scholarly journals Clinical profile and renal complications among cases of malaria in children attending a tertiary care hospital of South India

2019 ◽  
Vol 6 (4) ◽  
pp. 1445
Author(s):  
Tenali Ravi Kumar ◽  
Sai Lakshmi Ananya Tenali

Background: Malaria is one of the major vectors borne disease globally responsible for 1 million deaths a year. Changing trends in the causative species and epidemiological distribution have identified icterus and renal involvement as an emerging complication associated with severe mortality in children. The objectives of this study were aimed to study the clinical profile of malaria cases admitted in a pediatric ward. The study also highlights the involvement of renal manifestations in the cases with regard to species distribution and associated complications in the study group.Methods: A prospective study for 14 months was conducted, and all positive cases of malaria admitted in paediatric unit were enrolled and socio demographic data, clinical history were collected, and biochemical investigations were performed and analyzed. SPSS software version 12 was used for analysis. Statistical significance was set at p ≤0.05.Results: About 278 subjects with 55.4% males, 44.6% females and with 5-10 years was most common age group. 102 cases of vivax malaria, 152 cases were falciparum and 24 were mixed cases. Cerebral malaria, hyperparasitemia was identified in 28 cases, DIC in 5.04% of cases. Renal involvement was observed in 38.16% of falciparum infections and 27.45% of vivax infections. 68 cases developed acute renal failure as a severe complication.Conclusions:  Renal involvement is more in falciparum and mixed infections than vivax malaria. Early diagnosis and prompt treatment help in early recovery of cases and halts to progression to renal failure. An urgent need for a biomarker for early identification of renal involvement in malaria before biochemical involvement is detected.

2017 ◽  
Vol 4 (3) ◽  
pp. 822 ◽  
Author(s):  
Shanavas Abbas ◽  
Geetha S. ◽  
Deepthi R.V. ◽  
Jubin Kamar ◽  
Susan Uthup

Background: Henoch Schonlein purpura (HSP) is the most common systemic vasculitis in children. It is an immunoglobulin A (IgA) mediated systemic small-vessel vasculitis, with IgA deposition in vessel walls leading to symptoms involving the skin, joints, intestines, and kidneys. The objective of present study was to identify and describe the clinical profile, pattern of joint involvement, histopathological features, treatment modalities and complications of Henoch Schonlein purpura.Methods: 52 children less than 12 years diagnosed to have Henoch Schonlein Purpura according to the European League against Rheumatism criteria were included in the study. All patients were subjected to detailed history taking and thorough examination. The clinical features, investigations, management and complications of the disease were studied. Descriptive statistics was used to analyse the results.Results: The common clinical features were palpable purpura (100%) followed by arthritis (66%) and abdominal pain (50%). Renal manifestations were in the form of hematuria in 12% of the patients. Skin biopsy was done in 25 patients of which 19 had findings suggestive of Henoch Schonlein purpura. Steroids were used in 42% of patients. The severity of illness was associated with lower mean age, arthritis, leg edema and stool occult blood.Conclusions: The clinical features of Henoch Schonlein purpura in the population were different from the previously published studies. Renal involvement was less common. The short-term outcome of the patients were satisfactory. 


Author(s):  
Dr. Shahid Hassan

INTRODUCTION: The current perception among dermatologists based on their experience in the outpatient’s clinics is that there is a huge change in clinical profile, both qualitative and quantitative, in the patients presenting with dermatophytosis. The prevalence of superficial mycotic infection is about 20%–25% of the world population, and dermatophytes is the leading microorganism responsible. Now there is a changing trend in the dermatophytic infections, the cases are presenting as chronic, not responding to usual treatment and also there are recurrent cases. Dermatophytosis is a contagious disease that spreads by direct or indirect contact. Until a few years ago, it had been a disease treated with ease using antifungal agents. In the recent past, there has been a failure of treatment with conventional therapy and emergence of an epidemic of recurrent and chronic dermatophytosis in India. MATERIAL AND METHODS: Our study population included 112 patients who were clinically diagnosed as dematophytosis in the Outpatient department (OPD). Clinical history of all patients was taken. Demographic data such as age, sex, occupation, duration of disease, history of recurrence, habits and associated diseases was recorded. Culture were done in all suspected cases. Nail scrapings, clippings and sub-ungual debris were collected. RESULTS: In present study there were in all 112 patients among which maximum number of patients about 33% belonged to age group 11 to 20, majority of which were males 66.96% whereas 33.04% were females. 50% were culture positive among all patients and microscopy was positive in 58.93% of cases. Trichophytonrubrum species was isolated predominantly in 57.1% cases, Trichophytonmentagrophyte was found in 23.2% of patients followed by microscoporumgypsium isolated in 12.5% cases and E.floccosum was seen isolated in 7.1% among all clinical types. Percentage of tineacorporis, tineacapitis and tineacruris was 39.3%, 18.8% and 13.4% respectively. CONCLUSION: Dermatophytosis was found to be common in second decade of life and male were commonly affected. T. rubrum was most common isolate. The need of the hour is carry out multicentric large epidemiologic studies that can effectively establish the prevalence of fungal isolates and its antifungal resistance status.


2020 ◽  
Vol 7 (4) ◽  
pp. 541
Author(s):  
Usham Gangaram ◽  
Giri Raju Sarikonda ◽  
Bhimasen Soren ◽  
Venkatakrishnan .

Background: Malaria is a major health problem in many parts of India and some parts of Andhra Pradesh is one of the endemic areas for malaria. The objective was to study clinical profile and outcome of malaria in both species and mixed infection.Methods: Present study was carried out on 100 patients admitted during the period of  November 2016 - October 2018 in Narayana medical college and hospital, Nellore. Malaria confirmed by Peripheral thick and thin smear or Antigen Assay underwent detailed clinical history and physical examination. This was followed by monitoring the outcome of the patients with respect to morbidity and mortality.Results: Out Of the 100 patients 58 patients were from rural background, males were predominant, most common age group was 20-30 (34%) followed by 31-40 (31%). Out of 100 patients, 54 patients were  falciparum,44 patients had vivax  and two had mixed infection. All of the patients had fever followed by chills and rigors (75%), nausea and vomiting (59%), easy fatiguability (28%), pain abdomen (17), cough (14%) in both infections, altered sensorium was seen in only falciparum (20.3%). On clinical examination,70% of the patients had pallor, splenomegaly in 46%, icterus (23%), hepatomegaly (14%) and pedal edema in12 patients were observed. All 0f the patients were treated with appropriate antimalarial drugs for appropriate duration, and all were recovered without any mortality.Conclusions:Malaria is very common disease in our country especially in South India, which is one of the endemic areas. Severe malaria usually caused by the falciparum more than vivax, early diagnosis and treatment decreases the mortality and morbidity. 


Author(s):  
Jyothi Gandavaram ◽  
Bindu Reddy Pamulapati

Background: Cervical malignancy is ranked second among the malignancies in females with breast carcinoma the first. Screening for cervical cancer by conventional cytology and supported by colposcopy and histopathology can easily identify the premalignant lesions and also other non-invasive inflammatory lesions of the cervix. Objective of this study was to find the correlation of Pap smear, colposcopic findings and colposcopic guide biopsy in evaluation of cervical lesions in women and to analyze the various risk factorsMethods: A prospective study for two years was conducted by department of obstetrics among women aged from 20-60 years. Socio demographic data, clinical history and examination were done and findings noted. Pap smear, colposcopy and colposcopic guided biopsy was done and findings were noted and analyzed foe sensitivity, specificity and compared with Pap smear.Results: In present study sensitivity of Pap smear for detecting lesions above LSIL was 28%, specificity 99.32%, PPV was 93.47%, negative predictive value 76.21% and accuracy of Pap smear was 78%. The sensitivity of colposcopy in detection of low grade lesions and above came out to be 80.2%, specificity 82.14%, positive predictive value 66.78%, negative predictive value 86.78% and accuracy of colposcopy was 84.65%.The incidence of preinvasive lesions (LSIL and HSIL) was 33.6% with LSIL (19.2%) and HSIL (14.4%) and of invasive lesions was 9.6%.Conclusions: This study suggests that accuracy of detection of cervical abnormalities is higher when cytology, colposcopic biopsy and colposcopy are used complimentarily in diagnosis of cervical lesions. Colposcopy eliminates the need for repeated follow up as in Pap smear which has low sensitivity.


Author(s):  
Reenu Jose ◽  
Krishnaveni K ◽  
Jesna Maria ◽  
Shanmuga Sundaram R ◽  
Sambathkumar R

Objective: The objective of this study is to evaluate the common medication error (ME), and its causes, category, and severity by using suitable questionnaire.Methods: A prospective observational study was carried out for 6 months in a psychiatric department. Demographic data, clinical history, and complete prescription were noted.Results: A total of 120 psychiatric cases were collected, among that 116 MEs were identified in which male patients were 64 (55%) and females 52 (44.8%). The number of MEs occurred due to physician was 67 (57.7%), due to nurses was 15 (12.9%), and combined was 38 (32.7%). Incomplete prescription was the main type of error that we found. About 43.1% of the error we identified was informed to the staff and and no specific action was needed for 37.1% of errors. In our study, we found that majority of 54 (46.5%) errors were categorized under category B, but there was no harm to the patient.Conclusion: The present study concluded that most of the patients admitted in the psychiatry department would experience MEs. Clinical pharmacist can play a major role in the early detection and prevention of MEs and thus can improve the quality of care to the patients.


2021 ◽  
Author(s):  
Naveenraj Palanisamy ◽  
Nakka Vihari ◽  
Durga Shankar Meena ◽  
Deepak Kumar ◽  
Naresh Midha ◽  
...  

Abstract Background: Bloodstream infections (BSIs) are emerging cause of significant morbidity and mortality in severe Corona virus disease (Covid-19). We aimed to assess the prevalence, clinical profile and outcome of BSIs in critically ill Covid-19 disease. Material and Methods: This was a single-centre retrospective study conducted at a tertiary care hospital in Western India. All the patients (age >18 years) with reverse-transcription polymerase chain reaction (RT-PCR) confirmed Covid-19 pneumonia admitted in Covid intensive care unit (ICU) between September 2020 to February 2021 were included. Hospital electronic records were searched for demographic data, time of bloodstream infection since admission, clinical profile, antimicrobial resistance pattern and clinical outcome of all patients who developed BSIs.Results: Out of 750 patients admitted in Covid ICU, 8.5% developed secondary BSIs. All severe Covid-19 pneumonia patients developed BSIs succumbed to illness. The major proportion of BSIs were gram-negative pathogens (53/64, 82.8%). Acinetobacter baumannii was the commonest isolate followed by Klebsiella pneumoniae (32.8% and 21.9% respectively). Multidrug-resistance microorganisms (MDRO) were found in 57.8% of the cases. The majority of MDRO belonged to K. pneumoniae and Enterococcus groups. The proportion of gram-negative bacteria resistant to carbapenems was 47.2% (25/53). Conclusion: BSIs in severe Covid-19 patients carries a substantial mortality, which is a cause for concern. Timely initiation of empirical antibiotics and prompt de-escalation are vital to improve the outcome. At the same time, strict compliance of infection control practices should be accomplished to reduce the occurrence of MDRO.


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