ABSTRACT
Background: Scrub typhus is caused by Orentia (formerly Rickettsia) tsutsugamushi. It is an infectious disease of variable severity .Scrub typhus has a wide geographical distribution. Scrub typhus is grossly under diagnosed in India due to its nonspecific clinical presentation, limited awareness and low index of suspicion. Methods: This study was a cross sectional observational study conducted in Department of Medicine Government Medical College, Haldwani .The duration of this study was two years i.e. from November 2013 to October 2015 and 103 patients included in study. Results: 36 patients were found to be scrub typhus positive. It was commonly seen in males in the age group of 20-30 years. Besides fever, cough, myalgia and headache were the common presenting symptoms. Scrub typhus was seen most commonly in farm worker in our study. Most common complication was hepatitis followed by multiorgan dysfunction. In our study, out of 36 positive patients, 5 (13.8%) patients died and 31 patients ultimately recovered completely without any complication whatsoever. Conclusion: Scrub typhus is not a uncommon disease in India more so in hilly areas. So high index of suspicion should be there while dealing a patient of fever in these regions.
ABSTRACT
Background: Acute renal failure (ARF) or acute kidney injury (AKI) is a clinical condition in which rapid decline in glomerular filtration rate over an hour to days. It is an important clinical condition and common cause of mortality in hospitalized patients. Aims: To analyze the aetiological spectrum and outcome of ARF in Kumaon region of Uttarakhand and to compare data with that of other parts of country. Settings and Design: Hospital based observational analytic study. Methods: This study was conducted on patients admitted to Government Medical College & associated Dr. Susheela Tiwari Memorial Hospital Haldwani from November 2011 to October 2012 with ARF irrespective of the cause. ARF was defined according to AKIN criteria. Statistical analysis used: Statistical analysis of data was performed using SPSS V.20.0 (Windows). All data was summarized and expressed as mean ± SD or as percentages as appropriate. The chi square test was used to analyze categorical variables while the student T-test used to analyze normally distributed data. Statistical significance was accepted at p<0.05. Results: Out of 100 patients, 77% had community acquired ARF and 23% had hospital acquired ARF. Medical causes were leading contributors (68%), while surgical causes in 20% and obstetrical causes in 12% of patients. 36% patients required hemodialysis. The overall mortality was 21%, and highest mortality was found in celphos poisoning group (100%). Conclusion: ARF is still common in the community and is associated with high mortality. Aetiologies like acute gastroenteritis, septicaemia, snakebite and malaria were the leading cause of ARF in our study.