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Background-COVID 19 pandemic had disrupted the traditional method of face-to-face learning and paved the way for online learning. Students' and teachers' perspective are important for further improve the quality of online learning. Objective -To study the perception of online teaching by the undergraduate medical students. Materials and method-The study was conducted on 216 undergraduate medical students of a medical college in Kolkata over a period of 2 months. All the students who completed the predesigned and pretested questionnaire administered through google forms were included in the study. The analysis was done in SPSS version 22. Results-The mean age of the study participants was 20.8 years. Majority of the participants used mobile phones for attending classes and WhatsApp for coordinating online classes and uploading live classes. Most of the participants perceived online class for lecture classes and face-to-face class for practical classes. There is statistical association between mode of interaction with faculty and sex (P=0.000).The main advantages of online learning were attending from comfort zone, more time for self-study, flexible timing, not hectic and boring, easy storage and accessibility, downloadable sessions and study materials can be studied for multiple times. Conclusion-There is a need to train the teachers and the students about online platforms for improving the quality of teaching learning methods. Qualitative research may be done to fine out the core problems of the students to handle this new method of education. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Drug resistant tuberculosis is a major public health threat that hinders progress in tuberculosis control worldwide. In 2019, India contributed highest cases of TB (27%) Worldwide. In 2019, 3.3% of new TB cases and 18% of previously treated cases had MDR/RRTB worldwide and India (27%) had the largest share of the global burden. This study was done to find out the sociodemographic and clinical profile of drug resistant TB patients. Methodology: It is an observational descriptive study with cross-sectional design, conducted at the drug resistant tuberculosis centre of R. G. Kar Medical College of Kolkata, West Bengal. Study Population consisted of the patients who were registered for the DR-TB regimen. Study duration was July 2016-March 2017. Pre-tested, semi-structured schedule was designed to capture their sociodemographic profile, treatment history, clinical findings and available medical records. Data were compiled in MS Excel and analyzed in IBM SPSS 23.0. Results: Out of 159 cases, 27% patients were between 21-30 years. Males were predominant (68.6%). Most patients (56.6%) were underweight (BMI<18.5kg/m2). HIV seropositivity was found in 4 (2.5%) cases. Among all cases, 81.1% had history of taking ATD and 34.4% was cured in previous episode of treatment. The commonest associated comorbidity was DM (15.7%). Rifampicin resistance (93.1%) was most common followed by Isoniazid (8.2%). Pallor was found among 94.3% patients. Most patients had bilateral (62.3%) and moderately extensive (57.2%) lesions in chest x-ray. Conclusion: DR-TB control should focus adequately on younger age group as numbers of resistance is increasing among them. Relapse in previously cured cases was found to be major contributor of DR-TB suspect cases. Though, Rifampicin resistance was so common but prevalence of resistance to 2nd line drugs is still low. Focus should be given on early detection of drug resistance in all TB cases and improvement of nutritional status of the TB patient. [ABSTRACT FROM AUTHOR]

The Corona virus epidemic has seen its one year of emergence and in many ways it has changed the way the world was. While virtually all the countries have been affected by the disease, the proposed measures to prevent the disease is simple but has to be sustained, like wearing masks, washing hands, avoiding crowded places. In spite of that most of the people have not been able to diligently follow these advices in almost all the countries. The author wants to explore some of the factors here that may have deterred people from sticking to these measures using the newly emerging field of behavioral economics. The author starts from a philosophical point of view and goes into the debate between utilitarianism and libertinism and comes to the criticism of both the theories. In fact a middle way of paternalistic libertinism has been proposed as a better way of explaining many of the behaviors that are apparently not rational according to neoclassical frameworks. Kahnemann’s prospect theory, with its cognitive biases like heuristics, anchoring, salience and above all social norms are found to be explaining many of the behaviors in a better way. The author, however has to give evidences from popular media and anecdotes in many cases, due to paucity of better quality evidence. [ABSTRACT FROM AUTHOR]

Introduction: There has been a new challenge to the already existing threat of tuberculosis (TB) and that is drug resistance TB (DR-TB). The causal relationships between mental disorders and TB are complicated and relatively unexplored. For this reason a qualitative study was done on DR-TB patients attending R G Kar Medical College. Materials and Methods: The study population consisted of the patients who are registered for the DR-TB regimen are followed up four times with General Health Questionnaire (GHQ). Those scoring poorly were sent for expert evaluation by psychologist, who counselled them, and followed them up after in-depth interviews. These records of in-depth interview were analysed as qualitative research inputs. Results: In our study out of 165 patients, (4.8%) needed interventions. The domains emerging from the study are worried about future and as well as family, disbelief about the diagnosis, embarrassment regarding the diagnosis, fear of death, blaming fate for the disease, stigma, suicidal ideation. Conclusion: This study finds out the important domains of psychogical problems among the patients and also advocates a psychologist to remain at DR-TB centres. [ABSTRACT FROM AUTHOR]

Background: Video Display Unit use and Information Technology creates a host of problems like Ocular Problems and Work Related Musculo Skeletal Problems. Many experience visual symptoms including eyestrain, headaches, ocular discomfort, dry eye, diplopia and blurred vision either at near or when looking into the distance after prolonged computer use. Very few and sporadic studies have been done in this part of the world especially in India, to address the issue in all its scope. Aim & Objective: To find out the proportion of different ocular problems among the study population and to find out the association of their ocular problems with the socio-demographic, work related and ergonomic factors. Materials and methods: It was an institution based, cross sectional, analytical epidemiological study and was conducted over one-year period. The study population comprised of persons working with Video Display Terminals. A predesigned, semi-structured instrument for elaborating the socioeconomic, lifestyle related and a few job-related health behaviors were used. Combination of few instruments to elicit different morbidities like and many ergonomic checklists to evaluate office workspace were also used. Results: Of the total 79.1 % had any kind of ocular problems currently, with around 65% of them reporting to be having problem constantly in the last 12 months. Headache (63.6%) seemed to be the most important problem, followed by Eye fatigue (52.4%). Repetition of work and poor ergonomic practices turned out to be the statistically significant factors. Increased Years of working and female sex were also found to be important factors. Screen Character was found to be the most important risk factor of eye problems. Conclusion: A simple model was proposed where interaction of Individual factors and factors related to workstation was identified as the main culprit, which exaggerated by the repetition of work. [ABSTRACT FROM AUTHOR]

Background: Chronic pain, though a most common cause of disability worldwide, is one of the most underestimated health problems throughout the world. With the ageing population and its increasing prevalence, understanding related care seeking practices is key to plan effective interventions. Objectives: To find out the characteristics of chronic pain and to study related and care-seeking practices and the influence of sociodemographic factors among adult chronic pain sufferers in a rural setting. Methods: Data were collected from 697 adults (>18 years) chronic pain (>12 weeks duration) sufferers chosen randomly from all 81 villages of Amdanga block, West Bengal, through a household-based survey in a cross-sectional design. A pre-designed, pre-tested structured questionnaire containing socio-demographic information, Brief Pain Inventory (BPI) and Patient Health Questionnaire-9 (PHQ-9) was used. During analysis, dimension reduction by Principal Component Analysis was done to derive pain intensity and interference scores. Results: Low back pain and knee pain were first and second most frequent. Major Depressive Syndrome (MDS) was found in 9.04 % [95% CI: 7.95% - 10.13%]. The severity of pain increased with age and decreased with advancing level of education & income. Care-seeking was significantly predicted by MDS (AOR= 0.185), pain intensity (AOR=1.06) & interference (AOR=1.06).Conclusion: Patients tend to seek care more at an advanced severity and more from a private facility. About 1 in 10 persons with chronic pain was seen to suffer from major depression, with which, persons were seen about five times less likely to seek care. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: The WHO defines the use of medications without prior medical consultation regarding indication, dosage and duration of treatment as self-medication. The practice is a global problem. Aims and Objectives: The study was conducted to describe the care seeking behavior of rural self-medicators living in Amdanga Block of West Bengal and to assess the belief in medicines by the self-medicators. Material & Methods: A descriptive cross-sectional study was conducted by interviewing with a pretested semi-structured questionnaire on 665 self-medicators out of 1740 adults who were interviewed in 80 villages of Amdanga Block, West Bengal. A three-stage sampling method was used to reach the study population. A three month recall on self-medication practice was considered operationalizing the "pull" and "push" factors of self-medicators using a Pshycho-social framework. The variables were Socio-demographic factors, Care Seeking Behaviors, Health System related factors, Belief in Medicines according to the framework. Results: The prevalence of self-medication was found to be 38.2%. 63% of the study subjects were female and 56.3% had a literacy status of middle school and above. 54.4% relied on their old prescription for self-medication. 68.7% had an initial choice to consult a doctor but later self-medicated of whom 53.2% changed their choice due to monetary and transport issues while 38.5% thought of self-medication considering their disease was mild in nature. Conclusion: Awareness and health education can link rural subjects with primary care facility and right decisions on care can be provided. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Congenital nephrotic syndrome (CNS) is a rare but serious condition which affects neonates and is caused by monogenic defects of glomerular structural proteins or congenital viral infections. Several reports have established a causal relationship between human cytomegalovirus (HCMV) intrauterine infection and CNS, but thorough study assessing parameters has not yet been done. Methods: This study aimed to ascertain significant demographic, biochemical, serological, inflammatory and etiological parameters with 12 months follow-up to clinically identify and monitor neonates with HCMV-associated CNS and sought to decipher the phylogenetic nature of infecting strains. Differences between four patient groups (neonates < 4 weeks old) with or without CNS and HCMV infection were compared by unpaired t testing and one-way analysis of variance (ANOVA). Linear regression was performed to assess statistical significance among individual groups. Maximum-likelihood–based phylogenetic analysis was performed with HCMV gH gene sequences to compare clinically isolated and referenced NCBI strains. This was further supported by analysis of effective number of codons (ENc), codon adaptation index (CAI) and mRNA structural variation. Results: Patients with HCMV-associated CNS were found to have significant variations in many studied parameters compared with controls. The majority of clinical strains formed a separate phylogenetic cluster defining them as somewhat distinct from standard reference strains, which was supported by the other analyses. Conclusion: This study defined parameters for monitoring cases of HCMV-associated CNS, which suggest the possible existence of a selection force acting and rendering these HCMV strains able to infect selective host tissues and cause specific disease types. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Chronic disease is a common public health problem worldwide. Adherence to long-term treatment is a key determinant of therapeutic success in patients with chronic diseases. Aim & Objective: The purpose of the study was to know the people's attitude towards intake of drug, medication adherence and their relationship with socio demographic profile. Settings and Design: Data were collected from 729 individuals chronic disease sufferers chosen randomly from all 81 villages of Amdanga Block West Bengal through a household-based survey in a cross- sectional design. Methods and Material: A pre designed, pre tested, semi structured schedule containing socio-demographic profile and attitude among the respondents regarding adherence to long-term treatment. Statistical analysis used: To compare Attitude scores among different groups, median (IQR) attitude score was calculated and compared with Mann-Whitney U test and Kruskal-Wallis test to know the level of significance of variables. p-value < 0.05 considered statistically significant. Results: Attitude towards long-term adherence to treatment to chronic diseases were significantly associated to caste (p=0.043), education (p=0.001) and occupation (p=0.001) of the study subject. Conclusions: Attitude towards long-term adherence to treatment to chronic diseases were significantly associated to caste, education and occupation. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Human Cytomegalovirus has been implicated as a probable cause for the development of hepatic cholestasis among neonates. Our study tried to ascertain the exact demographic, biochemical and immunological markers to differentially diagnose patients with HCMV associated intrahepatic and extrahepatic cholestasis and also decipher the phylogenetic variability among the viral strains infecting the two groups. A total of 110 neonates collected over a span of 2 years were selected for the study classified into four different groups based on the presence of hepatic cholestasis and active HCMV infection. Our analysis predicted that total Cholesterol, GGT, ALP and TNFα were the only significant biological markers with exact cut-off scores, capable of distinguishing between HCMV associated intrahepatic and extrahepatic cholestasis. We confirmed that in patients belonging to both of these groups, the inflammasome is activated and the extent of this activation is more or less same except for the initial activators NLRP3 and AIM2 respectively. When we performed two separate phylogenetic analyses with HCMV gM and gN gene sequences, we found that in both cases the sequences from the IHC and EHC groups formed almost separate phylogenetic clusters. Our study has shown that the HCMV clinical strains infecting at intrahepatic and extrahepatic sites are phylogenetically segregated as distinct clusters. These two separate groups show different physiological as well as immunological modulations while infecting a similar host. [ABSTRACT FROM AUTHOR]