A study on allergen sensitivity in patients with allergic rhinitis in Bangalore, India.

BACKGROUND: Allergic rhinitis is the most common form of non-infectious rhinitis, affecting 500 million people worldwide, with one-fifth of those affected living in the Indian subcontinent. The skin prick test is the most valuable test for detecting offending allergens, and can be helpful for patient education, allergen avoidance and immunotherapy planning. METHOD: The skin prick test was performed with 49 allergens in 486 patients who presented with symptoms of allergic rhinitis, and the allergen profile was studied. RESULTS: Of the 486 allergic rhinitis patients, 335 (68.93 per cent) showed allergen positivity to the skin prick test. Dust mite was the most common allergen, with positive results in 44.65 per cent of cases. CONCLUSION: The most common offending allergen in our study was the dust mite. Identification of specific allergens for a particular geographical area aids patient education and enables allergen-specific immunotherapy.

Prevalence of chronic obstructive pulmonary disease and its association with tobacco smoking and environmental tobacco smoke exposure among rural population.

A field survey was conducted for chronic obstructive pulmonary disease (COPD) epidemiology in the rural field practice area of Kempegowda Institute of Medical Sciences, Bangalore, India, which covers a population of 44,387 to find out the prevalence of COPD in adult subjects of 35 years and above using cluster sampling technique and to determine the association of tobacco smoking, environmental tobacco smoking (ETS) exposure and type of cooking fuel used with COPD. The overall prevalence of COPD was 4.36%. The prevalence among males and females were 5.32% and 3.41% respectively. The prevalence was found to be increasing with an increase in age. The tobacco smoke and exposure to ETS was significantly associated with higher odds of COPD with adjusted odds ratio 2.97 and 2.67 respectively. Thus, there was a significant association between tobacco smoking and ETS exposure with COPD.

Safety, tolerability and clinical efficacy of ultra-rush sublingual immunotherapy among patients suffering from allergic rhinitis.

BACKGROUND: Conventional immunotherapy for allergy with 3-5 years of treatment period has poor compliance. Ultra-rush sublingual immunotherapy with a shorter period of treatment can have better compliance. There are very few studies on ultra-rush sublingual immunotherapy all over the world. OBJECTIVES: (1) To determine allergen sensitivity among allergic rhinitis patients. (2) To assess safety, tolerability and clinical efficacy of ultra-rush sublingual immunotherapy. METHODS: The present study was conducted in Allergy clinic, KIMS Hospital & Research Centre, Bangalore, India from January 2010 to June 2011. After obtaining Institutional Ethics Committee approval, 40 allergic rhinitis patients (according to ARIA guidelines) in the 18-60 years age group who were positive for aeroallergens in skin prick test were recruited for ultra-rush sublingual immunotherapy (20min initial phase and 4-month maintenance phase) and followed for 8 months with symptom and treatment diary. RESULTS: Out of 40 patients, the majority, 36 (90.00%) patients were sensitive to house dust mites. Six patients had seven immediate adverse reactions and seven patients had eight delayed adverse reactions. All subsided without medication or with symptomatic oral medications. All patients tolerated ultra-rush SLIT and there was significant decrease in both symptom-score and treatment received in these patients. CONCLUSION: Ultra-rush SLIT regimen has excellent safety, tolerability and clinical efficacy among allergic rhinitis patients.

Prevalence of bronchial asthma and its association with smoking habits among adult population in rural area.

A cross-sectional study was conducted in the rural field practice area of Kempegowda Institute of Medical Sciences, Bangalore. A total of 3194 adult individuals (18-70 years) were selected from 30 villages (clusters) using a cluster-sampling technique. Individuals with symptoms suggestive of asthma were subjected for clinical examination for the diagnosis of asthma. Among the 3194 respondents, 1518 (47.5%) were males and 1676 (52.5%) were females. The prevalence of bronchial asthma was 2.88%. The prevalence of asthma was higher among those reporting a history of current smoking. Among current smokers, the number of cigarettes/bidis/hookah smoked daily did not differ (P > 0.05) between individuals without asthma and with asthma, whereas the mean number of years of smoking did differ (P < 0.001). There was significant association between tobacco smoking and bronchial asthma.

A study on teenage pregnant mothers attending primary health centers of Kempegowda Institute of Medical Sciences, Bangalore.

Data were collected from 78 teenage pregnant mothers (15-19 years) out of 1446 pregnant mothers who attended the primary health centers situated in the field practice area of the rural health center, Kengeri of Kempegowda Institute of Medical Sciences, Bangalore, between May and July 2009 to study the factors associated with teenage pregnancies and awareness regarding family planning. This was a descriptive study. Out of 78 teenage pregnant mothers, 57 (73%) were Hindus and 45 (57.7%) belonged to joint families. 76 (97.4%) teenage pregnant mothers were housewives, i.e. 55 (70.5%) of the spouses of the teenage pregnant mothers were laborers, in majority, i.e. 40 (51.3%) teenage pregnant mothers' age at marriage and the age at first pregnancy were 18 years. The mean age at marriage increased significantly with an increase of the educational status of the teenage pregnant mothers (F value = 7.08%, P< 0.002). The mean age at first pregnancy was also increased with an increase of the education status of both the teenage pregnant mothers and their spouse. The most common reason for early marriage and early pregnancy was traditional practices and family pressure among 50 (64%) and 45 (57.7%) teenage pregnant mothers, respectively. 49 (63%) teenage pregnant mothers were not aware of any family planning methods.

Evaluation of a new premedication protocol for administration of equine rabies immunoglobulin in patients with hypersensitivity.

OBJECTIVES: The present study was undertaken to standardize skin testing and to develop a safe and effective premedication protocol for administration of ERIG in those with skin test positivity/hypersensitivity. METHODS: A method of grading of skin testing was developed using injection histamine as a positive control. This was evaluated by using it on 517 subjects who had severe (WHO category III) exposure to rabies. A premedication protocol consisting of injections pheniramine, ranitidine, hydrocortisone and adrenaline was evaluated by using it on fifty one subjects who were skin test positive/hypersensitive to ERIG. RESULTS: The premedication protocol was safe and effective as all the S1 subjects could be administered the full dose of ERIG despite being skin test positive/hypersensitive to ERIG. Besides the premedication drugs/protocol did not affect the immune response to vaccine and ERIG therapy.

A study on the effectiveness of DOTS on tuberculosis patients treated under RNTCP.

A total of 88 Tuberculosis patients who registered for treatment were followed up until their completion. These patients were given treatment under the Government of India implemented RNTCP in the year 1999-2000 in a Tuberculosis unit in Bangalore Mahanagara Palike. Majority of the patients were male and from lower middle class In the present study the cure rate was 72.00 %, treatment completion was 80.55%, default patients were 22.72% and chronic cases were 6.25%.