Murshidabad Medical College and Hospital

Inguinal hernia is rare in females, and involvement of ovaries or Müllerian structures is exceptionally uncommon. Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome presents with congenital absence of the uterus and upper vagina despite normal ovarian development, and may coexist with renal or skeletal defects. We describe a rare Type-2 MRKH case presenting with bilateral inguinal hernias containing ovaries, identified unexpectedly during surgery for a presumed right inguinal hernia. Laparoscopic transabdominal preperitoneal repair was completed successfully while preserving both ovaries. The case underscores the need for careful assessment of inguinal swellings in females and supports the diagnostic and therapeutic value of laparoscopy in atypical hernia presentations.

Diphtheria is a vaccine-preventable disease that remains endemic in several developing countries. Neurological complications, such as polyneuropathy, are rare but serious, often mimicking other neuromuscular disorders and leading to delayed diagnosis. Herein, we report the case of a 20-year-old incompletely immunised woman who presented with bilateral ptosis, multiple cranial neuropathies, and mild limb weakness following a prodrome of fever, headache, and peri-orbital pain. Initial investigations revealed albumin-cytologic dissociation in the cerebrospinal fluid, raising suspicion of Guillain-Barré syndrome, for which intravenous immunoglobulin was administered; however, there was no clinical improvement. Myasthenia gravis and botulism were also considered but excluded based on clinical and laboratory findings. Throat swab culture indicated the presence of Corynebacterium diphtheriae, confirming the diagnosis of diphtheritic polyneuropathy. The patient was treated with diphtheria antitoxin and erythromycin, resulting in an improvement of bulbar symptoms; nonetheless, ptosis persisted at discharge. Prophylaxis was provided to close contacts, and the patient was scheduled for diphtheria vaccination. This case highlights the significance of considering diphtheria in the differential diagnosis of acute cranial neuropathies in endemic regions and the role of vaccination in preventing such life-threatening complications.

Background and objectives: The survival rate of premature low-birth-weight newborns is increasing globally as a result of the swiftly growing number of neonatal intensive care units with cutting-edge infrastructure. The preterm low-birth-weight babies face several complications. One notable complication is retinopathy of prematurity (ROP), which can lead to blindness and visual impairment. It is the outcome of the interplay of multiple risk factors. However, there is a dearth of information regarding the exact magnitude of ROP and the identification of risk factors, especially in lower- and middle-income nations like India. Therefore, the purpose of this study is to identify risk variables among enrolled newborns and to estimate the incidence of ROP. Methods: This hospital-based prospective observational study included 179 newborns who met the inclusion criteria over 1.5 years. All research participants were screened at the District Early Intervention Centre by an authorised ophthalmologist. The enrolled neonates' data, including ROP reports, were entered into the pre-made proforma and analysed with SPSS-22 software. Results: Of the neonates who were enrolled, 55.3% were boys, and the remaining 44.7% were girls; the incidence of ROP was 11.17%. The multivariate logistic regression model determined the independent risk factors for ROP to be blood transfusion (AOR: 14.93, 95% CI: 3.16-70.47, P value = 0.0006), ionotropic use (AOR: 4.89, 95% CI: 1.29-18.6, P value = 0.0199), and apnoea of prematurity (AOR: 7.93, 95% CI: 1.54-40.8, P value = 0.0132). Conclusion: We found that, in addition to well-known risk factors, including oxygen therapy and a preterm low birth weight baby, apnoea of prematurity, ionotropic usage, and blood transfusions were independent risk factors for ROP. Hence, these risk variables are to be addressed meticulously at all levels of newborn care facilities.

Objective: To explore perceptions and behavioural intentions towards dengue preventive practices (DPP) using the Health Belief Model (HBM) among slum dwellers in Berhampore Municipality, Murshidabad of India. Methods: Our study, conducted in two selected slums of Berhampore between January and March 2024, explored varied perceptions and intentions in respect to six theoretical constructs: Perceived severity, perceived susceptibility, perceived benefit and barriers, cues to action and self-efficacy with a phenomenological approach. The study participants were purposively selected adult slum dwellers (≥18 years), representing certain socio-demographic characteristics (age, sex, occupation etc). After obtaining informed consent, each participant was interviewed with a priorly-framed in-depth interview guide based on six theoretical constructs of HBM. All in-depth interviews were also audio-taped. With 20 such interviews data saturation was reached, and content and thematic analysis was applied for presenting and interpreting the findings. Results: Despite favorable perceptions of severity and benefits, the intention of those slum dwellers to adopt DPP remains below the desired level, with low perceived susceptibility to dengue, certain perceived barriers, and misconceptions likely being the reasons. Conclusions: The nature and pattern of DPP among slum dwellers, along with prevailing perceptions and barriers, indicate that though participants were aware of dengue's severity and the benefits of prevention, they still remained unsure about taking necessary actions. This signifies the need to strengthen targeted interventions and apply participatory learning for action techniques.

Introduction: Dyspnoea is one of the most common presenting complaints in the Respiratory Intensive Care Unit (RICU). It reflects a wide spectrum of underlying pulmonary conditions with varying severity and outcomes. Early identification of clinical and laboratory predictors can aid in risk stratification and management planning in critically ill patients. Aim: To evaluate the demographic and clinical profiles, initial Arterial Blood Gas (ABG) findings, and factors associated with short-term outcomes in patients with pulmonary-origin dyspnoea admitted to the RICU. Materials and Methods: A prospective observational study with follow-up until ICU discharge was conducted in the RICU of the College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India from December 2023 to 2024. A total of 76 patients presenting with dyspnoea of pulmonary origin were enrolled. Demographic parameters, presenting symptoms, primary diagnosis, microbiological findings, co-morbidities, neurological status, initial ABG parameters, oxygen or ventilatory support, and outcomes were recorded. Patients with non pulmonary causes of dyspnoea were excluded. Data were analysed using Statistical Package for the Social Sciences (SPSS) statistical software (Version 26.0), employing appropriate statistical methods. A p-value <0.05 was considered as statistically significant. Results: Of the 76 patients included, 67.1% were male, with a mean age of 59.5±11.74 years. Hypertension and diabetes mellitus were the most common co-morbidities, and obstructive airway disease was the predominant diagnosis (55.3%). Non survivors were significantly older (p-value=0.041) and more likely to have altered sensorium {Richmond Agitation Sedation Scale (RASS) < +1; p-value <0.0001}, Acinetobacter baumannii infection (p-value <0.0001), metabolic and mixed acidosis (p-value <0.0001), initial arterial pH ≤7.20 (p-value=0.044), septic shock (p-value <0.0001), Acute Respiratory Distress Syndrome (ARDS) (p-value=0.001), ventilator-associated pneumonia (p-value=0.001), and massive haemoptysis (p-value=0.008). The requirement for Invasive Mechanical Ventilation (IMV) was the strongest predictor of mortality (p-value <0.0001). On bivariate logistic regression analysis, age {Odds Ratio (OR) 1.07, p-value=0.007), RASS < +1 (OR 7.29, p-value <0.0001}, Acinetobacter baumannii infection (OR 30.00, p-value=0.002), metabolic acidosis (OR 7.13, p-value <0.0001), and mechanical ventilation (OR 304.5, p-value <0.0001) were significantly associated with mortality. On multivariate analysis, metabolic acidosis (OR 6.67, p-value=0.005), mechanical ventilation (OR 68.47, p-value <0.0001), and RICU stay <6 days or >12 days (OR 1.18, p-value=0.015) independently predicted poor outcomes. Conclusion: Older age, lower RASS scores, gram-negative infection, severe acidosis, and the need for invasive mechanical ventilation were associated with increased mortality. Early identification of these adverse prognostic markers and timely intervention may improve outcomes in RICU patients presenting with dyspnoea of pulmonary origin.