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INTRODUCTION: Heart failure is one of the most common heart problems seen in the Indian population. There are various drugs used to prevent further progression of the disease. In India, there are few studies in relation to treatment outcome in a tertiary care hospital. AIM: To study the treatment outcome of drug therapies used in heart failure patients with associated co-morbidities in a tertiary care hospital. MATERIALS AND METHODS: This was an observational study conducted on 250 patients with heart failure. Details collected using the proforma were demography (age, gender); medical history; medication history for heart failure patients on admission and discharge; ejection fraction; median length of stay in hospital; number of readmissions & in-hospital mortality. RESULTS: One hundred and twenty eight patients categorized into LVSD group (ejection fraction <40%) and 122 patients in PSF group (ejection fraction > 40%). Medical history of coronary artery disease (54%) was significantly higher in LVSD group (p<0.05) and anaemia (19%) was significantly higher in PSF group (p<0.05). On admission, inotropes (30%), digoxin (59%) and statins (54%) were prescribed more in LVSD patients (p<0.05) while calcium channel blockers (20%) were prescribed more in PSF group (p<0.05). At discharge, patients with LVSD were receiving ACE inhibitors (51%), beta blockers (30%), digoxin (67%) and statins (59%) (p<0.05) while calcium channel blockers (20%) was prescribed more in PSF group. The median length of stay was slightly higher in patients with PSF (7 days) as compared to LVSD (6 days). In-hospital mortality was lower in patients with PSF (6%) than patients with LVSD (20%). The percentage of readmissions within one month was slightly higher in patients with PSF (15%) compared to LVSD (14%). CONCLUSION: Length of stay in hospital was 6-7 days in heart failure patients. In hospital mortality in LVSD patients (20%) was higher compared to PSF patients (6%). A 15% heart failure patient were readmitted within 1month of discharge.
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BACKGROUND: Multiple myeloma accounts for 1% of all neoplastic disorders and 10% of all haematological malignancies. Drugs like thalidomide, lenalidomide and bortezomib have emerged as active drugs in the treatment of multiple myeloma.There are few studies which have compared thalidomide-dexamethasone (thal/dex) and lenalidomide-dexamethasone (len/dex) in the treatment of multiple myeloma in Indian scenario. AIM: To compare the efficacy and the adverse events observed with thalidomide-dexamethasone and lenalidomide-dexamethasone in the treatment of newly diagnosed cases of multiple myeloma. SETTINGS AND DESIGN: Observational Study conducted in tertiary care centre. MATERIALS AND METHODS: The case record files of patients from the year January 2006 to July 2011 with diagnosis of multiple myeloma were studied. STATISTICAL ANALYSIS: Primarily Descriptive. RESULTS: There was no significant difference between thal/dex and len/dex treatment groups with respect to efficacy and safety in our study. CONCLUSION: Studies with larger sample size and a longer follow up to compare efficacy and safety of thal/dex and len/dex in treatment of multiple myeloma are required to be carried out to provide significant results.
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The author reports a 55-year-old female diagnosed of chronic kidney disease grade-5 with associated co-morbidities like type 2 diabetes mellitus, diabetic retinopathy and hypothyroidism was admitted for arteriovenous fistula construction. She was started on ferric carboxymaltose for the treatment of anaemia. She was given a test dose before administering the drug intravenously and she did not develop any reaction. The drug ferric carboxymaltose was then administered over a period of one hour. About half an hour after drug administration, the patient developed breathlessness and myalgia. After half hour of the above episode of breathlessness and myalgia she also developed vomiting (one episode). Patient was managed with oxygen therapy, IV fluids and other drugs like corticosteroids, phenaramine maleate and nalbuphine which controlled the above symptoms.