ABSTRACT
Mental health professionals across the globe foresaw the mental health impact of the coronavirus disease 2019 (COVID-19) pandemic. They have faced scarcity of trained professionals, rising morbidities, lack of protective gear, shortage of psychotropic drugs, and poor rapport building due to masking and social distancing. Amidst all, they have responded with approaches that focus on continuing mental health services to the patients already in care, education of the vulnerable people to help them cope with these stressors, and provide counselling services to patients and families affected by the pandemic.
ABSTRACT
Purpose: To compare intracameral Ropivacaine to Lignocaine during phacoemulsification under augmented topical anesthesia, in terms of efficacy and safety. Methods: This prospective, randomized, double-masked clinical trial included subjects planned for phacoemulsification with posterior chamber intraocular lens implantation for visually significant uncomplicated senile cataract, under augmented topical anesthesia. Cases were randomized into two groups, Group A (Ropivacaine 0.1%) or Group B (Lignocaine 1.0%). The pain experienced by the patients during the surgery, mydriasis, post-op inflammation and endothelial cell change at six weeks after the procedure was evaluated. Surgeon's feedback was recorded to evaluate the cooperation of the patient during surgery. Results: A total of 210 subjects were screened and 184 were randomized to have 92 subjects in each group. There was no statistically significant difference seen on comparing Group A and B with respect to Age (P = 0.05), painful surgical steps (P = 0.85), visual analog scale scores (P = 0.65), surgeon's score (P = 0.11), postoperative inflammation (P = 0.90) and average ultrasound time during phacoemulsification (P = 0.10). Subjects in Group A fared better when compared to Group B with respect to endothelial cell loss (P = 0.0008), and augmentation in mydriasis (P < 0.001). Conclusion: Intracameral Ropivacaine and Lignocaine, both are equally effective in providing analgesia during phacoemulsification. However, intracameral Ropivacaine is superior to Lignocaine with regards to corneal endothelial cell safety, and augmenting mydriasis.
ABSTRACT
Gangetic plains are known to have a very high incidence of cholelithiasis, the eiopathogenesis of which cannot be ascertained. Aim: to conduct a study to find a correlation, if any between the incidence of gallstone disease and the serum Iron and serum Calcium levels of patients and compare it with controls. Methods: 50 patients and 50 controls were taken and serum Iron and serum Calcium of both were evaluated. The distribution of age, sex and gender were taken as factors. Results and conclusion: The number of female patients was higher than the males but no strong association could be proven in the study. Among the symptoms dyspepsia had the highest incidence but could not be taken as a reliable marker for the diagnosis of cholelithiasis clinically. Hence, ultrasonography remains a very important tool for the diagnosis of the diasease .The role of serum Iron and serum Calcium in the etiopathogenesis could not be established. There was however a strong correlation of previous surgery in the formation of new gallstones .The family history was a strong factor for the formation of new gallstone disease however, the association was not established in this study. Gallstone disease had stronger association with anaemia than with serum Serum Iron. Calcium levels were comparable between the cases and the controls.
ABSTRACT
Invasive fungal infections (IFIs) are an important cause of morbidity and mortality in paediatric leukaemias. Antifungal combinations to treat these patients are being explored. Fourteen children with leukaemias and IFIs were treated with a combination of antifungal agents at our centre. The first antifungal was amphotericin-B in 13 children and voriconazole in one child. In view of no improvement and clinical deterioration, in nine patients, voriconazole was added as the second antifungal agent and in four, it was caspofungin. All patients completed 4�weeks of antifungal therapy. The overall mortality attributable to IFI for the cohort was 4/14 (28%).
ABSTRACT
Background: Thyroid diseases are, debatably, among the commonest endocrine disorders worldwide. According to a projection from various studies on thyroid disease including thyroid nodules, it has been estimated that about 42 million people in India suffer from thyroid diseases. The ultrasonography is a non-invasive sensitive diagnostic in assessing thyroid nodule size and number. This study aimed to determine the ultrasound findings of thyroid nodules in patients and correlate it with clinical records. Methods: This was a cross-sectional study conducted at teerthanker Mahavir medical college and research centre. In these patients, high frequency 7.5-10.0 MHz probe was used for Ultrasound examination of a thyroid nodule. It includes diameter, echogenicity (Hyper, Hypo, Iso and An Echo), composition (Cystic, Solid, Mixed), microcalcifications (Presence and Absence), Borders (Irregular and Regular) and Halo (Presence and Absence). From Lew et al. guidelines ultrasound of nodule margins, suggestive of malignancy guidelines was adopted. A fine needle aspiration (FNA) biopsy was recommended to the referring physician is required. Results: Benign and malignant lesions were recorded in 88.9% and 11.1% patients respectively. On the other hand, histopathological findings revealed that 90.9% and 9.1% as benign and malignant correspondingly. In the present study, sensitivity, specificity and positive predictive values were 91%, 8.5% and 50% respectively. Whereas, the negative predictive value was 47%. Conclusion: Findings of the current study suggest that radiological evidences are reliable enough for the diagnosis of the benign and malignant thyroid tumours. However, studies on larger populations are warranted to establish guideline for the radiological diagnosis of thyroid tumours.
ABSTRACT
Background: Drug prescription in menopause is complex as estrogen deficiency, hypertension (HT) and other risk factors, rapidly increase the risk of cardiovascular diseases (CVD) in post-menopausal women (PMW). Objectives: To evaluate the prescription trends of anti-hypertensive drugs in PMW. Methods: This was an observational, cross sectional study conducted over a period of 1 year, on hypertensive PMW. The prescriptions were evaluated for antihypertensive drug use patterns and also as per WHO core drug indicators. Results: 21.82% of prescriptions had monotherapy, amongst which angiotensin receptor blockers (ARB) (10%) and individually, telmisartan (5.45%) were most commonly prescribed. Majority of prescriptions had two drug therapy (44.09%), among which ARB + beta-blockers (BB) (20.91%) and individually, Telmisartan + Metoprolol (13.64%) were most frequently prescribed. ARB + Diuretic (DI) (9.55%) was the most common fixed drug combination (FDC) prescribed. ARB + BB + DI (10.45%), ARB + 2DI + BB (4.09%) and ARB + 2DI + BB + Calcium channel blocker (1.82%) were most commonly prescribed three, four and ≥five drug combinations, respectively. Hypolipidemic drugs (60.45%) were maximally co-prescribed. Percentage of drugs prescribed by generic name was 4.63% and from essential drug list was 32.62%. Conclusions: A high trend of polypharmacy was observed in hypertensive PMW. HT, being a multifactorial disease, deserves a multidisciplinary and a comprehensive approach in the care of this population subgroup. Knowledge of prescription pattern and thus the rational utilisation of drugs will help achieve better control rates of HT and hence curb down the burden of CVDs in PMW.
ABSTRACT
Background: Drug prescription in menopause is complex as estrogen deficiency, hypertension (HT) and other risk factors, rapidly increase the risk of cardiovascular diseases (CVD) in post-menopausal women (PMW). Objectives: To evaluate the prescription trends of anti-hypertensive drugs in PMW. Methods: This was an observational, cross sectional study conducted over a period of 1 year, on hypertensive PMW. The prescriptions were evaluated for antihypertensive drug use patterns and also as per WHO core drug indicators. Results: 21.82% of prescriptions had monotherapy, amongst which angiotensin receptor blockers (ARB) (10%) and individually, telmisartan (5.45%) were most commonly prescribed. Majority of prescriptions had two drug therapy (44.09%), among which ARB + beta-blockers (BB) (20.91%) and individually, Telmisartan + Metoprolol (13.64%) were most frequently prescribed. ARB + Diuretic (DI) (9.55%) was the most common fixed drug combination (FDC) prescribed. ARB + BB + DI (10.45%), ARB + 2DI + BB (4.09%) and ARB + 2DI + BB + Calcium channel blocker (1.82%) were most commonly prescribed three, four and ≥five drug combinations, respectively. Hypolipidemic drugs (60.45%) were maximally co-prescribed. Percentage of drugs prescribed by generic name was 4.63% and from essential drug list was 32.62%. Conclusions: A high trend of polypharmacy was observed in hypertensive PMW. HT, being a multifactorial disease, deserves a multidisciplinary and a comprehensive approach in the care of this population subgroup. Knowledge of prescription pattern and thus the rational utilisation of drugs will help achieve better control rates of HT and hence curb down the burden of CVDs in PMW.
ABSTRACT
Background: Hypertension is one of the most common diseases in the world. It is an important and independent risk factor for atherosclerosis, heart failure, renal disease, and peripheral arterial disease. It is directly responsible for 57% of all stroke deaths and 42% of coronary heart disease deaths in India Objectives: To evaluate and compare efficacy and cost effectiveness in hypertensive patients receiving Olmesartan and Telmisartan in Stage I hypertension Material and methods: The present study was an open, prospective, randomized, parallel group comparative study conducted in 60 patients of stage I hypertension over a period of 16 weeks. Patients were randomly allocated to two, age and sex, matched groups of 30 patients each. Group I patients were started on Olmesartan at a dose of 20 mg & Group II patients were put on Telmisartan at a dose of 40 mg. The BP lowering efficacy and cost effective analysis of Olmesartan versus Telmisartan was calculated & compared. The data was entered in Microsoft excel and compiled. Statistical analysis was done using various tests. Results: Maximum patients in both the groups were in age group of 51-60 years. In group I there were 13 males and 17 females. In group II there were 14 males and 16 females. Both Olmesartan and Telmisartan are effective in lowering systolic & diastolic BP in supine & sitting positions & mean BP is also lowerer, more in Olmesartan group. By cost effective analysis Telmisartan was found more cost effective. Incremental cost effective ratio was found to be 218.35. Conclusion: Both Olmesartan and Telmisartan belong to the same antihypertensive drug class, effectively reduce systolic and diastolic blood pressure at various visits. Taking into account Total cost Telmisartan was more cost effective than Olmesartan. ICER was found to be 218.35.