A study of clinical profile of patients with Dengue fever at a tertiary care hospital

Background: Dengue is the most common fever. Among all flavi-viruses, it is the most common. It can cause around 50-100 million infections. Every year 2-5 lakh cases of Dengue hemorrhagic fever occur. The objective of the research was to study clinical profile of patients with Dengue fever at a tertiary care hospital.Methods: Present study was cross sectional study. The patients were interviewed and examined at one point of time and later they were never followed which is similar to the cross-sectional study design. Present study was carried out in the hospital. This was done in the department of General Medicine of a tertiary care hospital. Present study was carried out over a period of one year.Results: In the present study, there were 78 males and 22 females. The sex ratio was 3.5:1. Maximum number of males (29.5%) was in the age group of 15-25. Among females, the maximum (40.9%) were in the age group of 26-35 years and 46-55 years (9%). The most common presenting symptom was fever in all cases followed by headache in 90%. Among bleeding manifestations, epistaxis, gum bleeding and hematuria (15%) were the common symptoms. Most patients presented with generalized lymphadenopathy in 52%. 56 patients showed only hepatomegaly and 46 splenomegaly, and 30 patients showed hepato splenomegaly. 99 showed leucopenia and 10 were anemic and 25 showed platelet count less than 1,50,000cells/cumm.Conclusions: Males were commonly affected. Younger age group of 15-25 was most commonly affected and fever and headache were the most common presenting symptoms. These findings help physicians in early diagnosis of dengue by suspecting these features as of dengue and can prevent morbidity and mortality associated with dengue.

A cross sectional study on factors affecting treatment outcome among TB patients

Background: Many factors affect treatment outcome negatively. Study of these factors is essential to prevent relapse and treatment failure. The objective of the research was to study the factors affecting the treatment outcome among TB patients.Methods: Patients diagnosed to have tuberculosis who are attending the DOTS centre at a tertiary care hospital, and fulfilling the inclusion and exclusion criteria were included in the present study. 50 patients who were being treated under DOTS regime were included in the present study. The study was conducted for a period of two years. The patients were followed for a period of six months to observe the treatment outcome among them.Results: Maximum patient were in the age group of 21-40 years (50%) followed by 41-60 years (28.3%). Cough was present in 76.7% of the cases and was the most common presenting symptom of the cases. The cure rate was significantly more among non alcoholics compared to alcoholics. The cure rate was only 60% among smokers compared to 88.5% among non smokers. The non cure rate was high among smokers i.e. 40% compared to only 11.5% among those who never smoked. This difference was found to be statistically significant.Conclusions: Smoking and alcohol were found to be important risk factors for treatment failure in the present study.

Effectiveness of DOTS regime in terms of cure, failure, default and relapse in the treatment of TB patients

Background: DOTS has given very good results in terms of cure and satisfaction among tuberculosis patients. But still some failure and relapse cases occur. Hence studies on effectiveness of DOTS are required. The objectives of research were to study the effectiveness of DOTS regime in terms of cure, failure, default and relapse in the treatment of TB patientsMethods: A hospital based prospective follow up observational study was undertaken in the department of general medicine at a tertiary care medical college and hospital. The present study was conducted among the 60 eligible subjects as per the inclusion and exclusion criteria laid down for the present study.Results: 41 were pulmonary cases and 19 were extra pulmonary patients. At the end of intensive phase only 7 cases were sputum positive out of 37 which reduced to three at the end of extended intensive phase of treatment which further reduced to two at the end of two months of continuation phase. But by the end of completion of continuation phase, one case again became sputum positive i.e. failure case making a final tally to three. It was seen that there was significant weight gain over the period of time in both pulmonary and extra pulmonary cases. The cure rate was 78%. One patient died. Two defaulted and three were failure cases.Conclusions: The DOTS was found to be 78% effective in terms of cure rate. Still there is a huge gap of 22% found in the present scenario which needs to be addressed seriously and by all to prevent multi drug resistant tuberculosis.

Study of incidence, manifestations and complications of dengue fever

Background: Dengue is endemic in India and epidemics are common. Due to poor availability of resources, there is increased morbidity and mortality related to dengue. The objective of the research to study the incidence, manifestations and complications of dengue fever.Methods: Patients admitted in medicine wards of a tertiary care hospital during the study period of two years with the history of fever with other nonspecific symptoms were included in the present study. Data was collected in a pre-tested proforma by meeting objectives of the present study. 100 patients who fulfilled World Health Organization criteria for dengue fever were selected by simple random sampling method.Results: In 75 patients the platelet count was above 150000cell/cumm. Most of them had dengue fever. 12 patients showed platelet count between 20000-100000cells/cumm. and among them 10 were DHF and 2 were simple dengue infection. Five patients showed platelet count less than 20000cells/cumm. and among them 2 were DHF and 3 were DSS. Most of the bleeding skin manifestations were seen when platelet count was below 50000cells/cumm. Mucosal bleeding was observed when the platelet count was below 30000cells/cumm. Abnormal coagulation profile was noted in 18% of the patients and 6% patients were in acute renal failure. Mortality was 0% in dengue fever, 44% in DHF and 100% in DSS.Conclusions: Platelet count was directly related to the number of complications. Dengue shock syndrome and dengue hemorrhagic fever was associated with increased mortality.