Search

Background: In India, high mortality and morbidity rates of human rabies is observed. Hence, a structured surveillance system is yet to be put in place for public health discussion. At the tertiary care hospital and all public health centres, requirement of anti-rabies vaccine is needed in advance to predict the upcoming months coverage so that wastage of vaccine is minimum. Objective: To find a suitable model for forecasting the appropriate stock of anti-rabies vaccines to avoid shortage and over-supply at anti rabies clinic. Methods and Material: This was a record based cross sectional study, conducted at anti rabies clinic of Jawaharlal Nehru Medical College and Hospital, Ajmer. Data of used anti rabies vaccine was taken from immunization inventory during the period from 2017 to 2020. Time series analysis based on Holt-Winter and Box-Jenkins methods were carried out to predict the need of vaccine. Results: Study series was not stationary and stationarity was observed by taken difference in the observation between two consequent months. Residuals of the series were normally distributed and independent to each other. ARIMA(0, 1, 1) was the best model in comparison to Holt-Winter model for prediction because of low value of model selection criterion. The forecasted value for anti-rabies vaccine was done for the year 2021. Conclusions: The following study concluded that time series can be used as a tool to forecast anti-rabies vaccine coverage and will help the policy makers to formulate appropriate plans and strategies and improve the management of vaccination resources and inventory.

Introduction: Chest x-ray (CXR) is the primary modality for diagnosis and severity assessment and monitoring the ATT response in pulmonary tuberculosis (PTB). The aim of our study was to determine the correlation between the radiographic involvement of disease on CXR based on Timika CXR score with the clinically and bacteriological specications at diagnosis and initiation of ATT in sputum smear-positive PTB patients. Material And Method: A cross-sectional study was conducted in the Department of Pulmonary Medicine, a tertiary care hospital, Punjab, from January to June 2020. Seventy new sputum smear-positive cases of PTB were included. At the time of diagnosis, the patient's baseline test, clinical signs and symptoms were evaluated using TB scores I, II, Karnofsky performance score (KPS), and body mass index (BMI). Two chest physicians, according to the Timika CXR score, evaluated the CXR of each patient Independently. Result: Cavitary lesion on CXR resulted in a signicantly higher Timika score associated with higher Mycobacterial load in sputum grading compared to non-cavitary disease. 55.17% of patients with CXR score ≥71 had statistically signicant higher baseline sputum grading compared to 9.76% of patients with CXR ≤ 71. Higher Timika CXR score ≥ 71 was signicantly associated with a longer mean duration of symptoms, lower BMI, higher TB score, lower KPS at baseline, higher ESR, low hemoglobin, low serum albumin. Discussion: The study shows that Timika CXR score signicantly correlates with radiographic involvement and extent of disease severity on CXR with the clinically and bacteriological prole of PTB patients, which a pulmonologist can use in a medical practice. A Higher CXR Timika score is associated with the patient's poor clinical condition and the severity of the disease. Cavitary lesion on CXR associated with higher sputum smear grading. It is observed that the Timika CXR score can be used to identify the PTB patients at risk of treatment failure for their more aggressive management.

Background: India has high prevalence of chronic respiratory diseases, especially bronchial asthma and chronic obstructive pulmonary disease (COPD). Both of these are also recognized as risk factors for severity and poor outcome of COVID-19 disease. It is assumed that COVID-19 outbreak as well as an effective lockdown might have affected the incidence and outcome of some of these. Methods: To substantiate above hypothesis, an online survey was mailed to 547 pulmonologists across the country; 314 (54.7%) responses were recorded in the given period. The survey included observations on incidence and outcome of common chronic respiratory diseases such as asthma, COPD and interstitial lung diseases (ILD) in predefined pre-COVID and during COVID period in a total of 24 questions. Results: It was observed that the reduction in incidence of outpatient department cases, acute exacerbations and hospitalization for asthma, COPD and ILD was statistically significant. The outcome of acute exacerbations of these chronic respiratory diseases was analyzed in terms of discharges from hospitals after satisfactory recovery and/ or mortalities. For COPD and ILD, it was not significantly affected during the COVID period. At the same time, a relatively higher proportion of acute asthma mortality was reported. A wide variation in nebulization practices was reported during this period. The doses of inhaled corticosteroids in asthma management were not affected. A wide variety of factors including effective lockdown, better quality of air and regular use of masks were probably responsible for reduced incidence of exacerbations of these chronic respiratory diseases. Conclusion: We conclude that while outpatient department visits, acute exacerbations and hospitalizations were significantly reduced during COVID-19 period, outcome of asthmatics was relatively unfavorable as compared to that of COPD and ILDs.

Background: Coronary artery disease (CAD) among CVDs is the largest killer in the developed world and is rapidly becoming one in the developing countries. CAD is a leading cause of mortality, morbidity and disability with high healthcare costs. Materials and Methods: Cross sectional study was conducted to assess epidemiological factors of Coronary artery disease (CAD) in patients. First case was selected randomly then further every case was selected till 300 study subjects were covered. Results: Mean age of the study subjects of coronary artery disease (CAD) was studied in the present study and found to be 54.79±1.146. Majority of study subjects of coronary artery disease. 110 (36.67%) were current smokers. In the present study, study subjects of CAD were found to be decreasing with increasing level of education. Conclusions: The findings of present study suggest that a number of modifiable risk factors and non modifiable risk factors are responsible for Coronary artery disease like age, past history of diseases, education level.

Implementation research with pre- and post-comparison was planned to improve the quality of evidence-based intrapartum care services in Indian medical schools. We present the baseline study results to assess the status of adherence to intrapartum evidence-based practices (IP-EBP) in study schools in 3 states in India and the perception of the faculty.A concurrent mixed-methods approach was used to conduct the baseline assessment in 9 medical schools in Rajasthan, Gujarat, and Union Territory from October 2018 to June 2019. IP-EBP among pregnant women in uncomplicated first (n=135), second (n=120), and third stage (n=120) of labor were observed using a predesigned, pretested checklist quantitatively. We conducted in-depth interviews with 33 obstetrics and gynecology faculty to understand their perceptions of intrapartum practices. Quantitative data were analyzed using SPSS (version 22). COM-B (Capability, Opportunity, and Motivation Behavior) model was used to understand the behaviors, and thematic analysis was done for the qualitative data.Unindicated augmentation of labor was done in 64.4%, fundal pressure applied in 50.8%, episiotomy done in 58.3%, and delivery in lithotomy position was performed in 86.7% of women in labor.Intrapartum practices that are not recommended were routinely practiced in the study medical schools due to a lack of staff awareness of evidence-based practices and incorrect beliefs about their impact.