scholarly journals Clinical features & outcome of dengue cases at a tertiary care centre

2021 ◽  
Vol 53 (1-2) ◽  
pp. 3-7
Author(s):  
Md Nazrul Islam ◽  
Sabikun Nahar Chowdhury ◽  
SK Moazzem Hossain ◽  
Arina Shorani Mousi

Background: Dengue is a very common seasonal public health problem causing significant mortality every year. In 2019 an outbreak occurred in Bangladesh. Few new manifestations and multi organ involvement were found. Objective: The objective of the study was to see the clinical and laboratory manifestations and outcome of dengue fever in a medical college hospital. Methods: It was an observational study in a medical college hospital in Bangladesh. Study period was one year. The patients were confirmed cases of dengue. Apart from detailed clinical history, examination of patient, relevant investigations and follow up was done until discharge. Result: Total number of cases was 98. Out of them 62 (63.2%) were male and 36 (36.73%) were female. Fever was most common (100%) manifestation and duration of fever ranged from 5 to 8 days with a mean duration of 6.3 (± 1.0) days. Among other symptoms generalized body ache was most common (63, 64.3%). Generalized weakness was present in 60 cases (61.2% cases) Bleeding manifestations was present in 41 cases; abdominal manifestations were found in 11 cases. Blood for NSI was positive in 94 (95.9%) cases; most cases (71, 72.4%) became positive between 2nd to 4th day. Ninety (91.9%) cases developed thrombocylopcnia and it started at 5th day in 45 (45.9%) cases. Blood transfusion was given in 12 (12.2%) cases & Platelet transfusion was given in 3 (3.1%) cases. Complete recovery was in 96 (98%) cases and Death occurred in 2 (2.0%) cases. Conclusion: Bleeding was a dominant presentation. Some atypical manifestations like gastro intestinal features were also observed. These findings will help physicians in early diagnosis of dengue. Bang Med J Khulna 2020: 53 : 3-7

Author(s):  
Mohammed Thoyyib ◽  
Roshni Menon ◽  
Brinda G. David

<p class="abstract"><strong>Background:</strong> Facial melanosis (FM) which refers to brown, black or blue pigmentation over the face is a common cosmetic concern in Indian patients. This increased incidence could be due to remarkable diversity of Indian ethinic population. Pigmentary disorders of the face are a great cosmetic and psychological concern for the patients.</p><p class="abstract"><strong>Methods:</strong> This is an extensive descriptive clinico epidemiological study comprising of 1024 patients, conducted at Sri Venkateshwara Medical College Hospital and Research Centre, Puducherry, for a period of one and a half years. A detailed clinical history and examination was done, and all the clinical photographs and data were recorded. Necessary investigations like skin biopsy and patch testing was done wherever required.<strong></strong></p><p class="abstract"><strong>Results:</strong> The maximum number of patients belong to the age group of 21-35 years with a female predominance (67.2%). Among patients of FM, post inflammatory pigmentation (35.3%) was the most common comprising of 362 patients, followed by melasma (17.2%), periorbital melanosis (15.7%), seborrheic melanosis (7.5%) followed by other causes.</p><p><strong>Conclusions:</strong> FM is common in Indian skin, several of which have overlapping features, and some have defined clinical classification. Additionally, climatic conditions, cosmetic usage and social parameters predispose to the increased incidence of FM.</p>


Author(s):  
Karthik Rao ◽  
Gurukanth Rao ◽  
Navin Patil ◽  
Balaji Ommurugan ◽  
N R Rao ◽  
...  

OBJECTIVE To study the incidence, age and sex distribution among adults, various modes of presentation, correlation between thrombocytopenia and bleeding manifestations and various modalities of treatment of Idiopathic Thrombocytopenic Purpura in a tertiary care hospital in India.MATERIALS AND METHODSProspective study consisting of 4o cases of ITP admitted to Kasturba Medical College Hospital, Manipal from November 2005 to March 2007. Patients above 14 years of age admitted with thrombocytopenia in this institution were screened based on detailed clinical history, physical examination and laboratory investigations.RESULTSThe maximum incidence was in the 3 rd decade of life accounting for 27.5% of the patients. Ratio of male to female was 1:1.9 with female preponderance. Females in 3 rd decade had maximum incidence while males in 4th decade have maximum incidence. Majority 12 (85.71%) of male patients and 15(57.69%) of female patients  developed purpura during the course of disease. The mean count was 17.8X109/L with range between 2.0 X109/L to 76 X109/L. Cutaneous bleeding spots were found to be assosiated with counts above 25000X109/L and hematuria with lowest counts around 4000 X109/L. 20 (50%) of the above 40 patients responded to corticposteroids alone and did not have any further relapse. Among the remaining patients 3 (7.5%) had a relapse of symptoms within next 6 months and responded to repeat prednisolone started at 1mg/kg. 2 (5%) patients were given steroids tapering dose with IV Immune globulins for initial 5 days as therapy to which they responded.CONCLUSIONIdiopathic thrombocytopenia is 1.9 times more common in females than males. Most common presentation is bleeding spots over body. Bleeding manifestations are more common with thrombocytopenia less than 30000/mm3. Corticosteroids are the mainstay in treatment. Complete remission is seen in up to 57.5% of the patients. Splenectomy is the second modality of treatment in ITP. Complete and sustained remission is seen 75% of patients.  


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. 


2020 ◽  
Vol 6 (2) ◽  
pp. 114-117
Author(s):  
Shimul Akter ◽  
Naznin Rashid Shewly ◽  
Kashefa Khatun ◽  
Rokshana Parvin Nupur ◽  
Kamrun Nahar ◽  
...  

Background: Vesico-vaginal fistula can occur in different women with varied socio-economic condition. Objectives: The purpose of the present study was to see the socio-demographic characteristics of vesico-vaginal fistula (VVF) patients attended at a tertiary care hospital in Bangladesh. Methodology: This cross-sectional study was carried out from July 2013 to December 2013 for a period of 6 months in the National Fistula Centre in the Department of Obstetrics & Gynaecology at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh. All patients who underwent surgical repair for iatrogenic VVF in National Fistula Centre of the department of Obstetrics and Gynaecology of Dhaka Medical College Hospital were included in this study. Patients who got themselves admitted to Obstetrics & Gynaecology department of DMCH with the complaints of fistula. The entire selected patients were interviewed for detailed socio-demographic characteristics. Result: A total number of 51 cases of VVF were recruited for this study. The mean age was 46.02 (±SD 6.104) years. Most of the respondents were illiterate (55.0%) and one-third patients had primary level education. The number of highly educated patients was scarce (12.0%). It was evident that average age at marriage of the patients was 15.8(±4.74) years. Some females were forced to accept marriage at the age of 10 years. The mean interval between initiation of menstruation and the marriage was only 4.72 years. Mothers were on an average 17.48 years old at the time of first delivery. Conclusion: In conclusion middle age illiterate women are most commonly suffering from VVF. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 114-117


2013 ◽  
Vol 3 (1) ◽  
pp. 29-31
Author(s):  
Swapna Bhattacharjee ◽  
Shekhar Bhattacharjee ◽  
Rukhsana Parvin

Background: Cough variant asthma (CVA) is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional study was conducted in Enam Medical College Hospital, Savar, Dhaka over a period of two years from July 2009 to July 2011. Cough variant asthma was diagnosed mainly on clinical ground as chronic cough without wheezing, fever, weight loss, shortness of breath or sputum or any other apparent cause that persisted for more than eight weeks with absolutely normal physical examination of chest, normal chest radiography and blood count except raised eosinophil count and IgE level. Patients who met these criteria were given 2 weeks course of inhaler beclomethasone propionate and were assessed for improvement. Those who improved after steroid inhalation were categorised as having cough variant asthma. Results: Out of purposively selected 148 patients complaining only of chronic dry cough for more than eight weeks, 92 patients met the primary selection criteria for cough variant asthma. These 92 patients were given 2 weeks trial of 250 ìgm beclomethasone inhalation twice daily. Seventy nine patients reported almost complete recovery from chronic cough after 2 weeks and were categorized as having CVA. Thirteen patients did not improve and were not categorized as CVA. Conclusion: These findings suggest that cough variant asthma is the most common among the patients with chronic cough not due to any apparent cause. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of this disease. DOI: http://dx.doi.org/10.3329/jemc.v3i1.13871 J Enam Med Col 2013; 3(1): 29-31


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