scholarly journals Chikungunya in infants: a descriptive study in a district hospital

2020 ◽  
Vol 7 (3) ◽  
pp. 500
Author(s):  
Palanivel Sengottaiyan ◽  
Ramaswami Muthusamy
Keyword(s):  
District Hospital ◽  
Clinical Manifestations ◽  
Close Monitoring ◽  
Erythematous Rash ◽  
Older Children ◽  
Axillary Temperature ◽  
Igm Elisa ◽  
Government District ◽  
Pedal Edema ◽  
One Year

Background: To define the clinical profile of Chikungunya in infants admitted at a District Hospital in South India.Methods: All infants admitted in Government District Headquarters Hospital, Namakkal from January 2019 to December 2019 with fever (defined as axillary temperature > 99.6 F) and any one of the following features; seizure, loose stools, peripheral cyanosis, skin manifestations or pedal edema in children less than one year with chikungunya IgM ELISA positive were included in this study. Details of disease from onset of illness till admission were noted. This was a descriptive observational study.Results: Fifty-six (46) infants were included in this study, out of it 27(58.69%) were males and 19(41.30%) were females. 7(15.21%) infants were less than 1 month of age, 21(45.65%) were 2-6 months old and 18(39.13%) were 7-12 months old. Fever was invariably present but associated constitutional symptoms in infants consisted of lethargy or irritability and excessive cry. The most characteristic feature of the infection in infants was acrocyanosis and symmetrical erythematous rash were noted in most infants. Erythematous macules and patches were observed which later progressed to morbilliform rashes.Conclusions:Atypical clinical manifestations of chikungunya infection in infants as compared to older children to be carefully observed for its proper management. The morbidity and mortality of the disease may be avoided by the rational use of drugs and close monitoring of all infants. 

Scrub typhus (Orientia tsutsugamushi), A rapidly spreading epidemic in Chennai - A standalone lab experience

2016 ◽  
Vol 5 (09) ◽  
pp. 4896
Author(s):  
Sripriya C.S.* ◽  
Shanthi B. ◽  
Arockia Doss S. ◽  
Antonie Raj I. ◽  
Mohana Priya
Keyword(s):  
Scrub Typhus ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Orientia Tsutsugamushi ◽  
The Past ◽  
Igm Elisa ◽  
The Mean ◽  
Specific Symptoms ◽  
Symptoms And Signs

Scrub typhus (Orientia tsutsugamushi), is a strict intracellular bacterium which is reported to be a recent threat to parts of southern India. There is re-emergence of scrub typhus during the past few years in Chennai. Scrub typhus is an acute febrile illness which generally causes non-specific symptoms and signs. The clinical manifestations of this disease range from sub-clinical disease to organ failure to fatal disease. This study documents our laboratory experience in diagnosis of scrub typhus in patients with fever and suspected clinical symptoms of scrub typhus infection for a period of two years from April 2014 to April 2016 using immunochromatography and IgM ELISA methods. The study was conducted on 648 patients out of whom 188 patients were found to be positive for scrub typhus. Results also showed that pediatric (0 -12 years) and young adults (20 – 39 years) were more exposed to scrub typhus infection and female patients were more infected compared to male. The study also showed that the rate of infection was higher between September to February which also suggested that the infection rate is proportional to the climatic condition. Statistical analysis showed that the mean age of the patients in this study was 37.6, standard deviation was 18.97, CV % was 50.45. 

scholarly journals AB0750 FUNCTIONAL CONDITION OF KIDNEYS IN THE LONG-TERM COURSE OF SLE IN ADOLESCENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1403.2-1403
Author(s):  
L. Bohmat ◽  
N. Shevchenko ◽  
I. Bessonova
Keyword(s):  
Renal Function ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Clinical Analysis ◽  
Average Dose ◽  
One Year

Background:Lupus nephritis is the most severe and adverse systemic lupus erythematosus (SLE) syndrome. According to modern recommendations, the clinical manifestations of active nephritis should be taken under medical control in 6 months after the start of the disease’s treatment1.Objectives:The aim of this study was to examine the functional status of the kidneys in children with SLE in the course of the disease for more than one year.Methods:The analysis included case histories of 43 patients with SLE, mostly females (41), aged 7 to 18 years (mean age 14.4 years) with disease duration of 4.75 ± 0.58 years of whom 22 were less than three years, 21 - more than three years. All children received corticosteroid therapy, at the time of the examination the average dose was 13.85 ± 1.86 mg per day in terms of prednisolone. The second component of therapy was azathioprine (average dose 97.61 ± 2.11 mg). All children received hydroxychloroquine (5 mg/kg per day).To determine the functional state of the kidneys a clinical analysis of urine, a study of the scope of specific gravity of urine during the day (Zymnytsky test), the content of creatinine and urea in serum to determine the glomerular filtration rate (GFR), the level of microalbuminuria per day were evaluated.Results:Renal involvement in the developed SLE occurred in 73.08% of patients. Among them, therapy during the first 6 months was considered quite effective in 58.06% of patients. It was found that in children with disease duration from one to three years proteinuria was registered in 68.18%, a decrease in GFR in 4.45% and hyperfiltration in 9.09%. In the group of children with duration of SLE more than three years revealed deeper changes in renal function; there was proteinuria in 90.47%, the frequency of GFR decreased was in 19.04%, a decrease of renal concentration function was in 14.28% of cases.Indicators of renal function in children with SLE depending on the duration of the disease (M ± m)IndicatorDuration of the diseasefrom 1 year to 3 years n = 22over 3 yearsn = 21Creatinine, mmol/l0,080 ± 0,0140,090 ± 0,018Мочевина, mmol/l5,66 ± 1,425,63 ± 1,61GFR, ml/min117,05 ± 19,68100,20 ± 18,98 *Microalbuminuria, mg/day24,41 ± 13,1334,73 ± 24,76Density min1,007 ± 0,0051,006 ± 0,005Density max1,024 ± 0,0051,019 ± 0,005 ***р<0,03;**р<0,01 the probability of differences when comparing between groupsConclusion:Long-term follow-up of children with SLE over one year reveals a prolongation of renal dysfunction, which worsens after three years, and is the basis for the development of irreversible renal impairment.References:[1]European evidence-based recommendations for the diagnosis and treatment of childhood-onset lupus nephritis: the SHARE initiative /Noortje Groot, Nienke de Graeff, Stephen D Marks et all. //Ann Rheum Dis. 2017 Dec;76(12):1965-1973.Disclosure of Interests:None declared

MATERNAL AND PERINATAL OUTCOMES WITH ANTENATAL CORTICOSTEROID ADMINISTRATION IN PRETERM DELIVERIES AT GOVERNMENT DISTRICT HOSPITAL, NANDYAL- AN OBSERVATIONAL STUDY

2021 ◽  
pp. 8-14
Author(s):  
P. Swathi ◽  
K. Radhikajyothi
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Distress Syndrome ◽  
District Hospital ◽  
Antenatal Corticosteroid ◽  
Antenatal Corticosteroids ◽  
Corticosteroid Administration ◽  
Antenatal Steroids ◽  
Government District

BACKGROUND: Preterm birth remains a major health issue worldwide. Preterm delivery affects over 7–12% of births in India and is responsible for up to 75% of neonatal deaths. Despite advances in medical technology, the prevalence of preterm birth is increasing. Discovery of antenatal corticosteroid for fetal maturation and its adoption into clinical practice highlights several fascinating and universal truths about science and medicine. The challenge in human studies is to demonstrate antenatal corticosteroid administration in pregnancy contributes to developmental programming and how this is manifested in later life. The World Health Organization recommends the use of one course of antenatal steroids for all pregnant women between 26 and 35 weeks of gestation who are at risk of preterm delivery within 7 days. Both, the American College of Obstetricians and Gynaecologists and the Royal College of Obstetricians and Gynaecologists recommend their use between 24 and 34 weeks of gestation (1). The use of antenatal steroids after 34 or 35 weeks of gestation is not recommended unless there is evidence of fetal pulmonary immaturity. Despite this, antenatal steroids are widely used globally across all gestational periods. In a diverse country like India, diversity in clinical practice is a reality. Hence, the present research study intends to study the maternal and perinatal outcomes with antenatal corticosteroid administration in preterm deliveries at Government district hospital, Nandyal in South India. AIMS AND OBJECTIVES Ÿ To determine the incidence of RDS at District hospital, Nandyal among neonates delivered between 28-37 weeks due to PTL, PPROM or severe PET whose mothers received ACS and in those whose mothers did not receive ACS. Ÿ To determine the severity of RDS at District hospital, Nandyal among neonates delivered between 28-37 weeks due to PTL, PPROM or severe PET whose mothers received ACS and in those whose mothers did not receive ACS. Ÿ To compare the neonatal mortality among neonates delivered between 28-37 weeks due to PTL, PPROM or severe PET whose mothers received ACS with those whose mothers did not receive ACS. Ÿ To determine the effectiveness of antenatal corticosteroid administration in preventing early neonatal respiratory distress syndrome in early preterm labour versus late preterm labour. Ÿ To determine the effectiveness of ACS administration in preventing neonatal complications with respect to the mode of delivery. METHODOLOGY: Study was conducted at Government District Hospital, Nandyal from 01/01/2019 to 30/10/2019. A structured questionnaire was prepared under guidance of thesis guide. All pregnant women with gestational age between 28 completed weeks to 37 completed weeks, presenting in OPD either in labour or getting admitted due to any other maternal medical complication, are initially assessed thoroughly to estimate the gestational age by history, LMP, early USG, and clinical examination. They are given a course of ACS if they were not expecting delivery within next 1 hour, after explaining the benets and risks of ACS as per recommendations of Federation of International st Gynecology and Obstetrics. Those who did not receive ACS or those who delivered within 24hrs of administration of 1 dose of ACS were considered as subjects in NACS group. Those who received ACS were considered as subjects in ACS group. After delivery, the neonate is followed up in NICU until discharged or until 7 days whichever is shorter. Mother is followed up for any clinical signs of infection, until she is discharged. Data is analyzed scientically. RESULTS: In Antenatal corticosteroids group (ACS), there were 36 subjects within 20 years, 43 subjects between 20-25 years, 29 subjects between 25-30 years, 25 subjects between 30-35 years. In No Antenatal corticosteroids group (NACS), there were 32 subjects within 20 years, 49 subjects between 20-25 years, 25 subjects between 25-30 years, 10 subjects between 30-35 years. Study observed that Antenatal corticosteroids group had lower incidence of Respiratory distress syndrome compared to No Antenatal corticosteroids group (12.07% versus 23.28%). Antenatal corticosteroids group had lower incidence of severe Respiratory distress syndrome compared to No Antenatal corticosteroids group (21.3 % versus 33.33%) among those who had Respiratory Distress Syndrome. Antenatal corticosteroids group had fewer admissions to NICU than No Antenatal corticosteroids group (20.69% versus 33.62%). Antenatal corticosteroids group had lower mortality than No Antenatal corticosteroids group (12.07 % versus 22.41%). Antenatal corticosteroids group had 35 % less chances of Respiratory distress syndrome compared to No Antenatal corticosteroids group. In No Antenatal corticosteroids group, subjects who underwent vaginal delivery had 10% less risk compared to those who underwent LSCS for their neonates to have Respiratory distress syndrome. In Antenatal corticosteroids group, subjects who underwent vaginal delivery had 14.29 % less risk compared to those who underwent LSCS for their neonates to have Respiratory distress syndrome. Antenatal corticosteroids group had maternal infection rate comparable to No Antenatal Corticosteroids group. CONCLUSION: Use of antenatal corticosteroids was found to be benecial in pregnant women with Gestational age of 28 completed weeks to less than 37 completed weeks at Government District hospital, Nandyal. Antenatal corticosteroids did not have statistically signicant adverse effects (i.e. increased rate of infection) in mothers.

scholarly journals Graves Disease in Childhood

2021 ◽  
Author(s):  
Madhukar Mittal ◽  
Vanishri Ganakumar
Keyword(s):  
Thyroid Hormone ◽  
Side Effects ◽  
Age Of Onset ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Older Children ◽  
Prepubertal Children ◽  
Pediatric Age Group

Graves’ disease (GD) is an autoimmune disease caused by autoantibodies against thyroid stimulating hormone receptor (TSH-R), resulting in stimulation of thyroid gland and overproduction of thyroid hormones resulting in clinical manifestations. It is uncommon in children and is 6 times more prevalent in females. The symptomatology, clinical and biochemical severity are a function of age of onset of disease. Prepubertal children tend to present with weight loss and bowel frequency, associated with accelerated growth and bone maturation. Older children are more likely to present with the classical symptoms of thyrotoxicosis like palpitations, tremors and heat intolerance. Prepubertal children tend to have a more severe disease, longer duration of complaints and higher thyroid hormone levels at presentation than the pubertal and postpubertal children. The non-specificity of some of the symptoms in pediatric age group can lead to children being initially seen by other specialities before being referred to endocrinology. Management issues are decided based on patient’s priorities and shared decision making between patient and treating physician. Radioactive Iodine Ablation is preferred when there is relatively higher value placed on Definitive control of hyperthyroidism, Avoidance of surgery, and potential side effects of ATDs. Similarly Antithyroid drugs are chosen when a relatively higher value is placed on possibility of remission and avoidance of lifelong thyroid hormone treatment, Avoidance of surgery, Avoidance of exposure to radioactivity. Surgery is preferred when access to a high-volume thyroid surgeon is available and a relatively higher value is on prompt and definitive control of hyperthyroidism, avoidance of exposure to radioactivity and avoidance of potential side effects of ATDs. Continental differences with regards to management do exist; radio-iodine ablation being preferred in North America while Anti-thyroid drug treatment remains the initial standard care in Europe.

scholarly journals CLINICAL AND LABORATORY CHARACTERISTICS OF SARS-COV-2 INFECTION IN CHILDREN AND ADOLESCENTS

2021 ◽  
Vol 39 ◽  
Author(s):  
Marlos Melo Martins ◽  
Arnaldo Prata-Barbosa ◽  
Maria Clara de Magalhães-Barbosa ◽  
Antonio José Ledo Alves da Cunha
Keyword(s):  
Latin American ◽  
Inflammatory Responses ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Current Evidence ◽  
Cochrane Library ◽  
Childhood And Adolescence ◽  
Inflammatory Reactions ◽  
One Year ◽  
Novel Coronavirus

ABSTRACT Objective: To present the current evidence on clinical and laboratory characteristics of infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during childhood and adolescence. Data source: This is a narrative review conducted in the databases: Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Latin American and Caribbean Health Sciences Literature in the Virtual Health Library (LILACS/VHL), Scopus, Web of Science, Cochrane Library, portal of the Coordination for the Improvement of Higher Education Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES), Scientific Electronic Library Online (SciELO), ScienceDirect, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). The terms used were SARS-CoV-2, COVID-19, novel coronavirus, child, newborn, and adolescent. Data synthesis: Unlike adults, most children infected by SARS-CoV-2 have mild or asymptomatic clinical presentations. Symptomatic children mainly have low fever and cough, with some associated gastrointestinal symptoms. Severe cases are rare and occur especially in infants under one year of age. Detection of viral particles in feces seems to be more persistent in children and can be used as a tool for diagnosis and control of the quarantine period. Different from adults, children can present distinct inflammatory responses, as has happened in new cases of Kawasaki-like syndrome associated with SARS-CoV-2 infection. Conclusions: Most children have asymptomatic or mild presentations, with a prevalence of fever, cough, and gastrointestinal symptoms. New cases with different systemic inflammatory reactions in children have been reported, with clinical manifestations distinct from those typically found in adults.

scholarly journals Clinicohaematological profile of dengue in children: a hospital based study

2017 ◽  
Vol 4 (4) ◽  
pp. 1340 ◽  
Author(s):  
Irshad Abdul Majeed ◽  
K. Shreedhara Avabratha ◽  
Lokesha R. Gowda ◽  
Sadia Syeda
Keyword(s):  
Dengue Fever ◽  
Early Recognition ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Haematological Parameters ◽  
Severe Dengue ◽  
Clinical Feature ◽  
Igm Elisa ◽  
Ns1 Antigen ◽  
Atypical Presentations

Background: Dengue fever is one of the most common arbo virus mediated outbreaks, being reported from different parts of the world. Now as the outbreaks are hitting different geographic locations, different clinical manifestations are being reported recently. The aim of this study is to document varied clinical manifestations and haematological parameters of dengue patients in a tertiary care centre.Methods: A total 130 cases of any of NS1 antigen, IgM card test positive or IgM ELISA positive dengue patients were included in this observational study. Clinical and haematological parameters were noted and analysed statistically.Results: Most common clinical feature was fever (100%) followed by headache (51.5%). Atypical features like seizures due to encephalitis was seen in a child with dengue. Seizure were present in 1.5% of cases, two children died due to severe dengue with shock and multi organ failure. In our study 26.92% of patients had thrombocytopenia. The mean Hb was 12.86 g/dl and platelet count was 104202/mm3.Conclusions: Fever and headache are the main features of dengue. However, one should be aware of different atypical presentations of dengue fever to diagnose and intervene timely. Early recognition of complication and timely intervention are required in the management of dengue cases. 

Management of wide open apices in non-vital permanent teeth with Ca(OH)2 paste

2001 ◽  
Vol 25 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Tarun Walia ◽  
Harpinder Singh Chawla ◽  
Krishan Gauba
Keyword(s):  
Retrospective Study ◽  
Root Growth ◽  
Porous Structure ◽  
Success Rate ◽  
Treatment Time ◽  
Permanent Teeth ◽  
Older Children ◽  
Barrier Formation ◽  
Open Apices ◽  
One Year

A retrospective study on 15 non-vital immature incisor teeth was done using Ca(OH)2 Pulpdent® paste. A success rate of 100 percent was achieved within one year. The variables influencing the time taken for apexification were also evaluated. The teeth were followed up to a period of 24 months. It was found that older children having narrow open apex had a shorter treatment time than the younger children (NS); teeth without periapical infection showed some amount of root growth and closing of apex that was faster than those with periapical infection (p&lt;0.001). The calcified bridge formed following apexification is a porous structure. This investigation provides information about the time taken and procedure required to achieve apical barrier formation in non-vital immature incisors.

SALICYLATE INTOXICATION

PEDIATRICS ◽  
1956 ◽  
Vol 18 (4) ◽  
pp. 578-594
Author(s):  
Harris D. Riley ◽  
Lee Worley
Keyword(s):  
Acetylsalicylic Acid ◽  
Renal Excretion ◽  
Clinical Manifestations ◽  
Respiratory Alkalosis ◽  
Underlying Disease ◽  
Hemorrhagic Diathesis ◽  
Older Children ◽  
Acid Base Balance ◽  
Accidental Ingestion ◽  
Salicylate Intoxication

Forty-two cases of salicylate intoxication in infants and children observed over a 10-year-period are reviewed. The majority of the 13 cases of poisoning due to accidental ingestion occurred in the 2- to 4-year age range whereas the 29 intoxications resulting from therapeutic administration of salicylates occurred chiefly in infants. Accumulative therapy intoxication is more likely to occur in infants rather than older children not only because of an unawareness of the dangers and of the proper dose of acetylsalicylic acid, but also because of the decreased renal excretion of salicylates due to renal immaturity, and pre-renal azotemia due to dehydration resulting from the disease for which the drug is given. The marked variability in time response of an individual to salicylates is emphasized. Even in poisoning resulting from accidental ingestion, where the effects of an underlying disease do not have to be considered, the plasma concentration of salicylate, clinical response, degree of toxicity at a given concentration of salicylate, and time required for renal excretion varied greatly for children of time same age and size who ingested comparable amounts of salicylate. Severe intoxication at how concentrations of salicylate in the plasma was observed. Hyperventilation and vomiting are the most common clinical manifestations of salicylism but a hemorrhagic diathesis due to hypoprothrombinemia, hyperpyrexia, delirium or coma, circulatory collapse, and respiratory failure may be observed. The unique effect of salicylates on acid-base balance with an initial respiratory alkalosis progressing to a metabolic acidosis is discussed. A treatment program based on physiologic principles is outlined. The important role of drug ingestion, especially acetylsalicylic acid, as a cause of death is re-emphasized and a plea is made for better education and attention to the potential dangers of salicylates.

CASE FATALITY IN INFANTS AND CHILDREN WITH PERTUSSIS, 1942-1946

PEDIATRICS ◽  
1950 ◽  
Vol 5 (5) ◽  
pp. 840-852
Author(s):  
JEROME L. KOHN ◽  
ALFRED E. FISCHER ◽  
HERBERT H. MARKS
Keyword(s):  
United States ◽  
Case Fatality Rate ◽  
Communicable Disease ◽  
Case Fatality ◽  
The United States ◽  
Fatality Rate ◽  
Older Children ◽  
Severity Of The Disease ◽  
One Year ◽  
In Infants And Children

Analysis of data on patients with pertussis during 1942-1946 obtained by means of a questionnaire from communicable disease hospitals and from health officers in a number of cities in the United States and Canada showed these results: Case fatality rates of patients admitted to hospitals for treatment have declined substantially in the period under review. This decline is general, both among infants under one year of age and among older children. In 1946, the case fatality rate of the infants hospitalized for the disease was 5.0% in those cities for which data for at least four years were available. This may be compared with the rate of 7.8% in 1942 and 11.1% in 1943. At ages one year and over, the rate was only 1.3% in 1946, as compared with 1.7% in 1942 and 3.7% in 1943. The rates in the hospitals with larger experiences were generally more favorable than in hospitals with smaller experiences. Despite the incomplete reporting of pertussis, which results in exaggerating the case fatality rate for the general population, the level of these rates in the community as a whole was lower than for hospitalized cases. This reflects the higher proportion of the severer cases in the hospitalized group. Indications are that in many places hospitalization is limited more and more to severe cases. Progress in the management of pertussis, especially of the severer cases admitted to hospitals, is believed to be the chief factor in the decline in case fatality of pertussis. A request contained in the questionnaire for an opinion on the severity of pertussis during the period studied elicited few replies, and these replies showed a division of opinion on the matter. It appears unlikely that there has been much of any change in the severity of the disease.

scholarly journals Rare Presentation of Self-Limiting Kikuchi–Fujimoto Disease in Relapsing Nature

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Karo Servatyari ◽  
Hero Yazdanpanah ◽  
Chamara Dalugama
Keyword(s):  
Lymph Nodes ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Cervical Lymphadenopathy ◽  
Excision Biopsy ◽  
Presentation Of Self ◽  
Rare Presentation ◽  
Cervical Lymph Nodes ◽  
One Year ◽  
Loss Of Appetite

Background. Kikuchi–Fujimoto disease (KFD) is a rare, benign, and self-limiting disease that is commonly associated with cervical lymphadenopathy and fever. The disease has a wide spectrum of clinical manifestations, and definitive diagnosis is based on the histological appearance in the excision biopsy of the lymph nodes. Recurrence of KFD is reported rarely. Case Presentation. A 56-year-old Iranian woman with a background history of thrombocytopenia presented with fever, malaise, loss of appetite, and weight loss with cervical lymphadenopathy. The excision biopsy of the cervical lymph nodes confirmed the diagnosis of KFD, and she made a full recovery with improvement of symptoms, regression of cervical lymph nodes, and normalization inflammatory markers. One year after remission, she presented with similar clinico-biochemical profile, and repeat biopsy confirmed KFD. Conclusion. Although the rate of recurrence of the disease is very low, the treating physician should consider the possibility and confirm it histologically.

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