ABSTRACT
Background: Awareness about the infection is scarce especially in the developing countries as a consequence of which, it is rarely thought of in the differential diagnosis of febrile illnesses. Failure to diagnose leptospirosis is particularly unfortunate: severely ill patients often recover completely with prompt treatment but if therapy is delayed or not given, death or renal are likely to ensure. Methods: A total 50 patients who were admitted with fever at JSS hospital, medicine department over a period of 2 years that is during August 2005 to August 2007 who have been diagnosed to have leptospirosis fulfilling the inclusion and exclusion criteria. Present study design is a prospective study during which patient will be followed up during hospital stay, recovery and one month after discharge. Results: In our study out of 5 patients 16 patients (32%) had no complications, 34 patients (68%) have developed various complications. 4 patients (8%) developed ARF, 7 patients (14%) developed hepatitis, 17 patients (34%) ARF with Hepatitis, 2 patients (4%) Hepatitis with altered sensorium, 1 patient (2%) developed Myocarditis; Hepatitis; ARF, 1 patient (2%) developed ARF; ARDS; Hepatitis; Myocarditis, 2 patients (4%) ARDS with ARF and Hepatitis. Conclusion: Early diagnosis & initiation of treatment of leptospirosis prevents mortality and morbidity.
ABSTRACT
Background: Ancylostoma duodenale and Necator americanus are the blood sucking nematodes commonly called hookworms. They cause mild to severe anemia in patients especially children. The most common cause for hookworm infection is unhygienic conditions of the surroundings. Methods: 780 stool samples were collected from the children in wards, ICUs and schools. All the stool samples were subjected to wet mount by iodine and saline. They were also subjected to concentration technique by formalin ethyl acetate solution. Complete Blood Picture, estimation of Hemoglobin was done for all children for anemia and eosinophil testing. Results: 10.1% of the stool samples were positive for hookworms with 43 boys and 36 girls. 79.1% of the males and 88.3% of females were anemic with overall percentage being. Most of the children were from poor background with unhygienic conditions. Conclusion: Since most children belonged to poor background with unhygienic conditions, health education, improvement in sanitation, and mass treatment in affected areas can be tried.
ABSTRACT
Background: Sympathetic and parasympathetic autonomic nervous system act in opposition to each other which enable us to perform our regular functions and maintain the state of the body. Disorders of the autonomic nervous system may result from disorders of the central and the peripheral nervous system. In the elderly, autonomic neuropathy, orthostatic hypotension is prevalent leading to cognitive slowing, hypo or hyperthermia, loss of sweating etc. Methods: 50 elderly patients with no hypertension, Diabetes mellitus, ischemic heart disease and arrhythmias, without addictions and habituations were studied for autonomic dysfunction based on clinical symptoms and using different tests including HR variability with deep respiration, HR Response to Valsalva maneuver, HR response to standing, BP response to standing and SBP response to Valsalva maneuver. Results: We found that the autonomic dysfunction was more prominent in the age above 60 years and more so in males than females. Postural hypotension such as dizziness, blacking out, loss of consciousness, impaired cognition, Calf Claudication was the most common symptom followed by gastric and urinary tract disturbances. There was a significant decline in the heart rate variability but not so much in the BP response test. The decline in the HRV was equal in both males and females showing no disparity between the sexes. Conclusion: The indices based in the heart rate differences are more suitable for assessment of autonomic disturbances in the elderly than BP response tests.
ABSTRACT
Background: The diagnosis of Pulmonary Tuberculosis is largely dependent of the positive result of the sputum smear by ZN staining. But in many cases, although active tuberculosis is present, due to many reasons, sputum smear may yield a negative result. With a late culture result, no reliable serological test available to enable an early diagnosis, role of induced sputum and bronchoscopy has been tried with excellent results. Methods: 50 fresh smear negative cases between the ages of 16-65 years, clinically and radiologically suspected of Pulmonary Tuberculosis were subjected to induced sputum and bronchoscopy after detailed history and thorough clinical examination as done. Clinical symptoms were noted, 2 sputum smears (spot and early morning) and chest x-rays were taken for all patients. Results: Males between 24 – 44 years were seen to be predominant patients. The most common symptom appeared to be cough in 80% followed by fever in 60% of the cases. 76% of patients had unilateral lesions and 24% with bilateral lesions. 84% of the sputum negative patents were identified as active tuberculosis cases. Conclusion: Induced sputum and fiber optic bronchoscopy with bronchial aspirate and post bronchoscopic sputum can provide excellent material for diagnosis of suspected cases of Pulmonary Tuberculosis in whom smears of expectorated sputum do not reveal mycobacteria. There is minimum patient discomfort, reduced complications and relatively good yield which makes these procedures justifiable in the diagnosis of fresh smear negative pulmonary tuberculosis.