Sushama Dugad ¹, Pankaj Bhandare ², Gauri Kulkarni ¹, Sunil Patil ³

Affiliations
1 Department of Pulmonary Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, IN
2 Department of Pulmonary Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
3 Department of Community Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, IN

Abstract

A chillum consist a mixture of Cannabis and tobacco.Cannabis, also known as marijuana; it is a psychoactive drug from the Cannabis plant intended for medical or recreational use; nowadays widely being abused for getting high and temporary relaxation. Sputum examination of chillum smokers may indicate harmful effects of chillum smoking on lungs. Objectives of present study were to study the sputum characteristics and differential cell count of chillum smoking Sadhus of Kumbh Mela. Present descriptive observational study was conducted among fifty Sadhus of Kumbh Mela of Nashik. Participants were selected using purposive sampling method. In present study all sputum samples showed raised differential cell count and statistically significant association was observed between differential cell like Neutrophils, Lymphocytes and Macrophages with different content present in chillum.

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Sushama Dugad ¹, Pankaj Bhandare ², Ramesh Sundrani ³, Gauri Kulkarni ¹, Nilesh Patil ²

Affiliations
1 Associate Professor, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Adgaon - 422003, Nashik, Maharashtra, IN
2 PG Resident, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Adgaon - 422003, Nashik, Maharashtra, IN
3 Professor & Head, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Adgaon - 422003, Nashik, Maharashtra, IN

Abstract

Background: Our knowledge on reasons of non-acceptance and complication to H1N1 Vaccination by health care workers is limited. A better understanding of factors having significance in vaccine acceptance is crucial. With this background in mind present study was conducted at tertiary care centre to determine the Acceptance, Compliance, and Complication of anti-H1N1 seasonal vaccine among Health Care Workers (HWCs). Materials and Methods: Prospective Observational study was conducted to observe the rate of acceptance, compliance and complications of anti H1N1 seasonal vaccine among 100 health care workers in the period of December 2015 to December 2017 in Tertiary Health Care Centre. All participants were counselled 3 times at interval 6 months (0, 6, and 12 months) regarding H1N1 vaccine. Result: Vaccine acceptance rate among health care workers was only 03% before counseling. The main cause for not acceptance of vaccination was fear of adverse effects reported by 27% health care workers followed by cost of vaccine (12%) and work pressure (10%) or non-availability of time. Conclusion: As counseling sessions progressed health care workers also started accepting vaccination. After completion of third counseling session rate of vaccine acceptance increased from 3% to 71% and also negative and doubtful conception of health care workers were and changed completely. After counseling their knowledge regarding influenza vaccine was increased. Even though some post vaccination complications had been reported by recipient; those symptoms lasted for short duration of time and there was no serious adverse effect of H1N1 vaccine.

Keywords

Health Care Workers, H1N1 Vaccine.

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Sushama Dugad ¹, Pankaj Bhandare ², Ramesh Sundrani ³, Gauri Kulkarni ¹, Nilesh Patil ²

Affiliations
1 Associate Professor, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Adgaon - 422003, Nashik, Maharashtra, IN
2 PG Resident, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Adgaon - 422003, Nashik, Maharashtra, IN
3 Professor & Head, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Adgaon - 422003, Nashik, Maharashtra, IN

Abstract

Background: Our knowledge on reasons of non-acceptance and complication to H1N1 Vaccination by health care workers is limited. A better understanding of factors having significance in vaccine acceptance is crucial. With this background in mind present study was conducted at tertiary care centre to determine the Acceptance, Compliance, and Complication of anti-H1N1 seasonal vaccine among Health Care Workers (HWCs). Materials and Methods: Prospective Observational study was conducted to observe the rate of acceptance, compliance and complications of anti H1N1 seasonal vaccine among 100 health care workers in the period of December 2015 to December 2017 in Tertiary Health Care Centre. All participants were counselled 3 times at interval 6 months (0, 6, and 12 months) regarding H1N1 vaccine. Result: Vaccine acceptance rate among health care workers was only 03% before counseling. The main cause for not acceptance of vaccination was fear of adverse effects reported by 27% health care workers followed by cost of vaccine (12%) and work pressure (10%) or nonavailability of time. Conclusion: As counseling sessions progressed health care workers also started accepting vaccination. After completion of third counseling session rate of vaccine acceptance increased from 3% to 71% and also negative and doubtful conception of health care workers were and changed completely. After counseling their knowledge regarding influenza vaccine was increased. Even though some post vaccination complications had been reported by recipient; those symptoms lasted for short duration of time and there was no serious adverse effect of H1N1 vaccine.

Keywords

No Keywords.

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Gauri Suhas Kulkarni ¹, Abhijit Janardhan Telkhade ¹, Sushama Dugad ¹

Affiliations
1 Department of Respiratory Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN

Abstract

Background: Resistance to MDR TB has additional resistance to fluoroquinolones and second line injectables it is defined as XDR-TB. The present study is designed to evaluate drug resistance patterns in such XDR patients. Aims and Objectives: To study drug resistance patterns in XDR-TB patients. Material and Methods: Researcher carried out a cross-sectional study over a period of two years. In this study, 43 patients were studied. The criteria used to observe was that – Newly diagnosed cases of XDR-TB patients by using the second line Drug Sensitivity Testing (DST). This method was used at an accredited RNTCP lab regardless of age and gender of the patients. Further, demographic, clinical and treatment data were analyzed in terms of drug sensitivity of the patients. Results: 48.83% of patients showed resistance with fluoroquinolone, 20.93% showed resistance with XDR with Second line injectables, 30.23% with flouroquinolones + second line injectibles. Maximum resistance was seen in Ofloxacin (81.4%) followed by kanamycin (44.2%). 41.86% patients were diabetics showing that drug resistance was more prevalent in these population. Maximum defaulters (80%) were from the lower class. Conclusion: Flouroquinolones and second-line drugs must be administered rationally and considerately to prevent the widespread drug resistance. The role played by diabetes and lower socio economic status in the emergence of drug resistance must not be undermined.

Keywords

Diabetes, Drug Sensitivity, Fluoroquinolones, XDR TB, MDR TB

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Nikhil Raj ¹, Sushama Dugad ², Jaspreet Singh Khandpur ¹, Kappagantu Surya Chaitanya Neeladrirao ³, Siddhesh Bharadi ³, Ravindra Shinde ⁴

Affiliations
1 Former PG Resident, Department of Respiratory Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Professor and Head, Department of Respiratory Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
3 PG Resident, Department of Respiratory Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
4 Associate Professor, Department of Respiratory Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN

Abstract

Background: The common causes of respiratory emergencies include pneumonias, acute severe asthma, acute exacerbation of Chronic Obstructive Pulmonary diseases (COPD), TB, lung cancers, pneumothorax, pleural effusion, pulmonary embolism and Acute Respiratory Distress Syndrome (ARDS) from other causes. Aims and Objectives: To study patterns and co-morbidities of respiratory disease in patients attending casualty department. Materials and Methods: This Cross Sectional Study was conducted on 193 patients of Respiratory disease attending emergency department in Medical College and tertiary health care institute. Study was conducted for a period of 2 years (August 2018 to December 2020). Patients were enrolled after matching inclusion and exclusion criteria. Institutional ethics committee permission was taken prior study. Observations and Results: The most common age group amongst study population was 51 to 60 years (39.4%) followed by 61 to 70 years (37.8%) and more than 70 years (19.2%). There was male predominance (76.7%) amongst study population as Most of the study population had normal BMI (55.4%) followed by Underweight (27.5%) and Overweight (13.5%). Most of the study population were Farmer (37.3%) followed by Housewife (23.5%), Labourer (11.8%) and Shopkeeper (9.8%). The most common clinical features amongst study population was Breathlessness (100%) followed by Cough with expectoration (58%) and dry cough (22%). Most of the study population had mMRC Dyspnoea Grade 3 (48.2%) followed by grade 2 (30.1%), grade 4 (11.9%), grade 1 (9.8%). COPD (38%) was the most common respiratory disease amongst study population followed by Pleural effusion (19%), Asthma (15%), Pulmonary TB (11%), Pneumonia (6%), Pneumothorax (4%), ARDS (3%), ILD (2%), Pulmonary embolism (1%) and Swine flu (1%). Diabetes (46%) was the most common comorbidity amongst study population followed by Hypertension (36%), Ischemic Heart Disease (15%), Chronic Liver Disease (11%), Chronic kidney Disease (8%), Pneumonia (6%), Pneumothorax (4%) and Malignancy (2%). Conclusion: In the present study, Diabetes (46%) was the most common comorbidity amongst study population followed by Hypertension (36%), Ischemic Heart Disease (15%), Chronic Liver Disease (11%), Chronic kidney Disease (8%), Pneumonia (6%), Pneumothorax (4%) and Malignancy (2%). This findings was comparable with the study conducted by Sonisha Gupta et al. (2016)41, among these patients 10 (35.7%) were diabetic, 16 (57.1%) hypertensive, 6 (21.4%) had cardiac problem and 17 (60.7%) joint pain.

Keywords

Acute Respiratory Distress Syndrome (ARDS), Arterial Blood Gas (ABG), Body Mass Index (BMI), Chronic Obstructive Pulmonary Disease (COPD), Community Acquired Pneumonia (CAP), Interstitial Lung Disease (ILD)

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Jaspreet Singh Khandpur ¹, Sushama Dugad ², Ravindra Shinde ³, Kappagantu Surya Chaitanya Neeladrirao S ⁴, Juhi Kadukar ¹

Affiliations
1 Former PG Resident, Department of Respiratory Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Professor and HOD, Department of Respiratory Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
3 Associate Professor, Department of Respiratory Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
4 PG Resident, Department of Respiratory Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities caused by significant exposure to noxious particles or gases. Aims and Objectives: 1. To estimate the proportion of insomnia in Chronic Obstructive Pulmonary Diseases patients, 2. To study the association of insomnia with severity of Chronic Obstructive Pulmonary Diseases among study participants and 3. Assessment of Quality of Life among study participants. Materials and Methods: This prospective observational study was conducted in Department of Respiratory Medicine in a tertiary care center and medical college. Written informed consent was taken from all the study participants and those who give consent were enrolled in the present study. Total 159 COPD patients were included in the study, after satisfying the eligibility criteria. The COPD patients were enrolled after satisfying the eligibility criteria given GSAQ Questionnaire to find the presence of insomnia, PSQI for quality of sleep and then SF-36 score questionnaire to assess Quality of Life. Study was conducted for duration of 2 years (August 2018 to December 2020). Observation and Results: The most common age group amongst study population was 51 to 60 years (42%) followed by 40 to 50 years (29%) and more than 60 years (29%). There was male predominance (54.5%) in the study population as compared to females (45.5%). The most common occupation amongst study population was farmer (28%) followed by Shopkeeper (23%) and Driver (19%) and most of the study population were obese (65.2%) followed by normal BMI (28.8%) and underweight (6.1%). Most of the study population were Grade 2 dyspnea (36%) followed by Grade 3 (34%) and Grade 4 (16%). Most of the study population were Moderate COPD (45.5%) followed by severe COPD (27.3%) and very severe (21.2%). Comorbidities like Diabetes and Hypertension was observed in 11% and 28% of study population. 29% of study population was ex smokers. 69.57% of ex smokers had more than 20 pack years while 30.43% had less than 20 pack years. The prevalence of insomnia in our study population was 43%. The prevalence of insomnia was most commonly observed in severe COPD (40%) followed by Very severe COPD (35%), Moderate COPD (19%) and mild COPD (6%) and the difference was statistically significant. Mean Physical health score and Mental health score was significantly lower in insomnia patients as compared to non insomnia patients. Mean PSQI was significantly higher in insomniac patients as compared to non insomnia patients. Conclusion: 40% of our patients with COPD experienced poor sleep quality. Presence of insomnia in patients with COPD is also associated with increased day time sleepiness and worse QOL.

Keywords

COPD - Chronic Obstructive Pulmonary Disease, GSAQ - Global Sleep Assessment Questionnaire, PSQI – Pittsburgh Sleep Quality Index, SF 36 - Short form 36 Health Survery Questionnaire

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