scholarly journals The Optimum Cut-off Value of the Nelwan Score to Diagnose Typhoid Fever in Adults

2021 ◽  
Author(s):  
Erni Juwita Nelwan ◽  
Luh Putu Listya Paramita ◽  
Robert Sinto ◽  
Fransiscus Nikodemus Hosea ◽  
Pringgodigdo Nugroho ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms ◽  
Sensitivity Specificity

AbstractIntroductionTyphoid fever can be challenging to diagnose since clinicians often depend merely on clinical presentation. Clinical scores are useful to provide more accurate diagnosis. Variables in Nelwan Score are derived from clinical signs and symptoms of suspected cases for typhoid. Diagnostic value of Nelwan Score based on a cut-off value has never been evaluated.MethodsA cross sectional study was conducted between July 2017 and January 2018 in five hospitals and two Primary Health Centers in Jakarta and Tangerang. The inclusion criteria were patients with 3-14 days of fever and gastrointestinal symptoms between July 2017 and January 2018. Diagnosis are confirmed by blood culture, rectal swab culture, or PCR. Cut-off analysis was performed by using Receiver Operating Characteristic (ROC) curve and diagnostic value was analyzed to generate sensitivity, specificity, predictive value and likelihood ratio.ResultFrom 233 subjects involved, 4.72% of them were confirmed to have typhoid fever. The optimal cut-off value of Nelwan Score is 10 with AUC 71.3%. This cut-off value has sensitivity 81.8%, specificity 60.8%, PPV 9.3%, NPV 98.5%, LR + 2.086, and LR – 0.299.ConclusionNelwan Score with cut-off value of 10 provides a good diagnostic performance as a screening tool for patients with suspected typhoid fever clinical presentation.

STUDY OF ABSOLUTE, IMMATURE NEUTROPHIL COUNT AND CRP AS DIAGNOSTIC MARKERS FOR EARLY ONSET NEONATAL SEPSIS.

2021 ◽  
pp. 25-26
Author(s):  
Pooja Poswal ◽  
Manisha Rohilla ◽  
Sunil Arora ◽  
Irbinder Kour Bali
Keyword(s):  
Blood Culture ◽  
Neutrophil Count ◽  
Neonatal Sepsis ◽  
Hematological Parameters ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms

Introduction: Neonatal Sepsis is difcult to differentiate from other conditions due to non- specic clinical signs and symptoms. Inammation in neonates shows variations in hematological parameters. Our study is to evaluate the hematological parameters and C-reactive protein estimation in neonatal sepsis for early diagnosis. Material And Methods: It was a cross-sectional study including 80 neonates admitted in the neonatal care unit, 40 (proven sepsis) and 40 probable cases); blood culture being the gold standard. Hematological parameters, immature to total neutrophil ratio (I/T ratio), Absolute neutrophil count (ANC), CRP and Blood culture were done as per standard protocols. Results: ANC had highest sensitivity of 90% followed by I/T ratio (87.5%) and CRP (77.5%). The sensitivity and specicity for the combination of ANC and I/T ratio was 78.3% and 83.6% respectively. Conclusion: ANC, I/T Ratio and CRP are quick, simple and cost-effective routine laboratory tests which help in neonatal sepsis prediction and to start proper and timely antibiotic therapy.

scholarly journals CLINICAL PROFILE OF TYPHOID FEVER IN CHILDREN

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Poonam Meena ◽  
Satish Meena ◽  
Ashok Meena ◽  
Kailash Meena
Keyword(s):  
Typhoid Fever ◽  
Prospective Study ◽  
Enteric Fever ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Definitive Diagnosis ◽  
Clinical Profile ◽  
Widal Test ◽  
Clinical Signs And Symptoms

Background: The present study describes the clinical presentation of typhoid fever. Methods: The study was a hospital based prospective study. Children of age 2 -18 years who presented with fever of 5 days or more with clinical signs and symptoms suggestive of typhoid fever and positive Widal test or Typhidot tests were included in the study. Results: Commonest sign noticed was toxic look (88.00%) followed by coated tongue (79.00%) and splenomegaly (63.00%). Hepatomegaly was also noted in 35.00% of cases. Conclusion: Typhoid fever remains to be as an endemic disease in this locality. All the signs and symptoms of the disease are nonspecific common with other acute febrile illnesses; a definitive diagnosis of the disease is required for treatment and to prevent transmission. Keywords: Enteric fever, Splenomegaly, Toxic look

scholarly journals Clinical symptoms, paraclinical tests and histopathological results in children with acute appendicitis in Zabol southeast of Iran: a cross-sectional study

2017 ◽  
Vol 5 (7) ◽  
pp. 2836
Author(s):  
Mehran Hesaraki
Keyword(s):  
Acute Appendicitis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Intestinal Loop ◽  
Negative Appendectomy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms ◽  
Histopathological Results

Background: This article aimed to assessment clinical signs and symptoms, paraclinical tests and histopathological results in children with acute appendicitis.Methods: A cross-sectional study conducted on 100 children with acute appendicitis in an urban hospital in southeast of Iran from January to December 2016. Participants were selected by simple random sampling method. Clinical signs and symptoms, paraclinical tests and histopathological results recorded in checklists. The data were analyzed using SPSS 22.Results: Mean age of the patients was 10.26±3.25, fourthly-eight of patients (58.5%) were males and 34 patients (41.5%) were females. The most frequent clinical signs and symptoms were acute suppurative appendicitis with peri appendicitis (45.83%) and acute suppurative appendicitis (39.58%). The most frequent results in ultrasound reports were Intestinal loop thickness greater than 6 mm without peristalsis (positive report) (46.34%) and Invisible appendix (nega Hesaraki tive report) (13.41%).Conclusions: The results of this study showed that abdominal pain and RLQ tenderness were the most common signs and symptoms and WBC left-shift was the most common laboratory finding. Since the rate of negative appendectomy in this study was consistent with surgical results and other articles, it is concluded that diagnostic accuracy of preoperative appendectomy was acceptable and most children with acute appendicitis underwent appendectomy.

scholarly journals Determinants of hypoxemia in children associated with pneumonia

2015 ◽  
Vol 7 (2) ◽  
pp. 64-70 ◽  
Author(s):  
Pramila Ramawat ◽  
Balkishan Sharma
Keyword(s):  
Clinical Signs ◽  
Severe Pneumonia ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Specific Sign ◽  
Severe Manifestation ◽  
Clinical Signs And Symptoms ◽  
Very High

Background and Objectives: The most severe manifestation of pneumonia is hypoxemia has been shown to be a risk factor for morbidity and mortality. Authors investigated associating factors and determinants of hypoxemia in children with pneumonia.Materials and Methods: A cross-sectional study is designed among children of pediatric outpatient and emergency department that enrolled at Government Multi-Speciality Hospital, Chandigarh. One hundred fifty children recruited for study. The demographic and clinical parameters were recorded. Oxygen saturation measured by pulse oximeter.Results: The prevalence of hypoxemia was 48% and 61 (84.7%) infants aged 1 year found with hypoxemia. Age (p=0.006), respiratory rate (p=0.001) and severity of pneumonia (p=0.001) were strongly associated with hypoxemia. The prevalence of severe and very severe pneumonia among hypoxemic were 56.1% and 73.7% respectively. Central cyanosis (98.7%), peripheral (98.7%) cyanosis, head nodding (97.4%) grunting (96.15%) were highly specific but suprasternal (62.82%), subcostal (43.58%) and intercostal retractions (44.87%) were fairly specific sign. Sensitivity for subcostal (81.94%) and intercostal retractions (83.33%) was very high but was fair for intercostal (83.33%) retraction. Grunting (p=0.009), nasal flaring (p=0.008), subcostal (p=0.001) and intercostal (p=0.000) retractions were strongly but suprasternal retraction was significantly (p=0.024) associated with hypoxemia. Dyspnea (97.22%) was very sensitive while decrease feeding (84.61%) and irritability (83.33%) was highly but lethargy (58.97%) was fairly specific symptom.Conclusions: Study suggested that clinical signs and symptoms such as chest wall retraction, decrease feeding, dyspnea, grunting and nasal flaring in children with pneumonia may be utilized as markers for hypoxemia in conditions where pulse-oximeter isn’t available. This study supports the view of hypoxemia was disabling factor in better functional recovery in severity of pneumonia.Asian Journal of Medical Sciences Vol.7(2) 2015 64-70

scholarly journals How long before hospital admission do the symptoms of heart failure decompensation arise?

2019 ◽  
Vol 27 ◽  
Author(s):  
Maraísa Carine Born ◽  
Karina de Oliveira Azzolin ◽  
Emiliane Nogueira de Souza
Keyword(s):  
Heart Failure ◽  
Hospital Admission ◽  
Clinical Signs ◽  
Emergency Admission ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms ◽  
Heart Failure Decompensation

ABSTRACT Objective: to identify the signs and symptoms of decompensation of heart failure (HF) and the duration of time to hospital admission. Method: this is a cross-sectional study with adult patients hospitalized for decompensated HF in a teaching hospital located in southern Brazil from July to October 2017. Data collection was performed through a structured questionnaire that included sociodemographic, clinical signs and symptoms of HF. In the data analysis, the following tests were applied: t-Student, Mann Whitney U-Test, Chi-Square Tests. Results: 94 patients, aged between 42 and 98 years old (mean of 71.2 years old) were included. The most prevalent signs and symptoms before emergency admission were dyspnea (79.8%), cough (29.8%), orthopnea (27.7%), edema (23.4%), and fatigue (22.3%). The median time from onset of signs and symptoms to arrival in the emergency room is fatigue and edema 7 days, orthopnea 5 days, cough 4 days and dyspnea 3 days. Conclusion: the set of classic signs and symptoms of decompensation of HF occurs around seven days before the emergency search and dyspnea is the worsening that leads the patient to a hospital emergency.

scholarly journals Molecular and Seroepidemiological Survey of Visceral Leishmaniasis in Owned Dogs (Canis familiaris) in New Foci of Rural Areas of Alborz Province, Central Part of Iran: A Cross-Sectional Study in 2017

2020 ◽  
Author(s):  
Aliehsan Heidari ◽  
Mehdi Mohebali ◽  
Mozhgan Vahed ◽  
Kourosh Kabir ◽  
Zabihollah Zarei ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Rural Areas ◽  
Nested Pcr ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Leishmania Species ◽  
Cross Sectional Study ◽  
Capital City ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms

Background: Mediterranean form of visceral leishmaniasis (VL) is endemic among some provinces of Iran. The pre­sent study was designed to determine the prevalence of canine visceral leishmaniasis (CVL) in the owned dogs of the rural areas of Alborz Province near Tehran as the capital of Iran. Methods: This study conducted on 303 owned dogs that selected using a stratified random sampling method. The direct agglutination test (DAT) was used to determine the frequency of Vl. The spleen biopsy was taken from the serology-positive dogs for the confirmation of CVL in the suspected dogs. Nested PCR and sequencing methods were used to determine the type of Leishmania species in the dogs which were parasitological positive. Results: Overall, the DAT results of 9 dogs (2.97%, CI: 1.57–5.55) showed anti Leishmania antibodies at titers ≥ 1:320 indicating VL infection. One dog (0.33%, CI 95%: 0.06–1.85) showed clinical signs and symptoms of VL. There was a significant correlation between the positive cases of CVL and rural area (p< 0.001). The Leishmania was observed in the impression smears that were prepared from spleen biopsy of five the studied dogs. Leishmania infantum were con­firmed in all them using nested–PCR assay. The sequence analysis of all five isolates was 95% similar to L. infantum. Conclusion: This study shows that domestic cycle of L. infantum has been established in rural areas of Alborz province where located near Tehran as capital city of Iran. It is necessary to increase the awareness and monitoring of the disease periodically.

scholarly journals Etiology Based on Clinical Manifestation of Acute Diarrhea Incidence of Children Hospitalized in Dr. Soetomo General Hospital Surabaya Period 2011-2013

2019 ◽  
Vol 2 (1) ◽  
pp. 31
Author(s):  
Ashfahani Imanadhia ◽  
IGM Reza Gunadi Ranuh ◽  
Djohar Nuswantoro
Keyword(s):  
General Hospital ◽  
Clinical Manifestation ◽  
Acute Diarrhea ◽  
Pediatric Patients ◽  
Clinical Signs ◽  
Length Of Hospital Stay ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms

Introduction: Diarrhea is one of the most common causes of morbidity and mortality of children worldwide, especially in developing countries. Acute diarrhea can occur from a large number of causes. We aim to describe the clinical manifestation characteristics of acute diarrhea on pediatric patients that are presented to the hospital.Methods: A cross-sectional study from all pediatric patients treated in Dr. Soetomo General Hospital Surabaya in 2011-2013.Age, gender, nutritional status, length of hospital stay, duration of breastfeeding, clinical signs and symptoms, as well as laboratory results collected and analyzed descriptively.Results: One hundred and fifty patients were included with characteristics of male(54%), infant (55.3%)with a mean age of 6-7 month. History of being exclusively breastfed(54%) and lack of nutrition(48%). Vomiting is mostly present (72.7%) and commonly come with a combination of two symptoms (42%) which were vomiting and fever. Mild to severe dehydration degree could be found on the patient who had vomiting, seizure, and fever. The most length of stay was frequently >72 hours. The occurrence of acute diarrhea on a child who was treated in Dr. Soetomo General Hospital Surabaya is dominated by vomiting and it could be inferred that the most acute diarrhea has a tendency of being caused by a virus, where liquid acute diarrhea without blood, mucus, or fever is found.Conclusion: The etiology of acute diarrhea is mostly caused by viruses and symptoms dominated by a combination of vomiting, fever, and diarrhea without blood caused by villi damage.

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