scholarly journals Study on rickettsial diseases evidenced by Weil-Felix test among febrile patients visiting a tertiary care hospital in Mymensingh

Mediscope ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 112-121
Author(s):  
Abu Md Mayeenuddin Al Amin ◽  
Shyamal Kumar Paul ◽  
Md Abdul Aziz ◽  
Anindita Paul ◽  
Syeda Noorjahan Karim ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Agglutination Test ◽  
Diagnostic Tools ◽  
Spotted Fever Group ◽  
Care Hospital ◽  
Wide Range ◽  
Rickettsial Diseases ◽  
Fatal Complications

Background: Rickettsial diseases are neglected, re-emerging vector borne zoonosis & increasingly considered as one of the most important causes of pyrexia of unknown origin (PUO). They are grossly underdiagnosed due to wide range of non-specific symptoms, low index of clinical suspicion, lack of widely available specific diagnostic tools, leading to significant morbidity & mortality. Appropriate diagnosis in early stages is therefore necessary to prevent fatal complications associated with this disease. Objective: Present study was attempted to assess the burden of rickettsial illness by Weil-Felix agglutination test, among the suspected febrile patients, visiting a tertiary care hospital as well as to analyze the demographic profile & clinical manifestations of the seropositive cases. Methods: This was a cross-sectional study, conducted at department of microbiology, Mymensingh Medical College from March 2018 to February 2019. A total of 453 febrile patients of suspected rickettsial illness, irrespective of age and sex, were enrolled in this study. Serum sample from all the enrolled cases were then analyzed for rickettsial antibodies by Weil-Felix slide agglutination test. Results: Out of 453 cases, a total of 260 (57.39%) showed significant agglutination by Weil-Felix test, of which 101 (38.84%) were reactive to OX2 (spotted fever group rickettsiae), 65 (25%) were reactive to OXK (Scrub typhus) & 13 (5%) showed significant titers to OX19 (typhus fever). Remaining 81 (31.15%) sera were reactive to more than one antigens (mixed reactivity). Seropositivity was higher among female subjects (142; 54.61%) & age group >15-30 accounted for highest number of cases (95; 36.53%). Positive cases showed diverse clinical manifestations like headache (55.76%), myalgia (50.76%), skin rash (10.38%), eschar (9.23%), oliguria (7.3%), jaundice (10.76%), splenomegaly (6.81%), hepatomegaly (7.30%) etc. Conclusion: Rickettsial diseases should be considered as an important etiology of PUO & early diagnosis should be done to initiate proper treatment to prevent fatal complications. Though it lacks sensitivity & specificity, in a resource constraint area like Bangladesh, Weil-Felix test still serves as the cheapest initial diagnostic tool for rickettsial illness to guide the physician for further approaches. Mediscope 2021;8(2): 112-121

scholarly journals The PREVALENCE OF CLINICAL SPECTRUM OF INHERITED METABOLIC DISORDERS IN INFANTS AND CHILDREN AT A TERTIARY CARE HOSPITAL IN RAWALPINDI, PAKISTAN

2020 ◽  
Vol 70 (6) ◽  
pp. 1616-21
Author(s):  
Ayesha Batool ◽  
Saeed Zaman ◽  
Ammara Ayub ◽  
Kulsum Bilal ◽  
Qudratullah Malik
Keyword(s):  
Metabolic Disorders ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Infants And Children ◽  
P Value ◽  
Care Hospital ◽  
Inherited Metabolic Disorders ◽  
Wide Range ◽  
In Infants And Children

Objective:  To determine the frequency of a wide range of clinical presentations of inherited metabolic disorders diagnosed in infants and children at a tertiary care hospital in Rawalpindi, Pakistan. Study Design: Cross sectional study Place and Duration of Study: MH Rawalpindi, from June 2015 till June 2016. Material and Methods:  64 children diagnosed with metabolic disorders, reporting to the MH Rawalpindi, were enrolled in the study. History was taken with special reference to family history, consanguineous marriage, sibling’s death and clinical manifestations. Thorough physical examination was done in every patient to find out the clinical signs present. All the data was recorded on a proforma. SPSS-20 version was used to derive the results and p-value of <0.05 was taken as statistically significant. Results: In children with metabolic disorders, gastrointestinal manifestations were more significant 78·1% (p-value 0.022). Neurological signs were present in 60·9% (p-value 0.094) while respiratory manifestations were present in 15·6% children (p-value 0.251). 53·1% were males and 46·9% were females. The positive history of other affected children in family was significant (p-value 0.015), along with hypoglycaemia (p-value 0.001). Conclusion:  Pallor, failure to thrive, poor feeding, convulsions, lethargy and hypoglycemia were the most frequent clinical manifestations in children with metabolic disorders.

PREVALENCE OF CLOSTRIDIUM DIFFICILE INFECTION IN PATIENTS EXPOSED TO ANTIBIOTICS IN PREVIOUS 6 WEEKS AND ADMITTED WITH DIARRHEA IN A TERTIARY CARE HOSPITAL.

2021 ◽  
pp. 62-64
Author(s):  
Sanjay Kumar Singh ◽  
Ashwini Kumar Setya ◽  
Abhishek Deo ◽  
Vivek Raj ◽  
Suneel Chakravarty
Keyword(s):  
Clostridium Difficile ◽  
Pseudomembranous Colitis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Care Hospital ◽  
Common Cause ◽  
Wide Range ◽  
Antibiotic Associated Diarrhoea

Clostridium difficile is a signicant cause of morbidity and mortality among hospitalized patients, and the incidence of C. difficile infection (CDI) has dramatically increased due to frequent usage of broadspectrum antibiotics in these patients. The wide variation in the spectrum of clinical manifestations of CDI makes the diagnosis difcult. Further, the wide range of variability in the sensitivity and specicity of the various diagnostic methods and the high cost of these methods add to the difculty. It is a spore-forming gram-positive anaerobic organism. Until the 1970s, it was considered as a microorganism that is rarely present in normal intestinal microbiota. But it was not until 1978 that C. difcile was identied as a cause of [1] pseudomembranous colitis . Since then, C. difcile has been recognized as a common cause of antibiotic associated diarrhoea and nosocomial diarrhoea. The incidence of C. difcile infection (CDI) varies from place to place. In India, it is known to infect up to 25 % of [2] people taking antibiotics

scholarly journals A study about Knowledge, Attitude and Practice (KAP) regarding worm infestation among the caregivers of children aged between 5 – 12 years in a tertiary care hospital

2019 ◽  
Vol 10 (3) ◽  
pp. 1818-1820
Author(s):  
Jagadeesan M ◽  
Mariraj I ◽  
Prasanna Karthik S ◽  
Kannan R ◽  
Nivaas M ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Negative Impact ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Care Hospital ◽  
Class Iii ◽  
Nail Biting ◽  
Worm Infestation ◽  
Prophylactic Measures

Worm infection is a public health problem, especially in developing and underdeveloped countries as it has a negative impact on the child’s development. Proper sanitation and personnel hygiene have to be emphasized and monitored to overcome the nutritional deprivement in children. The study is done to evaluate the knowledge and attitude about worm infestation and to assess the deworming practices employed among the caregivers of children aged between 5 – 12 years attending a tertiary care hospital. A cross-sectional descriptive study was conducted among 206 caregivers of pediatric age group after obtaining proper informed consent. The KAP parameters were assessed using a pretested structured questionnaire, and the results were analyzed. Out of 206 caregivers, 61% were mothers, 37% were fathers. Their mean age was 30 years. 41% belong to class III socioeconomic status. 23% were reported to play in the mud, 17% nail-biting and 6% keeping objects in mouth.12% Had open-air defecation practice, which is quite alarming in a developing country.67% were found to have the knowledge and 33% lacked the knowledge about worm infestation. Knowledge was directly proportional to the socioeconomic class. 88% were aware that worm infestation would cause clinical manifestations. 85% preferred allopathy medicines, while 15% preferred homemade remedy. 68% didn’t practice any prophylactic measures, where in 21% of the caregivers dewormed their kid once in 6 months and 11% once a year. The study provides information that most of the caregivers had a good knowledge regarding deworming but failed in practicing necessary measures to control and prevent it. Health education, frequent monitoring, and conducting interventional programs among parents and caregivers would be vital so that the prevalence of the disease can be minimized.

The rise and fall of epidemic Neisseria meningitidis from a tertiary care hospital in Delhi, January 2005–June 2007

2008 ◽  
Vol 38 (4) ◽  
pp. 222-224 ◽  
Author(s):  
Surinder Kumar ◽  
Bineeta Kashyap ◽  
Preena Bhalla
Keyword(s):  
Neisseria Meningitidis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Latex Agglutination ◽  
Meningococcal Meningitis ◽  
Agglutination Test ◽  
Latex Agglutination Test ◽  
Care Hospital ◽  
Gram Staining ◽  
Health Goals

Meningococcal meningitis is endemic in India. There has been a sudden surge of cases of meningococcal meningitis in 2005 in Delhi. Present study was undertaken to find out changing trends in incidence of this disease from a tertiary care hospital in New Delhi over a period of two and half years. All samples from suspected cases of meningococcal meningitis were subjected to Gram staining, culture and latex agglutination test for detection of Neisseria meningitidis ( N.meningitidis). Antimicrobial susceptibility of all isolates was performed using the disc diffusion test. 78.6%, 71.4% and 100% of the samples were positive for N.meningitidis by smear examination, culture and latex agglutination test respectively. Except for resistance to Penicillin and Erythromycin in 8.8% and 5.9%, the isolates were sensitive to the commonly used antibiotics. Using simple, rapid and reliable methods for diagnosis, defining risk factors and continuing surveillance remain important public health goals for the control of meningococcal disease.

scholarly journals Cryptococcal Meningitis: A Retrospective Cohort of a Brazilian Reference Hospital in the Post-HAART Era of Universal Access

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Aline Z. de Azambuja ◽  
Gustavo Wissmann Neto ◽  
Guilherme Watte ◽  
Luciana Antoniolli ◽  
Luciano Z. Goldani
Keyword(s):  
Risk Factors ◽  
Intracranial Hypertension ◽  
Amphotericin B ◽  
Opportunistic Infection ◽  
Cryptococcal Meningitis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Care Hospital ◽  
Southern Brazil

Objective.Cryptococcus neoformansis a common opportunistic infection in adults with acquired immunodeficiency syndrome worldwide. However, limited data exist for HIV-infected patients in the post-HAART (highly active antiretroviral therapy) era in Brazil. The aim of this study was to describe the clinical characteristics and outcomes of cryptococcosis in a cohort of patients attending a teaching tertiary care hospital in southern Brazil after the introduction of HAART in Brazil.Patients and Methods. A retrospective study was conducted in tertiary care hospital in southern Brazil. Detailed data on risk factors, clinical manifestations, diagnosis methods, treatment, and prognosis of patients with meningeal cryptococcosis were evaluated from January 2009 to December 2016.Results. Seventy-nine cases of cryptococcal meningitis were identified. Most of the patients presented positive CSF (cerebrospinal fluid) cultures forCryptococcus neoformans(96%). The prevalence of males and females with meningeal cryptococcosis was similar. The age of the patients ranged from 5 to 67 years. The median time of hospitalization was 28 days. The most common underlying disease was HIV (82%), followed by solid transplant (10%). Fever, nausea, vomiting, headache, and altered mental status were the most common clinical manifestations. Initial opening intracranial pressures varied from 30 to 130 cm H2O. CNS imaging abnormalities include hydrocephalus and hypodensities. Widened Virchow–Robin spaces were described in only 2 patients (2.5%). Induction treatment of the majority of the patients consisted of amphotericin B and flucytosine (67%) followed by amphotericin B and fluconazole (19%). Multivariate analysis of Cox regression identified headache at presentation, mechanical ventilation, CSF glucose <20 mg/dL, and CSF cryptococcal antigen ≥1 : 1000 for independent risk factors for death. All-cause 30-day and 60-day mortalities were 19% and 24%, respectively.Conclusions. Meningeal cryptococcosis mostly caused byC. neoformanscontinues to occur predominantly in HIV-infected adults despite HAART being widely distributed in Brazil. Cryptococcosis remains a significant opportunistic infection in solid organ transplant recipients. Despite adequate antifungal treatment and management of intracranial hypertension in a reference tertiary care hospital, mortality was high. Identification of risk factors and additional treatment modalities, especially for intracranial hypertension, are necessary to improve care for patients with cryptococcal meningitis.

scholarly journals Clinical Spectrum and Neuroimaging Changes in Neurodegenerative Disorder-Experiences in Tertiary Care Hospital of Bangladesh

2021 ◽  
Vol 2 (6) ◽  
pp. 10-14
Author(s):  
Gopen Kumar Kundu ◽  
Rumana Islam ◽  
Noor E-Sabah ◽  
ABM Mukib
Keyword(s):  
Neurodegenerative Diseases ◽  
Tertiary Care Hospital ◽  
Neurodegenerative Disorder ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Care Hospital ◽  
Female Ratio ◽  
History Of ◽  
The Mean ◽  
Male To Female

Neurodegenerative diseases (NDD) are a heterogeneous group of disorders characterized by progressive loss of previously acquired skills that are of varied etiology, clinical manifestations, and natural course. There is a paucity of data on clinical profile of neurodegenerative diseases in our population. We conducted a retrospective study with 68 diagnosed cases of NDD at a tertiary care hospital in Bangladesh. Among them, more than one-third of children were in 1-5 years age group. The mean age was 10.2±3.1 year and male to female ratio was 2:1. Fifty percent of cases had a history of consanguineous parents. Leukodystrophy was most common (30.88%) among NDDs, followed by Wilson disease (26.47), SSPE (22.1%), and Degenerative Ataxia (20.59%). Motor skill regression was the most common presentation (97%), followed by speech regression in 91% and Gait disorder in 83% of children. Seizure was presenting features in 24% of children. Neuroimaging abnormalities were found in 80.88% NDD cases. Among them white matter hyper intensity in 29.41%, cerabeller atrophy in 13.25 %, and cerebral atropy in 11.76% of children. Eye changes were found in about two-thirds (69.12%) of cases of NDD. Among them, optic atrophy was found in 29.41%, and KF rings in 25.00% of cases.

scholarly journals Clinical and Genetic Spectrum of Inborn Errors of Immunity in a Tertiary Care Center in Southern India

2021 ◽  
Author(s):  
Harsha Prasada Lashkari ◽  
Manisha Madkaikar ◽  
Aparna Dalvi ◽  
Maya Gupta ◽  
Jacinta Bustamante ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Warning Signs ◽  
Southern India ◽  
Care Hospital ◽  
Optimal Care ◽  
Inborn Errors ◽  
Inborn Errors Of Immunity

Abstract Objectives To study the incidence, clinical manifestations, and genetic spectrum of primary immunodeficiency diseases (PID)/inborn errors of immunity (IEI) in a tertiary care hospital in Southern India. Methods A retrospective analysis of all patients with a clinical suspicion of PID/IEI seen at a tertiary care hospital was performed. All patients had at least one or more warning signs of PID. Serum immunoglobulin levels and other targeted investigations were performed as warranted by the clinical presentation. All families with suspected PID were counseled and offered genetic testing. Results A total of 225 children were evaluated for PID during the study period of 6 y. Fifty-six of them did not meet the European Society of Immunodeficiencies (ESID) criteria (working definition of clinical diagnosis) and were excluded. An IEI was found in 30/49 (61.2%) patients. The most frequent reason for referral was recurrent/unusual or serious infections (28%), or cytopenia (16%). Group IV diseases of immune dysregulation was the most common category (19%), followed by group III predominant antibody deficiencies in 23/163 (14%), as per the International Union of Immunological Societies (IUIS) classification. Conclusions This study highlights the heterogeneity of the present cohort, the underuse of genetic tests, and efforts to provide optimal care for children with possible IEI in this center.

scholarly journals Clinical Profile and Role of Septic Screen in Early Onset Sepsis in a Tertiary Care Hospital of Western Nepal - A Prospective Observational Study

2020 ◽  
Vol 8 (1) ◽  
pp. 14-18
Author(s):  
Binod Kumar Gupta ◽  
Raju Kaphle ◽  
Buby Philip Kurian ◽  
Badri Kumar Gupta
Keyword(s):  
Respiratory Distress ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Coagulase Negative Staphylococcus ◽  
Care Hospital ◽  
Early Onset Sepsis ◽  
Wide Range

INTRODUCTION: Neonatal sepsis is an important cause of neonatal mortality and morbidity with wide range of clinical manifestations. This study was aimed to study the clinical characteristics of sepsis along with the role of septic screen for early diagnosis of septicemia. MATERIAL AND METHODS: A prospective observational hospital based cross-sectional study was conducted in 113 screen positive newborns over a 12-month period at Universal College of Medical Sciences, Teaching Hospital Bhairahawa, Nepal. RESULTS: Out of 489 cases admitted to the NICU during the study period, 113 babies with screen positive sepsis were included in the study. Poor feeding (46%, n=52), respiratory distress (38.9%, n=44) and lethargy (30.1%, n=34) were top three clinical presentations in neonates with sepsis followed by seizures, jaundice, vomiting, fever and hypothermia respectively. 57.5% (n=65) of clinical sepsis cases enrolled had culture positivity with staphylococcus aureus in 41.5% (n=27) and Coagulase negative Staphylococcus (CONS) in 27.7% (n=18).  Klebsiella was the third common organism isolated in blood culture (23.1%, n=15). The sensitivities and specificities of two-test and three-test combinations in proven sepsis was calculated. Two-test combinations showed sensitivities between 33-100% and specificities between 30-90% whereas three-test combinations showed the sensitivities and specificities between 60-100% and 20-90% respectively. CONCLUSION: Poor feeding, respiratory distress and lethargy were common presentations in early onset neonatal sepsis. Three-test combination of septic screen had no overall advantage over two-test combination in the present study.

Sign in / Sign up

Export Citation Format

Share Document