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Dengue virus is a positive stranded RNA virus belonging to genus Flavivirus and family Flaviviridae. Dengue virus can infect infants, young children and adults. Dengue fever is an emerging arboviral public health problem affecting a large endemic population in tropical and subtropical regions around the world, with various degrees of clinical manifestation. A study on prevalence of dengue and its associated factors of virus circulation in patients attending a tertiary care centre. A cross-sectional study conducted at Department of Microbiology during the period of 6 months i.e., July 2023 to December 2023. Blood samples was collected from clinically suspected patients with flu like symptoms as per WHO criteria. The samples were tested for the presence of dengue-specific IgM antibodies using MAC-ELISA and dengue NS1 antigen detection was done using NS1 ELISA kit, as per the kit guidelines follows. A total of 750 samples were analysed during the study period. Out of which 422 samples were found positive for dengue infection. Age group 31-40 been the mostly infected by Dengue in which males were more commonly infected than females. The clinical manifestation fever 100%, headache 44.54%, and abdominal pain 42.89%, nausea/vomiting 37.44%, thrombocytopenia 34.36%, aches and pain 23.45% was found in increase percent of the dengue confirmed positive patient, while bleeding from gums and nose 18.48% and skin rash 13.03% least found in patients. In conclusion, the present study showed that dengue infection was more prevalent among young males. Awareness and educating the community regarding mosquito breeding habits, prevention and control of the vector will help in controlling the dengue. Development and use of an effective vaccine will be beneficial in endemic areas to help and limit the spread of infection. [ABSTRACT FROM AUTHOR]

Migraine is a complex disorder with multigenic inheritance and is characterized by the cardinal symptom of unilateral headache. Many genes are responsible for increasing the susceptibility of disease within different populations. Therefore, our primary aim in this review was to catalog the many genes that have been studied in India and after collecting the necessary information, we calculated a more precise risk relationship between an identified variation and migraine. The gene and its associated risk variant were discovered in the Indian population using a PRISMA-based systematic literature review guideline from online databases such as PubMed & Google Scholar. We constructed pooled odds ratios with 95% confidence intervals using multiple genetic models. Also, we looked for heterogeneity using Cochran's Q Test and the I2 statistic. Publication bias was analyzed using Begg's and Egger's tests. A p-value less than 0.05 was judged to be statistically significant for all tests. After a critical analysis, a total of 24 studies explored about 21 genes with 31 variants out of which only nine genes have been studied more than two times in the Indian population and thus were found eligible for the meta-analysis. It has been found, that the ACE-DD variant (allele model: OR: 1.37 [1.11–1.69], I2 = 0%/ fixed model), ESR1-PvuII (allele model: OR: 1.47 [1.24–1.74], I2 = 0%/ fixed model) significantly increases the risk of migraine in Indian population. Also, a protective role of the LRP1-rs11172113variant was observed for both migraine and its clinical subtype i.e., MA (allelic model: OR of 0.65 [0.50–0.83] I2 = 44% and allele: OR: 0.54 [0.37–0.78], I2 = 52%) respectively. Overall, the results of this meta-analysis indicated that the ACE-DD variant and the ESR1-PvuII were associated with an increased risk of migraine in the Indian community, while the LRP1-rs11172113 variant was associated with protection from migraine in this population. [ABSTRACT FROM AUTHOR]

Introduction and Objective. Neurological disorders are without a doubt among the most terrifying ailments that humans can experience. Although several observational studies on neurological illnesses have been conducted worldwide, there are relatively few such studies in India. The aim of the study is to research patients with neurological disorders in terms of their profiles, demographic data, family history, dietary habits, social habits, occupational status, geographical location, diagnosis, and treatment plan. Materials and methods. The 6-month prospective observational study involved an in-depth interview schedule, and an information sheet in English and local languages using1,000 patients. Results. The findings of this study demonstrate that the prevalence of cervical discomfort followed by ischemic stroke is rather significant, and that neurological diseases were more common in rural areas than in metropolitan areas. Patients had hypertension (HTN), diabetes mellitus (DM), either alone or both together, Ischemic stroke, pain, epilepsy, thyroid, migraine, tuberculoma, and hamorrhagic stroke as previous illnesses. Conclusions. The prevalence of neurological problems was found to be higher in individuals over the age of 40 than in younger people. According to the statistics, females (58.5%) are more prone to neurological problems than males (41.5%). The patients’ body weight was also taken into account, and it was shown that the majority of the individuals with neurological diseases (33.7%) were of normal body weight. The frequency of neurological diseases was found to be much higher (55%) in rural regions than in urban areas (45%). The majority of patients with neurological illnesses were housewives. Analysis concluded that cervical discomfort is the most common neurological illness, compared to other neurological disorders. [ABSTRACT FROM AUTHOR]

Diabetes is one of the commonest morbidity among patients with tuberculosis (TB). We conducted this study to estimate the costs incurred by patients with TB comorbid with diabetes and to explore the perspectives of program managers as well as patients on the reasons and solutions for the costs incurred due to TB-diabetes. We conducted a descriptive cross-sectional study to estimate costs among 304 patients with TB-diabetes comorbidity registered in the public health system during 2017–2020 in the Bhavnagar region of western India, which was followed by in-depth interviews among program functionaries and patients to explore solutions for reducing the costs. Costs, when exceeded 20% of annual household income, were defined as catastrophic as this cut-off was most significantly related to adverse TB outcomes. Among the 304 patients with TB-diabetes comorbidity, 72% were male and the median (interquartile IQR) monthly family income was Indian rupees (INR) 9000 (8000–11,000) [~ US$ 132 (118–162)]. The median (IQR) total costs due to combined TB-diabetes were INR 1314 (788–3170) [~ US$ 19 (12–47)], while that due to TB were INR 618 (378–1933) [~ US$ 9 (6–28)]. Catastrophic costs due to TB were 4%, which increased to 5% on adding the costs due to diabetes. Health system strengthening, an increase in cash assistance, and other benefits such as a nutritious food kit were suggested for reducing the costs incurred. We conclude that, in addition to a marginal increase in the percentage of catastrophic costs, co-existent diabetes nearly doubled the median total costs incurred among patients with TB. Strengthening the TB-diabetes bi-directional activities, tailoring the cash transfer scheme for comorbid patients, and making the common two-drug combination diabetes tablets available at government drug stores would help TB-diabetes comorbid patients cope with the costs of care. [ABSTRACT FROM AUTHOR]

Burn injury is a global problem that equally concerns under-developed and developing countries. An ideal dressing material has to maintain a moist environment, act as a bacterial barrier and as a medium for free exchange of gases, while providing a barrier against toxic contaminants. Sixty-eight consecutive patients with fresh acute superficial partial thickness burns ≤ 15% BSA, registered in two tertiary care teaching hospitals in North India between January 2015 to December 2019, were divided into two groups: a collagen dressing group (group A) and a paraffin gauze (PG) plus silver sulfadiazine (SSD) group (group B). Forty-four patients received collagen dressing and 24 patients received conventional paraffin gauze (PG) plus silver sulfadiazine (SSD) dressing. Patients were followed up for clinical outcome until burn wounds healed. We observed complete healing in 5-7 days for 26 cases (59%) in group A, in 8-12 days for 16 cases (66.66%) in group B. A total of 95.5% of group A patients required analgesia only for ≤ 2days, while 90.90% of group B patients required analgesia for ≥ 6 days. Ninety percent of group A patients required none or a single dressing change with shorter hospital stay. In group B, 22 cases required 3-5 dressing changes. Collagen dressing has proved to be highly advantageous for acute small areas of partial thickness burns (< 15% BSA). It confers better pain relief, and minimal or no dressing change with better rate of wound healing. Pediatric patients preferred collagen sheet dressing. Conventional dressings tend to adhere to the wound surface, and their need for frequent changes traumatises newly epithelialized surfaces and may delay healing. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Areca catechu Linn. (Arecaceae) nut is a popular folk remedy for the treatment of migraine in Kerala and Tamil Nadu states of India. Aim of the study This study was designed to investigate the effect of hydroalcoholic extract of A. catechu L. nut (ANE) treatment on migraine pain in rat models to strengthen its use as an anti-migraine therapy. Materials and methods Bradykinin (0.1 μmol/kg) injection in to left femoral vein of rat produced PPE which was measured with luminescence spectrometer. Vocalizations were produced in rats with 10 μg of bradykinin infusion into common carotid artery. Phonogram was recorded before, during and for 5 min after bradykinin injection and sumatriptan was used as a standard anti-migraine drug. In both models, the ANE was orally administered at doses of 250 and 500 mg/kg, 60 min before bradykinin infusion. Results The PPE was reduced in both ANE treated groups of rats. The percent fluorescein was significantly increased in positive control group (97.00±1.7%; p <0.0001) compared to negative control (63.87±1.2%). With ANE treatments (250 and 500 mg/kg) PPE was significantly decreased to 88.88±1.4% ( p <0.01) and 83.55±0.1% ( p <0.0001) compared to positive control group, respectively. On the other hand in the model of vocalization, with 250 and 500 mg/kg ANE treatment, vocalization was significantly reduced to 33.33% and 16.66%, respectively, compared to saline treated rats. The reduction in vocalization is comparable to the reference drug sumatriptan. Conclusion The findings provide the strong evidence for anti-migraine potential of ANE in rat models of migraine. In summary, therapeutic intervention with ANE treatment could be a promising strategy for prevention of migraine. [ABSTRACT FROM AUTHOR]

Drug information can be obtained from various drug information sources that were available as government (National Formulary of India [NFI]; Central Drugs Standard Control Organization [CDSCO]), as well as commercial documents (Current Index of Medical Specialties [CIMS] and Monthly Index of Medical Specialties [MIMS]). Irrational drug usage may happen due to wide variation in the information available in these sources. In this study, we tried to assess these variations in a sample of drugs for the acute-specific management of migraine with ergot and Triptans antimigraine drugs in drug information sources such as NFI, CIMS, MIMS, and CDSCO. Scoring was done for various drug information based on the completeness of information about drugs used in acute-specific management of migraine. The scores for the completeness of drug information about the selected antimigraine drugs are 18.37% for CIMS (Ergotamine, Sumatriptan, Rizatriptan, and Zolmitriptan), 21.1% for NFI (Dihydroergotamine, Sumatriptan), 72.79% for MIMS (Ergotamine tartrate, Sumatriptan, Rizatriptan, Naratriptan, zolmitriptan, Almotriptan) and 21.77% for CDSCO (Ergotamine tartrate, Sumatriptan, Rizatriptan, Naratriptan, Zolmitriptan, eletriptan and almotriptan). The information for the antimigraine drugs available from various sources found to so much deficient. Necessary steps need to be taken in case of government public or hard documents to streamline drug information available with them as well the commercial documents as to provide reliable drug information uniformly for promoting rational use of the drug., Competing Interests: None

Background: Pain is the primary symptom of chronic pancreatitis (CP) and remains a considerable therapeutic challenge. In patients with obstruction of the pancreatic duct, including stones and strictures, endoscopic treatment with or without preceding extracorporeal shock wave lithotripsy (ESWL) has been used for pancreatic duct decompression. The rationale for these procedures is based on the assumption that obstruction of the pancreatic duct leads to ductal hypertension and pain. However, clinical pain symptoms correlate poorly with pancreatic duct morphology, and the evidence for pancreatic duct decompression as an effective treatment for pain is based on case series and comparison between different procedures. No randomized, prospective, sham-controlled trials are currently available. The SCHOKE (Extracorporeal Shock Wave Lithotripsy and Endotherapy for Pain in Chronic Pancreatitis) trial is a randomized, sham-controlled trial designed to determine if pancreatic duct decompression is an effective treatment for pain in patients with CP.Methods: The SCHOKE trial is a randomized, single-blind, parallel-group, sham-controlled trial designed to evaluate the effect of combined ESWL and endoscopic treatment for pain in patients with CP. In total, 106 adult patients with painful CP and pancreatic duct obstruction will be randomized to combined ESWL and subsequent endoscopic treatment or corresponding sham procedures. The primary outcome is pain relief during the 3-month postrandomization period as documented in a pain diary. Secondary outcomes include quality of life and functional scores, patient global impression of change, change in use of analgesics, frequency of hospitalization, and complications. Standard follow-up is at 3 and 6 months after randomization. In an experimental substudy, quantitative sensory testing obtained before and after intervention will be used to obtain information on central pain processing and to develop models for prediction of treatment outcome.Discussion: The SCHOKE trial investigates if pancreatic duct decompression, obtained by combined ESWL and endoscopic treatment, is effective for pain treatment in patients with CP.Trial Registration: ClinicalTrials.gov, NCT03966781. Registered on May 25, 2019. Protocol date and version identifier: March 1, 2020; version 3.0.Sponsor: Rupjyoti Talukdar, Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India. [ABSTRACT FROM AUTHOR]