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Background: Efficient hospital bed utilization is an important function of hospital administrators. Scarcity of beds, overcrowding, and flooring are often the picture of tertiary hospitals. Objectives: This study aims to find out hospital bed utilization indicators such as average daily census, bed occupancy rate (BOR), average length of stay (ALS), bed turnover rate (BTR), and bed turnover interval (BTI) in Medicine ward of a tertiary hospital in West Bengal, India. Methods: A descriptive cross-sectional study was conducted in acute male and female as well as chronic male and female wards under medicine department of a tertiary hospital in West Bengal from June to August 2018.The record of active beds, patient days, daily admissions and discharge were reviewed for May 2018 by complete enumeration method from admission, discharge and death registers and recorded in a pre-designed pretested checklist. Average daily census, BOR, ALS, BTR, and BTI were computed using standard formula. Pabon Lasso model was used to analyse the performance of the nedicine ward. Results: Average daily census, ALS, BOR, BTR, BTI in medicine ward were 261.81 patients, 8 days, 108.55%, 4.22 patients/ bed and -0.63 days respectively. Pabon Lasso graph reflected high BOR and high discharges per bed (productivity) in acute medicine wards reflecting good quantitative performance in contrast to chronic medicine wards with low discharges per bed (productivity or BTR) and higher ALS. Conclusion: Medicine ward reflected higher BOR and ALS but lower BTR (productivity) as per the Pabon Lasso graph. Efforts must be made to reduce ALS in chronic medicine wards.

Background: Intra-uterine contraceptive device is one of the most commonly used reversible method of contraception worldwide. In West Bengal Cu-T acceptance is decreasing in majority of the districts. Objectives: To determine the underlying factors for low acceptance of IUCD. Methodology: A qualitative study was carried out in Paschim Mednipur and Howrah districts of West Bengal in 2009 by organising seven Focus Group Discussions (FGD) in each district. Three FGDs among beneficiaries’ i. e eligible couples, 3 FGDs among service providers and one FGD among health administrators were undertaken in each district.Results: Beneficiaries experienced complications like bleeding, pain, misplacement etc. Fear of weakness, white discharge, occurrence of cancer existed. Providers highlighted lack of privacy, need for Cu-T re-orientation training, shortage of IEC material and inadequate time spent by doctor for motivation, rumour among clients. Administrators opined that sustenance of Behaviour Change Communication, training of ANMs would be useful.Conclusion: Different rumours& myth in the society responsible for low acceptance of Cu-T may be removed through strengthening the Behaviour Change Communication involving Doctors also.

Background & Objectives: As a part of Revised Filaria control strategy, MDA programme was implemented in Murshidabad district from 29th - 31st December 2008. A cross sectional study was carried out to assess drug compliance after Mass Drug Administration of DEC and the factors responsible for poor compliance among the population of Murshidabad district of West Bengal during Jan 2009. Materials & methods: Total study unit were 120 families covering 3 villages and one municipality ward area (30 families from each area). Results: Out of 601 family members, 571 were eligible for Mass drug administration (6 pregnant women and < 2 years age groups (24) were excluded). Drug distribution rate was 91.8%.Overall drug compliance was 42.3%.Total number of defaulters was 330 (57.7%). Non compliance was highest (75.5%) in urban area. Defaulters were more among male than female. Factors responsible for defaulters were no motivation (24.7%), drugs not supplied (22.5%) ,absence at home (13.5%),no faith (10.1%), fear of side effects (10.1%) and others (Forgotten, lack of prior IEC etc), illness, wrong information were 7.8%, 7.3%, 3.9% respectively. Majority has no side effects, only dizziness (3.3%), headache (1.7%), vomiting and others (4.1%) were experienced by the people after consumption of drugs. On an average 40% families were aware about ELF & transmission of disease. Only 43.7% of community members were informed about MDA by Health Workers prior to the implementation of MDA programme.

Background: Diarrhoea is one of the leading causes of under-five childhood morbidity and mortality in India, despite the availability of easy interventions through oral rehydration at the community level. The level of knowledge varies from country to country and within the country, further variations exist in state, district and sub district level based on difference in socio-demographic characteristics of the population. And based on these variations, different community needs different health education efforts in its extent and approaches. It was therefore relevant to explore the level of awareness about diarrhoea and its management among the mothers who were the first level of caregivers. Objective: To assess the level of knowledge about diarrhoea and oral rehydration therapy among the mothers having their children of 6 months to 5 yrs with diarrhea Materials and methods: It was a facility based cross-sectional descriptive epidemiological study conducted among 62 mothers having their children of 6 months to five years with diarrhoea. Mothers attended a rural hospital under the geographical area of Madhyamgram in North 24 Parganas district of West Bengal, India. Data was collected by face to face interview of the mothers in the outpatient department of the hospital using a pre-designed and pre-tested questionnaire. The analysis was done in Statistical Package for Social Sciences (SPSS), version 20.0 using bivariate and multivariate (multiple logistic regression model) to examine the statistical significance at 95% confidence interval. Results: Mean knowledge score was 7.8 (Range 0-17). Lower knowledge score group (0-8) accounted to 36 persons (37.1%) and higher knowledge group (9-19) accounted to 26 persons (62.9%). Knowledge about alarming symptoms of the dehydration was significantly poor. At the individual level, literacy of women and their caste were strongly associated with the knowledge about diarrhoea and its management. At the household level, the way of the disposal of household garbage was also strongly associated. Conclusion: Considering the poor knowledge of the mothers, the study recommends for extensive health education measures widely in the community with a special focus for the illiterate and socio-economically lower groups, and also for the families having the practice of open garbage disposal. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.267-273

Child health is prime concern of any country. Under five age morbidity profile has a far reaching consequence on future development of country. Malnutrition is the one of the leading cause of morbidity and mortality in children of under five in developing countries The Objectives of the present study were to evaluate the morbidity profile of under-5children in urban slum in Kolkata and to identify the risk factors associated with it. It was a cross-sectional, population based, descriptive study conducted in urban slums of Rajabajar, Kolkata. Total 122 under 5 children of both sex were studied during the 3 month study period (Dec 2013- Feb 2014). Among the 122 under 5 children 54.1% was male sex. Prevalence of under-five morbidity was 52.45% among children aged 1 to 5 yrs of urban slum of Rajabazar, Kolkata. Acute respiratory infection was most common (51.56) followed by loose stool (15.62%).Prevalence of malnutrition was 23.77 %. Children were mostly from lower socio-economic class (class V)- 59%.Immunisation status was up to date among 84.4% children. Keywords: ICD 10 code, morbidity, nutritional status, slum, under-5children (3) Most of the childhood illnesses are caused by acute respiratory infections, diarrhea, measles, malaria, malnutrition or a combination of these conditions (4). Each year 27 million children born in India.10% of them do not survive up to 5 years. India contributes 25% of over 6.9 million under 5 death world wise every year. under- 5 mortality rate in 2012 was 56/1000 live birth. Infant mortality rate 41 per thousand live birth in 2012.Prevalence of morbidity is about 42% to 48%. (5) With this background we carried our study in an urban slum. The Objectives of our study were to evaluate the morbidity profile of under-5children in urban slum in Kolkata and to identify the risk factors associated with it.

A hospital based descriptive cross sectional study was conducted in a girls' high school, Tarakeswar, Hooghly, West Bengal to assess the proportion of visual acuity and visual impairment among the students in a Rural High School along with its association with some socio-demographic, environmental and nutritional factors. Out of 160 students, 132 girl students of class VIII, IX, X attended the school on the day of survey. In first step Pre-designed pre-tested self administered questionnaire was filled in by the students. The second step involved eye examination, including students' visual acuity using the Snellen E chart and near vision chart. Data were tabulated in MS EXCEL 2007 and analysed by SPSS 20. Most of the students were Hindu (98.49%), Poor socio-economic class (63.64%). Education status of the fathers was mostly primary school completed (36.4%). 68.9% students had visual acuity 6/6 and 31.1% had visual acuity

Background: According to the World Health Organization(WHO) the "Promotion of oral health is a cost-effective strategy to reduce the burden of oral disease and maintain oral health and quality of life. It is also an integral part of health promotion in general, as oral health is a determinant of general health and quality of life . Objectives: To find out proportion of different types of common dental problems identified during the study period in dental OPD, to identify socio demographic factors related to dental problems and to assess the relationship between oral hygiene practices and common dental problems, if any. Study settings: Dental out patient department of Calcutta National Medical College & Hospital, Kolkata,India. Study design: Hospital based cross sectional observational study. Study population: Patients aged 10 years and above, attending dental OPD. Methodology: By systematic random sampling 366 patients were selected for interview . Socio- demographic information, type of dental problems, practices regarding maintenance of oral hygiene were recorded and analysed. Results: Maximum number of study subjects presenting with dental problems were in the age group of 30-39 and 40-49 years(24.6% and 20.2% respectively), 56.3% were females, and 35.8% were illiterate and just literate. 53.6% of patients used to brush their teeth twice or more, in 39.0% of subjects technique of brushing was horizontal, it was circular in 24.6% , Oral rinsing after every meal was done by 61.2% patients, and after major meals in 19.1%. 68.9% of total study subjects had dental caries, 50.8% had gingivitis and 32.2% had abrasion of teeth. Tobacco chewing was positively related to dental caries whereas increasing age positively influenced teeth abrasion. Brushing in circular direction and frequent oral rinsing were found to be protective against dental problems.

Background: Overweight among adolescents has high prevalence on the eastern part of India, especially West Bengal. Objectives: The current study was conducted to estimate and compare the effects of different dietary habits and habits related to physical activity in the development of overweight and obesity among rural schoolgoing adolescents. Methods: A prospective repeated measures study was conducted on 645 schoolgoing adolescents from selected rural government-aided schools from June 2017 to December 2017. Dietary habits of the students and physical activity-related factors were the major predictors. Adjusting for the age and sex of the participants, effect of these factors on the development of overweight and obesity was analyzed by generalized estimating equations for 2 repeated measures, taken 6 months apart. Results: Most of the respondents were aged ≥16 years (56.90%), female (52.87%), Hindu (76.74%), from a nuclear family (76.74%), and studying in the secondary level (57.68%). There was a stark rise in proportion of overweight from 0.93% to 7.44%. The prevalence of unhealthy dietary habits was 68.99% at the baseline, and 66.82% on follow-up. The overall prevalence of inadequate physical activity increased to 48.68% from 47.91%. Female gender and older age group were at higher risk of being overweight or obesity. Overall fast food showed highest risk (3.04, 95% confidence interval [CI]: 1.86–4.95), while among the boys, it was with less vegetable consumption (4.64, 95% CI: 1.84–11.69). Conclusions: Strong evidence was generated of dietary practices being more rigidly related to overweight among the adolescents. Healthy dietary practices coupled with physical activity should be promoted to mitigate the risk of obesity.

Background: In order to maintain the polio free status of India, it is vital to monitor the ongoing oral polio vaccination for international travellers. The aim of the study was to determine the status of oral polio vaccination program for international travellers from India to polio infected countries and to find out the determinants of deviation from proposed guidelines. Methods: A descriptive cross-sectional study was conducted among 101 International travellers from November 2014 to April 2015 at a designated Polio vaccination centre for international travellers in Kolkata. A pre-designed pre-tested schedule was used to collect oral polio vaccination related details. The travellers who gave consent were eligible for the study. Data was expressed in terms of mean, median, standard deviation etc. Association between variables was tested by Chi square test. Results: 32.7% of the travellers had inadequate gap between OPV & travel. Knowledge of gap between OPV and travel was perceived more from health centres and travel agencies than mass media. Inadequate gap was more among lower age group, males, those with information source as mass media, official purpose of visit, those with incorrect knowledge regarding the gap requirement and those who maintained at least four weeks gap between OPV and yellow fever vaccine. Conclusions: Wrong information from the source is responsible for wrong knowledge among the travellers which leads to inadequate gap between OPV and travel. It is crucial to increase awareness among the vaccinators and international travellers in order to contribute towards global polio eradication.

A cross sectional study was carried out to assess drug compliance after Mass Drug Administration of DEC and the factors responsible for poor compliance among the population of Murshidabad district of West Bengal during Jan 2009. Total study unit were 120 families covering 3 villages and one municipality ward area (30 families from each area). As a part of Revised Filaria control strategy, MDA programme was implemented in Murshidabad district from 29th-31st December 2008. Result revealed that total covered population were 601, out of which 571 were eligible population for Mass drug administration (6 Pregnant women and2 years age groups (24) were excluded). Drug distribution rate was 91.8%. Overall drug compliance was 42.3%. Total number of defaulters was 330 (57.7%). Non compliance was highest (75.5%) in urban area. Defaulters was more among male than female. Factors responsible for defaulters were no motivation (24.7%), drugs not supplied (22.5%), absence at home (13.5%), no faith (10.1%), fear of side effects (10.1%) and others (Forgotten, lack of prior IEC etc), illness, wrong information were 7.8%, 7.3%, 3.9% respectively. Majority has no side effects, only dizziness (3.3%), headache (1.7%), vomiting and others (4.1%) were experienced by the people after consumption of drugs. On an average 40% families were aware about ELFtransmission of disease. Only 43.7% of community members were informed about MDA by Health Workers prior to the implementation of MDA programme.

Background: Snake bite is a neglected public health problem in India. Very few community based epidemiological studies in India have been published so far on this issue. Most of the studies were carried out on hospital data. Previous community-based survey in the state revealed that only 22% snake bite victims attended hospitals. Objectives: The objective of the present study is to find out the epidemiological profile of snake bite in eight blocks of the South 24-Paraganas district of West Bengal and to explore the under reporting of snake bite deaths in health facilities in that area during the study period. Materials and Methods: A retrospective analysis of snake bite data was carried out from a community-based epidemiological survey on 1.9 million populations. This survey was done door-to-door from January 2009 to October 2010 to get epidemiological profile of snake bite of the previous 2 years. The data of direct survey was compared with the official report of the same area to evaluate the hospital-based data with focus on underreporting of snakebite deaths. Results: A total number of snake bite cases as found in the survey in the study area was 4871. There was a huge gap between the two data (direct survey and official data). Only 7.23% snake bite deaths were officially reported. Only 22.19% of the snake bite victims attended the hospitals. Nearly 65.7% of the snake bite deaths were due to common krait bite, most of them occurring in the months of June to September. Conclusions: Official reporting system is still having a huge deficiency in India. Snake bite needs to get more attention from the health authority.

Background: Fertility pattern has some influence on health of mother and child as well as it can resist population growth. Methods: A cross sectional study on fertility perception among married women of reproductive age group, was carried out in 3 blocks and 2 municipality areas of Howrah District of West Bengal, India, covering 12 villages and 4 wards, selected by stratified multistage random sampling, for a period of 6 months from April to September 2009. Two thousand married women were the respondents. Results: Respondents were mainly belonged to poor and below poverty line groups (86.7%), one third (33.4%) were illiterate and just literate group, 66.8% of the respondents belonged to Hindu by religion and 63.4% had history of teen age pregnancy and more than 50% of the respondents were married early (below 18 years). The study revealed that perception about age of marriage, interval between marriage and 1 st pregnancy and spacing were incorrect in case of 45.8%, 37.6% and 23% of the respondents, respectively. 22.3% and 13.1% of the respondents had no proper idea regarding desired no of children and Family Planning methods, respectively and their knowledge varied with literacy status, age and religion. Majority (67.5%) of the study population received information about family planning methods from health personnel. Conclusions: Correct Knowledge regarding different components of fertility among Eligible Couples to be enhanced by intervention through Information, Education and Communication (Interpersonal Communication and Mass Media).

This cross-sectional study of 35 multipurpose workers (MPWs) of Goalpokhar--II (Chakulia) block selected by random sampling in the district of Uttar Dinajpur showed that 30 respondents were female mostly in the age group less than 30 years and rest were male in the age group of above 30 years. Majority of respondents (65.7%) were educated up to the level of higher secondary. On an average each MPW used to spend only 5.8 hours per week for home visit. During referral of the patients, the problems faced by the health workers were due to non-availability of vehicles (71.4%), difficulties in the means of communication ie, long distance, road problems, etc (85.7%), and lack of awareness about referral centre (2.8%). Only 5.5% of the MPWs stated absence of difficulty during referral to the higher facility. Regarding difficulties faced during transmission of health related information, 25.7% of MPWs were unaware of the location of the reporting centre; 17.4% of MPWs were unaware of authority to be informed and 14.3% of MPWs complained about social barrier and 22.8% experienced non-availability of manpower. However 42.9% of MPWs did not face any problem while transmitting health related events/information to the higher authority. Most of the respondents (23.5%) opined that their performance may be enhanced by increasing community awareness.

Hepatitis B, is one of the major public health problems can be controlled with the active participation of the community. A descriptive cross-sectional study was conducted in the immunization clinic of Burdwan Medical College to identify the level of people's perception on the diseases Hepatitis B. A total of 210 individuals accompanying the children for routine immunization were interviewed. The study result showed that majority (65.3%) of the respondents were unaware that the diseases is caused by virus and 46.2% were unaware on transmission of disease. 38% of the respondents were unaware regarding the future consequences of the diseases. The knowledge on the preventive measures against Hepatitis B was high (76.2%) among the respondents. Incorrect knowledge in relation to vaccination like interval of vaccination, necessity of re-vaccination was 88.6%, 86.7% respectively. 49% had no idea about ideal age for vaccination. Significant difference of knowledge was found between illiterate and just-literate group with primary, secondaryabove group (p0.05). Receipt of vaccine (15.6%) also significantly more (p0.05) in case of higher income group.

Background: The rampant population growth has been viewed as the greatest obstacle to the economic and social advancement to the majority of people in the underdeveloped world. Objectives: To determine the social correlates of unmet need in a Community setting. Study Design: A cross-sectional, descriptive type of observational study. Methods and Materials: The sampling technique used was a Multistage stratified random sampling. One district was chosen randomly from the 19 in the state of West Bengal, India. Out of total 29 blocks in the district, 3 were selected randomly from different subdivision. From these blocks, 12 villages (4 villages from each block) and 4 urban wards were selected from municipality areas, so total 16 areas selected from the district. In West Bengal unmet need for family planning was 8% as per NFHS-3 (2005-2006), and considering maximum allowable error (20%), so minimum sample size works out to be 1150. From each village/ward, 125 eligible couples were covered, so (16 × 125) total 2000 currently married women of reproductive age constitutes the study population. Statistical Analysis: Proportions and Chi-square test. Results: 13.6% of currently married women of reproductive age group (15-49 yrs.) experienced unmet need for contraception. Unmet need was more in rural area than urban, lower age group than higher, Muslims than Hindus, lower level of literacy (including illiterates) than higher and also increase of joint families than nuclear families. Conclusion: Social correlates like age, religion, literacy status of respondent, type of family, age at marriage, even literacy status of husband also influenced the unmet need of family planning. Sustained and coherent Behavior Change Communication campaign is required to reduce unmet need.