Impact of zinc supplementation on subsequent morbidity and growth in Bangladeshi children with persistent diarrhoea

This study was conducted to explore whether supplementation of zinc to children during persistent diarrhoea has any subsequent effect on morbidity and growth. A prospective follow-up study was conducted among children, aged 3-24 months, with persistent diarrhoea, who participated earlier in a double-blind randomized placebo-controlled trial. During persistent diarrhoea, children were randomly allocated to receive either zinc in multivitamin syrup or only multivitamin syrup for two weeks. After recovering from diarrhoea, 76 children in the multi-vitamin syrup and 78 children in the zinc plus multivitamin syrup group were followed up for subsequent morbidity and growth. Weekly morbidity and two-weekly anthropometric data were collected for the subsequent 12 weeks. Data showed that episodes and duration of diarrhoea were reduced by 38% and 44% respectively with supplementation of zinc. There was no significant difference in the incidence or duration of respiratory tract infection between the zinc-supplemented and the non-supplemented group. Improved linear growth was observed in underweight children (weight-for-age <70% of the National Center for Health Statistics standard) who received zinc compared to those who did not receive.

A study on drug use in a district hospital of West Bengal

A cross-sectional study at Howrah General Hospital, West Bengal for prescription analysis and assessment of drug dispensing in 341 patients revealed that the average number of drugs prescribed per encounter was 2.98 +/- 1.69, 38.2% drugs were in generic name and majority were from essential drugs list. 18.6% and 5.2% encounters used antibiotics and injections respectively. Average consultation and dispensing time were short. Majority of drugs were dispensed but unlabeled. 46.8% patients knew correct dosage of drugs. Only 4.7% patients were treated without drugs. Average drug cost per encounter was Rs. 31.32+30.89 where antibiotics and injections shared 36.5% and 4.6% respectively.

A study on bed utilization in the gynaecological ward of a district hospital in West Bengal

A study was conducted in a non-paying gynaecological ward of the district hospital, South 24 Parganas, West Bengal to assess different bed efficiency indicators. Total 331 patients were admitted in 23 study beds (12 OPD beds and 11 emergency beds) during an observation period of six months. Overall average number of admissions were 14.4 and average length of stay 14.7days. Bed turnover rate was 13.8 and was higher for emergency beds (22.1) compared to OPD beds (9). Bed occupancy rate was 61.3% with significant difference between OPD beds (57.5%) and emergency beds (65.4%).

Study of KAP of the private medical practitioners about national disease control programmes

This study was carried out among the Private Allopathic Medical Practitioners (PMPs) at Khardah Municipal area (West Bengal) to find out their perception & practice about management protocol of diseases like acute respiratory infections and diarrhoel diseases in children, malaria and tuberculosis. Data was collected by interviewing the PMPs with pre-designed open-ended questionnaire. It was supplemented by analysing sample prescriptions of the same diseases. The study revealed that PMPs knowledge and practice were not at par with national guidelines. The need for periodic sensitization of PMPs regarding national disease control programme was emphasized.

Reproductive tract infection: an experience in rural West Bengal

A community based cross-sectional study was conducted in the villages of Singur block, Hooghly district, West Bengal during September 2000 to February 2001. The objectives of the study were to find out the magnitude of Reproductive Tract Infections (RTI) among reproductive age group women, their knowledge about RTI and utilization of service available locally. Out of an estimated 896 women of reproductive age group in the study area, 186 women were selected by multistage random sampling technique. The study revealed that 66.1% respondents experienced one or more symptoms of RTI in four weeks recall period of this study. There was significant association (p < 0.01) between literacy status and their experiences of reproductive illness. 57% had knowledge about RTI. This increased gradually with increase of their ages (p < 0.01); literacy status (p < 0.01) and their socio-economic condition (p < 0.05). 27.6% of RTI patient did not receive any treatment, and majority of those received treatment (41.5%) sought advice from private practitioners.

Solvent Dependence of the Spectra and Kinetics of Excited-State Charge Transfer in Three (Alkylamino)benzonitriles

Steady-state absorption and emission spectra and emission decay kinetics are reported for 4-aminobenzonitrile (ABN), 4-(1-azetidinyl)benzonitrile (P4C), 4-(1-pyrrolidinyl)benzonitrile (P5C), and 4-(1-piperidinyl)benzonitrile (P6C) in 24 room temperature solvents. In solvents of modest to high polarity, P4C, P5C, and P6C exhibit dual fluorescence and emission decays characteristic of the transformation from an initially prepared (LE) state to a more polar charge transfer (CT) state, whereas ABN does not undergo this reaction. The frequencies of the steady-state absorption and emission spectra of all of these solutes can be rationalized using a dielectric continuum description of the solvent and considering only the minima on the reactive surfaces, which are assumed to involve both an intramolecular (twisting) and a solvation coordinate. Characteristics of the gas-phase solutes deduced from this analysis are in good agreement with electronic structure calculations and indicate that differences in their spectra mainly reflect differences in the relative energies of the gas-phase LE and CT states. The relative yields of LE and CT emission are not described as satisfactorily by this model, and reasons for this failure are discussed. The kinetics of the LE --> CT reaction vary considerably with solute and solvent. In many solvents, the emission decays of P4C are reasonably described by a simple two-state kinetic scheme with time-independent rate constants. In P5C and P6C multiexponential decays are observed that reflect time-dependent shifts of the component spectra as well as time-dependent reaction rates. A simplified analysis of these complex dynamics provides estimates for both the free energy change Delta(r)G and (average) LE --> CT rate constant k(f) for a wide range of solute and solvent combinations. The driving force for reaction (-Delta(r)G) follows the order P6C > P5C > P4C and increases with increasing solvent polarity. The reaction rates are correlated to Delta(r)G and follow the opposite trend. The relationships observed between k(f) and Delta(r)G suggest that static solvent effects, i.e., barrier height changes, are the primary determinants of the solvent dependence in P4C. Correlations between barrier-corrected rates and solvation times suggest that dynamical solvent effects contribute substantially to the solvent dependence of the rates in P5C, and especially P6C.

A study of compliance status of diabetes mellitus patients

A clinic based descriptive (case series) study was conducted among 106 study subjects with poor glycaemic control in a tertiary care hospital, Kolkata. Poor compliance was observed in 89.62% and 10.38% had good/acceptable compliance. Compliance was better in above 60 years age group, in males, in married and educated persons. Non-compliance factors acted mostly in combination.

Utilisation pattern of blood in a teaching hospital of Kolkata

An annual utilisation of blood transfusion services at several depts. of R.G. Kar Medical College and Hospital, Kolkata were assessed among a sample of 3122 patients selected by Systematic Random Sampling Technique from the register made available in the blood bank there. Record analysis revealed that overall 79.4% of supplied blood units were actually transfused, wastage of 21.6%. Wastage was maximum in the Department of Gynae & Obstetrics (33.11%) and Surgery (32.87%). Only single unit of blood was requisitioned and transfused for 5.44% & 30.90% of the patients respectively. Most common indications of blood transfusion were for surgical cases (37.92%), followed by anaemia (34.80%) and haemorrhage (26.92%). The use of blood and blood products merit attention, appraisal and instructional guiding accordingly.

Anti-venom-induced myelopathy in a semipoisonous snakebite

A 40-year-old woman developed myelopathy manifesting as Brown Sequard syndrome after administration of Anti-venom (polyvalent enzyme-refined equine globulin supposed to neutralise 0.6 mg of standard cobra venom, 0.45 mg of standard krait venom, 0.6 mg of standard Russel's viper venom and 0.45 mg of saw scaled viper venom, manufactured by Serum Institute of India, Pune, India). It was concluded to be an immunological inflammation of the spinal cord after ruling out hematomyelia on imaging. The necessity of antivenom in semipoisonous snake bites have been addressed further in the article.

Evaluation of pulse polio immunization in some districts of West Bengal & Assam

A cross-sectional non-interventional survey was carried out in 5 districts of West Bengal and one district of Assam to find out the extent of coverage during IPPI. It was observed that in the recent rounds of IPPI, more than 95% coverage was observed in all the surveyed districts excepting in 24 Parganas South where coverage was around 92%. Situation at the Goalpara district further needed attention, as the coverage during February 03 as well as in the past two rounds were 90.13%, 88.13%, and 91.04% respectively. In all these districts booths were the main sites for IPPI dose though 1/3rd to 1/4th of the beneficiaries received immunization at home also. It was also observed that around 10% of the beneficiaries were not administered any PPI dose in the either of the rounds, in 24 Parganas (south) & Murshidabad districts, from where maximum number of Poliomyelitis cases were reported. At Goalpara it was 19%. Main reason for not being covered with PPI doses in either of the rounds in all the districts excepting Kolkata was "Not aware of the need for additional doses". In Kolkata "child sick" was the main reason. Health workers were main source of information of PPI in South 24 Parganas (67.13%), Malda (58.25%) & West Midnapur (54%). At Murshidabad "announcement through mike" (61.25%) was the main source of information while in Kolkata, TV was the main source (67.13%). Miking (56.38%) was the main source of information for PPI at Goalpara district of Assam. It was observed that involvement of multiple methods & media of communication was helpful in disseminating dates & other information of PPI.

An evaluation of routine immunization coverage in some districts of West Bengal and Assam

A coverage evaluation survey was carried out in the five districts of West Bengal and Goalpara district of Assam during the period from November 2002 to April 2003 through 40 clusters sampling technique. Results revealed that highest coverage with routine immunization was in Paschim Medinipur (82.5%) followed by Kolkata (71.6%), Malda (65.3%), 24 Parganas South (61.9%) districts of West Bengal. Murshidabad district of West Bengal had only 41.3% coverage while poorest coverage was observed in Goalpara district (27.2%) of Assam. "Not aware of the need for routine immunization" was the main reason for not being vaccinated with all the UIP vaccines. Vaccination was given mainly through government hospitals in Kolkata while it was administered mainly through subcentres in the other rural districts.

A study on arsenical dermatosis in rural community of West Bengal

The spatial distribution of chronic arsenicosis due to consumption of arsenic contaminated tube well water in different districts of West Bengal was gradually unfolding since 1983. Arsenical dermatosis was found to be the commonest and earliest manifestation of chronic arsenic toxicity. This study was conduct in Baruipur block of South 24 Parganas district of West Bengal. Total 313 people selected from three randomly selected villages with reported arsenic contamination in tube well water and 342 people living three randomly selected villages without such evidence of contamination were examined as control population. 5.97% of exposed population and 2.05% of unexposed population showed melanosis (p < 0.01). Moreover, 5.11% of exposed population and 0.88% of unexposed population showed keratosis (p < 0.01). The prevalence of dermatosis among exposed population was also seen to have increased with increasing age, from 7.19% in 0-19 year age group to 37.50% in above 40 year group (p < 0.001). Prevalence was also found to be more with increase in level of contamination. The prevalence rate of dermatosis among unexposedgroup was 2.92%. But age adjusted prevalence rate among exposed group was 19.08% at arsenic contamination level of 0.487 ppm. Mean arsenic concentration in nail and hair samples of exposed group was also found higher than the prescribed limit.

Development of a training programme for school teachers on school health service

A training programme was developed and implemented for 56 primary school teachers of Barasat II block in North 24 Parganas district as per their recommended roles and responsibilities in School health service. The methodology consisted of development of learning objectives, evaluation parameters (questionnaire and check list) and teaching-learning materials. This was followed by pre-training assessment, implementation of training and re-training and evaluation of the outcome 7 days and 3 months after initial training and re-training. One way analysis of variance revealed significant overall improvement of the cognitive, affective and psychomotor domain of learning of school teachers. The need of periodic re-inforcement training with adequate scope of practice under supervision were emphasized.

A yoga teacher with persistent cheilitis

This is a depiction of an evolving case report right from its presentation to the physician and its documentation and further sharing of it through the net via e-mails and evidence-based-health@jiscmail.ac.uk as well as other colleagues.

Osteopontin deficiency produces osteoclast dysfunction due to reduced CD44 surface expression

Osteopontin (OPN) was expressed in murine wild-type osteoclasts, localized to the basolateral, clear zone, and ruffled border membranes, and deposited in the resorption pits during bone resorption. The lack of OPN secretion into the resorption bay of avian osteoclasts may be a component of their functional resorption deficiency in vitro. Osteoclasts deficient in OPN were hypomotile and exhibited decreased capacity for bone resorption in vitro. OPN stimulated CD44 expression on the osteoclast surface, and CD44 was shown to be required for osteoclast motility and bone resorption. Exogenous addition of OPN to OPN-/- osteoclasts increased the surface expression of CD44, and it rescued osteoclast motility due to activation of the alpha(v)beta(3) integrin. Exogenous OPN only partially restored bone resorption because addition of OPN failed to produce OPN secretion into resorption bays as seen in wild-type osteoclasts. As expected with these in vitro findings of osteoclast dysfunction, a bone phenotype, heretofore unappreciated, was characterized in OPN-deficient mice. Delayed bone resorption in metaphyseal trabeculae and diminished eroded perimeters despite an increase in osteoclast number were observed in histomorphometric measurements of tibiae isolated from OPN-deficient mice. The histomorphometric findings correlated with an increase in bone rigidity and moment of inertia revealed by load-to-failure testing of femurs. These findings demonstrate the role of OPN in osteoclast function and the requirement for OPN as an osteoclast autocrine factor during bone remodeling.