Ferritin as a Marker of Severe Dengue in Children

Background: The aim is to evaluate ferritin levels in fever caused by dengue virus and their association with the severity of infection with dengue virus in children. Subjects and Methods: It is a Prospective that was done for 1 year in the department of pediatrics. 56 reported cases with a history of dengue fever for clinical evaluation by positive IgG and IgM antibodies and positive NS1 antigen and were included in the sample. All 16-year-old subjects with clinical dengue suspicion presenting in the department of emergency. Results: Out of total of 56 children with mean age of the children were 11.5 years and SD 3.5 years, and 59% were male who were majority. Mean hospital stay duration was 5 3 days. Most of the patients in study discharged in 5-7 days of admission in hospital. The mean serum ferritin levels among cases with DHF were raised than those with DF with significant p-values of< 0.05 on Day 5 and 6 of illness. During Days 5, 6, and 7 after the onset of fever, the results for sensitivity were 83, 86, and 92 per cent respectively. Conclusion: The incidence of hyperferritinaemia in patients infected with dengue virus is suggestive of highly active use of ferritin level in serum is 1,200 ng/ml as a method for predicting progression to DHF starting on Day 4 of the disease and continuing to recover.

Download Full-text

Correlation of D-Dimer level with outcome in traumatic brain injury

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v17i1.15177 ◽

2016 ◽

Vol 17 (1) ◽

pp. 21-30

Author(s):

Pradip Prasad Subedi ◽

Sushil Krishna Shilpakar

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Hospital Stay ◽

Glasgow Outcome Scale ◽

Significant Proportion ◽

Duration Of Hospital Stay ◽

Icu Stay ◽

The Mean ◽

Hospital Stay Duration ◽

D Dimer

Introduction: Traumatic brain injury (TBI) is a common neurosurgical emergency and a common public health problem with high mortality and long term morbidity. The cost incurred by TBI is immense. The major determinant of outcome following TBI is the severity of the primary injury. However, secondary injuries including coagulopathy are treatable prognostic factors. Many studies have revealed that coagulopathy of trauma depicted by increasing level of D-dimer is associated with poor prognosis in TBI. So, early dectection and correction of such abnormality is very important in management of TBI.Methods: This is a prospective observational study conducted at Department of Surgery TUTH (Tribhuvan University Teaching Hospital), Kathmandu,Nepal over a period of one year. One hundred and forty eight patients of TBI were included in the study. Clinical profile of the patients and D-dimer level were monitored during the hospital course. D-dimer level was correlated with outcome variables including duration of hospital stay, duration of Intensive care unit (ICU) stay and Glasgow outcome scale (GOS).Results: A total of 194 patients were admitted with the diagnosis of traumatic brain injury during the study period and out of them 148 patients were enrolled for the study. Out of 148 patients one hundred and twenty (81.1%) were males and twenty eight (18.9%) were females. The mean age was 29.71±18.07 and the age ranged from 1 to 78 years. Seventy (47.3%) patient were between 21 to 40 years of age. The mean duration of hospital stay was 9.83±13.58 days and the mean duration of ICU stay was 3.78±7.06 days. Contusion was the most common lesion in our patients. Of the patients studied 111 patients (75%) had good recovery with GOS of 5, 9 patients (6.1%) had GOS of 4, 6 patients (4.1%) had GOS of 3, 1 patients (0.7%) had GOS of 2 and 21 patients (14.1%) had GOS of 1. Normal D-dimer was seen in 102 patients (68.9%) and elevated D-dimer in 46 patients (31.1%). Man –Whitney test shows higher D-dimer levels positively correlated with duration of hospital stay, duration of ICU stay and Glasgow Outcome Scale. Pearson chi-square test revealed higher levels of D-dimer correlated with grade of injury but not with mode of injury.Conclusion: D-dimer is elevated in significant proportion of patients with TBI and abnormal D-dimer level is associated with poor outcome in TBI.Journal of Society of Surgeons of Nepal Vol.17(1) 2014: 21-30

Download Full-text

Outcome improvement in cerebral ventriculitis after ventricular irrigation: a prospective controlled study

Journal of Neurosurgery Pediatrics ◽

10.3171/2020.5.peds2063 ◽

2020 ◽

Vol 26 (6) ◽

pp. 682-690

Author(s):

Ahmed Al Menabbawy ◽

Ehab El Refaee ◽

Mohamed A. R. Soliman ◽

Mohamed A. Elborady ◽

Mohamed A. Katri ◽

...

Keyword(s):

Mortality Rate ◽

Hospital Stay ◽

Conventional Group ◽

Controlled Study ◽

Csf Shunt ◽

Duration Of Hospital Stay ◽

Cerebral Ventriculitis ◽

The Mean ◽

Prospective Controlled Study ◽

Hospital Stay Duration

OBJECTIVECerebral ventriculitis remains one of the most challenging neurosurgical conditions, with poor outcome and a long course of treatment and duration of hospital stay. Despite the current conventional management plans, i.e., using antibiotics in addition to CSF drainage, the outcome remains unsatisfactory in some cases, with no definitive therapeutic guidelines. This study aims to compare the outcome of ventricular irrigation/lavage (endoscopic irrigation or the double-drain technique) to conventional currently accepted therapy using just drainage and antibiotics.METHODSThe authors conducted a prospective controlled study in 33 patients with cerebral ventriculitis in which most of the cases were complications of CSF shunt operations. Patients were divided into two groups. Removal of the ventricular catheter whenever present was performed in both groups. The first group was managed by ventricular lavage/irrigation, while the other group was managed using conventional therapy by inserting an external ventricular drain. Both systemic and intraventricular antibiotics were used in both groups. The outcomes were compared regarding mortality rate, modified Rankin Scale (mRS) score, and duration of hospital stay.RESULTSThe mean age of the study population was 5.98 ± 7.02 years. The mean follow-up duration was 7.6 ± 3.2 months in the conventional group and 5.7 ± 3.4 months in the lavage group. The mortality rate was 25% (4/16) in the lavage group and 52.9% (9/17) in the nonlavage group (p = 0.1). The mRS score was less than 3 (good outcome) in 68.8% (11/16) of the lavage group cases and in 23.5% (4/17) of the conventional group (p < 0.05). The mean hospital stay duration was 20.5 ± 14.2 days in the lavage group, whereas it was 39.7 ± 16.9 days in the conventional group (p < 0.05).CONCLUSIONSVentricular lavage or irrigation together with antibiotics is useful in the management of cerebral ventriculitis and associated with a better outcome and shorter hospital stay duration compared to current conventional lines of treatment.

Download Full-text

High Expression of FcγII (CD32) Receptor on Monocytes in Dengue Infected Patients

The Indonesian Biomedical Journal ◽

10.18585/inabj.v10i3.434 ◽

2018 ◽

Vol 10 (3) ◽

pp. 256-62

Author(s):

Umi Solekhah Intansari ◽

Harina Salim ◽

Usi Sukorini ◽

Adika Zhulhi Arjana ◽

Muhammad Juffrie

Keyword(s):

Flow Cytometry ◽

Dengue Virus ◽

Healthy Subjects ◽

Dengue Infection ◽

Absolute Number ◽

Severe Dengue ◽

Cross Sectional ◽

Fluorescent Intensity ◽

The Mean ◽

Cross Sectional Design

BACKGROUND: Pathogenesis of severe dengue infection has not been elucidated. Immune complex of pre-existing antibodies and heterotypic dengue virus bind to FcγII (cluster of differentiation (CD32)) receptor (FcγIIR) on monocyte facilitates entry and replication of dengue virus. Aim of this study was to evaluate the expression of FcγIIR on monocytes in patients infected with dengue and in healthy subjects.METHODS: This study used a cross-sectional design that included patients infected with dengue who were hospitalized in Dr. Sardjito General Hospital, Panembahan Senopati Hospital, and Sleman Hospital, who met the inclusion criteria and selected consecutively. Examinations were completed using a lyse, no-wash method of flow cytometry. Computerized statistical analysis was conducted and was considered to be significant if p<0.05.RESULTS: Sixty-five study subjects were divided into healthy subjects (24 subjects) and patients with dengue infection (41 subjects). There were no significant differences in hemoglobin (Hb) and hematocrit (Hct) values between the groups, but differences were found in the number of leukocytes, absolute number of monocytes and platelet count (p<0.001, 0.002 and <0.001, respectively). The mean expression of FcγIIR monocytes in patients with dengue infection (208.77±32.06 median fluorescent intensity (MFI)) and the healthy subjects (124.03±47.76 MFI) with p<0.0001.CONCLUSION: The mean expression of FcγIIR monocytes in patients with dengue infection was higher than in healthy subjects.KEYWORDS: dengue infection, FcγII (CD32) receptor monocyte, flow cytometry

Download Full-text

Correlation of serum level and selective blood indices in children with feberile seizures in Chittoor district, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20202079 ◽

2020 ◽

Vol 7 (6) ◽

pp. 1337

Author(s):

Rajesh Kumar V. ◽

Ande Penchalaiah

Keyword(s):

Serum Ferritin ◽

Iron Status ◽

Ferritin Level ◽

Febrile Seizures ◽

Blood Indices ◽

Pediatric Age Group ◽

Iron Deficient ◽

History Of ◽

The Mean ◽

The Brain

Background: A seizure or convulsion is a paroxysmal, time-limited change in motor activity and/or behavior that result from abnormal electrical activity in the brain. Seizures are common in the pediatric age group and occur in approximately 10% of children. Most seizures in children are provoked by somatic disorders originating outside the brain, such as high fever, infection, syncope, head-trauma, hypoxia, toxins, or cardiac arrhythmias. To study the association between iron deficiency and the first febrile seizure.Methods: The present study is a retrospective study conducted at the teaching hospital, Chittoor district from August 2019 to December 2019. In this study to detect low iron status as a possible risk factor for first febrile seizures, 63 cases, and 63 age and sex-matched controls are studied and analyzed.Results: In this study family history of febrile seizures is seen only in 28.5% of cases. The mean serum ferritin level in this study is 14.5ng/ml. Thus the mean serum ferritin, HB, and MCV are found to be signed on the lower side among children with febrile seizures.Conclusions: Plasma ferritin level and blood indices are significantly lower in children with febrile seizures as compared to children without febrile seizures suggesting that iron-deficient children are more prone to febrile seizures.

Download Full-text

The effectiveness of early anticoagulant treatment in Covid-19 patients

Phlebology The Journal of Venous Disease ◽

10.1177/0268355520975595 ◽

2020 ◽

pp. 026835552097559

Author(s):

Yakup Arslan ◽

Gulden Yilmaz ◽

Deniz Dogan ◽

Mine Hasirci ◽

Hatice Cetindogan ◽

...

Keyword(s):

Hospital Stay ◽

Disease Onset ◽

Length Of Hospital Stay ◽

Anticoagulant Treatment ◽

P Values ◽

Treatment Groups ◽

Before And After ◽

Comparative Cohort Study ◽

The Mean ◽

Higher Doses

Objectives Coronavirus disease 2019 (Covid-19) is an emerging, fast-spreading and worldwide infectious disease that would be deteriorated with the precipitation of systemic or local thrombosis. The aim of current study was evaluating the effects of early anticoagulant treatment in hospitalized Covid-19 patients. Method The present retrospective and comparative cohort study investigated 413 hospitalized Covid-19 patients treated with or without Low Molecular Weight Heparin (LMWH) (n = 187 and 226, respectively) in the Covid Clinics of Gulhane Education and Research Hospital in Ankara, Turkey, between March 18 and May 03, 2020. The treatment groups were consisted of the patients evaluated before and after The Covid-19 Treatment Guide update on April 12, 2020 that included the anticoagulant treatment thereafter. Results The mean age of all 413 patients (204 male and 209 female) at disease onset was 50.6 ± 16.7 years. The LMWH-treated patients had significantly higher coagulation markers such as d-dimer and platelet count than LMWH-untreated patients (p values < 0.05). The inflammatory markers, ferritin, interleukin-6 and procalcitonin were significantly increased in LMWH-untreated patients (p values < 0.05). The presence of any comorbidity was significantly more common in LMWH-treated patients compared to LMWH-untreated group (39.6% vs 19.9%, respectively; p < 0.001). Hypertension and diabetes mellitus were the most frequent comorbidities in both groups. The number of intensive care unit (ICU) transfer and longer length of hospital stay were more commonly observed in LMWH-untreated patients (p values <0.05). Conclusions Early anticoagulant treatment with relatively higher doses of LMWH may improve the clinical outcome of Covid-19 patients and shorten the length of hospital stay.

Download Full-text

The Effects of Previous Renal Stone Surgery on Percutaneous Nephrolithotomy Outcomes

Grand Journal of Urology ◽

10.5222/gju.2021.47966 ◽

2021 ◽

Author(s):

Joshgun Hüseynov ◽

Nadir Kalfazde ◽

Ekrem Güner

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Percutaneous Nephrolithotomy ◽

Renal Stone ◽

Intraoperative Blood Loss ◽

Significant Difference ◽

History Of ◽

Renal Stone Surgery ◽

The Mean ◽

Free Status

Objective: We aimed to compare outcomes of percutaneous nephrolithotomy (PNL) surgery in patients who had and had not undergone renal stone surgery before PNL. Material and Methods: We retrospectively analyzed the medical records of all patients who underwent PNL in our department between 2010 and 2019. Examined parameters consisted of patient demographics, medical and surgical history, stone size, stone density, stone site, estimated intraoperative blood loss, duration of operation, hospital stay and stone-free status. Results: A total of 193 patients were included the study. The mean age of the patients was 45±13 years. The mean duration of surgery was 69±11.5 minutes. The mean stone area was 720.2±600.4 mm2 and the mean stone attenuation was 982.8±327.7 HU. The mean postoperative hemoglobin decrease was 1.8±1.3 g/dL. 66 patients had previous stone surgery including open stone surgery, PNL and retrograde intrarenal surgery (RIRS). There was no statistically significant difference between patients who had and had not previousşy undergone renal stone surgery in terms of age, gender, body mass index and stone area. Operative time, estimated intraoperative blood loss, postoperative hemoglobin decreases and hospital stay were comparable between patients who had, and hed not undergone previous renal stone surgery. Stone-free rate was significantly higher in primary PNL patients compared to patients with a history of renal stone surgery (92.1% vs 77.3%, p=0.006). Conclusion: PNL has a similar complication rate in patients with and without previous kidney stone surgery. However, achieving stone-free status may be challenging in patients with a history of ipsilateral renal stone surgery.

Download Full-text

Emergence and Autochthonous Transmission of Dengue Virus Type I in a Low-Epidemic Region in Southeast China

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2021.638785 ◽

2021 ◽

Vol 11 ◽

Author(s):

Yi Zhang ◽

Hongyi Chen ◽

Jingen Wang ◽

Shumei Wang ◽

Jing Wu ◽

...

Keyword(s):

Dengue Virus ◽

Dengue Fever ◽

Rapid Test ◽

Febrile Illness ◽

Severe Dengue ◽

Type I ◽

Dengue Outbreaks ◽

Ns1 Antigen ◽

And Control ◽

Autochthonous Transmission

BackgroundDengue fever is a mosquito-borne febrile illness. Southeast Asia experienced severe dengue outbreaks in 2019, and over 1000 cases had been reported in Jiangxi, a previously known low-epidemic region in China. However, the emergence of a dengue virus epidemic in a non-epidemic region remains unclear.MethodsWe enrolled 154 dengue fever patients from four hospitals in Jiangxi, from April 2019 to September 2019. Real-time PCR, NS1 antigen rapid test, and IgM, IgG tests were performed, and 14 samples were outsourced to be sequenced metagenomically.ResultsAmong the 154 cases, 42 were identified as imported and most of them returned from Cambodia. A total of 113 blood samples were obtained and 106 were identified as DENV-1, two as DENV-2, and five were negative through RT-PCR. All DENV-1 strains sequenced in this study were all classified to one cluster and owned a high similarity with a Cambodia strain isolated in 2019. The evolutionary relationships of amino acid were consistent with that of nucleotide genome result. The sequence-based findings of Jiangxi strains were consistent with epidemiological investigation.ConclusionEpidemiological analysis demonstrated that the emergence of dengue cases led to autochthonous transmission in several cities in Jiangxi, a low-epidemic region before. This study emphasized future prevention and control of dengue fever in both epidemic and non-epidemic regions.

Download Full-text

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽

10.1024/1023-9332.8.6.255 ◽

2002 ◽

Vol 8 (6) ◽

pp. 255-258 ◽

Cited By ~ 28

Author(s):

Perruchoud ◽

Vuilleumier ◽

Givel

Keyword(s):

Hospital Stay ◽

Pilonidal Sinus ◽

Primary Closure ◽

Average Length ◽

Length Of Hospital Stay ◽

Healing Time ◽

Incision And Drainage ◽

The Mean ◽

Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

Download Full-text

Revisiting the Natural History of Chronic Scaphoid Nonunions: A Retrospective Study of 20 Cases

Journal of Wrist Surgery ◽

10.1055/s-0040-1721435 ◽

2021 ◽

Author(s):

J. Terrence Jose Jerome

Keyword(s):

Retrospective Study ◽

Natural History ◽

Functional Outcome ◽

Grip Strength ◽

Scaphoid Nonunion ◽

Proximal Pole ◽

Degenerative Arthritis ◽

Level Of Evidence ◽

History Of ◽

The Mean

Abstract Background The natural history of scaphoid nonunion is the development of degenerative arthritis. A lot of information is still unclear about this progression. The purpose of this study is to analyze patients with scaphoid nonunions who had not received any kind of treatment and to assess the functional outcome. Materials and Methods This is a retrospective study that analyzed the patients with chronic scaphoid nonunions between 2009 and 2019. None of the patients received any treatment. The age at the time of injury, examination, pattern of fracture, types of scaphoid nonunion, symptoms, and duration of nonunion were noted. Diagnosis was confirmed by radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Scapholunate and radiolunate angles were recorded. Pain score, modified mayo wrist score, grip strength, range of movement, and the functional outcome of these scaphoid nonunions were analyzed. A statistical correlation between the scaphoid nonunion presentations and the functional outcome was assessed. Results The mean age of the patients was 62 years (range: 35–82 years.). There were 17 male and 3 female patients. There were 9 waist and 11 proximal pole scaphoid nonunions. The mean duration of scaphoid nonunion was 34 years (range: 10–62 years). None of the patients had avascular necrosis (AVN) of the proximal scaphoid. The age at examination, gender, side of injury, fracture pattern (waist/proximal pole), fracture displacement ≤ 1 mm or > 1 mm, nonunion duration, and radiographic arthritic parameters had no significant impact on the functional outcome. Conclusions Untreated chronic scaphoid nonunion leads to the development of degenerative arthritis over a period of years, which is still unpredictable. Most of the patients become aware of the nonunion following a precedent injury or other reasons. Most of the patients have fair/good functional outcome despite reduced range of movements and grip strength. Many do not favor surgical intervention in the course of nonunion. Chronic nonunions open a lot of unanswered questions. Clinical relevance There have been numerous studies on the treatment aspects of scaphoid nonunion, with little knowledge about certain people with nonunion who did not have any kind of treatment. The demographics, clinical findings, and radiological parameters do confirm the progression of these nonunion to arthritis, but most of them had fair-to-good outcome throughout their life. It opens our thinking about the real need of treatment in such nonunions and raises numerous questions about the disease. Level of evidence This is a Level IV study.

Download Full-text