Treatment with low-dose chlorthalidone, 6.25 mg daily, significantly reduced mean 24-h ABP as well as daytime and nighttime BP. Due to its short duration of action, no significant 24-h ABP reduction was seen with HCTZ, 12.5 mg daily, which merely converted sustained hypertension into masked hypertension. Thus, low-dose chlorthalidone, 6.25 mg, could be used as monotherapy for treatment of essential hypertension, whereas low-dose HCTZ monotherapy is not an appropriate antihypertensive drug. (Comparative Evaluation of Safety and Efficacy of Hydrochlorothiazide CR with Hydrochlorothiazide and Chlorthalidone in Patients With Stage I Essential Hypertension; CTRI/2013/07/003793).
Background: Tuberculosis is a major health problem in India. Early diagnosis and prompt treatment is the key to control this menace. Hence to improve diagnosis in peripheral region, it is imperative that other methods are used to supplement the diagnostic This study aimed at assessing the reactive thrombocytosis in patients with tuberculosis admitted in medicine ward of RGMC and CSMH, Kalwa, Thane, India.Methods: This study was conducted from 1st January 2016 up to 31st June 2016. Data was collected from the PM register and also from Post mortem records, entered in MS Excel and analyzed.Results: Newly discovered, 112 patients, diagnosed on basis of sputum AFB positivity, chest x-ray changes, pleural fluid, ascitic fluid and CSF analysis reports suggestive of tuberculosis were selected to be the cases, out of which 50 were males (44.6%) and 62 females (55.4%)and, 127 non-tuberculous patients admitted for other causes who did not have any symptoms or signs of tuberculosis were randomly selected to be the control group of the study. The ages of the patients ranged from 14 to 76 years old. Thrombocytosis was detected in 84 (75%)of the Tb patients, whereas only 3 (2.3%) in Non-Tb Patients. The erythrocyte sedimentation rate (ESR) was increased by more than 20 in 97.4% of the patients.Conclusions: The changes in these parameters (platelets count and ESR) may reflect a reaction to the inflammatory condition. Therefore, in endemic areas, the presence of such haematological peripheral blood changes may raise the suspicion of pulmonary tuberculosis.
Background Risk factors for the development of severe COVID-19 disease and death have been widely reported across several studies. Knowledge about the determinants of severe disease and mortality in the Indian context can guide early clinical management. Methods We conducted a hospital-based case control study across nine sites in India to identify the determinants of severe and critical COVID-19 disease. Findings We identified age above 60 years, duration before admission >5 days, chronic kidney disease, leucocytosis, prothrombin time > 14 sec, serum ferritin >250 ng/mL, d-dimer >0.5 ng/mL, pro-calcitonin >0.15 μg/L, fibrin degradation products >5 μg/mL, C-reactive protein >5 mg/L, lactate dehydrogenase >150 U/L, interleukin-6 >25 pg/mL, NLR ≥3, and deranged liver function, renal function and serum electrolytes as significant factors associated with severe COVID-19 disease. Interpretation We have identified a set of parameters that can help in characterising severe COVID-19 cases in India. These parameters are part of routinely available investigations within Indian hospital settings, both public and private. Study findings have the potential to inform clinical management protocols and identify patients at high risk of severe outcomes at an early stage.
Background: India is expected to bear the burden of world’s greatest increase of diabetes population. This burden needs to be considered in terms of costs.Methods: Cross-sectional study was done in type 2 diabetes mellitus 100 patients that attended Medicine OPD. Prior to enrollment Institutional Ethics Committee permission was taken. Written Informed consent was taken. Demographic information related to Education, Occupation and Income was taken down. Also Information related to diagnostic tests and medications were documented. Inclusion criterion were 18-70 years of either gender diagnosed by Physicians in OPD as type 2 diabetes, willing to participate and have followed in OPD for at least one year. The Exclusion criterion was Critically ill or unconscious patients and Pregnant women. Direct and indirect costs were calculated.Results: The average age was 56.31±10.50 years. The average fasting blood glucose was 120.65±22.70mg/dl. The average cost per month for investigations was 159.74±128.06. Annual visit to OPD was 13.06±7.35. Time loss per visit was 5.62±1.29 hours and of accompanying person was 6.55±3.87 hours. There were 2 from Lower and 63 from Upper Lower socioeconomic class. There were 41 patients having diabetic complications. The indirect cost was around 5838.51 and direct cost was around 19925. Total cost per annum per patient was around 32361.27 INR.Conclusions: There is need for strategies to reduce the cost burden. There is also needed to design financial systems for diabetes related nationwide health programs.
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