Bijit Biswas

BACKGROUND: There has been a growing interest in ivermectin ever since it was reported to have an in-vitro activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This trial was conducted to test the efficacy of ivermectin in mild and moderate coronavirus disease 19 (COVID-19). METHODS: A double blind, parallel, randomised, placebo-controlled trial conducted among adult COVID-19 patients with mild to moderate disease severity on admission in a COVID dedicated tertiary healthcare of eastern India. Enrolment was done between 1st August and 31st October 2020. On day 1 and 2 post enrolment, patients in the intervention arm received ivermectin 12 mg while the patients in the non-interventional arm received placebo tablets. RESULTS: About one-fourth (23.6%) of the patients in the intervention arm and one-third (31.6%) in the placebo arm were tested reverse transcriptase polymerase chain reaction (RTPCR) negative for SARS-CoV-2 on 6th day. Although this difference was found to be statistically insignificant [rate ratio (RR): 0.8; 95% confidence interval (CI): 0.4-1.4; p=0.348]. All patients in the ivermectin group were successfully discharged. In comparison the same for the placebo group was observed to be 93%. This difference was found to be statistically significant (RR: 1.1; 95% CI; 1.0-1.2; p=0.045). CONCLUSIONS: Inclusion of ivermectin in treatment regimen of mild to moderate COVID-19 patients could not be said with certainty based on our study results as it had shown only marginal benefit in successful discharge from the hospital with no other observed benefits.

BACKGROUND: Empathy is a desirable quality in every clinician. It is a crucial determinant of patient-physician communication and relation. There are very few existent Indian studies on empathy of medical students and its correlates. AIM: The aim of the study was to assess empathy level of medical students and its correlates. METHODOLOGY: It was a cross-sectional, hospital-based, analytical observational study conducted from July to November 2017. In total, 249 undergraduate medical students of a medical college of Kolkata were interviewed with a structured schedule. The schedule comprised of the sociodemographic questionnaire, career satisfaction, future career choice, and Jefferson Scale of Empathy. RESULTS: The mean empathy score was 98.5 ± 12.5. Third-semester students had higher empathy scores (102.4 ± 12.4) compared to fifth (97.2 ± 12.9) and seventh semester (95.0 ± 10.9) students. The difference between the mean scores of different semesters was statistically significant. Female students were more empathic than male students. In the multivariable linear regression model, sex, semester, residence, career satisfaction, future career choice, and current place of living were significant predictors of empathy scores. CONCLUSION: Empathy level of medical students of our study was quite low compared to other studies conducted outside India. Empathy eroded with semester, which supports earlier pieces of evidence in this regard.

CONTEXT: Urinary incontinence (UI) is a chronic debilitating disease which is often under reported, but laid significant impact on one's quality of life (QoL) thus is of public health importance. AIMS: The aim of this study is to find out proportion of rural women have UI, its associated risk factors and treatment-seeking behavior, QoL of affected women. METHODS: This was a cross-sectional clinic-based study conducted from October 2016 to January 2017 among 177 women aged 50 years or above attending a rural health facility with a structured schedule. Data were analyzed using appropriate statistical methods by SPSS (version 16). RESULTS: Forty-nine (27.7%) out of 177 women were found having UI. The most prevalent type of UI was stress UI (51.0%), followed by mixed UI (32.7%) and urge UI (16.3%). In bivariate analysis, study participants who were illiterate, having a history of prolonged labor, having a history of gynecological operation, normal vaginal deliveries (NVDs) (>3), diabetic, having chronic cough, having constipation, and having lower urinary tract symptoms (LUTS) had shown significantly greater odds of having UI. In multivariable illiteracy (adjusted odds ratio [AOR] - 2.41 [1.02-5.69]), NVDs (AOR - 3.37 [1.54-7.37]), a history of gynecological operation (AOR - 3.84 [1.16-12.66]), chronic cough (AOR - 2.69 [1.21-5.99]), LUTS (AOR - 2.63 [1.15-6.00]) remained significant adjusted with other significant variable in bivariate analysis. Those with mixed UI had 5.33 times higher odds having unfavorable QoL. Only 30.6% sought medical help. Treatment-seeking behavior shown negative correlation with QoL while fecal incontinence and LUTS shown possitive correlation. CONCLUSIONS: The study revealed that rural women are indeed at high risk of developing UI. Majority of them did not sought treatment for UI which is matter of concern. Generating awareness regarding UI may help to improve health-seeking behavior and QoL.

Background: Hypertension, also known as high blood pressure is a global public health concern. It is an important modifiable risk factor for cardiovascular disease and stroke. It remains silent, being generally asymptomatic during its clinical course and it accounts for a large proportion of cardiovascular deaths; lifestyle modification is the first line of intervention for all patients with hypertension, yet it was never been empirical. The aim of the study was to assess the pattern of self-care practices, if any and also to find out the factors associated with it, among the hypertensive patients in the outpatient department. Methods: A clinic-based, observational, cross-sectional study was conducted at health center under RHU & TC, Singur, which is the rural field practice area of All India Institute of Hygiene and Public Health, Kolkata among 124 hypertensive subjects. Binary logistic regression was done to find out the factors associated with the self-care practices using SPSS software. Results: In the present study, 62.9% of study participants suffering from hypertension had unfavourable self-care practices. Logistic regression showed age above 60 years (OR-3.1), primary level education (OR-5.6), poor socio economic status (OR-2.4), widow/separated (OR-3.3) and people with self-perceived poor health status (OR-2.8)had significant association with unfavourable self-care practices. After adjusting with other variables, age (AOR-2.3) and education (AOR-3.8) remained significant predictor of outcome. Conclusions: The findings revealed that the self-care practices among hypertensive patients were unfavourable in rural area. This calls for a deep need in increasing the awareness about healthy lifestyle among hypertensive patients. This study provides key elements to affect policy changes and social interventions.