099 CRRT: CLINICAL PROFILE FROM A TERTIARY CARE HOSPITAL IN SOUTH INDIA

Background: Dengue haemorrhagic fever is a potentially lethal illness that is universally prevalent in the tropics and has become a major health concern globally in recent decades. The clinical manifestation of dengue infection varies from asymptomatic to severe life threatening illness in the form of DHF/DSS. Dengue haemorrhagic fever or DSS may be fatal in 40% to 50% of untreated patients. A hallmark of dengue infection is severe thrombocytopenia which causes concern for the patients and treating doctors. The objective of this study was to correlate clinical profile during the evolution of dengue fever with severe thrombocytopenia (platelets <10,000/mm3), and comparing frequencies between the different clinical forms in order to predict the severity of the disease. The present study includes 40 individuals who were found to be seropositive with the detection of NS1Ag, IgM and IgG antibodies for dengue infection with severe thrombocytopenia. Early diagnosis and monitoring is largely dependent on haematological parameters. As no specific antiviral therapy is available, supportive therapy is of utmost importance.Methods: This is an observational, descriptive and retrospective study of 40 patients with clinical and serological diagnosis of dengue fever with severe thrombocytopenia (platelets<10,000/mm3), in the period from August 2015 to September 2016, who were admitted in a tertiary care hospital in South India. ELISA was performed for the detection of dengue NS1, Ig M and Ig G, haematological parameters by automated analyzer and peripheral smear, coagulation profile analysis were done.Results: Out of 40 cases with severe thrombocytopenia, 50% of the patients had classical dengue fever, 30% cases had DHF with bleeding manifests and 20% cases with DHF plasma leakage signs and 5% lead to DSS. There was lack of association studied between severe thrombocytopenia and bleeding manifestations as p value<0.065 was insignificant. However, the risk of complications increased with decreasing platelet counts in the present study.Conclusions: Thrombocytopenia was most predominant haematological discrepancy. There was no predilection for any age group or gender for thrombocytopenia or bleeding among the dengue patients. The results were relevant in assessing the severity of infection and can help by enabling the adaptation of the therapeutic conduct to the needs of individual patients.

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Resurgence of diphtheria: clinical profile and outcome in a tertiary care hospital of South India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20200695 ◽

2020 ◽

Vol 7 (3) ◽

pp. 652

Author(s):

Ananya U. Shetty ◽

Vinod Chavan ◽

Mahantesh Matti ◽

Vijay Kulkarni

Keyword(s):

South India ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Case Fatality ◽

Cervical Lymphadenopathy ◽

Demographic Characteristics ◽

Clinical Profile ◽

Major Public Health Problem ◽

Care Hospital ◽

Immunization Status

Background: Diphtheria is a potentially fatal acute disease caused by Corynebacterium diphtheria. It was one of the leading causes of mortality in the pre vaccination era. This study is an attempt to highlight the clinical profile, outcome and demographic characteristics, immunization status of pediatric diphtheria cases in South India. Objective of the study was to analyze the clinical profile, immunization status and outcome in children with diphtheria admitted to the PICU in a tertiary care hospital.Methods: This retrospective study was conducted in a tertiary care hospital in South India. The case records of all children admitted to the hospital between January 1st, 2014 to December 31st, 2018 with clinically suspected diphtheria were analyzed. The data was analyzed with respect to clinical features, demographic characteristics, immunization status, complications and outcome using appropriate statistical methods.Results: 18 cases were clinically suspected to have diphtheria. The average age of children presenting with diphtheria was 9 years. Out of the 18 cases, 11 were male, 7 were female. 16 out of 18 cases were from rural areas, whereas only 2 cases were from urban areas. Fever, sore throat and dysphagia were the presenting complaints in all cases. Neck swelling, white patch over tonsil and tender cervical lymphadenopathy were the other findings noted. Out of 18 cases, 7 were completely immunized, 8 were incompletely immunized and 3 were not immunized. Antidiphtheritic serum was given in 14 cases. Myocarditis, airway compromise and neurological deficits were the complications noted. Case fatality rate was 50%.Conclusions: Diphtheria still remains a major public health problem in developing countries like India. Mortality and morbidity due to diphtheria continues to be high despite ready availability of vaccines and antitoxin. Childhood immunization program, especially follow up and administration of booster doses must be prioritized.

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