Prevalence of migraine is high among females. Younger age and female sex are other contributory factors as prevalence of migraine is higher in these groups. Degree of allergic sensitisation determines the severity and frequency of headaches in those whom allergic rhinitis is a risk factor as evidenced by higher levels of IgE.

The fall in BP was significantly higher in obese (12 patients out of 50) than non obese (5 patients out of 50) patients. Probably obese patients had reduced cardiac sympathetic tone which caused post-prandial hypotension more than non obese patients.

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Background: Pneumonia is the most common hospital acquired infection in the intensive care unit. One of the causes for hospital acquired pneumonia is ventilator associated pneumonia. Tracheostomy is known to prevent occurrence of ventilator associated pneumonia as it decreases the respiratory dead space, assists in better clearance of secretions and prevents chances of aspiration. Generally, tracheostomy is done after 2 weeks of endotracheal intubation to prevent tracheal complications. The aim of this study is to identify the incidence of ventilator associated pneumonia in tracheostomised and non tracheostomised patients and to see if early tracheostomy can prevent development of ventilator associated pneumonia.Methods: The study was conducted at a tertiary care hospital during a period of four years. 100 patients who were on mechanical ventilation for more than 7 days where taken up for the study. APACHE 4 scoring system was used. The incidence of Ventilator associated pneumonia in tracheostomised and non tracheostomised patients was studied.Results: In our study the total incidence of VAP was 44 %. In our study out of the 42 patients who had undergone tracheostomy 13 (30.95%) patients had ventilator associated pneumonia. Among the non-tracheostomised patients 31 (53.44%) out of 58 patients developed ventilator associated pneumonia. In our study the incidence of ventilator associated pneumonia was much lesser (12%) in patients who underwent tracheostomy in the period 7 to 10 days after mechanical ventilation, whereas in those who underwent tracheostomy after 11 days incidence of ventilator associated pneumonia was much higher.Conclusions: Our study showed that the incidence of ventilator associated pneumonia was much higher among non tracheostomised patients compared to patients who underwent tracheostomy. Hence patients undergoing earlier tracheostomy had a clear advantage than those undergoing tracheostomy late or non tracheostomised patients in preventing ventilator associated pneumonia.

Background: Migraine and allergic rhinitis are common disorders. Studies have shown increased frequency of migraine headaches in patients with allergic rhinitis. The aim of this study is to identify how age, sex and degree of allergic sensitization influences the occurrence, severity and treatment outcome of migraine headaches in patients with allergic rhinitis.Methods: The study was conducted between 2014 and 2018 in a tertiary care hospital. 150 patients diagnosed with allergic rhinitis clinically were selected and total serum IgE levels were estimated. These patients were subjected to a detailed history taking to determine the characteristics of headache. All classifiable headache diagnoses had met criteria of the International Classification of Headache Disorders-II-2004. Severity of headache was assessed based on MIDAS score. The data was accessed based on age, sex, serum IgE levels, frequency and severity of migraine attacks and the treatment outcome using statistical methods.Results: The prevalence of migraine in this study was 68% among those who had allergic rhinitis. In this study out 150 patients 111 were females and 39 were males. Comparatively females’ patients 84 (75.7%) were found to be more prone for migraine. Majority patients were in the age group of 20 to 40 years (cumulative percentage of 67.3%). There was a negative correlation between age and IgE levels with r= -0.092. In comparison patients with higher levels of IgE (mean 3633) had more severe headaches. Patients with higher levels of IgE required a longer duration of treatment.Conclusions: This study shows that allergic rhinitis is a risk factor for development of migraine. Apart from high prevalence of migraine in patients with allergic rhinitis it is evident from the study that female sex, younger age group and high degree of allergic sensitization also play an important role as the severity of migraine and treatment course depend on these parameters. Hence the treatment for migraine in patients should aim at reducing the allergic sensitization in addition to concurrent treatment for migraine.