Clinical spectrum and predictors of severity of dengue among children in 2019 outbreak: a multicenter hospital-based study in Bangladesh

Abstract Background The mosquito-borne arboviral disease dengue has become a global public health concern. However, very few studies have reported atypical clinical features of dengue among children. Because an understanding of various spectrums of presentation of dengue is necessary for timely diagnosis and management, we aimed to document the typical and atypical clinical features along with predictors of severity among children with dengue during the largest outbreak in Bangladesh in 2019. Methods We conducted a cross-sectional study between August 15 and September 30, 2019. in eight tertiary level hospitals in Dhaka city. Children (aged < 15 years) with serologically confirmed dengue were conveniently selected for data collection through a structured questionnaire. Descriptive, inferential statistics, and multivariable logistic regression were used to analyze data. Results Among the 190 children (mean age 8.8 years, and male-female ratio 1.22:1) included in the analysis, respectively 71.1 and 28.9% children had non-severe and severe dengue. All children had fever with an average temperature of 103.3 ± 1.2 F (SD). Gastrointestinal symptoms were the most common associated feature, including mostly vomiting (80.4%), decreased appetite (79.5%), constipation (72.7%), and abdominal pain (64.9%). Mouth sore, a less reported feature besides constipation, was present in 28.3% of children. Atypical clinical features were mostly neurological, with confusion (21.3%) being the predominant symptom. Frequent laboratory abnormalities were thrombocytopenia (87.2%), leucopenia (40.4%), and increased hematocrit (13.4%). Age (AOR 0.86, 95%CI 0.75–0.98, p = 0.023), mouth sore (AOR 2.69, 95%CI 1.06–6.96, p = 0.038) and a decreased platelet count (< 50,000/mm3) with increased hematocrit (> 20%) (AOR 4.94, 95%CI 1.48–17.31, p = 0.01) were significant predictors of severity. Conclusions Dengue in children was characterized by a high severity, predominance of gastrointestinal symptoms, and atypical neurological presentations. Younger age, mouth sores, and a decreased platelet with increased hematocrit were significant predictors of severity. Our findings would contribute to the clinical management of dengue in children.

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Risk Factors, Pattern and Outcome of Motorcycle-associated Head Injury in Sokoto: An Analysis of 184 Cases

Indian Journal of Neurotrauma ◽

10.1055/s-0040-1722553 ◽

2021 ◽

Author(s):

Henry Olayere Obanife ◽

Nasiru Jinjiri Ismail ◽

Ali Lasseini ◽

Bello B. Shehu ◽

Ega J. Otorkpa

Keyword(s):

Developing Countries ◽

Head Injury ◽

Road Traffic ◽

Negative Impact ◽

Cross Sectional Study ◽

Cross Sectional ◽

Female Ratio ◽

Incidence And Mortality ◽

Male Female Ratio ◽

Significant Negative Impact

Abstract Background Road traffic accident (RTA) is the eighth leading cause of death worldwide. Motorcycle-associated head injury is the leading cause of road traffic associated morbidity and mortality in developing countries. Even though the incidence and mortality of head injury from motor cycle crash is on the increase in developing countries, especially in the African continent, most of the studies published in the literature on this subject matter took place in the developed Western countries. Methods This is a retrospective cross-sectional study of data from patients managed in our institution between December 2014 and November 2016. Results One hundred and eighty-four patients were analyzed. None of the patients used safety helmet for protection. The mean age was 27.6 ± 17.2 years with male female ratio of 6.7:1. Lone crash by cyclists and collisions accounted for 66.8% and 33.1% of the cases, respectively. Passengers and riders comprised 75% of the patients, while 25% were vulnerable pedestrians. The most frequently abused substance by the patients was tramadol (65.52%). Severe head injury and pupillary abnormality were found in 23.9% and 45.5% of the patients, respectively. Cranial CT scan showed abnormalities in 40.2% of the patients. Surgery was done in 28.3% of the patients with mortality rate of 20.7%. Conclusions The use of motorcycle as a mean of transportation has caused significant negative impact on the society. Young people, who constitute the workforce, are majorly affected, and this invariably leads to a serious economic burden on the concerned families and communities.

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Treatment of Chalazian: a Comparative Cross-sectional Study

Europasian Journal of Medical Sciences ◽

10.46405/ejms.v1i1.3 ◽

2019 ◽

Vol 1 (1) ◽

pp. 5-9

Author(s):

Binita Bhattarai ◽

Koshal Shrestha ◽

Sushila Patel ◽

Laxmi Devi Manandhar ◽

Rosy Karki ◽

...

Keyword(s):

Triamcinolone Acetonide ◽

Complete Resolution ◽

Cross Sectional Study ◽

Meibomian Gland ◽

Intralesional Injection ◽

Cross Sectional ◽

Female Ratio ◽

Male Female Ratio ◽

Eye Symptoms

Background: Chalazion is a common eyelid disease caused by plugged meibomian glands and chronic lipogranulomatous inflammation. It can affect individuals of all ages and may cause local eye symptoms such as irritation and inflammation and cosmetic disfigurement. There are mainly three methods of treating chalazion: Intralesional Triamcinolone Acetonide (0.1-0.3 ml of 40mg/ml), Incision and Curettage and Conservative Treatment (hot compression +lid hygiene + antibiotic ointment) to the affected eyelid. To comparing which method is the best this study has been carried out Methodology: Patients with chalazion presenting to OPD from 15 March to 15 July 2017 were included in the study. They underwent any of the three procedures according to their choice. Follow up visit was done at two weeks to determine effectiveness in terms of reduction of size or complete resolution of the chalazion. Results: Out of 112 patients enrolled in study 65(58%) were females and 47(42%) were male with a male: female ratio of (0.7:1). The mean age of involvement was 25.7years (SD 10.3). At 2 weeks follow up there was complete resolution in incision and curettage (I and C) group 77 %( 41/53) and in Triamcinolone Acetonide (TA) injection group 63 %( 20/32). Pearsons correlations showed that I and C were superior to any other forms of intervention for any size of chalazion followed by intralesional injection of TA. Conclusion: Among the three methods, Incision and Curettage remained the best choice for treatment of chalazion followed by triamcinolone acetonide injection but may need multiple injections. Keywords: Chalazion, Intralesional Triamcinolone, Incision and Curettage, Meibomian Gland

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The Social Capital among Elderly Population of Chandigarh: Cross Sectional Study

Healthline ◽

10.51957/healthline_179_2020 ◽

2021 ◽

Vol 12 (1) ◽

pp. 29-36

Author(s):

Kiranjit Kaur ◽

Naveen Krishan Goel ◽

Manoj Kumar Sharma ◽

Navpreet Singh ◽

Mamta Bishnoi ◽

...

Keyword(s):

Social Capital ◽

Elderly Population ◽

Social Trust ◽

Cross Sectional Study ◽

Elderly Subjects ◽

Cross Sectional ◽

Female Ratio ◽

The Social ◽

Male Female Ratio ◽

The Status

Introduction: Social capital is defined as social cohesion among communities. This refers to processes between people which establish network, social trust and co-operation and mutual benefit. The present study was conducted to know the status of social capital among elderly population of Chandigarh city, India. Methods: The study was conducted from January to April 2017. The study was community based using convenience sampling. A total of 300 elderly subjects were selected for interview from the electoral rolls. The survey instrument was modified Onyx and Bullen scale consisting of 30 items with responses on likert scale from 1-4. Results: Mean age of respondents was 66.47 years. Male: Female ratio was 1.4:1. 45.7% owned their residence whereas 54.3% lived as tenants. Social capital score of majorities of elderly was good (63.7%) followed by average (19.3%).Highest mean scores were received for questions namely: would you help someone if their vehicle breaks down (3.03±0.69), do you agree to helping yourself when you help others (3.15±0.78) and have you visited your neighborhood in the past week (3.01±0.82). Poorest scorewere received for questions: while on shopping, are likely to run into friends (1.11±0.53) and have you done a favor for a sick neighbor in last 6 months (1.33±0.53). Conclusion: Social capital status among elderly of Chandigarh city was good andhigher scores were seenamong males. Highest mean scores were seen in factor 4 (proactivity in social context) and lowest among family and factor 5 (friend’s connections).

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Role of Multidetector Computerised Tomography in Evaluation of Proptosis

Nepalese Journal of Radiology ◽

10.3126/njr.v9i2.27421 ◽

2019 ◽

Vol 9 (2) ◽

pp. 24-31

Author(s):

Elina Shrestha ◽

Narayan Bikram Thapa ◽

Shankar Bahadur Singh Rajbhandari

Keyword(s):

Predictive Value ◽

Clinical Information ◽

Cross Sectional Study ◽

Computerised Tomography ◽

Cross Sectional ◽

Female Ratio ◽

Male Female Ratio ◽

One Year ◽

Female Male Female

Introduction: Proptosis is defined as bulging of eye anteriorly out of the orbit. Our main objective was to analyze the pattern of computerised tomographic findings in evaluation of proptosis. Computerised tomography (CT) is noninvasive, easily accessible, affordable and reliable imaging which helps in early diagnosis and prompt treatment. Methods: A descriptive cross sectional study of total 58 patients presenting with proptosis referred to our department of radiology for computerised tomography evaluation during one year period were undertaken into study. The clinical information provided by ophthalmologist also helped our study to derive into conclusion. SPSS version 20 software was used for statistical data analysis. Results: Out of 58 patients, the most common cause of proptosis was neoplasm constituting of 25 cases (43.1%). Retinoblastoma was the commonest orbital tumor. Out of remaining cases, 15 (25.8%) were infective, 14 (24.1%) were inflammatory, two (3.44%) were traumatic and remaining two cases (3.44%) had no definitive cause for proptosis. Bilateral proptosis was commonly associated with thyroid ophthalmopathy. Among the subjects 32 were male, 26 were female. Male: Female ratio was 1:1.23. Age group was ranging from 1 month to 73 years.Mean age was 26.4 ± 22 years. Conclusions: Computerised tomography has an important role in distinguishing the different types of lesions based on their characteristics, location and extension prior to undertaking definitive surgical and medical treatment. Overall accuracy of CT in our study was 81%, sensitivity of 82.6%, specificity of 80.6%, positive predictive value of 76% and negative predictive value of 86.2%.

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A CROSS-SECTIONAL STUDY TO ASSESS THE IMPACT OF DIET & LIFESTYLE IN PREVALENCE OF HYPOTHYROIDISM IN FEMALES - AN AYURVEDIC PERSPECTIVE

November 2020 - International Ayurvedic Medical Journal ◽

10.46607/iamj0809122021 ◽

2021 ◽

Vol 9 (12) ◽

pp. 2971-2974

Author(s):

Pavan Kumar K ◽

Sudhakar P Reddy

Keyword(s):

Cross Sectional Study ◽

Clinical Syndrome ◽

Survey Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Female Ratio ◽

Male Female Ratio ◽

The Impact ◽

Diet And Lifestyle ◽

Female Subjects

Background: In India, 42 million people are suffering from thyroid disorders, out of which hypothyroidism is most common with a prevalence of 5.4%. It is more prevalent among females with the male-female ratio being 1:6. Hypothyroidism is a clinical syndrome resulting from a deficiency of thyroid hormones, which in turn results in a generalized slowing down of metabolic processes. Impaired metabolism can be compared with vitiation of Agni causing Agnimandhya according to Ayurveda. Agnimandhya further hampers the formations of Ahara Rasa and consecutive Dhatus Nirmana, diminishing the metabolism, thereby causing features similar to hypothyroidism. The objective of the Study: To assess the impact of diet & lifestyle on the prevalence of Hypothyroidism in Females. Materials and Methods: It is a cross-sectional survey study. A total of 150 female subjects were selected for the study. With the help of a validated pre-designed and pre-tested questionnaire, the interview was conducted on female subjects diagnosed with Hypothyroidism to assess the impact of diet and lifestyle on the prevalence of Hypothy- roidism in and around Mysuru city. Result: In the survey study, the majority of the hypothyroidism diagnosed subjects followed unhealthy daily regimes and the majority percentage of them practised unwholesome diet, food habits and lifestyle. Diet and lifestyle have a direct influence on the occurrence of hypothyroidism. Conclusion: Hypothyroidism is a metabolic disorder is mainly caused by Agni Mandhya and Rasa Pradoshaja as a result of faulty diet and lifestyle. One should follow Dincharya, Rutucharya and other Ayurveda principles to protect the Agni and thereby prevent Hypothyroidism. The practice of Ahita Ahara Vidhi and Ahita Vihara in the manifestation of Agnimandhya, followed by the development of features of hypothyroidism was substantiated by the result of the survey. Keywords: Hypothyroidism; Diet; Lifestyle; Agnimandhya; Rasa Pradoshaja Vikara.

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Prevalence of Anti-Red Cell Antibodies in Repeatedly Transfused Patients

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v14i1.42728 ◽

2019 ◽

Vol 14 (1) ◽

pp. 73-77

Author(s):

Masuma Ahmed Salsabil ◽

Ashesh Kumar Chowdhury ◽

Debashish Saha ◽

Arif Ahmed Khan ◽

Sazia Sultana

Keyword(s):

Haemolytic Anaemia ◽

Armed Forces ◽

Cross Sectional Study ◽

Red Cell ◽

Cross Sectional ◽

Transfusion Therapy ◽

Female Ratio ◽

Medical College ◽

Male Female Ratio ◽

Immune Haemolytic Anaemia

Introduction: The development of anti-RBC antibodies (alloantibodies and/or autoantibodies) can significantly complicate transfusion therapy, particularly in patients needed repeated transfusion. Objectives: To find out the prevalence of alloantibodies and autoantibodies in repeatedly transfused patients so that serious hazards due to immune reaction may be avoided. Materials and Methods: This descriptive cross-sectional study was carried out in Department of Immunology, BIRDEM and Armed Forces Institute of Pathology (AFIP) during the period of July 2015 to June 2016. Total 370 patients who had received at least five units of transfusions were enrolled in this study but known patients of auto immune haemolytic anaemia, patients in whom antibody was previously detected and pregnant women were excluded from the study. Blood grouping and Direct Anti-globulin Test (DAT) were performed with cell suspension using a poly-specific Coombs reagent. In cases of a positive DAT, further investigation using specific monoclonal reagents to detect IgG or a complement (C3d) was carried out. Serum was used to detect red cell alloantibodies using standard blood bank methods. Antibody identification was performed in antibody screening positive samples using red cell Identicells. Results: Maximum 132 (35.7%) patients were in the age group 1-10 years. The male-female ratio was 1.2:1. Among 370 total patients 290 were HHA and 80 were non-HHA. Antibody was detected in only 17(4.59%) patients. Among the Hereditary Haemolytic Anaemia (HHA) patients it was 11 (3.79%) but among the non-HHA patients it was 6(7.5%). Out of 8 auto-antibodies, 5 were anti IgG followed by 3 were anti C3d. Out of 14 alloantibodies, 4(28.6%) were anti E, 3(21.4%) were anti K and in 3(21.4%) cases specificity of alloantibody was not detected. Conclusion: Prevalence of anti-RBC antibodies was not so uncommon in multiple transfused patients. Journal of Armed Forces Medical College Bangladesh Vol.14(1) 2018: 73-77

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Evaluation of Demographic, Clinical and Beyond Clinical Characteristics in Patients with Multiple Sclerosis in Rafsanjan City, Iran

Internal Medicine And Medical Investigation Journal ◽

10.24200/imminv.v2i2.61 ◽

2017 ◽

Vol 2 (2) ◽

pp. 63

Author(s):

Amir Moghaddamahmadi ◽

Pouria Yazdian-Anari ◽

Siamak Kazemisufi ◽

Alireza Vakilian ◽

Aliasghar Ranjbartotoei ◽

...

Keyword(s):

Multiple Sclerosis ◽

Clinical Characteristics ◽

Demographic Data ◽

Cross Sectional Study ◽

Cross Sectional ◽

Female Ratio ◽

Mcdonald Criteria ◽

Male Female Ratio ◽

The Central Nervous System ◽

The Mean

Background and objectives: Multiple sclerosis is a chronic and progressive autoimmune disease of the central nervous system that causes motor and sensory impairment and physical disability in patients. This study was conducted to determine the demographic, clinical, and beyond clinical characteristics in patients with multiple sclerosis to help identify common disabilities and better understand of the specific needs of these ones.Materials and methods: This descriptive cross-sectional study was carried out on 50 MS patients in Rafsanjan, Iran. A definitive diagnosis has been done according to neurologist and McDonald criteria. The neurologist conducted examinations. The demographic data were recorded using questionnaire. MRI images were analyzed with the help of radiologist and all data were analyzed using SPSS software.Results: The mean age was 33.81±8.38 years and male/female ratio was 7/42. According to data, 66.7% of the patients were suffering from relapsing-remitting type (RR) disease, and most lesions on MRI in these patients were observed in pyramidal and JuxtaCortical areas. The mean EDSS scores of patients was 1.46. The duration of disease and the number of attacks had a significant correlation with educational level (P<0.05); age was significantly associated with pyramidal, mental and sphincter symptoms (P<0.05).Conclusion: These results suggest that the prevalence of MS in women is higher than in men, especially among housekeeper women. Relapsing and remitting disease showed higher frequency.

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The prevalence of asthma among children in South Africa is increasing - is the need for medication increasing as well? A case study in the Vaal Triangle

Clean Air Journal ◽

10.17159/caj/2014/24/1.7050 ◽

2014 ◽

Vol 24 (1) ◽

pp. 28-30

Author(s):

M.A. Oosthuizen ◽

A.J. Mundackal ◽

C.Y. Wright

Keyword(s):

Cross Sectional Study ◽

Health Concern ◽

Health Study ◽

Global Public Health ◽

Cross Sectional ◽

Respiratory Illnesses ◽

Chronic Inflammatory Condition ◽

Study Population ◽

The Difference ◽

Vaal Triangle

Asthma, a chronic inflammatory condition of the airways, is a global public health concern. In southern Africa the prevalence of asthma has increased over the last few decades. In the current study, all 10-year-old learners from three of the schools (one each in Sasolburg, Vanderbijlpark and Vereeniging) that participated in the 1990 Vaal Triangle Air Pollution and Health Study, were selected as the study population for a cross-sectional study conducted in 2010. Both the 1990 and 2010 studies investigated several exposure factors but focussed on respiratory illnesses as main health outcomes. Although the overall ethnicity profile in 2010 was different from that of 1990, the socioeconomic status of the study populations were very similar – the reason being that the same schools were used and the participating children were from the same immediate environment. The results of the 2010 study were then compared to the results of all 10-year-olds, from the same three schools, who participated in the 1990 study. The results showed the difference in prevalence of asthma during the two study years was statistically significant. The difference in the percentage of children who had ever been diagnosed with asthma and were reportedly on medication in 1990 and 2010 was, however, not statistically significant, indicating that although the prevalence of asthma increased, the demand for medication to control the condition may not have increased as well.

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ACUTE BRONCHIOLITIS IN CHILDREN;

The Professional Medical Journal ◽

10.29309/tpmj/2013.20.05.1524 ◽

2013 ◽

Vol 20 (05) ◽

pp. 707-712

Author(s):

SHAKIL AHMAD ◽

SADIDA AAMIR ◽

SHAHBAZ AHMAD

Keyword(s):

Socioeconomic Status ◽

Clinical Features ◽

Cross Sectional Study ◽

Oral Feeding ◽

University Hospital ◽

Acute Bronchiolitis ◽

Cross Sectional ◽

Female Ratio ◽

Male Predominance ◽

Clinical Variables

Objectives: To study the epidemiological and clinical features of acute bronchiolitis in children <2 years of age with mild tomoderate acute bronchiolitis. Study design: Descriptive, cross sectional study. Place and duration of study: Outpatient department ofDepartment of Pediatrics, independent university hospital, Faisalabad, Pakistan, from October 2010 to March 2011. Methodology: 200children diagnosed clinically with mild or moderate acute bronchiolitis were included in the study using convenient sampling technique.Epidemiologic variables of interest included age, gestational age at birth, sex, weight, breastfed or not, parental or caregiver tobaccosmoking and socioeconomic status. Clinical variables of interest included cough, fever, breathlessness, wheeze, Rhonchi, feeding andsleep pattern and severity of disease. Results: Predominant age group was between 2 to 12 months (76.5%) with mean age of 7.6±4.7.95.5% of children were full term at birth. Male predominance with male to female ratio of 1.4:1 was noted. Mean weight was 7.2±1.8 kg.Predominantly mixed feeding pattern (45%) was observed. Most of the parents/caregivers (70%) were nonsmokers. Majority of children(81.5%) belonged to families with poor socioeconomic status. Results of clinical variables revealed Cough (100%), breathlessness(69.5%), audible wheeze (59.5%) and rhonchi on chest auscultation (100%), disturbed sleep (80%) and decreased oral feeding (78%).Majority of children (79.5%) were afebrile. Mild acute bronchiolitis (73.5%) was predominant as compared to moderate acutebronchiolitis (26.5%). Conclusions: Acute bronchiolitis is more prevalent in children <1 year of age with male predominance and inchildren from families with poor socioeconomic status. Mild form of acute bronchiolitis is more common. A relative lack of fever alongwith cough, breathlessness, wheeze and/or rhonchi are major presenting clinical features of acute bronchiolitis.

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Psychological Distress Related to COVID-19 Among Nepalese Professionals: An Online Cross-sectional Study

Med Phoenix ◽

10.3126/medphoenix.v5i1.31389 ◽

2020 ◽

Vol 5 (1) ◽

pp. 10-18

Author(s):

Hussain Asraf ◽

Sawant Sandesh ◽

Jeetendra Mishra ◽

Ramji Ram ◽

Mahendra Pandey ◽

...

Keyword(s):

Psychological Distress ◽

Law Enforcement ◽

Health Workers ◽

Cross Sectional Study ◽

Anxiety Symptoms ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Female Ratio ◽

Care Workers ◽

Male Female Ratio

Background: COVID-19 is a highly infectious disease caused by SARS-CoV2 virus. It's psychological distress would be a major obstacle towards social normalcy to pre-COVID era. There were lacks of studies to assess these distresses. The aim of this study was to study psychological distress related to COVID-19 among Nepalese professionals. Methods: This online cross-sectional survey was conducted from 12th-20th, June-2020. Questionnaires were based on Corona-virus Anxiety Scale (CAS) and Obsession with COVID-19 scale (OCS). Results: Among 244 participants, majority were in the age group of 20-45 years with male female ratio of 2.1:1. About one third were health workers, 46% were teachers and service holders and remaining were from other professions. Majority of participants had subclinical obsessive (83.2%) and sub-clinical anxiety symptoms (69.3%). Law enforcement professionals (30.0%) and journalists 18.2% had highest prevalence of problematic obsessive symptoms. Law enforcement professionals (40%) had highest prevalence of problematic anxiety symptoms followed by health care workers (28.4%). About 35% of participants opted for multiple positive methods to cope with their obsessive and anxiety symptoms. Participants with higher obsession score had higher anxiety symptoms (r=0.592, p=<0.001). Conclusion: Majority of participants only had sub-clinical obsession and anxiety related to COVID. But, health workers, law enforcement and journalism professionals were having problematic symptoms. Thus, efforts need to be concentrated towards formulation of policies for safe and productive environment for these professionals.

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