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Introduction: There are a few studies on the psychotropic prescription pattern in Eastern India, particularly in West Bengal, with limited statistics and focus, as well as there is no study conducted in health facilities particularly catering to the labor class population. To improve the mental health-care delivery in laborers and their dependents through policy-making, information is required regarding psychotropic prescription patterns in laborers suffering from mental disorders. Materials and Methods: A hospital-based, cross-sectional study was conducted for 6 months. A total of 3000 patients were randomly selected from those who consented to utilize their information for study purposes. DSM-5 was used for psychiatric diagnosis. Descriptive statistic was used to describe drug use pattern. The World Health Organization-drug use indicators were used for analyzing prescriptions. Results: Among 3000 participants, 1114 (37.1%) and 537 (17.9%) were suffering from somatic symptom disorder and generalized anxiety disorder, respectively. Antidepressants and benzodiazepines (BZDs) with Z-drugs together form the major bulk of prescriptions. Amitriptyline, olanzapine, and alprazolam were the most commonly prescribed antidepressants, antipsychotics, and BZDs, respectively. Conclusion: Neurotic and anxiety disorders are major psychiatric morbidity among the labor class population. Antidepressants like amitriptyline and BZDs like alprazolam can meet the majority of mental health needs of laborers. Therefore, policy and provision are required for an adequate availability of these drugs in catering centers. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the relative efficacy of prophylactic intravenous (IV) clonidine and tramadol for control of intraoperative shivering following spinal anesthesia. Materials and Methods: After institutional ethical clearance, 142 patients were chosen from either gender, aged 20-60 years, physical status American Society of Anesthesiology Class I and II scheduled for elective infraumbilical surgery under spinal anesthesia. Patients were randomized into two groups: Group C (n = 71) received injection clonidine 50 µg) IV in 100 ml normal saline (NS) over 10 min and Group T (n = 71) received injection tramadol 50 mg IV. In 100 ml NS over 10 min after spinal anesthesia. Results: Incidence of shivering was not significant when compared between the two groups (P > 0.05). The axillary temperatures fell significantly in Group C from the baseline and remained at a significantly lower level up to 60 min after rescue drug was administered in patients who shivered. There was a similar fall in axillary temperature in Group T in patients having shivering, but the difference was not significant. When compared between the two groups among patients who shivered, the difference in fall of temperature was not significant. Side effects such as hypotension, bradycardia, and sedation were significantly more common in clonidine group, whereas nausea was significantly more common patients of tramadol group. Conclusion: Prophylactic administration of both tramadol and clonidine is effective for controlling shivering under spinal anesthesia. However, tramadol is better because of higher response rate, less sedation, and lesser hemodynamic alterations. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented based on the topic of diagnosis of sexually transmitted diseases syndrome-wise in a subdivision level hospital of rural West Bengal, India.

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Aims: The aim of the present study is to substantiate and compare the quality and extent of nerve block by using intrathecal bupivacaine or extradural bupivacaine alone and in combined spinal-epidural (CSE) technique using smaller dose of intrathecal bupivacaine and extradural injection of a smaller dose of bupivacaine or normal saline. Setting and Design: A prospective study design was set up with 60 adult patients scheduled for vaginal and lower abdominal operation under CSE technique and single spinal or epidural technique. Materials and Methods: 60 patients undergoing infra-umbilical surgery were divided into three groups (Group). Group A1 (control) 10 patients received 3 ml of intrathecal heavy bupivacaine. A2-10 patients received 16 ml isobaric bupivacaine extradurally Group B (n = 20) patients received 2 ml intrathecal heavy bupivacaine and 10 ml normal saline extradurally. Group C patients (n = 20) received 2 ml heavy bupivacaine intrathecally and 10 ml isobaric bupivacaine extradurally. A total duration of this study was 18 months. Duration of motor block, sensory block, analgesia, onset of sensory block and cephaloid extent of sensory block and side-effects noted among patients. Visual analog scale in the post-operative period was recorded. Statistical Analysis: The results were analyzed statistically by applying analysis of variable, odds ratio and Chi-square test. Results: Patients were comparable regarding the onset time and height and duration of sensory block with a significant difference, though there was no difference in duration of motor block and analgesia. The side-effects in the control group are higher than the other two groups. Conclusion: Quality of nerve block in combined technique using bupivacaine both intrathecally and extradurally is better and associated with lower side-effect compared with intrathecal heavy bupivacaine or extradural isobaric bupivacaine alone. [ABSTRACT FROM AUTHOR]