scholarly journals A study of etiology, clinical profile and outcome in children aged 1-12 years presenting with fever of 1-3 weeks duration in a tertiary hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 569
Author(s):  
Kavitha Devarajulu ◽  
Prabu Velusamy
Keyword(s):  
Tract Infection ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Signs And Symptoms ◽  
Tertiary Hospital ◽  
Connective Tissue Disorder ◽  
Cns Infection ◽  
Common Symptom ◽  
Different Types ◽  
The Common

Background: The objective of the study was to find out the etiology, associated signs and symptoms of fever of 1-3 weeks in the age group of 1-12 years and their outcome following treatment in a tertiary care hospital.Methods: This was an observational prospective study conducted at Institute of child health and hospital for children, Egmore, Chennai during the period from January 2011 to October 2012. A total of 621 children aged 1-12 years with 1-3 weeks of fever were included in the study. Demographic, clinical and diagnostic data were collected and analyzed for each patient and outcome was assessed for different types of febrile illness.Results: Out of 621 patients enrolled in the study, enteric fever was diagnosed in majority cases followed by respiratory tract infection, urinary  tract  infection  in  102  (16.4%), leptospirosis in 78 (12.6%), malaria in 60(9.7%), dengue fever in 8 (7.7%) rickettsia infection in 36 (5.8%), tuberculosis in 24 (3.9%), CNS infection in 18 (2.9%), viral hepatitis in12 (1.9%), malignancy in 5(0.8%), connective tissue disorder in 4 (0.6%), localized infection in 2 (0.3%) cases. The incidence was unknown in 10 patients (1.6%). Fever and vomiting were the common symptom seen in all the patients. Mortality was observed 18 (2.94%) cases.Conclusions: The similarity of illness and complexity in etiological conditions demonstrates the complications of diagnosis and treatment of fevers. The present study findings provided rationale information for development of guidelines necessary for treatment and thereby reducing the mortality rate in children of age 1-12 years with incidence of febrile illness.

scholarly journals THROMBOCYTOPENIA

2011 ◽  
Vol 18 (01) ◽  
pp. 75-79
Author(s):  
ATIF SITWAT HAYAT ◽  
MOHAMMAD SAEED SIDDIQUI ◽  
NAILA SHAIKH ◽  
Muqeet Ullah
Keyword(s):  
Plasmodium Falciparum ◽  
Falciparum Malaria ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Blood Film ◽  
Falciparum Infection ◽  
Common Symptom ◽  
Severe Thrombocytopenia ◽  
Care Hospital ◽  
Cell Counts

Background: Malaria is usually associated with reduction in blood cell counts and mild to moderate thrombocytopenia is a common feature of falciparum infection. This study has been conducted to find out frequency and degree of thrombocytopenia in patients suffering from falciparum malaria at a tertiary care hospital of Abbottabad. Methods: It was a descriptive case-control study being carried out at Ayub teaching hospital and Northern institute of Medical Sciences (NIMS) Abbottabad over a period of ten months. All patients with acute febrile illness without localizing signs were considered for study. A total 250 patients having falciparum malaria diagnosed by peripheral blood film examination have been studied. Complete blood counts were performed by Automated Beckman Coulter Analyzer. Blood films were examined by clinical pathologist for plasmodium falciparum via light microscopy using oil-immersion lens. Results: Out of 250 patients, 155(62%) were females and 95(38%) males with M:F ratio of 1:1.5. Mean age was 36±1.2 years (range 17-58 years). Out of 250, 175(70%) had thrombocytopenia (p<0.05) while 75(30%) had normal platelet counts. Thus mild, moderate and severe thrombocytopenia had been observed in 121(48.4%), 41(16.4%) and 13(5.2%) respectively (p<0.05). Fever appeared to be most common symptom observed in all patients (100%) followed by vomiting and nausea (88%). Anemia was the commonest sign present (80%) during our study. Conclusions: We discovered high frequency of mild thrombocytopenia in falciparum malaria. Therefore, thrombocytopenia can be supportive in diagnosis of plasmodium falciparum infection.

scholarly journals Incidence of scrub typhus in a tertiary care hospital in Kolkata, India

2020 ◽  
Vol 7 (5) ◽  
pp. 825
Author(s):  
Kausik Munsi ◽  
Sayonee Das ◽  
Ramiz Islam ◽  
Parvez Shahide Biswas ◽  
Satyabrata Ganguly ◽  
...  
Keyword(s):  
Scrub Typhus ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Signs And Symptoms ◽  
Care Hospital ◽  
Female Ratio ◽  
Gi Symptoms ◽  
Ns1 Antigen ◽  
Morbilliform Rash ◽  
Almost All

Background: Authors aimed to identify incidence of scrub typhus among patients of fever. Scrub typhus is an endemic disease in India caused by Orientia tsutsugamushi, transmitted by trombiculid mites. It is an important cause of acute febrile illness in India. Signs and symptoms include fever, headache, myalgia and GI symptoms and is generally associated with morbilliform rash (<40%), eschar (<50%) which is due to bite of the mite. Abnormal LFTs and lymphocytosis are commonly seen in early phase of illness. It’s often labelled as PUO. Early diagnosis and prompt administration of therapy mostly leads to complete recoveryMethods: Authors screened 100 patients presenting with fever, malaise, headache, with or without rash for more than a week from the month of May to December 2019. Routine blood investigations with fever profile (Dengue NS1 antigen, MP, MPDA, TyphidotM) and cultures were done. Patients in whom no cause of fever could be established, having lymphocytosis, hyponatremia and transaminitis, they were tested for Scrub typhus by using Indirect immunofluorescence & detection of IgM antibody.Results: Total 22 patients were found positive for scrub typhus by using the aforementioned method (22%). Male: Female ratio was 3:4 (9 vs 12). Patients were in the age group of 16-76 years. Lymphocytosis, hyponatremia and transaminitis were cardinal features seen in almost all patients diagnosed with Scrub Typhus.Conclusions: This study will help clinicians to have a stronger suspicion of scrub typhus in undiagnosed febrile patients.

scholarly journals Study of symptomatology and presentations of COVID-19 in pregnancy at a tertiary care hospital

2020 ◽  
Vol 9 (11) ◽  
pp. 4410
Author(s):  
Ankita M. Metkari ◽  
Tushar T. Palve
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
Common Symptom ◽  
Care Hospital ◽  
Mild Disease ◽  
Moderate Disease ◽  
Different Populations ◽  
Clinical Records ◽  
In Pregnancy

Background: Objectives of this study were to study the incidence of SARS-CoV-19 positivity and the incidence of different signs and symptoms associated with COVID-19 in pregnancy and comparison of the same with studies done in different populations previously.Methods: In this retrospective study, antepartum and postpartum parameters were integrated into the clinical records and total 205 ANC and PNC SARS-CoV-19 positive patients were evaluated for the signs and symptoms of COVID -19 over 2 months.Results: In our study, of all patients tested SARS-CoV-19 positive only 14.65% were symptomatic and rest were incidentally tested positive on admission. Of the symptomatic patients 50% had breathlessness followed by fever (13.33%). 92% patients had mild disease; approximately 8% had moderate disease and 6 out of 205 patient needed ICU care.Conclusions: The present study shows that 85.35% SARS-CoV-19 positive ANC and PNC patients were asymptomatic while only 14.65% symptomatic with breathlessness being the most common symptom at our institute.

Clinical Evaluation of Febrile Thrombocytopenia in Western Rajasthan - a Hospital-based Study

2020 ◽  
Vol 20 (5) ◽  
pp. 718-723
Author(s):  
Sahadev Choudhary ◽  
Deepak Kumar ◽  
Gopal K. Bohra ◽  
Alok Gupta ◽  
Durga S. Meena ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Clinical Evaluation ◽  
Liver Dysfunction ◽  
Febrile Illness ◽  
Common Symptom ◽  
Number Of Patients ◽  
Common Causes ◽  
Common Etiology ◽  
Bleeding Manifestation ◽  
The Common

: A number of patients of febrile thrombocytopenia increase during monsoon and postmonsoon period. Diseases like dengue fever, malaria, chikungunya fever, etc. are responsible for the clustering of febrile thrombocytopenia cases during this period. The diagnosis of fever with thrombocytopenia cases can be challenging and physicians should be aware of the regional and endemic seasonal cause of this syndrome. Study Design: It is a prospective observational study. Material and Methods: The study included 103 consecutive patients. The patients admitted with acute febrile illness defined by a duration of less than 2 weeks with thrombocytopenia were evaluated. Results: The present study included 103 consecutive cases of febrile thrombocytopenia. Out of these, 71.84% were male and 28.16% were female. The most common etiology for febrile thrombocytopenia was dengue fever (44.66%) and malaria (31.06%). Among clinical evaluation of the cases, fever was the inclusion criteria. Myalgia was the most common symptom found after fever, which was observed in 83.5% of the patients. The most common bleeding manifestation was petechiae/ purpura (12.62%) followed by hematuria (6.80%). Renal dysfunction was present in all 8(100%) cases of sepsis, followed by 14(43.75%) cases of malaria. All sepsis cases also had liver dysfunction, followed by 91.3% cases in dengue fever and 90.62 % cases in malaria had liver dysfunction. Conclusion: The study showed that acute febrile thrombocytopenia is an important seasonal syndrome. The common causes are dengue fever and malaria. Early identification of these diseases and prompt treatment decreases complications and reduces mortality.

scholarly journals Antimicrobial susceptibility pattern of urine culture isolates in a tertiary care hospital of Jharkhand, India

2017 ◽  
Vol 6 (7) ◽  
pp. 1733 ◽  
Author(s):  
Akhilesh Kumar ◽  
Rajiv Kumar ◽  
Manju Gari ◽  
Uma Shanker P. Keshri ◽  
Sumit K. Mahato ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Susceptibility ◽  
Urine Culture ◽  
Tertiary Care ◽  
Susceptibility Pattern ◽  
Antimicrobial Susceptibility Pattern ◽  
The Common

Background: Urinary tract infection (UTI) is one of the common infections encountered by the clinicians. Though a good number of antimicrobial agents are available, still UTIs have become difficult to treat due to development of resistance by the uropathogens. So, regional data regarding the common uropathogens and their sensitivity pattern is required to guide the clinicians to start empirical therapy while managing UTIs. The purpose of the study was to identify different species of microorganisms, along with their antimicrobial susceptibility pattern, causing urinary tract infection in outpatient and indoor patients at RIMS, Ranchi, Jharkhand.Methods: Observational study was conducted using urine culture and sensitivity reports collected retrospectively from records maintained in the department of Microbiology over a period from July 2016 to Feb 2017 in tertiary care hospital.Results: UTI was more common in females (57.74%) than in males (42.26%). Among the uropathogens isolated Escherichia coli (37.41%) was found to be the predominant organism followed by Klebsiella species (32.79%), Pseudomonas species (25.86%), and gram-positive bacteria Staphylococcus aureus accounted (3.92%) of total cases. The most common isolates were E. coli showed high sensitivity to amikacin (79.24%), followed by levofloxacin (77.21%) and gentamycin (62.26%). It was found to be resistant to norfloxacin (86%), nalidixic acid (86.76%) and cefotaxime (69.88%).Conclusions: Though various microorganisms are responsible for UTI. Escherichia coli species is the most common organism. Antimicrobial resistance has already emerged against many antibiotics, making empirical treatment of these infections challenging.

scholarly journals Comparative analysis of clinical, radiological and operative findings in acute abdomen

2019 ◽  
Vol 6 (3) ◽  
pp. 806
Author(s):  
Mir Zeeshan Ali ◽  
Vamsee Krishna Maddu
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
Diagnostic Utility ◽  
Common Symptom ◽  
Care Hospital ◽  
Hollow Viscus ◽  
Hollow Viscus Perforation

Background: The term acute abdomen refers to signs and symptoms of abdominal pain and tenderness that often requires emergency surgical therapy. The objective of the present study is to compare pre-operative diagnosis based on clinical examination with the operative diagnosis in acute abdomen.Methods: Total 60 cases of acute abdomen who underwent laparotomy in a tertiary care hospital   were analysed prospectively regarding clinical features and also assessed the diagnostic utility of radiological investigations like plain abdominal radiographs, ultrasonography and computed tomography.Results: Acute abdomen was most common in males and 2nd to 5th decade of life. Appendicitis was most common cause of acute abdomen followed by hollow viscus perforation and intestinal obstruction. Abdominal pain was the most common symptom. Tenderness was the most common sign. Diagnostic utility of x-ray is more in hollow viscus perforation and intestinal obstruction, whereas ultrasonography is diagnostic in 64.3%. Ultrasonography accurately diagnosed acute appendicitis in 74.2%, hollow viscus perforation in 50%, and intestinal obstruction in 60% of patients. 95% clinical accuracy was found when compared to intra operative diagnosis. Kappa is 0.912 (p<0.0001).Conclusions: Clinical judgement is key to diagnosis of acute abdomen and investigations are only supplementary and cannot replace the clinical decision.

Risk factors for urinary tract infection in pediatric patients

2017 ◽  
Vol 5 (1) ◽  
pp. 184 ◽  
Author(s):  
Kavitha J. ◽  
M. A. Aravind ◽  
Ganesh Jayachandran ◽  
Sathiya Priya
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Tertiary Care ◽  
Recurrent Infection ◽  
Signs And Symptoms ◽  
Tertiary Care Centre ◽  
Asymptomatic Children ◽  
Study Population

Background: Urinary tract infection (UTI) is one of the common infections occurring in children causing significant morbidity and mortality. The knowledge about the risk factors helps in the management as well as preventing the recurrence of urinary tract infection. Hence this study aims to assess the various risk factors and profile of UTI.Methods:In this prospective case control study conducted in tertiary care centre between July 2011 to August 2012, children with signs and symptoms suggestive of urinary tract infection and urine culture positive for UTI were included. Age and sex matched asymptomatic children were taken as control.  Preformed questionnaire was given to each patient and the results were analysed.Results: Among the 214 cases studied, 111 boys were not circumcised constituting 86.7%. Whereas the other risk factors like recent hospitalisation, recent catheterisation, common toilet usage, cleaning perineum from back to front, constipation, usage of tight underclothing, diaper usage, worm infestation, neurological abnormality, voluntary withholding of urine, reduced water intake constitute 9.3%, 0.5%, 19.6%, 17.4%, 18.2%, 0.9%, 7.9%, 26.2%, 3.7%, 33.6% and 34.6% respectively.Conclusions: Recurrent infection was most often due to unresolved bacteriuria or persistent bacteriuria than reinfection. Signs like supra pubic tenderness and hypertension are very rare. Common organisms causing urinary tract infection in our study population are E. coli followed by Klebsiella, Proteus and Pseudomonas. The risk factors of UTI depend on socioeconomic status and cultural habits.

Bacterial Uropathogens and their Antibiotic Sensitivity Pattern at a Tertiary Care Hospital in Birgunj, Nepal

Med Phoenix ◽  
2017 ◽  
Vol 2 (1) ◽  
pp. 74-77
Author(s):  
Dipak Bhargava ◽  
Bijay Raj Pandit ◽  
Amarullah Shidiki ◽  
Ravi Shankar Gupta
Keyword(s):  
Tract Infection ◽  
Urine Sample ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Clinical State ◽  
Care Hospital ◽  
E Coli ◽  
Sensitivity Pattern ◽  
The Common

Urinary tract infection is the second most common infection following respiratory tract infection. Among the outdoor and the indoor patients it is one of the common clinical state of affairs. For the effective management of this common clinical condition isolation of the common bacterial uropathogens and their antibiotic sensitivity profile is obligatory. In this present brief work an effort has been made to isolate the common bacterial uropathogen and their susceptibility pattern to the regularly used antimicrobial agents. We carried out this work in the Microbiology department of National Medical College from June 2016 to December 2016. In our study beside clean catched mid stream urine sample, catheterized urine sample and suprapubic aspirates are also collected. In our study we included a total of 516 UTI samples of patients. In our work 319 (62%) culture positive urine samples were from outpatient patient department while 197 (38%) were from inpatient department. Among both the outdoor and the indoor patient E. coli was the predominant organism followed by Klebsiella, Staphylococci, Enterococci and Pseudomonas. In our present work we found that the common bacterial isolates from the indoor patient showed higher degree resistance towards Aminopenicillin, Piperacillin, Nitrofurantoin, Ciprofloxacin and Nalidixic acid. Common bacterial uropathogens were found to be sensitive against Norfloxacin, Nitrofurantoin and Cephalosporins like Cefuroxime and Ceftazidime. It has also been found that beside E. coli other bacterial uropathogens were effective against third generation Cepahalosporins and Amikacin. This study clearly denotes that antibiotic sensitivity test should be carried out for determination of optimal treatment regimen against UTI.Med Phoenix Vol.2(1) July 2017, 74-77

scholarly journals Epidemiology of Hand Injuries in a Tertiary Care Center

2018 ◽  
Vol 5 (2) ◽  
pp. 35-39
Author(s):  
Suraj Bajracharya ◽  
S Shrestha
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Bone Fractures ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Metacarpal Bone ◽  
Hand Injuries ◽  
Medical Sciences ◽  
The Common

INTRODUCTION: This retrospective review was performed to identify the incidence, causes, and details of hand injuries in patients presenting to a tertiary hospital of Kathmandu.  MATERIAL & METHODS: Records of all patients who had sustained hand injuries for last 5 years were collected from the Medical Record section. 832 injuries of the hand in 484 patients were reported in this review. These patients were reviewed for a geat the time of injury, gender, location of the incident, mechanism of injury, and fracture specifics.RESULTS: Majority (85.5%) of patients were males with a mean age of 28.79±12.81years and the rest were females with a mean age- of 30.43 ±17.13 yrs. Machinery injuries (25.2%) were the most common cause of injuries followed by road traffic accidents (14.5%). Metacarpal bone fractures (34.6%) were the common estinjuries of the hand. Most of the patients were treated with open reduction and fixation with Kwires.CONCLUSION: The study revealed the aetio-epidemiological and clinical profile of hand injuries, and its burden in eastern Nepal.Journal of Universal College of Medical Sciences, Vol. 5, No. 2, 2017, Page: 35-39

scholarly journals Microbial Isolates from Patients and their Antibiogram at the Tertiary Care Burn Unit in Bangladesh

1970 ◽  
Vol 29 (2) ◽  
pp. 62-66
Author(s):  
H Begum ◽  
M Quamruzzaman ◽  
M Talukdar
Keyword(s):  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Klebsiella Species ◽  
Burn Unit ◽  
The Common ◽  
Clinical Signs And Symptoms ◽  
Flame Burn ◽  
Proteus Species

Infection and antibacterial resistance are important issue in severe burn. This prospective study was carried out in 112 patients who were enrolled from July 2007 to June 2008 in DMCH burn unit (only dedicated burn facility in Bangladesh with a mean annual admission of 869). The aim of this study were to investigate the profile of microorganism and resistance to antimicrobial agents; individuals who were admitted more than 5 days, with partial or full thickness burn developed clinical signs and symptoms of wound infection or pneumonia or septicaemia were included in this study. Nearly 50% of participants were aged 11-30 yrs, the most common type of burn was flame burn and females were the common victims. Bacterial isolates were found in 104 (92.85%) samples and eight (08) swabs were sterile (7.14%). Pseudomonas species was the commonest pathogens (46.42%) followed by Proteus species (21.41%) and Klebsiella species (19.6%). Multiple organisms were found in 38 samples(33.92%). Antibiogram results obtained from ten antimicrobial agents demonstrated that Imipenem was the most efective agent, followed by amikacin and ceftazidime (92.3%, 52.8% and 38.46% sensitive respectively). Hundred percent (100%) of Proteus species were sensitive to imipenem, then amikacin 58.33%; they were highly resistant to cephalosporins (nearly 100%) and ciprofloxacin (83.33%). The resistance of Pseudomonas aeruginosa to anti-pseudomonas agents were exceptionally high. Newer drugs were found to be effective. DOI: http://dx.doi.org/10.3329/jbcps.v29i2.7949 (J Bangladesh Coll Phys Surg 2011; 29: 62-66)

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