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Background:Acute febrile illness with thrombocytopenia is a common condition that is associated with an increased risk of morbidity and mortality. Infection is a common cause of thrombocytopenia. Infections like Malaria, Dengue, Typhoid and septicaemia are some of them. The present study is intended to know the various clinical presentation, laboratory studies, aetiology, clinical complications, relationship between platelet count and severity of disease and prognosis associated with acute febrile illness and thrombocytopenia. Material and Methods: Total 200 patients of age more than 12 years with acute febrile illness with thrombocytopenia attending medicine department were enrolled and studied for demographic details, clinical presentation and complications. Results: Majority of patients were aged <40 years (66.0%) with males (72%) preponderance. Out of total 200 cases enrolled in this study, 82 cases (41%) were diagnosed as dengue fever, 60 cases (30%) were of malaria, 36 cases (n=36;18%) were of scrub typhus, 6 cases (3%) were of Septicemia, 5 cases (n=5;2.5%) were of typhoid fever and 11 cases(5.5%) remain undiagnosed. Conclusion: Dengue was the commonest cause of fever with thrombocytopenia. Common Bleeding manifestations were petechiae /purpura and gum bleeding. Thorough clinical and laboratory evaluation would be helpful to evaluate different causes of fever with thrombocytopenia.
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Background:World Health Organization (WHO) estimated 0.3 million people die every year due to various poisoning agents. Poisoning is the fourth common cause of mortality in India. Acute poisoning accounts for 2-3% of all admissions to hospital in India. In India, as agriculture is the main occupation, insecticides and other agrochemical fertilizers are used to a greater extent and the poisoning with such products are more common. Methods: This prospective observational study was carried out in the Department of Medicine at Government Medical College and associated hospital Haldwani .172 patients who had taken some type of poison, who were more than 12 years of age included. A detailed clinical history and physical examination was performed and recorded on the predesigned proforma. All data were analyzed, documented and interpreted as per the standard laid down protocol.Results: Majority of patients lies were of organophosphate (42.4%) followed by rat killer poison (15.7%) , mosquito repellant (12.2%) , celphos (11.0%) and the least in drug overdose (0.6%). Majority patients survived (84.9%) followed by (15.1%) who expired. Conclusion: Organophosphorous poisoning is one of the most common poisoning in this region of Uttarakhand, predominantly in the young population with a male predominance, belonging to low socioeconomic class. The commonest motive of poisoning was suicidal.
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Background: A thorough understanding of the Rheumatic Heart disease is important to aid in the management of patients with RHD. We hereby thus study various presentations, distributions, clinical profile of various types of valvular involvement in patients with RHD, complications of RHD such as heart failure, arrhythmias, chamber dilation, thromboembolic manifestation, pulmonary hypertension etc. Methods: Total 100 patients of age more than 12 years with Rheumatic heart disease attending medicine and cardiology department were enrolled and studied for demographic details, clinical presentation and complications. Results: Most common age of presentation of valvular heart disease was 21-30 years (41%) with females (57%) preponderance. Mitral valve involvement was the most common (72%), while tricuspid & pulmonary valve involvements were rare. Mitral stenosis 33%) was the most common valvular lesion followed by mitral stenosis with mitral regurgitation. Conclusion: Each valvular lesion in Rheumatic heart disease presented with varied demographic characteristics with peculiar clinical presentation and complication rate.
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Background: Acute renal failure (ARF) or acute kidney injury (AKI) is a clinical condition in which rapid decline in glomerular filtration rate over an hour to days. It is an important clinical condition and common cause of mortality in hospitalized patients. Aims: To analyze the aetiological spectrum and outcome of ARF in Kumaon region of Uttarakhand and to compare data with that of other parts of country. Settings and Design: Hospital based observational analytic study. Methods: This study was conducted on patients admitted to Government Medical College & associated Dr. Susheela Tiwari Memorial Hospital Haldwani from November 2011 to October 2012 with ARF irrespective of the cause. ARF was defined according to AKIN criteria. Statistical analysis used: Statistical analysis of data was performed using SPSS V.20.0 (Windows). All data was summarized and expressed as mean ± SD or as percentages as appropriate. The chi square test was used to analyze categorical variables while the student T-test used to analyze normally distributed data. Statistical significance was accepted at p<0.05. Results: Out of 100 patients, 77% had community acquired ARF and 23% had hospital acquired ARF. Medical causes were leading contributors (68%), while surgical causes in 20% and obstetrical causes in 12% of patients. 36% patients required hemodialysis. The overall mortality was 21%, and highest mortality was found in celphos poisoning group (100%). Conclusion: ARF is still common in the community and is associated with high mortality. Aetiologies like acute gastroenteritis, septicaemia, snakebite and malaria were the leading cause of ARF in our study.
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Leishmaniasis is a major public health problem in various part of world; it has also emerged in new geographic areas and host populations. Visceral infection can remain subclinical or become symptomatic, with an acute, subacute or chronic course. Kala-azar, or visceral leishmaniasis (VL), presents as fever, pancytopenia and hypergammaglobulinaemia. The presence of splenomegaly is characteristic of VL. It may be absent in immunocompromised patients, who may present atypically. Absence of splenomegaly is rare in immunocompetent patients, though it may occur in the early stages. Atypical presentations can be challenging to the clinician. This paper presents an atypical presentation of kala-azar, with multiorgan failure in the absence of splenomegaly or fever.