Rare complications of chicken pox in immunocompetent children: Acute respiratory distress syndrome

Chickenpox is a highly contagious disease caused by varicella zoster virus. Fever and papulovesicular rash are hallmarks of this disease. These manifestations are self-liming and complete recovery is seen in most cases. We report two cases of chickenpox infection where the rare and atypical manifestations of acute respiratory distress syndrome with pleural effusion were seen.

CHICKENPOX VACCINE : NEED OF THE HOUR IN DIFFERENT REGIONS OF JHARKHAND

Varicella (chickenpox) is caused by varicella zoster virus (VZV). Epidemiological prole of chickenpox varies considerably across different parts of world. In Jharkhand, chickenpox remains an important public health issue and outbreaks are not uncommon, since vaccination is not universal. Aim: To study different demographic variables in the outbreaks of chicken pox infection in Jharkhand from January 2017 to December 2020. Methods: Surveillance data were collected monthly, as a part of the Integrated Disease Surveillance program, India. The clinical denition of cases and outbreak were used for the surveillance rates and outbreaks. Chickenpox outbreaks were analyzed in different districts of Jharkhand for a period of 4 years (2017 - 2020) and trends were analyzed according to age, sex, residency and seasonality. Results: Three, fteen, twenty four and seven Chickenpox outbreaks occurred in 2017, 2018, 2019 and 2020 respectively which caused fteen, seventy six, one hundred and thirty seven and fty two cases respectively altogether in Jharkhand . There was minor difference in occurrence among genders. A seasonal pattern was also observed. The age group of patients who were maximum affected were of 5-9 years followed by 10-14 years. Conclusion: A programme of varicella vaccination can potentially change the epidemiology of varicella and limit its burden in childhood as well as its social and nancial cost

Folk Medicinal plants Used by Herbal Practitioners in and around Rajshahi Metropolitan City, Bangladesh

Folk medicinal plants used by herbal practitioners in and around Rajshahi metropolitan city, Bangladesh were recorded. The present study include 111 medicinal plants used to cure various diseases such as anemia, asthma, burning sensation, blood disease, bronchitis, cough, chicken pox, constipation, dysentery, diarrhea, diabetes, eczema, fever, headache, itches, jaundice, menstrual disease, paralysis, piles, sex problems, skin diseases, snake-bite, toothache, worm, wound etc. The present documentation of medicinal plants from the study area provides recognition to the existing knowledge and helps in conservation of important medicinal plants for the betterment of the society.

SOME FEATURES OF NAMING DISEASES IN KOMI DIALECTS

The article analyzes the popular names of smallpox and chicken pox, recorded in the “Dictionary of the Komi language dialects” (2012-2014). The semantics and the formal structure of the names are explored. The lexical units referring to smallpox include separate lexemes, which are verbal nouns formed by suffixation ( kokas' ), and compound names with two elements. The latter mostly implements the following model: "noun (in the nominative) + noun meaning ‘smallpox’, ‘disease’. The attributive component indicates the disease, its cause or the mode of transmission ( pis't'i vis'an, jen kokas', ru kokač' ). In the names of chicken pox, which, in accordance with the common notion, is a lighter variety of smallpox, compound constructions indicate the milder nature of the disease ( prestej kokas' ), and its source - the wind ( tev jyv kokač' ). The lexemes denoting smallpox ( kokač'/ kokas', pis't'i/ pis'ki ) are the base words of such phrases as well.

Maternal and Fetal Outcome of Fever in Pregnancy

BACKGROUND This study was conducted to evaluate the maternal and fetal outcome of fever in pregnancy. METHODS The present study was a prospective observational study conducted from April 2012 – March 2014 among patients in the Department of Obstetrics and Gynaecology, Sri Ramachandra Institute of Higher Education and Research Institute, and they were followed up to the time of delivery to determine the maternal and foetal outcome. This is a prospective study and sample size was 120 patients. All patients admitted with fever irrespective of the gestational age and parity were included in the study. The ethical committee of Ramachandra Medical College and Hospital approved the study. Reference CSP-MED / 13 / AUG / 08 / 47. RESULTS Fever in pregnancy nearing term has been associated with adverse outcomes. Even elevated temperature in the first trimester can lead to fetal loss. Urinary tract infection was the most common infection during pregnancy. E. coli was the most common organism isolated. Other aetiologies encountered were dengue, malaria, scrub typhus, leptospirosis, enteric fever, H1N1, Influenza A viral fever, respiratory tract infections, and chicken pox. The most frequently seen adverse outcome in this study was abortion. There was one maternal mortality due to H1N1 and one neonatal mortality due to dengue haemorrhagic fever which was transmitted to the fetus. There was one fetus with multiple anomalies and the mother had a history of chicken pox in the first trimester. There were 15 cases of premature rupture of membrane and 12 cases had preterm labour. Intrapartum fever was associated with postpartum haemorrhage and meconium-stained liquor in some mothers. CONCLUSIONS Fever during pregnancy can potentially lead to adverse maternal and perinatal outcomes even at a low-grade temperature of a short duration of less than a week. Even elevated temperature in the first trimester can lead to fetal loss. Fever in pregnancy nearing term has been associated with adverse perinatal outcomes. Some virulent organisms can lead to fetal anomalies and maternal death. KEY WORDS Fever in Pregnancy, Maternal Outcome, Foetal Outcome

Role of Climatic Conditions on the Incidence of Varicella in an Out-patient Clinic of a Tertiary Care Pediatric Hospital at Dhaka

Background & objective : Chicken pox or varicella is a disease of both tropical and temperate zones bearing a complex-relationship with climatic variables, like temperature, rainfall and relative humidity, wind velocity and so on. As no study has, by far, been conducted to relate its occurrence with these climatic variables in Bangladesh, this study was intended to explore the effect of weather conditions on the incidence of varicella in Dhaka city of Bangladesh. Methods: The present cross-sectional study obtained data of 172 varicella cases from the records of the daily register of Out-patient Department of Dhaka Shisu Hospital, Dhaka between January 2018 to December 2019. According to the study protocol a child was diagnosed as having varicella or chicken pox who had a history of short febrile illness accompanied by a pruritic vesicular eruption (on the face and trunk)) of the skin and mucous membranes which ultimate weeps out and crusts. Total number of cases treated monthly at Out-patient Department (OPD) during the period was also recorded. Climatic data were provided by Bangladesh Meteorological Department, which among others, included monthly average temperature, relative humidity (RH) and amount of rainfall or precipitation. While the outcome variable was monthly number of varicella cases, the predictive variables were average temperature, humidity and rainfall during the study period. Result: Over 70% of children were 1-10 years old with median age of the children being 5.5 years (range: < 1 month -14 years). Boys were a bit higher (54%) than the girls (46%). A seasonal pattern of chicken pox was seen with clustering of cases between mid-February to mid-April (spring season) with two peaks – one in February and another in April, when monthly average temperature, total rainfall and humidity all were at their optimum. The peak incidences of chicken pox cases during the spring both in 2018 and 2019 as correlated with climatic data of the same period, it is seen that the prevailing weather then was optimum-average temperature was 23°C, average precipitation was 20-25% of the total annual precipitation and relative humidity was around 65%. Conclusion: The study concluded that majority of the varicella cases occur under ten years of age and boys are a little more susceptible to have the infection than the girls. A seasonal pattern of chicken pox is clearly seen with clustering of cases between mid-February to mid-April (spring season) with two peaks when monthly average temperature, total rainfall and humidity all are optimally favorable for the multiplication of varicella zoster virus. Ibrahim Card Med J 2020; 10 (1&2): 11-17

Bacterial and Viral Vaccination (non EPI) Coverage among Students in Three Educational Institutions in Bangladesh

Introduction: The implementation of the vaccine has already been shown to be a great success to reduce communicable diseases and its associated morbidity among human globally. The aim of this study was to figure out the actual rate of population who received non EPI bacterial and viral vaccines and to determine the risk factors associated with it. Materials and Methods: A retrospective observational study was conducted between September 2011 and August 2014 among 3600 students aged from 18 years to 24 years. Data of total 12 non EPI vaccines (5 bacterial - Cholera and ETEC diarrhea vaccine, Meningococcal, Pneumococcal, Tetanus and Typhoid; 7 viral- Chicken pox, Cervical vaccine, Hepatitis A, Hepatitis B, Measles Mumps Rubella vaccine, Rota viral and Seasonal flu vaccine) were collected from the individuals’ vaccine cards. All vaccine timelines were categorized into timely, early, delayed and missed based on recommended time of vaccination. Different parameters were considered to determine the socio-demographic factors related to vaccination. Results: Total of 3600 study population were selected from three different institutes. Percentage of rural students was almost 3.2 times higher than that of urban. About 1746(48.5%) student were from middle class family. About 2125(59.03%) of the participant’s had not adequate knowledge of vaccination. Out of 3600 study population for bacterial vaccine, rate of Tetanus vaccine was the highest in percentage which was 1248(34.67%). Percentage of other bacterial vaccines such as Cholera and ETEC diarrhea, Meningococcal, Pneumococcal and Typhoid vaccination percentages were only 27(0.75%), 29(0.81%), 111(3.08%) and 34(0.94%) respectively. Among viral vaccines, the highest receiving vaccine was Hepatitis B. 2763(76.75%) people were immune with hepatitis B vaccine. Percentage of Hepatitis A was 337(9.36%), Rota viral vaccine was 330(9.17%), Measles Mumps Rubella was 249(6.92%) and Chicken pox was 83(2.31%). The percentage was less in case of Cervical HPV and Seasonal flu vaccines which were 12(0.33%) and 20(0.56%) respectively. Conclusion: Vaccines have proven the potential capability to reduce vaccine-preventable diseases, however, findings from the study show that people have still not been aware of non EPI bacterial and viral vaccines which can protect people from life threatening diseases and their complications. Medicine Today 2021 Vol.33(1): 80-83

Seasonal variation and role of meteorological conditions in reported chicken pox cases in a residential hostel of Ramgarh

Background: Chicken pox is an acute, common, and highly contagious disease caused by the varicella zoster virus (VZV). Chicken pox is predominantly a childhood disease characterized by pruritic vesicular exanthema with systemic symptoms such as fever, loss of appetite, and malaise. Primary infection tends to occur at a younger age and is usually benign in immunocompetent children but can be life-threatening in adults and immunocompromised individuals, with an attack rate approaching >85% after exposure. This study attempts to evaluate the trend of chickenpox cases in a residential hostel in Ramgarh.Methods: This was a record based descriptive study done using reported Chicken Pox cases in the OPDs during the period from January 2015 to December 2018. Monthly average for meteorological data (Min and Max temperature, Precipitation and Humidity) for Ramgarh was recorded for the study period. Seasonality and trend was identified for chicken pox cases during this period by plotting the monthly number of clinically diagnosed cases over time period to identify any repeated pattern. Poisson’s distribution was used to estimate association between meteorological variables and incidence of chickenpox cases.Results: Analysis revealed strong correlations (r=0.7553, p<0.0001) between humidity and precipitation. There was a significant correlation between Incidence of varicella and meteorological factors under study (all p<0.05).Conclusions: The findings of this study will aid in forecasting epidemics and in preparing for the impact of climate change on the varicella epidemiology through the implementation of public health preventive measures such as promoting good hygiene practices, temporary closure of educational institutions, active vaccination and campaigns that include press releases and media events to encourage preventive activities.