Influenza A H1N1 pandemic patients at a northern India hospital

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Journal name: World Journal of Pharmaceutical Research
Original article title: Clinical scenario of influenza a pandemic (ph1n1) flu infected patients at tertiary referral hospital in northern india
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Original source:

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Author:

Nivedita Tiwari,Sheetal Verma, Tapan N. Dhole.


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: Clinical scenario of influenza a pandemic (ph1n1) flu infected patients at tertiary referral hospital in northern india

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research


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Summary of article contents:

Short summary of the chapter:
1) Introduction
The H1N1 subtype of the pandemic 2009 influenza virus has raised significant concerns regarding its potential for widespread impact. The epidemiological and clinical factors associated with H1N1 infections remain unclear in India's subcontinent. This study investigates the characteristics and outcomes of patients infected with the pH1N1 virus through a comprehensive analysis conducted at a tertiary referral hospital in Northern India from 2009 to 2014.

2) Clinical Characteristics of H1N1 Patients
Among the 5090 patients suspected of having influenza, 947 cases (18.6%) tested positive for the H1N1 virus. The demographic data revealed a male predominance, with the majority of patients aged between 6 and 20 years. Common symptoms included fever, cough, breathlessness, chest pain, and diarrhea. A notable proportion of patients (3.1%) required ventilatory support, while the primary cause of death was multi-organ failure, affecting 1.05% of the infected population.

3) Impact of Co-Morbid Conditions
The presence of underlying health issues significantly impacted H1N1 infection outcomes. In this study, co-morbidities such as asthma, diabetes, obesity, and heart disease were prevalent among patients and contributed to increased complications and mortality rates. Co-morbid conditions were particularly associated with a higher likelihood of requiring ventilatory support, emphasizing the need for targeted treatment and monitoring in at-risk populations.

4) Need for Vigilant Surveillance and Vaccination
The findings highlight the importance of active surveillance for H1N1 infections within the community, particularly aimed at populations most susceptible to severe outcomes. Vaccination strategies should be prioritized to prevent illness and effectively control the spread of influenza viruses. The study underscores the critical need for ongoing public health efforts to mitigate the impact of seasonal influenza outbreaks and pandemics alike.

5) Conclusion
The 2009 H1N1 influenza A infection predominantly affected younger individuals and those with pre-existing medical conditions, leading to severe complications and extended hospitalization. Given the trends observed in the study, it is crucial to enhance surveillance mechanisms and implement vaccination programs as preventive measures to control H1N1 outbreaks effectively and protect vulnerable populations.

FAQ section (important questions/answers):

What was the main aim of the study on H1N1 in India?

The study aimed to analyze clinical and epidemiological factors associated with H1N1 influenza cases in India, focusing on the characteristics and outcomes for patients infected with the pandemic strain.

What were the common symptoms observed among H1N1 patients?

Common symptoms included fever (95.23%), cough (92.06%), breathlessness (88.88%), and diarrhea (33.33%). Other symptoms included chest pain, vomiting, and throat pain, with severe cases leading to multi-organ failure.

How many patients tested positive for H1N1 during the study period?

Out of 5090 suspected cases, 947 (18.6%) were confirmed positive for the H1N1 virus through RT-PCR testing conducted between 2009 and 2014.

What demographic group was most affected by the H1N1 virus?

The majority of infected individuals were between 6-20 years of age, with a predominance in males, indicating that young individuals were significantly impacted by the 2009 H1N1 infection.

What were the mortality rates associated with H1N1 infection?

The overall mortality rate observed was 1.58%, with severe cases typically occurring in high-risk groups such as those with underlying health conditions, including respiratory and cardiac diseases.

What treatments or vaccinations were administered to patients?

Antiviral medications were the mainstay of treatment for H1N1 patients. Vaccination was recommended for the target population to prevent influenza illness and control future outbreaks.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Influenza A H1N1 pandemic patients at a northern India hospital”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Study (Studying):
The term 'Study' refers to a systematic investigation of clinical and epidemiological characteristics regarding the pH1N1 influenza virus in northern India. It emphasizes the research aspect of gathering data from patients, understanding the virus's impact, and analyzing outcomes for enhanced knowledge and better healthcare practices related to influenza.

2) Viru (Vīṟu):
This is possibly a typographical error for 'Virus', which is a key component of the research. The study focuses on the H1N1 influenza virus, its transmission, symptoms, and impact on patients. Understanding virus behavior is essential for developing effective treatments, prevention measures, and public health policies.

3) Disease:
The term 'Disease' is central to the article, focusing on the clinical manifestations of H1N1 influenza. It encompasses the spectrum of illnesses caused by the virus, detailing symptoms, complications, and the broader public health implications resulting from disease outbreaks associated with influenza infections.

4) Death:
The word 'Death' in this context is significant as it highlights the mortality associated with H1N1 influenza. The study reports cases resulting in death, emphasizing the importance of understanding risk factors, co-morbid conditions, and the urgent need for effective preventive measures to reduce mortality rates during pandemics.

5) Male (Mālē):
The term 'Male' denotes the gender distribution observed in the study's patient population. It notes a higher prevalence of H1N1 infection in male patients, which can inform future research regarding gender-specific responses to the virus, treatment outcomes, and potential biological or behavioral factors influencing infection rates.

6) India:
'India' refers to the geographical context of the study, reflecting the specific epidemiological trends and healthcare challenges faced during the H1N1 pandemic in the region. It underscores the relevance of localized data in understanding the virus's impact in different populations and informing targeted public health interventions.

7) Pain (Paiṇ):
The term 'Pain' is relevant as it relates to the physical discomfort reported by patients with H1N1 influenza. Symptom management is crucial in clinical settings, highlighting the need for healthcare providers to address pain effectively as part of comprehensive patient care strategies during influenza outbreaks.

8) Fever:
'Fever' is a common and critical symptom associated with H1N1 influenza. Its prevalence in patients aids in diagnosing the virus and understanding illness severity. Tracking fever patterns can assist healthcare providers in identifying and managing flu cases promptly to minimize complications and improve patient outcomes.

9) Lucknow:
This term illustrates the specific location of the research within India. Lucknow serves as the site for the data collection from patients, influencing the epidemiological outcomes due to regional demographic, environmental, and healthcare system differences impacting the prevalence and treatment of H1N1 influenza.

10) Science (Scientific):
'Science' underscores the scientific methodology employed in the study to analyze H1N1 influenza cases. It reflects the rigorous approach to data collection, statistical analysis, and clinical investigation necessary for advancing medical knowledge, enhancing treatment strategies, and informing public health policies regarding infectious diseases.

11) Vomiting:
'Vomiting' indicates a gastrointestinal symptom experienced by some patients with H1N1 influenza. Its presence highlights the diverse clinical spectrum of influenza, which includes atypical symptoms that healthcare providers must recognize. Understanding vomiting in this context can aid in early diagnosis and comprehensive patient care.

12) Post:
'Post' in this context may refer to the period following an event, such as the aftermath of the H1N1 epidemic. It signifies the research's focus on understanding the implications and consequences of the epidemic in terms of public health responses, clinical outcomes, and ongoing surveillance requirements.

13) Epidemic:
'Epidemic' describes the widespread occurrence of H1N1 influenza, impacting large populations. The term is vital as it contextualizes the urgency for intervention, surveillance, vaccination efforts, and healthcare resource allocation to control outbreaks, reduce infection rates, and mitigate associated morbidity and mortality.

14) Table:
'Table' refers to data presentation in the study, encapsulating demographic and clinical characteristics of patients. It provides visual insights into findings, facilitating comparisons across different patient cohorts, and enabling easier interpretation of complex information relevant for clinical practice and public health decision-making.

15) New Delhi:
'New Delhi' is noted as a significant administrative and health policy-making hub in India. Mentioning this location connects the study to broader national health initiatives and responses to influenza outbreaks, reflecting its role in directing public health measures and research funding at the national level.

16) Delhi:
'Delhi,' similar to New Delhi, indicates the broader regional context of the study, emphasizing the importance of metropolitan dynamics in the epidemiology of influenza. Its urban setting may contribute to disease transmission patterns, healthcare accessibility, and the effectiveness of public health responses to epidemics.

17) Pulse:
The term 'Pulse' relates to vital sign assessment in patients, reflecting their physiological status during clinical evaluation. Monitoring pulse rate is critical for diagnosing the severity of influenza infections and determining the need for immediate medical interventions in potentially life-threatening cases.

18) Blood:
'Blood' signifies the biological material involved in numerous health assessments, including complete blood counts and other laboratory tests to monitor patient conditions. Understanding blood parameters helps healthcare professionals gauge the severity of infections like H1N1 and tailor appropriate treatments and interventions.

19) Sign:
'Sign' relates to clinical indicators observed during patient examinations, which can show the presence or severity of illness. In the context of the study, identifying specific signs aids in diagnosing H1N1 influenza and gauging patient responses to treatment, thus improving clinical management strategies.

20) Northern India:
'Northern India' defines the geographical focus of the study, reflecting regional epidemiological trends and resource availability in managing viral outbreaks. The term emphasizes the importance of geographical context in understanding the dynamics of H1N1 transmission and developing population-specific health strategies.

21) Discussion:
'Discussion' refers to the section where the implications and interpretations of the study's findings are analyzed. It explores the relevance of the results, compares them with other studies, and suggests practical recommendations for healthcare practices and policies based on observed trends in H1N1 influenza cases.

22) Drowsiness:
'Drowsiness' refers to a clinical symptom that may accompany H1N1 infection. Recognizing symptoms like drowsiness is important for healthcare providers to assess the overall clinical condition of patients. It can indicate the severity of illness and the need for further evaluation and interventions.

23) Medicine:
'Medicine' encompasses the broader context of healthcare practices and pharmaceutical interventions utilized in treating influenza. The study addresses therapeutic approaches involving antiviral medications and highlights the critical role of modern medicine in managing infectious diseases and improving patient outcomes during epidemics.

24) Pregnant:
'Pregnant' highlights a specific population at increased risk for severe outcomes from H1N1 influenza. The study's mention of pregnant individuals underscores the need for targeted public health recommendations, including vaccination and special monitoring, tailored to protect vulnerable groups during influenza outbreaks.

25) Debility:
'Debility' captures the condition of weakness or infirmity that can result from influenza infection. In the study's context, it emphasizes how H1N1 can lead to significant health deterioration, affecting individuals' recovery and enabling a better understanding of long-term consequences post-infection.

26) Sheetal:
'Sheetal' is likely a reference to one of the authors involved in the study. It signifies the collaborative nature of research, recognizing contributions from various experts in the field to advance understanding of H1N1 influenza and its impact on public health.

27) Family:
'Family' in the context of healthcare could signify the importance of social dynamics in disease transmission. Understanding familial patterns of illness can help address the spread of influenza within households and help public health officials advocate for community-level vaccination and preventive measures.

28) Summer:
'Summer' may refer to seasonal variations in influenza prevalence. The study acknowledges how influenza patterns differ by season, impacting public health surveillance and responses. Understanding these seasonal trends is pivotal in strategizing immunization campaigns and healthcare resources during peak periods.

29) Medium:
'Medium' in the context of the study may relate to 'Viral Transport Medium' used for sample collection, emphasizing the importance of proper sample handling for PCR diagnostics. This ensures accurate detection of viruses, which is crucial for accurate epidemiological assessments during outbreaks.

30) Indian:
'Indian' reflects the cultural and demographic context of the study population. It signals the importance of understanding how local factors affect the epidemiology of H1N1 influenza, guiding public health interventions tailored to the Indian healthcare landscape.

31) Filling (Filled):
'Filled' may pertain to the completion of patient proformas or data collection instruments, which capture essential information regarding the patient's demographic, clinical, and treatment characteristics. Well-filled forms contribute to data integrity and enhance analysis quality, leading to more effective clinical insights.

32) Water:
'Water' could refer to the necessity of hydration for patients coping with influenza. Maintaining hydration is crucial during illness, affecting recovery rates and overall health. This consideration highlights the broader interdisciplinary aspects of patient care in managing influenza symptoms.

33) Miṇi (Mini):
'Mini' might refer to the 'Mini kit' used for RNA extraction in the study's PCR diagnostics. This emphasizes the technological aspects involved in viral detection and the importance of using efficient laboratory tools to enhance the accuracy and reliability of influenza testing.

34) Pune:
'Pune' is noted as a significant location in India where initial H1N1 cases were identified. The mention highlights the geographical spread of the outbreak, and chronicles the early response efforts taken within specific Indian cities to control the influenza outbreak.

35) Flag:
'Flag' may refer to warning signs or indicators of severe illness, particularly in pediatric patients. Diagnostic flags help healthcare professionals identify at-risk cases early on, enabling prompt intervention and tailored care strategies to mitigate potential complications associated with H1N1 infections.

36) Bird:
'Bird' likely refers to 'avian influenza' in the context of reassortment events that contribute to the emergence of new viral strains. Understanding the origin of influenza viruses is crucial for monitoring outbreaks and preventing cross-species transmission, guiding effective public health responses to influenza risks.

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