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Scrub typhus, also called bush typhus, is a zoonotic disease a Gram-negative bacterium. Its presentation may range from nonspecific febrile illness to severe disease, with cardiovascular, renal, hepatic and neurological involvement. Myocarditis is one of the rare complications of scrub typhus. Hence, we are reporting a case of a 50-year-old male, farmer by occupation, presenting to us in multiorgan dysfunction syndrome who developed myocarditis during second week of his illness.
ABSTRACT
ntroduction: Malaria continues to be one of the importantpublic health problems in India. Rajasthan is an endemic zoneof malaria with still a high prevalence rate. A revisedknowledge of present scenario of malaria is almost undercontrol. This prospective study was conducted to analyzevarious types of presentation of Malaria in adults, itscomplications and response to current treatment regimensavailable.Materials and Methods: This cross sectional study wascompleted over a period of 12 months; from 1st November2015 to 31st December 2016; carried out in Department ofMedicine RNT medical college and attached group of hospitalsUdaipur (Raj). 200 patients who presented with fever andassociated symptoms with test positive for malaria by slideand/or MPQBC (Malaria Parasite Quantitative buffy coat) andinclusion criteria were enrolled in the study. These patientswere then subjected to treatment regimens with regular vitalmonitoring and laboratory tests. The main method to establishdiagnosis was microscopy of PBF, however MPQBC helped indiagnosis of cases missed on slide examination and mixedinfections. The presence of various complications, treatmentresponse and outcome was studied.Results & Conclusion: P. falciparum was the major parasitetype causing malaria as 56% cases. All complications cerebralmalaria, respiratory distress, haematological, malariahepatopathy, acute renal failure and electrolyte disturbanceswere noted in greater frequency in P. falciparum. Howevereven P. vivax accounted for complicated cases of malaria inthis region. For dysnatremia, hyponatremia was more commonthan hypernatremia with increase frequency amongstP.falciparum cases and higher in cerebral malaria. There was agood response to artesunate and quinine drug with 2nd linedrugs. However 14 patients in artesunate group weresubsequently shifted to quinine based therapy after treatmentfailure. A total of 4 deaths were reported all P.falciparumpositive. However an early diagnosis and adequate treatmentwith antimalarials with timely supportive therapy withHemodialysis and blood component transfusion can save livesin malaria.
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Introduction: Portal hypertension and its complications are theleading causes of death and liver transplantation, in patientswith cirrhosis. Portal hypertension causes hemodynamic andmucosal changes in the entire gastrointestinal (GI) tract. Thesemucosal changes in upper and lower gastro intestinal tractresult in various hemorrhagic manifestations.Methodology: This study was conducted in RNT MedicalCollege and attached hospitals, Udaipur, Rajasthan. Theobjective of study was to find relationship betweencolonoscopic finding and upper GI endoscopy finding in portalhypertension patients. A total of 100 patients’ diagnosed casesof portal hypertension were included in study. A predesignedand pretested Performa were used for obtaining informationregarding socio-demographic variables and laboratoryinvestigations including upper GI endoscopy and colonoscopyat endoscopy laboratory.Result: In present study, 75% patient had esophageal varicesand 93% patient had portal hypertensive gastropathy. Rectalvarices, rectopathy and portal hypertensive colopathy werefound in 57% of cases,39% cases and 32% cases respectively.While hemorrhoids were found in 53% of cases. Among thepatients who had esophageal varices, rectal varices werepresent in 64%. In patients without esophageal varices, rectalvaries was present in 36%. Association was found statisticallysignificant (p = 0.01). There was no statistical significantassociation found between esophageal varices and othercolonic lesions like rectopathy, colopathy and haemorrhoids. Inpresent study there was no statistically significant associationbetween portal hypertensive gastropathy and portalhypertension related colonic lesions (PHC, rectal varices,rectopathy and hemorrhoids).Conclusion: Upper gastro intestinal lesions gastropathy andesophageal varices are more common finding than lowergastro intestinal lesions. Rectal varices are only significantlower gastro intestinal finding on colonoscopy among thepatients of portal hypertension who had esophageal varices onupper GI endoscopy.