An Epidemiological study on Snakebite in Karwar.

According to the World Health Organization, snakebites cause more death and disability and are more notorious than some tropical diseases. Snakebite is a leading medical emergency in Asia/Pacific. It is one of the major causes of mortality in India. The objective of the study was to gather epidemiological information on snakebite that will help to guide/design a snakebite prevention and treatment intervention in Karwar. A retrospective study was conducted, in which we have collected data of snakebite cases admitted to the district hospital from October 2010 to October 2014. Epidemiological and demographic profiles of three hundred victims were noted. Data was analyzed by using descriptive statistics. Three hundred snakebite cases were admitted to district hospital, Karwar over the period of four years. Incidence was highest in post monsoon (n=97). Victims affected were mainly in third decade. Male preponderance was clearly seen. Farmers or people involved in farming related activities accounted for more than half of the victims (n=196). Eighty seven percent (87%) (n=261) occurred on the lower limb. Snake bite is an important neglected health problem in Karwar and surrounding rural areas . Using this study as a guiding tool, awareness and education programs on prevention of snakebite can be planned. It is important to educate people regarding first aid treatment, dos and don’ts in case of snakebite. Medical personnel should be trained; facility should be improved in Karwar district hospital so as to manage even complicated cases.

Efficacy and tolerability of trandolapril in mild to moderate hypertension--a double blind comparative clinical trial with enalapril in Indian population.

Several large scale clinical trials have demonstrated that angiotensin converting enzyme inhibitors offer cardiovascular and renal protection independent of their effects on systolic BP. Trandolapril is a new angiotensin converting enzyme inhibitor approved for the treatment of hypertension. The potential advantages of this drug are long duration of action and better tolerability. The objective of the study was to compare the efficacy and tolerability of trandolapril with that of enalapril in mild to moderate hypertension in Indian population. In this double blind, multicentric, parallel comparative clinical study, 120 patients with mild to moderate hypertension were randomly assigned to receive trandolapril 2 mg or enalapril 5 mg once daily for 8 weeks. The attainment of sitting diastolic blood pressure <90 mmHg at the end of 8th week was considered as primary outcome measure and attainment of diastolic blood pressure <90 mmHg or reduction of at least 10 mmHg diastolic blood pressure compared to baseline at any visit was considered as secondary outcome measures. 98.4% patients treated with trandolapril and 92.6% patients treated with enalapril fulfilled the primary outcome measure. 54, 72 and 62% patients on trandolapril and 52, 61 & 64% patients on enalapril fulfilled secondary outcome measure at the end of 2nd, 4th and 8th week respectively. Also trandolapril was better tolerated than enalapril with no significant abnormality in lab parameters.