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Background: Sputum conversion and weight gain are prognostic markers of treatment outcome in tuberculosis (TB) patients. Very few studies in India have assessed impact of TB treatment on weight of patients and perceived improvement in symptoms. This prospective study aimed to assess the impact of anti-tubercular treatment on weight and perceived symptoms.Methods: Three interviews were done for each patient i.e. at start (within 7 days of starting anti-tubercular treatment), at the end of intensive phase and at the end of continuation phase for recording body weight and perceived symptoms. Descriptive statistics were used to summarize baseline characteristics. Mean scores at different stages of treatment were compared by repeat measure ANOVA. P<0.05 was considered to be statistically significant.Results: Out of 58 study subjects enrolled for the study, 53 could be followed up till the end. Mean weight improved in six months of anti-tubercular treatment. Improvement was statistically non-significant. Cough and fever were the most common symptoms prior to beginning of treatment. After the first 2 months the proportion of subjects with symptoms declined for all five symptoms i.e. fever, cough, chest pain, sweats, and dyspnoea.Conclusions: There was positive impact on weight gain in patients under category I treatment. The symptoms improved drastically in first two months with near complete resolution in six months of treatment.
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Background: Scrub typhus is the most common rickettsial infection in the Indian subcontinent with the manifestation ranging from mild symptoms to serious disease with or complication or death. The objective of this study was to study epidemiology and clinical profile of scrub typhus outbreak in a tertiary care centre of central India.Methods: Present study is a record based retrospective study enrolling 173 confirmed positive cases with ELISA test during the period from 1st August to 31st December 2018.Results: Maximum number of the cases 94 (54.3%) had occurred in September 2019. Majority of the female 94(54.3%) were Ig M positive for scrub typhus. Maximum cases 134 (77.5%) were from rural area. Most common symptoms were fever 170 (98.3%), followed by fever with chills 65 (37.6%), breathlessness 49 (28.3%), cough 35 (20.2%), and 28 (16.2%) each with altered sensorium and headache. Mortality was recorded in 30 (173%) and amongst them 10 (34.5%) and 4 (13.8%) cases had ARDS and septicaemia as complication respectively.Conclusions: This study shows that majority of the cases occurred in the month of September 2018 with female preponderance. Most of the residence were from rural areas with common presenting symptoms as fever or fever with chills followed by breathlessness, cough and altered sensorium and headache.
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Aims: There is an increasing recognition of the putative association between the use of biomass fuels and the risk of cataracts. However, the exact strength of this association is currently unknown. Our aim was to synthetically quantify the association between biomass fuel use and cataract. Study Design: Systematic review and meta-analysis. Methodology: Using results from the MEDLINE®, Scopus®, Web of Science® and Google® searches, we conducted a random-effects meta-analysis of the published studies. We also conducted subgroup meta-analyses, meta-regressions and sensitivity analyses to determine the contribution of potential confounders to between-study heterogeneity which was measured by the tau-squared and I2 statistics. Summary effect sizes (SES) were estimated using the DerSimonian and Laird method and the 95% confidence intervals (CI) and 95% prediction intervals (PI) were also estimated. Publication bias was examined using funnel plots and Egger’s test. Results: In spite of significant between-study heterogeneity (I2 70%, p=8.1x10-5), biomass fuel use was associated with a significantly increased risk of cataract (SES 2.12; 95% CI 1.61-2.80; 95% PI 0.88-5.09). Age-, gender- and other methodological differences did not significantly contribute to between-study heterogeneity but Indian studies showed a statistically significant association between biomass fuel use and cataract. Statistically homogeneous studies (n = 8) showed an SES of 2.01 (95% CI and PI 1.67-2.41). Conclusion: Synthetic evidence from observational studies indicates that biomass fuel use may increase the risk of cataract. Public health initiatives aimed at avoidance of biomass fuel use may reduce the burden of cataracts especially in settings where biomass fuels are commonly used.
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Routine exposure to domestic cooking fuels is an important source of indoor air pollution causing deterioration of lung function. We conducted a community based cross-sectional study in 760 non-smoking rural women involved in household cooking with four types of cooking fuels i.e. Biomass, Kerosene stove, Liquid Petroleum Gas (LPG) and Mixed (combination of two and more cooking fuels). Peak Expiratory Flow Rate (PEFR) less than 80% of the predicted was considered as abnormal PEFR. The overall prevalence of abnormal PEFR was found to be 29.1% with greater predominance among biomass fuel users (43.3%) with high risk ratio (1.86) as compared to kerosene (0.63), LPG (0.75) and mixed (0.66) fuel users. However the pair wise comparison of different groups of cooking fuels by Marascuilo procedure reported significant differences within different groups except kerosene - mixed group. The study also demonstrated a negative correlation between observed PEFR and exposure indices in different cooking fuels (r=–0.51). Our results indicate that prolonged exposure to cooking fuels particularly biomass fuels as a source of cooking adversely affects PEFR in nonsmoking rural women.
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The objectives of the present study were to study the (i) prevalence of hypertension and hearing impairment in iron and steel industry workers, (ii) association between hypertension and hearing impairment, (iii) association between hypertension and hearing impairment, with duration of exposure, and (iv) correlation between levels of sound and noise induced health problems viz. hypertension and hearing impairment in a cross sectional study involving Workers working in iron and steel industry at Nagpur. Of a total of 804 workers, 770 workers participated in the study. There were five sections in the factory; Steel melting section (SMS), rolling mill section (RMS), quality control department (QCD), maintenance department (MD) and administration department (AD). Workers working in SMS, RMS, & QCD formed a continuously exposed group (CEG); workers of MD and AD formed intermittently exposed group (IEG). Workers were interviewed, examined and information was collected in a pre-tested pro-forma. Blood pressure was measured, and tuning fork tests were done to assess hearing ability. Prevalence of hypertension among CEG (25.51%) was significantly higher than IEG (14.05%). (X2-14.28, df-1, P<0.001). There was positive association between duration of exposure and prevalence of hypertension. The prevalence of hearing impairment was significantly more in CEG (20.5%) as compared to IEG (8.91%). (X2-11.69, df-1, P<0.001). Occurrence of hearing impairment was also directly proportional to the duration of exposure. The correlation between level of sound exposure and hearing impairment was found to be significant (r=0.98; P<0.05), the correlation between level of sound and hypertension was found to be statistically insignificant (r=0.84; P>0.05). The results of the present study indicate that hypertension and hearing impairment are commoner in workers continuously exposed to high levels of occupational noise.