Dr Himadri Bhattacharjya | Agartala Government Medical College (original) (raw)

Papers by Dr Himadri Bhattacharjya

BACKGROUND: Sutureless glueless conjunctival autografting in pterygium surgery is gaining popular... more BACKGROUND: Sutureless glueless conjunctival autografting in pterygium surgery is gaining popularity due to short surgical time, no recurrence and good cosmetic outcome. AIM: To see the outcome of pterygium excision with sutureless glueless conjunctival autografting. METHODS: 30 cases of uncomplicated pterygia irrespective of eyes, age and sex were examined with slit lamp. All were nasal pterygia & progressive type. Blood sugar and xylocaine test were done. Pterygium mass was excised and autologous conjunctival graft without suture or glue were performed. Grafts were taken from inferotemporal area. Follow up was done on 1stday, 7thday, 45th day and on 6th month. RESULT: All the grafts were intact on each follow up. Graft retraction was present in one case on 7th POD. No recurrence was found till 6th month follow up. CONCLUSION: No glue, no suture conjunctival grafting in pterygium surgery takes short surgical time, easy to perform, excellent cosmetic outcome with no recurrence.

Background: Body Mass Index (BMI) is found to be positively co-related with the increased prevale... more Background: Body Mass Index (BMI) is found to be positively co-related with the increased prevalence of elevated blood pressure among younger individuals. The present study was designed to find out the prevalence of pre-hypertension and its relationship with BMI among the medical students.
Methods: A cross-sectional study was conducted during June - July 2013 among 306 medical students of Agartala government medical college, chosen by stratified random sampling.
Results: Prevalence of pre-hypertension, hypertension and optimum BP were found to be 45%, 4% and 51% respectively. Mean BMI was found to be 21.68 ± 3.55, 80% of the students had ideal waist hip ratio, 19% were underweight, 61 % had normal weight, 18 % were overweight, and 2% were found to be obese. Pre-hypertension was significantly more prevalent among the senior medical students (χ2 = 4.933, P = 0.026), males (χ2 = 10.826, P = 0.001) and those who had family history of hypertension (χ2 = 4.228, P = 0.039). Pre-hypertension was significantly higher among the obese medical students (χ2 = 6.941, P = 0.008). Logistic regression analysis revealed that medical students had 12.8% more chance of having pre-hypertension with one unit increase in their BMI.
Conclusion: Prevalence of pre-hypertension among medical students is high and BMI is found to be significantly associated with pre-hypertension. Hence it can be used as an effective tool for predicting pre-hypertension and development of hypertension among medicos later on.

Background: Intimate partner violence is increasing day by day and has become a matter of public ... more Background: Intimate partner violence is increasing day by day and has become a matter of public health concern.
Methods: To estimate the prevalence of intimate partner violence during pregnancy, to find out the pattern of violence and its determinants, a hospital based cross-sectional study was conducted among 1005 women admitted in the maternity wards of Agartala Government Medical College and Mohanpur Community Health Centre using multistage sampling and structured interview schedule during 20th November 2009 to 19th November 2010. Descriptive statistics, chi-square test and binary logistic regression analysis were used.
Results: Mean age of the study women was 23.21 (± 4.229). Prevalence of physical assault during pregnancy was 23.8 %, verbal abuse 40.6 %, forced intercourse 21.2 %. Violence was faced by 43.2 % women before pregnancy, and in 29.5 % cases, it continued during pregnancy also. 37.815 % violence occurred without any reason; 34.873 % due to financial matters, 12.605 % due to family affairs, 6.302 % for not giving birth to son, 8.403 % due to household work and suspicion of infidelity. Violence was more prevalent among Christian, daily labours (n = 31, 75.6%), illiterate and rural women. Women faced more violence from addicted husbands (n = 239, 26.3%) and in families where decision makers were illiterate (n = 201, 47.2%).
Conclusions: Improving literacy, eliminating addiction and marriage of women with men of lesser age difference may help in minimizing intimate partner violence in Tripura.

BACKGROUND: Manual small incision cataract surgery (SICS) has given visual results almost equival... more BACKGROUND: Manual small incision cataract surgery (SICS) has given visual results almost equivalent to Phacoemulsification but limited studies are available regarding the efficacy of small incision cataract surgery in phaco suitable immature cataracts. OBJECTIVE: To compare manual small incision cataract surgery and Phacoemulsification in immature cataracts. MATERIALS AND METHODS: A single blind randomized controlled trial was conducted with 105 eyes each for small incision cataract surgery and Phacoemulsification. RESULT: Mean IOL power was similar in both Phacoemulsifications as well as SICS. Four cases of posterior capsular rupture occurred in Phacoemulsification while one case of zonular dialysis occurred in SICS. Uncorrected visual acuity was good (6/6-6/18) in 80.0 % of the phaco and 93.33 % of the SICS group. CONCLUSION: SICS surgical technique resulted in significantly better visual acuity on the 1st postoperative day in comparison with phaco. Hence, SICS with rigid PMMA IOL implantation being a cheaper, faster and easier technique, may be recommended for immature cataract surgery in the developing countries.

BACKGROUND: Patient’s satisfaction is a measure of the quality of services offered by a hospital.... more BACKGROUND: Patient’s satisfaction is a measure of the quality of services offered by a hospital. OBJECTIVES: To determine the level of satisfaction of patients attending OPD of AGMC & GBP Hospital, to identify the determinants of satisfaction and to formulate recommendations for improvement. METHODOLOGY: A hospital based cross-sectional study was conducted during 17th August to 17th September 2013 using a pretested structured interview schedule among 515 patients attending OPD of AGMC and GBP Hospital recruited by concurrent sampling and ensuring probability proportionate to size representation based upon previous three month’s turnover. STATISTICAL ANALYSIS: Data entry and analysis were performed in computer using SPSS 15. Descriptive statistics and Chi-square test were used for presenting data and testing the significance. RESULTS: Cleanliness of OPD was satisfactory to 54.2% patients, 54.8% were satisfied with ventilation, 48.5% were satisfied with queuing and 49.9% were satisfied with the sitting facility of OPD. Clinical care was felt satisfactory by 75.9%, 70.5% were satisfied with the explanation of the disease & prescription given by the doctor, 72.4% patients did not get any medicine from the hospital and 17.5% patients were unaware about the enquiry services. Toilet was unsatisfactory to 26.6%, drinking water was unsatisfactory to 24.7% and the services of RSBY (Rastriya Swasthya Bima Yojana) help desk were unsatisfactory to 50% patients. Overall services of OPD were felt satisfactory by 57.5% patients and 30.3% felt it average. CONCLUSION: Cleanliness, ventilation, sitting facility, enquiry services, drinking water, toilet, RSBY help desk etc. of AGMC OPD require improvement.

Background: Agartala is one of the fastest growing cities in India. With rapid increase in the nu... more Background: Agartala is one of the fastest growing cities in India. With rapid increase in the number of bikes and other motor vehicles, road traffic accidents (RTA) are also increasing sharply. Ocular trauma and resultant ophthalmic morbidities following RTA is common.
Aims & Objective: To study the epidemiology and pattern of ocular trauma among the road traffic accident cases.
Materials and Methods: A hospital based study was conducted during February to July 2013 among 700 road traffic cases attending Ophthalmology and Casualty Department of Agartala Govt. Medical College, Tripura. Descriptive statistics and chi square test were used for presenting data.
Results: Out of 700 RTA patients 82.86% (580) were male and 17.14% (120) were female. Majority i.e. 76% (532) of the RTA cases occurred among the two- wheeler users, 42 (35.29 %) were drunk and 17% (119) of the RTA cased sustained ocular injuries. Among the ocular injury cases, 60% (72) suffered from ecchymosis. Out of 119 RTAs with ocular injuries, 22 (18.48%) had no PL at reporting due to due to ocular nerve injury and all of them failed to recover even after treatment.
Conclusion: Two-wheeler accident is common and an important cause for loss of vision following RTA. Victims of RTA reporting with loss of vision due to optic nerve injury had poor visual prognosis. Hence, primary preventive approach through behaviour change communication among the bikers for promoting safe riding practices and strict implementation of traffic rules like riding at safe speed, wearing helmet and avoiding alcohol before driving are needed to prevent RTA associated blindness.

A 65 years old male patient presented with gradually increasing painless swelling of both eyes (l... more A 65 years old male patient presented with gradually increasing painless swelling of both eyes (left eye more than right eye) associated with diminution of vision in left eye for last one year. Patient underwent thorough examination, proper investigation and diagnosed as non-Hodgkin’s lymphoma. Patient was put on chemotherapy and the immediate response was dramatic.

Introduction: Birth weight is an important indicator of maternal and child health of the country.... more Introduction: Birth weight is an important indicator of maternal and child health of the
country. Various socioeconomic and maternal factors are responsible in determining
birth weight. Hence, the present study was conducted to fi nd out the proportion
of low birth weight (LBW) among the babies born at Agartala Government Medical
College and Govinda Ballabh Pant Hospital and to reveal the relationship between
various maternal factors and birth weight. Materials and Methods: The present study
was conducted during the period from July 1, 2012 to August 31, 2012 among
305 mothers admitted in the postnatal ward selected by concurrent sampling.
Descriptive statistics and Chi-square test were applied. P < 0.05 was considered to
be statistically signifi cant. Results: Proportion of LBW was found to be 23.9% and it
was signifi cantly higher among rural mothers (28.6%, P = 0.017), anemic (28.8%,
P = 0.004), Venereal Disease Research Laboratory reactive (83.3%, P = 0.002) and
mothers who delivered vaginally (32.8%, P = 0.001). LBW was signifi cantly lower
among mothers who received iron and folic acid (IFA) tablets (22.4%, P = 0.007)
and were immunized against tetanus (22.8%, P = 0.011). Conclusion: Adequate
antenatal checkup, IFA supplementation, screening and treatment for syphilis, etc.
are necessary for improving birth weight in this community.

ABSTRACT: AIMS: To find out the prevalence, determinants and awareness regarding hypertension. SE... more ABSTRACT: AIMS: To find out the prevalence, determinants and awareness regarding hypertension. SETTING AND DESIGN: Community based cross-sectional study conducted in Saikot PHC area under Churachandpur district of Manipur. MATERIALS AND METHODS: Structured interview schedule was administered to 504 adults selected by multistage sampling during 1st October 2005 to 30th September 2006. STATISTICAL ANALYSIS: SPSS 11.5 was used for data entry and analysis, descriptive statistics, χ2 test, student - t test, binary logistic regression analysis etc. were used for presenting data and p ≤ 0.05 was considered significant. RESULTS: Prevalence of hypertension and pre hypertension were 25% and 14.3% respectively and 11.5% subjects had optimum BP. Awareness regarding hypertension was 7.7%.Prevalence of hypertension was significantly higher among older subjects (p = 0.000), females (p = 0.01), Meitei (p = 0.000), obese subjects (p = 0.003), sedentary workers (p = 0.000), ex-smokers (p = 0.000), regular BP checkers (p = 0.01) and subjects, who used to consume chicken and fish in more number of days per week (p = 0.000). Age (OR = 1.042, 95% CI = 1.027 – 1.056, p = 0.000), BMI (OR = 1.132, 95% CI = 1.050 – 1.220, p = 0.001), diet (OR = 7.381, 95% CI = 1.200 – 45.406, p = 0.031) etc. were significant determinants of hypertension. Very few subjects were aware about the risk factors of hypertension. Knowledge regarding the preventability and controllability of hypertension was also poor. CONCLUSIONS: Prevalence of hypertension was higher and knowledge regarding hypertension was poorer than other areas of India, so behaviour change communication for promotion of healthy lifestyle in order to prevent hypertension in this community is needed.

OBJECTIVES: To assess the knowledge of hand washing and food handling practices of the street foo... more OBJECTIVES: To assess the knowledge of hand washing and food handling practices of the street food vendors. STUDY DESIGN: Community based cross-sectional study conducted in Agartala municipal area. METHODS: Structured interview schedule was administered to 234 street food vendors selected by probability proportionate to size sampling technique during 1st July to 31st August 2011. Microsoft Excel and Epi-info version-6 were used for data entry and analysis and p ≤ 0.05 was considered significant. RESULTS: One hundred and seventeen vendors (50%) were aged between 30 – 40 years and 98.29% were males. Forty eight (20.5%) vendors were illiterate and 40.2% vendors were from rural areas. One hundred and five vendors (44.9%) with primary and 78 (32.1%) with secondary level education knew that unclean hands and dishes can transmit diseases while serving roadside foods. 58.3%, 61.9%, and 69.23% of the vendors were illiterate, primary and secondary educated respectively. Majority of them were not using soap for washing hands. 87.5%, 58.09%, 74.3% and 50% of the illiterate, primary educated, secondary educated, and senior secondary educated vendors did not use detergent for washing dishes before and after each serving. One hundred and sixty five (70.5%) vendors stored unsold food for the next day, while 29.1% of the vendors discarded the left-over food. CONCLUSIONS: Basic food safety knowledge and practice of hygiene and sanitation by the street food vendors was found to be inadequate. Issuing of food license to them should be subjected to fulfillment the above conditions or they should be trained regarding safe food handling.

Background: Consecutive decline in sex ratio of our country signals an impending crisis. Gender p... more Background: Consecutive decline in sex ratio of our country signals an impending crisis. Gender preference of women may have a role in determining sex ratio.
Aims & Objective: To study the gender preference and the factors affecting gender preference of mothers.
Material and Methods: A hospital based study was conducted during August – September 2013 among 390 pregnant women attending antenatal clinic of Agartala Government Medical College using a pretested semi-structured interview schedule. Descriptive statistics, χ2 test and logistic regression were used.
Results: 40.8% had son preference, 29.7% preferred daughter and the rest had no particular preference regarding the outcome of their current pregnancy. Significantly higher son preference was observed among the rural, illiterate and nullipara or women having no male child (68.24%, 58.33% and 68.24% respectively, p < 0.05). Higher son preference was also observed among housewives (58.00%), primigravida (54.61%) and women from joint families (61.18%), though it was not significant. Preference for son was higher in both the presumed situation of having either one or multiple children. Reasons for son preference were ‘better security in old age’ 39.1%; ‘generation continuation’ 31.1%; ‘status symbol’ 18.8%; and ‘better earning’ 11.1%. Reasons for daughter preference were, ‘daughters are more trust worthy’55.1%; ‘daughters help in household work’ 19.67%; ‘daughters are laxmi of family’ 15% and non-specific reasons 10.23%.
Conclusion: Improving social security at old age, facilities favouring girl children and steps for elimination of dowry from the society may help in improving the preference for girl children leading to a balanced population.

Background: Contraceptive use in India is poor so this study was designed to detect the prevalenc... more Background: Contraceptive use in India is poor so this study was designed to detect the prevalence of contraceptive use and its determinants among eligible couples in an urban slum of Tripura.
Methods: Community based cross-sectional study, conducted in the urban field practice area of Agartala Government Medical College during 15th June 2010 to 14th August 2010 among 180 eligible couples chosen by systematic random sampling. Descriptive statistics and chi-square test were used.
Results: Majority were Hindu from nuclear families. 56.7% wives and 62.8% husbands studied up to secondary level. Prevalence of contraceptive use was 43.9% and 88.9% of the study couples were aware about family planning. Tubal ligation was the most adopted and condom was the least practiced method. Decision regarding family planning was mostly made by the husband and wife jointly. Public health facilities were the main source of family planning materials and most of the study couples opined family planning as essential. Commonest reason for not practicing family planning was the desire for a son and the rest were fear of adverse effects and some non-specific reasons. The affect of caste, religion, occupation, education etc. was insignificant in determining the practice of family planning.
Conclusions: Despite a high rate of desire to limit family size, less than half of the couples were currently using contraception. It was mostly due to desire for more male babies. Hence behaviour change communication for eliminating preference for male babies and measures favouring girl children may promote couple protection in this community

Background: Dental carries is transmissible infectious disease and mother is the major primary so... more Background: Dental carries is transmissible infectious disease and mother is the major primary source of infection for their children.
Aims & Objective: To assess knowledge and practice of mothers of under-five children regarding dental caries.
Material and Methods: 140 mothers having < 5 years old children selected through simple random sampling were interviewed using semi-structured schedule to assess the knowledge of oral health to prevent dental caries.
Results: In the survey, 73.5% mothers knew about avoiding consumption of sweets/sweet fast foods/sugar beverages. A larger proportion of literate mothers were aware of regular cleaning of mouth, necessity of cleaning mouth after each feeding, sweets / sweet fast food & unclean mouth causes caries (p>0.05). They offers sweet/sweet fast food / sugar beverages more frequently, use toothpaste and brush for cleaning mouth for their children’s (p=0.010, p=0.008). A larger proportion of mothers who had an income > 3000 `/month were aware of sweets / sweet fast food & unclean mouth causes caries, necessity of regular cleaning after each feeding (p>0.05). But in spite of greater awareness of mothers a significantly lesser proportion of their children used toothpaste while brushing, do self-brushing and assisted brushing (p=00.007, 0.025, 0.022). An age group of >24 years and income > 3000 `/month were the predictors of good oral hygiene practice by mothers.
Conclusion: Mothers of the study area had basic knowledge of caries prevention. However, their theoretical knowledge has been not fully reflected in the way they cared for their children's teeth.

Background: Cervical cancer is the commonest malignancy among women in developing world and is co... more Background: Cervical cancer is the commonest malignancy among women in developing world and is considered to be preventable. Knowledge in this regard and timely screening is crucial for prevention.
Methods: This hospital based cross-sectional study was conducted during April to May 2014, using a validated interview schedule among a representative sample of 289 women attendees of a tertiary care centre of Tripura chosen by systematic random sampling. Descriptive statistics and χ2 test were used to present data. P value ≤0.05 was considered statistically significant.
Results: Cervical cancer was known as preventable by 61.9% women, 59.2% knew multiple sex partners, 42.6% knew early sexual intercourse, 72.7 % knew poor personal hygiene, 26.0% knew it as a familial disease, 16.3% knew that vaccine is available for preventing cervical cancer, 41.2% knew early diagnose is possible, 59.86% knew it as a treatable disease, 31.5% knew surgery as the main mode of treatment, 15.57% have heard about PAP smear test, 10.38 % underwent PAP smear test, lack of medical advice was the commonest reason for not undergoing PAP smear test and media was the main source of information for them.
Conclusions: Despite knowing cervical cancer as common among Indian women, knowledge regarding its early diagnostic methods, preventability and treatability is found to be low. Regarding the sources of information, health functionaries played poorer role than media and others. Health functionaries should gear up extensive IEC and BCC activities for making people aware and motivated regarding screening for cervical cancer to minimize preventable deaths in this community.

Background: Despite exclusive breastfeeding being a well recognized determinant of child survival... more Background: Despite exclusive breastfeeding being a well recognized
determinant of child survival, its practice is not up to the mark in our
country. Various social customs and misconceptions act as a barrier to
breastfeeding.
Methodology: To assess the practice and determinants of breast feeding
a community based cross-sectional study using structured questionnaire
was conducted during 1st August to 31st August 2009 among 116 mothers
from four sub-centre areas under Mohanpur CHC of West Tripura district
chosen by multistage sampling. Descriptive statistics, chi-square test
and logistic regression analysis were used.
Result: Prevalence of exclusive breast feeding was 25%. Median time of
initiating breast feeding was one hour following delivery, median duration
of breast feeding was four months and median age of starting weaning
was two months. Colostrum was fed by 87.9% women and advice
regarding this was mainly obtained from the healthcare providers. Prelacteal
feeding was practiced by 56% mothers and honey was the commonest
prelacteal feed. With the improvement in mothers literacy, there
was significant increase in colostrum feeding (p = 0.010) and decrease in
prelacteal feeding (p = 0.007). Mothers parity, age, literacy, place of delivery,
antenatal checkup and gender of the child were found to be significant
determinants of exclusive breast feeding.
Conclusion: Improving literacy status, promoting antenatal checkup and
encouraging institutional birth will reduce harmful infant feeding practices.
As the health workers were the major source of information, they
can initiate behavior change communication for promoting exclusive
breast feeding in this community.

ABSTRACT: BACKGROUND: Manual small incision cataract surgery is a simple and less expensive techn... more ABSTRACT: BACKGROUND: Manual small incision cataract surgery is a simple and less expensive technique of cataract surgery but gives visual result almost equivalent to Phacoemulsification. PURPOSE: To compare surgery induced astigmatism in manual small incision cataract surgery through superior and temporal approaches. METHODOLOGY: One hundred and thirty eyes were included in this study. Eyes with steeper vertical keratometric reading were subjected to superior small incision cataract surgery (SICS) and those with a steeper horizontal keratometric reading were subjected to temporal small incision cataract surgery (SICS). Eyes with no astigmatism were randomly subjected to either type of surgery. Each group had 65 eyes. All the patients were followed up on 1st, 7th, 30th and 90th postoperative days. During each follow up, UCVA and BCVA were recorded, slit lamp examination was performed; autorefractometry and keratometric examinations were also performed. RESULTS: Out of 65 in the temporal incision group only 55 completed follow up till 90th day. The mean surgery induced astigmatism was found to be 1.45 ± 0.4 D in superior and 0.70 ± 0.3 D in the temporal incision group. Amount of surgery induced astigmatism was found to be significantly lower among the temporal incision group (t = 11.444, p = 0.000). CONCLUSION: SICS through temporal approach provides a better stabilization of refraction with significantly lesser amount of SIA than superior approach.

Background: Stress is very common psychological phenomena where medical students faced in day to ... more Background: Stress is very common psychological phenomena where medical students faced in day to day activities. Epidemiological studies have asserted that about 70-80% of the diseases may be related to stress. Research related to this stress especially among medical students is essential, considering their learning, role and responsibilities as a future physician and health intervention programs. Objectives: To estimate the prevalence of stress and identify stressors among medical students. Materials and Methods: A Cross-sectional study was carried out among undergraduate medical students and self administered GHQ-12 and stressor questionnaire were used to collect information regarding stress. Binary logistic regression analysis was performed to calculate odds ratio (OR). Results: Prevalence of stress was 94.52% and more common among females. 33.56% students felt constantly under strain and 25.34% had loss of sleep over worry. Majority of the students of all semesters had stress (P > 0.05) and stressors viz. 'competition for marks' (P = 0.005), 'frequent examination' (P = 0.001), 'difficulty in finding time for recreation' (P = 0.014) and 'being away from home' (P = 0.027) were predominantly experienced by the 1 st year medical students. Multiple logistic regression analysis revealed the causal effect of main parameter on the GHQ caseness and students who found difficulties in following teaching language among the caseness had 81.59% higher chance of developing stress (OR = 8.159, CI = 1.228-54.213). Conclusion: The stress experience was more common due to academics and seen among all year of medical students. Strategy development for eliminating stressors is necessary for promoting healthy life.