Treatment Of Symptoms In Patients Research Articles

Current status of non-surgical treatment for pancreatolithiasis

Endoscopic shock-wave lithotripsy (ESWL) and endoscopic procedures are useful treatment for symptomatic patients with pancreatic stones distributed in the main pancreatic duct. When pancreatic exocrine function can be preserved by removing the stones, even patients without pain can benefit. In patients with large or multiple stones, following ESWL with endoscopic treatment may reduce duration of the course treatment. Reported stone clearance rates range from 42% to 89%, pain relief rates from 15% to 91.1%, and recurrence rates from 12% to 22%. Recurrence is among the most important problems encountered with non-surgical treatment. In several studies, recurrence was observed in about 20% of patients, sometimes requiring surgery. Non-surgical treatment is safe. ESWL combined with endoscopic treatment is the usual first option for pancreatolithiasis, largely limiting the need for surgery to patients with treatment failure or multiple recurrences.

Association between high on-treatment platelet reactivity and occurrence of cerebral ischemic events in patients undergoing percutaneous coronary intervention

IntroductionPercutaneous coronary angioplasty (PCI) has become a routine treatment in symptomatic patients with coronary artery disease. The use of new generation drug eluting stents (DES) and dual antiplatelet therapy has significantly improved treatment outcomes and increased patients' safety by reducing the risk of stent thrombosis. AimsThe goal of this study was to assess whether high on treatment platelet reactivity (HTPR), despite clopidogrel treatment, measured with Multiplate Electrode Aggregometer (MEA) is associated with the risk of adverse ischemic cerebral events. MethodsSymptomatic patients with coronary artery disease admitted for coronary angiography and angioplasty (PCI) were consecutively enrolled in this study. 249 consecutive patients underwent coronary artery stenting for stable angina (n=215) or non-ST-elevation acute coronary syndrome (n=34). Inhibition of platelet aggregation was assessed by MEA. Genetic polymorphism of CYP2C19 was tested by HRM Real-Time PCR method in 150 patients. ResultsPatients with HTPR were more frequently diagnosed with ischemic stroke (p=0.0351, OR=16.818, 95% CI [1.464–193.23]) and other ischemic cerebral events (stroke or TIA, p=0.0339, OR=6.5, 95% CI [1.36–31.07]). Cumulative assessment of all ischemic and hemorrhagic events showed no statistical significance. Cerebral ischemic event was the only adverse event that correlated with CYP2C19 (*2/*2) allele (p=0.0489, OR=10; 95% CI [1.39–71.80]). ConclusionsHTPR assessed by MEA, in patients treated with clopidogrel after coronary artery stenting was found to be an important risk factor of ischemic cerebral events. In concordance, the carriers of CYP2C19*2/*2 allele showed an increased rate of ischemic cerebral events.

The biggest experience in treatment of symptomatic patients with myocardial "bridges"

The anomaly of location of the coronary arteries (CA) is one of the lesser known areas in the development of ischemic heart disease. Literature reports about myocardial bridge (MB) have usually been based on single cases and there are no algorithms of treatment patients with this anomaly. We have the largest database of the patients with MB.

Ivabradine in practice

Ivabradine is an innovation in the cardiovascular fraternity with specific heart rate-lowering property, which expresses selective action on pacemaker activity in the sinoatrial node of the heart, resulting into important clinical benefits for improvement in coronary perfusion and pump efficiency. Ivabradine demonstrated substantial antianginal and anti-ischemic efficacy, improvement in exercise capacity and in quality of life in monotherapy or in combination with beta-blockers. The analysis of pooled data from ivabradine angina development programme assessing the antianginal efficacy of ivabradine across several different subgroups provided clinical evidence that ivabradine diminishes angina in all types of patients, whatever their age, sex, severity of angina, and revascularization status, history of previous myocardial infarction, peripheral vascular disease, or diabetes. These clinical benefits make ivabradine an important agent for symptomatic treatment of patients with angina pectoris. The important role of ivabradine in the management of patients with chronic heart failure (HF) is well established and supported by its benefits in prevention of morbidity and mortality demonstrated in SHIFT trial. Efficacy and tolerability of ivabradine in patients with HF, including those with different clinical profiles (elderly; severe disease; low blood pressure; comorbidities, including renal dysfunction, diabetes, chronic obstructive pulmonary disease), make ivabradine particularly pertinent for achievement of all targets in the treatment of HF, including improvement of symptoms and well-being, as well as outcomes. The available wealth of evidence supports the important place of ivabradine as an essential therapeutic modality to enhance the management of patients with angina or chronic HF.

Therapeutic interventions in parkinsonism: Corticobasal degeneration

Corticobasal degeneration (CBD) is a progressive neurodegenerative disorder resulting from pathological accumulation of tau protein and is included in the spectrum of Atypical Parkinsonism. The typical clinical phenotype of CBD is characterized by the Corticobasal syndrome (CBS). In recent years it has become clear that the clinical picture of CBS may be caused by different pathological conditions, resulting in frequent misdiagnosis.CBD has high morbidity and poor prognosis with no effective therapies. In this review, we will discuss the symptomatic treatment, the palliative care and the disease modifying strategies currently in use. Symptomatic treatment in patients with CBD may sometimes be useful for improving motor (parkinsonism, dystonia and myoclonus) and non-motor (cognitive-behavioral) symptoms, but the effects are often unsatisfactory. In addition, non-pharmacological strategies and palliative care are useful integrating components of the multidisciplinary therapeutic approach for patients with CBD. Despite many efforts, a disease-modifying treatment is still unavailable for CBD.

Umeclidinium/vilanterol versus fluticasone propionate/salmeterol in COPD: a randomised trial.

BackgroundUmeclidinium (UMEC; long-acting muscarinic antagonist) plus vilanterol (VI; long-acting beta2 agonist [LABA]) and the LABA/inhaled corticosteroid fluticasone propionate/salmeterol (FP/SAL) are approved maintenance treatments for chronic obstructive pulmonary disease (COPD). This 12-week, multicentre, double-blind, parallel-group, double-dummy study compared the efficacy and safety of these treatments in symptomatic patients with moderate-to-severe COPD with no exacerbations in the year prior to enrolment.MethodsPatients (n = 717) were randomised 1:1 to once-daily UMEC/VI 62.5/25 mcg or twice-daily FP/SAL 500/50 mcg. Endpoints included 0–24 h weighted mean (wm) forced expiratory volume in 1 s (FEV1) (Day 84; primary), trough FEV1 (Day 85; secondary), other lung function endpoints, symptoms, quality of life (QoL) and safety.ResultsImprovements with UMEC/VI versus FP/SAL were 0.080 L (95 % confidence interval: 0.046–0.113; wmFEV1) and 0.090 L (0.055–0.125; trough FEV1) (both p < 0.001). UMEC/VI statistically significantly improved all other lung function measures versus FP/SAL. Both treatments demonstrated a clinically meaningful improvement in symptoms (Transition Dyspnoea Index ≥1 unit) and QoL (St George’s Respiratory Questionnaire Total score ≥4 unit decrease from baseline) over 12 weeks. The incidence of adverse events was 28 % (UMEC/VI) and 29 % (FP/SAL); nasopharyngitis and headache were most common.ConclusionsOnce-daily UMEC/VI 62.5/25 mcg over 12 weeks resulted in significant and sustained improvements in lung function versus twice-daily FP/SAL 500/50 mcg in patients with moderate-to-severe COPD and with no exacerbations in the year prior to enrolment.Trial RegistrationNCT01822899 Registration date: March 28, 2013Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-015-0092-1) contains supplementary material, which is available to authorized users.

Oxycodone/Naloxone PR: A Review in Severe Refractory Restless Legs Syndrome.

An oral, fixed-dose combination of prolonged-release (PR) oxycodone with PR naloxone (Targin(®), Targiniq(®), Targinact(®); hereafter referred to as oxycodone/naloxone PR) is approved in Europe for the second-line symptomatic treatment of patients with severe to very severe idiopathic restless legs syndrome (RLS), after failure of dopaminergic therapy. Coadministration of naloxone represents a targeted approach to counteracting opioid-induced bowel dysfunction without compromising therapeutic efficacy; because of its very low oral bioavailability, naloxone blocks the action of oxycodone at opioid receptors locally in the gut. The efficacy of oxycodone/naloxone PR in patients with severe RLS inadequately controlled by previous (mainly dopaminergic) treatment has been demonstrated in RELOXYN, a 12-week, randomized, double-blind study with a 40-week open-label extension. In this pivotal study, oxycodone/naloxone PR significantly improved RLS symptoms compared with placebo from week 2 onwards; a beneficial effect of oxycodone/naloxone PR was maintained through 1 year of treatment. Furthermore, improvements in RLS symptoms in oxycodone/naloxone PR recipients were accompanied by similarly sustained improvements in disease-specific quality of life and subjective sleep variables. Oxycodone/naloxone PR was generally well tolerated, with a treatment-related adverse event profile (e.g. gastrointestinal disorders, CNS disorders, fatigue and pruritus) that was consistent with that expected for opioid therapy. Notably, there were no confirmed cases of augmentation among oxycodone/naloxone PR recipients throughout the course of the study. Results from the well-designed RELOXYN trial have thus demonstrated the value of oxycodone/naloxone PR as a second-line therapy for severe refractory RLS; further investigation of this combination product as a first-line treatment for severe RLS is now warranted.

Comparison of the symptomatic and chondroprotective effects of glucosamine sulphate and exercise treatments in patients with knee osteoarthritis.

The aim of the present study was to evaluate the symptomatic effects of glucosamine sulphate (GS) in comparison to the exercise therapy, as well effects on Magnetic Resonance Imaging (MRI) findings of cartilage loss in patients with knee osteoarthritis (OA). Seventy patients with a diagnosis of knee OA were randomly divided into two groups. First group of patients (n=40) were treated with 1500 mg/day oral glucosamine sulphate and the second group (n=30) performed a home exercise program for a period of 6 months. Compared with baseline, significant improvements were observed in the visual analogue scale pain scores and the Western Ontario and McMaster Universities osteoarthritis index and 20-min walking time in both groups (p< 0.001); there were no significant differences between the two treatment groups. Upon the evaluation of joint cartilage thickness by MRI, an improvement was evident in only in the area of medial femoral condyle of patients who had performed a home exercise program (p< 0.05). The results of the present study suggest that both oral GS treatment and exercise therapy are efficient in the symptomatic treatment of patients with knee OA. However, exercise therapy found to have a better chondroprotective effect than oral GS treatment in this patient population.

Intramyocardial bridges: anatomo-pathological characteristics, diagnosis, and therapeutic strategies

Intramyocardial bridge is defined as the segment of a major epicardial coronary artery that runs within the cardiac muscle wall (coronary tunneling). Usually, this kind of anatomic variant is asymptomatic but sometimes it may lead to acute coronary syndrome and/or arrhythmias, and more rarely to sudden cardiac death. Treatment for symptomatic patients is pharmacological, using beta-blockers.

Paliperidone Use in Behavioural Symptoms in Patients with Intellectual Disabilities

Introduction Behavioural symptoms are the first reason of psychiatric assessment in patients with intellectual disabilities (ID), and also the most frequent cause of psychopharmacological treatment. Different rates of prevalence of these symptoms appear in literature data (10-60%). Paliperidone has shown effectiveness in the treatment of behavioural symptoms in patients with autism and asperger syndrome, with significant reduction in ABC-I subscale scores. Conclusions Objectives: Study paliperidone effect in behavioural symptoms' improvement in patients with intellectual disabilities of diverse etiology. Methods 10 outpatients with intellectual disabilities and behavioral symptoms were selected and treated with paliperidone. Sociodemographic and clinical data (type of intellectual disability, previous antipsychotic and paliperidone dose) were registered. Agitation subscale Aberrant Behavior Checklist (ABC-I) scores were compared prior and 4 weeks after psychopharmacological treatment change. Otherwise we assessed clinical improvement with Clinical Global Impression-Improvement (CGI-I). Results All patients were similar in clinical and sociodemographic characteristics. Paliperidone mean dose was 8,4 mg/day (3-18 mg/day), changing from risperidone (44,4%), olanzapine (44,4%) and levomepromacine (11,1%). Mean reduction in ABC-I scores with paliperidone treatment was 6,2 points [with most significant improvement in items like irritability (1,2 points), aggressions (1,1 points) and slams (0,9 points)]. CGI-I scores showed a much better improvement in 60% patients, mildly betterin 30% patients and slightly better in 10% patients. No significant adverse effects leaded to treatment discontinuation. Conclusions 1. Paliperidone is an effective and safe treatment in behavioral symptoms associated to intellectual disabilities. 2. Paliperidone treatment reduces ABC-I subscale scores, with most significant improvement in irritability and aggressions.

Wernicke's Encephalopathy, Wet Beriberi, and Polyneuropathy in a Patient with Folate and Thiamine Deficiency Related to Gastric Phytobezoar.

Background. Wernicke's encephalopathy (WE) is an acute neurological disorder resulting from thiamine deficiency. It is mainly related to alcohol abuse but it can be associated with other conditions such as gastrointestinal disorders. This vitamin deficiency can also present with cardiovascular symptoms, called “wet beriberi.” Association with folate deficit worsens the clinical picture. Subject. A 70-year-old man with gastric phytobezoar presented with gait instability, dyspnoea, chest pain associated with right heart failure and pericarditis, and folate deficiency. Furosemide was administered and cardiac symptoms improved but he soon developed vertiginous syndrome, nystagmus, diplopia, dysmetria, and sensitive and motor deficit in all four limbs with areflexia. Results. A cerebral magnetic resonance imaging (MRI) showed typical findings of WE. He was immediately treated with thiamine. Neurological symptoms improved in a few days and abnormal signals disappeared in a follow-up MRI two weeks later. Conclusion. Patients with malabsorption due to gastrointestinal disorders have an increased risk of thiamine deficiency, and folate deficiency can make this vitamin malabsorption worse. An established deficiency mainly shows neurological symptoms, WE, or rarely cardiovascular symptoms, wet beriberi. Early vitamin treatment in symptomatic patients improves prognosis. We recommend administration of prophylactic multivitamins supplements in patients at risk as routine clinical practice.

Application of Ranolazine in Stable Angina Pectoris Therapy (ARETHA): Real-World Data from an Observational Study

Objective: Ranolazine, a late sodium current inhibitor, is indicated in adults as add-on therapy for the symptomatic treatment of patients with stable angina pectoris who are inadequately controlled or intolerant to first-line antiischaemic therapies. This study was conducted to assess the use of ranolazine as well as its safety and efficacy in patients with stable angina pectoris from different causes in a real world scenario. Methods: Patients with stable angina pectoris (AP) receiving ranolazine were enrolled in this non-interventional study. Data were documented at baseline and after 3 months of ranolazine treatment. Endpoints included changes in the number of AP attacks per week, frequency of using short-acting nitrates, current status of the CCS classification, overall estimate of quality of life assessed by both, the physician and the patient, and safety. Results: In total, 1,537 patients were eligible for efficacy evaluation. After 3 months, the mean (±SD) number of AP episodes per week significantly decreased from 4.4 ± 4.0 at baseline to 1.1 ± 1.8 (p<0.0001), and the weekly use of short-acting nitrates was significantly reduced from 3.4 ± 3.4 to 0.8 ± 1.5 (p<0.0001). Improvement occurred independent of diagnosed coronary heart disease (CHD). The CCS classification improved in 69.0% of patients and remained stable in 27.1%. Quality of life, assessed on a numerical analogue scale by physicians and patients, improved significantly by 43.7% and 44.9%, respectively (p<0.0001). Safety analysis was based on 2,726 patients. A total of 63 adverse drug reactions (ADRs) occurred in 37 patients (1.4%) and led to discontinuation in 34 patients (1.2%). By the end of the observation period, all ADRs were resolved or resolving. Conclusion: The adjuvant therapy with ranolazine is an effective treatment option with a positive benefit-risk balance for patients with angina pectoris of different causes, e.g. small vessel disease, endothelial dysfunction, including those without prior CHD diagnosis.

Metastatic small bowel adenocarcinoma in a 10-year-old Chinese girl

Small bowel adenocarcinoma is a rare entity in both adult and paediatric populations. Diagnosis is usually delayed due to vague symptoms. We report a case of ileal adenocarcinoma presented with multiple metastases. A 10-year-old Chinese girl presented with recurrent right lower quadrant pain developed intestinal obstruction. Computerized tomography showed terminal ileum wall thickening, a pelvic mass and suspicious pulmonary metastases. Laparotomy showed a terminal ileal tumour causing mechanical obstruction with metastases to the left ovarian and mesenteric lymph nodes. Palliative right hemi-colectomy with double-barrel ileostomy was performed. The pathology was reported to be ileocaecal adenocarcinoma with extensive lymphovascular permeation. She was the started on palliative chemotherapy with static disease. Diagnosis of small bowel adenocarcinoma remains a challenge to surgeons as the clinical presentation is subtle in spite of the advanced clinical course. Surgery plays a role in symptomatic treatment for patients with intestinal obstruction in advanced stage.

Abstract 12585: Antianginal Efficacy of Ivabradine in Patients With History of Coronary Revascularization

Introduction: Coronary revascularization procedures are widely performed for the symptomatic treatment of patients with coronary artery disease (CAD). Even after such procedures, angina symptoms often remain. Hypothesis: To evaluate the antianginal effectiveness and the effect on quality of life of ivabradine co-administered with a β-blocker, during 4-month therapy of CAD patients with a history of coronary revascularization. Methods: This is a post hoc analysis (926 post-revascularization patients) of a Pan-Hellenic, prospective, non interventional study including 2403 patients with CAD and stable angina. Data were recorded at baseline, and at 1 and 4 months after inclusion, while patients’ quality of life was assessed by means of the EQ-5D questionnaire. Results: Of 926 CAD patients who participated in the study, 28 (3%) prematurely discontinued treatment. Addition of ivabradine decreased mean heart rate from 80.3±9.5 bpm (1st visit) to 67.8±7.3 bpm (2nd visit) and 63.9±6.2 bpm (3rd visit) (P&lt;0.001). Mean number of angina attacks and nitroglycerin consumption decreased, respectively, from 2.2±2.3/1.5±2.2 times/week (1st visit) to 0.5±1.0/0.3±0.8 (2nd visit) and 0.3±0.6/0.1±0.4 times times/week (3rd visit) (P&lt;0.001). Moreover, the percentage of patients with angina CCS I (Canadian Cardiovascular Society classification) increased from 36% at baseline to 83% at study completion (P&lt;0.001), while those with angina CCS III-IV decreased from 21% to 2% (P&lt;0.001). All dimensions of the EQ-5D questionnaire were significantly improved after 4 months of treatment with ivabradine (P&lt;0.001) (Table 1). Compliance with ivabradine treatment was high. Throughout the trial, 884 patients (95.5%) were taking their treatment “every day” or “quite often.” Conclusions: These results confirm the antianginal effectiveness as well as the beneficial effect of ivabradine on the quality of life of patients with CAD and a history of coronary revascularization.

Right ventricular endomyocardial fibrosis (2013 Grover Conference series).

Endomyocardial fibrosis (EMF) is a restrictive cardiomyopathy of unknown origin, affecting predominantly the right side of the heart. Its highest prevalence is in poor regions of sub-Saharan Africa, where it is usually found in children and adolescents. In areas where it is endemic, EMF is a major cause of heart failure and premature death. EMF of the right ventricle has unique clinical, electrocardiographic, and echocardiographic signs. Several features of advanced disease are not fully understood, the most striking being the presence of severe ascites with little or no pedal edema. Echocardiography is the main diagnostic tool and supports management of the disease in most patients, as it allows assessment of the severity and extension of endocardial fibrosis, the quality of the right atrioventricular valve, and the presence of intracardiac thrombi. Pulmonary hypertension in the setting of right EMF is related to chronic thromboembolism, through the chronic thrombi present in the severely enlarged right atrium found in advanced disease. The management of right EMF is difficult. Treatment of symptomatic patients should be surgical. However, as the disease is usually detected in late stages, with severe and advanced lesions, surgery cannot be performed without a very high risk of death and complications. New surgical approaches addressing several components of the structural cardiac abnormalities have been attempted, with promising results. EMF remains one of the most neglected diseases worldwide, and research into its pathophysiological mechanisms will probably improve outcomes and alter the natural history of the disease. This requires improvement in the health systems in areas of endemicity as well as the design of international collaborative research projects.

Activity restriction in mild COPD: a challenging clinical problem.

Dyspnea, exercise intolerance, and activity restriction are already apparent in mild chronic obstructive pulmonary disease (COPD). However, patients may not seek medical help until their symptoms become troublesome and persistent and significant respiratory impairment is already present; as a consequence, further sustained physical inactivity may contribute to disease progression. Ventilatory and gas exchange impairment, cardiac dysfunction, and skeletal muscle dysfunction are present to a variable degree in patients with mild COPD, and collectively may contribute to exercise intolerance. As such, there is increasing interest in evaluating exercise tolerance and physical activity in symptomatic patients with COPD who have mild airway obstruction, as defined by spirometry. Simple questionnaires, eg, the modified British Medical Research Council dyspnea scale and the COPD Assessment Test, or exercise tests, eg, the 6-minute or incremental and endurance exercise tests can be used to assess exercise performance and functional status. Pedometers and accelerometers are used to evaluate physical activity, and endurance tests (cycle or treadmill) using constant work rate protocols are used to assess the effects of interventions such as pulmonary rehabilitation. In addition, alternative outcome measurements, such as tests of small airway dysfunction and laboratory-based exercise tests, are used to measure the extent of physiological impairment in individuals with persistent dyspnea. This review describes the mechanisms of exercise limitation in patients with mild COPD and the interventions that can potentially improve exercise tolerance. Also discussed are the benefits of pulmonary rehabilitation and the potential role of pharmacologic treatment in symptomatic patients with mild COPD.

SAT0427 Multicentric Osteoarthritis Intervention Study with Sysadoa (MOVES): Effects of Combined Glucosamine Hydrochloride and Chondroitin Sulfate VS Celecoxib for Painful Knee Osteoarthritis

BackgroundCombined glucosamine hydrochloride (GH) and chondroitin sulfate (CS) was found to be efficacious compared with placebo in subjects with knee osteoarthritis (OA) with severe pain in the GAIT trial1. The...

Hepatic Arterial Infusion Chemotherapy for Patients with Huge Unresectable Hepatocellular Carcinoma

Background and AimThe optimal treatment for huge unresectable hepatocellular carcinoma (HCC) remains controversial. The outcome of transcatheter arterial chemoembolization (TACE) for patients huge unresectable HCC is generally poor and the survival benefit of TACE in these patients is unclear. The aim of the study is to compare the effect of hepatic arterial infusion chemotherapy (HAIC) versus symptomatic treatment in patients with huge unresectable HCC.MethodsSince 2000 to 2005, patients with huge (size >8cm) unresectable HCC were enrolled. Fifty-eight patients received HAIC and 44 patients received symptomatic treatment. In the HAIC group, each patient received 2.4+1.4 (range: 1–6) courses of HAIC. Baseline characteristics and survival were compared between the HAIC and symptomatic treatment groups.ResultsThe HAIC group and the symptomatic treatment group were similar in baseline characteristics and tumor stages. The overall survival rates at one and two years were 29% and 14% in the HAIC group and 7% and 5% in the symptomatic treatment group, respectively. The patients in the HAIC group had significantly better overall survival than the symptomatic treatment group (P<0.001). Multivariate analysis revealed that HAIC was the significant factor associated with the overall survival (relative risk: 0.321, 95% confidence interval: 0.200–0.515, P<0.001). None of the patients died due to immediate complications of HAIC.ConclusionsHAIC is a safe procedure and provides better survival than symptomatic treatment in patients with huge unresectable HCC.

Trimetazidine and Cardioprotection

Trimetazidine (TMZ) is a metabolic agent used in cardiology for more than 40 years. Several studies assessed the cardioprotective effects of TMZ in patients with chronic coronary heart disease (CHD) as well as in patients with heart failure (HF). In light of the inclusion of TMZ in the current guidelines on the management of stable CHD, we reviewed the published literature on TMZ, focusing mainly its effects on patients with stable angina and HF. According to the published literature, there is sufficient evidence to support the addition of this agent in the treatment of symptomatic patients with stable angina.

Comparative sensitivity of RICA and MAC-ELISA for IGM antibody based early diagnosis of chikungunya virus infection in patients in Kadapa district of Andhra Pradesh, India

Chikungunya (CHIK) is a viral fever that spreads in human population through mosquito bite that is infected with Chikungunya virus (CHIKV). CHIK resembles Dengue fever. Although there is no specific treatment or vaccine available currently, the confirmative rapid diagnosis is based on detection of viral nucleic acid or IgM antibodies in serum, an indication of recent infection, helps in epidemiological monitoring, symptomatic treatment of patients and determining prognosis. In the present study, with the approval of the Kadapa district medical and health officer, 238 blood samples were collected from Chikungunya infection suspected patients, residing in the Kadapa district villages of Andhra Pradesh. Serological detection of anti-CHIKV IgM antibodies was performed using rapid immuno-chromatographic assay (RICA) and IgM-antibody capture enzyme-linked immuno Sorbant assay (MAC-ELISA). Convalescent sera (n = 170) were tested by RICA and 108 of them were found positive for anti-CHIKV IgM antibodies. All 108 anti-CHIKV IgM antibody RICA positive sera were further assayed using MAC-ELISA to compare the sensitivity of both assays for the early diagnosis of disease. Only 45 sera samples gave positive result. The sensitivity of RICA and MAC-ELISA were found to be 100% and 42% respectively.