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Introduction: India is committed to achieving universal health care for all by 2030. The objective of social marketing is to promote public health and its goal is to improve health for all, but there are some challenges like irregular availability, quality issue, inadequacy of marketing causes under- utilization of the government supplied health consumables. Objectives: Present study aims to find out the usage pattern and assess the perceived satisfaction level of beneficiaries of using various socially marketed health consumables at government settings and explore the perception of healthcare personnel regarding barriers to its usage in a rural area of India. Materials and Methods: A community-based, Mixed-Methods study (Convergent parallel design) was done in the service area of the Rural Health Unit and Training Centre (RHU&TC), Singur of Hooghly district, West Bengal, between January 2023 and December 2023, where the quantitative component was carried out by face-to-face interview among 150 beneficiary household respondents selected by two-stage cluster sampling; and qualitative component was done by 4 Key informant interviews (KII) among healthcare personnel (medical officer, public health nurse, pharmacist). Statistical data were analyzed by descriptive statistics using SPSS 16 version and Microsoft Excel for the quantitative part, and thematic analysis was done for the qualitative part. Institutional Ethics Committee clearance was obtained. Results: Ever use of government-supplied contraceptives like Chhaya (Ormeloxifene), Antara (Injectable contraceptive), emergency contraceptive pills, and intrauterine contraceptive devices (IUCD) was done by only 15.3%, 10.7%, 7.3%, 32% of eligible beneficiary households, respectively. The major reasons cited for irregular use were unawareness of availability of the products (Chhaya = 76.3%, Antara = 64.9%, EC pills = 46.7%), poor faith regarding quality (Male condom = 40%, Generic medicines = 70%), inadequate promotion (IUCD = 53.9%). The majority of users of male condoms (90%), IFA tablets (52.9%), ORS (51.1%), and generic medicines (55.7%) were not satisfied after using those products. Key informant interviews among healthcare personnel revealed avoidance of using modern contraceptive methods and frequent unavailability of some socially marketed health consumables were the predominant causes of reduced uptake of those products by beneficiaries. Conclusions: Proper social marketing strategies, adequate promotion, regular awareness campaigns, and tailored training of field healthcare workers are required to improve the acceptability, availability, and marketing of these health consumables.

Background: Cancer is emerging as a major public health problem. Two-thirds of cancer patients are in the advanced stage at the time of diagnosis. Public awareness plays a big role in cancer prevention. Aims and Objectives: To assess awareness, perception, and behavioral determinants of cancer prevention of urban adults. Materials and Methods: An observational, cross-sectional study was conducted in the urban slum of Kolkata. Four hundred fifteen respondents were interviewed using a pre-tested questionnaire after having consent. Results: Though majority (72.3%) of respondents had satisfactory awareness but had limited awareness on screening tests (58.6%) and vaccination (1.6%). Half of them had a favorable perception on cancer prevention but the perceived barrier was more. The behavior score was poor among the majority of participants. The main source of information was T.V. (88.2%) and friends and relatives (80.2%). Only one-fourth of participants mentioned of health workers and health camps as sources of information indicating inadequate activities on cancer awareness programs. Age (OR 7.08, 95% CI=1.07–46.74), sex (OR 0.38, 95% CI=0.19–0.76) education (OR 4.81, 95% CI=2.50–9.27) were significant predictors of satisfactory awareness. Higher levels of education, younger age, and female gender were factors that shaped perception. Only education level (OR 0.29, 95% CI=0.15–0.59) had a significant association with cancer preventive behavior. Conclusions: Though awareness on primary preventive measures was satisfactory but behavior was unsatisfactory among study participants. They had more perceived barriers while taking preventive measures. The finding indicates a need to promote health education and motivate people to recognize and modify cancer-related behavioral risk factors.

Introduction: Food safety and hygiene management are an important global public health concern. In correctional homes, people live with sketchy basic amenities and health-care facilities. Here the eating establishments run through mass self-catering services by inmates themselves. As noncompliance to hygienic and sanitary food handling can pose threat to food-borne illnesses, the current study was conducted to assess the status and bottleneck of safe food practice in eating establishments of correctional homes. Materials and Methods: A mixed-methods cross-sectional study was conducted over 10 months in three correctional homes of Kolkata. With pro forma based on Food Safety and Standard Rules, food and environmental hygiene of eating establishments was observed and thirty food handlers were assessed for knowledge and practice related to food hygiene. Two food samples from each establishment were collected for laboratory examination for contamination, if any. Superintendents and welfare officers were interviewed in-depth for barriers toward safe food practice. QDA miner lite, 2022 was used for the analysis. Results: All the three eating establishments were categorized as “poor” having total scores of

The social structure of India is rapidly evolving, towards modernization. The urban population of India is projected to approach 60 crores by 2036. Urban health resilience stands for building the capacity of urban systems to withstand and adapt to health-related stresses like natural disasters, man-made disasters, and pandemics like COVID-19 and the capability to recover from them by well-equipped hospitals, efficient emergency response mechanisms, and a network of well-trained and motivated healthcare professionals. Also, the involvement of communities is central to building urban health resilience. Strong policy frameworks are required for establishing a resilient urban health ecosystem. Addressing social determinants, such as income inequality, education, and housing, is also a basis of building urban health resilience. Some examples have been instrumental in designing a resilient urban health system like Singapore’s Smart Nation Initiative, Copenhagen, Denmark’s Model for Sustainable Urban Living internationally, Ahmedabad’s Heat Action Plan and Kochi’s Waterfront Development for Climate Resilience are excellent examples from our country. The suggested strategy for an urban resilient system is a Rapid, Extensive, Sturdy, Ingenious, Lucid approach with an International collaboration for an Enthusiastic, Non-latent, Continuous Early warning system (RESILIENCE).

Introduction: Self-directed learning (SDL) is the process in which individuals take the initiative and learning environment involves all other aspects of the institute. Good SDL ability is the foundation of lifelong learning. Students’ perception of the educational environment plays a subtle role in learning and contributes to learning input and students’ achievement. Self- directed learning is integral to public health teaching. Objectives: To assess the perceptions of learning environment and self-directed learning readiness and association between the two among public health researchers and also to elicit the factors associated with SDLRS. Method: A cross-sectional study was conducted from July to December 2023 in a public health institute in Kolkata. A total of 102 participants across five courses were selected by Complete Enumeration method and their self-directed learning readiness (SDLRS) and perceptions of learning environment were assessed using a self-administered questionnaire. The data was analysed in SPSS, version 16. Ethical approval was taken. Results: The mean age of the study participants was 26.7 years and 64.7% of the study participants were from MBBS background. The median academic hours was 18 hours per week, 37.3% of the participants were studying in the institute for less than 6 months and 20.6% for more than 24 months. The overall perception of learning environment was more positive than negative. There was significant positive correlation between SDLRS and Learning Environment (Spearman’s rho=0.281, p=0.004). Age (p=0.015) and prior academic qualification (p=0.016) were significantly associated with SDLRS. Conclusion: SDLRS was associated with positive Learning Environment. The overall perception of SDLRS was average and the SDL ability improved with duration of study in the institute and deteriorated with age of the study participants.

Background: On January 16, 2021, India rolled out the COVID vaccination drive. A successful and effective vaccination campaign requires much more than the availability of a safe and effective vaccine. This includes identifying vulnerable populations with lower vaccine confidence and identifying the drivers of vaccine hesitancy. Objective: This study aims to find out vaccine hesitancy among the tribal population regarding COVID-19 vaccination. Methods: It was an observational descriptive cross-sectional study, conducted at Manindranagar and Hatinagar gram panchayat of Berhampore Block of Murshidabad district, West Bengal, from June 2021–November 2021, among tribal people aged >18 years. A total of 198 tribal people were selected by applying the probability proportional to size sampling method. Participants were interviewed using predesigned, pretested, and semi-structured schedules. Potential predictors of hesitancy were investigated using the multivariate logistic regression model. Results: Vaccine hesitancy was present among 36.9% of the study participants. Fear of side effects (78.1%) was the most common reason of vaccine hesitancy. Only 30.8% of them received at least one dose of vaccine. Vaccine hesitancy was associated with decreased family income in the last 1 year (adjusted odds ratio [AOR] = 8.23), knowledge regarding vaccine (AOR = 0.41), adherence to COVID-appropriate behavior (AOR = 0.45), and trust on the local health-care worker (AOR = 0.32). Conclusion: Vaccine hesitancy among the tribal population is driven by a lack of knowledge and awareness. Their economic status, attitudes toward the health system, and accessibility factors may also play a major role in vaccine hesitancy. Extensive information, education, and communication activity, more involvement of health-care workers in the awareness campaign, and establishment of vaccination centers in tribal villages may be helpful.

Background: To facilitate healthy aging in India, it is important not only to acknowledge older people's contribution but also to understand their perception regarding their impact in the society along with society's attitude toward them. Objectives: This study aims to assess their self-perceived contribution in the society and the factors related with their contribution. Methods: It was an observational, descriptive, cross-sectional study, conducted at Amdanga block of North 24 Parganas district, West Bengal, during July 2021–June 2022. A total 0f 384 geriatrics were interviewed by the house-to-house survey with the help of a predesigned, pretested and semi-structured schedule. Potential predictors of contribution were investigated using the multivariate logistic regression model. Results: 78.9% of participants had contribution in the society. 85.9% were taking care of family members when they were sick. 93.2% were sharing their opinion with the family members. 86.5% were participating in various social works. 79.1% were suffering from at least one physical health problem. With increase in the number of health problems, chances of good contribution decreases. In case of self-perceived contribution in the society family type, employment, physical health and social participation are influencing the most. Conclusion: Elderly people are taking care of not only family members, but even relatives and neighbors also. They are sharing their knowledge and experience with family members and in the society. They are also contributing financially. Employment and proper health-care infrastructure for geriatric may be helpful to maximize their contribution.

Background: Chronic kidney disease of unknown etiology (CKDu) has been a growing concern in the Indian population causing significant morbidity and mortality in these recent years. Thus, it is vital to understand the probable risk factors associated with its manifestation. This study aims to assess the distribution of various etiologies among CKD patients, investigate all the probable risk factors associated with CKDu, and estimate the health-related quality of life (QoL) among all CKDu patients in the study area. Materials and Methods: It was an analytical, observational, cross-sectional study where one objective had a case–control study design. It was conducted at Bankura Sammilani Medical College in Bankura district, West Bengal, during July 2022–August 2022. A total of 198 patients have been studied through detailed interviews using a predesigned, pretested, semi-structured schedule. Potential risk factors and their strength of association were analyzed with the help of multivariate logistic regression. Results: It was found that the prevalence of CKDu was almost 71% in the study population, mostly affecting agricultural workers (67.17%), daily laborers (46.46%), and construction workers. Perceived heat stress, excessive daily dietary intake of salt, and drinking contaminated water are the factors that had shown the strongest association with the occurrence of CKDu in this population. The deterioration in QoL in CKDu pretty much mirrors that of CKD. Conclusion: CKDu is definitely an occupational disease, mostly affecting the wage workers and farmers spending long hours in unhealthy work environments. Environmental exposure to heavy metals must be checked and dietary modification must be done through counseling to regulate salt intake. CKDu, as a rising public health concern certainly needs special attention and immediate planning as it has a different etiopathology than CKD and the affected population, disease progression, and risk factors are markedly distinctive as well.

Background: Vaccines provide a crucial role in decreasing disease severity in COVID-19 infection. However, the accelerated pace of vaccine development has heightened public anxieties and could compromise acceptance. The World Health Organization has identified vaccine hesitancy as one of the top ten global health threats. There needs to be more community-based data on the causes of vaccine hesitancy of COVID vaccine in India, especially in the Eastern part. Aims: In this study, we intended to estimate the proportion of vaccine hesitancy in the community and elicit the reasons for COVID-19 vaccine hesitancy amongst the population of a slum in Kolkata. Patients and Methods: This was a descriptive observational study, cross-sectional in design conducted in the urban field practice area of a Tertiary Care Centre in Kolkata. Data were collected on the demography of the participants, awareness about COVID-19 and vaccination, willingness to accept the vaccine and willingness to pay for the COVID vaccine. Results: Most participants were willing to take the vaccine (73.95%). Amongst those who were not willing to take the vaccine (26.04%), the most common reason for not taking the vaccine was the concern about efficacy and safety. The willingness to pay for a single dose of the COVID vaccine ranged between 100 INR and 2000 INR with a median value of 250 INR. Conclusion: Transparent communication by the Government addressing the concerns of beneficiaries regarding vaccination may benefit the ongoing vaccination drive.

Abstract During advanced HIV infection, Human Cytomegalovirus (HCMV) has been proven to produce devitalizing end-organ diseases (EOD). The interactive co-existence of HIV and HCMV has been reported by many researchers and has been suggested to be linked with a more aggressive disease state. This study has been designed to bring forward an assessment of the clinical risk factors capable of defining the conditions of HCMV induced retinitis and gastro-enteric diseases among HIV1 seropositive patients. We also intended to analyse the phylogenetic variation if any, among the infecting virus types inducing the two separate clinical conditions. The patients were arranged in three different groups; (Group 1 with 26 individuals and group 2 and group 3 with 25 individuals each) based on their current status of HIV and HCMV infections. Serum ELISA, qualitative and quantitative detection of HCMV DNA, Real time mRNA expression study, sequencing, and phylogenetic analysis were performed. All statistical analyses and graphs were exercised using relevant software. We found that in HIV patients with HCMV induced end-organ diseases the components of the CXCL9, 10, 11-CXCR3 chemokine pathway is highly expressed with significant differences existing among patients with retinitis and gastrointestinal disease. We found that the gL gene sequences from the retinitis (HR) group clustered almost separately from that of the gastroenteritis (HG) group in the phylogenetic tree. It may be suggested that a form of natural selection pressure is working on the clinical HCMV strains creating a slight divergence in their phylogenetic lineage thereby helping them adapt to the particular tissue microenvironment they are colonizing.

Background: Adolescence is the most vulnerable developmental period in one's life. In low to middle-income countries like ours, adolescence living in the rural area face increasing physical and mental health challenges that are not addressed due to ignorance or resource limitation. This study is conducted with the aim of assessing the magnitude of health behavior and protection factor among school children in the study area and to compare the same between boys and girls. Materials and Methods: An explanatory sequential mixed method descriptive observational study with cross-sectional study design was conducted on 102 students aged 15-19 years studying in a government school in Amdanga block, West Bengal. Purposive sampling was done for the quantitative part. Global school health survey questionnaire was used. Qualitative study with FGD was done after the quantitative part. Results: Out of 102 students, 58 (56.66%) re females and 44 (43.13%) are males, only 10 (9.8%) have consumed alcohol and 14 (13.72%) have consumed tobacco of some form. 15 (14.8%) students were bullied last year. Around 11 (10.8%) students had suicidal thoughts in the last 1 year. Most of them have proper hygiene behavior. Qualitative analysis revealed issues amongst both males and females regarding body image perception etc., Conclusion: It is seen that males have more addictive behavior and gets into fighting easily then females. It is found that there are many issues regarding mental and physical health of the adolescents. That needs to be addressed and measure should be taken seriously and proper services like counseling, monitoring, parent's support should be given.

BACKGROUND: Multi-transfused thalassemic children are at higher risk of acquiring transfusion-transmitted infections (TTIs). There are limited data available on TTIs among thalassemic children, especially on its impact on their quality of life (QoL). AIM: The aim of this study is to find out the proportion of multi-transfused β-thalassemia major (β-TM) children suffering from TTIs, its risk factors and impact on QoL. METHODS: This was a hospital-based, analytical observational study, cross-sectional in design, conducted among 328 β-TM children and their caregivers attending thalassemia day care unit of a medical college during May 2015–April 2016, with a structured schedule. Data were analyzed with appropriate statistical methods using the Statistical Package for the Social Sciences. RESULTS: Two-fifth (39.9%) of them were found to have TTIs with hepatitis C being the most common (34.5%), followed by hepatitis B (4.5%) and human immunodeficiency virus (1.8%). In the multivariable model, place of residence (adjusted odds ratio [AOR] – 2.23 [1.19–4.17]), per capita monthly family income (AOR – 1.84 [1.10–3.07]), and blood transfusion frequency (AOR – 1.19 [1.10–1.29]) were significant predictors of TTIs adjusted with their age, age at diagnosis, last pretransfusional hemoglobin level, size of spleen, and caregivers knowledge regarding the disease. The study participants with TTIs had a lower QoL compared to others as there were significant differences in between the total QoL scores ([49.9 ± 15.6 vs. 57.4 ± 15.5], P ≤ 0.001) and its various domains. CONCLUSION: There was high burden of TTIs among multi-transfused β-TM children and it has significant negative impact on their quality of lives.

Context: Cancer is a serious global public health problem. Public awareness plays a big role in the prevention of cancer. Aims: This study aims to evaluate influence of sociodemographic characteristics and related factors on knowledge, attitude, and practice (KAP) regarding the prevention of common cancers. Settings and Design: This community-based observational, cross-sectional study was conducted in the slum area of urban field practice area of a tertiary care hospital, Kolkata. Materials and Methods: The survey was conducted with a sample of 415 using a semistructured questionnaire related to KAP regarding the prevention of cancers. Mann–Whitney U-test and Kruskal–Wallis test were conducted to determine group differences for sociodemographic variables. Linear correlational analysis was performed to identify associated factors and measure the strength and direction of relationships Results: Median scores for knowledge, attitude, and practice differed by sociodemographic characteristics. Positive correlations were observed between knowledge–attitude (r = 0.395, P < 0.01), attitude–practice (r = 0.391, P < 0.01), and knowledge–practice (r = 0.460, P < 0.01). Age, gender, educational status, and socioeconomic class were significantly associated with KAP score of participants. Conclusions: Knowledge about primary preventive measure was found to be less. The study found varying degrees of positive correlation between KAP. Knowledge and level of education had positive associations with attitude and adherence to preventive measures. The findings suggest a need for targeted community awareness interventions for the elderly populations, among men and those with no school education. The positive linear correlations reaffirm that better knowledge can lead to positive attitude and subsequently in good practices. Extensive health educational campaigns should be provided to the general population.

Introduction: Apart from age, sex and racial affiliation, estimation of stature from human extremities is an important step in developing a biological profile for identification of an unknown individual especially when the body found is either dismembered, mutilated, or disfigured. Stature estimation plays an important role in developing a biological profile for human identification and provides as a valuable indicator for an unknown individual in a population. Aim: To identify stature using various lower limb dimensions. Materials and Methods: This analytical, cross-sectional study was conducted at Kolkata based school from March 2019 to September 2019 amongst 120 adolescent school going boys aged 10-16 yrs of age. The lower limb length, knee height, navicular height, foot length and foot breadth were taken by using standard anthropometric procedures. Pearson correlation coefficient was used for assessing relationship between stature and various lower limb dimensions. Significance of differences was tested using independent t-test. Results: This study showed that all variables of both right and left side were significant predictors of stature (p

Background: Nutrition transition has replaced homemade foods with processed items that increased the prevalence of noncommunicable disease in adult population. But we know little about the food intake pattern of adults specially in urban sector. Aims: The study aimed at describing the food-consumption patterns in a sample of adults residing in urban area. Settings and Design: An observational cross-sectional study was done from April to June, 2019 at urban field practice area of a teaching hospital of Kolkata. Methods and Material: A prevalidated, pretested, 51-item, food-frequency questionnaire was applied to assess the food-consumption pattern of 110 participants. Results: Adults reported poor dietary intakes; more than half reported no consumption of green-leafy vegetables (GLV) (66.4%), other vegetables (52.8%), and fruits (63.6%). Whereas 72.7% reported consumption of three or more servings of energy-dense foods and 90.9% reported consumption of three or more servings of energy-dense beverages on previous day. Mean intake of food varied from 0.34 (SD = 0.47) for GLV to 8.19 (SD = 2.39) for cereals. Females consumed more servings of GLV, other vegetables, roots-tubers, and fruits than males. Fruit consumption was low in all age groups. Higher socioeconomic class people strikingly consumed no GLV. Conclusions: Study participants reported consumption of more energy-dense snacks, beverages than healthy food like GLV, fruits. Study findings highlight to design strategies to promote nutrition education and practical application of healthy food habits in target population group.

Background: While a smartphone can be a hugely productive tool, excessive use of this device can interfere with work, education, our physical and mental health, and productivity. Nowadays, we do not just use our smartphones, but we rely on them. Objectives: The present study aims to develop and validate an instrument measuring the problematic use of smartphones among adults in a rural area of West Bengal, India. Methods: The questionnaire on problematic use of smartphone is a self-designed tool. The items were selected by literature review. The psychometric properties of the questionnaire were assessed by content validity, construct validity, and reliability. Exploratory factor analysis was performed to identify the factors. Results: Forty-two items were generated by literature review. After final analysis, the main questionnaire contained 28 items with 5 domains, namely “impulsive use of phone,” “dependence,” “impaired control,” “denial,” “decreased productivity,” and “emotional attachment.” The Cronbach's alpha value for three domains was found to be >0.7 and >0.8 for the other three domains. Conclusion: Excessive mobile phone use is associated with various adverse consequences which is emerging as a public health problem in a large number of population in India. Problematic use of smartphone questionnaire is a valid and reliable tool to assess the pattern of mobile use among Indian population.

Background: Drug utilisation studies are relevant for the analysis of prescription rationality and are pertinent in today’s context of the increasing burden of antimicrobial resistance. Prescriptions for patients with diarrhoea or Acute Respiratory Infection (ARI) have been analysed in this study to understand the prescription pattern among various categories of prescribers in two tertiary care centers. Methods: This cross-sectional study was conducted from August 2019 to December 2020 in the medicine and pediatrics outpatient departments of two government teaching hospitals in West Bengal, India. A total of 630 prescriptions were evaluated against WHO standards. Prescriptions were assessed by a ‘Rational Use of Medicine Consensus committee’ approach. Results: The Fixed Dose Combination (FDC) was used in half of the patients (51%). Both the generic prescription (23.3%) and adherence to hospital formulary rates (36.5%) were low. The antibiotics prescription rate was high (57%), and it was higher for diarrhoea than ARI. Deviations from the standard treatment guidelines were found in 98.9% of prescriptions. Deviations were commonly found with prescriptions written by the junior doctors (99.6%). Conclusion: Irrational prescribing patterns prevail in tertiary care centers and indicate the necessity of awareness generation and capacity building among prescribers regarding AMR and its unseen consequences.

Background: Health seeking behaviour (HSB) of thalassemic children is one of the rarely explored entity. Aim: To explore HSB of β-Thalassemia Major (β-TM) children and its attributes. Materials and Methods: It was a cross-sectional design, observational study, conducted among 328 β-TM children and their caregivers attending a tertiary care health facility of Kolkata; West Bengal situated in Eastern India in between May 2016 and April 2017 with a structured schedule. The data were analyzed using SPSS 16.0 version. Results: At the disease onset, 79.6% of them consulted an allopathic doctor. In multivariable logistic regression model, those who were residing in urban area [adjusted odds ratio, AOR: 3.2 (1.2-8.7)], Hindu by religion[AOR: 3.0 (1.2-7.4)], had educated parents [AOR: 3.2 (1.1-9.2)], no family history of the disease [AOR: 3.6 (1.5-8.5)], belonged to higher socio-economic status (Class II, III and IV) [AOR: 2.9 (1.2-6.8)] and had caregiver with satisfactory knowledge related to the disease (≥4)[AOR: 12.2 (5.1-29.6)] were significantly more likely to seek healthcare from an allopathic doctor at onset of the disease. When we consider their HSB till date, 61.0% continued to consult allopathic doctors only. The multivariable determinants of satisfactory HSB till date were place of residence [AOR: 2.7 (1.4-5.2)], caste [AOR: 3.3 (1.6-6.7)], religion [AOR: 3.4 (1.7-6.9)], family history of the disease [AOR: 2.3 (1.2-4.6)] and caregiver's knowledge related to the disease [AOR: 5.3 (3.1-9.2)]. Conclusions: HSB of the study participants were significantly associated with their caregiver's knowledge regarding the disease, parents' educational level, socio-economic status, caste, religion and family history of the disease.

Introduction: Chronic pain is one of the most neglected health problems throughout the world. A close association of depression with chronic pain adds to the burden. There is severe dearth of epidemiological studies regarding depression in chronic pain among general population in India. Aim: To evaluate the prevalence of chronic pain among the selected rural population and to find out association between chronic pain and depression, if any. Materials and Methods: This cross-sectional study was done with the objective of studying the relationships between sociodemographic factors, depression with characteristics of chronic pain among adult population in a community setting. Data was collected from 697 adult (>18 years) chronic pain (>12 weeks duration) sufferers chosen randomly with proportionate representation from all 81 villages of Amdanga block, West Bengal, through a household-based survey in cross-sectional design. A pre-designed, pre-tested structured questionnaire containing socio-demographic information where Brief Pain Inventory (BPI), Patient Health Questionnaire-9 (PHQ-9) and Physical Functional Ability Questionnaire (FAQ-5) were used. During analysis, indices representing perceived pain, impairment and functional ability were generated from the questionnaire by principal component analysis. Results: Low Back Pain (LBP) was found to be significantly higher among females that is 57.7% (p-value=0.022), followed by knee pain (54.8%). Age (p

BACKGROUND: Student absenteeism is a major concern for undergraduate medical education training in India. Regular class attendance helps students have a proper understanding of the topic of discussion. This study explores the pattern of absenteeism among medical students and whether absenteeism is associated with their academic performances. MATERIALS AND METHODS: A record-based, cross-sectional study was done by reviewing departmental attendance registers, item cards and marks obtained in exam by 190 students in the community medicine department who had passed their 3rd professional part 1 examination in 2018. The data was entered and analyzed using SPSS version 16. A descriptive analysis summarizes the pattern of absenteeism and their marks obtained in the semester and professional exam of community medicine. The primary outcome indicator was the 3rd professional exam marks. The correlation between class absenteeism and other predictors and exam result was analyzed. Regression analysis was done to predict dependence of outcome variable on class attendance and formative examination marks. RESULTS: Overall, female students had better class attendance than male students. There was a positive correlation of lecture class attendance (r = 0.369) and marks obtained in the 6th semester exam (r = 0.717) with the final exam result. Further regression analysis showed final marks had a higher dependence on the 6th semester examination score (B = 0.669) when compared to lecture class attendance (B = 0.051). CONCLUSION: Although lecture class attendance is an important predictor of final result, this study showed that the 6th semester marks were a better predictor. This may be due to multiple factors (alternate source of learning, student's motivation, etc.) which require further exploration.

Background: Caregivers knowledge regarding thalassemia is one of the vital areas in the prevention of the disease. Studies related to caregivers knowledge and its sociodemographic predictors are very few in number which is helpful in designing interventions across different study settings. Objectives: the study aimed to find out the knowledge level of caregivers of thalassemic children and its sociodemographic determinants. Materials and Methods: It was a cross-sectional observational study conducted in a thalassemia day care unit of Eastern India. The study included 328 caregivers of thalassemic children attending thalassemia day care unit during May 2015–April 2016. Data were analyzed using Statistical Package for the Social Sciences (SPSS) (version 16). Results: Out of 328 caregivers only 47.6% knew about genetic etiology of the disease, while only 52.4% and 50.9% knew about premarital counseling and antenatal screening, respectively. Regarding treatment of the disease, 75.9% knew that both blood transfusion and iron chelation are the treatment of thalassemia, while only 19.2% and 2.7% of them had knowledge regarding splenectomy and bone marrow transplantation, respectively. Only 52.7% had satisfactory knowledge regarding the disease. In multivariable model, caregivers educational level (adjusted odds ratio, AOR-3.13 [1.87–5.25]), working status (AOR-2.18 [1.23–3.86]), place of residence (AOR-2.05 [1.19–3.52]), and socioeconomic class (AOR-2.11 [1.25–3.58]) were significant predictors of their knowledge. Conclusion: Caregivers' knowledge regarding thalassemia was not at all satisfactory. Regular counseling of caregivers should be done addressing the knowledge lacunae's among them.

Caregivers are the persons who provide care at the time of distress or illness. They face many stress and strain to provide the best possible medical care for their children. There are very few studies that explored the care-related quality of life (CarerQoL) of the caregivers of thalassemic children and its correlates. With this background, the current study was designed to explore the CarerQoL of the caregivers of β-Thalassemia Major (β-TM) children and its various correlates. It was a cross-sectional observational study conducted among caregivers of β-TM children attending a tertiary care health facility of Eastern India in between May 2016 and April 2017 with a structured schedule. The median CarerQoL score was found to be 5 with an interquartile range of 4–7 (range: 11). In the final multivariable logistic regression model, care receivers’ (thalassemic children) age [adjusted odds ratio (AOR): 2.2 (1.2–4.2)], spleen status [AOR: 4.1 (2.0–8.7)], blood transfusion frequency [AOR: 2.1 (1.1–3.9)], and quality of life (QoL) [AOR: 3.0 (1.6–5.5)] and caregivers’ educational level [AOR: 2.3 (1.2–4.1)], perceived social discrimination [AOR: 2.3 (1.3–4.1)], debt [AOR: 2.3 (1.2–4.3)], nongovernmental organization assistance [AOR: 2.0 (1.0–4.0)], and wage loss due to seeking treatment [AOR: 1.9 (1.1–3.4)] were significant predictors of CarerQoL of the study participants adjusted with their age, sex, working status, per-capita monthly income, knowledge level related to the disease, and care receivers’ comorbidity status. To conclude, CarerQoL of the study participants were significantly associated with QoL of their wards. Other significant associates of CarerQoL were caregivers’ education level, financial profile, patients’ age, and their clinico-therapeutic profile.

Background: The discourse of mental health is getting its due attention after all these years in India. A major threat to the mental health system is the demand side factors, namely, knowledge, attitude, and practice (KAP) of the general population toward this. In spite of growing concern regarding mental health in India, this kind of study to assess the mental health status has been very few in India, more so in West Bengal. Objectives: With this background, this study was carried out with the objectives to validate the Community Attitude to Mental Illness (CAMI), to assess the different sociodemographic factors among the study population, to assess the KAP regarding mental illness among the study population. Methods: It was an observational, descriptive study with cross-sectional design done at Amdanga Community Development Block, North 24 Parganas, West Bengal, India, in 2015-16. Questionnaire validation to assess the KAP was the primary objective with obtaining the descriptive data were the second one. CAMI questionnaire was used which was validated for the given area by validation methods such as Cronbach's alpha and structural equation modeling. The resultant questionnaire was used in the field on adult population after a single-stage survey design to collect 730 samples. Results: The test statistics showed that the questionnaire was reasonably valid after a few tweakings. SEM identified well-define domains in the attitude part. 94.9% says that they are willing to live with a people with mental illness. 14.9% has actually done so. Health-care seeking behavior shows that 19.2% will go to a GP in case of any mental illness. Furthermore, attitude toward mental illness showed mixed picture as also knowledge. This study correlated with various studies of developing countries and it was seen that these population showed markedly different attitudes for probability of the patients getting cured than many other countries. Furthermore, stigma was gradually decreasing, as evident from various other studies. Conclusion: This study will provide valuable insights into the cognitive and affective aspect of mental illness among these population and thus help in implementing better policies in this regard, as this is fast becoming the talk of the day.

Background: Menstrual hygiene is a neglected issue in rural India. Lack of menstrual hygiene in adolescent girls can make them susceptible to various morbidities, for example, reproductive tract infection and urinary tract infection and their long-term consequences, for example, cervical cancer, infertility, and ectopic pregnancy. This study aims to find out the determinants of menstrual hygiene among the school going adolescent girls in a rural area of West Bengal. Objectives: To elicit the menstrual hygiene practices among the study population and to find out the association of poor menstrual hygiene practices with sociodemographic factors, such as age, occupation and education of the parents, housing, and presence of sanitary toilet. Materials and Methods: A descriptive, cross-sectional study was conducted among 307 school going adolescent girls of 12–17 years age group in a rural area of West Bengal. Results: Majority of the students in both schools (62.9%) were Hindu, general caste (54.1%) and belonged to nuclear family (69.7%). Most of the parents in both schools had completed their education up to primary level. Bivariate analyses were done, and the significant factors predicting good menstrual hygiene were entered into the multivariable logistic regression model. It revealed that good menstrual hygiene was more among those whose mothers were educated (adjusted odds ratios [AOR] 2.3 [1.06–5.01]), and who were homemakers (AOR 2.3 [1.06–5.01]). Conclusions: Menstrual hygiene among the study population was found to be poor. The improving education level of the mothers can go a long way in improving menstrual hygiene practice.

BACKGROUND: Although prevention the birth of children with β-thalassemia major (β-TM) is an important health issue, it is rarely explored. With this background, the study was designed to find family planning practices and related factors of couples with children affected by β-TM. MATERIALS AND METHODS: This was a cross-sectional, observational study, conducted among 324 parents with children affected by β-TM attending a tertiary care health facility in Eastern India. Data were analyzed using univariate and multivariable logistic regression using SPSS. RESULTS: Of 324 parents, 89.5% were sexually active, 44.8% of which were currently using family planning method to prevent the birth of another child with the oral contraceptive pill most preferred (46.9%) followed by tubectomy (33.9%). Those who were sexually active, but not desirous of a child were 223, of which 41.7% had the unmet need for family planning with religious belief (41.9%) being the most predominant reason followed by unaware of methods (26.9%). In multivariable analysis, religion, caste, per capita monthly income, mothers' education level, and working status were significant predictors of unmet need for family planning adjusted with others. CONCLUSIONS: Burden of unmet need for family planning among the study population was alarmingly high. Parents of the thalassemic children should be counseled in easily comprehensible local language to increase the rate of contraception among them.

Introduction: IT has revolutionized economies throughout the world, more so in India. West Bengal has also got its share of IT boom. But with this, it has brought in the class of human resource of Video Display Terminal workers operators that and along with that can cause a host of occupational problems in them namely musculoskeletal, ocular and psychological systems. The current study had assessed some of the musculoskeletal disorders occurring due to VIDEO DISPLAY TERMINAL use. Materials and Methods: An analytical cross-sectional study was done in a Software Company of Sector V, Kolkata, the IT hub of West Bengal. Of all the employees, required sample size of 206 was selected by Simple Random Sampling. After proper permissions and consent, socio-demographic variables were collected by standardized instruments, musculoskeletal morbidity was collected by Nordic questionnaire, and ergonomic practices were obtained by checklists. Results: 90.78% of population showed some form of musculo skeletal symptoms. They were highest in fingers, elbows, wrist, shoulder, upper, while legs and lower back showed low morbidities. Increasing age, female sex, increasing years of work, repetition of work, poorer ergonomic scores all showed to have increased the symptoms. The regionwise ergonomic scores revealed how the poorer scores affected the musculo skeletal systems adversely. Several individual adverse ergonomic practices were also elicited. Discussion: The study goes hand to hand with many other studies throughout the world and also in India. However, a much higher morbidity has been found in this study probably due to a symptom based questionnaire. The adverse practices obtained here goes well with other relevant studies. Conclusion: This study puts occupational health problems of VIDEO DISPLAY TERMINAL users, and upholds the need of future multicentric cohort studies along with implementation of proper measures to ameliorate the effects of this occupational hazard.

Aim: Age, sex, living place (urban or rural), smoking, alcohol consumption, dietary pattern, obesity are considered as risk factors for Colorectal cancer. Our study was done to evaluate the association between these risk factors and colorectal cancer in the population of North Bengal. Materials and Methods: The present study was done over a period of one year as a hospital-based analytical observational type of study with cross-sectional type of study design. All the patients undergoing colorectal endoscopic biopsy at the Department of Surgery, NBMC&H during the study period for various clinical indications comprised the study population. History and clinical examination were done of the patients whose colorectal biopsy were taken and filled-up in a predesigned pre-tested proforma. Significance was tested at 95% confidence interval. Results: There is an increased risk of colorectal carcinoma (CRC) with increasing age in our study population. Odd’s ratio for last 2 age groups are statistically significant with 2.83 for 41-50 years age group (95% CI is0.3-24), 13.6 for 51-60 years age group (95% CI is 2.1-85.9), 42.5 for more than 60 y age group patients (95% CI is 3.1-571). There is increased risk of colorectal carcinoma in males with an Odd’s ratio of 1.6 (95% CI is 0.5-5.5), but it is not statistically significant. There was an increased urban incidence of colorectal carcinoma compared to rural population with an Odd’s ratio of 1.8 (with a 95% CI of 0.6-5.9). In our study smoking also proved to be a risk factor and it is significant with an Odd’s ratio of 5.4 with a 95% CI of 1.6-8.7. Odd’s ratio for cases of alcohol consumption was 3.5 with a 95% CI of 1-11.6. Carcinoma cases were more common among patients with history of non-vegetarian dietary intake with Odds ratio of 1.5 (with a 95% CI of 0.3-8.7), but it was not statistically significant. Obesity has got a significant association with CRC in our study with an Odd’s ratio of 7.2 (with 95% CI of 1.3-40.2). Conclusion: More than 50 years of age, smoking, obesity were significant risk factors in our study. Other risk factors were though not significant, but much more common in colorectal cancer patients compared to non-malignant population.