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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]

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]

Introduction: Though two-third of rural healthcare is served by URPs, most of them lack in proper training on treatment of Tuberculosis. Objective: To evaluate effect of educational intervention on perception of Tuberculosis management among URPs. Methodology: Knowledge and Attitude of participants were assessed using a predesigned questionnaire before and after an educational intervention. Results: Pre-intervention assessment revealed that majority (92.9%) had heard about PTB. Only 39.3% knew at-least 3 sites of EPTB. Nearly one-third knew about daily regime but 10.7% could name all five first-line ATDs. Few responded that Levofloxacin (25%), Moxifloxacin (10.7%), Amikacin (7.1%) should be avoided in chest symptomatics. Knowledge of punishment for intentional nonnotification (10.7%) was poor. Only 42.9% opined for ATD use in pregnant and children. After intervention, knowledge had improved significantly (P<0.001). Attitude improved with no statistical significance. Conclusion: Educational intervention can improve knowledge of Tuberculosis among URPs and regular reinforcement is recommended for such programs. [ABSTRACT FROM AUTHOR]

Context: Rice mill workers usually belong to unorganized sector and lack in training regarding hazard prevention. Unprotected exposure to suspended particles and fumes can lead to respiratory morbidities among them. Workers, especially loaders, were susceptible to work‑related musculoskeletal diseases. Aim: To find out the morbidity profile and associated factors among rice mill workers. Methodology: A cross‑sectional workplace‑based study was conducted during July‑‑September 2018 among 143 workers of two rice mills in Indas block, West Bengal. Workers, employed for at least 6 months in the rice mills and who gave informed written consent was interviewed using a predesigned pretested questionnaire and were clinically examined. Nonfasting capillary blood glucose estimation and spirometry were carried out. Workers contraindicated to spirometry were excluded. Result: Commonest morbidities were musculoskeletal discomfort (65%), hypertension (20.9%), and chronic respiratory morbidity (16.9%). No personal protective equipment (PPE) was used by these workers. Significant association of musculoskeletal discomfort was found with tobacco abuse (Adjusted Odds Ratio (AOR) =2.90), job of loader (AOR = 3.51), and central obesity (AOR = 3.39). Hypertension was significantly associated with increasing age (AOR = 1.06), and increasing body mass index (AOR = 1.17). Whereas increasing age (AOR = 1.08), working inside mill (AOR = 7.58), working more than 48 hours a week (AOR = 7.37) were significantly associated with chronic respiratory morbidity. Conclusion: Optimization of working hours, effective continuous use of PPE, and use of proper ventilation technology are recommended. Proper work placement, preplacement examination, and periodic health screening with spirometry are also needed. [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]

Background: Infertility, which is an inability to conceive after a prolonged time period, is a neglected domain of reproductive health. Infertility affects couples physically and psychologically and leads to discrimination and stigma in society, especially to women. Various sociodemographic, physiological, and environmental attributes and access to health care may interplay with the quality of life (QoL) of the women afflicted with infertility. Objectives: The aim of this study was to assess the QoL and its predictors among women diagnosed with infertility. Materials and Methods: A cross‑sectional study was conducted among 247 women diagnosed with infertility and receiving treatment for at least 6 months at a gynecology outpatient department in a tertiary care hospital of Kolkata. Results: The mean (±standard deviation) score of total ferti‑QoL was 65.76 (±11.15). Differential mean scores were observed in domains of ferti‑QoL such as emotional (58.49 ± 12.75), body/mind (47.67 ± 16.14), relational (78.36 ± 15.51), social (60.71 ± 12.43), core (61.31 ± 12.71), environment (80.09 ± 10.77), tolerability (70.95 ± 11.97), and treatment (76.44 ± 10.36). Nearly half of them also reported abuse in terms of verbal (50.6%) and physical (6.9%). On multivariable analysis, unsatisfactory QoL was significantly associated with age above 32 years (adjusted odds ratio [AOR] = 2.76, confidence interval [CI] = 1.07–7.12), increasing duration of infertility (AOR = 1.46, CI = 1.17–1.82), and presence of chronic diseases (AOR = 2.21, CI = 1.01–4.83). Conclusion: There is, till date, no provision of management for women suffering from infertility in the Reproductive and Child Health Programme. The problem of infertility must be considered as a public health problem, and all policymakers, health administrators, and other stakeholders should come forward with exemplary guidelines specially targeted for providing relief to these affected women in every stratum of the health‑care system. [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]

Summary Constitutive cell-autonomous immunity in metazoans predates interferon-inducible immunity and comprises primordial innate defense. Phagocytes mobilize interferon-inducible responses upon engagement of well-characterized signaling pathways by pathogen-associated molecular patterns (PAMPs). The signals controlling deployment of constitutive cell-autonomous responses during infection have remained elusive. Vita -PAMPs denote microbial viability, signaling the danger of cellular exploitation by intracellular pathogens. We show that cyclic-di-adenosine monophosphate in live Gram-positive bacteria is a vita -PAMP, engaging the innate sensor stimulator of interferon genes (STING) to mediate endoplasmic reticulum (ER) stress. Subsequent inactivation of the mechanistic target of rapamycin mobilizes autophagy, which sequesters stressed ER membranes, resolves ER stress, and curtails phagocyte death. This vita -PAMP-induced ER-phagy additionally orchestrates an interferon response by localizing ER-resident STING to autophagosomes. Our findings identify stress-mediated ER-phagy as a cell-autonomous response mobilized by STING-dependent sensing of a specific vita -PAMP and elucidate how innate receptors engage multilayered homeostatic mechanisms to promote immunity and survival after infection. [ABSTRACT FROM AUTHOR]

Background: Regular physical activity is an important behavior for promoting health or preventing diseases. Poor participation in physical activity, especially in school-going children, has a multifactorial causation. Present study aimed to find out the proportion and determinants of insufficient physical activity among school-going adolescents at selected government high schools of Dumdum. Methodology: A cross-sectional observational study was conducted among school-going adolescent students of class VIII, IX, X, XI, XII in two selected government high schools of Dumdum municipality of North 24 Parganas. Complete enumeration method was used to select 199 participants. Students, who were absent during the day of the survey or were not willing to participate were excluded. A pre-designed pretested structured schedule was used to collect data. Data was analyzed using statistical software SPSS version 16. Results: Out of 199 students, 62.9% were aged 13--14 years with mean age 14.4 (±1.37). 54.3% were females. Only 22.1% do adequate physical activity, 59.8% participants have satisfactory attitude towards adequate physical activity practices. 42.2% participants were addicted to smartphone according to smartphone addiction scale (SAS). Physical activity was significantly associated with female gender (OR = 2.56. 95% CI = 1.28--5.11), unsatisfactory attitude (OR = 2.41, 95% CI = 1.13--5.10) towards PA practices, high smartphone addiction (OR = 2.57. 95% CI = 1.23--5.35), and more screen time (OR = 2.20, 95% CI = 1.11--4.37). Conclusions: Physical activities in the school environment have short-term as well as long-term benefits over health. Various factors act as a barrier to physical activity. PA promotion programs in the school setting is needed for disease-free and healthy life. [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]

Introduction: Hypertension is a major risk factor for cardiovascular and cerebrovascular diseases. Thus, regular and accurate measurement of Blood Pressure (BP) is essential for its early diagnosis and follow-up. There is a surge in popularity of digital sphygmomanometer due to its convenience of use and functionality. In contrast, the traditional universally accepted sphygmomanometer is aneroid type, hence there arise a need for comparison of digital and universally accepted Aneroid Sphygmomanometer in terms of agreement and correlation. Aim: To evaluate the agreement and correlation between blood pressure measurement by digital and aneroid sphygmomanometer. Materials and Methods: The clinic based cross-sectional study was conducted in the Out Patient Department (OPD) of Urban Heath Centre, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India. Adults visiting the OPD on two chosen days of the week, between June 2019 to July 2019 were selected using systematic random sampling. A total of 400 participants were included. Agreement and correlation between BP measurements by digital and aneroid sphygmomanometer was analysed by Cohen's Kappa, Bland Altman Plot along with sensitivity, specificity and predictive values using Microsoft Excel and Statistical Package for the Social Sciences (SPSS) version 16.0. the p-value <0.05 was considered significant for the statistical test in the analysis. Results: Cohen's Kappa value (0.59) revealed these two tools had moderate agreement in diagnosing hypertension. Sensitivity and specificity of digital sphygmomanometer taking aneroid sphygmomanometer as gold standard is 86% and 83.1% respectively. The BP readings of these two-tools showed moderate correlation as Intraclass Correlation Coefficient (ICC) for Systolic BP (SBP) and Diastolic BP (DBP) were 0.804 and 0.624, respectively. Bland Altman plot showed gross disagreement of SBP findings and disagreement between DBP findings was also noted. Conclusion: Digital device was found to be less accurate in detecting hypertension. Therefore, more similar research work is solicited to verify the accuracy of the very easy to use, the Digital BP monitor. [ABSTRACT FROM AUTHOR]

Context: Tobacco smoking is one of the preventable causes of death. Global Adult Tobacco Survey 2 report showed that 19% Indian males were current smokers. It is important to find out factors which help smokers on smoking cessation, ultimately to prevent of lung and other morbidities. There are few community-based studies on intention and attempt to quit smoking in rural area. Aims: The present study aimed to determine the factors associated with intention and attempt to quit smoking among current smokers. Settings and Design: A cross-sectional study was conducted from June to September 2019 among 198 male daily smokers residing in the rural field practice area of AllH and PH, Kolkata. Subjects and Methods: After cluster sampling, data were collected by predesigned schedule by the face-to-face interview. Results: 151 (76.3%) study subjects intended to quit smoking. 63 (31.8%) study subjects attempted to quit in last 1 year. Thirty-one (47.5%) showed high-to-medium nicotine dependence. There was a significant association of intention to quit with agriculture as occupation (acquisitive crime [AOR]-2.17, confidence interval [CI]-1.01--4.63), low nicotine dependence (AOR-2.98, CI-1.43--6.21), doctor's advice (AOR = 2.84, CI-1.27--6.33), and family pressure (AOR = 2.16, CI-1.07--4.38). Attempt to quit was significantly associated with low nicotine dependence (AOR = 5.85, CI-2.85--12.00), family pressure (AOR = 2.94, CI-1.47--5.91). Conclusion: Along with counseling to reduce nicotine dependence, comprehensive approach both from family members as well as health care providers, is vital to escalate the quitting behaviour in smoking habit. [ABSTRACT FROM AUTHOR]

Context: Tobacco smoking is one of the preventable causes of death. Global Adult Tobacco Survey 2 report showed that 19% Indian males were current smokers. It is important to find out factors which help smokers on smoking cessation, ultimately to prevent of lung and other morbidities. There are few community-based studies on intention and attempt to quit smoking in rural area. Aims: The present study aimed to determine the factors associated with intention and attempt to quit smoking among current smokers. Settings and Design: A cross-sectional study was conducted from June to September 2019 among 198 male daily smokers residing in the rural field practice area of AllH and PH, Kolkata. Subjects and Methods: After cluster sampling, data were collected by predesigned schedule by the face-to-face interview. Results: 151 (76.3%) study subjects intended to quit smoking. 63 (31.8%) study subjects attempted to quit in last 1 year. Thirty-one (47.5%) showed high-to-medium nicotine dependence. There was a significant association of intention to quit with agriculture as occupation (acquisitive crime [AOR]-2.17, confidence interval [CI]-1.01--4.63), low nicotine dependence (AOR-2.98, CI-1.43--6.21), doctor's advice (AOR = 2.84, CI-1.27--6.33), and family pressure (AOR = 2.16, CI-1.07--4.38). Attempt to quit was significantly associated with low nicotine dependence (AOR = 5.85, CI-2.85--12.00), family pressure (AOR = 2.94, CI-1.47--5.91). Conclusion: Along with counseling to reduce nicotine dependence, comprehensive approach both from family members as well as health care providers, is vital to escalate the quitting behaviour in smoking habit. [ABSTRACT FROM AUTHOR]

Introduction: The automobile industry is a large and growing industry in India and this industry employs many workers as manufacturers, distributors, retailers, and automobile garage workers. Automobile garage workers suffer from many health problems among which Musculoskeletal Discomfort (MSD) is very common. Aim: To find the proportion of MSD among automobile garage workers in Chetla, Kolkata and to describe the factors associated with the musculoskeletal discomfort. Materials and Methods: The study was a work place based, observational study with cross-sectional design. The study was conducted among 101 automobile garage workers at nine automobile garages of Chetla, Kolkata. A pre-designed, pre-tested structured schedule was used to collect data. The outcome variable was MSD and it was assessed using Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). MSD score was categorised into mild, moderate and severe discomfort. Data was analysed using IBM SPSS Software version 16. Results: Around one-third (30.7%) study participants belonged to the age group 41-50 years with mean (SD) age 43.35 (13.46) years. Knee discomfort was present among 42% study participants while 21% had low back pain according to CMDQ tool. Around three fourth (73.3%) study participants had at least one kind of MSD and around 46.6% had moderate to severe musculoskeletal discomfort. MSD was significantly associated with increasing age and increasing duration of working hours per week in univariate and multivariable logistic regression. Conclusion: The proportion of musculoskeletal discomfort among automobile workers was quite high. Early diagnosis and regular screening of MSD is very much needed to introduce appropriate preventive and treatment measures at appropriate time. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes mellitus is considered as silent epidemic worldwide including India. Peripheral neuropathy is one of the most common complications of diabetes mellitus. Diabetes Self-Management (DSM) is crucial in mitigating the afflictions of diabetes and it’s after effects. There was dearth of studies in view of Diabetic Peripheral Neuropathy (DPN) and diabetes self-management in Kolkata, West Bengal. Aim: To assess the associations between diabetes selfmanagement and DPN in Type 2 Diabetes Mellitus (T2DM) patients attending an urban health clinic in Kolkata. Materials and Methods: This study was conducted from December 2018 to March 2019 among known case of T2DM patients aged 30 years and above attending the Non-Communicable Disease (NCD) clinic at Chetla, under the purview of field practice areas of Urban Health Unit and Training centre (UHU and TC) of All India Institute of Hygiene and Public Health (AIIH and PH) Kolkata, West Bengal. A pre-designed and pre-tested schedule was used to collect data which were analysed using International Business Machines Statistical Product and Service Solutions (IBM SPSS) version 16.0 and represented using various tables. Results: The mean (SD) age of the participants was 54.89 (8.98) years. About 32.4% of the patients had DPN which was significantly associated with increased duration of T2DM {AOR (95% CI)}={1.52 (1.22-1.91)}, lower glucose management sub-scale score {AOR (95% CI)}={2.84 (1.42-5.67)} and lower healthcare use sub-scale score {AOR (95% CI)}={1.86 (1.05-3.31)}. Conclusion: Earlier screening and education regarding diabetes self-care would be helpful in glycaemic control and in prevention of DPN. [ABSTRACT FROM AUTHOR]

Context: Anemia is a serious public health concern especially in women of reproductive age (WRA) as it causes a high burden of morbidity and mortality and persists through intergenerational cycle. As most of the risk factors are preventable, a thorough understanding of its risk factors is necessary to design better interventions. Aims: Current study aimed to estimate the burden of anemia as well as explore determinants of various grades of anemia among WRA in a rural area. Settings and Design: A community-based cross-sectional study was conducted among non-pregnant, non-lactating women of reproductive age in rural field practice area of All India Institute of Hygiene and Public Health. Methods and Materials: House to house visit was conducted for interviewing with pre-designed pre-tested questionnaire along with blood hemoglobin and anthropometric measurement. Statistical Analysis Used: Descriptive statistics and test of significance like multinomial logistic regression and Kruskal-Wallis test (with post-hoc) were used. Results: Majority (70.8%) of participants were anemic. Proportion of mild, moderate, and severe anemia were 24.16%, 37.5%, and 9.16%, respectively. Different levels of anemia were significantly associated with higher age, lower education, poor iron-rich food intake, lack of dietary diversity, and adiposity. Significantly low hemoglobin level in both underweight and obesity was noticed suggesting U shaped relationship between BMI and anemia. Conclusion: Periodic screening for anemia among WRA especially in both extremes of malnutrition, i.e., undernutrition and obesity should be considered at the policy level. Year-round behaviour change communication campaigns must be carried out for the promotion of necessary food groups in diet. [ABSTRACT FROM AUTHOR]

Introduction: Adolescent Hypertension (HTN) is one of the most alarming public health problems and is a potential risk factor for noncommunicable diseases as asymptomatic, mostly remain undiagnosed. Simple anthropometric indicators acting as preliminary screening tool to predict HTN among adolescents is the need of hour. Aim: The present study was undertaken to find out the magnitude of pre HTN and HTN among adolescent school students of North 24 Parganas and to find out the variation of blood pressure with different anthropometric parameters. Materials and Methods: A cross-sectional study was carried out from June to September, 2019 among 369 adolescent school students of class VIII to XII in two Government higher secondary schools, selected conveniently, in North 24 Parganas. Data was collected by face to face interview, blood pressure recording and anthropometric measurements in the selected schools was done. Data was analysed using SPSS version 16.0. Results: Among 369 participants, 189 (51.2%) were boys and 180 (48.8%) were girls. Mean Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) among boys were 110.2 (±14.9), 68.0 (±9.3) and among girls 113.1 (±14.3), 71.2 (±9), respectively. Overall HTN was found to be 7.0% (6.3% in boys and 7.8% in girls) and pre HTN was 13.8% (12.2% in boys and 15.6% in girls). There were significant (p<0.05) positive correlation of SBP and DBP with BMI (r=0.692; r=0.673), Body fat percent (r=0.686; r=0.676,), Waist Circumference (WC) (r=0.708; r=0.640), Neck Circumference (NC) (r=0.593; r=0.509,). HTN was significantly associated with physical activity and salt intake (p<0.05). Conclusion: As a rising trend of HTN was found among adolescents, early lifestyle modification and strengthening of school health setup using simple anthropometric measures are recommended for early detection of adolescent HTN and to prevent detrimental consequence. [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]

Introduction: Alzheimer Questionnaire (AQ) and Montreal Cognitive Assessment (MoCA) are tools for assessment of cognitive impairment. MoCA is a common tool for screening of cognitive impairment but it requires trained personnel. AQ questionnaire is informant-based, simple and less time consuming with or without the involvement of trained personnel. Aim: To estimate the prevalence of cognitive impairment and to find out the accuracy of AQ compared to MoCA in Cognitive Impairment screening among elderly population in an urban area of West Bengal. Materials and Methods: The Prospective cross-sectional study was conducted in urban field practice area of All India Institute of Hygiene and Public Health, Kolkata among 140 randomly selected elderly population from June to September 2019. Accuracy of AQ with MoCA tool as gold standard in screening cognitive impairment was analysed by Cohen’s Kappa, Receiver Operating Characteristics (ROC) Curve, Spearman rho Coefficient along with sensitivity, specificity, predictive values and likelihood ratio was obtained. Results: Prevalence of cognitive impairment using MoCA and AQ was 40% (95%CI=31.8-48.6) and 36.4% (95% CI=28.5- 45.0), respectively. AQ and MoCA showed good agreement (Cohen’s kappa, κ=0.834; 95% CI=0.739-0.928). The AQ and MoCA showed a strong negative correlation (spearman’s rho=-0.709; 95%CI=0.764-0.884, p-value <0.001). Considering MoCA as gold standard, AQ showed sensitivity of 85.7% (95% CI=74.2-92.6), specificity of 96.4% (95% CI=89.9-98.7) for cognitive impairment screening and the Positive predictive value of this tool was 94.1% (95% CI=84.0-97.9%). The Youden index of 0.821 showed highest sum of sensitivity and specificity of AQ tool at 4.5 score to anticipate cognitive impairment. Conclusion: AQ is equally effective as MoCA to screen cognitive impairment among elderly at the community level. AQ can be used even by grass root level health workers without involvement of trained personnel. So, community level screening of elderly for cognitive dysfunction can be made even in resource poor settings. Early identification and referral of elderly with cognitive dysfunction will help them in better living. [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]

Patients with cognitive deficits have a prolonged latency and reduced amplitude of the P300 wave. However, no study has correlated P300 wave alterations with the cognitive performance of patients with cerebellar lesions. We aimed to determine if the cognitive status of these patients was associated with P300 wave alterations. We recruited 30 patients with cerebellar lesions from the wards of the N.R.S. Medical College, Kolkata, in West Bengal (India). The Kolkata Cognitive Screening Battery tasks and the Frontal Assessment Battery (FAB) were used to assess the cognitive status and the International Cooperative Ataxia Rating Scale (ICARS) for cerebellar signs. We compared the results with the normative data of the Indian population. Patients had P300 wave alterations with a significant increase in latency and a non-significant trend in amplitude. In a multivariate model, P300 wave latency was positively associated with the ICARS kinetic subscale (p = 0.005) and age (p = 0.009), regardless of sex and years of education. In the model that included cognitive variables, P300 wave latency was negatively associated with performance in phonemic fluency (p = 0.035) and construction (p = 0.009). Furthermore, P300 wave amplitude was positively associated with the FAB total score (p < 0.001). In closing, patients with cerebellar lesions had an increase in latency and a decrease in the amplitude of the P300 wave. These P300 wave alterations were also associated with worse cognitive performance and some of the subscales of the ICARS, reinforcing that the cerebellum has motor, cognitive, and affective functions. [ABSTRACT FROM AUTHOR]