scholarly journals Epidemiological and clinical spectrum of dengue fever at tertiary care hospital in Chitwan: a hospital based study

2020 ◽  
Vol 10 (3) ◽  
pp. 29-33
Author(s):  
Bidhan Shrestha ◽  
Rakshya Shrestha ◽  
Arun Sedhain ◽  
Sabita Shrestha ◽  
Bishnu Mani Dhital ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Tertiary Care ◽  
Clinical Spectrum ◽  
Medical Attention ◽  
Categorical Variables ◽  
Severe Thrombocytopenia ◽  
Care Hospital ◽  
Continuous Variables ◽  
Health Authorities ◽  
Public Health Authorities

Background: Dengue fever is one of the most common tropical diseases caused by an arbo­virus. This virus is a member of genus Flavivirus and flaviviradae family, is transmitted by bite of Aedes aegypti mosquito. Its outbreak is being reported from different parts of the world including Nepal. This disease is prevalent throughout Nepal mostly in terai regions. The aim was to study the epidemiological and clinical spectrum of dengue fever at tertiary care hos­pital in Chitwan. Methods: This study was a hospital based prospective study where a total of 241 patients di­agnosed with dengue fever were assessed. This study was carried out from September 2019 to February 2020. Data was entered on predesigned proforma and analyzed by using SPSS version 16.0. Mean and standard deviations was calculated for continuous variables and frequencies for categorical variables. Results: More than half (56%) of the dengue patients belonged to the age group of 25-44 years. Out of 241 patients, 61.4% were males. Apart from fever the other common symptoms were ret­roorbital pain/headache comprising around 80% of patients. The mean duration of hospital stay in our study was 3.86 days. Approximately 72% (173) patients had leucopenia and 8.7% (21) had severe thrombocytopenia(<50000/cumm). NS1Ag positive were in 84% of total patients. Conclusions: Dengue fever is one of the dreadful diseases in tropical and hilly areas of Nepal. With the help of public health authorities, educating public about vector control and immediate medical attention may help in curbing this deadly disease.

Ultrasound Employed to Detect Breast Lumps among Symptomatic Patients in Tertiary Care Hospital

2020 ◽  
Vol 10 (4) ◽  
pp. 296-300
Author(s):  
Ameet Jesrani ◽  
Pari Gul ◽  
Nida Khan ◽  
Seema Nayab ◽  
Fahmida Naheed
Keyword(s):  
Predictive Value ◽  
Imaging Modality ◽  
Tertiary Care ◽  
Ultra Sound ◽  
Categorical Variables ◽  
Breast Lesions ◽  
Care Hospital ◽  
Continuous Variables ◽  
Cross Sectional ◽  
Breast Lumps

Objective: To assess different pathological breast lesions in ultra sound in a subgroup of population. Study design and setting: It was a cross sectional study conducted at Bolan Medical Complex Hospital Quetta, Pakistan from June 2018 to January 2019. Methodology: Total 103 patients with breast swelling, pain and discharge were targeted. Gray scale and Doppler Ultrasound of breast followed by FNAC/biopsy of breast lesion was performed. Data presented as mean ± standard deviation for continuous variables and frequency with percentages for categorical variables. Results: Out of 48 clinically palpable lumps US detected all of 48 lumps and additionally 12 clinically non palpable masses were detected on US examination. Thus, overall sensitivity of ultrasound in detecting breast lumps was 100%. Fibroadenoma of the breast was diagnosed accurately in 80.3% of women. Ultrasound reliably differentiated cystic from solid breast masses (100%). The sensitivity of ultrasound for detecting breast carcinoma was 63.4% with a positive predictive value of 87.5%, a negative predictive value of 99.5% and accuracy of 58.33%. US findings most suggestive of benign lesions were oval or round shape in 88.3%, well defined margin in 84%, absent lobulation in 86.04% and wider than taller ratio in 90.69% of the cases.US findings of most predictive for malignancy were of irregular shape in 81.8%, ill-defined margin in 90.9% and length to height ratio in 63.6% of cases. Conclusion: Ultrasound is simple, cheap, safe and relatively accessible imaging modality for evaluation of breast pathologies. Due to its high sensitivity in diagnosing benign breast lesions particularly cystic lesions and fibroadenoma unnecessary interventions can be avoided

scholarly journals Etiology and clinical spectrum of acute undifferentiated fever illness in patients in a tertiary care hospital Sheri Kashmir institute of medical science Soura, Jammu and Kashmir

2021 ◽  
Vol 9 (1) ◽  
pp. 15
Author(s):  
Sheenam Gazala ◽  
Mohmad Saleem Chesti ◽  
Syed Mushfiq
Keyword(s):  
Enteric Fever ◽  
Tertiary Care Hospital ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Medical Science ◽  
Categorical Variables ◽  
Care Hospital ◽  
Continuous Variables ◽  
Jammu And Kashmir ◽  
And Gender

Background: Current study aimed at s to delineate the etiology and clinical parameters associated with AUFI presenting to emergency department in a tertiary care hospital.Methods: This was a prospective hospital based study carried out at emergency medicine, SKIMS hospital, Soura Kashmir, India July 2017 to august 2018. Patients with acute undifferentiated fever were enrolled. Descriptive statistics were calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever, Frequency and percentage were used to analyse categorical variables such as causes of fever and gender, while as descriptive analysis was calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever.Results: Total numbers of patients included were 174, among these 112 (64.3%) were males and 62 (35.6%) were females. Most patients were diagnosed enteric fever (N=59, 33.9%) followed by UTI (N=25, 14.3%) dengue (N=12, 6.8%) and malaria (N=8, 4.5%) while rest of cases were associated with other viral illnesses (N=70, 40.5%) based on clinical basis and inconclusive laboratory results.Conclusions: Enteric fever was found to be the most common cause of acute undifferentiated fever followed by dengue and other viral illnesses, although causes and clinic spectrum of AUFI is varied.

scholarly journals Clinical and laboratory profile and outcome of dengue cases among children attending a tertiary care hospital of South India

2017 ◽  
Vol 4 (3) ◽  
pp. 1074 ◽  
Author(s):  
Punith Patak Nagaram ◽  
Prathima Piduru ◽  
Venkata Krishna Munagala ◽  
Vishnu Vandana Matli
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Bladder Wall ◽  
Tertiary Care ◽  
Severe Dengue ◽  
Wall Thickening ◽  
Severe Thrombocytopenia ◽  
Care Hospital ◽  
Age Group ◽  
Laboratory Profile

Background: Dengue fever is an arboviral disease which is endemic in tropical countries and is of major concern with its morbidity and mortality. WHO classified dengue into three categories: undifferentiated fever, dengue fever (DF) and dengue haemorrhagic fever (DHF). Severe dengue is also regularly observed during primary infection of infants born to dengue-immune mothers. The objective of present study was to assess the clinical profile, laboratory profile and associated risk factors related to outcome of children less than 15 years of age. The outcome of the children and their management protocols were also assessed in the study.Methods: A prospective cross sectional study with 174 confirmed cases of dengue in children <15 years were enrolled and classified as per WHO guidelines. The demographic data, clinical history, laboratory parameters were noted in a separate questionnaire form. Hematological parameters were noted, chest x-ray, ultra-sonogram in required cases was done and observations noted. Cases were managed as per WHO protocol and risk factors were observed. The outcomes of the cases were noted as discharge or death of the case.Results: A total of 174 children with 149 non-severe dengue and 25 severe dengue cases with 95 males and 79 females were enrolled in the study. 6-10 years was the most common age group. The mean age of children admitted with severe dengue fever was 5.81yrs.and without severe dengue fever was 7yrs.The mean duration of hospitalization was 5.21 days in severe dengue and 3.4 days in non-severe dengue cases. Fever was the most common presenting symptom and hepatomegaly was the common clinical finding in the study.  Bleeding manifestations were seen in cases of severe dengue with raised haematocrit levels, raised SGOT levels and severe thrombocytopenia. Pleural effusion and gall bladder wall thickening with ascites was seen in severe dengue cases. Management was by administration of colloids and crystalloids.Conclusions: Dengue is a dreadful fever among pediatric age group which needs to be considered with great caution in management.  Understanding the risk factors helps in predicting the mortality which helps in management and better outcome of the fever. 

scholarly journals Etiology of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care center in Karachi, Pakistan

2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Noman Ali ◽  
Nadeem Ullah Khan ◽  
Shahid Waheed ◽  
Syed Mustahsan
Keyword(s):  
Emergency Department ◽  
Enteric Fever ◽  
Care Center ◽  
Tertiary Care ◽  
Practical Importance ◽  
University Hospital ◽  
Categorical Variables ◽  
Care Hospital ◽  
Tertiary Care Center ◽  
Continuous Variables

Objective: Our study aimed at identifying the characteristics and etiology of various causes of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care hospital. Methods: This was a retrospective study conducted at the department of emergency medicine, Aga Khan University Hospital from January to June 2016. Adult patients presenting to Emergency department with acute undifferentiated fever were enrolled. Descriptive statistics were calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever, whereas frequency and percentage were computed for categorical variables like gender and causes of fever. Results: A total of one hundred and fifty five patients were included. Out of these 97 (62.6%) were males and 58 (37.4%) were females. Most patients (25.2%, n= 39) were diagnosed as malaria followed closely by dengue fever (n=33, 21.3%) and then enteric fever (n= 10, 6.5%). while 41.9% (n=65) were diagnosed as suspected viral fever based on clinical judgment and inconclusive laboratory results. Conclusion: Malaria was found to be the most common confirmed cause of acute undifferentiated fever followed by dengue and enteric fever. The provision of accurate epidemiological data will enable resources to be directed towards key areas and will be of practical importance to clinicians. doi: https://doi.org/10.12669/pjms.36.6.2334 How to cite this:Ali N, Khan NU, Waheed S, Mustahsan S. Etiology of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care center in Karachi, Pakistan. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.2334 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Clinical profile of dengue fever with severe thrombocytopenia and its complications: a retrospective study at a tertiary care hospital in South India

2017 ◽  
Vol 5 (5) ◽  
pp. 1751 ◽  
Author(s):  
Ch. Manoj Kumar ◽  
K. S. Keerthi Vyas ◽  
Y. Sai Krishna
Keyword(s):  
Retrospective Study ◽  
Dengue Fever ◽  
South India ◽  
Tertiary Care Hospital ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Severe Thrombocytopenia ◽  
Care Hospital ◽  
Haemorrhagic Fever

Background: Dengue haemorrhagic fever is a potentially lethal illness that is universally prevalent in the tropics and has become a major health concern globally in recent decades. The clinical manifestation of dengue infection varies from asymptomatic to severe life threatening illness in the form of DHF/DSS. Dengue haemorrhagic fever or DSS may be fatal in 40% to 50% of untreated patients. A hallmark of dengue infection is severe thrombocytopenia which causes concern for the patients and treating doctors. The objective of this study was to correlate clinical profile during the evolution of dengue fever with severe thrombocytopenia (platelets <10,000/mm3), and comparing frequencies between the different clinical forms in order to predict the severity of the disease.  The present study includes 40 individuals who were found to be seropositive with the detection of NS1Ag, IgM and IgG antibodies for dengue infection with severe thrombocytopenia. Early diagnosis and monitoring is largely dependent on haematological parameters. As no specific antiviral therapy is available, supportive therapy is of utmost importance.Methods: This is an observational, descriptive and retrospective study of 40 patients with clinical and serological diagnosis of dengue fever with severe thrombocytopenia (platelets<10,000/mm3), in the period from August 2015 to September 2016, who were admitted in a tertiary care hospital in South India. ELISA was performed for the detection of dengue NS1, Ig M and Ig G, haematological parameters by automated analyzer and peripheral smear, coagulation profile analysis were done.Results: Out of 40 cases with severe thrombocytopenia, 50% of the patients had classical dengue fever, 30% cases had DHF with bleeding manifests and 20% cases with DHF plasma leakage signs and 5% lead to DSS. There was lack of association studied between severe thrombocytopenia and bleeding manifestations as p value<0.065 was insignificant. However, the risk of complications increased with decreasing platelet counts in the present study.Conclusions: Thrombocytopenia was most predominant haematological discrepancy. There was no predilection for any age group or gender for thrombocytopenia or bleeding among the dengue patients. The results were relevant in assessing the severity of infection and can help by enabling the adaptation of the therapeutic conduct to the needs of individual patients.

scholarly journals Clinico-laboratory profile and outcome of dengue fever among children attending a tertiary care hospital of rural Telangana, India

2020 ◽  
Vol 7 (2) ◽  
pp. 382 ◽  
Author(s):  
V. Shekar ◽  
K. Praveen Kumar ◽  
C. Soren ◽  
K. Venkataramana Reddy ◽  
N. Dharani
Keyword(s):  
Dengue Fever ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Warning Signs ◽  
Severe Dengue ◽  
Severe Thrombocytopenia ◽  
Care Hospital ◽  
Presenting Symptoms

Background: Dengue is a self-limiting, vector-borne disease transmitted by Aedes mosquito, causing a major public health threat globally. The objective of this study is to assess the clinical profile and outcome of the dengue infection in children less than 14 years of age September 2018 to August 2019 at the Pediatric Department of S.V.S. Medical College, the tertiary care hospital in Mahabubnagar, Telanagana.Methods: Prospective study of 82 hospitalized children of <14 years with the diagnosis of dengue illness. Children with diagnosis of dengue were classified further in to two groups as per WHO guidelines, Non-severe dengue fever (probable dengue, dengue with warning signs) and ‘Severe Dengue’ (Dengue Haemorrhagic Fever and/or Dengue Shock Syndrome (DHF/DSS). A separate questionnaire form used for documenting clinical history, laboratory parameters. Haematological parameters were noted, chest x-ray, ultra-sonogram in required cases was done. Children were managed as per WHO protocol. The outcomes of the cases were mentioned as discharge, left against medical advice and death.Results: A total of 82 children with dengue were divided in to 55(67%) non severe dengue and 27(33%) severe dengue with males 56(68.2%) and females 26(31.7%). The most common age of presentation was between 6-10 years 34(41.5%). Fever 73(89%) was the most common presenting symptoms. Pleural effusion and hepatomegaly were the commonest clinical findings 28(34.1%) each, which were more among the severe dengue patients. Gall bladder edema 29(35.3%) was the most common ultra-sonogram finding. Significant elevation of transaminases (SGOP, SGPT) was seen in 39(47.5%). Severe thrombocytopenia was observed in 22(26.8%) children. Management was by administration of colloids and crystalloids.Conclusions: Dengue is a global problem. Presenting features include high grade fever, vomiting, abdominal pain, skin rash. Early recognition of symptoms and proper management can reduce the mortality.

scholarly journals Impact of COVID-19 pandemic on maternity services and challenges faced by pregnant women delivering at a tertiary care centre in South India

2021 ◽  
Author(s):  
Parvathi Teja Naik ◽  
Rupesh Bala Murugan ◽  
Haritha Sagili ◽  
Subitha Lakshminarayanan ◽  
Priyadarshini Muruganandhan ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Tertiary Care ◽  
World Health ◽  
Categorical Variables ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Continuous Variables ◽  
Maternity Services ◽  
The Impact

Background: Coronavirus disease 2019 (COVID-19), was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. India entered a nationwide lockdown on March 25, 2020, disrupting regular health services. Hence this study was conducted to estimate the impact of the COVID-19 pandemic on maternity services and to describe the challenges faced by pregnant women. Methods: A descriptive cross-sectional study conducted from July 2020 to October 2020 at tertiary care hospital, Puducherry, India. 422 pregnant women delivered during this period were included and detailed questionnaire was administered regarding antenatal, intrapartum, postnatal services and, challenges faced during the pandemic via telephonic call. Responses were documented in Epicollect version 5, transferred to Microsoft excel and analysed using Stata version 14.2. Continuous variables were expressed as mean (SD), and Categorical variables as proportions. Results: The 100% response rate was achieved with 32.5% high risk pregnancies. The 71.8% women availed direct emergency medical services while 28.2%. were referrals. The 79.9% and 25% of the women in third trimester had less antenatal visits and discontinued haematinics respectively. The 47.4% had first trimester testing, 30% didn’t receive lactation support. 81% and 69% of primiparous and multiparous women respectively had adopted postpartum Intrauterine contraceptive device as contraception. The 35-50% women faced challenges in availing essential obstetric care services.Conclusions: Development of robust linkage system between existing primary healthcare and tertiary care for managing both low and high-risk pregnancies is of paramount importance to alleviate maternal and perinatal mortality and morbidity.  

scholarly journals Lymphocyte-Neutrophil Ratio in the Diagnosis of Tubercular Pleural Effusion in a Tertiary Care Centre: A Descriptive Cross Sectional Study

2021 ◽  
Vol 6 (2) ◽  
pp. 1517-1521
Author(s):  
Rajneesh Jha ◽  
Ram Kumar Mehata ◽  
Puru Koirala
Keyword(s):  
Pleural Effusion ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
P Value ◽  
Care Hospital ◽  
Continuous Variables ◽  
Tertiary Care Centre ◽  
Cross Sectional

Introduction: Tuberculosis is a common infection in our community. Tubercular pleural effusion is the second most common form of extrapulmonary tuberculosis. Among the several causes of exudative pleural effusison tubercular remains the most common form in clinical practice. The aim of this study was to evaluate the significance of lymphocyte-neutrophil ratio(LN ratio) in cases of exudative effusion for diagnosis of tubercular effusion. Methods: This was a hospital based cross sectional studydone in Patients at tertiary care hospital from 1st September 2020 to 1st april 2021after taking ethical clearance from institutional reviw committee. Convienience samplingwas done. Statistical Analysis of data like percentages and frequencies  were used for categorical variables. Mean and SD (standard deviation) were used for describing continuous variables. Inferential statistical tools like Chi-Square test and Student’s t-test were used. P-value of <0.05 was considered statistically significant. Results: out of 200 cases 75% were tubercular pleural effusion and these cases were found have high levels of LN ratio (0.89 ± 0.11 for females and 0.97 ± 0.14 for males) and ADA (137.79 ± 44.61for females and 147.61 ± 51.64 for males) and more than 90% sensitivity and specificity of LN ratio and ADA level. Conclusion: Exudative pleural fluid L/N ratio >0.75 is an efficient means of diagnosing tuberculous pleural effusion and its combination with ADA level gives us more accuracy and surety about the diagnosis of tubercular pleural effusion.

scholarly journals Frequency of congenital birth defects in newborn babies born at Hyderabad, Sindh.

2020 ◽  
Vol 27 (04) ◽  
pp. 707-710
Author(s):  
Sajjad Ali Kazi ◽  
Aamir Memon ◽  
Abdul Hameed Radhan
Keyword(s):  
Pregnant Women ◽  
Birth Defects ◽  
Tertiary Care ◽  
University Hospital ◽  
Categorical Variables ◽  
P Value ◽  
Care Hospital ◽  
Continuous Variables ◽  
Observation Study ◽  
Congenital Birth Defects

Objectives: This study has been conducted in a tertiary care hospital to observe the frequency of congenital birth defects in newborn babies born at, Hyderabad, Sindh. Study Design: Prospective observation study. Setting: The Departments of Obstetrics and Pediatrics, Isra University Hospital, Hyderabad. Period: Two years from 2016 to 2018. Material & Methods: All the pregnant women irrespective of their parity and were included in the study after getting informed and written consent from their family heads and after the approval from Hospital’s ethical committee. We have used SPSS version 21.0 software for both data entering and analysis. All the continuous variables were analyzed using student t test and categorical variables were analyzed using chi-square test. P-value of ≤0.05 was taken as statistically significant. Results: A total of 150 pregnant women were included in our study with their mean age and SD was 26.72 ± 7.07 years and the mean years of marriage were 5.95±6 years. Most of the women were multiparous (47%), as compared to nulliparous and grandmultiparous, 33% and 20%, respectively. The prevalence of congenital birth defect was 11.3%, of these 30% had CNS malformations followed by 30% with gastrointestinal, 24% musculoskeletal, 12% genitourinary and 4% had ear malformations. Conclusion: The interfamily marriages (consanguineous marriages) are more common than outside family in study population. The frequency of birth defects was more than i-e: twice higher in interfamily marriages than outside family marriages.

Sign in / Sign up

Export Citation Format

Share Document