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Background: COVID-19 an infectious disease caused by the SARS-CoV-2 virus, started in late 2019 and became a pandemic within a short period. To respond to the pandemic vaccines like Covishield, Covaxin, Sputnik V, Covovax, etc., were developed rapidly. However, there were raising concerns about the development of immunity as well as adverse events following vaccination. Objectives: To compare anti-SARS-CoV-2 IgG antibody titres at different time-points post-vaccination between baseline seropositive and seronegative groups and to assess the adverse events following the 1st dose of Covishield vaccine among adult beneficiaries attending vaccination centre in a tertiary care hospital of Upper Assam. Materials and Methods: Prospective Cohort study was conducted from July 2021 to June 2022 among adult beneficiaries receiving the Covishield vaccine. The oral questionnaire was used incorporating socio-demographic variables, and clinical profiles including co-morbidities and adverse events following vaccination. Data analysis was done by Microsoft Excel and SPSS. Results: Out of a total of 146 study participants, IgG estimation showed 61% as seropositive and the rest as seronegative. A total of 55.40% had minor adverse events, majority of them were females (53.08%) and 88.80% belonged to 18-59 years compared to 11.11% above 60 years of age. The majority (71.60%) did not have any co-morbidities and the major AEFI was NIL among the study participants. The study group had 61% seropositive previously infected. Conclusion: Covishield vaccination induces an immune response and 90% seroconversion is achieved after 1st dose (booster dose). Antibody titres of the seropositive group by natural infection of SARS-CoV-2 were higher than seronegative cohort seroconverted by vaccination. The AEFI observed were minor and can be commented as safer.
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BACKGROUND AND OBJECTIVE: Renin-angiotensin system (RAS) blockers (angiotensin converting enzyme inhibitors ACEI, angiotensin receptor blockers, ARB) are preferred drugs to control hypertension among diabetic patients. To determine frequency of RAS blocker use in hypertensive patients with type 2 diabetes, we performed a multisite study in India. METHODS: We evaluated physician prescriptions in consecutive patients with type 2 diabetes at 9 sites in India. Details of socio-demographic characteristics, clinical findings and prescription medicines were obtained. Descriptive statistics are reported. RESULTS: Hypertension treatment details were available in 8056 of 8699 diabetic patients (4829 men, 3227 women). No hypertension was in 3300 (40.9%), hypertension in 3625 (45.0%), and hypertension with vascular disease in 1131 (14.0%). In diabetics with no hypertension, hypertension, and hypertension with vascular disease, respectively, prescriptions of antihypertensive drugs was: RAS blockers in 19.4, 48.2 and 58.1%, beta-blockers in 4.8, 31.6 and 38.8%, calcium channel blockers in 0.4, 27.4 and 14.3% and diuretics in 0.6, 36.4 and 17.1%. ACEIs were prescribed more frequently than ARB's in hypertensive diabetics (60.7 vs 39.2%) as well as in diabetics with vascular disease (58.6 vs 41.4%). In diabetics with hypertension (n=3625) prescription of one, two or three antihypertensive drugs was 49.8%, 33.7% and 3.5% while statins were prescribed in 54.1%. CONCLUSION: Use of RAS blockers (ACEI or ARB) in uncomplicated as well as complicated hypertensive patients with type 2 diabetes is sub-optimal. Most of the patients are on one drug and prescription of ≥3 drugs are rare. Statins are prescribed in only a half.
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Diabetes Mellitus Tipo 2/terapia , Hipertensión/terapia , Inhibidores de la Enzima Convertidora de Angiotensina , Antihipertensivos , Diabetes Mellitus Tipo 2/complicaciones , Femenino , Humanos , Hipertensión/complicaciones , India , MasculinoRESUMEN
BACKGROUND: Contemporary treatment guidelines advise statin use in all patients with diabetes for reducing coronary risk. Use of statins in patients with type 2 diabetes has not been reported from India. METHODS: We performed a multisite (n=9) registry-based study among internists (n=3), diabetologists (n=3), and endocrinologists (n=3) across India to determine prescriptions of statins in patients with type 2 diabetes. Demographic and clinical details were obtained and prescriptions were audited for various medications with a focus on statins. Details of type of statin and dosage form (low, moderate, and high) were obtained. Patients were divided into categories based on presence of cardiovascular risk into low (no risk factors, n=1506), medium (≥1 risk factor, n=5425), and high (with vascular disease, n=1769). Descriptive statistics are presented. RESULTS: Prescription details were available in 8699 (men 5292, women 3407). Statins were prescribed in 55.2% and fibrates in 9.2%. Statin prescription was significantly greater among diabetologists (64.4%) compared with internists (n=53.3%) and endocrinologists (46.8%; p<0.001). Atorvastatin was prescribed in 74.1%, rosuvastatin in 29.2%, and others in 3.0%. Statin prescriptions were lower in women (52.1%) versus men (57.2%; p<0.001) and in patients aged <40â years (34.3%), versus those aged 40-49 (49.7%), 50-59 (60.1%), and ≥60â years (62.2%; p<0.001). Low-dose statins were prescribed in 1.9%, moderate dose in 85.4%, and high dose in 12.7%. Statin prescriptions were greater in the high-risk group (58.0%) compared with those in the medium-risk (53.8%) and low-risk (56.8%) groups (p <0.001). High-dose statin prescriptions were similar in the high-risk (14.5%), medium-risk (11.8%), and low-risk (13.5%) groups (p=0.31). CONCLUSIONS: Statins are prescribed in only half of the clinic-based patients in India with type 2 diabetes. Prescription of high-dose statins is very low.
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INTRODUCTION: Risk factors for cardiovascular disease (CVD) are multifactorial. Previous research has reported a high prevalence of CVD risk factors in tea-garden workers. This study was conducted to assess prevalence and level of modifiable cardiovascular risk factors among tea-garden and general population in Dibrugarh, Assam. METHODS: A community-based cross-sectional study using the World Health Organization's (WHO) Stepwise methodology was conducted in Dibrugarh District of Assam. A multistep random sampling was done to include adults aged 35 years and above, with an intended equal sampling from tea-garden and general population. INTERHEART modifiable non-laboratory based risk score was estimated. Salt consumption was estimated using questionnaire-based methods in both subgroups. RESULTS: A total of 2826 individuals participated in the study (1231 [43.6%] tea-garden workers; 1595 [56.4%] general population). Tobacco consumption was higher in tea-garden workers as compared with general population (85.2% vs. 41.7% (p < 0.0001). Mean daily per-capita salt consumption was also significantly higher among tea-garden workers (29.60 vs. 22.89 g, p = 0.0001). Overall prevalence of hypertension was similar (44.4% vs. 45.2%), but among those who had hypertension, prevalence of undiagnosed hypertension was higher in tea-garden workers (82.8% vs. 74.4%, p < 0.0001). Tea-garden workers had lower BMI, were more physically active, and had a lower prevalence of diabetes mellitus and metabolic syndrome. Their INTERHEART modifiable risk score was also lower (1.44 [2.5] vs. 1.79 [2.8], p = 0.001). CONCLUSION: High prevalence of modifiable risk factors like tobacco consumption, high salt intake and high prevalence of hypertension indicates the need for early implementation of preventive actions in this population.