Background: Pharmacological treatment of chronic obstructive pulmonary disease (COPD) is mainly based on inhaled medications. Inappropriate use of inhalers due to the unrecovered peak inhalation ow rate (PIFR) results in an increased risk of early treatment failure. Therefore, this study was carried out to address the error patterns in using dry powder inhalers (DPI) versus pressurized metered-dose inhalers (MDI) inhaler devices among COPD patients with acute exacerbation. For this Methods: prospective cohort study, a cohort of 138 COPD patients with acute exacerbation were included from a tertiary care hospital in Karnataka. The inhalation technique and PIFR were evaluated at discharge and twice in follow-up at 15-day and 90 days intervals based on a list of the most common errors in the inhalation techniques. About 63% Results: of patients had comorbidities. The average length of hospital stay was 7.8 days and the mean PIFR value at discharge was 58.9L/min. About 51.4% of the COPD patients were MDI users and 48.6% were DPI users. The most frequent errors were inappropriate inhaling and short breath holding time for DPI (89.6% and 88.1%) and MDI (84.5% and 94.3%) device users, respectively. At follow-ups, these errors- inhaling deeply and shortbreath holding time continued to occur signicantly during 90-day follow-ups for DPI (79.1% and 82.1%) and MDI (79.2% and 90.1%) device users, respectively. However, the breath-out and mouthpiece placing errors were reduced signicantly at 90 days of follow-up among the DPI (50.7% and 40.3%, respectively) and MDI users (47.9% and 19.8%, respectively). Inappropriate inhali Conclusions: ng and short breath holding time were the most frequent and major errors made by inhaler device users. This emphasizes the training in proper inhalation techniques for COPD patients treated with inhalers
Introduction Obesity is a major risk factor for adverse outcomes after infection with Severe acute respiratory syndrome corona virus -2. This study aimed to evaluate the association between body mass index (BMI) with COVID-19 disease. A cross sectional study Materials And Methods conducted in SIMSRH, Tumkur during the study period from April 1, 2021 to may 31, 2021. Laboratory conrmed cases of covid-19 of moderate to severe category admitted in SIMSRH were enrolled in the study. All the ndings were recorded in the proforma and analysed. Results A total of 63 patients satisfying both inclusion and exclusion criteria were included in the present study. Out of 63 patients, majority (71.43%) of the patients were male and remaining(28.75%) were female. In the present study group, two ( 3%) had BMI < 18.5, 23 (36%) had BMI 18.5-24.9, 30 (47%) had BMI between 25-29.9 and eight (12%) had BMI over 30. According to present study ndings, patients with higher BMI are associated with increased risk of developing severe COVID-19 disease requiring ICU admissions, mechanical ventilation, longer duration of oxygen therapy and prolonged hospital stay. This study found that patients with higher BMI had a increa Conclusion se in risk of developing severe COVID-19 disease. This suggests that obesity is a risk factor for severe COVID-19 and inuence the disease outcomes
Introduction: Blood Transfusion is identified as one of the essential components of comprehensiveemergency obstetric care which has drastically reduced maternal mortality. Material and Methods:This is a prospective study conducted at NC Medical College and Hospital, in the Department ofOBGY. (Tertiary care center) from January 2019 – September 2020. All patients requiringintrapartum transfusion of blood or blood products are enrolled in the study. No exclusion criteria.Results: In the present study, various age groups of patients were enrolled. Maximum transfusion(77.8%) rates are seen in the age group of 21-30 years and the minimum no. of patients wereranges from 31-40 years (8.4%). Conclusion: Postpartum hemorrhage, placental causes, andanemia are the commonest causes of the need for transfusion in obstetric practice.
Multiple agents are being used for the purpose of chemical pleurodesis with varied success and risks. Povidone iodine was also a successful agent in inducing pleurodesis in pleural effusions and pneumothoraces. Aims and Objectives: To evaluate the efficacy and safety of povidone iodine pleurodesis through intercostal tube drainage (ICD) in patients with spontaneous pneumothorax. Materials and Methods: This was a prospective study where povidone iodine was infused into pleural cavity through ICD in patients with spontaneous pneumothorax. Success of procedure and adverse events recorded. Patients were followed up for 12 months for recurrence of pneumothorax. Results: A total of 38 patients with mean age of 58.6 ±12.5 years were included in study. 28 patients had successful first procedure, six patients required repeat pleurodesis, three had failed pleurodesis and two had recurrent pneumothorax after 6 months. All patients experienced chest pain of varying severity. Two patients had ARDS. Conclusion:Povidone iodine can be used as effective and safe agent for chemical pleurodesis in spontaneous pneumothorax.
BACKGROUND: Parent to child transmission is the most important source of HIV infection in pediatric age group. Antenatal , natal and post natal periods are crucial time for transmission of Human Immune-deficiency Virus infection from mother to child. OBJECTIVE: There are about 1.9 million expected pregnancies in a year in Rajasthan. With HIV prevalence rate amongst women attending ANC services is 0.19% (HIV sentinel surveillance report of 2008) a large number of pregnant women are expected to be HIV positive. There is about 30% a high rate of risk of HIV transmission from HIV infected mothers to their children. By ensuring safe delivery with mandatory services and preventive measures this transmission can be stopped. Therefore testing and counseling of every pregnant women for Human Immuno-deficiency Virus (HIV) / Acquired Immuno Deficiency Syndrome (AIDS) is of vital importance to forestall spread of HIV infection by this route. MATERIAL AND METHODS: Present study is carried out to evaluate status of HIV Testing and counseling of pregnant women in year 2011-2012 in Rajasthan state and to assess measures taken to reduce transmission from mother to child to achieve zero transmission status in new born. RESULTS: The study reveals that only 4, 16, 343 pregnant women i.e. only 21.91 % were tested in the year 2011-12 out of estimated 1.9 million pregnancies every year in Rajasthan state and 454 pregnant women i.e. only 12.39% were detected HIV positive out of about 3600 expected to be positive during that period. CONCLUSION: It is observed that around 1000 new born children in Rajasthan are likely to get transmission of HIV infection from unidentified positive pregnant women every year. This can be prevented by ensuring and HIV testing and by enhancing facilities for safe delivery of every pregnant women.
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