Search

Background: Common mental disorders (CMDs) are the most frequently encountered mental health problems. A relevant cultural formulation requires consideration of how such patients understand their illness and the kind of help they prefer. We aimed to clarify patient's priority symptoms, perceived causes (PCs), and help-seeking (HS) behavior for CMDs in a psychiatry outpatient clinic in West Bengal, India. Methods: We conducted a cross-sectional survey of consecutive patients with clinically confirmed depression, anxiety, or somatoform disorders in a psychiatry outpatient department in a hospital in North 24 Parganas district. An explanatory model interview based on the Explanatory Model Interview Catalogue was used to assess qualitative and quantitative data regarding sociodemographic characteristics, pattern of distresses, PCs, and HS experience. Results: Among 124 patients, 69% were women, mean age 34.5 years. Half of the patients had monthly income less than USD 32, and 22% were illiterate. Clinically, 42% had depression, 32% somatoform disorder, 10% anxiety, and 17% mixed disorders. Most common symptoms were headache (93%), disturbed sleep (93%) and anxiety or tension (92%). Most common PCs were psychological (96%), family problems (64%), and physical injury (42%). The preferred first providers were private allopathic doctors (50%), traditional healers (28%), and public sector doctors (22%). Conclusions: Clinicians need to recognize both physical and psychological presentations of CMDs. Brief clinical assessment only for pharmacotherapy may be inadequate to address the underlying psychological impact of social and financial causes, which require clinical attention to issues associated with poverty, family, and community.

Rubella is a contagious, generally mild viral infection that occurs most often in children and young adults. The infection in pregnant women may cause foetal death or congenital defects known as congenital rubella syndrome (CRS). Globally, the incidence of CRS was from 0.4-4.3/1000 live birth. The aims of the study were to (i) investigate outbreak to determine the magnitude of outbreak, and (ii) analyze outbreak in term of time, place and person distribution, and recommend preventive measures. We conducted investigation by house to house active case search at Dumra village of Purba Medinipur district, West Bengal; India between February and May’ 2016. Epidemic curve was drawn to see the dynamic of outbreak and spot map was plotted to see the distribution of cases. Blood specimen was taken for serological test of virus. A total of 54 cases were identified; among those five cases were found positive for rubella (IgM). The attack rate (AR) among the women more 7.5% (27/358) than men 7.0% (27/388), with overall AR was 7.2% (54/746). Maximum cases were found among age group of 5-9 years with AR was 8.0% (23/286), followed by age group 0-4 years with AR was 3.9% (12/309). Median age was 8 years with rage from 0.6 to 33 years. Seventeen percent (9) cases were among female reproductive age (15-33 years). None of them were pregnant. Under five children were 33% (18/54) and 72% (13/18) were vaccinated with measles but none of them were vaccinated with rubella vaccine. All the patients were treated at home and at outpatient department. Outbreak of rubella was confirmed. We recommended introduction of rubella vaccine in National Immunization Schedule of India.South East Asia Journal of Public Health Vol.7(1) 2017: 17-22

Background: To identify an effective misoprostol-only regime for the termination of second trimester pregnancy. Objectives: To compare the efficacy, safety and acceptability of sublingual and vaginal misoprostol for second trimester pregnancy termination. Methods: In a prospective randomized comparative study, over 138 pregnant women at 13 - 20 weeks (91 - 140 days) of gestation requiring medical abortion were randomly assigned to the sublingual or vaginal route for misoprostol administration with dose schedule of 400 mcg every 3 hours up to 5 doses within 24 hours. The course of misoprostol was repeated if the woman did not abort within 24 hours. Primary outcome was the efficacy of the treatment to terminate pregnancy completely at 24 and 48 hours. Secondary outcomes measured were induction-abortion interval, side effects, failure rate, and women’s perception to these treatments. Results: At 24 h, the complete abortion rate was 87.88% in the vaginal administration group and 79.41% in sublingual group (difference 8.5%, 95% CI: 3.8 to 13.2). No significant difference in the complete abortion rates was observed at 48 h(90.91% versus 88.24% difference: 2.7%, 95% CI: ?0.04 to 5.4) when vaginal and sublingual groups were compared. Mean induction-abortion interval in sublingual and vaginal groups was 12.28 h (95% CI of mean 11.019 - 13.541 h) and 13.11 h (95% CI of mean 12.0301 - 14.1899 h) respectively; p = 0.485. The rates of side effects were similar in both groups except for fever, which was more common in vaginal group. Significantly more women in the sublingual group preferred the route as compared to vaginal administration (RR 1.618. 95% CI: 1.277 - 2.050; p < 0.0001). Conclusion: Both sublingual and vaginal routes of misoprostol are equally effective in medical termination of pregnancy in second trimester but sublingual route was preferred by the women.

Health workers reported an increased number of diarrhea cases at Haibatpur village on June 17, 2012. This outbreak was investigated with the followingobjectives: to confirm the existence of diarrhea outbreak, to find out the risk factors, and propose control measures. Cases were listed; spot map and epidemic curve were drawn. Attack rate was calculated by age and sex and risk factors were found out by calculating odds ratio (OR) with 95% confidence interval (CI). Rectal swabs were taken and water specimens were collected for laboratory test. Forty-one cases of patients were identified with overall attack rate (AR) was 5% (41/780). AR among men was higher 6% (25/404) than women. There was no death.V. cholerae01 Eltor Ogawa was isolated from one (1/4) stool specimen. Spot map showed cases clustered around two ponds which were contaminated with coliform organisms. The underground water was a bit saline in nature. Using pond water for preparation of fermented rice (Panta Bhat) (OR 4.73, 95% CI 1.69–13.51), washing utensil in pond water (OR 7.31, 95% CI 1.77–42.29) were associated with cholera outbreak. Health education was done to villagers. Disinfection of two ponds with bleaching powder was done. We proposed supplying of safe drinking water and repairing defective deep tube well to village.

For any legged mobile machine, gait is the methodical, logical and scientific lifting and placement of foot to follow desired path on the desired terrain. To run a walking machine on any terrain, selection and analysis of gait is must. To meet the locomotion characteristics of an eight-legged robot in this paper we describe gait analysis of eight legged spider like robot. The longitudinal gait stability margin of the robot changes with change in duty factor. We analyze the wave gait and equal phase gait for this legged robot and found that there is a jump in stability margin of full cycle equal phase gait to that of wave gait at duty factor 3/4, and stability margin of half cycle equal phase gait jumps to wave gait at duty factor 7/8. We try to verify our result through graphical and simulation analysis.

background: During September 2012, an increased number of fever cases was reported from Ramnagar-II block, Purba Medinipur district. This study investigated the outbreak, with the following objectives: to describe the distribution of fever cases, to determine the risk factors and to recommend preventive measures. Materials and Methods: The clinical features, date of onset and outcome of all cases of fever were listed. Blood specimens were collected from affected patients and sent for serological examination. An epidemic curve was plotted and environmental and entomological surveys were carried out. results: There was a total of 100 cases, of which 56% (56/100) were men. Among the four villages studied, the highest number of cases was from Gopalpur 37% (37/100), followed by Badalpur 26% (26/100); 19% (19/100) of cases had a history of migration from dengue-endemic areas. The majority of cases were in age group 15–45 years – 52% (52/100), followed by the age group >45 years – 28% (28/100). All the cases had history of fever (100%), followed by myalgia – 82%, headache – 78%, and retro-orbital pain – 73%. The outbreak started on 7 September 2012, peaked on 18 September, then gradually declined and no further cases were noted after 28 September 2012. Seventy-nine per cent (79/100) of cases were NS1 test positive (non-structural antigen-1) and 72% (13/18) cases were positive on a dengue monoclonal antibody (IgM) capture enzyme-linked immunosorbent assay (MAC-ELISA) test. All recovered except one (case-fatality ratio: 1%). The values for Household Index, Container Index and Breteau Index of the four villages were: Badalpur, 3%, 10% and 5%; Gopalpur, 13%, 23% and 18%; Ramchandrapur, 9%, 11%, and 13%; and Tajpur, 2%, 2% and 2%. conclusion: The outbreak was probably due to dengue fever. The study led to a recommendation to destroy water containers and use mosquito nets. The outbreak was controlled.