Perforazione ileale da febbre tifoide

2021 ◽  
Vol 24 (9) ◽  
pp. 280-282
Author(s):  
Margherita Piqué ◽  
Elisabetta Ladisa ◽  
Luca Brasili ◽  
Giovanni Putoto ◽  
Lorenzo Iughetti
Keyword(s):  
Typhoid Fever ◽  
Public Health Problem ◽  
Wound Dehiscence ◽  
Exploratory Laparotomy ◽  
Watery Diarrhoea ◽  
Pelvic Cavity ◽  
Major Public Health Problem ◽  
General Malaise ◽  
X Ray ◽  
Clinical Conditions

Typhoid fever continues to be a major public health problem in developing countries and mortality is mainly related to its most frequent complication, namely: intestinal perforation. The paper presents the case of a 12-year-old girl with abdominal pain associated with watery diarrhoea, vomiting, fever and general malaise for two weeks. Typhoid fever was suspected, therefore therapy with ceftriaxone was started. Clinical conditions were worsening, so X-ray of the abdomen was performed with evidence of hydro-aerial levels and ultrasound showing abundant non-homogeneous echogenic material in the pelvic cavity, consistent with purulent ascites. Exploratory laparotomy was performed showing an isolated perforation of the ileus, which was sutured. In the postoperative period, antibiotic therapy was boosted with metronidazole and gentamicin. Due to the wound dehiscence, surgical revision with secondary tension sutures was necessary.

scholarly journals Multidrug-resistant typhoid fever: a review

2011 ◽  
Vol 5 (05) ◽  
pp. 324-337 ◽  
Author(s):  
Syed Ahmed Zaki ◽  
Sunil Karande
Keyword(s):  
Public Health ◽  
Typhoid Fever ◽  
English Language ◽  
Public Health Problem ◽  
Public Health Education ◽  
Abdominal Distension ◽  
Clinical Results ◽  
Multidrug Resistant ◽  
Major Public Health Problem ◽  
Handling Practices

Introduction: Multidrug-resistant typhoid fever (MDRTF) is defined as typhoid fever caused by Salmonella enterica serovar Typhi strains (S. Typhi), which are resistant to the first-line recommended drugs for treatment such as chloramphenicol, ampicillin and trimethoprim-sulfamethoxazole. Since the mid-1980s, MDRTF has caused outbreaks in several countries in the developing world, resulting in increased morbidity and mortality, especially in affected children below five years of age and those who are malnourished. Methodology: Two methods were used to gather the information presented in this article. First PubMed was searched for English language references to published relevant articles. Secondly, chapters on typhoid fever in standard textbooks of paediatric infectious diseases and preventive and social medicine were reviewed. Results: Although there are no pathognomonic clinical features of MDRTF at the onset of the illness, high fever ( > 104°F), toxaemia, abdominal distension, abdominal tenderness, hepatomegaly and splenomegaly are often reported. The gold standard for the diagnosis of MDRTF is bacterial isolation of the organism in blood cultures. Ciprofloxacin and ceftriaxone are the drugs most commonly used for treatment of MDRTF and produce good clinical results. Conclusion: MDRTF remains a major public health problem, particularly in developing countries. Mass immunization in endemic areas with either the oral live attenuated Typhi 21a or the injectable unconjugated Vi typhoid vaccine, rational use of antibiotics, improvement in public sanitation facilities, availability of clean drinking water, promotion of safe food handling practices and public health education are vital in the prevention of MDRTF. 

scholarly journals A study on awareness on tuberculosis among urban slum population of Hyderabad

2020 ◽  
Vol 7 (12) ◽  
pp. 4941
Author(s):  
Sai Ram A. ◽  
Rama Krishna M. N. ◽  
Sunil Pal Singh C.
Keyword(s):  
Public Health Problem ◽  
Signs And Symptoms ◽  
Urban Slum ◽  
Major Public Health Problem ◽  
Community Based ◽  
Cross Sectional ◽  
X Ray ◽  
Slum Dwellers ◽  
Inappropriate Treatment ◽  
Data Compilation

Background: Tuberculosis a major public health problem in India with highest burden of cases. India accounts for about 24% of global prevalence, 23% of the global incidence cases and 21% of global TB deaths. Irregular and inappropriate treatment of persons with active TB, unawareness about TB symptoms and treatment course, illiteracy, may be the major hurdles for TB eradication.Methods: A cross sectional, community based study was conducted in urban slum dwellers (n=153). Data compilation and analysis: All the data collected was entered and analyzed with MS excel software 2007 and Epi info 3.5.3. All tests were considered significant at p<0.05 level.Results: 18.3% told that cough+expectoration+evening rise of temperature+weight loss are the signs and symptoms of TB. 55.5% know that it spreads through cough and sneezing mixed with air. 23.5% knows blood examination, sputum examination, x-ray is the mode of diagnosis of TB.Conclusions: Literacy plays major role in creating awareness on TB.

scholarly journals The Effectiveness and Safety of Favipiravir in COVID-19 Hospitalized Patients in Bali, Indonesia

2021 ◽  
Vol 16 (4) ◽  
Author(s):  
Herni Damayanti ◽  
I Gede Ketut Sajinadiyasa ◽  
Rani Sauriasari
Keyword(s):  
Public Health ◽  
Adverse Events ◽  
Public Health Problem ◽  
Hospitalized Patients ◽  
Major Public Health Problem ◽  
Serious Adverse Events ◽  
Respiratory Problems ◽  
Public Health Burden ◽  
Appropriate Treatment ◽  
Clinical Conditions

COVID-19 is a major public health problem, with still questionable specific cure. Favipiravir is a COVID-19 antiviral that is included in several drugs, potentially a therapy for COVID-19. This study aimed to analyze its efficacy and safety in moderate to critical hospitalized patients. This study was a retrospective cohort in Denpasar City, Bali Province, Indonesia, from August 2020 to January 2021. There was a total of 192 patients; 96 patients in the favipiravir group and 96 patients in the non-favipiravir group (remdesivir/oseltamivir). Effectivity was measured by assessing the clinical condition at the end of the isolation period of 14 days. The favipiravir group showed better clinical conditions than the non-favipiravir group (79.2% vs. 56.3%; aRR 2.196; 95% CI = 1.084 – 4.451, p=0.029), seen from being free of fever and respiratory problems. Stratification analysis demonstrated that the clinical improvement was significantly different in the severe/critical group in favor of favipiravir (RR 1,573; 95% CI = 1.139-2.172). The most common non-serious adverse events (AE) found in the use of favipiravir were gastrointestinal disturbances (12.5%). In conclusion, favipiravir is effective in severe/critical cases, and no serious adverse events were found in its use. Appropriate treatment is expected to help in reducing the public health burden.

scholarly journals Typhidot IgM as a reliable and rapid diagnostic test for typhoid fever among children in a tertiary care hospital

2020 ◽  
Vol 7 (8) ◽  
pp. 1677
Author(s):  
Mohammad Ashfaque Ansari ◽  
Amit Kumar Thakur ◽  
Atindra Mishra ◽  
Md Jaffer Rain
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Predictive Value ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Antibiotics Resistance ◽  
Major Public Health Problem ◽  
Care Hospital

Background: Typhoid fever still continues to be a major public health problem in Nepal. A clinical spectrum of typhoid varies widely. It causes significant complication as well as mortality. A simple, reliable, affordable and rapid diagnostic test has been a long felt need of the clinicians to prescribe specific medication, adopt prevention of the emergence of antibiotics resistance and overall reduce the disease burden in the community.Methods: The prospective descriptive study was performed in 125 children between 2 years to 15 years of age admitted to the Pediatrics Department from September 2017 to September 2018. Blood culture, Typhidot rapid IgM were performed. MEDCALC software was used to calculate 95% confidence interval for sensitivity, specificity, predictive value positive, predictive value negative and accuracy. Kappa test was used to determine the agreement between Typhidot IgM and blood culture methods.Results: The study consisted of 125 children with acute febrile illness for more than 3 days with clinical symptomatology, consistent with typhoid fever. The reliability of Typhidot IgM in relation with blood culture and the study lighten that sensitivity 92.3% (95% CI: 63.9, 99.8), specificity 49.1% (95% CI: 39.5, 58.7), PPV 17.4% (95% CI: 14.2, 21.1), NPV 98.2% (95% CI: 89.2, 99.7) and accuracy 53.6% (95% CI: 44.5, 62.6). The two methods i.e. Typhoid IgM and blood culture shows significant agreement with p value 0.004.Conclusions: The present study demonstrates that Typhidot IgM has all the attributes of an ideal screening test.

scholarly journals A study on clinical profile of typhoid fever in children

2017 ◽  
Vol 4 (3) ◽  
pp. 1067
Author(s):  
Ranganatha A. Devaranavadagi ◽  
Srinivasa S.
Keyword(s):  
Public Health ◽  
Typhoid Fever ◽  
Clinical Manifestations ◽  
Antibiotic Sensitivity ◽  
Public Health Problem ◽  
Public Health Issue ◽  
Common Symptom ◽  
Major Public Health Problem ◽  
Sensitivity Pattern ◽  
Wide Range

Background: Typhoid fever is caused by Salmonella typhi. It is a major public health problem in India. Typhoid fever is endemic in many developing countries. Wide variations in the clinical manifestations of typhoid fever make its diagnosis a challenging task. This study was conducted to understand the wide range of clinical manifestations, complications and antibiotic sensitivity patterns of typhoid fever in children.Methods:Prospectively, 113 children admitted in pediatric unit with confirmed Typhoid fever from September 2015 to December 2016 at KIMS hospital, Bangalore were included. In each case, age, sex, presenting complaint, laboratory investigations and antibiotic sensitivity pattern are collected and analysed.Results: Out of 113 cases, 72 cases (63.8.1%) were males, 41 cases (36.2%) were females. The most common age group was 5-10 years. The most common symptom was fever, seen in 100% cases, followed by anorexia (61%), vomiting (44%) and abdominal pain (18%). The most common sign observed was toxic look in 68% of the cases, followed by coated tongue in 49% and hepatomegaly in 44%. Leucocytopenia was found in 34% of cases. Eosinopenia was found in 39% of cases. Anaemia was found in 16% of cases. Thrombocytopenia was found in 15% of cases. Blood culture was positive in 20% of cases. Use of municipal water for drinking was found in 65% of cases. Outside eating was found in 40% of cases. Unhygienic practices were found in 64% of cases. Duration of hospital stay varied from 3-10 days. No mortality reported.Conclusions:Typhoid fever is most commonly observed with unhygienic practices and eating of unhealthy outside food. This major public health issue can be tackled by bringing awareness among people regarding disease transmission and its various preventive measures. 

The status of strontium in biological apatites: an XANES investigation

2011 ◽  
Vol 18 (6) ◽  
pp. 912-918 ◽  
Author(s):  
D. Bazin ◽  
M. Daudon ◽  
Ch. Chappard ◽  
J. J. Rehr ◽  
D. Thiaudière ◽  
...  
Keyword(s):  
Bone Matrix ◽  
Public Health Problem ◽  
Fragility Fractures ◽  
Local Environment ◽  
Major Public Health Problem ◽  
Structural Description ◽  
Edge Structure ◽  
X Ray ◽  
The Status ◽  
Preparation Mode

Osteoporosis represents a major public health problem and increases patient morbidity through its association with fragility fractures. Among the different treatments proposed, strontium-based drugs have been shown to increase bone mass in postmenopausal osteoporosis patients and to reduce fracture risk. While the localization of Sr2+cations in the bone matrix has been extensively studied, little is known regarding the status of Sr2+cations in natural biological apatite. In this investigation the local environment of Sr2+cations has been investigated through XANES (X-ray absorption near-edge structure) spectroscopy in a set of pathological and physiological apatites. To assess the localization of Sr2+cations in these biological apatites, numerical simulations using theab initioFEFF9X-ray spectroscopy program have been performed. The complete set of data show that the XANES part of the absorption spectra may be used as a fingerprint to determine the localization of Sr2+cationsversusthe mineral part of calcifications. More precisely, it appears that a relationship exists between some features present in the XANES part and a Sr2+/Ca2+substitution process in site (I) of crystal apatite. Regarding the data, further experiments are needed to confirm a possible link between the relationship between the preparation mode of the calcification (cellular activity for physiological calcification and precipitation for the pathological one) and the adsorption mode of Sr2+cations (simple adsorption or insertion). Is it possible to draw a line between life and chemistry through the localization of Sr in apatite? The question is open for discussion. A better structural description of these physiological and pathological calcifications will help to develop specific therapies targeting the demineralization process in the case of osteoporosis.

scholarly journals Assessing the Impact of Drug Resistance on the Transmission Dynamics of Typhoid Fever

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
S. Mushayabasa ◽  
C. P. Bhunu ◽  
E. T. Ngarakana-Gwasira
Keyword(s):  
Public Health ◽  
Mathematical Model ◽  
Drug Resistance ◽  
Typhoid Fever ◽  
Public Health Problem ◽  
Transmission Dynamics ◽  
Reproductive Number ◽  
Major Public Health Problem ◽  
Drug Resistant ◽  
The Impact

Typhoid fever continues to be a major public health problem in the developing world. Antibiotic therapy has been the main stay of treating typhoid fever for decades. The emergence of drug-resistant typhoid strain in the last two decades has been a major problem in tackling this scourge. A mathematical model for investigating the impact of drug resistance on the transmission dynamics of typhoid fever is developed. The reproductive number for the model has been computed. Numerical results in this study suggest that when a typhoid outbreak occurs with more drug-sensitive cases than drug-resistant cases, then it may take 10–15 months for symptomatic drug-resistant cases to outnumber all typhoid cases, and it may take an average of 15–20 months for nonsymptomatic drug-resistant cases to outnumber all drug-sensitive cases.

scholarly journals ASSESSMENT OF CLINICAL AND LABORATORY PARAMETERS IN TYPHOID FEVER IN PEDIATRIC CASES ADMITTED TO NMCH, PATNA

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Samiksha Sharma ◽  
Girijanand Jha ◽  
Binod Kr Singh ◽  
Saroj Kumar
Keyword(s):  
Developing Countries ◽  
Typhoid Fever ◽  
Clinical Laboratory ◽  
Positive Culture ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Serological Tests ◽  
Laboratory Parameters ◽  
Medical College ◽  
Pediatric Age Group

India has a very high disease burden (214.2 per 1,00,000 individuals/year), primarily affecting children 5 to 15 years. Recently, there have been concerns of increasing proportion of infections in very young children, rising paratyphoid infections, and emerging drug resistance. Also, there are challenges in diagnosis and management of enteric fever due to lack of laboratory-based investigations. While blood culture remains the gold standard of diagnosis, the mainstays in developing countries are serological tests, which are suboptimal due to lack of standardization and uniformity. Hence based on above condition the present study was planned for Assessment of Clinical and Laboratory Parameters in Typhoid Fever in Pediatric Cases Admitted to NMCH, Patna. The present study was planned in Department of Pediatrics, Nalanda Medical College and Hospital, Patna, Bihar, India. The study was planned from January 2018 to November 2018. In the present study 50 childrens of age up to 18 years having fever more than 7 days were enrolled. These cases were enrolled based on the Widal positive or positive culture were enrolled in the present study. The data generated from present study concludes that Typhoid fever manifestations are diverse. The most common symptoms apart from fever were anorexia, vomiting, pain abdomen, diarrhoea followed by headache and cough. Also the Serum parameters are also seen changed in the Thyphoid affected patients. Typhoid fever remains a major public health problem in the developing countries predominantly seen in school going children among pediatric age group. Keywords: Clinical, Laboratory Parameters, Typhoid Fever, Pediatric Cases, etc.

scholarly journals Evaluation of Typhidot (IgM) for Early Diagnosis of Typhoid Fever

2009 ◽  
Vol 3 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Zohra Begum ◽  
Md Akram Hossain ◽  
AKM Shamsuzzaman ◽  
Md Monjurul Ahsan ◽  
AKM Musa ◽  
...  
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Predictive Value ◽  
Serological Test ◽  
Public Health Problem ◽  
Salmonella Typhi ◽  
Major Public Health Problem ◽  
Medical College ◽  
Sensitivity Specificity ◽  
Culture Positive

Typhoid fever still continues to be a major public health problem, particularly in many developing countries. A simple, reliable, affordable and rapid diagnostic test has been a long-felt need of the clinicians. We, therefore, prospectively evaluated the sensitivity and specificity of Typhidot (IgM), a serological test to identify IgM antibodies against Salmonella typhi. The study was carried out in the department of Microbiology, Mymensingh Medical College, Mymensingh between June, 2006 and July, 2007, on a total of 100 samples from clinically suspected patients to have typhoid fever. Blood culture as well as Typhidot test were performed for each of the cases. Out of 100 clinically diagnosed typhoid fever, 14 were blood culture positive for S. typhi and 73 were Typhidot (IgM) positive. Among 14 culture positive cases, 13 (92.85%) were Typhidot (IgM) positive. The test was also positive in 04 (20%) out of 20 febrile controls. None of the healthy controls was positive by Typhidot (IgM). The sensitivity, specificity, positive predictive value and negative predictive value of the test using blood culture as gold standard were 92.85%, 90.00%, 76.47% and 97.29% respectively for typhoid fever. Typhidot (IgM) test is rapid, easy to perform and reliable test for diagnosing typhoid fever, and useful for small, less equipped laboratories as well as for the laboratories with better facilities. Key words: Typhoid fever, Salmonella typhi, Typhidot (IgM) test   doi: 10.3329/bjmm.v3i1.2964 Bangladesh J Med Microbiol 2009; 03 (01): 10-13

scholarly journals All Members of a Single Family including a 5-Months Old Infant having Tuberculosis - A Case Report

1970 ◽  
Vol 6 (2) ◽  
pp. 38-42
Author(s):  
EUA Chowdhury ◽  
MN Huq ◽  
F Parveen
Keyword(s):  
Family Members ◽  
Public Health Problem ◽  
Mantoux Test ◽  
Socioeconomic Background ◽  
Screening Methods ◽  
Feeding Practice ◽  
Major Public Health Problem ◽  
Close Monitoring ◽  
X Ray ◽  
Chest X Ray

Introduction : The incidence and number of tuberculosis (TB) cases have been increased dramatically all over the world. It is a major public health problem in Bangladesh too. Case Summary : A 5-months old male infant, immunized as per EPI schedule, 3rd issue of a nonconsanguinous parents residence at downtown, Dhaka from a poor socioeconomic background was admitted into the Paediatrics ward, Bangladesh Medical College Hospital on 11th March 2004 with fever for 1 month, dry cough for 21 days, loose motion and vomiting for 14 days. He was weaned from breast milk at 3 months of his age and there was gross malfeeding history. BCG vaccine was given at 6 weeks. His mother had also been suffering from recurrent febrile illnesses and weight loss for many months. Baby was looking ill but conscious, mildly pale, afebrile with no dyspnoea. Z score of wt/age, lth/age, wt/lth and OFC were -2.9, -3.5, -0.3 and -0.3 respectively. Fontanel was open and normal. There was no lymphadenopathy and BCG mark was present. Breath sound was vesicular with fine crepitation on right lung. He was treated initially as septicemia by combined parenteral antibiotics. But response was not satisfactory. Lab data yielded raised ESR, eosinophillia, pyuria and haematuria with sterile culture. Chest X ray was abnormal. Mantoux Test (MT) was found strongly positive (18mm/72hrs.). Other family members were immediately screened for TB and all revealed positive. Complete Blood Count, MT and Chest X ray were chosen as screening methods for them. We treated with anti tubercular therapy to all of them including baby. We also corrected the feeding practice of the patient and kept in close monitoring. He showed remarkable clinical improvement with weight gaining. We discharged him as disseminated tuberculosis with having pulmonary tuberculosis among all other family members and advised for follow up. They all were cured. At present, they are healthy and baby is now 4 years of age with good physical and mental growth. Conclusion : TB can mimic everything. A high index of suspicion by the clinician is essential for early diagnosis. Message: Family members of affected child must be screened for active TB Keywords : Tuberculosis; Tuberculosis in infant; Pan family tuberculosis. DOI: 10.3126/saarctb.v6i2.3056 SAARC J. Tuber. Lung Dis. HIV/AIDS 2009 VI (2) 38-42

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