scholarly journals RELATIONSHIP OF MEASLES CASES IN MEASLES VACCINATED CHILDREN DURING OUTBREAK OF MEASLES IN BAHAWALPUR.

2019 ◽  
Vol 26 (07) ◽  
pp. 1125-1130
Author(s):  
Shahzadi Asma Tahseen

Objectives: To evaluate the clinical profile and case fatality rate and their comparison in relation with vaccination status in admitted children. Study Design: Case series retrospective study. Setting: Pediatric units of the tertiary care Hospitals (Bahawal Victoria Hospital and the Civil Hospital) affiliated with Quaid-e-Azam medical College Bahawalpur situated in Southern Punjab, Pakistan). Period: 01/01/2013 to 06/9/2013. Methods and Material: A clinical diagnosis of measles (as made by consultants of said Pediatric units) and residing in Bahawalpur district for more than one month of period before admitting in the hospital was included and reviewed. The help of Statistical department of Executive District Officer Health Bahawalpur was taken for missing information as the measles is notifiable disease and all cases were notified to Executive District Officer Health. The children who were nonresident of Bahawalpur District or with incomplete data were excluded. The children were divided into three groups depending on number of measles vaccine doses given. Results: The data of 557 children admitting during the period 01/01/2013 to 06/9/2013 with a clinical diagnosis of measles and resident of Bahawalpur district was included. 52.97% were males. 26.57% were unvaccinated and 73.43% vaccinated (39.14% with one dose and 34.29% with two doses). The mean age ± SD in unvaccinated children was 24.68±27.04, with one dose vaccination 50.94 ±35.58 and with two doses vaccination was 45.05 ±23.67 months. The case fatality rate was 2.87%. The case fatality was significantly higher in males vaccinated with two doses of vaccine as compared to either ones vaccinated with one dose or unvaccinated ones but this difference was not found in females. Conclusion: This study shows that there is urgent need of proper surveillance of measles cases.

Author(s):  
Deepak A. V. ◽  
K. J. Jacob ◽  
Sumi P. Maria

Background: Peripartum hysterectomy is a life-saving procedure resorted to when conservative measures fail to control obstetric haemorrhage. Several predisposing factors, suboptimal care and lack of infrastructure may lead to this emergency procedure. We wanted to find out factors associated with peripartum hysterectomy and the adverse maternal outcomes at our centre.Methods: A retrospective case series analysis of 40 cases of peripartum hysterectomy performed over a period of 5 years from January 2010 to December 2014 at Government Medical College Hospital, Thrissur, Kerala was done.Results: The incidence of peripartum hysterectomy was 0.29%. The most common indication for peripartum hysterectomy was hysterectomy was uterine atony (50%). Thirty-five women (88%) were between 20 and 35 years. Most of the subjects were unbooked. There were two maternal deaths (case fatality rate of 5%) following peripartum hysterectomy during this period. All the subjects required blood transfusion.Conclusions: Prompt performance hysterectomy before the patient’s clinical condition deteriorates is the key to success. The incidence of adherent placenta is increasing, so every effort should be taken to reduce the caesarean section rates globally. 


Author(s):  
Sawai Singh Rathore ◽  
Ade Harrison Manju ◽  
Qingqing Wen ◽  
Manush Sondhi ◽  
Reshma Pydi ◽  
...  

Background: Crimean-Congo hemorrhagic fever (CCHF) is a fatal acute tick-borne viral infection and a substantial emerging global public health threat. This illness has a high case fatality rate of up to 40%. The liver is one of the important target organs of the CCHF virus. Objective: The aim of this meta-analysis to evaluate the correlation between CCHF  and liver injury and draw more generalized inferences about the abnormal serum markers of liver injury such as alanine aminotransferase (ALT), aspartate aminotransferase (AST) in CCHF patients. Methods: A literature search was accomplished for published eligible articles with MEDLINE/PubMed and Embase databases. All eligible observational studies and case series were included from around the world. The inclusion criteria were articles describing liver injury biomarkers AST and ALT amongst patients diagnosed with CCHF. Results: Data from 18 studies, consisting of 1238 patients with CCHF  were included in this meta-analysis. The overall pooled prevalence of at least one raised liver injury biomarker was 77.95% (95% CI, I2 = 88.50%, p < 0.0001). Similarly, pooled prevalence of elevated AST and ALT was 85.92% (95% CI, I2 = 85.27%,  p < 0.0001) and 64.30% (95% CI, I2 = 88.32%,  p < 0.0001) respectively.  Both Egger and Begg-Mazumdar’s tests detected no apparent publication bias in all three meta-analyses(p > 0.05).  Conclusion: These elevated liver injury biomarkers have been identified as significant prognostic factors. Hence, Physicians must recognize and continuously monitor these biomarkers, since these aid early stratification of prognosis and the prevention of severe outcomes in infection with such a high case fatality rate.


2021 ◽  
Vol 34 (1) ◽  
pp. 55-62
Author(s):  
Be Nazir Ahmmad ◽  
Fazlur Rahman ◽  
Naznin Parvin ◽  
Md Shamsul Alam ◽  
Shitangshu Banerjee ◽  
...  

Background: Rajshahi medical college hospital is a tertiary care teaching and referral center in the North-West part of Bangladesh. To assess the epidemiological trend in hospital admission, including morbidity and mortality pattern of illness in the pediatric population, it needs to develop effective health care planning, appropriate resource allocation, and integration of existing health care service facilities. Objective: To evaluate the diseases and deaths of children admitted in the department of pediatrics, Rajshahi medical college hospital, Rajshahi. Materials and methods: This is a retrospective study. The collected case records of all patients admitted in the department of pediatrics from 1st January 2017 to 31st December 2019 (3 years) were analyzed.  Result: A total of 62000 children were admitted during the mentioned study period. All the patients were distributed into three age groups infant, under five, and more than five, contributing 22%, 27.5%, and 19%, respectively. Acute watery diarrhea (21%), hereditary hemolytic anemia (18%), bronchopneumonia (10.4%), acute gastritis (9.4%), and acute bronchiolitis and wheezy child (7.17%) were the top five diseases in each of the three years of admission. Among the total admitted patients, 1003 (1.61%) patients died. Infant, under five, and more than five age groups constitute 61.3%, 28.1%, and 15.1%, respectively. Encephalitis and fulminant hepatic failure found the top two diseases causing death with a case fatality rate was 61% and 43%, respectively. The next highest case fatality rate was found in acute leukemia (15%). Other common causes of death include meningitis, cerebral palsy with complications (7.5%), bronchopneumonia with complications (3.8%). Conclusion: An admission-related comprehensive evaluation of this study will help to understand the diseases and death patterns of a hospital, leading to the development of more effective planning and case management strategies. TAJ 2021; 34: No-1: 55-62


Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5871-5871 ◽  
Author(s):  
Ahmed Alaskar ◽  
Mohammed Bosaeed ◽  
Hina Rehan ◽  
May Anne Mendoza ◽  
Bader Alahmari ◽  
...  

We present the largest to date of a case series of nine patients with hematological and oncological malignancies who were infected with Middle East Respiratory Syndrome Coronavirus (MERS-CoV). MERS-CoV is a novel beta-coronavirus with a high fatality rate in comorbid patients. The majority of MERS cases globally were reported from Saudi Arabia (1983 cases, including 745 related deaths with a case-fatality rate of 37.5%) according to the WHO update of February 2019. All were clinically stable before acquiring the virus. Most of the cases had an active disease as relapse or refractory with three cases being neutropenic. The clinical presentation and radiological features of the patients were variable and inconsistent (Table 1). Diagnosis was confirmed with RT-PCR assays targeting upstream of the E gene and the open-reading frame gene 1a which had to be done repeatedly and required an average of 3 (with max. of 7) samples for a test to be positive (Table 2). All the patients developed respiratory failure, were admitted to the critical care unit (ICU) and required mechanical ventilation. The length of hospital stay ranged from 15 - 48, with an average of 24 days. Unfortunately, all nine patients died within days after admission to the ICU. In addition, the time from diagnosis to death has an average of 9 days ranging from 2-24 days, respectively. In conclusion, MERS CoV infection in hematology/oncology patients has a very poor prognosis regardless of the status of the underlying disease. The clinical presentation is not distinctive and confirming the diagnosis requires numerous respiratory samples. Measures to prevent nosocomial outbreaks should include proper compliance with personal protection equipment by health-care workers when managing patients with suspected and confirmed MERS-CoV infection and prompt isolation of infected patients. Future research is required to enhance our understanding of the disease and to evaluate superior diagnostic and therapeutic options. Disclosures No relevant conflicts of interest to declare.


2012 ◽  
Vol 36 (2) ◽  
pp. 66-70
Author(s):  
M Shameem Hasan ◽  
Sanat Kumar Barua ◽  
M Nasiruddin Mahmud ◽  
AHM Kamal ◽  
M Enayetullah ◽  
...  

Background: An understanding of epidemiological trend in hospital admissions, including diseases and death pattern, is critical for health care planning, appropriate resource allocation & improving existing services facilities. Objectives: To evaluate the disease and death pattern of children admitted in the department of Child Health, Chittagong Medical College Hospital (CMCH), Chittagong. Materials and Methods: This was a retrospective study. The case records of all patients admitted in the department from Jan 1, 2008 to Dec 31, 2010 were analyzed. Result: Total 38,692 children were admitted during this study period; among them total 1897(4.9%) patient died. Infant and under five age groups constitute 45.2% and 75.9% respectively, total admission whereas deaths from the same groups were 43.7% & 79.3% respectively. Bronchopneumonia (22%), acute watery diarrhea (15%), hereditary hemolytic anemia (12%), and bronchiolitis (10%), topped the first four positions in each of the three years of admission. Septicemia and encephalitis, with a case fatality rate of 24% and 35% respectively, were found as top two causes of death. Highest case fatality rate was found in hepatic encephalopathy (54%). Other common causes of death include meningitis (19%), severe malaria (21%), leukemia (22%), severe malnutrition with complications (11%), and congenital heart diseases (12%) Conclusion: Comprehensive evaluation of admission and death related findings of this study will help to determine possible gaps in patient care and planning for more effective case-management strategies. DOI: http://dx.doi.org/10.3329/bjch.v36i2.13081 Bangladesh J Child Health 2012; VOL 36 (2) : 66-70


2015 ◽  
Vol 144 (1) ◽  
pp. 198-206 ◽  
Author(s):  
R.-F. WANG ◽  
S.-H. SHEN ◽  
A. M.-F. YEN ◽  
T.-L. WANG ◽  
T.-N. JANG ◽  
...  

SUMMARYInformation is lacking on the integrated evaluation of mortality rates in healthcare-associated infections (HAIs). Our aim was to differentiate the risk factors responsible for the incidence from those for the case-fatality rates in association with HAIs. We therefore examined the time trends of both incidence and case-fatality rates over a 20-year period at a tertiary-care teaching medical centre in Taiwan and the mortality rate was expressed as the product of the incidence rate and the case-fatality rate. During the study period the overall mortality rate fell from 0·46 to 0·32 deaths/1000 patient-days and the incidence rate fell from 3·41 to 2·31/1000 patient-days, but the case-fatality rate increased marginally from 13·5% to 14·0%. The independent risk factors associated with incidence of HAIs were age, gender, infection site, admission type, and department of hospitalization. Significant prognostic factors for HAI case-fatality were age, infection site, intensive care, and clinical department. We conclude that the decreasing trend for the HAI mortality rate was accompanied by a significant decline in the incidence rate and this was offset by a slightly increasing trend in the case-fatality rate. This deconstruction approach could provide further insights into the underlying complex causes of mortality for HAIs.


2018 ◽  
Vol 5 (4) ◽  
pp. 1583 ◽  
Author(s):  
N. Muthukumaran

Background: The Neonatal mortality rate is an important indicator for newborn care and directly reflects prenatal, intranatal, and postnatal care. Objective: Primary objective was to analyse the neonatal mortality profile, incidence of neonatal sepsis among neonatal deaths and the pattern of antimicrobial resistance.Methods: This was a retrospective descriptive study done in a tertiary care regional center. All neonatal deaths from January 2017 to December 2017 were reviewed and primary causes of deaths, incidence of sepsis among neonatal deaths and pattern of antimicrobial resistance were analyzed.Results: Common causes of neonatal deaths were respiratory distress syndrome (27.4%), asphyxia (23.3%), sepsis (20.1%), congenital malformations, extreme preterm, meconium aspiration syndrome. Case fatality rate was high in extreme preterm neonates (96.8%), followed by respiratory distress syndrome (35.9%), asphyxia (33%), meconium aspiration syndrome (29.4%), congenital malformations (28.8%), and sepsis (22.6%). In present study incidence of neonatal sepsis among total neonatal deaths was about 20.1%. Coagulase negative staphylococcus(CONS) (38.6%) and Klebsiella pneumoniae (32.7%) were the predominant organisms isolated. Highest case fatality rate was associated with Pseudomonas sepsis (80%), K. pneumoniae sepsis (64.8%), followed by Escherichia coli sepsis (57%) and non fermenting Gram negative bacilli (55.6%).Conclusions: Sepsis still remains one of the leading cause of death in developing countries. Coagulase negative staphylococcus (CONS) and Klebsiella pneumoniae were the most common organism. 15 % enterococci and 9.7 % of CONS were resistant to vancomycin. 24 % of K. pneumoniae and 16.6% non fermenting Gram negative bacilli were resistant to amikacin. Multidrug resistance is an emerging problem.


2012 ◽  
Vol 7 (3) ◽  
pp. 120
Author(s):  
Erna Kusumawardani ◽  
Umar Fahmi Achmadi

Berbeda dengan beberapa negara, laporan kejadian kasus demam berdarah dengue (DBD) di perdesaan Indonesia belum banyak dilaporkan. Penelitian ini bertujuan untuk memberikan gambaran kejadian DBD di perdesaan di wilayah perbatasan Kabupaten Bogor dan Kabupaten Lebak, Jawa Barat. Penelitian ini menggunakan desain studi kasus seri dengan sampel seluruh penderita DBD yang tercatat di puskesmas pada periode bulan Januari 2011 sampai April 2012. Hasil penelitian menemukan 18 kasus DBD dan 4 kasus kematian (case fatality rate, CFR = 22%). Sebagian besar kasus berjenis kelamin laki-laki (58,3%), berusia ³ 15 tahun (58,3%), tidak bekerja/ibu rumah tangga (50%), melakukan mobilitas (66,7%), mempunyai pengetahuan yang baik (66,7%), berperilaku kurang baik (83,3%), dan mempunyai tempat penampungan air (100%). Lima dari 12 kasus DBD (41,7%) diduga merupakan kasus lokal. Dari empat puskesmas (57,1%) yang melakukan kegiatan penyelidikan epidemiologi DBD terindikasi bahwa kemungkinan besar telah terjadi transmisi DBD di wilayah perdesaan daerah perbatasan Kabupaten Bogor dan Kabupaten Lebak.Kata kunci: Demam berdarah dengue, perdesaan, transmisiAbstract Dengue hemorrhagic fever (DHF) has long been reported as disease affecting predominantly among urban populations. However, several recent studies suggest that DHF has spread into rural area. This study aims to describe disease occurrence of DHF in border rural areas of Bogor – Lebak. The study design is case series. The sample of this study was all patients with confirmed DHF admitted to public health centers between January 2011 and April 2012. The study was conducted in April to May 2012. The results showed that there were 19 DHF cases and four out of 18 cases died (case fatality rate, CFR was 22%). Out of 12 eligible respondents, most of them were male (58,3%), aged ³ 15 years (58,3%), unemployed/housewife (50%), conducting mobility (66,7%), having good knowledge (66,7%), behave poorly (83,3%), and having water containers (100%). Five of 12 DHF cases (41,7%) were suspected as local cases. Four primary health centers (57,1%) were able to perform PE DBD (DHF Epidemiological Investigation). These results indicate that the transmission of DHF in border rural areas of Bogor – Lebak, most likely has occurred.Key words: Dengue hemorrhagic fever, rural, transmission


1970 ◽  
Vol 37 (2) ◽  
pp. 66-70 ◽  
Author(s):  
A Pal ◽  
R Bhattacharyya ◽  
S Adhikari ◽  
A Roy ◽  
D Chakrabarty ◽  
...  

This cross sectional record based institutional study was conducted in the Department of Obstetrics & Gynaecology, Burdwan Medical College, Burdwan over ten years (1999-2008) aiming analysis of eclamptic mothers for evaluation of maternal and perinatal outcome with different anticonvulsant medications. Total 5991 pregnant mothers with eclampsia admitted in the inpatient department of the tertiary care teaching hospital were recruited for the study, irrespective of their previous antenatal check up history. Subjects with known seizure disorders were excluded from the study. The subjects were managed according to standard regimens (Menon, Ph-sodium, diazepam & magnesium sulphate) and results were documented in standardised format. Case fatality rate, mean induction delivery time & birth-weight, perinatal mortality rates were recorded. Study reveals that the incidence of eclampsia <20 years was 6.97% and majority (5.41%) came from rural areas. Eclampsia was noted primarily in primigravida (7.43%) and unbooked (6.41%) mothers. Ante partum eclampsia predominated (64%) and incidence of caesarean section was 22.25%.The overall case fatality rate was 6.05% and eclampsia contributed 27.85% of all maternal deaths during the last two years of the study period. The overall incidence of low birth weight baby was 26.96% and perinatal mortality was 30.33% (1411/4651).The incidence of perinatal mortality and low birth weight babies are lower in the last 4 years when compared to earlier studies. Proper socio-demographic assessment of pregnancy with eclampsia, planned delivery, shorter induction delivery interval, good control of convulsion by magnesium sulphate, intensive intranatal monitoring causes less maternal and perinatal morbidity and mortality. DOI: http://dx.doi.org/10.3329/bmrcb.v37i2.8437 BMRCB 2011; 37(2): 66-70


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