associated extrapulmonary locations. The diagnosis was established on the basis of clinical features and imaging studies supplemented by serological test. Surgical approach consisted of a posterolateral thoracotomy in all cases of thoracic HCs. For cysts in extrathoracic locations, either laparotomy or local excisions were performed. Results: Radical resections [lobectomy] were done in four cases, and conservative operations in the remaining. Post-operative complications occurred in 12 cases (14.63 %). We had two recurrences, three cases of prolonged air leak with bronchopleural fistula, two had atelectasis, and five wound infections. At 6 months follow-up, 97.56% of our patients were free of any recurrence. Conclusion: HCs of the lung are best treated with surgery. Even when associated with HCs in other locations in the body, surgery is considered the treatment of choice. When supplemented with long-term perioperative Albendazole therapy, the chance of recurrence is practically negligible.

Prevalence of aerobic bacteria causing wound infection in patients with filarial elephantiasis in a tertiary care hospital of Kolkata, India

Prevalence of aerobic bacteria causing wound infection in patients with filarial elephantiasis in a tertiary care hospital of Kolkata, India

Clinicopathological alteration of symptoms with serotype among dengue infected pediatric patients

Dengue fever is a self-limiting, acute febrile illness caused by an arbovirus. This infection may be asymptomatic or symptomatic with its potential life-threatening form as DHF/DSS. Severe dengue cases occur typically in children due to overproduction of proinflammatory and anti-inflammatory cytokines (called cytokines storm) as well as increased microvascular permeability in them. This study aimed to find circulating dengue serotype and their clinicopathological association among pediatric patients admitted to tertiary care hospitals in Kolkata, India. Overall, 210 patients were approached, among them, 170 dengue suspected children admitted to three tertiary care hospitals were included in this study. Dengue samples were screened for the presence of dengue NS1 antigen and IgM antibodies by enzyme-linked immunosorbent assay. Viral RNA was extracted from NS1 seropositive serum samples and subjected to molecular serotyping by semi-nested reverse-transcription polymerase chain reaction. All patients were followed up for clinical manifestations and biochemical parameters associated with dengue. Cocirculation of all four serotypes was observed and DENV2 was the major circulating strain. Physiological classification of associated clinical symptoms was done as per WHO guideline and represented as a percentage variable. A multivariate logistic regression approach was used for making a regression model including dengue-associated clinical symptoms with dengue positivity or negativity as dependent variables. Thrombocytopenia was observed in 69% of patients and the commonest bleeding manifestation was petechia. Liver function profiles of infected patients were observed during follow-up and represented using a box plot. A significant change in trends of dengue-associated clinical manifestations and differential expression of liver functional profile with different phases of transition of dengue fever was observed in this study population.

A STUDY ON CORRELATION OF ACIDEMIA WITH PATIENTS 30 DAYS MORTALITY THOSE PRESENTING TO EMERGENCY DEPARTMENT OF A TERTIARY HOSPITAL

Introduction: Acidosis is a process causing increased acidity in the blood and other body tissues (i.e., an increase in hydrogen ion concentration). If not further qualied, it usually refers to acidity of the blood plasma Acidemia is said to occur when arterial pH falls below 7.35 , while its counterpart (alkalemia) occurs at a pH over 7.45. Arterial blood gas analysis and other tests are required to separate the main causes.Aims: To nd out correlation between different grades of Acidemia with 30 day mortality of patient diagnosed as academic in emergency department Materials and method: This was a single center observational, retrospective cohort study from tertiary care hospital in Kolkata, India from January 2021 – January – 2022. All Patients were presenting with signs of Acidemia in Emergency Department. Age >18 years, Blood gas analysis, Done in ED and pH ≤ 7.34 were included in this study. Result: In mortality, 33(32.4%) patients were in <7.0 PH group, 31(30.4%) patients were in 7.0-7.10 PH group, 23 (22.5%) patients were in 7.11-7.20 PH group and 15 (14.7%) patients were in 7.21-7.34 PH group. Association of PH group with Mortality was statistically signicant (p<0.0001). In without Mortality, the mean Age (mean± s.d.) of patients was 57.0268 ±9.2811. In with Mortality, the mean Age (mean± s.d.) of patients was 56.2549±9.0758. Distribution of mean Age with Mortality was not statistically signicant (p=0.4506). In without Mortality, the mean PH (mean± s.d.) of patients was 7.1898 ±.1189. In with Mortality, the mean PH (mean± s.d.) of patients was 6.9708 ±.2907. Distribution of mean PH with Mortality was statistically signicant (p<0.0001). In without Mortality, the mean Hospital Stay (mean± s.d.) of patients was 14.1512 ±5.5302. In with Mortality, the mean Hospital Stay (mean± s.d.) of patients was 7.4804 ±6.1010. Distribution of mean Hospital Stay with Mortality was statistically signicant (p<0.0001). Conclusion: Patients presenting in emergency with low PH (acidemia) require immediate management and hospitalization for better outcome.

STUDY OF INFECTION RATE DUE TO FOLLEYS CATHETER INSERTION IN ED, MEDICAL WARD AND ICU IN A TERTIARY CARE HOSPITAL

Introduction: Indwelling urinary tract catheterization (IUTC) is a very common intervention frequently required in hospitalized patients. It is estimated that 10-12% of hospital patients and four per cent of patients in the community have urinary catheters in situ at any given time.1 Nosocomial UTIs (urinary tract infections) develop in ve per cent of catheterized patients per day in the US, with associated bacteremia in four per cent and as many as 80% are a consequence of urinary catheters. Research has shown that just reminding physicians to remove unnecessary urinary catheters can signicantly reduce the duration of urinary catheterization and the catheter associated urinary tract infection (CAUTI) rate in a hospital. Aims:To Study of Infection Rate due to Folleys Catheter Insertion in ED, Medical Ward and ICU. Methods: This was a single centre observational, retrospective cohort study from tertiary care hospital in Kolkata, India from May 2021 – JANUARY– 2022 were included no Past History of UTI, No Past History of renal Infection and No Previous Indwelling Folleys Catheter. Result: In Critical Care (ICCU) Group, 166 (21.3%) patients had CAUTI. In Emergency Group, 297 (42.9%) patients had CAUTI. In Medical Ward Group, 332 (30.1%) patients had CAUTI. Association of CAUTI with Group was statistically signicant (p<0.0001). In Critical Care (ICCU) Group, 166 (21.3%) patients had Culture. In Emergency Group, 297 (42.9%) patients had Culture. In Medical Ward Group, 332 (30.1%) patients had Culture. Association of Culture with Group was statistically signicant (p<0.0001) Conclusion: The rate of CAUTI in emergency dept is higher than rate of CAUTI in other medical ward of ICCUs. and we also see that rate of CAUTI in ICCU is much lesser than rate of CAUTI in other medical ward or emergency

KNOWLEDGE, ATTITUDE AND REPORTED PRACTICE REGARDING DONNING AND DOFFING OF PERSONAL PROTECTIVE EQUIPMENT AMONG THE DOCTOR AND NURSE AGAINST COVID-19 IN OUR HOSPITAL

Introduction: Personal protective equipment (PPE) is a protective gear designed to safeguard the health of workers by minimizing the exposure to a biological agent. PPE usage is a primary strategy to prevent disease transmission in health-care settings where health-care professionals directly come in contact with infected patients. Kang et al. discovered that health-care personnel contaminated themselves in almost 80% of the PPE simulations.Aims: This study was done aiming to assess the knowledge, attitude, and reported practice, and identify the associated factors regarding donning and dofng of PPE among frontline healthcare workers in our institution. Materials and method: This was a single center observational, Cross sectional study from tertiary care hospital in Kolkata, India from duration of study: May 2021 – January – 2022. Personal protective equipment was used among the doctor and nurse against covid-19 in our hospital. Doctor and Nurse and Personal protective equipment among the doctor and nurse against covid-19 in our hospital. Result: 47(94.0%) doctors had corrected response and 3(6.0%) doctors had incorrected response about donning and dofng of PPE for frontline healthcare workers. 47(94.0%) nurses had corrected response and 3(6.0%) nurse had incorrected response about donning and dofng of PPE for frontline healthcare workers. This association was not statistically signicant (P=1.0000). 33(66.0%) doctors had corrected response and 17(34.0%) doctors had incorrected response to the following components based on their sequence of appearance during donning of PPE. 12(24.0%)nurse had corrected response and 38(76.0%) nurses had incorrected response to the following components based on their sequence of appearance during donning of PPE. This association was statistically signicant (P<0.0001). Conclusion: This study demonstrated an overall good knowledge, attitude, and reported practice regarding donning and dofng of PPE among frontline doctors and nurse However, the reported shortcomings like poor knowledge regarding the sequence of donning and dofng.

INITIAL P/F RATIO FROM ABG ON MORTALITY AT 7 & 30 DAYS IN COVID-19 POSITIVE PATIENTS PRESENTING TO EMERGENCY DEPARTMENT

Introduction: Coronavirus disease 2019 (COVID-19), the highly contagious viral illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a catastrophic effect on the world's demographics resulting in more than 3.8 million deaths worldwide, emerging as the most consequential global health crisis since the era of the inuenza pandemic of 1918. Aims: The objective of the study is to analyse whether this formula can early diagnose the severity of the disease, so that rescue measure can be started early which can eventually decrease the mortality. Materials and Methods: This was a single center observational, retrospective cohort study from tertiary care hospital in Kolkata, India from July 2020 – January – 2022 with 224 patients were included in this study. Result: Data of our study showed that majority number of patients had normal ARDS [107(47.8%)], mild ARDS [99 (44.2%)], Moderate ARDS [12 (5.4%)] and Severe ARDS [6 (2.7%)] but this was not statistically signicant. (p=.44726). Conclusion: Present study showed that higher number of alive patients in mortality 30 day had Oxygen ow rate 2 liter/min, 1 liter/min and 4 liter/min but this was also statistically signicant, COVID-19 is highly infectious and can lead to fatal comorbidities especially ARDS which can ultimately lead to death and we come to a conclusion that P/F ratio from initial ABG can be used as an indicator to rule out ARDS in a hypoxic patient presenting in emergency department. Thus it might help in early identication of ARDS in patients which can benet in therapeutics and reduce mortality.

KNOWLEDGE AND PRACTICES OF HAND WASHING AMONG HEALTH WORKERS IN EMERGENCY DEPARTMENT OF A TERTIARY CARE HOSPITAL IN KOLKATA

Introduction: Nosocomial infections due to poor hand hygiene are a major cause of increasing morbidity, mortality and health care costs among hospitalized patients worldwide. The high prevalence of these infections, as high as 19%, in developing countries poses a challenge to health care providers. Hand hygiene is considered the single most cost-effective public health measure for preventing health care associated infection (HCAI). Aims: To assess the compliance, identify factors inuencing compliance and to study the knowledge, attitude and perceptions associated with HH among health care workers (HCW). Materials and method: This was a single centre cross sectional study from tertiary care hospital in kolkata, India from February 2021 – February – 2022 were included all healthcare workers who are directly involved in management of the patient (Doctors, Nursing stuff, paramedic stuff and group D stuff) in this study. Result: Knowledge about proper and consistent hand washing prevents infections in health facilities was signicantly high in doctor group [49(98.0%)], in nurse group [47(94.05%)] and in others group [43(86.0%)]. (P=0.0488). Knowledge about no need for hand washing for those who perform their activity with caution was signicantly more in others group [13(26.0%)] and in nurse group [3(6.0%)]. (P<0.0001). Doctor had [48(96.0%)] always and [2(4.0%)] usually practice of hand washing about after contact with patients, most of the nursess had always [38(76.0%)], Usually [7(14.0%)], often [3(6.0%)] and somestimes 2(4.0%) practice of hand washing about after contact with patients and lower number of others had [5(10.0%)] often ,[6(12.0%)] somestimes, [18(36.0%)] always and [18(36.0%)] Usually practice of hand washing about after contact with patients but this was statistically signicant (P<0.0001). Conclusion: Majority of the study participants were knowledgeable. However, they had poor practice of hand washing

Two-dimensional Echocardiographic Study of Left Ventricular Volume and Function in COPD Patients Admitted in Tertiary Care Hospital in Kolkata

Two-dimensional Echocardiographic Study of Left Ventricular Volume and Function in COPD Patients Admitted in Tertiary Care Hospital in Kolkata

Correlates of COVID-19 vaccination drop-out among health care workers in a tertiary Care hospital of West Bengal

The Government of India launched “COVID-19 vaccination drive” on 16th January, 2021 and health care workers were the first to be prioritised for vaccination. However, the uncertainty regarding safety and efficacy of the vaccine was the major concern amongst them. These led to vaccine hesitancy and ultimately drop out.To estimate the proportion of drop out of COVID-19 vaccination among vaccine-hesitant health care workers (HCWs) of a tertiary care hospital and to find out their perception and other background characteristics responsible for drop out. A facility based descriptive type of observational study, cross-sectional in design was carried out among 329 HCWs of a tertiary care hospital in Kolkata from 16th March- 12thApril, 2021using a pre-designed, pre-tested, structured questionnaire. The study population selected by simple random sampling technique. Data was analysed using Microsoft Excel 2010 and SPSS v25.0 in the form of descriptive statistics and binary logistic regression. About 44.1% of the study population didn’t take the COVID-19 vaccine. Socio-demographic factors like age, gender, religion, education, occupation,perception regarding necessity of vaccination, vaccine efficacy, dose and contraindication, safety in humans and role in future infections were significantly associated with drop out. There was a high proportion of vaccine drop out among health care workers. Different modifiable perceptions with socio-demographic factors had played important roles in COVID-19 vaccination drop out. As the global threat of COVID-19 continues, greater efforts through campaigns that target HCWs are needed to improve the intention of professionals’ vaccine acceptance.

COVID-19 Vaccine Hesitancy among the Non Medical Adult Population Attending a Tertiary Care Hospital of Kolkata, India: A Cross-sectional Study

Introduction: Vaccines play an important role in the fight against diseases whose cure is unavailable. In the battle against pandemics such as Coronavirus Disease-2019 (COVID-19), the vaccine is the only available course of prevention. The hesitancy has been found all over the world, while some find it against their religious values, others are concerned about safety, or have doubts about its efficacy. Some are hesitant due to fear of needles while some show brass negligence. Being the second most populated country globally and a developing nation, India had faced its fair share of struggles with her citizens vaccinated. Even a minute percentage of people accounts for millions; hence, it is of utmost importance to get to the root of the causes of delay in vaccination. Aim: To find the causes of delay or hesitancy among the people attending COVID-19 vaccination centre of a tertiary care hospital of Kolkata, (a year after vaccines were introduced to the general population). Materials And Methods: A cross-sectional study was performed in the COVID-19 vaccination centre of Medical College Kolkata, West Bengal, India, from 14th January to 14th April 2022. Total 74 non medical (not related to healthcare work) people who had come for 1st or 2nd dose of COVID-19 vaccination were included in the study. A prestructured, pretested, prevalidated questionnaire was used to collect data from the participants of the study. The Likert scale comprising of nine questions were used to assess hesitancy. Data were analysed using Chi-square test. Binary logistic regression was done to confirm any predictability of occupation, literacy rate, age and gender on vaccine hesitancy. Results: The participants comprised of 45 (60.8%) females and 29 (39.2%) males, aged between 18 to 60 years with the mean age of 33.75±11.06 years. The participants included 22 (29.7%) people who had just taken their first dose. Twenty six (35.1%) participants were hesitant. The most common causes of hesitancy were individuals’ fear of the vaccine and its impact on general health, unavailability of slots for vaccination and reluctance. Out of total, 58 (78.4%) people had faith in vaccines made in India and 48 (64.9%) persons believed that the vaccine would provide complete protection against COVID-19. Conclusion: People were mainly concerned about safety issues as adequate and reliable information was not available to them. Some of them ignored the importance of vaccination while some could not get vaccinated due to the unavailability of slots.

Current trends in peripartum hysterectomy in a tertiary care hospital of Kolkata, India over a period of five years

Background: Emergency peripartum hysterectomy is a lifesaving procedure done as a last resort to save mother’s life. This study is to analyse the incidence, maternal characteristics, indications and complications following peripartum hysterectomy. Methods: A descriptive and retrospective study of obstetric hysterectomy was done at Medical College and Hospital, Kolkata, India from March 2016 to October 2021. Case records were analysed to record the incidence, indications, risk factors and complications associated with peripartum hysterectomy during the study period. Total 129 cases of obstetric hysterectomy fulfilling the inclusion criteria were included in the study. Template was generated in MS excel sheet and analysis was done on SPSS software. Results: Incidence of peripartum hysterectomy was 0.045%. The most common indication for peripartum hysterectomy was Placenta Percreta with 29 cases (22.5%) followed by 27 cases of Atonic PPH (20.9%). most common maternal complications were repeated transfusion 47 (36.4%), followed by shock 43 (33.3%). Most common fetal complications were Perinatal Asphyxia 37 (28.7%), followed by jaundice 12 (9.3%). Conclusions: Emergency peripartum hysterectomy remains a lifesaving procedure. Proper antenatal care, early referral, blood bank facilities and timely decision greatly influences maternal outcome.

Neutrophil-lymphocyte Ratio as Independent Prognostic Factor among Breast Cancer Patients in a Tertiary Care Hospital, Kolkata, India

Introduction: The most important prognostic factor for breast cancer is tumour stage and tumour grade. However, the assessment of the above parameters are time-consuming and require expertise. Thus evaluation of the prognosis of breast cancer is still limited to tertiary care hospitals, with appropriate facilities for histopathological techniques. Recently, inflammatory blood markers have shown a role as a prognostic factor. Out of all the inflammatory blood markers, neutrophil-lymphocyte ratio has emerged as the most useful. Abundant evidence suggests the role of NLR as an adverse prognostic factor in breast cancer. NLR is simple and inexpensive. It can be easily obtained, as the differential count of every patient is done routinely. Thus it can act as an indicator of high-risk patients who are likely to show poor prognosis. Though NLR has been found to play a role in prognosis prediction in breast cancer, much is unknown in this field. Aim: To assess the effectiveness of Neutrophil-Lymphocyte Ratio (NLR) as an independent prognostic parameter among breast cancer patients in a tertiary care hospital in Kolkata, India. Materials and Methods: This observational cross-sectional study was conducted in Department of Pathology, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India, where 140 female patients undergoing mastectomy for breast cancer were studied from 1st February 2019 to 31st January 2020. The clinicopathological parameters, histopathological parameters, and molecular subtypes were evaluated. NLR was calculated and related with the other prognostic parameters. Data entry was done in Microsoft Excel and analysis was done using Statistical Package for Social Sciences (SPSS) software version 20.0. One way Analysis of Variance (ANOVA) test and Chi-square test was conducted to assess the relationship of NLR with various other prognostic factors. Results: Out of 140 patients, 78 patients showed NLR values within 1.8 to 3.33. Higher NLR (>3.33) was associated with poor prognostic factors like higher T stage (T4) {17 (53.1%)}, higher stage (stage III) 95 (67.8%), skin involvement 19 (47.5%), Lymphovascular involvement in 23 (39.7%), perineural involvement in 10 (71.4%) and in patients with HER2 positive molecular subtype in 8 (5.7%). Conclusion: This study suggests that a high NLR value was associated with poor prognosis in breast cancer patients. Thus, it can be used as an independent marker of poor prognosis and can help guide the treatment of breast cancer patients. The more we study the role of NLR, the more useful it will be in predicting the course of breast cancer as early as possible.