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Objective: Hemoglobin A1c (HbA1c), a key indicator of glycemic status over the last 3 months, is increasingly favored by clinicians to diagnose diabetes. Iron deficiency anemia (IDA), the most prevalent anemia worldwide, may alter HbA1c levels. However, data from eastern India are scarce, and existing studies offer conflicting results. This study aimed to investigate the impact of IDA on HbA1c levels in nondiabetics and to explore the correlation of HbA1c with hemoglobin (Hb), parameters of the iron profile, and red blood cell (RBC) indices. Methods: This cross-sectional analytical study compared 60 euglycemic patients with IDA, aged 18 to 60, to 60 age- and sex-matched euglycemic individuals without anemia. Data analysis was performed using SPSS version 25, with significance set at P < .05. Spearman's rho correlation coefficients examined correlations between Hb, serum iron, serum ferritin, total iron binding capacity (TIBC), transferrin saturation, packed cell volume (PCV), reticulocyte count, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) with HbA1c. Multinomial logistic regression analyzed the relationships of HbA1c (dependent variable) with RBC indices and iron profile parameters (independent variables). Results: The mean (SD) HbA1c value for IDA patients was 6.5 (0.5)% compared to 5.13 (0.80)% for controls (P < .001). HbA1c showed significant negative correlations with Hb, PCV, serum iron, serum ferritin, transferrin saturation, MCV, MCH, and MCHC, while TIBC was positively correlated with HbA1c. Each unit decrease in Hb increased the likelihood of HbA1c values in the prediabetic and diabetic range by 2.61 times (95% CI = 1.65-3.50) and 2.40 times (95% CI = 1.81-3.77), respectively (P < 0.001). Conclusion: The study highlights a significant increase in HbA1c levels with the worsening of IDA in non-diabetics, indicating that IDA should be addressed before interpreting HbA1c results accurately. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare workers (HCWs) are constantly on the frontlines, facing the brunt of the COVID 19 pandemic in their personal, professional, and social lives. They are not only the front liners battling this pandemic since the beginning, this pandemic has also taken a toll on the lives of healthcare workers over the past two years. Facing the stress and burnout since the pandemic has begun, currently, during the third wave of the pandemic, there might be an increase in mental health issues among HCWs in this state. The aim of the study is to assess the magnitude of anxiety and depression during the third wave of COVID-19 pandemic among the healthcare workers in a tertiary care hospital in West Bengal. Materials and methods: The observational study was conducted at IPGMER & SSKM Hospital, a tertiary care teaching hospital in Kolkata, West Bengal, over a period of one week from January 19 to January 26, 2022. A cross-sectional rapid survey was conducted using an online questionnaire containing the Beck Anxiety Inventory (BAI) and Beck Depression Inventory-II (BDI-II) among HCWs in the hospital using a Google Proforma through various social media groups. A total of 86 HCWs participated over a period of one week. The data was analysed using SPSS 16 software. Descriptive statistics and univariate logistic regression were used. Result: In the present study, it was found that among 86 people, 61 of them were aged between 26-40 years, half of them, i.e., 45 people, were male, and more than one-fifth (22.1%) (n = 86) had moderate to severe anxiety. Most of the participants, i.e., 39 of them (45.3%), had clinical depression ranging from borderline to extreme. No significant association of moderate to severe anxiety and depression and socio-demographic characteristics was noticed, except for the significantly higher preponderance of anxiety in female gender (p value= 0.0001) Anxiety showed a good positive correlation with depression (p value less than 0.001) and all who had severe anxiety was also suffering from either severe or extreme depression. Conclusion: An alarming proportion of anxiety and depression was noticed among HCWs. The prevalence of anxiety and depression (severe grade) among HCWs are 6% and 8% respectively. So awareness regarding their own mental health, preventive therapies, and proper diagnosis and treatment of cases are needed. [ABSTRACT FROM AUTHOR]

Background: Optic neuritis (ON) is an acute and often immune-mediated inflammatory condition of the optic nerve. Vitamin D acts as an anti-inflammatory agent and may confer neuroprotection. Visual evoked potential (VEP) and optical coherence tomography (OCT) are emerging tools for demyelinating diseases. Aims and Objectives: We tried to correlate between Vitamin D insufficiency and acute demyelinating ON using different parameters such as VEP, ganglion cell layer (GCL) thickness, and retinal nerve fiber layer (RNFL) thickness. Materials and Methods: This observational longitudinal analytical study included thirty non-consecutive patients with primary ON and 30 healthy controls. All patients with ON underwent detailed clinical and ophthalmological examination, and detailed blood workup, including serum 25 (OH) Vitamin D. VEP P100 latency, amplitude, OCT, RNFL thickness, and GCL thickness at presentation and after 3 months from May 2019 to November 2020. Results: Vitamin D insufficiency (below 30 ng/mL) was present in 60% of cases of ON. The baseline VEP showed significantly prolonged P100 latency in affected eyes in the Vitamin D insufficient group (mean 129.78±7.97 ms vs. 121.0±4.99 ms) whereas the P100 amplitude was not significantly altered between the two groups (5.5±3.13 μV vs. 7.08±3.01 μV). The baseline RNFL thickness (132.21±10.69 μm vs. 118.01±10.4 μm) and GCL thickness (76.82±2.04 μm vs. 73.06±3.2 μm) were greater in affected eyes of vitamin D insufficiency ON. There was greater RNFL thinning (79.93±3.42 μm vs. 74.80±3.5 μm) and GCL thinning (64.78±1.9μm vs. 69.02±2.22 μm) in affected eyes of ON with Vitamin D insufficiency at 3 months. Conclusion: Vitamin D insufficiency was found in most cases of ON. Insufficient Vitamin D positively correlated with optic nerve affection severity as evidenced by significantly increased baseline thickness of RNFL and GCL and more thinning of RNFL and GCL at the end of 3 months of follow-up. [ABSTRACT FROM AUTHOR]

Background: Use of maternal near-miss (MNM) cases as an adjunct has been advocated to understand the processes of obstetric care because they share similar pathways as maternal deaths. Identifying the predictors and care pathway is crucial to improve the quality of care and end preventable maternal deaths. Materials and Methods: This case–control study was conducted at a tertiary care facility in Kolkata from May 2019 to March 2020. Women admitted with complications during pregnancy, childbirth, or within 42 days of postpartum, who met the World Health Organization (WHO) near-miss criteria, were identified as cases, and equivalent age-group matched controls were recruited. Sample size of 60 cases and 60 controls was estimated, assuming a power of 80%, level of significance 0.05, and case–control ratio of 1. After obtaining approval from the institutional ethics committee and informed written consent from the participants, data was collected through face-to-face interview and review of records. Statistical analysis including care pathway analysis (using three-delay model) was performed using Statistical Package for Social Sciences version 16. Results: Joint family type (adjusted odds ratio [AOR] [CI] = 5.06 [1.48, 7.28]), lack of antenatal checkups (AOR [CI] = 7.85 [1.47, 12.09]), previous history of cesarean section (AOR [CI] = 3.94 [1.09, 14.33]), first delay in seeking care (AOR [CI] = 13.84 [3.62, 32.83]), and preexisting medical disorders (AOR [CI] = 11.03 [4.62, 22.80]) were identified as significant predictors of MNM in the adjusted model. Significant difference in the proportion of first and second delays in the care pathway was observed between cases and controls. Conclusions: Identification of risk factors of MNM and pattern of delays in the care pathway will help improving quality of obstetric care. [ABSTRACT FROM AUTHOR]

Background: Malnutrition is still a great barrier to the growth and development of children, especially in India. Children from the underprivileged sections of the society like slum children are more vulnerable to both undernutrition and overnutrition. This study aimed to estimate the magnitude of malnutrition among school-going children in a slum area of Kolkata and to elicit the association of nutritional status with parental education. Methods: A cross-sectional observational study was conducted from November 2017 to May 2018 among 508 school-going children of 6 years to 19 years of age in slums of Chetla, Kolkata. Out of three coeducation high schools catering to those children, two schools were randomly selected. 254 participants from each school were selected using systematic random sampling. Students, unwilling to participate and/or whose parents denied providing informed written consent were excluded. After the interview by a predesigned, pretested schedule, their anthropometric examination was conducted. Results: Prevalence of stunting and severe stunting was present in 9.4% and 1.2% of subjects whereas the prevalence of thinness was 23.6% among them. The prevalence of overnutrition was 11%. Boys are more stunted (OR = 2.13, P = 0.013) and thin (OR = 1.73, P = 0.011) than girls. Poor parental education was significantly associated with both undernourishment (stunting and thinness) as well as overweight and obesity. Conclusion: Substantial burden of double malnutrition was observed among school-going slum children. Parental education had an important role to prevent malnutrition of their children. Thus, periodic growth monitoring with the strengthening of the Mid-Day Meal program and awareness generation campaigns regarding malnutrition among parents of slum children are highly needed. [ABSTRACT FROM AUTHOR]

Context: In India, despite implementation of the strategies under National Tobacco Control Programme [NTCP], women are easily exposed to tobacco consumption that is smokeless (SLT) and smoking tobacco along with second-hand smoke [SHS], making them highly susceptible to tobacco hazards. Aims: This study aimed to assess the exposure of women to tobacco use and SHS at home and to elicit predictors of tobacco exposure in a rural community of West Bengal. Methodology: A community based, cross-sectional study was conducted among 176 women aged 18 years and above. Data was collected by cluster sampling technique (16*11) using predesigned pretested structured schedule. Tobacco exposure was measured using a composite score including tobacco consumption and SHS at home. Results: Tobacco use (SLT and smoking tobacco) was significantly associated with educational attainment [AOR = 2.12], occupation [AOR = 2.13] and knowledge [AOR = 1.22]. There was significant association between SHS at home with knowledge [AOR = 1.16] and attitude of the study subjects. [AOR = 1.93]. Overall tobacco exposure (SLT, smoking tobacco, and SHS), was found to be 79.5%. Significant association was found between high tobacco exposure with age group [AOR = 3.82], educational attainment [AOR = 1.74] and knowledge regarding hazards of tobacco [AOR = 1.31]. Conclusion: Prevalence of SLT use as well as exposure of women to SHS at home is unexpectedly high in the study population. Women specific information and education campaigns focusing on tobacco hazards (both tobacco use and SHS) through existing primary health care infrastructure should be strategized under NTCP. [ABSTRACT FROM AUTHOR]

Background: Dietary preferences and childhood eating behavior has marked influence on nutritional status of children. The objective of the study was to find out eating behavior of primary school children in a rural area of West Bengal using Child Eating Behavior Questionnaire and to determine association of body mass index (BMI) with eating behavior. Methodology: It was an institution-based observational study with cross-sectional design done from May to August, 2018. The study was done among 142 children studying at four primary schools at Singur, in the rural field practice area of our institute. The four schools were selected randomly using list of primary schools in the area. Eating behavior of children was assessed using Child Eating Behavior Questionnaire (CEBQ). BMI of the children was assessed using WHO Z scores tables for children. Data analysis was done using SPSS Version 16 and binary logistic regression was done to find out association of BMI with eating behavior of study participants. Results: The proportion of under-nutrition and overnutrition was 22.0% and 16.0%, respectively. Food fussiness was significantly associated with thinness [BMI below (−2SD)]. Enjoyment of food, satiety response was significantly associated with overnutrition [BMI above (+1 SD)]. Food avoidance subscale was significantly associated with thinness [OR: 2.5, CI: 1.11, 5.63] and this subscale was protective for overweight [OR: 0.22, CI: 0.07, 0.69]. Conclusion: This study showed association of BMI with child eating behavior. Therefore, awareness among parents should be created to change problematic eating of their children which would further help them to achieve normal BMI. [ABSTRACT FROM AUTHOR]

Background: On March 27, 2014, the Regional Certification Commission of the World Health Organization certified South-East Asian Region, which includes India, as polio free. Since then, as part of Polio Endgame Strategy, high-quality national and sub-national polio rounds are being conducted to maintain herd immunity through each year. With years of no fresh cases of polio, several sections in the community have raised doubts over the continuation of the Intensified Pulse Polio Immunization (IPPI) program in postcertification era. Thus, this study with mixed method approach was aimed at assessing the community perceptions toward IPPI using quantitative approach and stakeholder's perception using qualitative approach in a high-risk area of Kolkata. Methods: This cross-sectional study was conducted over a period of 2 months from March to April 2018 in Southern part of Kolkata which involved surveying 104 randomly selected households followed by key informant interviews with community influencers. Pearson's Chi-square test was performed to determine the association between categorical variables. SPSS v. 16.0 software was used for analysis. Results: Inadequate knowledge (32%) and unfavorable attitude (45%) regarding IPPI were observed among the interviewed respondents. Safety concern (5.7%), spouse/elderly pressure (4.8%), and sterility issues (1.9%) were identified as prominent barriers resulting in hesitancy (16.2%) during IPPI. Statistically significant association of respondent's attitude was observed between gender, religion, and education. Conclusion: Social behavior change communication involving community and community influencers would help to overcome the barriers to IPPI coverage and thus to mitigate the risk of re-emergence of polio in future. [ABSTRACT FROM AUTHOR]

Context: "Frailty" is a multidimensional geriatric syndrome that increases the risk for adverse health outcomes, such as falls, hospitalization, increased morbidity, and mortality, among elderly persons. Aim: The objective of this study is to find out the proportion of frailty and its associates among elderly (aged ≥60 years) in a rural area of West Bengal. Settings and Design: It is a community-based cross-sectional observational study done during May–August 2018 among 165 elderly persons selected by systematic random sampling by probability proportionate to size method from three villages at the rural field practice area of our institute. Materials and Methods: Tilburg frailty indicator is used to measure frailty. An elderly is considered as frail if s/he scores ≥6 in this scale. Statistical Analysis: Data analysis is done by SPSS Version 16. The logistic regression is done to find out the associates of frailty. Results: Proportion of frailty is 38.8% (mean age ± SD: 67.03 ± 3.43 years) among the study subjects. Age, female gender, loss of spouse, illiteracy, economic dependency, no job/at home status, ≥2 chronic diseases are significantly associated with frailty in univariate logistic regression. In multivariable logistic regression, ≥2 chronic diseases [AOR: 8.4, CI: 4.6, 11.33] and illiteracy [AOR: 3.3, CI: 1.05, 9.8] retain their significance. Conclusion: Frailty should be recognized as a public health priority and awareness generation among elderly population for healthy ageing including self-motivation for proper management of their ailments should be emphasized for reduction of morbidity as well as for augmenting their quality of life. [ABSTRACT FROM AUTHOR]

Black-pearl (B1p) is a highly conserved, essential inner-mitochondrial membrane protein. The yeast Blp homologue, Magmas/Pam16, is required for mitochondrial protein transport, growth, and survival. Our purpose was to determine the role of Drosophila BIp in mitochondrial function, cell survival, and proliferation. To this end, we performed mitotic recombination in Drosophila melanogaster, RNAi-mediated knockdown, MitoTracker staining, measurement of reactive oxygen species (ROS), flow cytomelly, electron transport chain complex assays, and hemocyte isolation from Drosophila larvae. Proliferation-defective, Blp-deficient Drosophila Schneider cells exhibited mitochondrial membrane depolarization, a 60% decrease in ATP levels, increased amounts of ROS (3.5-fold), cell cycle arrest, and activation of autophagy that were associated with a selective 65% reduction of cytochrome c oxidase activity. N-acetyl cysteine (NAC) rescued Blp-RNAi-treated cells from cell cycle arrest, indicating that increased production of ROS is the primary cause of the proliferation and survival defects in Blp-depleted cells, blp hypomorph larvae had a 35% decreased number of plasmatocytes with a 45% reduced active mitochondrial staining and their viability was increased 2-fold by administration of NAC, which Mocked melanotic lesions. Loss of Blp decreases cytochrome c oxidase activity and uncouples oxidative phosphorylation, causing ROS production, which selectively affects mitochondria-rich plasmatocyte survival and function, leading to melanotic lesions in Blp-deficient flies. [ABSTRACT FROM AUTHOR]