Role of vitamin D3 supplementation in allergic rhinitis: an outpatient department based prospective analytical observational study

Background: Allergic rhinitis is a common disorder characterized by sneezing, rhinorrhoea, nasal congestion, itching and lacrimation which adversely affect quality of life to a substantial degree. Evidence suggests that low serum vitamin D3 has correlation with severity of allergic rhinitis. The objective of the study was to evaluate whether vitamin D3 supplementation has any role to reduce the severity of disease spectrum among allergic rhinitis patients.Methods: This prospective analytical observational study was carried out in 6 months in ENT OPD of Midnapore medical college and Hospital. Only the persistent moderate to severe allergic rhinitis patients as per ARIA-WHO guideline, aged >12 years were included in this study. 64 subjects were randomised into two groups. The test group received oral vitamin D (60000 IU/week for 2 months) along with levocetirizine, fluticasone spray and montelukast while the control group received three drug therapies without vitamin D3. Allergy symptom score (ASS) was assessed at the start and end of the study period.Results: The study population (n=64) was predominantly female (37) and had a mean age of 39.79 years. The ASS score was 14.06±1.01 in Test group and 13.93±1.01 in Control group and the Post treatment ASS score was 2.65±1.12 and 6.06±0.87 respectively. This difference between groups was significant (p<0.001).Conclusions: There was significant reduction in the Allergy symptom score after vitamin D3 supplementation which alters the course of disease towards clinical improvement

Effect of Intratympanic Dexamethasone in Idiopathic Sudden Sensorineural Hearing Loss

Introduction Oral steroids currently represent the standard treatment for idiopathic sudden sensorineural hearing loss The aim of this study is to assess the effectiveness of intratympanic dexamethasone injection for treating ‘Idiopathic sudden sensori-neural hearing loss’ (ISSNHL) not improved with conventional oral steroid. Materials and Methods A prospective study was conducted on 30 patients refractory to oral steroid therapy between June 2017 to May 2018. ‘Intratympanic dexamethasone injection’ (ITDI) was given every week for 3 consecutive weeks. Hearing was assessed by performing pure tone audiogram before every ITDI and also 1 week after the completion of treatment. Results Hearing improvement was found in 19 out of the 30 cases (63.3%).   Conclusions Intratympanic dexamethasone significantly improves the prognosis of ISSNHL and is a safe, inexpensive and effective treatment

An Outcome Analysis of Endoscopic Sinus Surgery in Chronic Sinusitis with Chronic Rhinitis Non-responsive to Medical Therapy

Introduction   Chronic sinusitis with chronic rhinitis affect the patients’ quality of life significantly. Aim of this study is to assess the outcome of Endoscopic Sinus Surgery (ESS) in terms of Quality of Life (QoL) in patient with Chronic Sinusitis with Chronic Rhinitis (CSCR), non-responsive to medical therapy.     Materials and Methods Prospective study was conducted among 75 patients of CSCR non responsive to medical therapy in the age group of 15 to 80 years over a period of 18 months (January 2018 to June 2019). The subjects were randomly grouped into two, namely Group 1- CSCR with Polyp and Group 2- CSCR without Polyp. Subjects were asked to complete SNOT-22 score and Visual analogue scale (VAS) and conventional medical treatment was given for 2 weeks. Those failed to respond as per EPOS guideline were subjected to ESS and followed up at 6 weeks and 12 weeks, re-assessed by SNOT-22 questionnaire and VAS. Data was analyzed by using Paired t- test.   Results Statistically significant (p-value <0.05) improvement in symptom score assessing QoL after Endoscopic sinus surgery.   Conclusion Patients with CRS non- responsive to medical treatment, the decision for surgery should be guided by their pre-operative QoL impairment, as measured by SNOT-22 and VAS

Effect of Intratympanic Dexamethasone in Idiopathic Sudden Sensorineural Hearing Loss

Introduction Oral steroids currently represent the standard treatment for idiopathic sudden sensorineural hearing loss The aim of this study is to assess the effectiveness of intratympanic dexamethasone injection for treating ‘Idiopathic sudden sensori-neural hearing loss’ (ISSNHL) not improved with conventional oral steroid. Materials and Methods A prospective study was conducted on 30 patients refractory to oral steroid therapy between June 2017 to May 2018. ‘Intratympanic dexamethasone injection’ (ITDI) was given every week for 3 consecutive weeks. Hearing was assessed by performing pure tone audiogram before every ITDI and also 1 week after the completion of treatment. Results Hearing improvement was found in 19 out of the 30 cases (63.3%).   Conclusions Intratympanic dexamethasone significantly improves the prognosis of ISSNHL and is a safe, inexpensive and effective treatment

Not Available

Not AvailableFrontline demonstration on potato (Kufri Sindhuri) was conducted by Krishi Vigyan Kendra,East Sikkim, India. A total 158 nos. of demonstration were conducted in rice-fallow (farm-ers’ practice) at farmer’s field in nine numbers of villages during the year 2019-20. Resultsrevealed that average yield of rice and potato recorded was 2.09 t/ha and 14.13 t/ha, respec-tively. Higher system rice equivalent yield (REY) was recorded 16.22 t/ha in rice-potato and 2.1t/ha and rice-fallow system. System production efficiency (SPE) was also higher in rice-potato(62.14 kg/ha/day) as compared to rice-fallow (14.51 kg/ha/day). Land use efficiency (LUE)was recorded 71.51 % and 39.45 % in rice-potato and rice-fallow system, respectively. Netreturn was found Rs.16032/ha in rice-fallow and Rs.183952/- with rice-potato system duringthe years of demonstration. Higher benefit to cost (B: C) ratio was found 2.82:1 in rice-potatothan in rice-fallow (1.62:1) system. Economic efficiency was also recorded higher in rice -potato(704.80 Rs/ha/day) than rice-fallow (111.33 Rs/ha/day) during the demonstrated year. Hence,it may be concluded that the inclusion of potato in rice -fallow is an option for increasing theadditional income of the farmers for their livelihood improvementNot Availabl

An Outcome Analysis of Endoscopic Sinus Surgery in Chronic Sinusitis with Chronic Rhinitis Non-responsive to Medical Therapy

Introduction   Chronic sinusitis with chronic rhinitis affect the patients’ quality of life significantly. Aim of this study is to assess the outcome of Endoscopic Sinus Surgery (ESS) in terms of Quality of Life (QoL) in patient with Chronic Sinusitis with Chronic Rhinitis (CSCR), non-responsive to medical therapy.     Materials and Methods Prospective study was conducted among 75 patients of CSCR non responsive to medical therapy in the age group of 15 to 80 years over a period of 18 months (January 2018 to June 2019). The subjects were randomly grouped into two, namely Group 1- CSCR with Polyp and Group 2- CSCR without Polyp. Subjects were asked to complete SNOT-22 score and Visual analogue scale (VAS) and conventional medical treatment was given for 2 weeks. Those failed to respond as per EPOS guideline were subjected to ESS and followed up at 6 weeks and 12 weeks, re-assessed by SNOT-22 questionnaire and VAS. Data was analyzed by using Paired t- test.   Results Statistically significant (p-value <0.05) improvement in symptom score assessing QoL after Endoscopic sinus surgery.   Conclusion Patients with CRS non- responsive to medical treatment, the decision for surgery should be guided by their pre-operative QoL impairment, as measured by SNOT-22 and VAS

Factors affecting willingness to participate in vaccine clinical trials in an underdeveloped country: perspective from Nepal

Due to the inherent complex nature of clinical trials, individual’s willingness to participate and hence, enrollment in a clinical trial maybe challenging. When it comes to vaccine clinical trial in children, informed consent needs to be secured from the parents or legally acceptable representatives (LARs). Some of the factors which contribute to hesitancy in taking part in clinical trials are based on the level of education, living standards, part of the world they live, associated burden of disease, fear of different procedures in clinical trial, side effects, limited understanding, limited time, and mistrust with Investigational product. This study included 201 parents/LARs, who approached Kanti Children Hospital site in Kathmandu with the interest to get their children enrolled in a vaccine clinical trial with objectives of describing the reasons for agreeing or disagreeing to participate in the vaccine clinical trial, factors affecting decision making, and finding the major concerns of parents/LARs. The acceptance for the study vaccine was 136 (67.7%) whereas denial was 65 (32.3%). This study showed that age, education level, family structure, advice from family and friends, and medical guidance play important roles in willingness of parents to get their child enrolled in the trial. If a proper counseling is done, fear of blood sampling is not a big factor which is contrary to the belief among clinical researchers. Safety of vaccine, frequency of injections, and cost of vaccine were the main concerns of the parents, which need to be addressed extensively while planning for any clinical trial in children

Efficacy and safety of ridinilazole compared with vancomycin for the treatment of Clostridium difficile infection: a phase 2, randomised, double-blind, active-controlled, non-inferiority study

Background: Clostridium difficile infection is the most common health-care-associated infection in the USA. We assessed the safety and efficacy of ridinilazole versus vancomycin for treatment of C difficile infection. Methods: We did a phase 2, randomised, double-blind, active-controlled, non-inferiority study. Participants with signs and symptoms of C difficile infection and a positive diagnostic test result were recruited from 33 centres in the USA and Canada and randomly assigned (1:1) to receive oral ridinilazole (200 mg every 12 h) or oral vancomycin (125 mg every 6 h) for 10 days. The primary endpoint was achievement of a sustained clinical response, defined as clinical cure at the end of treatment and no recurrence within 30 days, which was used to establish non-inferiority (15% margin) of ridinilazole versus vancomycin. The primary efficacy analysis was done on a modified intention-to-treat population comprising all individuals with C difficile infection confirmed by the presence of free toxin in stool who were randomly assigned to receive one or more doses of the study drug. The study is registered with ClinicalTrials.gov, number NCT02092935. Findings: Between June 26, 2014, and August 31, 2015, 100 patients were recruited; 50 were randomly assigned to receive ridinilazole and 50 to vancomycin. 16 patients did not complete the study, and 11 discontinued treatment early. The primary efficacy analysis included 69 patients (n=36 in the ridinilazole group; n=33 in the vancomycin group). 24 of 36 (66·7%) patients in the ridinilazole group versus 14 of 33 (42·4%) of those in the vancomycin group had a sustained clinical response (treatment difference 21·1%, 90% CI 3·1–39·1, p=0·0004), establishing the non-inferiority of ridinilazole and also showing statistical superiority at the 10% level. Ridinilazole was well tolerated, with an adverse event profile similar to that of vancomycin: 82% (41 of 50) of participants reported adverse events in the ridinilazole group and 80% (40 of 50) in the vancomycin group. There were no adverse events related to ridinilazole that led to discontinuation. Interpretation: Ridinilazole is a targeted-spectrum antimicrobial that shows potential in treatment of initial C difficile infection and in providing sustained benefit through reduction in disease recurrence. Further clinical development is warranted. Funding: Wellcome Trust and Summit Therapeutics