Dengue Fever: Clinical, Laboratory Profile and Outcome in Pediatric Patient

Introduction: Infection with any of the 4 dengue virus serotypes results in a diverse range of symptoms, from mild undifferentiated fever to life-threatening hemorrhagic fever and shock. Given that dengue virus infection elicits such a broad range of clinical symptoms, early and accurate laboratory diagnosis is essential for appropriate patient management. So a study was carried out to know its clinical profile, correlation between the laboratory profile and the severity of dengue fever and outcome in dengue patients. Aim: To study the clinical profile, correlation between the laboratory profile and the severity of dengue fever and outcome in dengue patients at tertiary care center. Method: Retrospective Observational study from 1st May 2019 to 31st April 2021. Result: Total 323 patients were studied during 1st May 2019 to 31st April 2021. Most common presentation was fever (100%), most common clinical finding is hepatomegaly (14.2%). All severe dengue infection has platelet count < 50000/cumm. In study of 323 patients 194(60%) of dengue fever,85(26.4%) of DHF GRADE 1,9(2.8%) of DHF GRADE 2 were discharged .13(4%) patients of DSS were expired.22 patients (6.8%) went DAMA. Conclusion: Reliable diagnosis of dengue fever in endemic areas can be done by clinical parameters like presence of nausea, vomiting, pain abdomen and hepatomegaly. Monitoring platelet count, hematocrit and WBC count is very useful for management of dengue cases. Keywords: dengue fever, platelet count, outcome

Morbidity, mortality and clinico-laboratory profile of COVID-19 related illness in children: a retrospective observational study from a tertiary care centre in India

Background: As India is poised for a third wave of SARS Co-V2 infection with a large unvaccinated pediatric population, it becomes imperative and pertinent for a study to find out its demographic, clinico-laboratory profile, and outcome in children with COVID-19 disease and its related illness.Methods: This is a retrospective observational study undertaken for Children and Adolescent admitted in the department of pediatrics of a teaching and tertiary care referral hospital, Delhi.Results: The median age of admitted children with COVID-19 disease was 11 years with an interquartile range 3 to 16 years. The median duration of hospital stay was 10 days (mean: 18±14 days). Mortality was 9/62 (14%). Recovery in non-severe (asymptomatic, mild, moderate) was 41/41 (100%), and in severe and critical illness including MISC was 42.8% (9/21). Mortality in severe and critical patients managed in SARI and COVID ward was 44% (8/18). Death among MISC patient in PICU was 33% (1/3). Difference in CRP rise was significant in severe and non-severe group of COVID-19 (p=0.017).Conclusions: Even though the morbidity and mortality associated with COVID-19 infection and related illness seems to be miniscule, the infection causes significant illness in the subgroup of children who requires hospitalization and can be fatal in those with comorbidity.

Wild mushroom poisoning in Kumaon region of Uttarakhand: a case series

Mushrooms have been dietary source in hilly and ethnic tribes of India. More than 5000 mushroom species are known worldwide and nearly 100 species are known to be poisonous for humans. Mushroom poisoning occurs due to unintentional and accidental ingestion of poisonous mushroom due to misidentification of poisonous variety as edible one. There has been increasingly incidence of reporting of mushroom poisoning cases nowadays. Here we are reporting case series of 4 patients admitted hailing from same village with accidental ingestion of poisonous mushrooms with clinical-laboratory profile and outcome at our institution. Mushroom Poisoning is an emerging healthcare concern nowadays. Education and mass awareness for identification of poisonous mushrooms is an important preventive measure. Early hospitalization, proper hydration, gastric decontamination, silibinin and N- acetyl cysteine therapy with hepato-renal support constitutes mainstay of treatment. Delay in treatment and complications results in poor prognosis and mortality.

Clinical and laboratory profile of multisystem inflammatory syndrome in children: A cross-sectional study in a tertiary care hospital, Mysuru

Background: Multisystem inflammatory syndrome in children (MIS-C) is considered to be a rare, yet serious complication of coronavirus disease 2019, where there is immune dysregulation related to past infection with the virus. It is an inflammatory syndrome affecting multiple systems with varied manifestations including gastrointestinal, cardiovascular, respiratory, neurological, renal, hepatobiliary, and dermatological symptoms. Aim: Current study aimed to investigate the clinical and laboratory profile of MIS-C. Materials and Methods: A cross-sectional study of 40 hospitalized children who were diagnosed as MIS-C and studied over a 12-month period from June 2020 to May 2021 at Cheluvamba Hospital in a tertiary care center attached to Mysore Medical College and Research Institute Mysuru, Karnataka. Results: Out of the 40 children studied, all fulfilled the diagnostic criteria of MIS-C. The most common symptom was fever (100%), followed by gastrointestinal symptoms (90%). The next most common system involved in our study was cardiovascular system (52.5%). The most common laboratory findings included elevated inflammatory markers (100%). Furthermore, there was high incidence of hematological alterations, in the form of anemia (62.5%), thrombocytopenia (57.5%), and neutrophilia (27.5%). About 33.3% cases had echocardiography abnormalities. All patients received intravenous methylprednisolone and intravenous immunoglobulin. There were six deaths (15%) in our study and the remaining cases had good immediate outcome. Conclusion: Early recognition and prompt medical attention are necessary for a favorable outcome in MIS-C. However, there is scarcity of data regarding its long-term outcome.

A Retrospective Study on Laboratory Profile and Clinical Parameters of Dengue Fever Patients

Introduction: Over the past decade, the number of cases of dengue fever has augmented intensely globally. Half the world's population is now under threat. Pakistan has also very high dengue fever per year, with regular reports of dengue outbreaks compared to other countries. Dengue infection should be treated as a solitary ailment with various clinical pictures, vacillating from symptomless situations to severe clinical sequences, which may result in high mortality and morbidity. Aim: To investigate the laboratory parameters and clinical profile in patients with dengue fever. Study Design: A Retrospective observational study. Place and Duration: In the Department of Medicine of Jalan Bani Bu Ali hospital Oman for one-year duration from July 2020 to July 2021. Methods: At least IgM positive or NS1 positive or IgM with NS1 positive or reactive ELISA assay for dengue fever detection but without any co-infection, bone marrow disease confirmed the cases of dengue without other confounding factors, such as alteration of clinical and laboratory data. The results were analyzed for the study. SPSS 21.0 was applied for Statistical analysis. Results: A total of 52 cases were tested positive for dengue fever. The patients mean age was 27.60 +/- 13.98 years and vacillated from 13 to 75 years. Of the total number of patients, 30 (57.69%) were in the age group 21 to 40 years. Of the 52 cases, 36 (69.23%) were male, 16 (30.77%) were female with M:F ratio was 2.2: 1. 42 (80.77%) of all cases were hospitalized for 5 days or less, and 10 (19.23%) were hospitalized for more than 5 days. The mean hospital stay was 3.67±1.40, ranging from 2 to 8 days. Fever was observed in all (100%) of the total number of cases. Conclusions: In this analysis, all patients have fever, and body pain, headache and malaise were communal signs, but a substantial quantity of cases also had respiratory and gastrointestinal symptoms such as nausea, abdominal pain, vomiting, dry cough and diarrhea. Keywords: Dengue fever, clinical profile, retrospective study, laboratory profile, thrombocytopenia

Epidemiological and laboratory profile of patients confirmed with Covid-19 and admitted to a reference hospital

The new coronavirus, SARS-CoV-2, which causes COVID-19 is easily transmitted from person to person. About 15% develop severe pneumonia and of these, 6% progress to severe acute respiratory syndrome (SARS) and multiple organ failure. Identify biomarkers that can predict which individuals are likely to be affected by severe disease and are at risk of death is crucial. However, the pathophysiology of the disease is not completely elucidated and the characterization of the clinical profile of people infected with SARS-CoV-2 remains unclear. Therefore, the objective of this study was to evaluate the epidemiological and laboratory profile of patients confirmed with COVID-19 and admitted to the University Hospital Lauro Wanderley, based on the correlation of laboratory tests to the evolution of the disease, determination of the most influential variables in the worsening of the disease. Data consisted of complete blood count and serum biochemical analyzes. Overall, 74 patients met all criteria of this study and were included, 40 from the Intensive Care Unit (ICU), and 34 from the Infectious Diseases Infirmary (IDP), both exclusively for patients with COVID-19. Based on these findings, patients with increased WBC count, ALT, AST, and LDH should be closely monitored as these factors predict ICU admission and mortality. Among other laboratory parameters, patients admitted to the ICU have higher levels of D-dimer compared to IDI patients. The results suggests that higher levels of D-dimer on admission is related to a worse prognosis of the disease.

Evaluation of COVID-19 patients requiring oxygen therapy in a tertiary care teaching hospital

Background: COVID-19 disease is a public health emergency and declared as a pandemic in March 2020 by World Health Organization (WHO). Our aim was to study the clinical features, laboratory profile and outcome of COVID-19 patients needing oxygen therapy.Methods: All patients diagnosed to be having COVID-19 and SpO2 less than 94% on admission were included in the study. Detailed history, systemic examination and investigations were done and data was analyzed.Results: Out of 100 patients studied, 66% were males and 34% were females. Comorbidity was seen in 83% of cases, predominantly hypertension (30%) followed by diabetes mellitus (27%) and ischemic heart disease IHD (11%). Most common presenting complaints were breathlessness (84%) followed by dry cough (63%) and fever (48%). Mean values of absolute counts of neutrophils, lymphocytes, eosinophils and basophils were 4,835 cells/cu.mm, 1,332 cells/cumm, 66 cells/cumm and 86.5 cells/cumm respectively. Serum C-reactive protein (CRP) was raised in 90%, lactate dehydrogenase (LDH) in 96% and D-dimer in 64 % of cases on admission. Incidence of happy hypoxia was 16%. Mortality in our study was 2%. Greater the values of serum CRP, LDH, ferritin, lesser was the SpO2 of patients and greater the oxygen requirement. However no such correlation was found between D-Dimer and SpO2 of patients and their oxygen requirement.Conclusions: COVID-19 has varied presentations. The most common comorbidity was hypertension followed by diabetes mellitus. Serum inflammatory markers are raised in COVID disease. Eosinopenia can be a pointer towards COVID disease. One should be aware of the entity happy hypoxia seen in these patients.

Epidemiological, clinical and laboratory profile of dermatopathies of household dogs and cats in a semi-arid region of Northeast Brazil

The present study aims to determine the epidemiological, clinical and laboratorial profile of the dermatopathies that affect dogs and cats living in a semi-arid area in the Northeast of Brazil. Seventy-eight dogs and cats consulted at the Veterinary Hospital with dermatological complaints were included in this study. Skin lesions were characterized with respect to morphology, appearance, and distribution, an epidemiological questionnaire was applied, and samples were collected for complementary examination. The diagnosis was confirmed by parasitological and microbiological tests. There was a predominance of the canine species (93.6%), of young animals (46.3%), and of animals of undefined breeds (61.5%). It was observed that 29.5% of the affections were of fungal aetiology, 14.1% were bacterial, 3.9% were scabies. In 5.1% of the cases there were associations between different pathogens, and in 47.4% the laboratory examination was negative for the pathogens investigated. The most frequent clinical manifestations included alopecia (74.4%), pruritus (61.6%) and erythema (43.6%), distributed mainly in the dorsal-ventral region (36.1%) or even disseminated (43.1%). With respect to One Health, 51.3% (40/78) of the owners reported that they did not know what "zoonoses" were. Dermatopathies have been shown to be important disorders, especially the mycotic and bacterial diseases. Atypical cases of infections motivated by pathogens little described in the literature as etiologic agents of dermatopathies in dogs and cats were observed.