A Prospective Study on Epidemiology, Clinical Profile and Outcome of Hospitalized Cases of Swine Flu (H1N1) During 2018-2019 Outbreak in North West Zone of Rajasthan
Shyam Lal MeenaAbhishek BinnaniSunil RulaniyaBal Kishan GuptaAnjli GuptaNarendra DaraKashish NarulaJigyasa GuptaRakesh Kumar Baberwal
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Background: Since World Health Organization declared H1N1 (Swine flu) a pandemic disease on April 29, 2009, it is continuing to be a major public health problem and it has significant regional and seasonal variation. Therefore, this study was planned to evaluate epidemiology, clinical profile, course of illness and their outcome. Material and Method: Present prospective crosssectional study was conducted on RT-PCR confirmed cases of swine flu admitted in dedicated swine flu ward in the Department of Medicine, S.P. Medical College & Associated Group of P.B.M. Hospitals, Bikaner. All patients were subjected to detailed clinical examination and relevant investigation as per proforma. Clinical and epidemiological data were collected. All patients subjected for routine lab examination including complete blood count, renal function test, liver function test, fasting blood sugar, ABG, X-ray chest PA view and other specific investigation as per requirement. Result: Most females belonged to age group 18-35 years and most of the malesbelonged to age group >55 years. Most of cases belonged to category C (62%) and urban residential area (55.7%). Most common symptom was cough (98.7%) followed by fever (91.1%), sore throat (86.1%), sputum (83.5%), nasal discharge (73.4%), breathlessness (72.2%), headache (58.2%), chest pain (27.8%) and palpitation (16.5%). Our study shows multiple organ involvement during the course of swine flu as indicated by increasing blood urea (36.7%), serum direct bilirubin (19%), serum creatinine (18.9%), SGOT (68.3%), SGPT (37.8%) and decreasing serum albumin (63.3%). Overall mortality rate in our study was 8.8%.It was high in females (9.1%) as compare to males(8.6%).All deceased belonged to category C and cough was the most common presenting symptom followed by sore throat, nasal discharge, sputum and fever. Conclusion: Our study shows there are certain factors which can affect outcome in the cases of swine flu. Female gender, elderly age, co morbidity and the duration of illness(6-10 days) are the important factors associated with poor outcome. Early recognition and alertness is important to reduce morbidity and mortality. Patients should also be screened for multiple organ involvement at the time of hospitalization by laboratory test like CBC, RFT, LFT for early diagnosis of multiple organ involvement so as to treat appropriately to prevent multiple organ failure and mortality.Keywords:
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A review of 341 adult-onset Still’s disease (AOSD) patients noted that 69% of all reported cases1 and 84% (69/82) of our series2 displayed sore throat early in the disease course. Despite the presence of severe sore throat, physical examinations showed normal findings or only mild pharyngeal infection, and imaging studies (including computed tomography (CT) scans) of the neck were negative.1–4 The lesions responsible for sore throat in active AOSD patients have not yet been explored.
We performed magnetic resonance imaging (MRI) of the larynx5 in 6 active AOSD patients (3 females and 3 males; mean age 33.5 years; table 1) presenting with sore throat and fulfilling the Yamaguchi criteria.6 Our aim was to identify the lesions responsible for sore throat in AOSD patients. Throat swabs for bacterial cultures were negative and serological tests for …
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Introduction: Antibiotics are inappropriate for most sore throats and unnecessary use is a major cause of antibiotic resistance. This study aimed to understand the factors that drive patients with sore throat to seek antibiotics. Materials and methods: Consumers from 12 countries (Australia, Brazil, China, France, Germany, India, Mexico, Russia, South Africa, South Korea, UK, USA), who had sore throat in the previous 12 months, completed a questionnaire on general attitudes to health and well-being and treatments used for sore throat and cold or flu. Results: A total of 5,440 consumers completed the questionnaire (mean age 37 years, 54% female, average of four episodes of sore throat in the previous 12 months). Nineteen percent had used antibiotics to treat their last sore throat, although there was variation between countries. Antibiotic use was higher (23%) among respondents with more severe sore throat symptoms than less severe symptoms (15%). Antibiotic use was also higher (22%) among respondents who had cold/flu symptoms at the same time as their sore throat compared with those without cold/flu symptoms (11%) . Efficacy was selected as a driver of treatment choice by 79% of those who took antibiotics and healthcare professional (HCP) recommendation was a strong driver of prescription medications in general. Conclusions: The key drivers of antibiotic-seeking behavior are severe sore throat symptoms, perceived efficacy of antibiotics and HCP recommendation. These findings highlight the need for improved patient education and HCP–patient communication to provide effective symptom relief and dispel common misconceptions on the efficacy of
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Evaluate the efficacy of flurbiprofen 8.75 mg spray for sore throat relief.Randomized, double-blind study in adults with sore throat due to upper respiratory tract infection who took flurbiprofen (n = 249) or placebo spray (n = 256). Pain relief was assessed using the Sore Throat Relief Rating Scale.Flurbiprofen spray provided significantly greater relief versus placebo from 20 min to 6 h (p < 0.0001; maximum difference: 75 min). Sore throat severity was reduced ≥-2.2 on the Sore Throat Scale from 75 min to 6 h, indicating meaningful relief. Significantly more patients taking flurbiprofen spray reported ≥30 min of 'at least moderate' relief versus placebo over 6 h (p < 0.0001). Most adverse events were mild.Flurbiprofen spray provides rapid, long-lasting and clinically meaningful relief from sore throat (ANZCTR: ACTRN12612000457842).
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Background: Sore throat and cough during emergence are common side effects of general anaesthesia and its incidence is reported by 30-70% of patients after tracheal intubation. Also, not to forget the hemodynamic fluctuations associated with it, adds on to the magnitude of the problem. Thinking of a simple and cost-effective way to tackle this problem, this study was undertaken to determine the benefits of using intra-cuff lignocaine to prevent post intubation sore throat and emergence cough. The objective of this study to assess the efficacy of intra-cuff 2% lignocaine solution, in reducing emergence cough and post-operative sore throat after extubation in general surgery patients intubated for 2-4 hours.Methods: A prospective observational study where 100 ASA I and II status patients divided into 2 groups of 50 each was compared. In one group ETT cuff was filled with air, while in the other group, 2% plain lignocaine solution was used. Side effects like sore throat, coughing and blood pressure changes were assessed. Chi square and t-tests were used to compare the findings.Results: Among those patients where intra-cuff lignocaine was used, only 27.5% complained of sore throat and 12.5% had emergence cough, whereas among those patients where intra-cuff air was used, 72.5% had post-operative sore throat and 87.5% of patients had cough on emergence.Conclusions: This study proves that 2% intra-cuff lignocaine is an effective method in reducing post-operative sore throat and emergence cough and thereby beneficial in controlling the hemodynamic changes associated with emergence.
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Background: Cuff volume additionally impacts a postoperative sore throat and dysphagia. The rate of a sore throat has likewise been discovered to be higher in the event of Laryngeal Mask Airway (LMA) than that of endotracheal intubation (ETT).Aim: To know the duration of a sore throat and level of severity of a sore throat after endotracheal intubation among patients of Sanglah General Hospital.Method: This cross sectional study was conducted on patients of Sanglah General Hospital. There were 100 students were participated in this study. They were asked to fill up a self-administered questionnaire. The variables assessed were their duration towards patients who have used anesthetic during surgery.Result: About 54% of 100 patient of Sanglah General Hospital, respectively had a sore throat for 4 to 6 days after endotracheal intubation. However, 28% of patients had a sore throat from day one to day three after the endotracheal intubation method. For the severity of a sore throat over 50% of the patients have experienced pain in eating, drinking, talking and for some people it has given them an enormous side effect towards their daily activity. Though the overall duration and severity of a sore throat among the patient, lasted less than a week and for the severity patient have voted respectively high. Patients with good diet control after the surgery tend to heal faster.
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We appreciate Singh et al.'s thoughtful comments about our systematic review examining the efficacy of topical benzydamine hydrochloride for preventing postoperative sore throat in adults 1. Firstly, we share the common concern that intubation with a double-lumen tube may increase the incidence and severity of postoperative sore throat. Although not shown in our article, sub-group analysis confirmed that benzydamine hydrochloride prevents postoperative sore throat (risk ratio [RR] 0.38; 95%CI 0.19–0.77) and mitigates its severity (standardised mean difference [SMD] −0.50; 95%CI −0.91 to −0.08) in patients whose tracheas are intubated with double-lumen tubes 2. Benzydamine hydrochloride also prevents postoperative sore throat (RR 0.28; 95%CI 0.17–0.47) and mitigates its severity (SMD −0.24; 95%CI, −0.66 to 0.19) in the other sub-group. Singh et al. suggested that the incidence of postoperative sore throat that we used was different to that reported by Nimmaanrat et al. 3, who stated that 25 patients (58.1%) from each group experienced postoperative sore throat, without specifying the time point they examined. We obtained the unpublished data from these authors, which we pooled into our analysis. We reaffirm, therefore, that topical benzydamine hydrochloride prevents postoperative sore throat.
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Introduction: Sore throat following tracheal intubation is a common postoperative complaint with a reported incidence of up to 90%. We performed a prospective randomised doubleblind clinical trial to compare the effectiveness of lignocaine 2% gel with waterbased lubricant (KY Jelly) in reducing post� intubation sore throat. Materials and Methods: One hundred and fifty one patients with American Society of Anaesthesiologists (ASA) physical status I or II undergoing elective surgery under general anaesthesia with tracheal intubation were enrolled into this study. Cuffed endotracheal tubes were lu� bricated with either lignocaine 2% (Group A) or a waterbased lubricant (Group B). Patients were as� sessed at three intervals (1, 12, and 24 h after surgery) by a blinded investigator for presence of sore throat, severity of sore throat and throat related complaints. Results: Significantly larger number of patients in Group A complained of throat dryness at 1 h ( p=0.035) and sore throat at 12 h ( p=0.001). Incidences of sore throat and throat related complaints were comparable at other time intervals. No differences in severity of sore throat were observed, and none of the patients required further treat� ment. Conclusion: Lignocaine 2% gel was not effective in reducing postintubation sore throat in com� parison with waterbased lubricant.
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Background: postoperative sore throat is the commonest complication after endotracheal intubation. The efficacy of intravenous non-steroidal anti-inflammatory drugs in alleviating postoperative sore throat has not been investigated.Objective: To evaluate the effect of intravenous diclofenac sodium on the occurrence and severity of postoperative sore throat.Methods: 42 in-patients scheduled for laparoscopic surgery were randomized into two equal groups to receive either a single dose of 75mg intravenous diclofenac sodium in addition to standard treatment taken at our hospital for the prevention of postoperative sore throat or to receive standard treatment only. All patients were interviewed postoperatively at 2, 6 and 18 hours. Data of the baseline characteristics, the incidence and severity of sore throat were collected. If sore throat was present, a Visual Analogue Score was used to assess its severity.Results: the baseline characteristics of the participants were similar. The majority of the patients undergoing laparoscopic surgery were women. There was no statistically significant difference in the occurrence or severity of postoperative sore throat between the diclofenac and standard treatment groups at 2, 6 and 18 hours postoperatively.Conclusion: Intravenous diclofenac sodium does not reduce the occurrence or severity of postoperative sore throat.African Health Sciences 2013; 13(4): 999 - 1006
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Post-operative sore throat is a common minor complication after anesthesia. This paper reviews the factors which influence post-operative sore throat in intubated patients. Two hundred and sixty six intubated patients were investigated to find the incidence of sore throat after elective anesthesia in a middle eastern population. The overall incidence of sore throat was 63.9%. There was no significant difference in the incidence of sore throat between males and females, and in the age groups studied. Anesthetic factors including the use of relaxants, the experience of the anesthesiologist, the number of intubation attempts and lubrication of the tracheal tube did not significantly alter the incidence of sore throat. Duration of anesthesia of greater than 90 minutes was associated with significant increase in sore throat (p < 0.001). Surgical factors including type of surgery, the use of throat packs and early oral intake did not alter the incidence of sore throat. Nasogastric tube insertion was associated with a significantly increased incidence of sore throat (p < 0.01).
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Sore throat and hoarseness are common complications after surgery. Flurbiprofen spray has been successfully used for treatment of oral inflammations, but its effects on postoperative sore throat and hoarseness are unknown. We conducted this study to evaluate the effectiveness of flurbiprofen spray on postoperative sore throat and hoarseness, by comparing it with benzydamine hydrochloride spray and placebo.One hundred fifty patients who were scheduled to undergo elective ear surgery were enrolled. Patients were randomized to three groups of 50 patients each; flurbiprofen oral spray, benzydamine hydrochloride oral spray and placebo spray groups. Patients received sprays just before intubation, and the incidence and severity of postoperative sore throat and hoarseness were evaluated by a blinded investigator at 0, 1, 6 and 24-hour post extubation. Patients were also questioned for possible side effects at all time points.The sore throat severity scores were significantly lower in treatment groups when compared to placebo group at all time points (P=0.003/108). Similarly, the incidence of sore throat was significantly lower in both of the treatment groups (P=0.007/104). The incidence of hoarseness and hoarseness scores were significantly lower in treatment groups when compared to placebo group (P=0.006/105 and P=0.005/104, respectively). While none of the patients complained of any adverse effects in flurbiprofen group, only two patients in benzydamine hydrochloride group experienced numbness.Both oral flurbiprofen and benzydamine hydrochloride sprays were found to be more effective than placebo in decreasing the incidence and severity of postoperative sore throat and hoarseness, with no adverse effects.
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