Seema Rani

To compare the efficacy and safety of fixed dose combination of thiocolchicoside and aceclofenac versus chlorzoxazone, aceclofenac and paracetamol in patients with acute lower backache associated with muscle spasm.

Background: The fixed dose combinations (FDCs) of muscle relaxants, non-steroidal anti-inflammatory drugs and paracetamol are commonly prescribed in the treatment of acute lower backache. Aim: The present study was undertaken with the aim of comparing the efficacy and safety of FDCs of thiocolchicoside and aceclofenac versus chlorzoxazone, aceclofenac and paracetamol in patients with acute lower backache associated with muscle spasm. Materials and Methods: A total of 100 patients between ages range from 18 and 55 years having low back pain of ≤7 days duration were randomly divided into two groups. Group A was prescribed thiocolchicoside (4 mg) + aceclofenac (100 mg) while Group B was prescribed chlorzoxazone (500 mg) + aceclofenac (100 mg) + paracetamol (325 mg) orally twice daily for 7 days. Severity of pain at rest and on movement was recorded using visual analogue scale. Muscle spasm was evaluated by hand-to-floor distance and Lasegues maneuver. Readings were noted on day 1 (baseline), day 3 and day 7. Results: There was statistically significant reduction in severity of pain and muscle spasm on day 3 and day 7 in both groups. There was no statistically significant difference in pain relief and muscle spasm among the treatment groups but clinically showed better improvement in the Group A. The adverse drug reactions occurring during study showed a statistically significant better safety profile in the Group A than Group B. Conclusion: These findings confirm that FDC of thiocolchicoside and aceclofenac is a preferred option for patients with lower backache pain associated with muscle spasm.

A Focus Group Discussion (FGD) Based Studyto Understand the Patient Perspectives ofHealth Care Along with the Satisfaction toServices Among the Adult HIV/AIDS Patients

Background: HIV/AIDS infection is one of the most important public health problems in India. Although the state of Himachal Pradesh falls in the low prevalence zone, the needs and satisfaction levels of patients is of immense importance in planning health care services for them. Qualitative research methods like focus group discussions provide real life views of the patients in this regard. Objective: To understand the patient perspectives of health care along with the satisfaction to services among the adult HIV/AIDS patients. Methodology: A study was carried out among the adult HIV-positive patients who were on ART at IGMC Shimla from November 2008 through May 2009. Focus Group Discussions were conducted to collect data. A total of 11 FGDs were conducted in which 104 patients took part. Results: Although the patients were generally satisfied to the services being provided, financial security, cross referrals to other departments, accessibility of the ART Centre, waiting space and infrastructure at the ART Centre were the key issues of dissatisfaction identified.

To compare the efficacy and safety of eperisone with thiocolchicoside in patients with acute lower backache associated with muscle spasm

Background & Objectives: Eperisone hydrochloride is a new drug came in market with centrally acting muscle relaxant, having additional vasodilator effect and used for treatment of backache associated with muscle stiffness like thiocolchicoside but supposed to be slightly better in efficacy and adverse effect profile. The aim of this study was to compare the efficacy and safety of eperisone with thiocolchicoside in patients with acute lower backache associated with muscle spasm. Methods: 100 eligible subjects were taken and assessment of severity of pain and muscle spasm was done by using Visual Analogue Scale, finger-to-floor distance (FFD), Lasegue’s maneuver and modified Schober’s test. Results: No statistically significant difference in pain relief and muscle spasm among both the treatment groups but clinically pain relief is slightly better in eperisone group. The adverse drug reactions occurring during study showed a slightly better safety profile in patients on eperisone than on thiocolchicoside. Conclusion: These findings confirm that eperisone represents a valuable and safer alternative to thiocolchicoside for treatment of low back pain associated with muscle spasm.

Clinico-demographic profile of HIV patients from a low prevalence state of Northern India

Background: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic represents the most serious public health problem in India with various zones in the country based on the HIV prevalence. The state of Himachal Pradesh falls in the low prevalence zone, but the exact demographic profile of the patients is not known. Objective: To study the social, demographic, and clinical profile of patients attending the Antiretroviral Therapy (ART) center at Indira Gandhi Medical College (IGMC) Shimla. Materials and Methods: A cross-sectional study was carried out among the adult HIV-positive patients who were on ART at IGMC Shimla from November 2008 through May 2009 for a period of 6 months. Data was collected using a pre-designed and pre-tested structured questionnaire. The questionnaire was administered by the investigator in person in local vernacular language of the patients. Data was also obtained from the ART cards of the patients. Quantitative data so obtained was analyzed using means and proportions. Results: A total of 384 patients were enrolled in the study. Male to female ratio was 1.19:1. Majority of the patients were in the age group 25-44 years. Mean age of the patients was 37.1 ± 6.6 years. Among females, 61.1% were widows. Patients had been referred to the ART center by a physician, with self-referral being very less. Conclusion: The findings are suggestive of a predominantly heterosexual route of transmission and the maturation of the epidemic in Himachal Pradesh. This information indicates the need for interventions aimed at reducing risky sexual behavior.