scholarly journals Thalidomide in Axial Spondyloarthropathy: An Eastern Indian Experience

2018 ◽  
Vol 5 (2) ◽  
pp. 3-6
Author(s):  
Rudrajit Paul ◽  
Arijit Sarkar ◽  
Urmimala Bhattacharjee ◽  
Ritasman Baisya ◽  
Pallab Biswas ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Human Leukocyte ◽  
Limiting Factor ◽  
Care Hospital ◽  
Necrosis Factor Alpha ◽  
Mediators Of Inflammation ◽  
Axial Spondyloarthropathy ◽  
Tnf Α ◽  
One Year

ABSTRACT Background Axial spondyloarthropathy (SpA) is seronegative arthritis which mainly affects young adults and causes much morbidity. Tumor necrosis factor-alpha (TNF-α) is one of the main mediators of inflammation in joints and enthuses in SpA. Nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and biologics like TNF-α inhibitors are the mainstay of therapy in SpA. However, in India, the cost is one limiting factor in the use of biologics for the treatment of SpA in eligible patients. Thalidomide is an oral TNF-α inhibitor which has reported benefit in axial SpA, and it is a cheap option in the Indian setting. However, there is almost no Indian data on its efficacy. Materials and methods This is a retrospective analysis of patients receiving thalidomide for axial SpA in the rheumatology clinic of a tertiary care hospital of Kolkata. In this clinic, thalidomide was used at 100 mg/day. Patients receiving thalidomide, who had completed at least one year follow up were included in the analysis. Assessment of SpondyloArthritis International Society (ASAS)-20, ASAS-40, and ankylosing spondylitis disease activity score with C-reactive protein (ASDAS-CRP) were measured three monthly during the follow-up. Side effect profile of thalidomide was also recorded. Results The completed data of 66 patients were analyzed. All patients were human leukocyte antigen (HLA) B27 positive. Ninety-five point percent fulfilled ASAS-20 criteria at 12 months and 71.2% fulfilled the ASAS-40 criteria at 12 months. Three patients were nonresponders. The average ASDAS-CRP score also decreased from 2.9 to 1.5 over one year. Conclusion In our study, oral thalidomide resulted in significant improvements in axial SpA. Further randomized controlled trials are needed to find the relative efficacy of thalidomide with respect to other forms of treatment.

scholarly journals Assessment of the success rate of specialised female surgical clinic in tertiary care hospital

2019 ◽  
Vol 7 (1) ◽  
pp. 271
Author(s):  
Anand Gupta ◽  
Anshuman Sharma
Keyword(s):  
Success Rate ◽  
Multidisciplinary Approach ◽  
Tertiary Care ◽  
General Medicine ◽  
Care Hospital ◽  
Surgical Department ◽  
Female Patients ◽  
One Year ◽  
Surgical Clinic

Background: Specialized female surgical clinics are the basic requirement in surgical department which should be addressed routinely. The management of surgical problems in female patients requires multidisciplinary approach mainly general surgery, obstetrics and gynaecology, general medicine, paediatrics, dermatology and psychiatry. If proper care is provided then this will uplift the follow up of same patients in such clinics. The objective of the study was to assess the success rate of female surgical clinics and to determine the follow up visits done by female patients once visited the female surgical clinics.Methods: Prospective educational interventional study was conducted. A total of 952 patients visiting the clinic were studied. Statistical analysis was done.Results: Out of 952 cases 944 (99.2%) cases were willing to continue visit to the clinic, while 809 (84.9%) cases revisited for follow up treatment in female surgical clinics within one year duration.Conclusions: It can be concluded that there is a requirement and need of a fully functional specialized female surgical clinic in our hospital. As the success rate for follow up visit by patients in this clinic was high.

Acute kidney injury and it's outcome following maternal near miss event: A prospective observational study from a tertiary care hospital

2021 ◽  
pp. 1753495X2110690
Author(s):  
Geetika Thakur ◽  
Aruna Singh ◽  
Vanita Jain ◽  
Pooja Sikka ◽  
Aashima Arora ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Near Miss ◽  
Care Hospital ◽  
One Year

Purpose Haemorrhage, preeclampsia and sepsis are the leading causes renal dysfunction in women with a maternal nearmiss(MNM) complication. The study aimed to assess the prevalence, pattern and follow up of these women. Methods This was a hospital based prospective observational study, conducted over one year. All women with a MNM leading to acute kidney injury (AKI) were analysed for fetomaternal outcomes and renal function at 1 year of followup. Results Incidence of MNM was 43.04 per 1000 livebirths. 18.2% women developed AKI. 51.1% women developed AKI in the puerperal period. Most common cause of AKI was haemorrhage seen in 38.3% women. Majority of women had s.creatinine between 2.1 to 5 mg/dl and 44.68% required dialysis. 80.8% women recovered fully when the treatment was initiated within 24 h. One patient underwent renal transplant. Conclusion Early diagnosis and treatment of AKI results in full recovery.

Onset of Hypertension in Leflunamide Treated Low Socioeconomic Rheumatoid Arthritis Patients: An Unseen Iceberg

2019 ◽  
Vol 15 (3) ◽  
pp. 242-245 ◽  
Author(s):  
Muhammad Ishaq ◽  
Salma Razzaque ◽  
Fadieleh Shohail ◽  
Ajeet Kumar ◽  
Jibran Sualeh Muhammad
Keyword(s):  
Rheumatoid Arthritis ◽  
Blood Pressure ◽  
Tertiary Care ◽  
Asian Population ◽  
Chronic Hypertension ◽  
Care Hospital ◽  
Low Socioeconomic ◽  
One Year ◽  
Control Study

Objective: To determine the frequency of new-onset hypertension in patients with Rheumatoid arthritis taking leflunomide, in comparison with methotrexate in Asian setting. Material and Methods: Perspective case-control study was conducted in 2014 in a tertiary care hospital located in Karachi, Pakistan. Adult patients, having rheumatoid arthritis were randomly prescribed leflunomide or methotrexate. Patients having chronic hypertension, proteinuria and chronic kidney disease were excluded. Patients were monthly followed for blood pressure and heart rate measurements. Hypertension was defined using JNC 7 criteria. Results: Out of 144 patients enrolled, 80 patients received Leflunomide while 64 were started on methotrexate. Mean systolic blood pressure in leflunomide group at the start and at the end of study was 108.5 and 135.4mmHg, respectively while in methotrexate group, mean systolic BP was 109.8 and 110.5 mmhg, respectively. After one year follow up, 33 out of 80 (41%) patients were receiving leflunomide had pre-hypertension or hypertension, while only 3 out of 64 patients (4.7%) were receiving methotrexate had hypertension. Conclusion: Risk of developing hypertension in patient receiving Leflunomide is much higher in Asian population like Pakistan as compared to western population.

scholarly journals Study of antihypertensive effect of ramipril alone and in combination with telmisartan

2017 ◽  
Vol 6 (4) ◽  
pp. 821
Author(s):  
Mustafa Raja ◽  
Ajay Kumar Shukla ◽  
Astha Agnihotri
Keyword(s):  
Hemorrhagic Stroke ◽  
Moderate Hypertension ◽  
Tertiary Care ◽  
General Medicine ◽  
Arterial Disease ◽  
Care Hospital ◽  
Increased Risk ◽  
One Year ◽  
Peripheral Arterial

Background: Hypertension is one of the leading causes of the global burden of disease. Hypertension has been associated with increased risk of cardiovascular diseases, including coronary heart disease (CHD), congestive heart failure (CHF), ischemic and hemorrhagic stroke, renal failure, and peripheral arterial disease. Majority of the hypertensive population are still either untreated or inadequately treated. Aims and objectives of the study were to compare ramipril alone and in combination with telmisartan as an antihypertensive in mild to moderate hypertension.Methods: This study was a hospital based prospective, comparative randomized, observational study conducted over a period of one year. The subjects of this study had mild to moderate hypertension selected from outpatient department of department of General Medicine of a tertiary care hospital. For the purpose of this study, equal numbers of subjects were randomly allocated equally between two groups: one group on ramipril alone and the other group on combination of ramipril and telmisartan. Patients were assessed for the blood pressure (BP) reduction during follow-up period of 6-months.Results: Ramipril alone and in combination with telmisartan, both were associated with significant reduction of systolic BP (SBP), diastolic BP (DBP), and mean BP (MBP) from beginning to the end of study. Combination of ramipril with telmisartan was more effective than ramipril in lowering SBP during 4 to 12 weeks but at the end of study both drug groups were found to be equally effective antihypertensive. Both ramipril alone and in combination with telmisartan were equally effective in lowering DBP and MBP from beginning to end of study.Conclusions: There was a significant reduction of SBP, DBP, and MBP from beginning to the end of study with both ramipril alone and in combination with telmisartan. Ramipril alone and in combination with telmisartan, both were equally effective antihypertensive for mild to moderate hypertension.

scholarly journals Varied presentations of gestational trophoblastic disease in Asian women: one year follow up

2016 ◽  
Vol 4 (1) ◽  
pp. 269
Author(s):  
Sumitra Bachani ◽  
Neha Pruthi ◽  
Sana Tiwari ◽  
Pratima Mittal
Keyword(s):  
Hydatidiform Mole ◽  
Tertiary Care ◽  
First Trimester ◽  
Gestational Trophoblastic Disease ◽  
Good Prognosis ◽  
Care Hospital ◽  
Asian Ethnicity ◽  
Trophoblastic Disease ◽  
One Year

Gestational trohoblastic tumors are rare tumors which constitute less than 1% cancers of female reproductive system. They have varied presentations of which hydatidiform mole is most common. The incidence is higher in Asia and South America as compared to the rest of the world. We present a total of 5 cases of Gestational trophoblastic disease (GTD) constituting 12.2% of admissions in Gynaecology ward of a tertiary care hospital over one year. There are various risk factors which predispose to GTD include maternal age less than 20 years or more than 35 years, prior GTD, prior miscarriages, Asian ethnicity and blood group A. Commonly the woman  presents with vaginal bleeding in first trimester. Sonography and β-hCG are decisive in establishing the diagnosis and further management. Follow up of the patient is very crucial. Early diagnosis and timely management results in good prognosis.

scholarly journals A retrospective analysis on acceptability and complications of PPIUCD insertion

2018 ◽  
Vol 7 (11) ◽  
pp. 4536
Author(s):  
Prabha Lal ◽  
Nihita Pandey ◽  
Abha Singh
Keyword(s):  
Family Planning ◽  
Post Partum ◽  
Tertiary Care ◽  
Unmet Need ◽  
First Year ◽  
Care Hospital ◽  
Population Crisis ◽  
One Year ◽  
Long Acting

Background: In India, 65% of women in the first year postpartum have an unmet need for family planning but only 26% of women are using any method of family planning during the first year postpartum. This leaves a huge gap which needs to be addressed if maternal health is to be optimized. This calls for a method which is both effective and acceptable immediately post-partum. This is where the role of PPIUCD needs to be studied.Methods: This study was a retrospective observational study conducted in a tertiary care hospital. All deliveries during the time period from September 2016 to August 2017 were included in the study and the women accepting PPIUCD were studied for analysed for their age, parity, booking status and complaints during the follow up visit.Results: A total of 13,039 deliveries took place in one year between Sept 2016 to Aug 2017 out of which, 1118 (8.6%) accepted PPIUCD as a method of contraception. 44.3% PPIUCD users were in the age group of 21-25 years. 57% of PPIUCD users were primigravidas. 84% of PPIUCD users were booked cases. Missing threads was the most common complication, with 8.4% patients reporting it at follow up. There were no major complications noted in the study.Conclusions: PPIUCD is a safe and effective long acting reversible contraception method. Is particularly beneficial in a setting where women do not return for contraceptive advice. With low expulsion rates and high continuation rate, authors can conclude that PPIUCD can be the solution to a country like India currently facing population crisis and high unmet need.

Chemo-prophylaxis of COVID-19 with hydroxychloroquine: a study of health care workers attitude, adherence to regime and toxicities/side effects (Preprint)

2020 ◽  
Author(s):  
Debajyoti Bhattacharyya ◽  
Neeraj Raizada ◽  
Bharathnag Nagappa ◽  
Arvind Tomar ◽  
Prateek Maurya ◽  
...  
Keyword(s):  
Side Effects ◽  
Health Care Workers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Perceived Threat ◽  
Care Hospital ◽  
Care Workers ◽  
Perceived Danger ◽  
Structured Questionnaire

BACKGROUND There are apprehensions among healthcare worker (HCWs) about COVID-19. The HCWs have been given hydroxychloroquine (HCQ) chemo-prophylaxis for seven weeks as per Government of India guidelines. OBJECTIVE To assess the apprehensions among HCWs about COVID-19 and to document accessibility, adherence and side effects related to HCQ prophylaxis in HCWs. METHODS A longitudinal follow up study was conducted in a tertiary care hospital. HCQ was given in the dose of 400 mg twice on day one, and then 400 mg weekly for seven weeks. 391 HCWs were interviewed using semi structured questionnaire. RESULTS 62.2% HCWs expressed perceived danger posted by COVID-19 infection. Doctors (54%) showed least acceptance and paramedics (88%) showed highest acceptance to chemo-prophylaxis. 17.5% participants developed at least one of the side effects to HCQ. Females and nursing profession were significantly associated with adverse effects. Common side effects were gastro-intestinal symptoms, headache and abnormal mood change. Most of these were mild, not requiring any intervention. Gender, professions and perceived threat of COVID-19 were significantly associated with acceptance and adherence to HCQ prophylaxis. CONCLUSIONS Two third of HCWs had perceived danger due to COVID-19. Three fourth of the HCWs accepted chemo-prophylaxis and four out of five who accepted had complete adherence to prophylaxis schedule. One out of five had developed at least one of side effects; however, most of these were mild not requiring any intervention.

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