A survey on insight of blood donors during COVID pandemic in Southern India

ABSTRACT Introduction: Knowledge, Attitude and Practices (KAP) surveys prove beneficial to the transfusion services by providing an insight into the donors and, thus, aiding in mobilizing and retaining voluntary blood donors. We aim to study the knowledge, attitude and practices of donors towards blood donation in a pandemic setting. Methods: A cross-sectional observational study to assess the knowledge, attitude and practices of blood donors was conducted between June to and October 2020. Non-parametric tests (Mann - Whitney U and Kruskal - Wallis) were performed to evaluate the relation of knowledge, attitude and practices overall scores with age group, gender and history of blood donations (first us. repeat). The Chi-Square test/Fisher's Exact test was used to evaluate the differences in the distribution of Knowledge, Attitude and Practices items within the groups. Results: A total of 403 of 2,748 individuals who came for whole blood donation participated in the study. The mean age of the study population was 31.1years (SD ± 8.4 range: 18 - 58), with 75% of the donors donating for the first time. The fear of acquiring COVID-19 infection was perceived as a major reason for the eligible population not to donate. The overall knowledge, attitude and practice score among the donors was satisfactory, being 76.14%, with a significant association with age. The overall positive attitude and practices scores of blood donors were 85.48% and 78.04%, respectively. Conclusion: The KAP scores were satisfactory among the donors. Timely communication of the precautionary measures at blood centers to contain the spread of the COVID-19 infection and effective counseling would help in motivating and retaining blood donors.

Phacoemulsification, pinhole pupilloplasty, and pre-Descemet抯 endothelial keratoplasty for keratoconus with Fuchs� endothelial dystrophy

The comorbidity of keratoconus with Fuchs� endothelial dystrophy with cataract is a rare clinical combination. We present an amalgamation of surgical techniques to manage the above clinical conditions and its complications in single setting. The modified triple procedure, namely, the phacoemulsification, pinhole pupilloplasty, and pre-Descemet抯 endothelial keratoplasty (PDEK) in the order of description is followed in single sitting. Lens removal by phacoemulsification, correction of irregular astigmatism by pinhole pupilloplasty (pinhole optics), and exchanging the endothelial layer for PDEK forms the main segments of the triple procedure. This combination of techniques may decrease the risk of multiple surgeries and its related complications. Moreover, it will allow the patient for faster visual rehabilitation by improving the uncorrected visual acuity and visual quality.

Effect of Aging and Thermocycling on Flexural Strength of PEEK as a Provisional Restoration for Full Mouth Rehabilitation – An In vitro Study

Introduction: To compare the flexural strength of autopolymerizing poly methyl methacrylate resins (PMMA) resin, CAD/CAM milled PMMA and CAD/CAM milled poly ether ether ketone (PEEK) when used as provisional restorative materials for long span situations in full mouth rehabilitation after aging and thermocycling. Materials and Methods: Sixty samples (25 mm × 2 mm × 2 mm) were fabricated using autopolymerizing PMMA resin (GROUP I), CAD/CAM milled PMMA (GROUP II) and PEEK (GROUP III). The groups were subdivided into A and B and subjected to 7 days of aging and 500 cycles of thermocycling (subgroup A) and 14 days of aging and 1000 cycles of thermocycling (subgroup B), respectively, and flexural strength was evaluated using a three?point bend test. The data were analyzed with student t test and pair?wise comparison of mean values was done by ANOVA. Results: The flexural strength of PEEK subjected to 7 days of aging and 500 cycles of thermocycling (III (A) ? 6628.70 MPa) was the highest among all groups followed by PEEK subjected to 14 days of aging and 1000 cycles of thermocycling (III (B) ? 3760.50 MPa). Conclusion: The mean flexural strength of PEEK was statistically significant than the other two materials tested and hence can be recommended for use as a provisional restorative material for long span situations in full mouth rehabilitation. However, the mean flexural strength of PEEK reduced approximately by 44% when subjected to further aging

Hypersonic vitrectomy in intraoperative posterior capsular rupture with retained nuclear fragments

In our report, we present the hypersonic vitrectomy (Vitesse, Bausch and Lomb) being employed for anterior vitreous liquefaction and removal in posterior capsular rupture. The capsular tear with nucleus drop during conventional phacoemulsification was managed by vitrectomy using the hypersonic vitrector after posterior-assisted levitation followed by intraocular lens (IOL) implantation. The minimal cortical and epinuclear lens particles in the anterior chamber and vitreous were also liquefied with a stoke length of 30 to 40 ?m and aspirated via the Vitesse vitrectomy system. The same probe performs the vitrectomy and the nucleus removal. The postoperative period was uneventful with clear cornea, normal fundus, and 20/20 best-corrected visual acuity (BCVA). The hypersonic vitrectomy utilizes the ultrasound power of 29.5 kHz and a stoke length of 0 to 60 ?m for liquefaction of the vitreous. It can be a safe alternative for vitrectomy and lens removal in a single setting.

Erythropoietin as a treatment option for indirect traumatic optic neuropathy: A pilot study

Purpose: Our study aims to evaluate the effectiveness of intravenous erythropoietin (EPO) in patients with indirect traumatic optic neuropathy (TON), assess the side effects, and compare the visual function results among three groups of patients who had received different treatment options – EPO, steroids, and observation. Methods: Patients with indirect TON presenting to the neuro?ophthalmology clinic from August 2019 to March 2020, were assigned to three groups, with six patients in each group. In group 1, patients were recruited prospectively and received recombinant human erythropoietin, whereas, in groups 2 and 3, patients were recruited retrospectively and received intravenous methylprednisolone followed by oral steroids and multivitamins, respectively. Groups 1 and 2 included patients presenting within 2 weeks of trauma, whereas group 3 included those presenting beyond that. Best?corrected visual acuity, pupillary reaction, color vision, and visual fields following treatment were measured. Results: Initial visual acuity in the EPO group ranged from 20/80 to no perception of light (No PL). The mean initial BCVA (1.82 logMAR, standard deviation [SD] = 0.847) improved to 1.32, SD = 0.93 logMAR after treatment recorded at the third month (P = 0.0375), with no significant adverse effects. The initial BCVA of group 2 ranged from 20/120 to No PL. The mean initial BCVA (1.95, SD = 0.77 logMAR) improved to 1.45 logMAR, SD = 0.97 after treatment (P = 0.0435) but three patients had side effects of steroids. Initial visual acuity in Group 3 ranged from 20/40 to no PL. The mean initial BCVA (1.09 logMAR, SD = 1.10) worsened to 1.19 logMAR, SD = 1.06 after treatment after treatment (P = 0.0193). The improvement in BCVA when compared between the three groups was not significant. Conclusion: Both erythropoietin and steroids are effective in the management of traumatic optic neuropathy. However, erythropoietin shows lesser or no side effects when compared to steroids

Career Preferences Among Final Year Medical Students and Interns: A Cross Sectional Study

Introduction: The increase in the number of undergraduate medical seats in India, suggests the need for faculties trained in specialist fields to ensure adequate education at the university level. Career selection is considered an important aspect of medical course admission and some career options are often overlooked by students. An insight into factors affecting the decision making could aid preparing workforce to prevent the over or under supply of doctors in various specialties. Aim: To determine the career preferences among final year medical students and interns in a private medical college in Tamilnadu, India. Materials and Methods: A cross sectional survey was conducted among final year part two MBBS students and CRRI’s who were going to complete their internship in three months, by a pre validated questionnaire consisting of two sections, the first section consisting of demographic details and the second section consisting of fixed response questions about their career choices. A sample of 100 final year students and 140 CRRI’s participated in this study. The primary data is analysed with SPSS software, and chi square test was done. Results: Female students mostly preferred General medicine, Obstetrics & gynaecology and Paediatrics, while male students preferred General medicine, Paediatrics, General Surgery and Radiology. Among the students who participated in the study, 20.4% have not decided which speciality to pursue. Conclusion: The medical students career options in our medical college was in favour of a few departments.

Apoplexy in pregnancy

Headache during pregnancy is a common complaint in the emergency room. In pregnancy, pituitary disorders include both hormone active and hormone inactive tumors. Apoplexy may be the first clinical presentation of an underlying pituitary tumor. Red flag signs of presenting symptoms, to be assessed for identifying life-threatening etiology. Various pathophysiological mechanisms have been passed for pituitary apoplexy in pregnancy. Magnetic resonance imaging of the brain is the gold standard investigation. The mainstay of management is the initiation of steroids. Transnasal transsphenoidal removal of the tumor is the definitive treatment that requires a multidisciplinary approach. The indications of surgery are the presence of symptoms due to compression and endocrine abnormalities; however, gestational period should be taken into consideration. We report a case of headache in antenatal women who presented to our emergency room diagnosed with pituitary apoplexy managed with steroids and early surgery, and discharged with good clinical outcome. We recommend a methodical approach to common symptoms that assist in diagnosing forgotten etiology.

Semilunar sign of cornea: A multimodal analysis of the posterior corneal opacity in non-infectious anterior scleritis

Purpose: To analyze the morphological outcomes of the posterior corneal opacity or 搒emilunar sign� in noninfectious anterior scleritis using multimodal imaging. Methods: This was a prospective observational case series. Patients with anterior scleritis from January 2018 to January 2019 were included. Clinical and demographic data were collected. Posterior cornea was visualized using the digital slit lamp photography (Elite, mega digital vision), spectral domain optical coherence tomography (MS39), and specular count analyzer (EM?3000). 揝emilunar sign� was defined by the (1) presence of posterior corneal opacity, (2) concave semilunar pattern, (3) absence of blood vessels, and (4) normal anterior cornea. Incidence, clinical characteristics and significance, correlation with Mantoux sensitivity, and role of multimodal valuation were assessed. Results: Overall 76 eyes of 72 patients were recruited with anterior scleritis. Fifteen eyes of 11 patients (15.3%) presented with semilunar sign. The scleritis was both nonnecrotizing (n = 8) and necrotizing (n = 7). The semilunar configuration appeared as isolated (n = 9) and continuous lesion (n = 6). The extent was directly related to the scleral disease extent (P = 0.002). The mean thickness measured 212.5 � 129.3 ?m. The mean central endothelial cell density (ECD) was 2540.8 � 351.7 cells/mm2, which was significantly higher than the involved peripheral cornea (P = 0.05). The mean surface area of the semilunar sign was 7.7 � 5.2 mm2. There was no significant correlation between the opacity thickness and the best?corrected visual acuity (P = 0.895, r = ?0.39), ECD (P = 0.52, r = ?0.188), and Mantoux (P = 0.696, r =? 0.142). Conclusion: Corneal semilunar sign of scleritis affected the peripheral cornea and caused no functional abnormality in early presentation. Multimodal analysis can aid in clinical assessment and severity.

Outcome of audit and education on blood transfusion practice in obstetrics setting

Abstract Introduction Audit and education are essential pre-requisites in the review and update of blood transfusion practices. Although standard guidelines on appropriate utilization of blood components exists, erroneous use of blood components with no justification still continues. This study evaluates appropriateness of blood transfusion in obstetric settings and identifies key areas requiring educational intervention to improve blood transfusion practice toward the evidence-based at our hospital. Method This was a prospective observational study on the analysis of blood transfusion requisition forms for obstetric patients before and after educational intervention, performed in two Phases from September 2011 to August 2012 and October 2012 to September 2013. The appropriateness of blood utilization was assessed against the Royal College of Obstetricians and Gynecologists Guidelines for blood transfusion and Green-Top Guideline no. 47. Data required for the study were obtained from department records and statistical analysis was performed using the SPSS, version 20 (IBM, USA). Results The total transfusion episodes were 214 in 51 patients and 181 in 43 patients in Phases 1 and 2, respectively. Fresh frozen plasma was the most misused blood component, next to whole blood in Phase 1. However, appropriate utilization of components, including cryoprecipitate (6.6%), reduction in whole blood (34.5-14.4%) and single unit transfusion (23.3-18.2%) were observed in Phase 2. Inappropriate use of blood components, namely, packed red blood cells and fresh frozen plasma dropped significantly (p < 0.05) from 29.7% to 13.1% and 45.1% to 22.5%, respectively, with the exclusion of platelet concentrate (33.3-20.6%, p-value 0.414). Conclusion Audit and targeted education helped in optimizing transfusion practices in the obstetric setting.

Intraocular lens power calculation changes before and after isotonic collagen cross-linking in keratoconus patients

Purpose: To find the intraocular lens (IOL) power calculation changes before and after isotonic collagen cross?linking (CXL) in keratoconus patients. Methods: Thirty?five eyes of 25 patients who underwent isotonic CXL were included. The cases included conventional CXL (n = 16), accelerated CXL (n = 7), contact lens?assisted CXL (CACXL) (n = 9), accelerated CACXL (n = 3). All underwent ocular biometry (IOL master), corneal topography (Orbscan II), and simulated keratometry (Orbscan II) preoperatively and 1?year post CXL. Change in best?corrected visual acuity (BCVA), axial length (AL), simulated keratometry (Sim K), anterior chamber depth (ACD), and IOL power were analyzed in the overall data and then grouped based on flattening (Group A) and no flattening (Group B) of Sim K value post CXL procedure. Results: For the overall data, there was no significant change in IOL power (P = 0.05) at the end of 1 year, BCVA showed a significant increase (P < 0.01), and Sim K reading showed a statistically significant flattening (P = 0.001); ACD and AL showed insignificant change. In intergroup comparison, there was no statistically significant change in IOL power. However, in Group A, a significant change in BCVA and Sim K values was observed. In both groups (Group A and Group B), IOL power was found to be negatively correlated with AL and Sim K values. Conclusion: Isotonic CXL did not affect IOL power calculation at the end of 1 year. However, significant change in BCVA and sim K reading was noted

COVID-19 pandemic and blood transfusion services: The impact, response and preparedness experience of a tertiary care blood center in southern Karnataka, India

Abstract Introduction With the outbreak of COVID-19 and its containment measures, blood centers faced a huge challenge in balancing blood demand and supply and devising a preparedness plan to withstand the uncertain situation. This study assesses the effect of the COVID-19 pandemic on blood transfusion services and discusses the appropriate mitigation strategies adopted. Methods We analyzed our center's blood transfusion services during the first half-period of the pandemic (Y3) and non-pandemic years 2018(Y1) and 2019(Y2) in two-quarters Q1 (pre-lockdown), from January to March and Q2 (post-lockdown), from April to June. The blood donation variables, the packed red blood cells (PRBCs) demand and the utilization pattern were compared between pandemic (Y3) and non-pandemic years (Y1 and Y2) in each quarter. The mitigation strategy adopted at every step of the transfusion service is highlighted. Results During post-lockdown (Q2) of the pandemic year (Y3), the blood donation was majorly by repeat donors (83%) from the in-house site (82.5%). Furthermore, the proportion of outdoor donation, deferral, blood collection, demand and issue demonstrated a significant drop of 50%, 32.6%, 33%, 31.8% and 32.3%, respectively, in comparison to Q2 of the non-pandemic years (Y1 and Y2), with a statistically significant difference for surgical and hemorrhagic indications (p < 0.05). Coping strategies, such as blood donor education and motivation using e-platforms emphasizing eligibility during the pandemic, staggering of donor in-flow, postponement of elective surgeries and donor and staff' COVID-19 safety assurance, were followed. Conclusion The timely adoption of coping strategies played a crucial role in the better handling of shortcomings at our center's blood transfusion services caused by the COVID-19 pandemic.

Drug - Drug Interactions among Chronic Kidney Disease patients in a tertiary hospital.

Background: Drug interaction (more precisely ‘drug-drug interaction’) refers to modifying the action of one drug by another when administered simultaneously or in quick succession. Chronic Kidney Disease (CKD) patients often require polypharmacy, which puts them at the risk of the developing Drug - Drug Interactions (DDIs) and various adverse reactions. Not all patients taking interacting drugs experience adverse consequences, but it is advisable to take due precautions to avoid mishaps in all cases where interactions are possible. Hence, this study was undertaken to identify the DDIs among the drugs prescribed to CKD patients. Materials and methods: A Cross-sectional study was conducted in the Department of Nephrology. A total of 80 patients with CKD were included. Patients with CKD with other comorbid conditions, CKD patients of either sex above the age group of 18 years were included. LEXICOMP drug interaction software was used for potential DDI (pDDI) identification. Results: Patients mean age was 47.24±14.37 years with male predominance of 72.5 %. A total of 604 drugs were prescribed with a mean of 7.55 ± 2.73. The most common medications prescribed was Amlodipine (6.3%). DDIs were identified in 74 patients. 46 showed 1 to 5 pDDIs, 22 patients showed 6 to 10 p DDIs, 4 patients showed 11 - 15 DDIs, and 2 patients showed 16 to 20 pDDIs. According to the Lexicomp severity classification, 270 were Type C, 57 were Type D & 55 were Type B. Conclusion: The recognition of potential DDI and key combinations of drugs avoids treatment failure situations or minimizes drug toxicity .

Fostemsavir, a Drug with Novel Mechanism for the Treatment of HIV-1 Infection

HIV is a global problem with increased mortality and morbidity. The highly active antiretroviral therapy is effective in reducing the HIV RNA and improving the immune response. The drugs in the current regimen have certain disadvantages such as adverse effects, drug intolerance, and drug resistance. Since there is a demand for identifying the drugs with new mechanism of action, the compounds which target the viral gp120 receptor were screened and the most suitable drug among them was identified. In a Phase II and Phase III trial, the drug BMS-663068 fostemsavir was found to be efficacious in reducing the viral RNA levels. The drug is a prodrug that gets converted into metabolite temsavir BMS-626529. The preferred dose is 600 mg orally 12 hourly in patients who had undergone many treatment schedules with multidrug-resistant infection and those who cannot tolerate the drug regimen due to resistance and safety issues. The drug is metabolized by CYP3A4 and has drug interactions with CYP3A4 inducers and inhibitors. This review mainly comprises the mechanism of action, clinical trials, pharmacological properties, and adverse effects of the drug fostemsavir.

Lumpy Bumpy Weepy Face - A Rare Case Report of a Frequently Misdiagnosed Disease

.Infectious clinical conditions that can present with swellings and sinuses more commonly, include cutaneous tuberculosis, and subcutaneous and deep fungal infections. One of the differentials that should be considered in such a scenario is actinomycosis. Actinomyces are filamentous gram-positive bacteria that are facultative anaerobes which can form endospores. The individual bacterium is rod shaped filamentous organism. After its discovery in 1890, a misconception was that it is a mycosis that affected individuals who chewed grass or straw. The pathogen is still known as the ‘great masquerader’.1Many entities can mimic cutaneous mycobacterial infections and deep cutaneous mycosis. One such great mimicker is actinomycosis – a bacterial infection caused by Actinomyces israelii. Though it is sensitive to many antibiotics, the duration of treatment for effective clearance of the lesions is long.

Labour analgesia and obstetric outcome in heart disease complicating pregnancy in tertiary care center

Background: One of the most severe pain experienced by a woman is during child birth. It is imperative to understand the pain transmission for providing labour analgesia. Hemodynamic status in labour fluctuates greatly during uterine contraction and true labour pains. Therefore, pregnant women with cardiovascular disease need epidural anaesthesia during labour depending upon the type of cardiovascular disease. Objective of this study was to assess the impact of labour analgesia and the obstetric outcome and cardiac events during labour.Methods: This is an observational study conducted in 46 pregnant women with cardiovascular disease during the period of January 2019 to December 2019 (12 months).Results: A total of 46 antenatal mother with cardiovascular disease was admitted in the department of obstetrics and gynecology over a period of one year out of which 25 patients who had epidural analgesia during labour and 21 patients who had no epidural analgesia during labour. Cardiovascular events significantly reduced in epidural group (25 patients) and there was no increase in cesarean section in epidural group.Conclusions: The data showed there was significant decrease in cardiovascular events related to arrhythmia hence decreased maternal morbidity and mortality. There was no associated increase in cesarean section rate but slight increase in instrumental vaginal delivery.

Anti-IH: An Innocuous Antibody Complicating Pre-Transfusion Testing

@#The positive antibody screen during pre-transfusion testing helps in the detection of clinically significant antibodies. However, sometimes clinically insignificant antibodies might perplex the serologic workup and can cause a delay in transfusion. Prompt recognition and timely resolution of these discrepancies in pre-transfusion testing, although time-consuming, is essential for the provision of safe blood to recipients. We report a case with an anti-IH antibody complicating the serological workup of pre-transfusion testing and an approach for its resolution and management. The role of transfusion medicine specialists in the characterization of antibodies and the selection of appropriate blood is paramount or warranted to promote safe transfusion practices.

Cytological intracellular glycogen evaluation using PAS and PAS-D stains to correlate plasma glucose in diabetics

Background: Oral cytology studies have claimed that cytoplasmic Periodic Acid Schiff (PAS) positivity in type-2 diabetics is due to glycogen content. But, it can also be due to mucin and glycoconjugates. Aim: 1. To confirm that cytoplasmic PAS positivity in type-2 diabetics is due to glycogen using diastase. 2. To know the effect of diabetes by determining the number of glycogen-containing cells in the smear. 3. To assess the impact of duration of diabetes based on PAS staining of cells. 4. To correlate between random blood glucose level and the number of PAS-positive cells. Materials and Methods: Study population comprised 45 individuals with 30 type-2 diabetics as case group (Group I < 5 years duration; Group II > 5 years duration) and 15 healthy volunteers (age and gender-matched) as control. For all subjects, random blood glucose was estimated and two cytosmears were obtained. The smears were stained with PAS and PAS-diastase stains (PAS-D). Staining intensity was documented as score 1 (mild-to-moderate) and score 2 (moderate-to-intense) and data obtained were statistically analyzed in SPSS version 16.0. Results: Mann-Whitney U test revealed that in diabetics cytoplasmic PAS positivity is because of glycogen (P < 0.05). There is an increase in the number of glycogen-containing cells (P < 0.05) in diabetics. The duration of diabetes had less impact on intracellular glycogen accumulation (P > 0.05). Spearman's correlation test revealed no significant correlation (P > 0.05) between random blood glucose and a number of PAS-positive cells. Conclusion: PAS positivity is because of intracellular glycogen accumulation in type-2 diabetics. It can convey the glycaemic status of an individual in the recent past, thus a beneficial role in screening and therapeutic monitoring.

Lipid profile abnormalities in newly diagnosed type 2 diabetics: a cross-sectional study

Background: India is fast becoming the diabetes capital of the World. A direct atherogenic effect of triglyceride rich particles has been noted. This study assesses the lipid profile abnormalities in newly diagnosed type 2 diabetes mellitus. Since dyslipidemia is a risk factor for cardiovascular disease, such assessment will enable better recognition, prevention and management of cardiovascular mortality and morbidity.Methods: The study was conducted over a period of one year at a tertiary care hospital in South India. A cross-sectional study of 100 newly diagnosed type 2 diabetics in a rural South-Indian population was done.Results: In our study, 55 (55%) participants had high triglycerides and 45 (45%) had normal triglycerides. Among the 55 participants with abnormal triglycerides, 34% had borderline high levels (150-199mg/dl), 18% had high levels (200-499 mg/dl) and 3% participants had very high triglycerides (≥500 mg/dl). 26% male and 29% female participants had above normal triglyceride levels. In our study, 25% had borderline high cholesterol levels and 5% had high total Cholesterol. 39% of participants had near optimal levels of LDL, 19% had borderline high levels of LDL, 7% had high levels of LDL and 4% had very high levels of LDL. Significantly higher levels of triglycerides and LDL were noted.Conclusions: Deranged lipid profiles are quite prevalent in type 2 diabetics with females having higher triglyceride levels. Recognition of such elevated triglyceride levels in even newly diagnosed type 2 diabetics will help in better prevention of associated cardiovascular disease.

Challenges faced by the patients in the management of risk factors of non-communicable diseases in a government primary health care setting of Puducherry

Background: India’s current approach for intervention in non-communicable diseases (NCDs) is more in terms of early diagnosis and treatment. The focus should also be on the management of risk factors in the diseased individuals. The objectives of the study are to measure the risk factors of NCDs, lifestyle modification followed by them and to assess the challenges in reducing the risk factors of NCDs faced by the study population.Methods: The study was conducted between March and June 2017 in 2 government primary health centres (PHCs) in Puducherry. Based on systematic random sampling, 200 patients enrolled in NCD clinic with diabetes mellitus, hypertension, Stroke and myocardial infarction were selected for the study. After obtaining written informed consent, data was collected.Results: Out of 200 participants, majority of them were in the age group of 51-70 years (60%), females (71%) and living in nuclear family (83%). Among 200 participants, 23.5% of them had diabetes mellitus, 42% had hypertension and 24% had diabetes with hypertension. The risk factors that many of the participants had were excessive salt and sugar intake, overweight and obesity, less vegetable and fruits intake and alcohol consumption. Out of 200 participants, the major challenges in reducing the salt and sugar intake were lack of awareness and no family support.Conclusions: Most of the participants were oldest females who had diabetes or hypertension. The most common NCD they were suffering from were diabetes and hypertension. The major challenge in the management of NCDs is lack of awareness.

Clinical profile of Dengue fever in an urban tertiary care hospital in South India

Background: Dengue is among the most common flavivirus infections in the world. Today dengue ranks as the most important mosquito- borne viral disease in the world. Current estimates report that, at least 112 countries are endemic for Dengue and about 40% of the world populations (2.5-3 billion people) are at risk in tropics and subtropics. Annually 100 million cases of dengue fever and half a million cases of DHF occur worldwide. The clinical features are noted to be different in varying demographics of the world outlining the importance of bringing out data from different parts of the world, so clinicians are better equipped to anticipate the problems associated with clinical dengue.Methods: The study was conducted over a period of 2 years at a tertiary care hospital in urban Bengaluru, India. A cross sectional study of a total of 250 patients was done. They were diagnosed to be positive for dengue serology (NS1 or IgM) before including them in the study. Clinical features, haematological, biochemical and radiological parameters were assessed.Results: Out of 250 patients with dengue fever, the most common symptoms were fever (100%), headache (94.4%) and myalgia (97.2%). Bleeding manifestations were noted in 11.6% of the patients. Bradycardia was noted in 14.8% of the study population. Leukopenia was noted in 36% of the study population. Increased SGOT was seen in 59.6% and increased SGPT in 52.8% of the 250 subjects. The clinical outcome of the 250 patients of dengue fever was classical dengue fever in 86.8%, DHF in 11.6%, DSS in 0.8% and death in 0.8%.Conclusions: All patients with dengue fever present with fever. Other common features noted were headache, myalgia. Bleeding manifestations are to be looked out for. Rare but important features that a clinician must be vigilant to look for are bradycardia and leucopenia.