Self-medication and its associated factors in Amdanga block of West Bengal

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

Socio-Demographic and Clinical Profile of Drug Resistant Tuberculosis Patients in a Tertiary Care Centre of Kolkata

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

Ocular Problems among Video Display Terminal Users in a Software Company of Sector V, Kolkata

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 socio-economic, 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

An analytical observational study on chronic kidney disease of unknown etiology at a rural tertiary care hospital in West Bengal

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

Knowledge of the caregivers of thalassemic children regarding thalassemia: A cross-sectional study in a tertiary care health facility of eastern India

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

Determinants of menstrual hygiene among school going adolescent girls in a rural area of West Bengal

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

Attitude towards adherence to long term therapy

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

Rationality of Prescriptions by Rational Use of Medicine Consensus Approach in Common Respiratory and Gastrointestinal Infections: An Outpatient Department Based Cross-Sectional Study from India

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