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Background: Malaria a tropical disease has a wide clinical spectrum ranging from uncomplicated disease to a fatal one. The objectives were to study clinical profile of Malaria with special reference to its complications and outcome. Materials and methods: A study was carried out in a tertiary care hospital including total of 50 patients diagnosed with P. Vivax or P. Falciparum Malaria. Data on patients’ clinical details with investigations, complications, and outcome was studied. Results: Out of 50 patients (37 male and 13 female), 41 had P. Vivax and 9 had P. Falciparum Malaria. Total 3 patients were complicated; two had cerebral malaria due to P.falciparum and one had multi organ failure due to P. vivax which eventually succumbed. Conclusions: Clinical profile of Malaria was studied which suggest, P.falciparum malaria was more complicated; which comprises cerebral complications, renal complication, hepato-biliary and respiratory complications leading to increased morbidity and mortality. It was observed that P. vivax had better outcome but it can also present with serious and life-threatening complication.
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Introduction: Dengue fever is one of the most common arboviral mediated outbreaks reported with increased prevalence year after year with considerable morbidity and mortality. This study was designed to assess the clinical and biochemical parameters of dengue fever patients. Materials and methods: Prospective observational study was undertaken among adult patients in a Civil Hospital, Ahmedabad. Fifty patients were studied and analyzed. All patients who were NS1 antigen/ IgM dengue positive were included in the study. Clinical features, hematological and biochemical parameters were noted. Results: Of the 50 patients studied, majority were males (64%). Fever was the major symptom (100%) followed by headache (96%), myalgia (94%), retro-orbital pain (64%), conjunctival injection (24%), rash (38%), abdominal pain (74%), pleural effusion (30%) and ascites (26%). Significant derangements in platelet (70%), leucocyte counts (78%) and serum transaminases (74%) were noted. Mortality rate was zero. Conclusion: Fever associated with headache, retro-orbital pain, erythematous morbilliform rash, conjunctival suffusion and itching in palms and soles along with thrombocytopenia, leucopenia, elevated liver transaminases should prompt a clinician on the possibility of dengue infection. Platelet transfusions have little role in management of dengue patients.
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Background: In developing countries, the widespread use of organophosphorus compounds (OPCs) has been accompanied by increasing incidence of poisoning with these agents, both suicidal and accidental. This is attributed mainly to their easy availability, indiscriminate handling, storage and lack of knowledge about the serious consequences of poisoning. Of the various substance used for suicidal attempts in India, OPCs form a significant group. Since the clinical manifestation of OPC poisoning is diverse ranging from mild symptoms to fatal complications in the course of time, we need proper management of the situation. Materials and methods: We studied 50 patients of organophosphorus poisoning. We checked vital parameters, general examination and systemic examination. We also checked for various parameters on like cholinesterase level, complete blood counts, renal function test with electrolytes, liver function test. Results: In this study majority of patients fell in 20-30 years of age group with male predominance from lower and middle socio-economical class and most common reason was suicidal. Precipitating event were domestic problem, marital friction and financial problem. Most common clinical features were vomiting, miosis and giddiness. Majority of the patients belonged to mild grade. The average S.cholinesterase level was low as severity increases. More doses of PAM and atropine are required in severe poisoning. Most common complication was respiratory paralysis. Death was more in severe poisoning. Conclusion: OPC is one of the most common poisoning in India. Reason for poisoning is most commonly suicidal. It is common in male with low socio-economical class mainly due to domestic Janak Chokshi, Kothi Zuber Suleman, Bhavikkumar Prajapati. A study of 50 cases of Organophosphorus poisoning and its complications. IAIM, 2019; 6(1): 16-22. Page 17 problems, financial issue and unhappy married life. In patients of OP poisoning presenting symptoms and S.ChE level directly correlated with severity. Therapeutic required dose of PAM and atropine are different in different grade of severity. Survival amongst patients is definitely better if atropine and PAM are being given with Mechanical ventilator support in cases of respiratory insufficiency.
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Introduction: Thyroid dysfunction is a disorder of the thyroid gland which manifests either as hyper - or hypothyroidism and is reflected in the levels of thyroid stimulating hormone (TSH). Type 2 Diabetes Mellitus is the commonest endocrine disorder and leading cause of morbidity worldwide. These two most common endocrine disorders encountered in clinical practice have been shown to mutually influence each other, and association between both the conditions has long been reported. The present study was conducted to find out the prevalence of thyroid disorders in patients of type 2 diabetes mellitus. Materials and methods: 100 cases of type 2 diabetes mellitus were examined for thyroid dysfunction. A detailed history was taken regarding presenting symptoms, duration of type 2 diabetes mellitus and clinical course of disease. A family history was taken with special reference to type 2 diabetes mellitus and other comorbidities. BMI was calculated to diagnose obesity. A thorough clinical examination was done. Ophthalmic examination was done to diagnose retinopathy and cataract. Detailed blood investigations were done including serum TSH, free T3 and free T4. Results: Males were more affected with diabetes than females and occurrence of thyroid dysfunction was found more common in females with Type 2 DM in our study. Hypothyroidism was most common type of thyroid dysfunction with affected age group was 51-60 years. DM and thyroid dysfunction were more common in overweight patients. Thyroid dysfunction in type 2 DM was seen more commonly with higher levels of HBA1C. Dyslipidemia was more in patients of diabetes with thyroid dysfunction. Patients taking insulin had more incidence of hypothyroidism than patients on OHA. Diabetes related microvascular complications increase the risk for thyroid dysfunction. Krunal Talsaniya, Chitralekha Vora, Bhavikkumar Prajapati. A study of thyroid dysfunction in known cases of diabetes mellitus type 2 and their clinical profile. IAIM, 2019; 6(1): 103-108. Page 104 Conclusion: Thyroid dysfunction prevalence is very high in patients with diabetes. Patients with diabetes having microvascular complications are more affected with thyroid diseases. Dyslipidemia is also common in DM with thyroid diseases. So thyroid function test must be done on regular basis in each and every patient of DM 2.
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Background: Cerebrovascular accident (CVA) remains a major cause of morbidity and mortality worldwide. There is growing evidence that high homocysteine level contribute to the pathogenesis of ischemic stroke. High hohmocysteine levels are associated with increased risk of cardiovascular and cerebrovascular disease, although there are few studies that show no increase in risk, and there is still debate as to the strength and validity of the association. This study has been undertaken to correlate the serum homocysteine level in patients of cerebrovascular accident. Materials and methods: This study comprised of 100 patients of cerebrovascular accident admitted with acute onset of neurological deficit which are radiologically diagnosed. The diagnosis of cerebrovascular accident was made on the basis of history and clinical examination. We did CBC with ESR, renal function test, liver function test, serum homocysteine level, RBS, Fasting lipid profile, vitamin B12, urine routine analysis, HIV, CT scan Brain/ MRI Brain, ECG, 2D ECHO, Carotid Doppler if required, ANA / RA factor and any specific investigation if indicated. Results: Highest no of patients were in 5th and 6th decades of life with highest mean serum homocysteine level. Males were more affected with CVA than females and the mean serum homocysteine level was also higher in males. Urban population has higher homocysteine level than rural. Most common presenting symptom of CVA in the present study was hemiplegia. Convulsion was more associated with hemorrhagic CVA rather than ischemic CVA. Hypertension is one of the major risk factors for CVA. The mean homocysteine was higher in vegetarian population. Out of 72 patients having raised S. homocysteine level, 38 patients had vitamin B12 deficiency. Chitralekha Vora, Krunal Talsaniya, Bhavikkumar Prajapati. Clinical profile of cerebrovascular accident patients with special reference to serum homocysteine level. IAIM, 2019; 6(1): 76-82. Page 77 Conclusion: Hyperhomocysteinemia is an independent risk factor for CVA. Urban lifestyle is associated with higher incidence of CVA and higher homocysteine level. Homocysteine estimation should be included as a routine laboratory test for persons with cerebrovascular risk factors. Plasma vitamin B12 concentration is inversely associated with s. homocysteine concentration. Treatment of hyperhomocysteinemia with vitamin B12 supplements will reduce homocysteine level and ultimately reduce risk of CVA.