scholarly journals Congenital Rubella Syndrome: An Overview of Clinical Presentations in Bangladeshi Children

2014 ◽  
Vol 2 (2) ◽  
pp. 42-47 ◽  
Author(s):  
Nure Ishrat Nazme ◽  
Md Mahbubul Hoque ◽  
Manzoor Hussain

Background: Congenital Rubella Syndrome (CRS) has long been characterized by the triad of deafness, cataract and cardiovascular malformations with or without mental retardation. Objective: This study was conducted to observe the clinical manifestations of CRS in children of Bangladesh. Materials and method: This cross sectional study was carried out in Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh and National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh. Total 40 cases of CRS were enrolled from indoor and outpatient departments of these two hospitals, who were diagnosed according to standard case definition. Serological test for rubella antibody, chest X-ray, colour Doppler echocardiography, visual examination and hearing assessment were done in relative specialised centres. Results: The mean(±SD) age of the study subjects was 6.6(±5.7) months (range: 0-24 months). Among the subjects, 68% were male and 32% were female. Serum for rubella specific antibody revealed positive IgG in 60% cases and IgM in 28% cases. Neurological problem was the most frequently observed (90%) systemic complication followed by visual problem (83%), congenital hearing loss (80%) and congenital heart disease (78%). Cataract was the commonest (55%) among visual problems and microcephaly (62%) among neurological manifestations. Patent ductus arteriosus (PDA) was the most common (37.5%) isolated structural cardiac defect. Maximum (62.5%) children came from poor socioeconomic status. Maternal onset of infection was commonly detected in 1st trimester of pregnancy. Conclusion: Diagnosis of CRS and recognition of its versatile pattern of clinical presentation are crucial for better prognosis of the affected children. DOI: http://dx.doi.org/10.3329/dmcj.v2i2.20522 Delta Med Col J. Jul 2014; 2(2): 42-47

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Imran Jivraj ◽  
Chris J. Rudnisky ◽  
Emmanuel Tambe ◽  
Graham Tipple ◽  
Matthew T. S. Tennant

Purpose. Congenital rubella syndrome (CRS) is a global cause of preventable hearing impairment, blindness, and intellectual impairment. The present study sought to identify ocular and auditory manifestations of CRS in school-aged children in Mbingo, Cameroon.Design. Cross sectional study.Subjects. Students at two schools, one for children with hearing impairment, were screened for cataract, congenital glaucoma, and pigmentary retinopathy.Methods. Students underwent seven-field digital fundus photography through a dilated pupil using a Topcon NW200 nonmydriatic camera. Images were assessed by retina specialists in Canada via teleophthalmology. Clinical evidence was integrated to form case definitions for CRS based on Center for Disease Control and Prevention guidelines. Serological evidence of rubella infection was obtained using standardized IgG antibody titers.Main Outcome Measure. Number of probable and suspicious cases of CRS.Results. Between September 2009 and May 2010, 320 students participated. There were 28 (10.2%) probable cases, 104 (37.8%) suspects, and 143 (52.0%) unaffected. Rubella IgG serology was positive in 79 (48.7%) of children with hearing impairment and 11 (7.4%) of children with normal hearing.Conclusions. The present study identified 28 probable cases of CRS. Furthermore, 92.6% of students with normal hearing did not possess rubella IgG antibodies making future cases of CRS likely without intervention.


2021 ◽  
Vol 64 (5) ◽  
pp. 27-32
Author(s):  
Andrei Ungurean ◽  
◽  
Alina Malic ◽  
Tatiana Osipov ◽  
Evelina Lesnic ◽  
...  

Background: The surge demand and decreased availability of the health workers determined the designation of the Clinical Municipal Hospital of Phthisiopneumology (CMHP) into a hospital for the case-management of COVID-19 patients during the period of December 2020 – April 2021 for the treatment of the mild cases. The aim of the study was to assess the main peculiarities of the patients with COVID-19 through a cross-sectional study developed during the period February-April 2021 in the CMHP. Material and methods: A cross-sectional, analytical and prospective study was realized, which included 145 patients with COVID-19 hospitalized in the CMHP during February-April 2021. The inclusion criteria were: patient older 18 years, COVID-19 infection diagnosed by the pulmonologist with the positive polymerase chain reaction result for SARS-CoV-2 (COVID-19) and signed informed consent. Results: The peculiarities of patients with COVID-19 were dominated by the female sex, age over 60 years, residence in the urban districts of Chisinau and the infection acquired in the Republic of Moldova. Common clinical manifestations were: high temperature, profuse sweats, asthenia and headaches, productive cough, dyspnea, loss of smell or taste, and sore throat. The typical radiological findings such ground-glass pattern or consolidation with bilateral multifocal involvement were most frequent. Were cured most of the patients and the death rate was low. Conclusions: Peculiarities and clinical manifestations of the patients admitted in CMHP were typical for the COVID-19 infection. These findings did not show the real outcome of the standard case-management of the COVID-19 due to the restricted admission criteria.


2018 ◽  
Vol 68 (10) ◽  
pp. 1658-1664 ◽  
Author(s):  
Nkengafac Villyen Motaze ◽  
Jack Manamela ◽  
Sheilagh Smit ◽  
Helena Rabie ◽  
Kim Harper ◽  
...  

Author(s):  
Mukesh S. Bawa ◽  
Amol D. Kinge ◽  
Ananta Borde ◽  
Sarika Patil ◽  
Shriram Gosavi ◽  
...  

Background: Diarrhoeal diseases represent a major health problem in developing countries. Conservative estimates place the global death toll from diarrhoeal diseases at about two million deaths per year (1.7 - 2.5 million deaths), ranking third among all cases of infectious disease death worldwide. The prime purpose of an outbreak investigation is to control the outbreak, limit its spread to other areas and assess how preventive strategies could be further strengthened to reduce or eliminate the risk of such outbreak in future.Methods: It was a descriptive cross sectional study of epidemic occurred in Khetiya village, Dist Barwani (MP), population of 67,500 during 17 October 2016 to 17 November 2016. All the cases reported within last one week around the market place village in Khetiya, presenting with symptoms and signs of AGE (as per standard case definition of IDSP) and willing to participate in the investigation.Results: Males were 56.96%, & female cases were 43.03%. Majority of the study subjects lied between 20-40 years. The mean age was 30.15±5 years. Majority of the cases belonged to lower middle class SES (38%). 87% population was tribal, 48% cases were labourers, 42% were farmers and 10% were others.Conclusions: Males were 56.96%, & female cases were 43.03%. Majority of the study subjects lied between 20-40 years. The mean age was 30.15±5 years. Majority of the cases belonged to lower middle class SES (38%). 87% population was tribal, 48% cases were labourers, 42% were farmers and 10% were others.


2015 ◽  
Vol 38 (3) ◽  
pp. 137-141
Author(s):  
Nure Ishrat Nazme ◽  
Manzoor Hussain ◽  
Md Mahbubul Hoque ◽  
Arjun Chandra Dey ◽  
Ashith Chandra Das

Background: Congenital Rubella infection is a serious disabling problem for children resulting in Congenital Rubella Syndrome (CRS). The exact pattern of the CRS related cardiovascular malformation has not yet been well established in Bangladesh. The objective of this study was to observe the pattern of cardiovascular malformation in Congenital Rubella Syndrome. Methodology: This cross-sectional study was conducted in Dhaka Shishu (Children) Hospital and National Institute of Cardiovascular Diseases (NICVD). Total 40 suspected CRS cases were recruited from both indoor and outpatient departments of the two study hospitals. Serum samples were tested for rubella-specific IgM and IgG, visual and hearing assessment, chest radiography and colour doppler echocardiography were performed at appropriate specialized centres. Results: The mean (±SD) age of the study population (n=40) was 6.6 (±5.7) months (range: 0–24 months), 68% children were male and 32% were female. Congenital heart disease (CHD) was found in 78% children. Patent ductus arteriosus was the commonest (47.5%) structural defect followed by pulmonary stenosis (22%), atrial septal defect (17.5%) and ventricular septal defect (17%). The chest X-ray of CHD cases showed cardiomegaly in 71% cases and patchy opacity and/or consolidation in 65% cases. Regarding serological assessment of the 37 patients (3 patients rejected blood collection), 60% cases showed IgG positive and 28% cases revealed positive IgM. Conclusions: Various forms of cardiovascular malformation are present in CRS patients. Treatment modalities differ in each type of CHD and its early detection can reduce childhood mortality and morbidity. DOI: http://dx.doi.org/10.3329/bjch.v38i3.22822 Bangladesh J Child Health 2014; VOL 38 (3) :137-141


2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
Anna Lena Lopez ◽  
Peter Francis N. Raguindin ◽  
Maria Asuncion Silvestre ◽  
Xenia Cathrine J. Fabay ◽  
Ariel B. Vinarao ◽  
...  

Background. As part of regional elimination efforts, rubella-containing vaccines (RCV) have recently been introduced in the Philippines, yet the true burden of rubella and congenital rubella syndrome (CRS) in the country is largely unknown.Objective. To provide baseline information on rubella and CRS prior to routine vaccine introduction in the Philippines.Methods. We conducted a systematic literature review on rubella and CRS in the Philippines, including a cross-sectional study conducted in 2002 among 383 pregnant women attending the obstetric outpatient clinic of the Philippine General Hospital to assess rubella susceptibility of women of childbearing age.Results. 15 locally published and unpublished studies were reviewed. Susceptibility to rubella among women of childbearing age was higher in rural communities. Retrospective reviews revealed congenital heart diseases, cataracts, and hearing impairments to be most common presentations in children of CRS. In the cross-sectional study, 59 (15.4%) of the 383 pregnant women enrolled were seronegative for rubella IgG.Conclusion. Similar to other countries introducing RCV, it was only recently that surveillance for rubella has been established. Previous studies show substantial disabilities due to CRS and a substantial proportion of susceptible women who are at risk for having babies affected with CRS. Establishment of CRS surveillance and enhanced awareness on rubella case detection should be prioritized.


2020 ◽  
Vol 103 (5) ◽  
pp. 465-471

Background: Hyponatremia is associated with unfavorable outcomes in many cases. The mainstay of hyponatremia treatment depends on its symptoms and etiology. However, etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia have been rarely reported. Objective: To analyze and report etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia. Materials and Methods: In the present cross-sectional study, the authors enrolled hospitalized patients with hyponatremia who had consulted a nephrologist between October 1, 2017, and October 31, 2018. Their baseline characteristics and clinical manifestations were recorded. Etiologies were confirmed by the attending nephrology staff. Factors associated with severe symptomatic hyponatremia were evaluated using logistic regression analysis. Results: One hundred patients were included in this study. The syndrome of inappropriate antidiuresis (SIAD), hypovolemia, and hydrochlorothiazide use were the leading hyponatremia etiologies. Hyponatremia etiologies differed between patients with community-acquired hyponatremia (n=50) and those with hospital-associated hyponatremia (n=50). Patients with communityacquired hyponatremia were older, presented with a higher frequency of severe symptomatic hyponatremia, and showed lower SNa-levels. Low SNa-levels were significantly associated with severe symptomatic hyponatremia (p=0.014). Conclusion: Hyponatremia remains an important health problem. SIAD, hypovolemia, and hydrochlorothiazide use are among the leading etiologies of hyponatremia. Low SNa-levels are associated with severe symptomatic hyponatremia; thus, physicians should pay close attention to low SNa-levels in hospitalized patients. Keywords: Hyponatremia, Symptomatic Hyponatremia, Community-acquired hyponatremia, Hospital-associated hyponatremia


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Iman Ahmed Ragab ◽  
Shereen Mohamed Abd El-Ghany ◽  
Tarek Mostafa Kamal ◽  
Ghada Samir Abd El-Halim Elsayed

Abstract Background β-thalassemia syndromes involve a collection of extremely diverse phenotypes. The term β-thalassemia intermedia (β-TI) was suggested to describe patients who had clinical manifestations that are too severe to be termed minor thalassemia yet too mild to be termed major thalassemia. However, there remains substantial overlap between the three conditions. Aim of the Work To evaluate the variable clinical phenotypes among pediatric patients with βTI and to study the phenotype / genotype correlation with the encountered β-chain mutations. Patients and Methods A cross-sectional study was conducted on 37 Egyptian children and adolescents with TI following up regularly in the Pediatric Hematology clinic – Ain Shams University. Detailed Clinical evaluation and laboratory investigations were done. Reverse hybridization PCR based assay covering beta globin Mediterranean mutations onto specific biotinylated primers, was done. Results IVS 1.6 (T>C) was the most frequent mutation detected in 20 patients and 31 alleles (47.7%), followed by IVS 1.110 (G>A) detected in 7 patients and 8 alleles (12.31%), followed by IVS 1.1 (G>A) and CD27 knossos (G>T), each was detected in 6 patients and 6 alleles (9.23%). β+β+ was the most frequent genotype (54%), followed by β+β/β°β (21.6%) and β°β+ (13.5%). 60% of β°β+ patients had TDT(Transfusion dependent thalassemia), while 87.5% of β + β/β°β patients and 55% of β + β+ patients had NTDT ((Non transfusion dependent thalassemia). Conclusion Inheritance of mild β+ thalassemia mutations among Egyptian children; as IVS 1.6 (T>C) and IVS 1.110 (G>A) is the most frequent contributor to TI phenotype in either homozygous or compound heterozygous states. Patients with the same underlying genotype presented variable phenotypes with different degrees of severity.


Vaccine ◽  
2019 ◽  
Vol 37 (1) ◽  
pp. 202-209 ◽  
Author(s):  
Michiko Toizumi ◽  
Hien Minh Vo ◽  
Duc Anh Dang ◽  
Hiroyuki Moriuchi ◽  
Lay-Myint Yoshida

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