Prevalence and determinants of hypertension among urban tribal communities in Nagaland, India-A community-based study.

Background: There is a paucity of data on the burden and factors associated with hypertension among the Nagas (collective term for tribal ethnic groups predominantly residing in Nagaland) living in an urban environment. Insights from this study will aid in mapping focused community-based and primary care interventions for hypertension. Objectives: To determine the prevalence and risk factors associated with hypertension among Nagas aged 30-50 years residing in urban Dimapur, Nagaland. Methods: A community-based cross-sectional study was conducted between January and July 2019. This study screened 660 participants for hypertension using a digital blood pressure apparatus. A semi-structured questionnaire was used to assess the risk factors, and anthropometric measurements were recorded using standard guidelines. Results: The prevalence of hypertension and pre-hypertension was 25.9% and 44.5%, respectively. Non-modifiable risk factors such as male gender (adjusted odds ratio [AOR]: 2.02; 95% confidence interval [CI]: 1.32-3.09), age > 40 years (AOR: 2.32; 95% CI: 1.57-3.41), family history of hypertension (AOR, 1.87, 95% CI: 1.19-2.92) and modifiable risk factors such as current alcohol consumption (AOR: 2.05; 95% CI: 1.27-3.31), high/very high perceived stress (AOR: 2.15; 95% CI: 1.28-3.62), lack of participation in stress relief activities (AOR: 2.08; 95% CI: 1.17-3.71) and overweight/obesity (AOR: 2.26; 95% CI: 1.55-3.30) were independently associated with hypertension in this study. Conclusion: To avert an impending health crisis in this community, a multipronged approach involving primary-care/family physicians, culturally appropriate awareness, and targeted community-based screening programs with an adept referral system must be implemented to curtail this emerging threat.

Evaluation of physicochemical and biological properties of nonreconstituted MYL-1401O vials, reconstituted MYL-1401O suspension in vial, and diluted MYL-1401O suspension in infusion bags (0.9% saline) for extended duration.

BACKGROUND: MYL-1401O; trastuzumab-dkst (Ogivri™; Mylan Inc.) is a biosimilar to the trastuzumab reference product (Herceptin®; Genentech, USA). Assessment of physicochemical stability and biological activity for the non-reconstituted, reconstituted, and infused solution over an extended, clinically relevant duration is critical for ensuring optimal patient outcomes and health resource utilization. METHODS: The physicochemical and biological stability of MYL-1401O was assessed in non-reconstituted vials stored at 25 °C ± 2 °C/60% ± 5% relative humidity (RH) for 6 months, reconstituted 21 mg/mL solution in vials stored at 2 °C to 8 °C for 10 days, and diluted in 0.9% saline-containing infusion bags at 0.3 mg/mL and 4.0 mg/mL stored for 77 days at 2 °C to 8 °C, plus an additional 2 days at 25 °C ± 2 °C/60% ± 5% RH. RESULTS: At all storage conditions tested, MYL-1401O was physicochemically and biologically stable for extended duration and under various temperature and humidity conditions. CONCLUSIONS: MYL-1401O retained its physicochemical and biological stability under different storage conditions, which supports advanced preparation of MYL-1401O, better efficiency, less wastage, and cost-savings for better patient management.

Clinical characteristics and complications of skull base osteomyelitis: A 12-year study in a teaching hospital in South India.

CONTEXT: Skull base osteomyelitis (SBO) is an uncommon disease with substantial morbidity and mortality. AIMS: The aim of this study is to characterize clinical features, outcomes, and complications of SBO. We also looked at differences in clinical profile in otogenic and non-otogenic SBO. MATERIALS AND METHODS: This is a single-center retrospective observational study. Patients aged more than 15 years of age with clinical and radiological diagnosis of SBO admitted in general medicine department in a teaching hospital in South India from March 2006 to February 2018 were recruited. RESULTS: A total of 41 patients with SBO were identified and included. Mean age was 56.9 ± 10.7 years. In all, 90% of patients (37/41) had diabetes mellitus and 29% (12/41) had recent head/neck surgery. Only 19% (8/41) needed ICU care, and mortality was 21% (9/41). Most common symptom was headache seen in 73% (30/41) of patients. Majority, 61% (25/41), had otogenic infections. Otogenic infections were associated with longer duration of diabetes mellitus (mean = 11.5 vs. 5 years, P = 0.01), higher creatinine levels (mean = 1.66 vs. 0.9 mg/dL, P = 0.014, odds ratio [OR] = 3.8), and higher incidence of cranial nerve palsy (92% vs. 56%; OR = 8.9) compared to non-otogenic SBO. Cranial nerve palsy (78%), meningitis (63%), and cerebral venous thrombosis (43%) were frequent complications of SBO in this study. The causative organisms for SBO in our cohort was bacterial in 60% (15/25) and fungal in 40% (10/25) of the patients. Surgical debridement for source control was done in 54% of patients (22/41) and was associated with survival at discharge (P = 0.001). CONCLUSIONS: Bacterial infections are the most common cause of SBO. Otogenic SBO is associated with longer duration of diabetes mellitus and higher incidence of cranial nerve palsy. Therapeutic surgical debridement plays an important role in treatment of SBO and is associated with improved survival.