scholarly journals Albumin Cobalt Binding or Ischaemia Modified Albumin: A test of great prognostic value in malaria

2017 ◽  
Vol 9 (1) ◽  
pp. e2017041 ◽  
Author(s):  
Kinjalka Ghosh ◽  
M G Muddeshwar ◽  
Monoj Lokhande ◽  
Kanjaksha Ghosh
Keyword(s):  
Severe Malaria ◽  
Falciparum Malaria ◽  
Prognostic Marker ◽  
Medical College ◽  
Complicated Malaria ◽  
Cobalt Binding ◽  
College Setting ◽  
Time Of Admission ◽  
Work Up ◽  
Detailed Work

Background :  We evaluated albumin cobalt binding (ACB) assay as a prognostic marker for severe malaria  in a medical college setting .Methods :Consecutive adult patients admitted with both vivax and falciparum malaria were evaluated with ACB assay at the time of admission. Detailed work up and individual patient directed management were instituted in addition to immediate artemisin based antimalarial therapy.Results :100 consecutive patient ( 50 with vivax and 50 with falciparum malaria ) were evaluated . Reference range for ACB assay was established using 50 adult healthy ( 25 male and 25 female ) individuals . 16 out of 50 p. falciparum infected developed complicated malaria. All malaria infected patients had high ACB levels ( P<0.0001). There was step wise increase in ACB levels from healthy volunteers to different category of malaria( P<0.0001 ) without any overlap.  Conclusion: ACB can be used as a robust simple and cheap prognostic marker for organ dysfunction in  severe malaria.

scholarly journals A prospective study to assess glycemic status as a possible prognostic marker in non diabetic acute organophosphate poisoning patients

2020 ◽  
Vol 7 (3) ◽  
pp. 464
Author(s):  
Raveendra K. R. ◽  
Chandana V. ◽  
Sanjana Kodur
Keyword(s):  
Prognostic Marker ◽  
Prognostic Indicators ◽  
Organophosphate Poisoning ◽  
Glycaemic Variability ◽  
Medical College ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Resource Limited ◽  
A Prospective Study ◽  
Time Of Admission

Background: Organophosphates (OP) are a diverse group of insecticides used for pest control. Due to easy availability of these compounds over the counter, organophosphate poisoning continues to be a major cause of deliberate self-harm. Although choline esterase inhibition plays a key role in OP poisoning, other metabolic factors like dysglycemia contribute to the severity of poisoning. The present study attempts to assess glycaemic variability as a probable prognostic factor in acute OP poisoning. Aim of the study was to correlate the blood glucose levels with the severity and treatment outcome of acute organophosphate poisoning.Methods: 100 patients of acute organophosphate poisoning admitted in the hospitals affiliated to Bangalore Medical College and Research Institute during the study period from August 2018 to July 2019, were enrolled into the study as per the inclusion criteria and graded into mild, moderate & severe, based on Peradeniya organophosphorus poisoning (POP) scale. Random blood sugar (RBS) was estimated at the time of admission and patients were followed up till recovery/death.Results: The patients in this study were categorized into hypoglycemics (10%), euglycemics (75%) and hyperglycemic (15%). 16% of euglycemics, 30% of hypoglycemics and 60% of hyperglycemics had severe grade of poisoning. The ventilator requirements in hypoglycaemics, euglycemics and hyperglycemics were 40%,48% and 80% respectively. The outcome in terms of mortality was 8% in euglycemics group and 20% in hyperglycemics group. Hence hyperglycemia was found to be a poor prognostic marker in acute organophosphate poisoning.Conclusions: RBS at admission in acute organophosphate poisoning patients is a simple, inexpensive tool that may help to predict the clinical outcome. Early identification of the poor prognostic indicators may help in timely intervention, to reduce morbidity and mortality, especially in a resource limited country like India.

scholarly journals Study of clinical presentation of falciparum malaria and correlation with laboratory indices of poor prognosis

2017 ◽  
Vol 4 (6) ◽  
pp. 1591
Author(s):  
Hazarimal Choudhary ◽  
Prema Ram Choudhary
Keyword(s):  
Severe Malaria ◽  
Falciparum Malaria ◽  
Poor Prognosis ◽  
Clinical Presentation ◽  
Blood Film ◽  
Medical College ◽  
The North ◽  
North Eastern ◽  
High Incidence ◽  
Peripheral Blood Film

Background: Severe malaria is a chief cause of death in the North-eastern states of India. The criteria for defining severe malaria have fluctuating over the last many years. Detection of both specific and sensitive clinical features of falciparum malaria to predict death is required to improve clinical management. Therefore, the objective of present study was designed to investigate the clinical presentation of falciparum malaria and correlation with laboratory indices of poor prognosis.Methods: This prospective observational study was conducted at the R N T Medical College Udaipur, India. Total 53 malarial patients who tested positive for plasmodium falciparum were included. A detailed clinical presentation, haematological and biochemical variables were scrutinized. SPSS-16 software was used for statistical analysis.Results: Out of 53 patients, 6 (11.3%) patients had (>5%) parasitaemia, 3 (5.66%) patients had schizonts in peripheral blood film, 2 (3.77%) patients had serum creatinine >3.0 mg%, 4 (7.54%) patients had raised SGOT and SGPT and all have been died while 11 (20.75%) patients had haemoglobin <7.1 gm% and amongst these 3 (27.27%) patients were died. Out of 53 patients, 13 patients (24.53%) died. Most of the patients had over lapping features with anemia (13.32%), ARDS, 16.98 %, Jaundice 9.43% and impaired consciousness (32.96%). These four features were responsible for high incidence of mortality in malaria.Conclusions: Decisively 29 (54.71%) patients were having laboratory indices of poor prognosis and amongst them 19 (65.51%) patients were died. Therefore, our findings confirm that patients who had P. falciparum malaria with laboratory indices of poor prognosis had high incidence of mortality.

scholarly journals Predictors of treatment failures of plasmodium falciparum malaria in Vietnam: a 4-year single‐centre retrospective study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Minh Cuong Duong ◽  
Oanh Kieu Nguyet Pham ◽  
Phong Thanh Nguyen ◽  
Van Vinh Chau Nguyen ◽  
Phu Hoan Nguyen
Keyword(s):  
Plasmodium Falciparum ◽  
Treatment Failure ◽  
Severe Malaria ◽  
Falciparum Malaria ◽  
Control Strategies ◽  
Artemisinin Resistance ◽  
Plasmodium Falciparum Malaria ◽  
Molecular Technique ◽  
Drug Resistant ◽  
Public Health Burden

Abstract Background Drug-resistant falciparum malaria is an increasing public health burden. This study examined the magnitude of Plasmodium falciparum infection and the patterns and predictors of treatment failure in Vietnam. Methods Medical records of all 443 patients with malaria infection admitted to the Hospital for Tropical Diseases between January 2015 and December 2018 were used to extract information on demographics, risk factors, symptoms, laboratory tests, treatment, and outcome. Results More than half (59.8%, 265/443, CI 55.1–64.4%) of patients acquired Plasmodium falciparum infection of whom 21.9% (58/265, CI 17.1–27.4%) had severe malaria, while 7.2% (19/265, CI 4.6–10.9%) and 19.2% (51/265, CI 14.7–24.5%) developed early treatment failure (ETF) and late treatment failure (LTF) respectively. Among 58 patients with severe malaria, 14 (24.1%) acquired infection in regions where artemisinin resistance has been documented including Binh Phuoc (11 patients), Dak Nong (2 patients) and Gia Lai (1 patient). Under treatment with intravenous artesunate, the median (IQR) parasite half-life of 11 patients coming from Binh Phuoc was 3 h (2.3 to 8.3 h), two patients coming from Dak Nong was 2.8 and 5.7 h, and a patient coming from Gia Lai was 6.5 h. Most patients (98.5%, 261/265) recovered completely. Four patients with severe malaria died. Severe malaria was statistically associated with receiving treatment at previous hospitals (P < 0.001), hepatomegaly (P < 0.001) and number of inpatient days (P < 0.001). Having severe malaria was a predictor of ETF (AOR 6.96, CI 2.55–19.02, P < 0.001). No predictor of LTF was identified. Conclusions Plasmodium falciparum remains the prevalent malaria parasite. Despite low mortality rate, severe malaria is not rare and is a significant predictor of ETF. To reduce the risk for ETF, studies are needed to examine the effectiveness of combination therapy including parenteral artesunate and a parenteral partner drug for severe malaria. The study alerts the possibility of drug-resistant malaria in Africa and other areas in Vietnam, which are known as non-endemic areas of anti-malarial drug resistance. A more comprehensive study using molecular technique in these regions is required to completely understand the magnitude of drug-resistant malaria and to design appropriate control strategies.

scholarly journals Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania

2020 ◽  
Vol 6 (1) ◽  
pp. 1
Author(s):  
Boushab Mohamed Boushab ◽  
Mohamed Salem Ould Ahmedou Salem ◽  
Ali Ould Mohamed Salem Boukhary ◽  
Philippe Parola ◽  
Leonardo Basco
Keyword(s):  
Renal Failure ◽  
Respiratory Distress ◽  
Severe Malaria ◽  
Falciparum Malaria ◽  
Clinical Features ◽  
Signs And Symptoms ◽  
Plasmodium Falciparum Malaria ◽  
Severe Anaemia ◽  
World Health ◽  
Health Organization

Severe malaria in adults is not well-studied in Sahelian Africa. Clinical features and mortality associated with severe Plasmodium falciparum malaria in adult patients hospitalized in Kiffa, southern Mauritania, were analysed. Patients over 15 years old admitted for severe malaria between August 2016 and December 2019 were included in the present retrospective study. The World Health Organization (WHO) criteria were used to define severe malaria. The presenting clinical characteristics and outcome were compared. Of 4266 patients hospitalized during the study period, 573 (13.4%) had a positive rapid diagnostic test for malaria, and 99 (17.3%; mean age, 37.5 years; range 15–79 years; sex-ratio M/F, 2.1) satisfied the criteria for severe malaria. On admission, the following signs and symptoms were observed in more than one-fourth of the patients: fever (98%), impairment of consciousness (81.8%), multiple convulsions (70.7%), cardiovascular collapse (61.6%), respiratory distress (43.4%), severe anaemia ≤ 80 g/L (36.4%), haemoglobinuria (27.3%), and renal failure (25.3%). Patients were treated with parenteral quinine or artemether. Fourteen (14.1%) patients died. Multiple convulsions, respiratory distress, severe anaemia, haemoglobinuria, acute renal failure, jaundice, and abnormal bleeding occurred more frequently (p < 0.05) in deceased patients. Mortality due to severe falciparum malaria is high among adults in southern Mauritania. An adoption of the WHO-recommended first-line treatment for severe malaria, such as parenteral artesunate, is required to lower the mortality rate associated with severe malaria.

Evaluation of -Catenin Expression in Relation to Staging and Grading of Colorectal Carcinoma – A Study Conducted in Jubilee Mission Medical College and Research Institute, Thrissur

2021 ◽  
Vol 8 (32) ◽  
pp. 2993-2998
Author(s):  
Rashifa Vakiyath ◽  
Jeena Varghese Chimmen ◽  
Kizhake Varium Praveen ◽  
Abhijith Valsalan
Keyword(s):  
Colorectal Carcinoma ◽  
Prognostic Marker ◽  
Nodal Metastasis ◽  
Genomic Alteration ◽  
Lymph Node Status ◽  
Colorectal Cancers ◽  
P Value ◽  
Histopathological Diagnosis ◽  
Medical College ◽  
Keywords Immunohistochemistry

BACKGROUND Colorectal carcinoma is the most frequently encountered malignancy worldwide. The main cause of mortality associated with colorectal malignancy is tumour invasion and metastasis. The major genomic alteration that has been found in colorectal carcinoma is mutation in the adenomatous polyposis gene. Mutated APC causes unrestricted action of the Wnt signalling pathway which results in accumulation of the β - catenin protein in the nucleus responsible for cell proliferation, differentiation and enhanced survival of colorectal epithelial cells. Role of β - catenin expression as a prognostic marker needs to be studied. It will help in aiding the possibility of the future of anti β - catenin targeted chemotherapy for the treatment of colorectal cancers. METHODS A total of 85 samples from histopathologically proven cases of adenocarcinoma colon were taken. Histomorphological features and their immunohistochemical expression of β - catenin were studied. Data thus obtained was analysed using SPSS version 25. Histopathological diagnosis is considered as the gold standard. RESULTS Among the 85 samples of adenocarcinoma 9 case were stage T1 tumours, 24 were stage T2. 31 cases were stage T3, and 21 colorectal cancers were stage T4. Statistically significant correlation was obtained between tumour stage and β - catenin expression. (P value = < 0.001) With regard to tumour grade 24 out of 85 cases were well differentiated and 45 were moderately differentiated, 16 cases were poorly differentiated. Correlation of tumour grading and β - catenin expression also were statistically significant (P value = < 0.001). 45 out of 85 cases were having no nodal metastasis. 22 cases showed metastasis in 1 to 3 lymph nodes. 18 cases were N2. No statistically significant correlation was obtained between lymph node status and β - catenin expression. (P value = 0.003) CONCLUSIONS In this study the membranous, cytoplasmic and nuclear scores of β - catenin shows the linear progression with the advancing stages of colorectal carcinoma. So β - catenin can be used as a prognostic marker in malignant colorectal neoplasm. KEYWORDS Immunohistochemistry, β – Catenin, Colorectal Carcinoma

scholarly journals STUDY OF COMPLICATIONS OF MALARIA IN ADULTS PATIENTS: A PROSPECTIVE STUDY FROM BHOPAL

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Nikhil Gupta ◽  
RS Maniram ◽  
Garima Vijayvergiya
Keyword(s):  
Leukocyte Count ◽  
Severe Anemia ◽  
Major Health Problem ◽  
Major Health ◽  
Medical College ◽  
Major Complications ◽  
Gandhi Medical College ◽  
A Prospective Study ◽  
Time Of Admission ◽  
Poor Population

Background: Malaria is a major health problem all over the globe. WHO recorded that 228 million people suffered and 405000 died due to malaria in 2018. Severity of malaria is known to be the cause of serious morbidity and mortality in poor population. Understanding of its current symptoms and associated complication can help in early diagnosis. Aims and objectives: To study the malarial complications among the adult patients. Materials and Methods: Hundred malaria patients were studied at Gandhi Medical College and associated with Hamidia Hospital from Jan 2019 to Dec 2019. For all the subjects’ medical history, demographic details and medical complications were recorded. Results: Major symptoms at the time of admission were fever, nausea and headache. Major complications in SM patients were severe anemia, prostration, hyperpyrexia (9%) respiratory distress in (6%), thrombocytopenia (70%), low leukocyte count (21%), and cerebral malaria was recorded in 4%. No mortality was recorded during this study. Conclusion: Severe anemia, prostration, hyperpyrexia, ARDS, thrombocytopenia and low leukocyte count are the major complications of SM. Keywords: nausea, anemia, prostration, hyperpyrexia, thrombocytopenia

scholarly journals Study of common clinical types of cutaneous tuberculosis: two years study experience in a tertiary care centre

2020 ◽  
Vol 6 (2) ◽  
pp. 199
Author(s):  
Raghu M. T. ◽  
Ashwini S. ◽  
Yogendra M. ◽  
Virupakshappa H. E. ◽  
Gangaraju Harish ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Group ◽  
Lupus Vulgaris ◽  
Tertiary Care Centre ◽  
Cutaneous Tuberculosis ◽  
Medical College ◽  
Plaque Type ◽  
Study Experience ◽  
The Common ◽  
Work Up

<p class="abstract"><strong>Background:</strong> Cutaneous tuberculosis (TB) is frequently found worldwide, especially in tropical countries. The number of extrapulmonary TB reaches up to 14%, and 1% to 2% are cutaneous TB. Diagnosis of cutaneous tuberculosis (CTB) is complicated and requires a full work-up. Clinical manifestation of cutaneous TB is varied and causes difficulties to diagnose. Scrofuloderma and plaque type of lupus vulgaris (LV) are common forms of cutaneous TB.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted on patients attending Department of Dermatology, Venereology and Leprosy, at Basaveshwara Medical College and Hospital, Chitradurga over a period of 2 years. A total of 15 cases of cutaneous tuberculosis were diagnosed.</p><p class="abstract"><strong>Results:</strong> A total of 15 cases out of which included predominantly males, with age group being affected commonly are 20-40 decades, histopathology showing tuberculoid granuloma in 11 cases, and common clinical variant being lupus vulgaris seen in 66.6% of the cases and. Second common being scrufuloderma seen in 26.6% of the cases and least common is TB verrucosa cutis (TBVC) seen in 6.6% of the cases.</p><p class="abstract"><strong>Conclusions:</strong> The study showed that the common clinical type of cutaneous tuberculosis during the study period was lupus vulgaris, scrofuloderma and less common being TBVC.</p>

Silver-assisted syntheses of fused five-membered N-heterocycles

2021 ◽  
Vol 25 ◽  
Author(s):  
Navjeet Kaur ◽  
Neha Ahlawat ◽  
Yamini Verma ◽  
Pooja Grewal ◽  
Pranshu Bhardwaj ◽  
...  
Keyword(s):  
Organic Chemistry ◽  
Heterocyclic Compounds ◽  
Stereoselective Synthesis ◽  
Review Article ◽  
Highly Efficient ◽  
Work Up ◽  
Detailed Work

: The metal-mediated formation of heterocycles is one of the most emerging and essential strategies in organic chemistry. The reactions utilized previously to synthesize heterocycles were less familiar to the scientists due to their detailed work-up, expensive nature, and complex operations. The silver-assisted cyclic reactions are highly efficient for both regioselective and stereoselective synthesis of five-membered fused N-heterocyclic compounds. The applications of silver in the preparation of five-membered fused N-heterocyclic compounds are covered in this review article.

scholarly journals Perinatal outcome in uncomplicated pregnancies with oligohydramnios

2018 ◽  
Vol 8 (1) ◽  
pp. 215
Author(s):  
Snehal Gaware ◽  
V. B. Bangal
Keyword(s):  
Birth Weight ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Perinatal Outcomes ◽  
Induction Of Labor ◽  
P Value ◽  
Amniotic Fluid Index ◽  
Medical College ◽  
Time Of Admission ◽  
Singleton Pregnancies

Background: Oligohydramnios refers to amniotic fluid volume that is less than expected for gestational age. We aimed to assess the perinatal outcomes in pregnancies with oligohydramnios.Methods: The prospective study was conducted in the Department of Obstetrics and Gynecology, Pravara Medical College, Loni in which 200 consecutive singleton pregnancies delivered vaginally, with intact membranes were included. Amniotic fluid index was determined using the Phelan’s technique at the time of admission and women were diagnosed with oligohydramnios if AFI was five or less, which formed the first group and the rest of mother formed the second group. Perinatal outcomes were noted in the proforma as well.Results: Of the 200 mothers included in the study, 38 had AFI ≤ 5. Baseline characteristics was similar in both the groups. Most common antenatal risk factors studies were pregnancy induced hypertension (29% vs 12%; p value <0.05), intrauterine growth restriction (34% vs 10%; p value <0.001) and severe anemia (21% vs 9%; p value <0.05). Proportion of pregnancies needing induction of labor and birth weight less than 2.5 kgs were significantly higher among mothers with oligohydramnios.Conclusions: Authors observed that induction of labor and low birth weight were significantly associated with oligohydramnios. Prospective randomized trials are needed to establish whether early induction of labor in the presence of a oligohydramnios improves perinatal outcome.

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