scholarly journals Case series on congenital malaria from a tertiary care hospital in North Eastern India

2021 ◽  
Vol 12 (9) ◽  
pp. 166-168
Author(s):  
Joydeep Das ◽  
Saugata Choudhury

Malaria in early life is due to transfer of parasitized maternal red blood cell across placenta or direct transfer of parasite from placental syncytotrophoblast. Congenital malaria is defined as malaria acquired from mother in prenatal or perinatal period. Most of the cases in endemic area, passive transfer of high amount of maternal IgG antibody binds to malarial antigen and various components of parasites giving rise to various atypical clinical presentation. This case series will help neonatologist to think malaria in all non-specific symptoms of inconsolable cry, poor feeding, lethargy, even persistence of physiological jaundice. Very few reports of congenital malaria from India is reported in literature. Our series of five cases will address these few atypical symptoms.

2020 ◽  
Vol 7 (7) ◽  
pp. 2363
Author(s):  
D. Vinoth ◽  
S. Rajeshkumar ◽  
Sheik Asik Abu Sali

Intussusception is the telescoping of one segment of the gastrointestinal tract into an adjacent one. Adult intussusception is less than 0.1% of all hospital admissions. Non-specific symptoms often delay the diagnosis with most cases diagnosed only after emergency laparotomy, hence the need for imaging as a screening investigation. The gold standard is computed tomography with the limitations of cost, radiation and contrast hazards. Our suggested initial screening tool is ultrasound. the aim of this study was to evaluate the sensitivity of ultrasound in diagnosing this rare entity. Thirteen patients (2013 to 2019) in a single tertiary care hospital diagnosed as “intussusception” were analysed. They were initially diagnosed by ultrasound and confirmed by CT or intra-op as needed. There were no exclusion criteria. The mean age was 50. There were 6 males and 7 females. Ultrasound sensitivity was 72%. Symptoms were variable. 100% had abdominal pain (1 day to 2 years duration). 69% had Intestinal obstruction. The most common type of adult intussusception observed was ileo-ileal (39%). The least common noted was gastro-jejunal (8%). The most common treatment was resection and anastomosis (77%). 3 cases were managed conservatively successfully. The biopsy was mostly benign (54%), 3 were malignant (23%) and 3 were unknown as they were not operated (23%). Our suggested initial screening is ultrasound with a fairly good sensitivity (72%). The upcoming improvement in technology can raise this sensitivity even further. The management protocols, biopsy findings, and clinical findings are however subjected to discretion.


2021 ◽  
Author(s):  
Aliye Bastug ◽  
Hurrem Bodur ◽  
Urartu Ozgur Safak ◽  
Nazlican Filazi ◽  
Omer Aydos ◽  
...  

Abstract Purpose Little is known about the characteristics of neutralizing antibody(NAb) response in patients recovered COVID - 19. We aimed to elucidate the factors affecting presence and titers of in an early phase of infection up to 30 days.Methods A total of 129 laboratory-confirmed COVID-19 patients in a tertiary-care hospital were enrolled. Clinical and laboratory data were obtained retrospectively. SARS-CoV-2 specific NAb, IgM, and IgG antibody responses were analyzed. NAb-positive and negative patients were compared, to examine potential associations between clinical, demographical, and laboratory characteristics and the presence/titers of NAb.Results SARS-CoV-2 specific NAb, IgM and IgG were detected at the time of hospital discharge in 60.5%, 30.2%, and 51.9% of the patients, respectively. The presence of antibodies was 42.4%(NAb), 20.3%(IgM) and 44.1%(IgG) among patients within 5-9 days since onset; increased to 79.5%(NAb), 34.1%(IgM) and 47.7%(IgG) by 10-14 days; and detected in 66.7%(NAb), 50%(IgM), 83.3%(IgG) at/after day-15, following symptom onset. The median titer of neutralizing antibody(SN 50) was significantly higher in severe patients(25 versus 7.5, p= 0.009). Of the 23 severe patients, 52.2%(n=12) had higher NAb titers (i.e., SN 50 ≥ 1:25) when compared to that in non-severe patients(p= 0.021; OR = 2.89; 95%CI= 1.15 – 7.28), yet, potential effect of follow-up time on NAb status and titers could not be ruled out.Conclusion Presence and higher titers of NAb were detected more in severe patients compared to their non-severe counterparts. Survival analysis suggested that this difference could at least be partially explained by the length of follow-up after symptoms’ onset.


2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)


Author(s):  
Elizabeth B. Habermann ◽  
Aaron J. Tande ◽  
Benjamin D. Pollock ◽  
Matthew R. Neville ◽  
Henry H. Ting ◽  
...  

Abstract Objective: We evaluated the risk of patients contracting coronavirus disease 2019 (COVID-19) during their hospital stay to inform the safety of hospitalization for a non–COVID-19 indication during this pandemic. Methods: A case series of adult patients hospitalized for 2 or more nights from May 15 to June 15, 2020 at large tertiary-care hospital in the midwestern United States was reviewed. All patients were screened at admission with the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) polymerase chain reaction (PCR) test. Selected adult patients were also tested by IgG serology. After dismissal, patients with negative serology and PCR at admission were asked to undergo repeat serologic testing at 14–21 days after discharge. The primary outcome was healthcare-associated COVID-19 defined as a new positive SARS-CoV-2 PCR test on or after day 4 of hospital stay or within 7 days of hospital dismissal, or seroconversion in patients previously established as seronegative. Results: Of the 2,068 eligible adult patients, 1,778 (86.0%) completed admission PCR testing, while 1,339 (64.7%) also completed admission serology testing. Of the 1,310 (97.8%) who were both PCR and seronegative, 445 (34.0%) repeated postdischarge serology testing. No healthcare-associated COVID-19 cases were detected during the study period. Of 1,310 eligible PCR and seronegative adults, no patients tested PCR positive during hospital admission (95% confidence interval [CI], 0.0%–0.3%). Of the 445 (34.0%) who completed postdischarge serology testing, no patients seroconverted (0.0%; 95% CI, 0.0%–0.9%). Conclusion: We found low likelihood of hospital-associated COVID-19 with strict adherence to universal masking, physical distancing, and hand hygiene along with limited visitors and screening of admissions with PCR.


2021 ◽  
pp. 12
Author(s):  
Faisal Konbaz ◽  
Taif Alqahtani ◽  
Nada Alharthi ◽  
Mohammad Baraja ◽  
Nazish Masud ◽  
...  

Introduction: The COVID-19 pandemic has challenged the healthcare system’s capacities around the world. Due to the alarming situation, medical activities have been restricted to allocate resources to treat COVID-19-infected patients. However, medical emergencies still need urgent medical intervention. Considering the lack of reliable data regarding spinal surgeries during the COVID-19 pandemic, the present study sought to analyze the pattern of spinal surgeries in KSA. Methodology: A case series of patients who had urgent spine surgeries during COVID-19 pandemic was conducted in a tertiary care hospital. Data on patients’ demographics, COVID-19 test result, American Society of Anesthesia Score, SSS grade, diagnosis, and data related to surgery and postoperative findings were collected. All collected data were then processed and analyzed. Surgical outcomes based on source of admission were compared using Chi-square test. Result: A total of 63 patients who underwent spine surgery during the COVID-19 pandemic were included. The mean age of the patients was 53 ± 18 years and males were predominant (59%). The positive COVID-19 patients were 3%. Almost half of the patients were classified into ASA II. The majority were categorized into grade B (65%) according to SSS. The frequently diagnosed condition was fracture (33%), followed by spinal stenosis (18%) and metastatic (10%), while the most mentioned location was lumbar (61%). Postoperative complications were found in 11% of the patients. The readmission rate within 30 days, unplanned return to OR and ICU admission were 19%, 13%, and 11%, respectively. While the mean duration between admission and surgery was 8 ± 20 days, the mean duration of length of stay was 20 ± 29 days. Further, a significant association was seen between the admission source and the surgical procedure performed and surgical indication. Conclusion: It has been demonstrated that the surgical intervention was only provided to patients requiring immediate or urgent spinal management. However, the length of hospitalization and duration between hospital admission and surgery was substantially prolonged. Further studies are warranted to determine the factors leading to prolonged hospitalization and time between hospital admission and surgery.


2017 ◽  
Vol 157 (4) ◽  
pp. 602-607 ◽  
Author(s):  
Alexander Lanigan ◽  
Brentley Lindsey ◽  
Stephen Maturo ◽  
Joseph Brennan ◽  
Adrienne Laury

Objective Define the number and type of facial and penetrating neck injuries sustained in combat operations in Iraq and Afghanistan from 2011 to 2016. Compare recent injury trends to prior years of modern conflict. Study Design Case series with chart review. Setting Tertiary care hospital. Methods The Joint Theater Trauma Registry (JTTR) was queried for facial and neck injuries from Iraq and Afghanistan from June 2011 to May 2016. Injury patterns, severity, and patient demographics were analyzed and compared to previously published data from combat operations during January 2003 to May 2011. Results A total of 5312 discrete facial and neck injuries among 922 service members were identified. There were 3842 soft tissue injuries (72.3%) of the head/neck and 1469 (27.7%) facial fractures. Soft tissue injuries of the face/cheek (31.4%) and neck/larynx/trachea (18.8%) were most common. The most common facial fractures were of the orbit (26.3%) and maxilla/zygoma (25.1%). Injuries per month were highest in 2011 to 2012 and steadily declined through 2016. The percentage of nonbattle injuries trended up over time, ranging from 14.7% to 65%. Concurrent facial/neck soft tissue trauma or fracture was associated with an overall mortality rate of 2.44%. Comparison of our data to that previously published revealed no statistical difference in concurrent mortality (3.5%-2.2%, P = .053); an increase in orbital fractures ( P < .005), facial nerve injury ( P < .0005), and ear/tympanic membrane perforations ( P < .0005); and a decrease in mandible fractures ( P < .005). Conclusion Penetrating neck and facial injuries remain common in modern warfare. Assessing injury characteristics and trends supports continued improvements in battlefield protection and identifies areas requiring further intervention.


2022 ◽  
Vol 9 (1) ◽  
pp. 75-81
Author(s):  
Muhammad Bilal ◽  
Shafqat Ali Shah ◽  
Marina Murad ◽  
Saad Ali ◽  
Ammad Ali ◽  
...  

OBJECTIVES: To determine the frequency of complications following cataract surgery in diabetic patients admitted in the ophthalmology unit. METHODOLOGY: A prospective descriptive interventional case series study was conducted after approval of the ethical committee, from June 2017-June 2020 at the Ophthalmology department MTI-MMC. A total of 129 patients from either gender were enrolled in study. All the study patients went through detailed history and complete ocular examination. After necessary investigations, surgical procedure was carried out. Results were analyzed through the SPSS-24 version. RESULTS: Out of the total 129 eyes of the diabetic patients, fifty-nine (45.7%) were males and seventy (54.3%) were females with a ratio of 1:1.2. Uveitis leads the chart in complications found in twenty (15.50%) eyes while PODR being the least common found in only ten (7.75%) eyes. Worse visual acuity was observed in fourteen (10.85%) eyes. Striate keratopathy and posterior capsule opacification were found in sixteen (12.40%) and fifteen (11.62%) eyes respectively. Among the patients, 15.7% were having more than one complication during follow-up visits and eighty-eight (68.2%) eyes were found to have none complication. The age group 51-60 years observed frequent complications as compared to other groups. Similarly female gender (38.57%) has frequent complications as compared to males (2.7%). CONCLUSION: The study concludes Uveitis as the most common complication observed in 15.50% 0f the eyes while worse visual acuity (10.85%) and progression of diabetic retinopathy (7.75%) being the least common. Striate keratopathy was found in 12.40% while posterior capsule opacification in 11.62% of the eyes.


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