Background
Limited supply, cost and potential for severe adverse effects observed with the blood derived rabies immunoglobulin products has led to search for alternative therapies. This issue has been addressed by developing an antirabies monoclonal antibody cocktail.
Methods
This is a phase 3, randomized, open-label, noninferiority trial conducted in patients with WHO category III exposure with suspected rabid animal. Eligible patients were assigned to either the test arm, TwinrabTM (docaravimab and miromavimab) or the reference arm, Human rabies immunoglobulin (HRIG; Imogam® Rabies-HT), in a ratio of 1:1. The primary endpoint was the comparison of responder rates between the two arms assessed as percentage of those with rabies virus neutralizing antibodies titers ≥ 0.5 IU/mL on day 14.
Results
A total of 308 patients were equally randomized into the two arms. In the per-protocol (PP) population, there were 90.21% responders in the TwinrabTM arm and, 94.37% in the HRIG arm. The Geometric Mean of RFFIT titres in the PP on day 14 were 4.38 and 4.85 IU/mL, for the TwinrabTM and HRIG arms, respectively. There were no deaths or serious adverse events reported.
Conclusions
This study confirmed that TwinrabTM is non-inferior to HRIG in terms of providing an unbroken window of protection up to day 84. This trial in healthy adults with WHO category III exposure from suspected rabid animal also establishes the safety of TwinrabTM in patients with one WHO approved vaccine regimen (Essen).
Trials Registration
CTRI/2017/07/009038
Background: In India the first positive case of pandemic H1N1 was reported in May 2009 and by end of the year 2010, 20604 cases with 1763 deaths were reported. Since 2010 Maharashtra has been reporting cases of Swine flu year after year. According to the state health department, 2010 saw 6,118 swine flu cases and 669 fatalities. For pregnant women influenza may have severe clinical course leading to complications and a risk to pregnancy. Effective prevention depends on knowledge of the community regarding the causative agent, modes of spread and remedial measures about swine flu. Methodology: This cross sectional study was conducted among obstetrics out-patient attendees of a tertiary care hospital in central India, wherein 100 pregnant women were interviewed to assess their knowledge about swine flu. Results: 42 % study participants correctly knew that the swine flu is caused by a virus. 44 % participants correctly knew that it is an airborne infection. Most common symptoms as told by participants were Cough 57%, Fever 42%, Shortness of breath (14 %). Other symptoms known to participants were joint pain, body ache, throat Pain.97% subjects weren't aware of the correct method of diagnosis while knowledge about preventive measures was also deficient in majority of study subjects. Conclusions: The knowledge regarding swine flu among study subjects was inadequate. There is need to orient the preventive programmes including information, education and counselling to educate the pregnant females about swine flu (H1N1).
Background: Since the first case of COVID-19 in late January 2020, India has become one of the hardest hit countries by COVID-19 in world. According to 2011 census, the number of PwDs in India is roughly 2.2% of total population which is approximately 26.8 million. They are more vulnerable to COVID-19 infection due to their disability and lack of accessibility to protect them.Methods: A cross sectional, mixed-methods approach, using a purposive sampling technique, a quantitative survey were adopted for the study.Results: The study showed that 99% of the participants have access to regular updated knowledge of COVID-19. 74% participants faced scarcity of protective measures, 35% faced scarcity of ration supply, 48% PwDs faced major issues to access screening, testing and treatment facilities in suspected COVID-19 cases. 43% PwDs faced scarcity of access to assistive services and devices. 40% faced issues to get their regular medicines and necessary items like catheters. 86% of the participant faced financial crises due to loss of employment and businesses. Around 16% amongst them faced severe crises which was not possible to manage.Conclusions: Facing COVID-19 situation is extremely stressful for PwDs. This study was conducted for short period of 4 months so it gives a snapshot of impact of COVID-19 on accessibility issues of PwDs.
Background: Sputum conversion and weight gain are prognostic markers of treatment outcome in tuberculosis (TB) patients. Very few studies in India have assessed impact of TB treatment on weight of patients and perceived improvement in symptoms. This prospective study aimed to assess the impact of anti-tubercular treatment on weight and perceived symptoms.Methods: Three interviews were done for each patient i.e. at start (within 7 days of starting anti-tubercular treatment), at the end of intensive phase and at the end of continuation phase for recording body weight and perceived symptoms. Descriptive statistics were used to summarize baseline characteristics. Mean scores at different stages of treatment were compared by repeat measure ANOVA. P<0.05 was considered to be statistically significant.Results: Out of 58 study subjects enrolled for the study, 53 could be followed up till the end. Mean weight improved in six months of anti-tubercular treatment. Improvement was statistically non-significant. Cough and fever were the most common symptoms prior to beginning of treatment. After the first 2 months the proportion of subjects with symptoms declined for all five symptoms i.e. fever, cough, chest pain, sweats, and dyspnoea.Conclusions: There was positive impact on weight gain in patients under category I treatment. The symptoms improved drastically in first two months with near complete resolution in six months of treatment.
Background: Adolescence is defined by WHO as the age group of 10-19 years. In India, adolescents (10-19 years) constitute about 21.4 percent of the population, comprising one fifth of the total population. Adolescents are apparently healthy people but they may also have various kinds of problems. If they are to reach adulthood in a healthy state, then it’s necessary to analyze the common health problems prevalent in this age-group so that targeted and concerted services could be provided to them. Objective of current study was to assess the health status of adolescents in urban field practice area of tertiary care hospital in Central India.
Methods: A community based descriptive cross-sectional study was conducted in urban field practice area of Government Medical College and Hospital Nagpur. House to house survey was conducted among 330 adolescents out of which 214 (64.84%) were male and 116 (35.16%) were female.
Results: In present study most common morbidity found was dandruff in 127 (38.48%) adolescents followed by acne vulgaris in 102 (30.90%). Anemia was present in 52 (15.75%) of study subjects. Out of 237 morbid study subject, 114 (48.10%) study subjects had single morbidity followed by 2 and 3 morbidities in 52 (21.94%) and 63 (26.59%) respectively. About 8 (3.37%) study subjects had more than 3 morbidities.
Conclusions: The present study shows that adolescents experience various health problems. Predominant morbidities observed in study subjects are dandruff (pityriasis capitis), acne vulgaris, anaemia, dental carries.
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