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Background: Mortality profile is an analytical tool used to identify the various factors responsible for poor outcome of disease and it can also use to evaluate quality and efficiency of healthcare providers. The aim of this study is to summarise the clinical and epidemiological factors as well as to identify the risk factors associated with mortality among swine flu cases.Methods: It is a cross-sectional, descriptive, hospital-based study conducted on 62 deceased patients due to swine flu reported at Maharana Bhupal Government Hospital, Udaipur, Rajasthan during the outbreak of influenza A H1N1 in the year 2015. A standardized pre-structured questionnaire with consent was filled by help of bed head tickets and by interview of attendants of deceased patients.Results: Deaths were higher among age group of 31-45 years (35.48%). Case fatality rate for male patients (13.88%) was higher. Mortality was highest in females of rural background 27(43.55%). Majority of deceased patients (70.97%) had delay of 4-7 days in admission after onset of symptoms. Diabetes, cardiovascular diseases and pregnancy was the major risk factors for poor outcome.Conclusions: Delay in diagnosis and admission may be the reason for higher mortality rate. The most common co morbid illness was Diabetes mellitus, cardiovascular diseases (Ischemic heart disease, Rheumatic heart disease, Hypertension) and pregnancy.
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Background: Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae (the influenza viruses). Swine flu cases resurfaced in month of January 2015 in Southern region of India which are continuation of pandemic 2009. Aim of this study is to summaries the clinical and epidemiological factors associated with swine flu as well as to estimate the burden of Influenza A H1N1 (Swine Flu) cases.Methods: A complete data of all the patients visiting swine flu OPDs, swine flu wards and ICU were maintained for year 2015. Each patient visiting either the swine flu OPD or the swine flu ward, who was suspected clinically to be H1N1 positive were tested for real time PCR.Results: Out of 1247 samples tested for rt-PCR 491 (39.37%) cases were identified as positive for H1N1. Maximum swine positivity was seen in the age group of 16-30 year i.e. 147 (29.94%). Overall swine positivity was significantly (<0.001) higher in females than male and extremely statistically significant (p<0.0001) higher in rural areas than urban. Cough was the most common clinical symptoms affecting 469(95.52%) patients followed by fever (92.26%) and breathlessness 402(81.87%).Conclusions: Our study will help epidemiologist and clinician to identify epidemiological factors and clinical picture of swine flu.
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Background: Management of pain is a primary clinical concern for any pathology in medical field. Addiction liability of opioids and troublesome gastrointestinal side effects of NSAIDs leads to intensive research for compound with lesser side effects.The aim of the study to evaluate the anti-nociceptive activity of Acacia Tortilis Seed Extract (ATE) in experimental animals.Methods: First of all, animals were randomly allocated into four groups of six animals each. In acetic acid induced writhing test model, Group I (NC) served as vehicle control received saline/Tween 80 0.1%, 10ml/kg BW orally, group II (ATE-100) and III (ATE-200) received ATE in dose of 100 and 200mg/kg BW orally respectively and group IV received the standard drug diclofenac sodium in dose of 50 mg/kg BW orally. Group I to IV were same in rest of three experimental models. One additional group of standard drugs (group V) morphine sulfate in dose of 5 mg/kg BW subcutaneously (SC) was allocated for screening method hot plate and tail flick tests. In Formalin induced paw licking test, three additional groups (group V) morphine sulfate in dose of 5mg/kg BW SC, group VI- morphine+naloxone (5mg/kg SC +2mg/kg intra-peritoneally (IP) and group VII - ATE+ naloxone (200mg/kg BW orally +2mg/kg BW IP) were also made.Results: The ATE when administered orally in dose of 100 and 200mg/ kg body weight (BW), produced significant analgesic activity (P <0.01) in acetic acid induced writhing syndrome and late phase of formalin test. In the hot plate test in mice and tail flick test in rats, ATE in same doses also showed significant analgesic activity (P <0.05) which is almost equally efficacious to standard drug diclofenac sodium (50mg/kg BW orally) but far less efficacious than morphine sulfate (5mg/kg BW subcutaneous).ATE (200mg/Kg BW orally) activity did not blocked by naloxone (2mg/kg intra-peritoneal).Conclusions: ATE possesss significant anti-nociceptive activity as evidenced in all the animal models of nociception. It might exert its effect through the peripheral mechanism of analgesic action possibly by interference in biosynthesis, release and/or action of prostaglandins and leukotrienes.
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Background: Same drug can be sold for different prices under different brand names due to various reasons. Branded medicine is the original product that has been developed by a pharmaceutical company and generic medicine is a copy of the original branded product, marketed after the expiry date of the patent and hence supposed to be of low cost as compared to their branded versions. The objective was to compare the costs of various branded and generic medicine and to ascertain the rationality of emphasizing generic versus branded prescription. Methods: Prices of 50 commonly used branded and generic medicines available as both branded and generic forms and in same concentration, dosage form and combination were selected and the percentage difference in the mean cost of generic and branded medicines was calculated. Results: The mean cost of 26 generic medicines out of the selected 50 medicines was higher than their branded versions. Mean cost of 20 branded medicines was higher than generic ones, and cost of 4 medicines was approximately same. Percentage difference in the mean costs of branded and generic medicines varied from <10% to >70%. Conclusions: Most of the drugs available in the market have brand names whether they are branded or generic medicines. Hence, doctor should write a cheapest known brand with the name of the generic salt in bracket so that the patient can buy another if that brand is not available. Furthermore, the Drug Controller of India should release a website where every doctor should be able to fi nd the cheapest and approved drugs in the market.
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The present study aims at comparing the prescribing pattern of antihypertensive drugs in essential hypertension with specific co-morbid conditions with JNC-VII and WHO-ISH guidelines. Adult patients of both sex, who were attending medicine OPD of Shri Krishna Hospital, Karamsad, Gujarat since last 6 months and being prescribed antihypertensive drug/s for hypertension, were selected for the study. Hypertensive patients with co- morbities diabetes mellitus, ischemic heart diseases, congestive heart failure, and chronic renal diseases were included in the study. Adherence to JNC-VII guideline and WHO-ISH guidelines with respect to prescribing antihypertensive drugs in patients with diabetes mellitus were found to be 97% and 40.81% respectively, while it was found to be 72.27% to both the guidelines in patients with IHD. Similarly in cases of hypertension with CHF, adherence to prescribing antihypertensive were found to be 93.62% and 38.30% respectively, whereas for CKD patients, adherence to both guidelines was found to be same i.e. 33.33%. There is need of following such authentic guidelines in managing hypertension like chronic disease since these guidelines are based on various clinical trials and successful attainment of target BP in patients will be much easier by implementing them.