Samiran Bisai | Vidyasagar University (original) (raw)

Papers by Samiran Bisai

Objective Obesity has become known as an epidemic worldwide. Therefore a study was undertaken to ... more Objective
Obesity has become known as an epidemic worldwide. Therefore a study was undertaken to assess the prevalence of adolescent overweight and obesity in Midnapore town, West Bengal, India. The results were compared with national
and international prevalence levels in respect to economic status.
Methods
The subjects were selected from Bengalee speaking lower-middle socioeconomic class. A total of 1265 (640 boys and 625 girls) children aged 10-12 years were measured and included in the present analysis. Body mass index (BMI) was computed using the following standard equation: BMI = Weight (kg)/height (m)2. Presence of overweight and obesity were evaluated using the International cut-off values as recommended by International Obesity Task Force (IOTF).
Results
The overall frequencies of overweight and obesity were 5.69% and 0.79%, respectively. The prevalence of overweight was significantly higher among girls
(7.20%) compared to boys (4.22%). They had 1.89 (95% CI: 1.33 – 3.18) fold more chances to being overweight than the boys. There was a significant decreasing trend in the rate of overweight with increasing age among boys. The odds ratios for ages 10 and 11 were 3.94 and 3.01, respectively. The highest rate was observed among 10 year in both boys (5.88%) and girls (7.88%), while the lowest rate was found among 12 years in both boys (1.46%) and girls (6.37%). The prevalence of obesity was slightly higher in girls than in boys across ages.
Conclusions
The moderate rates of overweight and low rate of obesity were found among adolescents of Midnapore Town, West Bengal. We recommend that similar studies be undertaken among children and adolescents of different socioeconomic groups of different ethnicities from diverse parts of India. Such studies would help us to have a better and clearer picture on the overweight and
obesity situation in India and other developing countries experience with rapid economic transition.

To determine the relationship between maternal nutritional status and infant growth pattern, a cr... more To determine the relationship between maternal nutritional status and infant growth pattern, a cross
sectional study was conducted in a postnatal clinic of government general hospital of south Kolkata,
West Bengal, India. A total of 97 mother and their children were measured following standard
techniques. Nutritional status of mothers and children’s were assessed based on WHO recommended
body mass index (BMI) guidelines, mid upper arm circumference (MUAC) and z-score methods,
respectively. The result shows that BMI is the most important predictive variable of WAZ, LAZ and
WLZ. Maternal BMI explained for 34.9%, 10.2% and 15.6% variation of WAZ, LAZ, and WLZ.
When maternal MUAC enter into the model, further MUAC explained by 4.5% and 5.3% of
variation for WAZ and WLZ score. In conclusion, interventions by improving maternal nutritional
status could have a significant role in the prevention of childhood malnutrition.

To assess the nutritional status among urban poor children aged 1-5 years a cross sectional study... more To assess the nutritional status among urban poor children aged 1-5 years a cross
sectional study was undertaken during February-June 2006 in three municipal wards of
North 24-Parganas district, West Bengal, India. All information like age, sex, religion,
caste, weight and height were collected from each subject through questionnaire
following simple random sampling method. Nutritional status was assessed based on
weight-for-age, height-for-age and weight-for-height z-score method. Undernutrition
was defined as Z-score below -2.0 SD from the National Centre for Health Statistics
(NCHS) reference population. A total of 899 children (boys=517; girls=382) aged 1-5
years were included in the present study. Overall, the prevalence of underweight,
stunting and wasting was 63.6 (95% CI: 60.5 - 66.8) %, 52.7% (95% CI: 49.5-56.0)
and 22.0% (95% CI: 19.6-25.1). Overall, 16.7 % (CI: 14.1-19.0), 25.1% (CI: 22.3-28.0)
and 5.3% (CI: 4.0- 6.9) children were found to be severely underweight, stunted and
wasted, respectively. Moreover, the prevalence of underweight was significantly higher
among tribal (71.5%) children than Muslim (67.2%) and Hindu (57.6%) children. On
the other hand, the prevalence of stunting and wasting was higher among Hindu and
Muslim children, respectively.
In addition, according to WHO (1995) criteria for severity of malnutrition, the overall
prevalence of underweight, stunting and wasting were very high indicating a critical
situation. Therefore, appropriate health policies and measures must be implemented to
reduce the burden imposed by poverty on childhood health and nutritional stress among
these areas.

Low birth-weight is a leading health problem in developing countries. In a randomized controlled ... more Low birth-weight is a leading health problem in developing countries. In a randomized controlled trial,
the effect of antimicrobials in pregnant women on improving birth-weight and duration of gestation
was evaluated. Two hundred twenty-four pregnant women in their second trimester were randomized
to receive metronidazole (200 mg 3 times daily for 7 days) and cephalexin (500 mg twice daily for 5
days) orally by one group. The mean (±SD) birth-weights were 2,545 g (±374) and 2,584 g (±358,
p=0.51), the low birth-weight rates (<2.5 kg) were 40% and 36% (p=0.28), and the prematurity rates
were 8% and 11% (p=0.6) in the treated group and the control group respectively. Due to small sample
size, it is cautiously concluded that routine antimicrobials for genital and urinary tract infections of
pregnant women do not improve birth-weight or duration of gestation. Rather an unexpected observation
was the proportion requiring caesarian section or forceps, which was five-fold higher in the treated
group (p=0.001), and given no plausible explanations, this finding needs confirmation. Stunted mothers
(<25th centile or 146.4 cm) had two-fold higher risk for low birth-weight (p=0.04) and assisted delivery
(p=0.1). Low maternal body mass index (<25th centile or 18) had six-fold higher risk for stillbirth or
abortion (p=0.007), and high body mass index (>75th centile or 21.2) had three-fold higher risk for
assisted delivery (p=0.003).

SUMMARY The most common complication of herpes zoster in immunocompetent patients is postherpetic... more SUMMARY The most common complication of herpes zoster in immunocompetent
patients is postherpetic neuralgia, which is very diﬃcult to treat. Signiﬁcant
beneﬁcial eﬀects have been found for amitriptyline, gabapentin, pregabalin,
carbamazepine, sodium valproate, oxycodone, corticosteroid, topical capsaicin,
tramadol, etc. The aim of this open randomized comparative study was to demonstrate
clinical eﬃcacy of amitriptyline and pregabalin. The study included 50
patients, 32 (64%) male and 18 (36%) female, randomized to receive either amitriptyline
or pregabalin (n=25 each). Amitriptyline was administered in a dose of
25 mg once daily and pregabalin in a dose of 75 mg twice daily. Inclusion criteria
were as follows: postherpetic neuralgia of more than 1 month duration; pain of
at least moderate severity; and patient age 40 years or older and no pregnancy.
Patients with a history of any serious diseases (renal, cardiac, hepatic or seizure)
were excluded. Total treatment period spanned 8 weeks, with patient follow up
visits at 2, 4 and 8 weeks to assess the degree of improvement in pain perception
and any adverse reaction. Patients with four herpes zoster types were included in
this study, of which thoracic type predominated (54%). Other types were cervical
in 12 (24%), trigeminal in 8 (16%) and lumbosacral in 3 (6%) patients. Prodromal
symptoms before herpes zoster were reported by 66% of study patients. Satisfactory
improvements of pain perception at the end of 8 weeks (>75%) were noticed
in pregabalin group, which was statistically signiﬁcant (χ2=10.08; P<0.05).
Dry mouth was the commonest complication in amitriptyline group and dizziness
in pregabalin group. More importantly, none of the patients stopped treatment
due to adverse reaction. In conclusion, therapy with pregabalin is better
compared to amitriptyline in postherpetic neuralgia patients. However, a similar
study in a larger sample is required to validate the present ﬁndings.

Background: Acyclovir, a specific and selective inhibitor of replication of herpesviridae family,... more Background: Acyclovir, a specific and selective inhibitor of
replication of herpesviridae family, has well documented efficacy
for speedy rash healing and decreasing pain of herpes zoster.
Limited oral bioavailability of acyclovir requires frequent dosing.
Valacyclovir is rapidly and almost completely converted to
acyclovir in vivo and gives three to fivefold increase in acyclovir
bioavailability. The aim of this study was to assess the clinical
efficacy, safety and tolerability of oral valacyclovir versus standard
oral acyclovir in the treatment of herpes zoster.
Methods: A blind randomized prospective study was performed
during May 2007 to August 2007 in Midnapore Medical College.
Immunocompetent patients, aged ≥40yrs presenting with herpes
zoster within 72 hours after onset of rash were enrolled and
randomized to receive one of the following treatments: 1000
mg of valacyclovir thrice daily for 7 days or acyclovir 800 mg 5
times daily for 7 days. A total of 60 patients were included and
randomized to receive either valacyclovir (n=30) or acyclovir
(n=30) and they were evaluated at 8 days, 15 days and 29 days,
respectively.
Results: A statistically significant reduction of skin lesion and
zoster associated pain were noticed in valacyclovir compared to
acyclovir group. However, presence of post herpetic neuralgia
on the 29th day was less in acyclovir compared to valacyclovir
group (70.0% vs. 83.3%, P>0.05). Only one patient on valacyclovir
and two patients on acyclovir complained of nausea and mild
abdominal pain.
Conclusion: We conclude that for the management of herpes
zoster, valacyclovir might be superior to acyclovir in respect to
reduction of skin lesions and pain.
Keywords: acyclovir, herpes zoster, treatment,

Objectives There is a paucity of data on nutritional status among tribal preschool children. Ther... more Objectives
There is a paucity of data on nutritional status among tribal preschool children. Therefore a study was conducted to determine the nutritional status based on anthropometry among rural preschool children.
Methods
A community based cross sectional study was conducted during July-August 2009 in a village of Paschim Medinipur district, West Bengal, India. Nutritional status was determined based on weight-for-age, height-for-age and weight-for-height and mid
upper arm circumference-for-age z-scores method. Prevalence of undernutrition was defined as Z-score <-2.0 SD from the new WHO reference standards.
Results
A total of 65 Munda and Oraon children aged 13-60 months were included in the present study. Overall, the prevalence of underweight, stunting and wasting was 61.5 %, 38.5% and 55.4%, respectively. The prevalence of undernutrition was 56.9% based on MUAC, of whom, 44.6% and 12.3% children was moderately and severely undernourished, respectively. It was observed that the MUAC had good agreement (Kappa=0.84) with underweight, followed by moderate agreement with wasting (Kappa=0.53). While poor agreement was found with stunting (Kappa=0.28).
Conclusion
According to WHO criteria for severity of malnutrition, the overall prevalence of stunting was high while underweight and wasting were very high, indicating a critical situation.

This paper reviews the status of undernutrition or chronic energy deficiency (CED) among tribals ... more This paper reviews the status of undernutrition or chronic energy deficiency (CED) among tribals of West Bengal. A comparison is also made with tribal females of other parts of India. This review provided strong evidence that, in general, tribal populations of West Bengal were experiencing serious or critical nutritional stress. Immediate appropriate nutritional intervention programs are needed for implementation among these ethnic groups.

BACKGROUND: Low Birth Weight is a major public health problem in developing countries. The causes... more BACKGROUND: Low Birth Weight is a major public health problem in developing countries. The causes of LBW
are multifactorial including complication during pregnancy, genetic, environmental, social-cultural, demographic
and nutritional variables. Comparison of anthropometric risk factors for neonatal size of adolescent mothers are
lacking from West Bengal. Therefore, this study was undertaken to identify maternal anthropometric
characteristics, which most strongly influence neonate weight and length among Bengalee mothers.
METHODS: A hospital based cross-sectional study was undertaken during 2004 in a Government general hospital
in South Kolkata, India. A total of 76 adolescent (age<20years) pregnant women were enrolled from obstetric ward
who were admitted for delivery. Due to 4 perinatal deaths; a total of 72 adolescent mother- baby pairs were included
in this analysis. Anthropometric measurements were undertaken immediately after delivery following stabilization
as well maternal body mass index (BMI) was calculated using standard formula.
RESULTS: The prevalence of low birth weight (LBW) in the present study was 52.8%. The results revealed that
30.6% of mothers were undernourished (BMI<19.8 kg/m2). It was noted that about 64% of undernourished mothers
delivered LBW baby. Linear regression analyses of neonatal weight and length as dependent variables revealed that
in both cases, maternal height had the most significant impact. It showed 12.9% (birth weight) and 16.1% (birth
length) of variation. Moreover, the proportion of LBW was 75%, 52.3% and 25% among short (height ≤145 cm),
average (146-155cm) and tall (>155cm) mothers (x2=6.855, p<0.01), respectively. Short mothers had 2.74 and 9.0
fold greater risk of delivering LBW baby than average and tall mothers. In contrast, mean birth weight and length
of baby was lower in short mother than their counterparts.
CONCLUSION: This study revealed that maternal height had the strongest significant impact on neonate size. This
strong association could have serious health implications for Bengalee adolescent mothers. However, since this is a
preliminary finding, it needs validation using a larger sample of adolescent mothers.

To assess the nutritional status among Kora-Mudi children based on recently developed body mass i... more To assess the nutritional status among Kora-Mudi children based on recently developed body mass index
(BMI) cutoff points for children and adolescents. The study subjects were selected following simple random
sampling method form two villages in Paschim Medinipur District of West Bengal, India. A total of 119 children
(49.6% boys and 50.4% girls) aged 2-13 years were measured and included in the present study. Height and weight
were measured and BMI was computed following standard formula. New age and sex specific international cutoff
points were utilized to assess nutritional status. The overall prevalence of thinness, normal weight and overweight
were 67.2%, 31.9%, and 0.8 %, respectively. There was no significant sex difference of thinness, normal weight and
overweight. However, prevalence of grade-I and grade-III thinness were 1.31 and 1.51 times higher among girls
than the boys. Moreover, the prevalence of grade-II thinness was 2.58 times greater among boys compared to girls.
The nutritional status of these children is not satisfactory. There is much scope for improvement of their nutritional
status. Therefore effective public health policies should be undertaken to combat the child malnutrition in India and
adjoining countries.

Background. Undernutrition among adult tribal women is a major health problem in India. Objectiv... more Background. Undernutrition among adult tribal women
is a major health problem in India.
Objectives. To compare the utility of two different anthropometric indicators of chronic energy deficiency
(CED) among tribal Kora Mudi women and to determine which of these two is a better indicator of undernutrition.
Methods. A cross-sectional study of 123 individuals was conducted. The body mass index (BMI) and mid-upper-arm circumference (MUAC) were used to evaluate CED.
Results. The prevalence of CED based on BMI less than 18.5 was 55.3%, and the prevalence of CED based on MUAC less than 22.0 cm was 51.2%. Both of these prevalence rates are classified in the very high-prevalence category (≥ 40%) and indicate a critical situation according to World Health Organization recommendations.
Mean BMI increased significantly with higher quartile of
MUAC. There was a significant difference in the prevalence
of CED between the MUAC quartiles. The risk ratio
for CED for women in the lowest quartile of MUAC was
9.33 compared with those in the highest quartile. There
was a significant positive association between MUAC
and BMI. Regression analysis demonstrated that MUAC
had a significant positive impact on BMI; the percentage
of the variation in BMI explained by MUAC was 52%.
Logistic regression analysis demonstrated that overall,
82.11% of cases of CED were correctly classified with
the use of MUAC. The use of MUAC correctly diagnosed
82.35% of cases of CED and 81.82% of women with
normal nutritional status.
Conclusions. This population was facing severe nutritional
stress. With limited resources and in the absence of skilled manpower, it may be more appropriate to use
MUAC for human population surveys, particularly
among tribal populations of developing countries.

Introduction: To assess the overall nutritional status of Santal tribal preschool children of Pa... more Introduction:
To assess the overall nutritional status of Santal tribal preschool children of Paschim Medinipur district, West Bengal, India.
Methods and Materials:
A cross sectional study was conducted from February 2012 to September, 2012 of a Santal community in the rural area of Paschim Medinipur district, West Bengal. The study children were selected multi stage cluster sampling method. The level of underweight, stunting and wasting was assessed using standard deviation (SD) classification as against National Center for Health Statistics (NCHS) reference standards.
Results:
This study comprises of 299 (boys=153, girls=146) Santal preschool children age between 0-5 years to assess the prevalence of underweight, stunting and wasting. The overall prevalence of underweight was 65.2%, out of, 54.2% and 11.0% children are found to be moderate and severe underweight. It is found that the severe underweight was significantly higher among girls than boys (15.1% vs 7.2%, p<0.05). The girls had 2.3 fold greater risk of being severely underweight. Overall the prevalence of stunting was 54.2%. Among them, 31.4% and 22.7% children were experiencing moderate and severe
stunting. Moreover, the overall prevalence of wasting was 20.1%, out of, 17.4% and 2.7% children were found to be moderate and severe wasting.
Conclusion:
According to World Health Organization (WHO) classification for assessing severity of malnutrition, this study found very high rates of malnutrition in the form of underweight, stunting and wasting, indicating a critical situation. Therefore, respective authority should be undertaken an effective public health strategy to combat child malnutrition among socio-economically vulnerable communities in India and adjoining countries.

Introduction Malnutrition among tribal preschool children is highly prevalent in almost all stat... more Introduction
Malnutrition among tribal preschool children is highly prevalent in almost all states of India and is the predisposing factor for morbidity as well as mortality. Aim of the study was to detect
prevalence of malnutrition and their associated factors.
Materials and Methods
This cross-sectional study on 141 children aged 1-5 years , of Lodha tribal were included in the present study. Data was collected in pre-structured questionnaire, which included household sociodemographic data, morbidity status of child and anthropometric measurements like height, weight.
Statistical analyses were undertaken using MedCalc statistical software.
Results
The overall prevalence of malnutrition in the form of underweight, stunting, wasting and overweight was 40.4%, 29.8%, 34.0%, 5.0%, respectively. According to the WHO classification of severity of malnutrition, the overall prevalence of underweight and wasting was very high, indicating a critical situation. The reported morbidity was 20.6% and majority of children suffered from diarrhoea (7.8%). The results revealed that morbidity status, number of sibling, mother literacy status had significant association on underweight more importantly( P<0.05(; rate of underweight was significantly higher among children who had reported morbidity, no of sibs 3 and
above and or illiterate mothers. They had 3.7, 2.15 and 2.81 times greater risk of beinmes greater chance of developing wasting.
Conclusion
The Lodha pre-school children were suffering from nutritional stress which was associated with reported morbidity, mother’s lack of education and high number of siblings.

Aim To report the anthropometric characteristics and nutritionalstatusofadultmaleLodhaandBhumij,t... more Aim To report the anthropometric characteristics and nutritionalstatusofadultmaleLodhaandBhumij,twotribesofthe
Paschim Medinipur District, West Bengal.
Subjects and Methods Atotalof157Lodhaand161Bhumij
adult (>18 years) men from four villages located near
Kharagpur towninPaschim Medinipur District, West Bengal
was investigated. Height and weight were recorded and the
body mass index (BMI) computed using the standard
equation. Nutritional status was evaluated using internationally
accepted BMI guidelines. The public health problem of
low BMI inthese populations was classifiedaccording to the
World Health Organization criteria.
Results Lodha males had significantly higher mean height
(p<0.01),weight(p<0.001)andBMI(p<0.01)comparedwith
Bhumijs. Both Lodha (45.2%) as well as Bhumij (48.4%)
males had similar high rates of chronic energy deficiency
CED. According to the WHO classification of the public
healthproblemoflowBMI,theprevalenceofCEDwasvery
high (≥40%) in both these groups, indicating a serious
situation.
Conclusion Since the nutritional status of these two populations
was unsatisfactory, immediate public health programs
should be initiated toreduce the prevalence of CED.

Background: Nutritional status of tribal children in West Bengal has not been investigated ade... more Background: Nutritional status of tribal children in
West Bengal has not been investigated adequately. The
present study was undertaken to determine the prevalence
of underweight, stunting and wasting in Kora-Mudi
children of Paschim Medinipur, West Bengal, India.
Methods: A cross sectional study was undertaken in
two villages of the Paschim Medinipur District. Of 119
children aged 2-13 years, 59 boys and 60 girls were studied.
Height and weight measurements were made by standard
techniques. Children were considered as underweight,
stunting and wasting if their weight-for-age, height-for-age
and weight-for-height Z-scores <-2.0 SD of the National
Center for Health Statistics reference standards.
Results: The overall prevalence of underweight,
stunting and wasting was 52.9%, 49.6% and 22.7%,
respectively. About 16.0%, 24.4% and 1.7% of children
were found to be severely underweight, stunted and
wasted. The prevalence of underweight, stunting and
wasting was higher in preschool children than in school
going children. The chance of underweight, stunting and
wasting was 1.80, 1.10 and 1.58 times greater in preschool
children than in school going children. Moreover, the
prevalence of underweight, stunting and wasting was
higher in boys than in girls. The boys had 1.45, 1.66 and
2.02 times greater risk to be underweight, stunted and
wasted. According to the WHO classification of severity
in malnutrition, the overall prevalence of underweight,
stunting and wasting was as high as ≥30%, ≥40 and ≥15%.
Conclusions: The nutritional status of Kora-Mudi
children in West Bengal is critical. Appropriate measures
should be taken by the respective authorities to improve
childhood health and nutritional status.