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Background: Humans are accidental hosts in the zoonotic disease Scrub typhus. The disease though widespread in our county, it remains grossly underdiagnosed because of its non-septic clinical manifestations and lack of access to specific laboratory facilities. Aims and Objectives: The objective of present study is to evaluate the clinical presentations of Scrub Typhus among the study group. Furthermore, to assess the various laboratory findings in Scrub Typhus cases among the study group is the other objective of this study. Materials and Methods: The present study is an Institution-based, observational, and cross-sectional study conducted for 18 months with the admitted patients having 14-70 years of age. Data collected regarding patients' demographic profile, symptoms, clinical findings, laboratory, and radiological findings. Data had been summarized as mean and standard deviation for numerical variables and count and percentages for categorical variables. Results: In our study, we found that most of the patients were 14-20 years old and female population was higher. It was found that 34.3% of patients had Eschar, 42.9% of patients had Rash, and 91.4% of patients had Pallor, 8.6% of patients had Ascites, 25.7% had Edema, 8.6% of patients had Jaundice, 11.4% had shock, and 57.1% had pneumonia/pneumonitis. The present study showed that 65.7% of patients had drug response (Doxycycline). Conclusion: Knowledge of geographical distribution, evidence of exposure to vector, clinical features such as fever, rash, eschar, headache, and myalgia along with high index of suspicion are crucial factors for early diagnosis and that helps in timely treatment of the cases. [ABSTRACT FROM AUTHOR]

Background: Subarachnoid anesthesia also known as spinal anesthesia is now considered to be a safe form of anesthesia for lower abdominal and lower limb surgeries. The height of sensory block achieved in spinal anesthesia after drug administration can be altered by changing the position of the patient, and this precisely is the advantage of using hyperbaric local anesthetic drug. Aims and Objectives: The aim of this study is to compare the effect of position - horizontal and Trendelenburg on the height of sensory block in spinal anesthesia. Materials and Methods: After obtaining the institutional ethical clearance, total 66 patients scheduled for lower abdominal surgery under spinal anesthesia were selected and divided into two groups - Group A patients were placed in Trendelenburg position with 20° head down for 40 s and then returned to horizontal position and Group B patients were placed in horizontal position after spinal anesthesia. The level of sensory block was compared among the two groups at different points of time up to 30 min of drug administration. Results: The patients who remained in Trendelenburg position for 40 s after spinal anesthesia achieved a higher level of sensory block earlier as compared to the horizontal group and the maximum block height was two spinal segments higher than that of the horizontal group. Conclusion: From our current study, we can conclude that Trendelenburg position can be used to achieve a higher level of sensory block as compared to horizontal position after successful neuraxial block. [ABSTRACT FROM AUTHOR]

Kolkata, home of 4.5 million people, is generating 1112 million liters of sewage per day and facing the challenge of managing this wastewater. The 125 km wide wetland on the eastern fringe of the city, popularly known as the East Kolkata Wetlands is serving as a natural sewage treatment plant for more than a century where nearly 78 % of city sewage goes through an intricately designed canal network. This wetland is a designated RAMSAR site where the sewage treatment process is a rare example of an intertwined symbiotic relation between wastewater treatment and wetland aquaculture, where livelihood dependence of the local people on sewage-fed fisheries becomes of strategic importance in sustainable performance of the system. An aggressive urban expansion in the eastern fringe of the city is disturbing this age-old eco-balance by making this sewage water pisciculture less profitable. There is push factor due to reduced attraction of the wastewater fisheries and a pull factor due to emergence of alternative livelihood options through rapid urbanization. To protect wetland in its original form, the civil society and the administrative authorities are designing active interventions. However, these are not generating expected results as these instruments are targeting to mitigate the push factor only without paying much heed to the push-pull interactions. [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]

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]

Education and health are considered to be two vital sectors that can play a crucial role in determining the level of social development of a region. This paper analyzes the education and health scenario (in terms of both infrastructure and attainment) in 15 major states of India by constructing suitable composite indices. An attempt has also been made to study the inter-linkages between the education and health sectors. We find a high positive correlation not only between health infrastructure and health attainment, but also between health infrastructure and educational attainment. On the other hand, we not only observe a relatively weaker association between educational infrastructure and educational attainment, the association between educational infrastructure and health attainment is also very weak. Thus, in case of the health sector, both the direct and indirect effects are stronger compared to the education sector. This seems to indicate that in improving the overall quality of life in a poor country like India, the health sector plays a more fundamental role compared to the education sector. This calls for special attention and a greater share of resources for the health sector. [ABSTRACT FROM AUTHOR]