Acute pancreatitis - a rare manifestation in scrub typhus

Background: Scrub typhus is an acute febrile illness caused by the bacteria - Orientia tsutsugamushi, transmitted through the bite of an infected chigger. This infection is endemic in tropical countries like India, Pakistan, and Bangladesh. It usually presents with fever, headache, myalgia, nausea, vomiting, abdominal pain, and tender lymphadenopathy. The presence of an eschar clinches the diagnosis clinically. Commonly encountered complications in scrub typhus include acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), acute liver injury, and rarely acute pancreatitis. Case Presentation: We report a case of a 70 year-old teetotaller male, who presented with acute febrile illness and respiratory distress during the peak period of the COVID -19 pandemic. During the course of illness, the patient developed acute pancreatitis as evidenced by elevated serum amylase and lipase as well as features of pancreatitis in the CT abdomen. Common causes of acute pancreatitis were ruled out with necessary investigations. He tested negative for malaria, dengue fever, enteric fever, and leptospirosis, but his IgM and IgG ELISA for scrub typhus were positive with high titres. He also had AKI, ARDS, and acute liver injury. The patient was treated symptomatically and with doxycycline. His condition improved gradually. Conclusion: Even though acute pancreatitis is one of the rare manifestations of scrub typhus, it should be suspected early and treated promptly.

An Interesting Case of Inflammatory Myositis

Background: Idiopathic inflammatory myopathies (IIM) are a class of long-lasting autoimmune diseases that typically affect the proximal muscles. Dermatomyositis (DM), polymyositis (PM), necrotizing autoimmune myopathy (NAM), and sporadic inclusion body myositis are the most prevalent kinds. Patients usually have subacute to chronic proximal weakness, which presents as difficulty getting out of a chair, getting up the stairs, lifting objects, and brushing their hair. They are distinguished by their clinical presentation, which includes muscular and ex-tramuscular signs. Elevated serum creatine kinase (CK) levels and myositis-specific antibodies may help distinguish clinical phenotypes and confirm the diagnosis. Biopsy of the muscle, on the other hand, is still the gold standard for determining the cause of the problem. These disorders may be cured with proper diagnosis and treatment. The treatment's goals are to reduce inflammation, restore muscle performance, and alleviate pain. Method(s): 36-year-old man K/C/O dermatomyositis came complaints of redness swelling in the right eye for 3 months, dysphagia, easy fatiguability. Patient was neither hypertensive nor diabetic. Result(s): This case describes the severity of NXP2 autoantibody and a potential to be life threatening. Patient was started with immunoglobulins, monoclonal antibodies. After which patient improved from his present condition.Copyright © 2022 Novyi Russkii Universitet. All rights reserved.

Comparison of Dengue NS1 Antigen ICT, NS1 ELISA & RTPCR among the Patients Having <5 Days of Dengue like Fever

Introduction: Dengue viral infection is an arboviral disease which is transmitted by Aedes aegypti and Aedes albopictus. Dengue cases are now increasing a global burden especially in tropical and subtropical countries.1 The patients with dengue fever have high levels of nonstructural protein-1 (NS1) protein in their serum after onset till <5 days. The present study aims to establish most sensitive and reliable method for the early diagnosis of dengue infection. Materials & Methods: Total 110 patients were screening who were having <5 days of history of dengue like fever at NIMS Medical College, NIMS University, Jaipur from June 2020 to Oct 2022. For Dengue NS1 ICT & ELISA J. Mitra Pvt Ltd. Kits were used. Dengue RTPCR was done by TRU PCR 3B Black Bio kits as per standard protocol.5 Results: Out of 110, total 72 (65.45%) cases were positive (either by ICT, ELISA & RTPCR). Among 72 dengue positive cases 48 (66.6%) were male while 24 (33.4%) were females. Male: female ratio was 2:1 observed. 55 patients were positive by Dengue NS1 ICT, 59 were positive by NS1 ELISA while 72 cases were positive by RTPCR. Conclusion: Early detection and diagnosis are very important in the case of dengue infection as if it is not treated it may lead to many complications. RTPCR is the most sensitive and specific method for the early diagnosis of dengue. After this covid pandemic most hospitals have RTPCR lab facilities which can be utilized for dengue detection by RTPCR.

Role of Inflammatory Markers in Predicting Severity and Outcome in COVID-19 Patients Attending a Tertiary Care Institute of Tamil Nadu

Background: Severe acute respiratory syndrome Coronavirus 2 (SARS-COV 2) infection elicits an inflammatory response which is responsible for severe clinical manifestations, disease progression and, poor outcomes. Objectives: This study aims to assess the pattern of elevation of inflammatory markers in COVID-19 and to determine their association with clinical, radiological severity and outcome of COVID 19. Methodology: This is a retrospective single-center cross-sectional study conducted at Chettinad Hospital and Research Institute, a tertiary care Hospital in Tamil Nadu, India, encompassing a cohort of 1220 patients. The source population was all cases of COVID-19 admitted at the hospital with a confirmed diagnosis of COVID-19 using RT PCR. The data was obtained from the patient’s case sheets and laboratory investigations and from the electronic data management system. The patient’s clinical severity on admission, baseline characteristics, co-morbid illnesses, presenting complaints, vitals, and inflammatory markers like D-dimer, C-reactive protein IL-6, Serum ferritin, and Lactate dehydrogenase were collected. The data for radiological severity and outcome were coded and analysed. Results: Diabetes and hypertension were found to be the most common comorbidities in the study population;females more affected than males. Fever and cough are the most common presenting symptoms. The clinical severity of patients was found to have a significant association with radiological severity. D-dimer is having a strong correlation with disease severity and outcome at any point in time. IL-6, CRP, Serum ferritin also showed a strong correlation with outcome in COVID-19. Conclusion: Our study suggests D-dimer at any point of time in a hospitalized COVID-19 patient as a promising marker for the same. IL-6 is the next best inflammatory marker followed by CRP and Serum ferritin. LDH is the least significant one among these. Copyright (c) 2022: Author(s).

Paper-Based Point-Of-Care Biosensor for Covid-19

Corona virus disease 2019 (COVID-19) outbreak has developed into a universal pandemic. The harmful effects of corona virus have provoked the advance of diagnostic tools to supervise the spread of disease. While conservative technologies have been mostly used to detect COVID-19, they are protracted, manual and are unavailable in distant settings. Point-of-care (POC) biosensors, including paper-based biosensors are characteristicallylow-priced and accessible, which presentincredibleprospective for speedy medical diagnosis. In view of the risinginsist for quick diagnosis of COVID-19, a mini review that summarizes the currentadvancement in developing POC biosensors for COVID-19 is exceedinglyattractive. In this article, the most modern advances in POC biosensors, including paper-based biosensors for the recognition of COVID-19 infection are reviewed.

Spatial analysis of perceived health system capability and actual health system capacity for covid-19 in south africa

Introduction: People’s confidence in the health system's capability in managing the COVID-19 pandemic can determine public support, risk perceptions, and compliance to the required behaviors during the pandemic. Therefore, this paper investigated people’s perception of health system capability to manage the COVID-19 pandemic in different spatial areas across the country using data from an online survey. Methods: Multivariate logistic regression models were used to examine factors associated with people’s perception of the health system capability to manage the COVID-19 pandemic at the national and provincial levels. Spatial comparative analysis was conducted to contrast spatial density indicators of the number of hospitals, hospital beds, and ICU beds per given population across various provinces. Results: Findings showed that South Africans had low confidence in the health system capability, with only two in five (40.7%) reporting that they thought that the country’s health system was able to manage the COVID-19 pandemic. Sex and knowledge on COVID-19 were significantly associated with the people’s perception of the health system capability to manage the pandemic at the national level and in four of the nine provinces. Conclusion: Overall, the findings of this study clearly highlight challenges facing the country’s health system, both perceived or real, that needed to be addressed as part of the preparation for the COVID-19 pandemic. Timeous implementation of a countrywide National Health Insurance (NHI) system is now more critical than ever in improving healthcare outcomes of the South African population beyond the existence of the COVID-19 epidemic.

South Africans' understanding of and response to the COVID-19 outbreak: An online survey.

BACKGROUND: The COVID-19 outbreak is in an accelerating phase, and South Africa (SA) has had the highest number of documented cases during the early phase of the pandemic in sub-Saharan Africa. OBJECTIVES: To assess South Africans' understanding of and response to COVID-19 during the first week of the country's lockdown period. METHODS: An online survey was conducted in SA from 27 March to 2 April 2020. The survey was distributed widely among several websites and social media networks, including on a data-free platform. Descriptive statistics of knowledge, risk perception, access to and trust in information sources, and public and media opinions were calculated. Estimates were benchmarked to the 2019 national adult population estimates. RESULTS: Of the 55 823 participants, the majority (83.4%) correctly identified the main symptoms of COVID-19. Over 90% had correct knowledge of the incubation period, with lower rates for 18 - 29-year-olds. Knowledge of symptoms and the incubation period varied significantly by population group (p<0.001), dwelling type (p<0.001) and sex (p<0.001). A quarter (24.9%) perceived themselves as at high risk of contracting COVID-19. Risk perception varied by age, population group, employment status and dwelling type (p<0.001). The most prevalent COVID-19 information sources were government sources (72.9%), news websites/apps (56.3%), satellite television (51.6%) and local television (51.4%). CONCLUSIONS: Understanding knowledge, attitudes and behaviours of people facing the COVID-19 pandemic is crucial for guiding strategic policy. These findings provide public understanding of COVID-19 as the phases of the country-level epidemic progress, and also directly inform communication needs and gaps.