ABSTRACT
Background: There are a limited number of studies regarding the prevalence of hepatitis B, hepatitis C and HIV infections among the drug addicts in Himachal Pradesh; C virus (HCV) infection in north India especially Himachal with very high rates of substance abuse. The present study was attempted to study the prevalence of hepatitis C among the injectable drug users, which is more important in a country like India where viral hepatitis is estimated to be among the top ten causes of deaths.Methods: A study was conducted in 2019-2020 (July-April). HBsAg, anti-HBs, anti-HCV and anti-HIV tests in 235 drug addicts were studied. Urine samples obtained from drug addicts were analyzed for cannabis, opiate and cocaine metabolites.Results: The subjects included were 235 IDUs who were opioid dependent. All the 235 drug users were males, and their mean age was 30.69±9.494 years; 112 (47.7%) of them were in the age group ranging 20 - 29 years (p <0.05). Of 235 drug addicts, 113 (48.1%) and 115 (48.9%) were only cannabis and opiate users, respectively. The frequencies of HBsAg, anti-HBs and anti-HCV among drug addicts were 2.6%, 38.3%, and 9.4%, respectively.Conclusions: The obtained results showed that HCV infection was an alarming problem among opiate users in this part of Himachal. It is suggested to rapidly diagnose the infected persons; thus preventive measures and appropriate control may limit further transmission of these infections.
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Background: Deep vein thrombosis (DVT) is a major preventable cause of morbidity and mortality worldwide with the potential to cause a dreaded pulmonary embolism (PE). Disease and patient-specific considerations are preferably incorporated into therapeutic options for effective management. Materials and methods: Sixty-eight cases of acute deep vein thrombosis were treated within a period of 3 years from January 2016. All the cases were subjected to routine investigations with the Doppler study of the affected limb. Low molecular weight heparin (dalteparin) was administered in all the cases for a period of 15 days and the Doppler study was repeated at the end of the drug therapy. After the course of low molecular weight heparin, the patients were given acenocoumarol 2mg daily. Estimation of partial thromboplastin time and prothrombin time were performed before starting and during the treatment of the low molecular weight heparin and acenocoumarol regularly. A venogram was done only when the repeated Doppler study revealed unsatisfactory response to low molecular weight heparin therapy. Eight cases underwent thrombectomy and the postoperative period was uneventful. Results: Age group of 21-30 years was most affected (80.8%) with right lower limb being the commonest affected site of injection and associated lesions. Conclusion: DVT in the young population remains a challenge to the evaluating clinician. A variety of disease states can alter the anticoagulant factors. Urgent diagnosis and appropriate intervention carry paramount importance.
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Objective To assess the prevalence of overdose of heroin and risk factors in intravenous drug users (IDUs) in Yunnan Province.Methods During July-August of 2015,IDUs were recruited from four methadone maintenance treatment (MMT) clinics and two compulsory drug rehabilitation centers in Honghe and Dehong prefectures,Yunnan province.The information about IDUs' demographic characteristics and drug use history,overdose of heroin in previous12 months and the latest overdose of heroin were collected through face to face questionnaire survey.The factors associated with overdose of heroin were evaluated with logistic regression models.Results Of the 340 IDUs surveyed,85.3％(290/340) were males,the mean age was 37.7± 8.7 years,65.6％ (223/340) were Han ethnicity,and 49.4％ (167/338) were HIV positive,22.6％ (77/340) reported having used club-related drugs (such as ephedrine,methamphetamine,benzodiazepines and ketamine) in the previous 12 months.Of the 340 IDUs,41.8％ (142/340) had at least one overdose of heroin in their lifetime (median:3 overdoses) and 15.6％ (53/340) had at least one overdose of heroin (median:1 overdose use) in previous 12 months.The mean age of the 53 IDUs was (36.7 ± 8.4) years,and 83.0％ (44/53) of them were males,the average drug use history was (16.5 ± 7.6) years.Dosage increase (26.4％,14/53) and multidrug use (28.3％,15/53) were the main causes for overdose of heroin.Multiple logistic regression analysis indicated that methadone maintenance treatment during the past year (OR=0.534,95％CI:0.290-0.980) was independently associated with decreased risk of overdose of heroin,needle sharing in the past 6 months (OR=2.735,95％CI:1.383-5.407) and being forced to receive drug rehabilitation for less than one year (OR=2.881,95％CI:1.226-6.767) were independently associated with increased risk of overdose of heroin.Conclusion Overdose of heroin is common among IDUs in Yunnan.It is necessary to encourage IDUs to receive MMT and strengthen the health education about the prevention of overdose of heroin,especially before they leave drug rehabilitation centers.And it is important to establish a referral mechanism from drug rehabilitation center to MMT clinic for drug users.
ABSTRACT
Objective To assess the prevalence of overdose of heroin and risk factors in intravenous drug users (IDUs) in Yunnan Province.Methods During July-August of 2015,IDUs were recruited from four methadone maintenance treatment (MMT) clinics and two compulsory drug rehabilitation centers in Honghe and Dehong prefectures,Yunnan province.The information about IDUs' demographic characteristics and drug use history,overdose of heroin in previous12 months and the latest overdose of heroin were collected through face to face questionnaire survey.The factors associated with overdose of heroin were evaluated with logistic regression models.Results Of the 340 IDUs surveyed,85.3％(290/340) were males,the mean age was 37.7± 8.7 years,65.6％ (223/340) were Han ethnicity,and 49.4％ (167/338) were HIV positive,22.6％ (77/340) reported having used club-related drugs (such as ephedrine,methamphetamine,benzodiazepines and ketamine) in the previous 12 months.Of the 340 IDUs,41.8％ (142/340) had at least one overdose of heroin in their lifetime (median:3 overdoses) and 15.6％ (53/340) had at least one overdose of heroin (median:1 overdose use) in previous 12 months.The mean age of the 53 IDUs was (36.7 ± 8.4) years,and 83.0％ (44/53) of them were males,the average drug use history was (16.5 ± 7.6) years.Dosage increase (26.4％,14/53) and multidrug use (28.3％,15/53) were the main causes for overdose of heroin.Multiple logistic regression analysis indicated that methadone maintenance treatment during the past year (OR=0.534,95％CI:0.290-0.980) was independently associated with decreased risk of overdose of heroin,needle sharing in the past 6 months (OR=2.735,95％CI:1.383-5.407) and being forced to receive drug rehabilitation for less than one year (OR=2.881,95％CI:1.226-6.767) were independently associated with increased risk of overdose of heroin.Conclusion Overdose of heroin is common among IDUs in Yunnan.It is necessary to encourage IDUs to receive MMT and strengthen the health education about the prevention of overdose of heroin,especially before they leave drug rehabilitation centers.And it is important to establish a referral mechanism from drug rehabilitation center to MMT clinic for drug users.