ABSTRACT
Background: Thrombocytopenia is a frequent problem in neonatal sepsis and is among the most predic?ve, independent risk factors for sepsis-associated mortality. The present study was undertaken to correlate neonatal sepsis and thrombocytopenia in terms of severity, clinical course, organism specificity and outcome. Method: Total 384 neonates age <28 days with sepsis and thrombocytopenia were studied and analyzed with their clinical profile, symptoms, lab findings and outcomes. Results: Male babies (55.86%), age <72 hrs (80.35%), preterm (68.70%) and LBW babies (85.58%) were more prone to sepsis. Maternal fever (67.44%), foul smelling liquor (53.79%) and PROM >18 hrs (66.74%) make babies more prone to neonatal sepsis. The Commonest clinical features were not accepting feed (69.95%), lethargy (67.85%) and breathing difficulty (79.04%). Early onset sepsis (82.54%) and probable sepsis (40.26%) were more common and associated with preterm and LBW babies. Leucocytosis was seen in 64.57%, thrombocytopenia moderate degree 45.67% and severe degree 34.65%, MPV >12 69.11%, ANC <1800 47.50%, micro ESR >15 mm 72.16% and CRP posi?vity 28.60%. Severe degree thrombocytopenia (<50000) was more common with PROM >18 hrs (83.02%), maternal fever (83.09%) and gram-nega?ve organism(61.29%). Leucopenia (<4000) was more common with maternal fever (75.79%), proven sepsis (43.16%) and gram-nega?ve organism (70.31%). Severe degree thrombocytopenia (61.29%), leucopenia (70.31%) and mortality (64.51%) were more commonly associated with gram-nega?ve organism. Outcome was bad with severe degree of thrombocytopenia (62.32%), leucopenia (73.91%), and gram-nega?ve organism (64.51%). Conclusion: Proper antenatal mother care, hygiene and early evalua?on for illness can prevent early onset of sepsis in neonates. Severity of degree of thrombocytopenia directly propor?onal to the worst outcome.
ABSTRACT
Background: Malaria, despite intensive efforts to control, remains a leading cause of morbidity and mortality in humans. India contributes to 61 per cent of malaria cases and 41 per cent of malaria deaths in SEAR countries. The objective of the present study was to find out an incidence of mortality due to malaria with typical and atypical presentation.Methods: The present was conducted over a period of three years. During the study period 630 patients with clinical suspicion of malaria were tested for malaria using peripheral smear, QBC and RDT.Results: The mortality rate in this study group 161 (25.55%) out of which maximum mortality observed in patients with falciparum malaria either singly or with mixed infestation. There is no significant correlation between the typical and atypical presentations in the different age groups with mortality.Conclusions: For timely diagnosis and treatment a high index of suspicion for the disease should be maintained by treating physicians, especially in endemic areas. They should be aware of the varied manifestations to minimize the mortality due to malaria.
ABSTRACT
Background: There is a widespread range of diverse typical and atypical manifestations of malaria. The diagnosis of malaria may escape the attention of treating physician due to its unusual and vague presentations.The morbidity and mortality due to malaria is increased due to lack of early diagnosis and right treatment. The Aim of the present study was to examine the changing clinical pattern of malaria with special attention to atypical presentations.Methods: The present study comprised of 630 cases of definitively diagnosed malaria.Diagnostic methods used were conventional thick and thin peripheral smear stained with Leishman stain and rapid malarial antigen test.Results: This study revealed atypical symptoms like lack of taste (1.3%), throat discomfort (13.33%) and cough (24.0%) and vomiting (52.4%) as presenting complaints. These were significantly more in patients with P. vivax infestations.Conclusions: A high degree of suspicion is necessary for early detection and treatment of malaria, especially of unusual presentations.