ABSTRACT
Background:Hypertensive patients undergoing antihypertensive therapy are more prone to insulin resistance (IR). Thus, it is essential to monitor its prevalence, metabolic consequences and to individualize antihypertensive therapy to negate its potential adverse effects. Therefore, the presented study assessed the prevalence of IR among hypertensive patients undergoing antihypertensive therapy. Methodology:This prospective study involved 200 patients of either sex, diagnosed with essential hypertension, and undergoing treatment. Data regarding age, gender, medical history, body mass index (BMI), and waist circumference were collected. Laboratory investigations for fasting blood sugar levels, serum fasting Insulin levels, lipid profile, and glycosylated hemoglobin were performed. Homeostatic model assessment of IR (HOMAIR) was calculated. Statistical analysis was performed by using R software (Version. 3.6.0).Results:The prevalence of IR in hypertensive nondiabetic patients was 39%. The mean age and BMI of patients were 58.70 ± 16.64 year and 23.10 ± 2.57 kg/m2, respectively. The mean fasting blood sugar levels were 108.24 ± 20.99 mg/ dl. The mean HOMAIR levels were >2.8. IR was more in users of beta-blockers than in angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers, as a significant association was observed between the class of hypertensive drugs and presence of IR (P< 0.05). Asignificant association (P< 0.05) was observed between the duration of hypertension and IR indicated by HOMAIR >2.5 in patients on beta-blockers and on ACE inhibitors. Conclusion:Antihypertensive drugs like beta-blockers decrease insulin sensitivity in hypertensive patients leading to increased prevalence of IR
ABSTRACT
Background: Rabies is a fatal but preventable disease. Around the world, awareness studies about rabies have been widely used to understand the disease and in its preventive measures. Objectives: The present study was conducted to assess the awareness of rabies as a disease, its transmission, and prevention among the general population and also to assess the perceived health risks associated with exposure to animals. Methods: A cross-sectional study was undertaken across seven representative states in India between July and November 2017. Multistage sampling methodology was followed to select 1012 households as the primary sampling unit, and one adult responsible respondent from each household was interviewed as study participants. Results: Six hundred and eleven (60.4%) participants had heard of rabies. Only 0.2% had extensive knowledge of rabies. Majority (440, 72.0%) of the participants considered rabies as a fatal disease; 77.3% opined that risk of rabies from dogs was high compared to 41.6% who believed that there was little or no risk of rabies from cats. Only 37 (3.7%) participants were aware about preexposure prophylaxis. Conclusion: The awareness on rabies and its prevention in the study population was not satisfactory.
ABSTRACT
A coverage evaluation survey was conducted in Mandya and Koppal districts of Karnataka state following the Japanese Encephalitis (JE) vaccination campaign. The purposes of the survey were to assess coverage of children in target age group by JE vaccination and to assess adverse events following immunisation against JE, the knowledge of health care providers and community about JE & mass vaccination for JE. The study design consisted of both quantitative and qualitative methods. The quantitative data was used to know the coverage levels for children. The qualitative data collected through interviews of head of the family in the sample households, selected health care workers using a structured pretested questionnaire. The standard cluster sampling method was used for selecting the sample of children to be evaluated. In Mandya district the evaluation showed 92 % coverage in the selected sample of 313 children against the reported 83.85 %. In Koppal district the evaluation showed 70 % coverage, among the selected sample of 251 children, against the reported coverage of 69.8 %. The incidence of adverse events was 4% in Mandya sample and 6.37 % in Koppal sample. In Mandya district, about 42 % of households had knowledge of JE. About 68 % of households had prior knowledge of the immunization day. In Koppal district, the survey has revealed that only 19.85 % of the heads of household had the knowledge of JE and 48.53% had the knowledge of JE vaccination before the day of vaccination campaign.
ABSTRACT
Unruptured intracranial aneurysms (UIA) are common and in the absence of evidence from randomized controlled trials, management decision can be difficult. However with the various well-planned meta-analyses, certain guidelines can be formulated for risk assessment and surgical management. UIA in patients aged more than 64 years irrespective of size, and those measuring less than 10mm in the maximum diameter should be treated conservatively, but should be evaluated yearly with MR angiography or CT angiography to look for rapid increase in size. UIA showing a diameter increase of more than 0.95mm in a year should be treated by surgery or endovascular therapy. Surgery is indicated for all UIA measuring more than 10mm in maximum diameter in patients aged less than 64 years. Endovascular therapy is indicated for UIA, which need intervention but are not surgically accessible or where surgery is contraindicated due to high-risk medical factors.
ABSTRACT
Traumatic intracranial aneurysms constitute less than 1% of all intracranial aneurysms. A case of traumatic distal anterior cerebral artery aneurysm in 18 months old child, treated successfully by microsurgical excision of aneurysm is being reported, along with review of the literature.