ABSTRACT
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.
ABSTRACT
Background: Depression, a common mental disorder characterized by persistent unhappiness and lack of interest in daily activities, is one of the major important public health problems that are often comorbid with other chronic diseases like diabetes and can worsen the effect of the disease outcomes. Depression alone and/or as a comorbidity with diabetes is a common condition in the community. Aim of the study: To identify the prevalence of Depression among Type 2 Diabetes Mellitus patients and relationship between Depression and its effect on Drug Compliance among Type 2 Diabetes Mellitus patients, to determine the severity of Depression among Type 2 Diabetes Mellitus patients and the extent to which it affects Drug compliance. Materials and methods: The study was to be conducted in Rajah Muthiah Medical College and Hospital, Chidambaram in the year 2018-2019. A hundred patients with diagnosis of T2DM attending Diabetic OPD above 20 years of age were randomly selected. The Hamilton rating scale for depression by Hamilton is the most widely used rating scale to assess the symptoms of depression. The Ham-D is an observer-rated scale consisting of 17-21 items. Ratings are based on clinical interview. The items are rated on either a 0 to 4 spectrum or a 0 to 2 spectrum. The HAM-D also relies quite heavily on the clinical interviewing skills and the experience of rater in evaluating individuals with depressive illness. The strength of HAM-D is its excellent validation/research base, K.H. Mohamed Ibrahim, R. Gandhi Babu, M. Senthil Velan. Prevalence of psychiatric morbidity (depression) and its effect on drug compliance among patients attending diabetic outpatient clinic. IAIM, 2019; 6(11): 19-28. Page 20 and case of administration. Its use is limited in individuals who have psychiatric disorders other than primary depression. Results: Analyzing with HAMD score, 40 had no depression, mild depression in 24 cases, moderate depression in 21 cases, severe depression in 15 cases. MAQ score scale- low adherence in 41 cases, medium adherence in 37 cases, high adherence in 22 cases. MMAQ score scale and HAMD scorelow adherence with no depression were 9 cases (22.5%) mild depression were 6 cases (25%) moderate were 11(52.4%) severe depression were 15 cases (100%). MMAQ score scale and HAMD score - medium adherence with no depression were 23 cases (57.5%) mild depression were 9 cases (37.5%) moderate were 5(23.8%) severe depression were not seen. MMAQ score scale and HAMD score - Medium adherence with no depression were 8 cases (20%) Mild depression were 9 cases (37.5%) Moderate were 5(23.8%) severe depression was not seen. Pearson Chi-Square = 35.344**, p<0.001. Conclusion: Further, there was a significant association between the depression in Type 2 diabetes patients and medication adherence, where patients with depression had poor medication adherence as compared to those without depression and severity of depression correlates with worse adherence to diabetic medications
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Background: WHO announced influenza A H1N1 as pandemic (commonly known as swine flu) in 2009; but every year there is increase in influenza A H1N1 positive cases causing epidemics of febrile respiratory illness due to genetic re-assortment in influenza virus. This study aimed for clinical profile of patient with influenza A H1N1 and its outcome admitted at civil hospital Ahmedabad. Materials and methods: Present study was included 50 patients with influenza A H1N1; admitted in B.J. Medical College and Civil Hospital, Ahmedabad. This study was carried out for one year from June 2018 to June 2019. Patients were studied and managed as per standard Government of India protocol. Results: Total 50[19 (38%) males and 31 (62%) females] patients were studied for clinical spectrum, complications and outcome. All patients had fever (100%), dry cough in 92% of patients, throat pain in 88% of patients, breathlessness in 54% of patients, headache in 48% of patients, sputum production in 40% of patients and hemoptysis in 6% of patients. 35 (70%) patients had comorbidity. Total13 (26%) patients were complicated; out of which 4 (8%) patients required ventilatory support. Conclusion: Early case detection, categorizations according to symptoms prevention of treatment has better outcome and decreases disease related morbidity and mortality and burden of disease in community and voluntary early reporting should be encouraged through various health campaigns.
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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.