RESUMO
Background: Scrub typhus or tsutsugamushi disease is a febrile illness caused by Orientia tsutsugamushi. Uttarakhand State in the northern region of India has been witnessing increased incidence of this fever. There is paucity of data on this topic from this region. The present study was conducted to find out the clinical features, complications, response to treatment and outcome of patients suffering from scrub typhus in a tertiary health care institute of Uttarakhand, India. Methods: The study was performed at SGRR Institute of Medical & Health Sciences, Dehradun, which is a tertiary health care institute Uttrakhand. The study period was of 1year from December 2012 to November 2013. Patients of 12 years of age or above it who were IgM antibody positive by ELISA technique were included in the study. All such patients underwent detailed clinical examination and investigation. Results: 47 patients were found to be suffering from scrub typhus. The common symptoms noted fever, myalgias, headache, vomiting, diarrhoea, breathlessness, petechiae and jaundice. Common complications noticed were hepatitis (78.7%) acute respiratory distress syndrome (19.2%), thrombocytopenia (46.8%) and acute renal failure (31.9%), Mortality was seen in 3 (6.4%) patients. Conclusions: Scrub typhus is an important cause of mortality and morbidity in Uttarakhand. High index of suspicion, early diagnosis, monitoring of the clinical and laboratory parameters and prompt intervention may help in reducing the mortality.
RESUMO
Background: Dengue is an important cause of mortality and morbidity in India. Many recent studies have shown varied clinical manifestations from different geographical locations. There is paucity of data on this topic from this region. The present study was conducted to find out the clinical features, complications, response to treatment and outcome of patients suffering from dengue in a tertiary care centre of Uttarakhand, India. Methods: The study was performed at SGRR Institute of Medical & Health Sciences, Dehradun, which is a tertiary care hospital of Uttrakhand. The study period was of 1 year from July 2012 to June 2013. Patients of 12 years of age or above it who were antigen positive or antibody positive were included in the study. All such patients who were admitted in the hospital underwent detailed clinical examination and investigation. Results: Dengue infection was identified in 140 patients. Thrombocytopenia was the commonest hematological abnormality. Splenomegaly, hepatomegaly, and hepatosplenomegaly, were common findings. Renal, hepatic and cerebral dysfunctions were noted. Mortality was seen in 5 (3.6%) patients. Encephalitis, shock and ARDS were associated with high mortality and poor outcome. Conclusions: Dengue is an important cause of mortality and morbidity in Uttarakhand. High index of suspicion, early diagnosis, monitoring of the clinical and laboratory parameters and prompt intervention may help in reducing the mortality.
RESUMO
Background: Traditionally Plasmodium falciparum has been considered to cause severe malaria while Plasmodium vivax is known to cause benign malaria. However many recent studies have shown that Plasmodium vivax is also responsible for many cases of severe malaria. There is scarcity of data on this topic from this region. The present study was conducted to find out clinical and pathological manifestations of vivax and falciparum malaria in Dehradun. Methods: The study period was of one and half years, from January 2012 to June 2013. Patients of 18 years of age or above it who were smear positive or antigen positive were included in the study. Results: one hundred and thirty nine patients were found to be suffering from malaria. 90 (64.7%) had vivax malaria, while 49 (35.3%) patients suffered from falciparum. The study of morbidity profile showed that the complications related to severity, earlier attributed to only falciparum is equally seen in vivax case. Low platelet count was the commonest finding in both groups. Other complications seen in both groups were those of severe anemia, cerebral malaria, ARDS, renal failure, hepatitis, leucocytopenia, pancytopenia, and shock. Mortality in the two groups was of the same order. Conclusions: Vivax malaria causes significant mortality and morbidity. The morbidity and patterns are almost similar in both vivax and falciparum malaria.
RESUMO
Background: Malaria is an important cause of mortality and morbidity in India. Many recent studies have shown that vivax malaria which was once thought to be a benign condition has emerged in a more virulent form causing many cases of severe malaria and life threatening complications. There is paucity of data on this topic from this region. Objective: The present study was conducted to find out the clinical features, complications, response to treatment and outcome of patients suffering from vivax malaria. The study has also tried to find out severe malaria associated with P. vivax infection. Methods: The study was performed at SGRR Institute of Medical & Health Sciences, Dehradun, which is a tertiary care hospital of Uttarakhand. The study period was of two years, from September 2011 to August 2013. Patients of 18 years of age or above it who were smear positive or antigen positive were included in the study. All such patients who were admitted in the hospital underwent detailed clinical examination and investigation. Results: Plasmodium vivax infection was identified in 140 patients. Splenomegaly, hepatomegaly, and hepatosplenomegaly, were common findings. Renal, hepatic and cerebral dysfunctions were noted. Severe malaria was observed in 63(45.0%). Thrombocytopenia was the commonest hematological abnormality. Mortality was seen in 9(6.4%) patients. Cerebral malaria, shock and ARDS were associated with high mortality and poor outcome. Conclusion: Vivax malaria may cause life threatening complications. The complications of vivax malaria are similar to those which have been traditionally described with falciparum malaria.