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Objectives We examined the level of awareness about Rheumatic Heart Disease (RHD) among school-aged children in a rural district of India and evaluated the effects of a questionnaire-based survey in improving the level of awareness. Methods The study involved 8,646 students aged 10–16 years from 20 schools in West Midnapore, India which was conducted in August 2017. We examined changes in the level of awareness of RHD using a 29-point scoring system in seven domains. The baseline questionnaire survey assessed students’ knowledge and was followed by a multimedia presentation about RHD and a post-intervention survey using the same questionnaire. The questionnaire included 9 questions on different aspects of RHD including prevalence, nature of disease, symptoms, determinants, treatment options, impact of the disease and diagnosis. Results The mean age of the study population was 13 years and 46% were boys. At baseline, the mean level of knowledge about RHD was 42% (12.2 out of 29 points). After the school-based presentation, the score improved to a mean of 55% (15.9 points on the 29-point scale), a 31% relative improvement. Improvement in students' knowledge was noted across all seven domains, individually and combined ( p < 0.001). Conclusions Awareness among children in rural India about RHD is modest. A school-based intervention could help in improving awareness about this chronic condition and may promote secondary prophylaxis to reduce the morbidity and mortality from RHD.

Introduction: Intracerebral hemorrhage (ICH), a form of stroke syndrome results from the rupture of an intracerebral vessel leading to the development of a hematoma in the substance of the brain. Incidence rates are particularly high in Asians and Blacks. Attempts are made to prognosticate ICH patients and manage them accordingly. This is particularly important for the socio-economic profile of the patients availing our services. Methods: All together 90 patients of ICH were taken up in this study done in Gauhati Medical College and Hospital during the period from July 2013 to June 2015. Patients were diagnosed on the basis of a thorough medical history, a full neurological examination, standardized blood tests and CT scan of the brain. Prognostication was done on the basis of clinical and radiological findings. Prognosis was assessed as good or bad outcome on the 15th day based on neurological examination. Statistical analysis was done by using the chi-square test, fisher's t-test and student's t-test wherever applicable. Results: In our study 35.55% patients showed bad outcome. Increasing age, low level of consciousness, low GCS score, bilateral limb weakness, high blood pressure, gaze palsies, pupillary abnormalities and CT brain findings of higher volume (>=30 ml) of hematoma, midline shift, intraventricular extension and a high ICH score were associated with bad outcome.

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Background: Rheumatic heart disease (RHD) is prevalent in low income countries, with a regional prevalence in South Asia of 2.2 per 1,000 children aged 10-16 years. Awareness among school children is very important for seeking effective secondary prophylaxis. We studied the current level of awareness in school-aged children and evaluated the effect of a 7-item questionnaire-based survey in improving awareness of RHD. The study was conducted in a rural district of India in August, 2017. The objectives were to assess the level of awareness of RHD and to evaluate the effect of a questionnaire-based survey in improving awareness. Methods: The study involved 8,646 students in the age group 10-16 years from 20 schools in Midnapore, India. We carried out a pre-test questionnaire survey, a multimedia presentation on RHD, and a post-test survey that assessed students’ knowledge and awareness of its incidence and prevalence, symptoms and signs, morbidity and mortality, ways to prevent and/or reduce the disease burden, and when to seek medical attention. The data were analyzed to evaluate improvement in the level of awareness by this intervention using a 29-point scoring system in 7 domains. Regression analysis was performed to identify the factors that may enhance awareness. Results: Awareness among the school children (mean age 13, 45% boys) was modest. There was a significant improvement in their knowledge after the intervention with the survey questionnaire and the presentation by the study team (Table). Regression analysis showed female sex and higher grade in school were major determinants for improvement of the knowledge level by this intervention (p < 0.05 without any significant interaction noted between sex and grades in school). Conclusions: Current awareness among children about RHD is modest. A school-based intervention by administration of a survey questionnaire and presentation can help in improving the awareness about RHD and hopefully promote secondary prophylaxis to reduce the morbidity and mortality from the disease.