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Background: Dengue fever is one of the most common acute viral illness associated with considerable morbidity and mortality. Recently, there is an alarming rise of dengue in India. This study was undertaken to know the clinical profile and laboratory findings during the evolution of dengue fever.Methods: A total of 120 patients of dengue fever who were NS1 antigen or IgM dengue positive, admitted to medical wards of Narayana Medical College, Nellore included in the study. Thorough clinical examination and relevant laboratory investigations performed in all patientsResults: Males were commonly affected (72.4%). Fever was the most common presentation (100%), followed by headache (96%) myalgia (94%), abdominal pain (24.46%), and retro-orbital pain (12.45%). Malena was the most common hemorrhagic manifestation. Laboratory findings include varying degree of thrombocytopenia in all patients, leukocytopenia (30.52%), increased hematocrit (>45%) (67.59%) and deranged liver function test (58.33%)Conclusions: Early diagnosis, monitoring, and prompt supportive management can reduce mortality in dengue. Atypical presentations of dengue should be kept in mind, which may cause a delay in the diagnosis. Increased community awareness and vector control measures need to be strengthened during the peri-monsoon period to reduce the burden of dengue cases.
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Background: The main aim of the present study is to investigate the differences in clinical, microbiological, characteristics of Urinary tract infection between diabetic and non-diabetic patients and influence of diabetes on the spectrum of URO pathogens and the antimicrobial resistance in patients with urinary tract infections.Methods: The present study is conducted from February 2018-April 2019 in Narayana general hospital. A total of 181 diabetics and 124 non-diabetics are included. A thorough history examination investigations done. The final data was analysed using statistical package SPSS. The percentages in different categories were compared using chi square test and means were compared using student ‘t’ test.Results: The mean age among diabetic and non-diabetic patients was 60.2+/-13.79 years and 53.47+/-18.56 years. Fever is the most common presenting symptom. BPH was the most common predisposing factor in both diabetes and non-diabetes followed by indwelling catherization but there was no statistically significant difference. Diabetics with UTI majority (87.14%) had glyco HBA1C >6.5% with p<0.001. The prevalence of recurrent UTI is higher in diabetics compared to non-diabetics however difference was not statistically significant. Recurrent UTI is higher in females in both diabetics and non-diabetics. The presence of E coli is significantly higher in diabetics compared to non- diabetics. The antimicrobial resistance pattern was similar in both diabetic and no-diabetic subjects in E coli with maximum sensitivity to meropenem and least to ampicillin and there is no statistically significant difference.Conclusion: The host factors found to be associated with UTI are female sex, presence of diabetes, poor glycemic control, presence of fever. No correlation was noted with age, duration of diabetes and type of treatment for diabetes. An elevated HBA1C correlates with occurrence of UTI. Escherichia coli (E. coli) was the most frequent uropathogen. The resistance of uropathogens to antibiotics are similar in patients with and without diabetes and non-diabetes.
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Background: To compare TIMI & HEART SCORE for their risk stratification in Acute Myocardial Infarction Patients, prognostic accuracy and Arrhythmia incidence.Methods: This observational study is conducted in a Tertiary care hospital over a period of 2 years from August 2017 to July 2019. A total of 100 patients presented to ER with Chest Pain are selected for study. Patients were monitored for a period of one month in ICCU.Results: In present study out of 61 cases with TIMI score ≥5, mortality of 11.5%(7 cases, p value 0.028). Heart score more than 6 constitutes high risk group, out of which mortality was observed in 7.45% cases (p=0.48). Most of the arrhythmias (70.49%) in present study observed in patients with TIMI score ≥5 (High risk group) which is statistically significant with p value 0.002. Most of the arrhythmias in present study observed in patients with HS ≥8 which is not statistically significant with p value 0.135.Conclusions: In present study, overall mortality rate was 7% and these patients who died constitutes to high risk group with TIMI. HEART SCORE identified more patients as low risk compared to TIMI SCORE. TIMI SCORE is a good predictor of arrhythmia incidence.