Snake Bite Victim Treatment Outcome In Tertiary Care Setting In Kumaon Region Of Uttarakhand

Background: Kumaon region of Uttarakhand has a wide array of snakes. According to national health profile 2016 report on state wise cases and death due to snake bite was 167 and 1 respectively in Uttarakhand 2015 (Jan- December).This led to enquire this statistical disparity in spite of high prevalence of snake bite cases. Aim: To asses treatment outcome of Snake bite victim in tertiary care setting. Material And methods: Outcome was assessed in terms of clinical status at the time of discharge and duration of hospitalization. Results: Dose range of anti snake venom (ASV) for all snake bite victim was 10 -20 vials. 86.36%% case recovered and 13.6% died. Conclusion:Timely appropriate dose of anti snake venom administration has led to better outcome for which transportation of snake bite victim to appropriate health facility with in golden hour is imperative.

Comparative study of efficacy and safety of garenoxacin and moxifloxacin in acute exacerbation of chronic bronchitis in COPD patients

Background: Acute exacerbation of chronic bronchitis in COPD (AECB) is the major cause of morbidity, mortality and marked reduction in quality of life and imposes significant burden on both patients and healthcare systems. Bacterial infections causing AECB frequently require antibacterial treatment, so more evidences are needed to guide better antibiotic choice. Objective of the study was planned to compare efficacy and safety of Garenoxacin, a new fluoroquinolone versus moxifloxacin for treatment of Acute exacerbation of Chronic bronchitis in COPD patient.Methods: This was a prospective open label comparative study done in department of pharmacology and T.B & Chest of Government Medical College attached Dr Shusila Tiwari Hospital, Haldwani. 60 subjects with clinical symptoms suggestive of Anthonisen type II AECOPD (any two of following criteria: Increased dyspnea, cough, sputum purulence) were enrolled and randomized to receive either Moxifloxacin 400 mg once daily for 7 days or Garenoxacin 400mg once daily for 7 days. The primary outcome measure was clinical success rate at day 7 visit. Secondary outcome measures were changes in clinical global impression (CGI) scales and incidence of adverse events.Results: The mean age of patient was 60.98±9.9 years and 57.9±9.3 years in the Moxifloxacin and Garenoxacin groups. The clinical success rates were comparable with 86.2% in moxifloxacin group 84.6% and in garenoxacin group. Adverse effects were mild and self limiting. We observed two adverse effects in garenoxacin and three in moxifloxacin group.Conclusions: The result of study showed that garenoxacin is comparable to moxifloxacin in terms of efficacy and safety.

Errors in drug labeling and medico-legal awareness.

The importance of drug labels can not be overlooked. Many a times drug labels are missing which may lead to toxicological effects catastrophic accident and medico -legal implication. The objective of the present study was to learn and highlight the problems faced by the medical practitioner, pharmacist and the patients as regards to drug label it’s, medico- legal problems and suggest remedial measures. 55 medical practitioner of Government Medical College, Haldwani and 40 pharmacist of Haldwani town were surveyed through a questionnaire. The 90% of medical practitioners and 80% of pharmacist had faced problem with label related errors. None had been charged for malpraxis and negligence. Remedial measures suggested were barcoding (96%, 60%) colour coding, prefilled syringes (90%, 30%), increasing font sizes and more awareness about medico-legal liability, ethical issue and punishment. Drug label errors are an important cause of patient morbidity, mortality and medico-legal liabilities of medical practitioners. Improved and correct labeling understanding medico-legal importance and communication is the key element in minimising errors. Bar code generated labels, embossing, waterproof labels, improving quality of stickers, increasing font sizes, overcoming language barriers and sense of responsibility will readdress these deficiencies in services.

Novel ideas and approaches to learning medical sciences.

Medicine is a progressive discipline for medical students who are going to be future doctors. Therefore to determine the opinion of students regarding the 2nd Professional M.B.B.S. subject, teaching methodology, reforms to be introduced, computer and Internet use and its application in teaching learning process this study was done. 475 students were given a questionnaire which consisted of 2-5 options. Questionnaire consisted of 2 parts. First part was about demographic characteristic, second part was about the subject 465 students in the age group 19-24 yr with male female ration 1:1, mostly from northern India were included in the study. Forensic Medicine emerged as the favorite subject followed by Pharmacology, Pathology and Microbiology. 40.86% (190) wanted more of clinically oriented classes, problem based learning and use of audiovisual aids. 72.04% (335) wanted integrated teaching curriculum. So in our opinion we can adopt a curriculum which is clinically oriented, integrated, revised pattern with computer application and internet use. This will make the teaching learning process in the medical sciences more effective and relevant to the health of the society.

Age of menarche in girls of Uttarakhand.

Menarche is a physiological and developmental phenomenon significant in the life of a female. It occurs between the ages of 10 to 16 years. Study suggests that menarche tends to appear earlier in life as the social, nutritional and economic condition of society improves. There is paucity of information about menarchial age in hilly regions of Uttarakhand. Therefore, this research was undertaken to determine age of menarche and its variation with geographical, seasonal and nutritional status. This study was carried out through a questionnaire in 450 girl students between age 17-26 years at Uttarakhand Forest Hospital Trust, Medical College, Haldwani, India. The mean age of onset of menarche was 13.6 (+ 1.1) years. The monthly occurrence of menarche had peaks in May-June. The mean menarchial age of girls belonging to plain area was 13.18+ 1.31 years, which showed significantly earlier onset as compared to girls from hilly area (14.21 + 1.46 years). In hilly areas girls having vegetarian diet had significantly higher age of menarche (14.60 + 1.33 years), compared to girls having non-vegetarian diet (14.09 + 1.56 years). Therefore altitude, season and nutritional status have bearing on the mean menarchial age in girls of Uttarakhand.