A Study on Relationship of Thrombocytopenia and Likelihood of Severe Malaria in Patients Admitted With Malaria in a Tertiary Care Hospital of Dakshina Kannada

2019 ◽  
pp. 1-7
Author(s):  
Mukhtarahmed Bendigeri ◽  
Apoorva Panchakshare ◽  
Nazir Attar ◽  
Prakruthi Jaladhar
Keyword(s):  
Renal Failure ◽  
Cerebral Malaria ◽  
Severe Malaria ◽  
Hepatic Dysfunction ◽  
Severe Disease ◽  
Tertiary Care ◽  
Plasmodium Species ◽  
Malarial Parasite ◽  
Severe Thrombocytopenia ◽  
Care Hospital

Background: Malaria continues to be a huge socioeconomic burden despite various measures taken to curb the spread worldwide. It is also a global concern and more so in countries with a resource-limited setting. This inspired us to look at variables that could represent a severe disease in those limited settings, one such parameter being thrombocytopenia in malaria.   Aims and Objectives: To find the relationship between thrombocytopenia and renal failure, hepatic dysfunction and cerebral malaria (severe malaria) and to identify if thrombocytopenia on the first day of admission increases the likelihood of severe malaria. Methods: The study included 85 patients admitted in Yenepoya medical college hospital with fever and peripheral smear or malarial parasite fluorescent test (MPFT) positive for Plasmodium species. Results: A total of 85 patients were included in the study. It was noted that the patients with profound thrombocytopenia (<20,000/ml) on day 1 were more commonly associated with manifestations of severe malaria-like cerebral malaria, renal failure, and jaundice. Platelet count of <50,000/ml was associated with increased incidence of  renal failure, hepatic dysfunction, and cerebral malaria and increased mortality by an odds ratio of 4.37 on multivariate analysis. Conclusions: It was noted in our study that the presence of thrombocytopenia in a case of acute febrile illness increases the probability of malaria. This finding along with clinical suspicion of malaria should entail early treatment initiation. We have also noted that the presence of profound and severe thrombocytopenia was found to have a statistically significant correlation with cerebral malaria, renal failure and jaundice, and increased mortality.

scholarly journals Acute Acute Renal Failure and Hepatic Disfunction in Malaria

2004 ◽  
Vol 43 (151) ◽  
pp. 7-9
Author(s):  
Sanjib Kumar Sharma ◽  
B HK Sharma ◽  
K Shakya ◽  
S Khanuiya ◽  
N Shrestha ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Organ Failure ◽  
Hepatic Dysfunction ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Care Hospital ◽  
Major Health Problem ◽  
Close Observation ◽  
Time Of Presentation

The clinical presentations of severe and complicated malaria vary. The prognosis is poor when associatedwith cerebral malaria and acute renal failure. Clinical profile, biochemical parameters and outcome werestudied in 46 adult patients of malaria admitted in a tertiary care hospital between April 2002 to April2003. The age of the patients ranged from 15 to 60 years. Majority (n=30) of the patients were in age groupof 15 to 34 years. 67% of the patients were from terai belt. Mean duration of febrile illness was 10 days atthe time of presentation. 39% (n=18) patients had hepatic dysfunction and 22% (n=10) had acute renalfailure (ARF) according to WHO criteria. All patients with ARF were oligo-anuric and required dialysissupport. Four patients died of which three were patients with ARF and hepatic dysfunction. Althoughmalaria still remains a major health problem, malarial renal disease has not been formally reported previouslyfrom Nepal. Early initiation of antimalarial therapy, close observation for organ failure and early initiationof dialysis in ARF is instrumental in the recovery of the patient.Key Words: Malaria, Organ Failure.

scholarly journals Hematological changes in patients with malaria in a tertiary care hospital, Multan, Punjab, Pakistan

2021 ◽  
Vol 8 (12) ◽  
pp. 6026
Author(s):  
Naseem Akhter ◽  
Nazishmazari . ◽  
Maliha Asif ◽  
Ahmed Raza Khan ◽  
Umme Habiba ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Plasmodium Species ◽  
Parasite Load ◽  
Malarial Parasite ◽  
Care Hospital ◽  
Significant Difference ◽  
Wbc Count ◽  
Complete Blood Counts ◽  
Hematological Changes ◽  
Patient Department

Background: Malaria is one of the most common human infections and continues to cause significant morbidity and mortality all over the world. To assess and compare the hematological changes in common types of malaria in our patients.Methods: This observational study included 100 diagnosed malaria patients of Multan Medical and Dental college, Multan both from out patient department (OPD) and in-patient department, between March 2020 and March 2021. The diagnosis of malaria was confirmed by thick and thin film stained with Geimsa’s staining for malaria parasite and plasmodium species and the parasite index (MPI) in some cases. Complete blood counts (CBCs) were performed and WBC differential was done on all cases.Results: The most common type of malarial parasite was Plasmodium vivax followed by Plasmodium falciparum and 89% of the patient had thrombocytopenia, 70 % anemia, 23% had leukopenia and 10% had raised WBC count. The mean parasite load was 1.275±0.629%, 20 % of the cases showed neutropenia, 40 % had lymphopenia and 40 % showed monocytopenia. Of all the cases 15 % had neutrophilia, 8 % had lymphocytosis and 5 % had eosinophilia. Thrombocytopenia was slightly more in P. falciparum (58.69%) than P. vivax (30.18%) cases, p>0.05, whereas there was no significant difference in the incidence of anemia in two groups (34.68% vs 33.82%) with p>0.05.Conclusions: P. vivax is the common malarial parasite in our population. Both P. vivax and P. falciparum can cause marked hematological changes including thrombocytopenia, anemia, lymphopenia and monocytopenia.

scholarly journals Clinico-epidemiological features of malaria among children attending a tertiary care hospital: a two year study

2017 ◽  
Vol 4 (5) ◽  
pp. 1781
Author(s):  
Venkata Krishna Munagala ◽  
Ramisetty M. UmaMahesh ◽  
Kandati Jithendra ◽  
Muni Lakshmi Ponugoti ◽  
Mohan Rao Nandam
Keyword(s):  
Severe Malaria ◽  
Falciparum Malaria ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Plasmodium Species ◽  
Health Concern ◽  
Mixed Infections ◽  
Common Symptom ◽  
Care Hospital ◽  
Epidemiological Profile

Background: Malaria caused by Plasmodium species and transmitted by Female anopheles mosquito, still remains as a major public health concern around the world. India is one of the major contributors of malaria cases in South East Asia. Malaria accounts for 205,000 deaths with 55,000 deaths occurring in early childhood. In endemic areas, children under 5 years are particularly susceptible to infection, illness and death. The present study was aimed to study the clinical, epidemiological profile of malaria cases among children (<12 years) attending a tertiary care hospital. We also assessed the complications associated with non-severe and severe malaria. Methods: The study was conducted at a tertiary care hospital for a period of two years and all children <12 years of age diagnosed with malaria were enrolled in the study. The demographic, clinical and laboratory parameters were observed and noted. Cases were categorized into severe and non-severe malaria based on the WHO guidelines.Results: A total of 2420 cases were observed and 250 cases of malaria were diagnosed, of which 136 were p. vivax mono infections, 82 falciparum malaria and 32 had evidence of mixed infections. Males were predominant in the study (58.8%) and 1-5 years was the common age group. Fever was the most common symptom (100%) in all cases and pallor, edema was common in falciparum malaria. jaundice was observed in 62% of mixed infections and altered sensorium in 43% of mixed infections. Severe malaria was observed almost equally in vivax and falciparum cases. Hyperparasitemia, cerebral malaria was common in falciparum cases than vivax. Thrombocytopenia, hypoglycemia and impaired consciousness were more common in mixed infections than falciparum and vivax cases.Conclusions: Present study finally concludes that there is a significant change in the trends of vivax malaria in this region where both species coexist. The spectrum of complications seen in vivax and falciparum follow a similar pattern, then mentioned earlier that complications are less frequently seen in vivax than falciparum malaria. Hence more number of studies is required to generate the differing patterns associated with vivax and compare them with different studies from geographic regions. 

scholarly journals Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany

Infection ◽  
2021 ◽  
Author(s):  
Johanna Koehler ◽  
Barbara Ritzer ◽  
Simon Weidlich ◽  
Friedemann Gebhardt ◽  
Chlodwig Kirchhoff ◽  
...  
Keyword(s):  
High Risk ◽  
Tertiary Care Hospital ◽  
Severe Disease ◽  
Treatment Options ◽  
Tertiary Care ◽  
Antibody Therapy ◽  
Additional Treatment ◽  
Care Hospital ◽  
Cross Sectional ◽  
Asymptomatic Patients

AbstractAdditional treatment options for coronavirus disease (COVID-19) are urgently needed, particularly for populations at high risk of severe disease. This cross-sectional, retrospective study characterized the outcomes of 43 patients with nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with and without treatment using monoclonal SARS-CoV-2 spike antibodies (bamlanivimab or casirivimab/imdevimab). Our results indicate that treatment with monoclonal antibodies results in a significant decrease in disease progression and mortality when used for asymptomatic patients with early SARS-CoV-2 infection.

Frequency of factors leading to acute renal failure in obstetric patients.

2021 ◽  
Vol 28 (05) ◽  
pp. 640-646
Author(s):  
Shaheena Zafar ◽  
Riffat Jaleeel ◽  
Kouser Karim Lodhani
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Serum Creatinine ◽  
Placental Abruption ◽  
Post Partum ◽  
Common Factor ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional

Objective: To determine the frequency of factors leading to acute renal failure in obstetric patients. Study Design: Cross Sectional study. Setting: Department of Obstetrics and Gynecology, Civil Hospital Karachi, Tertiary Care Hospital. Period: July 2015- Jan 2016. Material & Methods: Total 250 women during pregnancy and within 42 days after delivery who were diagnosed as ARF were included. Serum creatinine was done on admission and then after 24 hours of delievery. Those with urine output < 30ml / hour and serum creatinine > 1.5 mg / dl were recruited. All data was recorded on proforma. Results: The average age of the women was 29.36±5.87 years. Post-partum hemorrhage was the important and common factor i.e. 40.4%, followed by placental abruption 25.6%, Severe pre-eclampsia 18.4%, puerperal sepsis 8.4% and eclampsia 7.2%. Conclusion: Ante partum hemorrhage like placental abruption, eclampsia and preeclampsia, and postpartum hemorrhages’ are the major causes of obstetrical ARF. Good antenatal care and provision of universal health facility can prevent this dangerous condition. Though it is a treatable and curable complication, but if not diagnosed and treated timely, it can lead to significant maternal morbidity and mortality.

scholarly journals Cerebral malaria in children : an update

2015 ◽  
Vol 6 (2) ◽  
pp. 45-47
Author(s):  
Mirza Md Ziaul Islam ◽  
M Mizanur Rahman
Keyword(s):  
Cerebral Malaria ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Medical Emergency ◽  
Care Hospital ◽  
Medical College ◽  
Antimalarial Therapy ◽  
Neurological Presentation ◽  
Supportive Management ◽  
Prompt Diagnosis

Cerebral malaria (CM) is the most severe neurological presentation of acute falciparum malaria. It is a medical emergency, the hallmark of which is the presence of coma probably due to diffuse encephalopathy. A compromised microcirculation with sequestration of parasitized erythrocytes is central to the pathogenesis of cerebral malaria. The death is unacceptably high even with effective antimalarials in tertiary care hospital. The mainstay of treatment of cerebral malaria include prompt diagnosis and early institution of effective antimalarial therapy, recognition of complications, and appropriate supportive management in an ICU. Neurological sequlae are increasingly recognized, but further research on the pathogenesis of coma and neurological damage is required to develop other ancillary treatmentsNorthern International Medical College Journal Vol.6(2) 2015: 45-47

scholarly journals Clinico-epidemiological profile of patients admitted with Plasmodium vivax malaria in a tertiary care hospital, Delhi

2018 ◽  
Vol 5 (12) ◽  
pp. 5420 ◽  
Author(s):  
Geeta Yadav ◽  
Geeta Pardeshi ◽  
Neelam Roy
Keyword(s):  
Plasmodium Vivax ◽  
Severe Malaria ◽  
Vivax Malaria ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Fatality ◽  
Care Hospital ◽  
Who Criteria ◽  
Epidemiological Profile ◽  
Safdarjung Hospital

Background: Malaria is an important public health problem in India. Severe and complicated forms of malaria are usually associated with Plasmodium falciparum species. But recently published literature suggests that Plasmodium vivax infection also presents as severe malaria. The objective was to study clinical and epidemiological profile of patients with P. vivax malaria admitted in Safdarjung hospital.Methods: A record based retrospective study was conducted in Vardhman Mahavir Medical College & Safdarjung Hospital, a tertiary care hospital in Delhi. Data were collected from all case records with ICD 10 codes for Malaria (B50-B54) for the year 2011 obtained from Medical Records Department, Safdarjung Hospital and analyzed using SPSS 21.0.Results: A total of 147 case records which had information about the test results for type of malaria infection were reviewed. Out of 147, 89 (60.5%) had P. vivax malaria. Of the 89 patients with P. vivax malaria, 47 (53%) were children and 63 (70.7%) were males. A peak in the number of inpatients was seen in September with median duration of hospital stay of 4 days and case fatality rate of 9%. A total of 56 (63%) patients had one or more severe manifestations of malaria as per WHO criteria. The most common severe manifestation was bleeding 27 (30%) followed by impaired consciousness 18 (20%).Conclusions: In more than half of the malaria patients admitted at the tertiary care centre the diagnosis was P. vivax malaria. Of them 63% patients had severe malaria as per WHO criteria.

scholarly journals Role of BAP 65 (Blood Urea Nitrogen, Altered Mental Status, Pulse, Age 65 Years) Scoring System in Risk Stratification of Patients with Acute Exacerbation of Chronic Obstructive Lung Disease in Tertiary Care Hospital

2019 ◽  
Vol 2 (2) ◽  
pp. 5-10
Author(s):  
Ashish Thapa
Keyword(s):  
Mechanical Ventilation ◽  
Acute Exacerbation ◽  
Severe Disease ◽  
Tertiary Care ◽  
Chronic Obstructive Lung Disease ◽  
Institutional Review Boards ◽  
Mortality Data ◽  
Chronic Obstructive ◽  
P Value ◽  
Care Hospital

Introduction: Exacerbations are important events in the management of COPD because they negatively impact health status, rates of hospitalization and readmission, and disease progression. COPD AE is one of the commonest case presenting to the TUTH Emergency, average being 5 patients a day. The aim of the study was to co-relate the BAP 65 score, mortality and mechanical ventilation in patients with acute exacerbation of COPD. Methods: It was an observational study, 648 patients from emergency of TUTH were screened for the study from Magh 2073 to Asar 2074 after getting approval from the institutional review boards, among them 114 were included after applying inclusion and exclusion criteria and BAP 65 score was calculated. The patients were followed till discharge, mechanical ventilation or mortality. Data entry was done in MS EXCEL and statistical analysis was done using SPSS version 24. Results: Total of 114 patients enrolled for the study from the emergency of TUTH. There were total 16 mortality and 12 patients were mechanically ventilated. Most of the mortality and mechanical ventilation were from severe group ie BAP class IV and V. We used Pearson Chi-squared test to compare between BAP 65 class and Mortality, and found that mortality rate increased with increasing BAP 65 class with a p value of < 0.0001. The need of Mechanical Ventilation increased as well, as the BAP 65 Class increased, less than 1% of the patients with BAP class I needed MV, the cause being Type II Respiratory Failure, while around 50% of the patients with BAP class V needed MV. Conclusions: BAP 65 score is an effective and simple tool to classify the patients presenting with AECOPD, it correlated well with both the need of mechanical ventilation and mortality. Higher the score higher the chances of severe disease.

scholarly journals THROMBOCYTOPENIA

2011 ◽  
Vol 18 (01) ◽  
pp. 75-79
Author(s):  
ATIF SITWAT HAYAT ◽  
MOHAMMAD SAEED SIDDIQUI ◽  
NAILA SHAIKH ◽  
Muqeet Ullah
Keyword(s):  
Plasmodium Falciparum ◽  
Falciparum Malaria ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Blood Film ◽  
Falciparum Infection ◽  
Common Symptom ◽  
Severe Thrombocytopenia ◽  
Care Hospital ◽  
Cell Counts

Background: Malaria is usually associated with reduction in blood cell counts and mild to moderate thrombocytopenia is a common feature of falciparum infection. This study has been conducted to find out frequency and degree of thrombocytopenia in patients suffering from falciparum malaria at a tertiary care hospital of Abbottabad. Methods: It was a descriptive case-control study being carried out at Ayub teaching hospital and Northern institute of Medical Sciences (NIMS) Abbottabad over a period of ten months. All patients with acute febrile illness without localizing signs were considered for study. A total 250 patients having falciparum malaria diagnosed by peripheral blood film examination have been studied. Complete blood counts were performed by Automated Beckman Coulter Analyzer. Blood films were examined by clinical pathologist for plasmodium falciparum via light microscopy using oil-immersion lens. Results: Out of 250 patients, 155(62%) were females and 95(38%) males with M:F ratio of 1:1.5. Mean age was 36±1.2 years (range 17-58 years). Out of 250, 175(70%) had thrombocytopenia (p<0.05) while 75(30%) had normal platelet counts. Thus mild, moderate and severe thrombocytopenia had been observed in 121(48.4%), 41(16.4%) and 13(5.2%) respectively (p<0.05). Fever appeared to be most common symptom observed in all patients (100%) followed by vomiting and nausea (88%). Anemia was the commonest sign present (80%) during our study. Conclusions: We discovered high frequency of mild thrombocytopenia in falciparum malaria. Therefore, thrombocytopenia can be supportive in diagnosis of plasmodium falciparum infection.

scholarly journals Predictors of mortality in adult patients with dengue: a study from South India

2018 ◽  
Vol 6 (5) ◽  
pp. 1605 ◽  
Author(s):  
Vasudeva Acharya ◽  
Mohammed Fahad Khan ◽  
Srinivas Kosuru ◽  
Sneha Mallya
Keyword(s):  
Renal Failure ◽  
Prothrombin Time ◽  
Tertiary Care ◽  
P Value ◽  
Bleeding Tendency ◽  
Care Hospital ◽  
Laboratory Parameters ◽  
Prolonged Prothrombin Time ◽  
Risk Of Death ◽  
Increased Risk

Background: Dengue is one of the important causes of acute febrile illnesses in India. Dengue can be a fatal disease, however there are no reliable markers which can predict mortality among these patients.Methods: A prospective cross sectional study was done in patients who were admitted to a tertiary care hospital with features of dengue fever. A total of 364 patients with IgM dengue serology positive were included in the study. Relevant clinical and laboratory parameters were collected from all patients. Association between clinico-laboratory parameters with mortality was studied using appropriate statistical methods.Results: Among the 364 patients recruited in this study, 14 (3.85%) patients died. Mortality among patients with age group 18-40 years was 2.04%, in patients aged above 40 years was 7.56%. Mortality among patients with hypotension was 42.42% (14 out of 33), bleeding manifestations was 15.38% (8/52), platelets <20,000/mm3 was 10.41% (10/96), ALT >200 was 13.04% (6/46), AST>200 was 12.34% (10/81), prolonged prothrombin time was 60%(12/20), renal failure was 28%(14/50), encephalopathy was 31.57% (6/19), multi organ dysfunction syndrome(MODS) was 43.33% (13/30), acute respiratory distress syndrome (ARDS) was 45.45% (5/11), pleural effusion was 7.5% (6/80).Conclusions: The overall mortality in the present study was 3.85%. Following variables were associated with increased risk of death among the dengue patients: Age >40 years, presence of hypotension, platelets <20000 cells/mm3, ALT>200U/L, AST>200U/L, prolonged prothrombin time, presence of renal failure, encephalopathy, MODS, ARDS and bleeding tendency (p value <0.05). Early identification of factors associated with mortality can help to make appropriate decision on care required.

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