ABSTRACT
Background: 1.Effect of atropinization with different methods.2.Outcomes in terms of duration of hospital stay and patients recovery. Methodology: An open-label randomized clinical trial was conducted in, Shri B M Patil Medical College Hospital and Reasearchcentre, Vijyapura, Karnataka in 108 individuals with OPC poisoning .We compared two groups that used a titrated dosing protocol based on a structured monitoring sheet for atropineinfusion with another group using an ‘ad hoc’ regime. The aim was to compare the efficacy andsafety of conventional bolus doses with individualized incremental doses of atropine for atropinization followed by continuous atropine infusion for management of OPC poisoning. Results: Out of 108 patients ,54 patients received conventional bolus dose atropine (group A) and 54 patient received rapidly incremental doses of atropine followed by infusion (group B).36 subjects analysed in group A and 32 in group B for moderate to severe poisoning.The mortality in group A was 11.1%(4/36) and in group B was 6.3%(2/32).The mean duration of atropinization in group A was 5.8hrs (348)in minutes compared to time 26.9minutes for group B. Conclusion: Administration of atropine using a fixed algorithm is easy and effective in providing the atropine requirement in management of early phase of acute OPC poisoning.Rapid incremental dose atropinization followed by atropine infusion reduces mortality and morbidity from OPC poisoning and shortens the length of hospital stay and early recovery .Incremental atropine and infusion should become the treatment of choice for OPC poisoning.
ABSTRACT
Aim of the study:Effect of atropinization with different methods.Outcomes in terms of duration of hospital stay and patients recovery. Methodology: An open-label randomized clinical trial was conducted in, Shri B M Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka. 108 individuals with OPC poisoning .We compared two groups that used a titrated dosing protocol based on a structured monitoring sheet for atropine infusion with anoth-er group using an ‘ad hoc’ regime. The aim was to compare the efficacy and safety of conventional bolus doses with individualized incremental doses of atropine for atropinization followed by continuous atropine infusion for manage-ment of OPC poisoning.Result: Out of 108 patients, 54 patients received conventional bolus dose atropine (group A) and 54 patient received rapidly incremental doses of atropine followed by infusion (group B).36 subjects analyzed in group A and 32 in group B for moderate to severe poisoning. The mortality in group A was 11.1%(4/36) and in group B was 6.3%(2/32).The mean duration of atropinization in group A was 5.8hrs (348) in minutes compared to time 26.9minutes for group B. Conclusion: Administration of atropine using a fixed algorithm is easy and effective in providing the atropine requirement in management of early phase of acute OPC poisoning. Rapid incremental dose atropinization followed by atropine infusion reduces mortality and morbidity from OPC poisoning and shortens the length of hospital stay and early recovery .Incremental atropine and infusion should become the treatent of choice for OPC poisoning.
ABSTRACT
Background & objectives: Pandemic H1N1 caused deluge of cases from 74 countries and prompted World Health Organization to raise warning to phase 6. The present study was conducted on throat and nasal swab samples received and tested at National Centre for Disease Control, Delhi, India during 2009-2010 to collect epidemiological and clinical information on positive cases. Methods: Throat and nasopharyngeal swabs from category C influenza A H1N1 patients during May 2009-September 2010 along with their clinico-epidemiological details were collected from identified hospitals from Delhi and other States. Samples were tested by Real time reverse transcriptase PCR using primers and probes developed at CDC, Atlanta for four influenza target genes. Results: A total of 33,751 samples, both throat and nasal swab samples from each patient were tested for H1N1 influenza virus, of which, 7943 (23.5%) were positive for pandemic influenza A H1N1 and 3759 (11.1%) were positive for influenza A (seasonal flu). Maximum number of positive cases (N=2792, 35.1%) were from 20-39 yr age group, comprising 1790 (22.5%) males and 1182 (14.8%) females. Only 2620 (33%) positive cases were close contact of influenza A H1N1 positive patient. Majority cases presented (N=2792, 35.1%) with fever 7005 (88.1%), followed by 6133 cases (77.2%) exhibiting fever and cough, 377 (4.7%) complained of fever, cough, nasal catarrh and 362 (4.5%) cases had fever with shortness of breath. Interpretation & conclusions: The study showed a peak of cases of pandemic influenza A H1N1 in December 2009 and indicated predominance of H1N1 positive cases among 20-39 yr age group and among males compared to females.