Prevalence of scrub typhus in a tertiary care centre in Telangana, south India

2020 ◽  
Author(s):  
Ram Mohan Mylavarapu Venkata Naga Lakshmi ◽  
Teja Vijay Dharma ◽  
Sukanya Sudhaharan ◽  
Subbalaxmi Malladi Venkata Surya ◽  
Rajkiran Emmadi ◽  
...  
Keyword(s):  
Scrub Typhus ◽  
Point Of Care ◽  
Tertiary Care ◽  
Delayed Presentation ◽  
Serum Samples ◽  
Tertiary Care Centre ◽  
Doxycycline Treatment ◽  
Clinical Records ◽  
High Index Of Suspicion ◽  
Point Of Care Tests

Background and Objectives: Scrub typhus is re-emerging as an important cause of acute undifferentiated fever in the last decade from various parts of India. Complexity in performing the “gold standard” immunofluorescent assay and the unre- liable nature of Weil Felix test often results in delayed or misdiagnosis in a majority of cases. The present study seeks to integrate the results of rapid diagnostic tests, clinical and laboratory features to aid the diagnosis and management of scrub typhus patients. Materials and Methods: A total of 645 serum samples with suspected scrub typhus sent to the Department of Microbiology were included in the study. Scrub typhus was tested by rapid immunochromatographic test (SD Diagnostics) and IgM ELI- SA (Inbios International, USA). Clinical features, laboratory parameters and final outcome were analysed from the clinical records of positive patients. Results: Scrub typhus was diagnosed in 13.7% of patients and majority of them were observed in the month of August. 58.6% of scrub typhus patients presented with fever of one to two weeks duration. Eschar was documented in 13.7% of patients and 24% of patients gave a history of working outdoors or exposure to vegetation. All the patients responded to Doxycycline treatment and there was no mortality. Conclusion: High index of suspicion for scrub typhus is necessary in febrile patients not responding to conventional anti- biotics especially during outbreak situations. Rapid immunochromatographic tests with excellent specificity and acceptable sensitivity can be used as potential point of care tests for quick diagnosis of scrub typhus especially in delayed presentation.

scholarly journals Tubercular mastitis: An institutional experience from a tertiary care centre of northern India

2017 ◽  
Vol 8 (3) ◽  
pp. 72-75
Author(s):  
Amit Gupta ◽  
Lovenish Bains ◽  
Deepshikha Yadav ◽  
Prashant Durgapal ◽  
Manish Kumar Agrawal
Keyword(s):  
Tertiary Care ◽  
Needle Aspiration ◽  
Care Centre ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Aspiration Cytology ◽  
Northern India ◽  
Institutional Experience ◽  
Needle Aspiration Cytology ◽  
High Index Of Suspicion

Background: Tuberculous mastitis (TM) is a rare extra pulmonary presentation of tuberculosis. It may be problematic to distinguish from carcinoma breast, a condition with which it may coexist.  Fine needle aspiration cytology (FNAC) / biopsy are indispensable for diagnosis and tuberculosis culture when positive may be very valuable to guide antimicrobial therapy.Aims and Objectives:  To disseminate the message to the concerned expertise that it can present a diagnostic problem on radiological and microbiological investigations, and thus a high index of suspicion is needed.Materials and Methods: 19 cases of tubercular mastitis between  January 2012 to March 2014 were identified and included in the present study. Cytology and biopsy alongwith AFB stain was done for confirmation.Results: Age ranged between 23- 55 years (median 33 years). Axillary nodes were palpable in 9 (47.3%) patients. Acid Fast Bacilli stain which was positive in only 3 patients. All the 19 patients were started on antitubercular treatment.Conclusion: This study highlights the importance of early diagnosis and aggressive medical and if required surgical management to cure this disease.Asian Journal of Medical Sciences Vol.8(3) 2017 72-75

Rapid HIV testing using Determine™ HIV 1/2 antibody tests: is there a difference between the visual appearance of true- and false-positive tests?

2012 ◽  
Vol 23 (9) ◽  
pp. 644-646 ◽  
Author(s):  
R Sacks ◽  
A Omodele-Lucien ◽  
N Whitbread ◽  
D Muir ◽  
A Smith
Keyword(s):  
False Positive ◽  
Point Of Care ◽  
Line Strength ◽  
Positive Sample ◽  
True Positive ◽  
Patient Anxiety ◽  
Serum Samples ◽  
Visual Appearance ◽  
Risk Patients ◽  
Point Of Care Tests

HIV point-of-care tests (POCTs) give occasional false positive results, causing unnecessary patient anxiety. We aimed to elicit whether false- and true-positive POCTs differed visually. Seventeen false- and 17 true-positive serum samples were randomized into pairs, comprising one false- and one true-positive sample. Two independent readers identified each POCT as negative or positive and compared line strength between pairs. Six further readers graded line strength, 0-5, from POCT photographs. All true-positive samples were identified positive and 8/17 false-positive samples negative, on repeat testing of stored sera. Eight out of the 9 remaining false-positive tests were described as having weaker pigment uptake than their paired true-positive POCT. Mean grade of line strength was 4.2 in true- and 0.9 in false-positive samples, on photographic evaluation. These results suggest false-positive POCTs may differ visually from true-positive POCTs. If larger studies confirm these findings, we may be able to alleviate anxiety in low risk patients with faintly positive POCTs awaiting their confirmatory laboratory result, where the possibility of a false-positive result could be emphasized.

scholarly journals Epidemiology and clinical profile of scrub typhus outbreak in a tertiary care centre of central India

2019 ◽  
Vol 6 (11) ◽  
pp. 4867 ◽  
Author(s):  
Uday W. Narlawar ◽  
Rushali Rajan Lilare ◽  
Bhagyashree S. Gawande
Keyword(s):  
Rural Areas ◽  
Scrub Typhus ◽  
Indian Subcontinent ◽  
Tertiary Care ◽  
Central India ◽  
Clinical Profile ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Altered Sensorium ◽  
Presenting Symptoms

Background: Scrub typhus is the most common rickettsial infection in the Indian subcontinent with the manifestation ranging from mild symptoms to serious disease with or complication or death. The objective of this study was to study epidemiology and clinical profile of scrub typhus outbreak in a tertiary care centre of central India.Methods: Present study is a record based retrospective study enrolling 173 confirmed positive cases with ELISA test during the period from 1st August to 31st December 2018.Results: Maximum number of the cases 94 (54.3%) had occurred in September 2019. Majority of the female 94(54.3%) were Ig M positive for scrub typhus. Maximum cases 134 (77.5%) were from rural area. Most common symptoms were fever 170 (98.3%), followed by fever with chills 65 (37.6%), breathlessness 49 (28.3%), cough 35 (20.2%), and 28 (16.2%) each with altered sensorium and headache. Mortality was recorded in 30 (173%) and amongst them 10 (34.5%) and 4 (13.8%) cases had ARDS and septicaemia as complication respectively.Conclusions: This study shows that majority of the cases occurred in the month of September 2018 with female preponderance. Most of the residence were from rural areas with common presenting symptoms as fever or fever with chills followed by breathlessness, cough and altered sensorium and headache.

scholarly journals Estimation of Anti-HBs Titer in Health Care Professionals of a Tertiary Care Centre of Southern Assam

2021 ◽  
Vol 8 (8) ◽  
pp. 510-515
Author(s):  
Debadatta Dhar Chanda ◽  
Atanu Chakravarty ◽  
Barnamoy Bhattacharjee
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
Protective Level ◽  
Serum Samples ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Chewing Tobacco ◽  
Increased Risk

Background- Due to occupational exposure to blood, body fluids and sharps, the health care professionals are at increased risk of contracting the Hepatitis B virus infection than general population. To combat this, all the health care professionals must be immunized with protective level of anti-HBs but anti-HBs titer gradually wanes with passage of time and may be influenced by gender, smoking or chewing tobacco, diabetes mellitus etc. This study was thus carried out to find the percentage of health care professionals with protective titer of anti-HBs and find the association (if any) of low anti-HBs titer and factors like gender, smoking, diabetes mellitus and time elapsed post vaccination. Method- This cross-sectional study has been carried out with proper ethical clearance from May2018- September2019 in Serology section of VRDL under Department of Microbiology in a Medical College of Southern Assam on serum samples collected from 150 health care professionals vaccinated with 3 doses of recombinant HBsAg vaccine atleast 5years back. Anti-HBs IgG concentration was measured by conventional ELISA in multistandard mode. Result- Out of 150 participants,95 were males and 55 were females.27 participants smoked/chewed tobacco,8 had diabetes mellitus. Booster dose was received by 23. Protective level of anti-HBs IgG (>10 IU/ml) was found in 66% (98/150) of HCP only. Low anti-HBs titer has been found to be significantly associated with Diabetes mellitus (p–0.03) and passage of more than 10 years post primary vaccination(p-0.005) but no significant association has been found with gender, smoking and history of blood transfusion. Conclusion- HBsAg vaccine doesn’t impart everlasting protection. So, all HCP, especially those with co-morbidities should get their anti-HBs titer estimated after vaccination to check out for adequate seroconversion and attainment of protective titer. If found inadequate, they should go for repeat vaccination /booster doses. Keywords: Healthcare professionals, Vaccinated, Anti HBs IgG, Assam,

scholarly journals Clinical and Laboratory Profile and Therapeutic Response of Scrub Typhus in Children in a Tertiary Care Centre in Nepal

2020 ◽  
Vol 5 (1) ◽  
pp. 897-901
Author(s):  
Sumit Agrawal ◽  
Krishna Hari Subedi ◽  
Rajesh Kumar Shah ◽  
Santoshanand Jha ◽  
Sher Bahadur Pun
Keyword(s):  
Retrospective Study ◽  
Scrub Typhus ◽  
Indian Subcontinent ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Common Disease ◽  
Tertiary Care Centre ◽  
Institutional Review ◽  
Laboratory Profile ◽  
Loss Of Appetite

Introduction Scrub typhus is the most common ricketisial infection from the Indian subcontinent. It is caused by the organism Orienta tsutsugamushi inhabiting in trombiculid mites and transmitied to humans by the bite of these mites. The disease has a variety of clinical manifestations in children. As this is a common disease in our country so a retrospective study was conducted to study the clinical and laboratory profile and therapeutic outcomes of scrub typhus in children. Methodology A retrospective study was conducted at Sukraraj Tropical and Infectious disease Hospital, Teku, Kathmandu, Nepal after obtaining ethical clearance from Institutional Review Committee, and reviewing the medical records of serologically confirmed scrub typhus in children aged less than 14 years admitted to the hospital between March 2017 and February 2018. Relevant data were entered in excel spreadsheet and analyzed using SPSS 20. Result A total of 20 children were enrolled in the study. Of them 70% were female, with the mean age being 11.45 ± 3.1 years (range 3-14 years) and majority were from Dhading district (40%). All the children had fever; while there was cough, loss of appetite, rashes, headache, myalgia, arthralgia and hepatosplenomegaly in 45%, 90%, 20%, 55%, 35%, 35% and 30% of children respectively. There was thrombocytopenia in 50% of children; while hyponatremia, elevation of SGOT and SGPT was present in 30%, 70% and 55% of patients respectively. Azithromycin was used for treatment in 95% of children and all had defervescence of fever. Conclusion Scrub typhus should be suspected in children having prolonged fever with organomegaly, thrombocytopenia and elevated transaminases. Azithromycin can be used effectively in children diagnosed as scrub typhus.

scholarly journals Threat of scrub typhus in post-earthquake Nepal

2017 ◽  
Vol 6 (4) ◽  
pp. 1-6 ◽  
Author(s):  
S Thapa ◽  
L B Sapkota ◽  
P Hamal
Keyword(s):  
Fever Of Unknown Origin ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Unknown Origin ◽  
Serum Samples ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Recent Outbreak ◽  
High Index Of Suspicion ◽  
A Prospective Study

Scrub typhus is a potentially fatal zoonotic infection, reported from many parts of Asia including Nepal. There is in­creasing reports of outbreak of Scrub typhus, after the earthquake hit Nepal on April 25, 2015. The recent outbreak of Scrub typhus posed problems in diagnosis and treatment of the disease. It may be related to poor awareness of the disease or lack of suspicion for Scrub typhus which often presents with clinical features indistinguishable from typhoid fever. Since, various parts of Nepal appeared to be suitable hubs for Scrub typhus, the clinical suspicion of Scrub typhus in the differential diagnosis of fever of unknown origin (FUO) is of utmost importance to prevent mortality and morbidity. This is a prospective study conducted in Chitwan Medical College (CMC), Chitwan, Nepal. This study was carried out over a period of 4 months extending from June 2016 to September 2016. A total of 410 serum samples were collected from all patients visiting CMC, clinically suspected of having Scrub typhus infec­tion. The samples were processed for the detection of IgM antibodies for Scrub typhus by ELISA. Results: A total of 410 samples from patients suspected with Scrub typhus infection were processed which included 200 males and 210 females. Out of total 410 samples tested, 181 (44.1%) were seropositive for Scrub typhus. Seropositivity was highest 25.9% among the age group 11-20 years of age. Females were infected more than males. This study implies the re-emergence of Scrub typhus in different regions of Nepal. Although the disease is endemic in our country, it is grossly underdiagnosed owing to non-specific clinical presentation and lack of diagnostic facilities. It is thus suggested that high index of suspicion should be maintained for cases presenting with febrile illness. Infection with Scrub typhus was found high and this calls for an urgent need to introduce vaccine against Scrub typhus. 

Delayed Presentation of Primarily Missed Fractures Reporting to a Tertiary Care Centre: A Retrospective Study

2013 ◽  
Vol 1 (2) ◽  
pp. 23
Author(s):  
Muzamil Ahmad Baba ◽  
Bashir Ahmed Mir ◽  
M A Halwai ◽  
Adil Bashir Shikari ◽  
Shakir Rasheed ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Tertiary Care ◽  
Delayed Presentation ◽  
Care Centre ◽  
Tertiary Care Centre

scholarly journals Serological evidence of human leptospirosis in patients with acute undifferentiated febrile illness from Uttarakhand, India: A pilot study

2019 ◽  
Vol 11 (01) ◽  
pp. 011-016
Author(s):  
Mohit Bhatia ◽  
Pradeep Kumar ◽  
Pratima Gupta ◽  
Puneet Kumar Gupta ◽  
Minakshi Dhar ◽  
...  
Keyword(s):  
Pilot Study ◽  
Scrub Typhus ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Immunoglobulin M ◽  
Serological Evidence ◽  
Serum Samples ◽  
Malaria Parasites ◽  
Human Leptospirosis ◽  
Igm Elisa

Abstract CONTEXT: To the best of our knowledge, there are no reports of serological evidence of human leptospirosis from Uttarakhand state in India. AIMS: The aim of this study was to screen for serological evidence of leptospirosis in patients with acute undifferentiated febrile illness at a tertiary care teaching hospital in Uttarakhand. SETTINGS AND DESIGN: A pilot study was conducted from March to November 2017. SUBJECTS AND METHODS: Fifty-three adult patients who presented in Medicine outpatient Department with a history of fever of ≥7 up to 14 days duration with or without other associated symptoms such as a headache, rashes, myalgia, arthralgia, and conjunctival suffusion were enrolled in the study using convenience sampling technique. Blood samples of these patients were collected and subjected to peripheral smear examination for malaria parasites, dengue immunoglobulin M (IgM) immunochromatographic card test, IgM Typhidot, Leptospira and Scrub typhus IgM ELISA, respectively. Aerobic blood culture was performed in 24 cases. Relevant clinico-epidemiological details were obtained as per the pro forma formulated in accordance with the modified Faine’s criteria. STATISTICAL ANALYSIS USED: Descriptive statistics. RESULTS: The study population consisted of 50.94% of males and 49.06% of females with a mean age ± standard deviation of 34.2 ± 15.2 years. Fifty febrile patients had additional symptoms of which myalgia was the most common (81.1%) followed by arthralgia (22.6%). Peripheral smears of all patients were negative for malaria parasites. Dengue and Typhidot IgM positivity was observed in two and eight patients, respectively. Six and five patients were tested positive by leptospira and scrub typhus IgM ELISA, respectively. Salmonella Typhi was isolated from blood sample of only one patient. Serum samples of two patients showed dual positivity. All six leptospira seropositive patients satisfied modified Faine’s criteria. CONCLUSIONS: Leptospirosis is a seemingly unexplored infection in Uttarakhand and should be considered as a differential diagnosis in patients with acute undifferentiated febrile illness.

P41 An audit of the screening and treatment of uveitis in children with juvenile idiopathic arthritis (jia) at a paediatric tertiary centre

2018 ◽  
Vol 103 (2) ◽  
pp. e1.46-e1
Author(s):  
Aragon Cuevas Octavio ◽  
Roughley Amy ◽  
Morecroft Charles
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Treatment Guidelines ◽  
Tertiary Care ◽  
Primary Objective ◽  
British Society ◽  
List Type ◽  
Tertiary Care Centre ◽  
Screening Guidelines ◽  
Junior Staff ◽  
Clinical Records

AimThe primary objective of this study was to audit the centre’s and its satellite clinics’ compliance with the British Society for Paediatric and Adolescent Rheumatology (BSPAR) and the Royal College of Ophthalmology (RCO) uveitis screening guidelines. The secondary objective of the study was to compare the centre’s compliance with the treatment guidelines of JIA and uveitis, as recommended by NHS England and following results from the SYCAMORE trial.MethodThe clinical records of 54 patients recruited from the Childhood Arthritis Prospective Study (CAPS) were analysed over a six-week period. The data collected included patient demographics, JIA sub-type, date of referral and uveitis screening, presence of uveitis and treatment (if applicable), and details of medication prescribed for JIA. Information was gathered from the centre’s EPMA system and paper records, and was requested from the satellite centres if needed. The raw data was inputted into the statistical software SPSS v23 to evaluate the categorical data. Chi-squared tests were performed on the data to detect any potential correlation between various demographic variables and primary and secondary outcomes.Results92.6% (50/54) of patients were referred for uveitis screening after being diagnosed with JIA. For 3 (5.6%) patients there was no evidence of referral and for 1 (1.9%) patient the documentation was not clear. 90% (45/50) of the referred patients were screened for uveitis. For the remaining 5 (10%) patients, there was no documentation of whether screening had taken place. The compliance of ophthalmology departments with the BSPAR/RCO guidelines was poor with only 17.8% (8/45) of patients being screened within six weeks of the ophthalmology referral. 8.9% of patients (4/45) were diagnosed with uveitis and 2 of these patients received adalimumab as part of the treatment regime. The treatment for JIA was documented for 75.9% (41/54) of patients and all treatments (100%) were in line with the current recommendations from NHS England. Statistical correlations could not be identified due to the low numbers of patients.ConclusionThe BSPAR/RCO guidelines suggest that all new patients are to be screened as soon as possible, no longer than 6 weeks after referral.1 As uveitis is commonly an asymptomatic condition2 with severe complications such as blindness,3 routine screening is imperative. Overall, the compliance of the tertiary care centre and satellite clinics with the BSPAR/RCO guidelines was poor. Immediate changes are required to improve patient care, focusing on facilitating sharing of documentation and communication between the primary centre and its satellite clinics. Raising awareness of targets recommended by BSPAR/RCO to emphasise the importance of timely uveitis screening via regional training days should take place. Ensuring all junior staff that might see JIA patients in clinic are aware of the need of uveitis screening via offering structured training during their rotation is recommended.ReferencesBSPAR: Guidelines for Screening for Uveitis in Juvenile Idiopathic Arthritis (JIA) (1st ed.)6 Oct 2016.Engelhard SB, Asima B, Ashvini RK. Causes of uveitis in children without juvenile idiopathic arthritis. Clinical Ophthalmology2015;9:1121–1128.Juvenile Idiopathic Arthritis (JIA). Cincinnatichildrens.org. N.p., 5 Oct 2016.

scholarly journals Seroprevalence of markers of transfusion transmissible infections among blood donors at a tertiary care hospital blood bank: a 5 year retrospective study

2019 ◽  
Vol 7 (8) ◽  
pp. 2976
Author(s):  
Irm Yasmeen ◽  
Supinder Kour ◽  
Imran Khurshid ◽  
Aasifa Malik
Keyword(s):  
Blood Donors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Blood Bank ◽  
Care Hospital ◽  
Serum Samples ◽  
Tertiary Care Centre ◽  
Healthy Donors ◽  
Hiv 1 ◽  
Apparently Healthy

 Background: Transfusion transmitted infections (TTIs) can be caused by various microorganisms present in the blood of apparently healthy donors. The recipient may get infected after being transfused with the unsafe blood. It is mandatory to screen the blood for HIV 1 and 2, HBV, HCV, Syphilis and Malaria. This study was undertaken to investigate the seroprevalance of Transfusion transmitted infections among blood donors at our tertiary care centre and to compare our study with other studies conducted at different hospitals of the country as well as outside.Methods: A retrospective review of blood donor records was made over a period of 5 years with effect from January 2014 to December 2018 at blood bank, department of Blood Transfusion and Immunohaematology, SKIMS, Soura, Srinagar. Both voluntary and replacement blood donors were selected after taking proper history and examination were included in the study. Serum samples were screened for HIV 1 & 2, HBV (HBsAg) and HCV using ELISA with 3rd generation kits.Results: A total of 56325 blood donors were screened. Out of total 55346 (98.2%) were males and 979 (1.73%) were females. Among them 38969 (69.1%) were replacement donors and 17356 (30.8%) were voluntary donors. The seroprevalance of HBV (HBsAg), HCV and HIV 1and 2 was 0.24%, 0.17% and 0.01% respectively and overall seroprevalance of TTIs was 0.43%.Conclusions: Continuous improvement and implementation of newer techniques like NAT and chemilumenescence for testing of blood for TTIs will reduce the risk of acquiring these infections.lance

Sign in / Sign up

Export Citation Format

Share Document