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Background: Non-communicable diseases are the leading causes of death globally, of which cardiovascular diseases are the most common. Cost-effective strategies, such as task shifting, are needed to mitigate the rising epidemic by controlling hypertension and diabetes in our country.Methods: This was a non-randomized interventional study undertaken in six (3 intervention and 3 control) villages of Lakkur primary health centre (PHC) area under Malur taluk, Kolar district, Karnataka, from November 2013 to April 2015. After obtaining written informed consent, baseline survey was done among 180 diabetics and hypertensives (adults>30 years). In the intervention villages, ASHAs who were trained did the intervention for 6 months. In non-intervention villages, standard usual care was given and repeat survey was done after 6 months to re-measure.Results: This study demonstrated that there was an increase of 44.8% in the proportion of hypertensives whose blood pressure was under control and increase of 26.5% in the proportion of diabetics whose blood sugar was under control in villages that received household visits by trained ASHAs (intervention villages). There was an increase in the medication adherence levels (29.6%) and reduction in tobacco usage (median difference of 4 times per day) among hypertensives and diabetics who are on medication in intervention villages.Conclusions: Findings from this study will provide policy makers and other stakeholders needed information to recommend scalable and cost-effective policy in respect to cardiovascular risk reduction, hypertension and diabetes control in resource-poor settings.
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GeneXpert is a novel, automated diagnostic test that can identify Mycobacterium tuberculosis (MTB) DNA and resistance to rifampicin (RIF) rapidly for Extrapulmonary tuberculosis (EPTB). Incidence of EPTB is increasing in low burden settings in comparison to pulmonary tuberculosis (PTB) & EPTB is relatively neglected. Aim: This study is aimed at knowing the incidence of EPTB and rifampicin sensitivity using an automated rapid detection method, GeneXpert. Methods: 271 EPTB positive patients were included in this retrospective study during a period from January to July 2018. Details regarding TB diagnosis, rifampicin sensitivity, nature of the sample and patient details including age, sex, occupation, address, habits, past history of TB, HIV status and other clinically relevant information was obtained from hospital and laboratory registers. Results: Out of 1290 tuberculosis positive patients, 1019 were of pulmonary tuberculosis (PTB) i.e., 78.9% and remaining 271 were of extrapulmonary tuberculosis (EPTB) i.e., 21.1%. 42.4% (115 out of 271) patients were in the age group of 31-40 years. Female predominance was observed in EPTB patients. Among 271 EPTB patients, 122 (45%) were diagnosed as pleural TB, 95 (35%) patients affected by tuberculosis at lymphnodes, 3(1.1%) had meningeal TB, 9(3.3%) EPTB cases were diagnosed from pus samples of various clinical conditions and remaining 42(15.4%) EPTB cases identified from various samples including tissues, genitourinary, synovial fluid, bones & joints. 247 (91.1%) out of 271 EPTB patients clinical samples showed rifampicin sensitive. 12 (9.8%) out of 122 pleural tuberculosis cases and 5 (5.2%) out of 95 TB lymphadenitis cases showed resistant rifampicin. Conclusion: TB can be diagnosed by various methods, among which GeneXpert is a rapid, reliable, easy to operate, automated system. GeneXpert helps physicians by providing rapid diagnosis within 90 minutes, in turn aid to initiate prompt treatment at the earliest.
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Background: Skin is the most common organ involved in adverse reactions due to drugs. With newer drugs released into market every year, there is changing pattern of the reported cutaneous adverse drug reactions (ADRs). In order to ensure safer use of medicines in patients, there is need for continuous monitoring of ADRs. This is a retrospective study to analyse spontaneously reported cutaneous ADRs.Methods: All the cutaneous ADRs reported between January 2017 and September 2018 were analysed for clinical patterns, suspected medications, causality, severity and preventability.Results: Of the 1035 reports received during the study period, 232 (22.41%) included cutaneous reactions. 113 (48.7%) were male and 119 (51.29%) were female. Maculopapular rash 70 (30.17%), pruritus 31 (13.36%), palmar plantar erythrodysesthesia 30 (12.93%), acne 19 (8.19%), urticaria 16 (6.89%) and fixed drug eruptions (FDE) 13 (5.6%) were the common clinical patterns. Antimicrobial agents followed by anticancer drugs, nonsteroidal anti-inflammatory drugs (NSAIDs), hormones and related drugs, and antiepileptic drugs were the common suspected group of drugs. Causality assessment as done by WHO-UMC scale showed that 3 (1.29%) were certainly related, 174 (75%) were probably related and 55 (23.7%) were possibly related to the suspected medication.Conclusions: Cutaneous ADRs are most frequently reported ADRs in the present study. With newer drugs released into market, there is a need for continuous monitoring of use of drugs to promote safer use of medicines in patients.
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Background: Extended-spectrum β-lactamase-producing K. pneumoniae (ESBL-Kp) has recently become an important nosocomial pathogen. Intensive care units infections are predominant hospital acquired infections especially in tertiary health care. It is essential to know about ESBL prevalence in tertiary health care to take necessary actions by curbing resistant microorganisms. We aimed to study ESBL prevalence in Klebsiella species among respiratory samples from ICU patients. Methods: Respiratory samples collected from Intensive care unit patients, were processed under aseptic precautions. All Klebsiella isolates were subjected to routine antibiotic susceptibility testing by modified Kirby Bauer’s disc diffusion method and also for ESBL testing along with control. The results were interpreted as per CLSI (Clinical Laboratory Standards Institute) guidelines. Results: 153 (47.2%) Klebsiella species were isolated from 324 culture positive respiratory samples. Out of the 153 isolates which were screened for ESBL production, 90 (58.8%) isolates were found to be ESBL positive by CLSI disc diffusion. On performing confirmatory tests on the 90 isolates which were ESBL positive by screening tests, 84 (54.9%) were found to be ESBL producers on CLSI phenotypic confirmatory test (PCT) and 88 (57.5%) were found to be ESBL producers on Double Disc Synergy Test (DDST). Conclusion: Discussing with clinical microbiologist about antibiotic therapy helps clinicians to tackle with these resistant pathogens; also prevents transmission of resistant bugs and indirectly aid to increase life expectancy of patients.
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Background: Birth weight is a reliable and sensitive predictor of a new-born’s chances for survival, growth and long-term physical and psychosocial development. There are few studies done in rural South India documenting valuable data such as detailed maternal nutritional intakes and psychological factors, and linking them to LBW. The objective was to estimate the proportion of LBW in a maternity center, Snehalaya hospital, Solur, Ramnagar district, Karnataka and to assess the factors affecting birth weight. Methods: We conducted a cross-sectional study in a maternity centre, Snehalaya, in Solur Village, Ramnagar District, Karnataka between September and November 2014. Consecutive sampling was used to recruit 144 patients and the questionnaire was then administered to them. Results: Among the 144 women, the proportion of LBW was found to be 14.6% and the mean birth weight was 2.6± 0.4kg. We also found a significant association of birth weight with per capita income, maternal pregnancy weight gain, number of antenatal visits, maternal education, tobacco consumption, and stress and egg consumption in diet. Multivariate analysis showed significant association of birth weight with maternal pregnancy weight gain, tobacco consumption and stress. Conclusions: A greater number of the subjects were found to have access to the basic antenatal care measures such as nutrition, free iron supplements and regular antenatal check-ups and this has shown to have a positive effect on the birth weight in the study population. Though various factors have been already proven to be associated, psychological and nutritional factors have to be concentrated henceforth.