Pulmonary function test in Tropical Pulmonary Eosinophilia

Introduction: Tropical pulmonary eosinophilia (TPE) is a syndrome of wheezing, fever and eosiniphilia seen predominantly in the Indian subcontinent and other tropical areas. The syndrome results from immunologic hyper-responsiveness to human filarial parasites, Wuchereria bancrofti and Brugia malayi. Absolute eosinophilia counts are usually more than 3,000 cells/mm3. Lung functions are severely compromised. Pulmonary function tests may show a mixed restrictive and obstructive abnormality with a reduction in diffusion capacity. The mean values of expiratory flow rates were significantly decreased. Oral DEC (6 mg/kg per day) for 3 weeks is treatment of choice. Methods: A total of 61, clinic-radiologically and haematologically suspected cases of tropical pulmonary eosinophilia were included in study along with 39 healthy controls. Pulmonary functions, which included forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC Ratio, maximum mid expiratory flow rate (MMEFR) and peak expiratory flow rate (PEFR) were observed in study cases and control. Results: The mean values ±S.D. of all spirometric parameters showed low value in cases in comparison to control. Statistically all parameters showed highly significant difference (‘p’ value were <0.001) except in FEV1/FVC ratio (‘p’ value was >0.05). After the treatment with DEC the mean values ± S.D. of all parameters in cases showed improvement but the values were remained still below the control value. Conclusion: This disease, if left untreated or treated late, may lead to long-term sequelae of pulmonary fibrosis or chronic bronchitis with chronic respiratory failure

A study of Autonomic Dysfunction in bronchial asthma patients in a tertiary care centre of central India

Introduction: bronchial asthma is a chronic inflammatory disorders of airways characterised by exaggerated bronchoconstriction due to certain indirect (e g dust, pollen, allergens, cold air) or direct (inhaled methacholine) stimuli. Autonomic system plays an important role in regulation of airways and their secretion. This study was planned to demonstrate existence of autonomic dysfunction in pathophysiology of bronchial asthma. Material & Methods: Present study is undertaken in 45 subjects who were divided in to 2 groups cases and controls depending up on age and sex and similar characteristics. 7 different non-invasive tests are applied in to all subjects to evaluate their autonomic function status. Results: It was found that out of 45 patients 33 patients had abnormal autonomic function tests. Comparing the duration of bronchial asthma, 12 patients had duration <5 years out of this 3 patients with duration of asthma <5 years had abnormal test the rest 9 had normal tests whereas 33 patients had bronchial asthma for >5 years out of these 30 had abnormal tests and only 3 patients had normal test. Comparing the severity of bronchial asthma and autonomic dysfunction, Out of 45 patients 24 were classified as having severe bronchial asthma. 21 of the study patients had only parasympathetic dysfunction i.e. 46.66%. 12 had both sympathetic and parasympathetic dysfunction i.e.40% and only 6 had isolated sympathetic dysfunction i.e. 13.33%. Conclusions: There is higher incidence of autonomic dysfunction in bronchial asthma patients. Parasympathetic hyper responsiveness appears to be the main pathological factor in the genesis of bronchial asthm

To study clinical and cardiovascular profile including TMT changes in tobacco addicts

Introduction: Tobacco addiction remains a substantial problem in the worldwide. As a consequence of its addictive qualities, the consumption of tobacco often becomes a lifelong habit with cumulative and deleterious effects on health. The Treadmill test unmasks the occult disease and thereby influences the long term prognosis and treatment. Material methods: A population based prospective observational study was performed in 200 subjects who agreed to participate in the evaluation and had a history of isolated tobacco-chewing and smoking were enrolled in study. The prevalence of major coronary risk factors- obesity, truncal obesity, hypertension, fasting hyperglycemia, and lipid levels were estimated using current guidelines. Electrocardiogram, Chest radiography and treadmill stress test was done in subjects when indicated by symptoms. Results: Most of the subjects were in the age group of 41-50 years (87%), were male (96.5%). Maximum subjects were consuming tobacco for more than 20 years. Atypical chest pain was the most common associated symptom (48.5%). most of subjects were motivated by others either by peer groups or family members (25.5% and 22.5% respectively), Number of positive T.M.T. cases increases with age. In 41 to 50 year age group incidence of positive T.M.T. was more common (14.9%) and we found that the duration of addiction was more important than the quantity of tobacco. Conclusion: Tobacco is the single greatest cause of preventable death globally, The effects depend on the number of years and how much a person smokes and chews. Tobacco addiction is highly prevalent in this part of country. The present work has been performed with the idea to detect the role of tobacco addiction in the development of the coronary artery disease. The treadmill test is presently the most simple, least expensive and fairly sensitive, non-invasive screening test for the early detection of latent ischemic heart disease

Study of maternal and fetal outcome in elective and emergency caesarean section

Introduction: Caesarean section is one of the most performed surgical procedures all over the world. The present study was conducted to determine the maternal & neonatal outcome and complications in two groups of pregnancy among women with elective and emergency cesarean section. So that measures can be taken to reduce morbidity and mortality in near future. Material & Methods: A prospective observational study carried out in department of Obstetrics and Gynecology, M.G.M Medical College and M.Y. Hospital ,Indore (M.P). All patients who underwent caesarean section are divided into two groups as per the timing of procedure in emergency or electively. The two groups were compared on the basis of age, parity, indication, booking status, intra operative & post op complications, and maternal & fetal outcome. Results: The incidence of caesarean section was 30.25%. The proportion of elective and emergency caesarean was 21.63% and 78.37% respectively. All of the complications were significantly higher in emergency group in terms of both maternal and fetal outcome. Conclusion: The incidence of caesarean section is high in MGM medical college Indore and the overall complication rate is higher in emergency caesarean than elective caesarean section group

Study of gender difference of opportunistic infections in AIDS patients

Introduction: Concerns about sex-based differences in the course of HIV infection were expressed early in the epidemic. Women appeared to have more rapid progression of illness than men and to present with a different constellation of opportunistic infections than men. Conducting sex comparisons within research studies is important to delineate sex differences or similarities. Material & Methods: A prospective cohort study involving HIV infected patients scheduled to start ART, in which 156 male, 82 female and 1 transgender was undertaken to compare the gender difference in age distribution, marital status, presenting symptoms .Structured questionnaires and patients file review were used to collect. data through history, physical ex:amination and laboratory investigations. Gender differences were assessed using chi-square test for categorical data. Results: In the study population 239 patients who fulfilled NACO guidelines for AIDS were included, 156 men and 82 women. Fever was the commonest presenting symptom (57.32%) in both males and females, 61.53% of males and 48.78% females presented with fever. The most frequent AIDS Defining Infections were tuberculosis (42.25%) and candidiasis (22.6%). Pulmonary Tuberculosis, Tubercular meningitis were significantly higher in males compared to females. Herpes simplex (P value 0.007) and non specific dermatitis showed statistically significantly higher in females compared to males in occurrence rate. Conclusion: Evaluation of differences between human immunodeficiency virus (HIV)-infected men and women in antiretroviral therapy (ART) enrollment characteristics and outcomes might identify opportunities to improve ART program, patient outcomes and prevention impact. We studied gender differences in opportunistic infections in AIDS patient

Comparative Analytical Study of Two Different Drug Regimens in Treatment of Covid 19 Positive Patients in Index Medical College Hospital and Research Center, Indore, India

Background: SARS-CoV-2 is a novel virus that first emerged in Wuhan, China. Considering the novel nature of the coronavirus, there are not yet any proven treatment strategies. In this emergency, there is no specific pharmacologic treatment that specifically targets and kill the virus or control the infection and improve the clinical outcomes. Several drugs were repurposed for this illness based on in-vitro studies or minimal evidence to combat the rapid spread of the COVID-19 pandemic.Aims and objectives: To compare efficacy of two regimens’, Regimen 1 (hydroxychloroquine and azithromycin) and Regimen 2 (hydroxychloroquine, azithromycin and ivermectin) in Covid-19 positive patients.Materials and methods: An observation study on 100 Covid 19 positive patients having age between 20-60 years of either sex was conducted from April to May 2020. Patients below 20 years of and above 60 years of age and having chronic conditions like hypertension, diabetes and others were excluded. Group 1 received oral hydroxychloroquine 400 mg twice a day with azithromycin 500 mg once a day. Both medications were given by per oral route for a period of 7 days. Group 2 received hydroxychloroquine 400 mg twice a day with azithromycin 500 mg once a day and ivermectin 12 mg once a day. All medications were given by per oral route for a period of 7 days.Results: Mean age of patients in Group 1 and Group 2 was 37.62 ± 11.609 years and 38.20±11.73 years respectively (p=0.804). No significant difference was obtained between the SpO2 concentration (p=0.778). When we did final the COVID-19 testing, it showed that majority of the patients were found negative in the group 2, whereas 94% were found to be positive in the group 1. This difference was statistically significant with the p value of <0.001. Conclusion: The treatment with HCQ, azithromycin, and ivermectin had a better success rate compared to HCQ and azithromycin. Based on the results, ivermectin could be the potential therapeutic agents for the COVID-19 disease. The study had various limitations; so further randomized controlled trial is required for the results to be implemented on the larger population

Crimean-Congo haemorrhagic fever in India

This article does not have an abstract

Audiometric studies in type 2 diabetes mellitus

Introduction: Hearing defects can cause inconvenience in communication which can have prodigious impact on the psychological, social and emotional functions. The increasing incidence of diabetes and profound effect of hearing loss on quality of life mandates the need to study the possible association between the two. Materials and method: An observational study was conducted including 100 participants such that 50 were non-diabetic (group A) and another 50 were diabetic. The participants of two groups were matched for age and gender. The Random Blood Sugar, HbA1c, Pure Tone Audiometry were assessed. The statistical analysis of data was done using SPSS (Statistical Package for Social Sciences) 21.0 version, IBM, Chicago. Results: The median age of the participants belonging to group A and B was 39.0 years and 40.0 years respectively. No significant association was observed between the presence or absence of diabetes and hearing loss (Chi-square value- 2.1, df-3, p value>.05). Amongst the patients with diabetes, the HbA1c level was found to have no significant association with the severity of hearing loss (Chi-square value- 9.243, df-4, p value>.05). Conclusion: It was concluded that there is no significant difference in hearing loss amongst the persons with and without diabetes