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 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 Clinical profile and seroepidemiology of scrub typhus and its concurrent infections associated with other tropical fevers: a two-year study from a tertiary care centre in North India

2020 ◽  
Vol 7 (11) ◽  
pp. 4440
Author(s):  
Monika Matlani ◽  
Supriya Maheshwari ◽  
Neha Dubey ◽  
Shyam S. Mina ◽  
Vinita Dogra
Keyword(s):  
Clinical Presentation ◽  
Scrub Typhus ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Clinical Profile ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Igm Elisa ◽  
Concurrent Infections

Background: The study showed epidemiological aspects, clinical profile and laboratory features of patients presenting with scrub typhus alone and scrub typhus along with concurrent infections namely typhoid, malaria, leptospira, chikungunya and dengue.Methods: A total of 383 suspected cases of Scrub typhus were tested by IgM ELISA from January 2017 to October 2018. Appropriates tests were performed to determine the coinfections of scrub typhus with dengue, chikungunya, malaria, leptospirosis and typhoid fever.Results: Of the 383 samples received, 68 were positive for scrub typhus. Commonest clinical manifestations were fever, shortness of breath, myalgia, headache and jaundice. Maximum number of co infection cases were observed along with dengue.Conclusions: With the rapidly changing epidemiology of scrub typhus, it is very important to become familiar with its clinical presentation when presenting alone and as a concurrent infection with other acute febrile infections. 

scholarly journals Clinical and laboratory profile of Scrub typhus in paediatric age group

2020 ◽  
Vol 11 (6) ◽  
pp. 63-67
Author(s):  
Atindra Mishra ◽  
Rupa Thakur ◽  
Ruby Thakur
Keyword(s):  
Scrub Typhus ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Care Hospital ◽  
Age Group ◽  
Open Defecation ◽  
Laboratory Findings ◽  
Laboratory Profile

Background: Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi, obligate intracellular organism. Incidence of Scrub typhus is increasing due to easy availability and decreased cost of diagnostic facility. This study was designed to study the clinical and laboratory profile of scrub typhus patient in department of paediatrics at National Medical College, Birgunj. Aims and Objectives: To study the clinical manifestations, laboratory findings and complications of Scrub typhus in Pediatric age group. Methods and Methods: A prospective observational study was carried out in children below the age of 15 years, admitted in paediatrics department of a tertiary care hospital of Nepal from June 2019 to May 2020. Clinical manifestations and laboratory findings were collected and recorded in predesigned data sheet. Scrub typhus was diagnosed with IgM ELISA. Results: A total of 52 patients were diagnosed as scrub typhus. All patients presented with fever and commonly had other symptoms such as headache (65.3%), vomiting (63.5%), cough (59.6%), breathing difficulty (57.7%), abdominal pain (53.9%), seizures (21.2%) and rashes (9.6%). Important clinical signs noticed were lymphadenopathy (84.6%), edema (76.4%), hepatomegaly (56.8%), splenomegaly (36.5%) jaundice (30.7%). About 12% (n = 9) had necrotic eschar. 54% of the admitted patient confirmed using open defecation. Myocarditis (67.3%) was the commonest complication followed by Acute Kidney Injury (65.4%). Conclusions: Scrub typhus must be considered in differential of tropical fever in children, especially in those residing in rural area and having open defecation. In our study, Fever was the ubiquitous symptom and Myocarditis was the commonest complication.

Comparison of Clinical Outcomes With Drug Coated Balloons Versus Plain Balloon Angioplasty In Chronic Limb-Threatening Ischemia

2021 ◽  
pp. 153857442110225
Author(s):  
Joel Mathew John ◽  
Vimalin Samuel ◽  
Dheepak Selvaraj ◽  
Prabhu Premkumar ◽  
Albert A Kota ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Interventional Procedure ◽  
Tertiary Care ◽  
Arterial Disease ◽  
Multivariable Logistic Regression Analysis ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Exact Test ◽  
Institutional Review ◽  
Chi Square Test

Objective: The use of drug coated balloon (DCB) for angioplasty has shown superior efficacy against plain balloons for treating complex infrainguinal arterial disease. We report and compare the clinical outcomes following application of DCB(Paclitaxel) and plain angioplasty (POBA) in our tertiary care centre. Methods: A retrospective, single centre analysis of 301 patients with chronic limb-threatening ischemia involving the infrainguinal segment was conducted between September 2014 and September 2018, after approval from the Institutional review board. We analyzed clinical outcomes by measuring postoperative ABI improvement, restenosis requiring reintervention procedure, minor and major amputations at the end of 18 months. . To find the association between the group variables (POBA and DCB) and other risk variables, Chi-square test/Fisher’s exact test was used. Multivariable logistic regression analysis was used. Results: Patients who underwent treatment with plain balloon (POBA) and DCB(Paclitaxel) angioplasty were 246(81.7%) and 55(18.3%) respectively. Our study group was predominantly male (Male: Female = 6.7:1), most patients were more than 50 years of age (n = 251, 83.4%). Smoking (n = 199, 66.1%) and diabetes (n = 210, 69.8%) were the most common atherosclerotic risk factors. Postoperative Ankle Brachial Pressure Index (ABI) improvement were similar in both groups (POBA = 57.7%; DCB = 69.8%; p = 0.103). Minor and major amputations following POBA were 26% and 22%; and DCB were 12.7% and 16.4% respectively. Re-stenosis requiring a re-interventional procedure within 18 months was 15%, (n = 37) following POBA; and 12.7% (n = 7) following DCB (p = 0.661). Conclusions: This retrospective study shows similar clinical limb related outcomes following POBA and DCB at 18 months. However, our comparative analysis between the POBA and DCB groups was totally unadjusted and not adjusted for common confounders such as age and sex. Hence, for one to draw definitive conclusions leading to changes in clinical practice; a randomized, prospective study with a larger patient cohort is needed.

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