Clinical Characteristics of SARS-CoV-2 Omicron Cases in Pune, Maharashtra, India.

Background The SARS-CoV-2 Omicron variant, within two months of its detection, replaced the Delta variant to become the dominant circulating variant globally. Therefore, it is essential to understand the characteristics of the disease caused by the variant and its impact on vaccination. Methods A total of 165 confirmed Omicron cases attending a tertiary care hospital in Pune, Maharashtra, between December 2021 to February 2022 were studied. Their demographic, clinical, and immunization history was recorded. Results Among the 165 cases, 7.88% were B.1.1.529 Omicron cases, 25.45% were BA.1 Omicron cases, and 66.67% were BA.2 Omicron cases. Of these 165 patients, 146 (88.48%) were discharged after treatment, 12 (7.27%) died during hospitalization, and seven (4.24%) were brought dead. The presence of one or more comorbid conditions was seen in 15.15%, of which diabetes mellitus and hypertension (28% each) were the most common conditions. Older age (greater than 60 years), an important risk factor for poor outcomes, was present in 9.1% of cases. Among the 165 cases, vaccination with at least one dose of vaccine was found in 80.61% of cases. Out of 165 cases, clinical data was available for 158 cases. Of these 158 cases, 86.71% had symptoms, and 13.29% were asymptomatic. Fever, followed by cough, myalgia, runny nose, and headache, were the most common presenting symptoms. The mean duration of illness was 2.69 days, with 91.14% of cases having the illness for less than five days, and 89.24% of cases had a National Early Warning Score (NEWS) of 1-4, suggesting a good prognosis. In 93.90% of cases, the chest X-ray findings were normal. Of the 158 cases, 92.41% of cases recovered with supportive treatment, and only 7.59% of cases required oxygen therapy. Conclusion The current study shows that the Omicron variant caused mild disease with reduced need for hospital admission and oxygen therapy in India.

Analysis of Clinical and Microbiological Features of Listeria monocytogenes Infection.

Introduction: To analyze the demographics and clinical features of 59 cases of Listeria monocytogenes, and determine the predisposing conditions for severe meningitis infections for reference. Materials and methods: A total of 59 cases isolated L. monocytogenes from 2009 to 2020 were enrolled. Electronic medical record data were used to determine the epidemiological and clinical characteristics of L. monocytogenes infection. Univariate and multifactorial logistic regression analyses were performed to predict risk factors for Listeria meningitis. Results: A total of 59 cases (median age of 52 years, 30 females and 29 males) were enrolled. Twenty-five patients (42.37%) developed a neuroinvasive infection. The indexes of interleukin-6 (IL-6), CD3+T, CD4+T, and CD8+T cells in the study group were higher than those in the control group (P<0.05). In univariate analysis, the use of hormone drugs (odds ratio=3.21, P=0.000) and immunosuppressive agents (odds ratio=3.06, P=0.000) were relevant predictors of severe meningitis. 47 patients (79.66%) were treated with ampicillin (27.12%), carbapenems (18.64%), quinolones (11.86%), and ß-lactamase inhibitors (11.86%) as the primary agents of antimicrobial therapy. Thirty-four patients (57.63%) showed clinical improvement, five patients (8.47%) had a poor prognosis, and two patients (3.39%) died. Conclusion: Infection with Listeria changed the levels of IL-6, CD3+T, CD4+T, and CD8+T cells, and these analyzing items were significantly different between L. monocytogenes and other bacterial infections. Long-term use of immunosuppressants and hormones may be risk factors for severe adult forms of Listeria-related infections. Sensitive antibiotics, such as penicillins and carbapenems, should be added or replaced in the early empiric treatment of L. monocytogenes.

Clinical, Laboratory Characteristics, and Treatment Outcomes of Histoplasmosis Among Patients Admitted to a Referral Tertiary Care Hospital in Bangladesh.

BACKGROUND: Histoplasmosis is a systemic mycosis caused by Histoplasma capsulatum (H. capsulatum). Systemic involvement of histoplasmosis usually occurs in immune-compromised patients, patients with AIDS, or those taking immunosuppressive therapy. The present study aims to describe the clinical and laboratory characteristics and treatment outcome of histoplasmosis as the diagnosis is challenging and management protocol differs. METHOD: This retrospective study was done using a data registry at the medicine department of Dhaka Medical College Hospital. Here, patients received the standard treatment of histoplasmosis. Here, patients received the standard treatment of histoplasmosis, and clinical outcome was assessed at 3 months following starting standard treatment. RESULT: A total of nine patients were enrolled, six (66.7%) had systemic histoplasmosis. Three were poultry workers, and the most common comorbidity was diabetes 3 (33.3%). Fever 7 (77.7%), weight loss 6 (66.7%), hyperpigmentation 5 (55.5%), cough 4 (44.4%), oral ulceration 4 (44.4%), lymphadenopathy 4 (44.4%), and hypotension 3 (33.3%) were the most common clinical presentations. Seven (77.7%) out of nine patients were cured of histoplasmosis; however, one died before initiating antifungal medications and another one died due to a hypersensitivity reaction to liposomal amphotericin B.  Conclusion: For local histoplasmosis, oral itraconazole is an effective antifungal medication. However, in disseminated Histoplasmosis, liposomal amphotericin B followed by oral itraconazole is still one of the preferable and effective treatment options. Clinicians should be aware of hypersensitivity reactions of liposomal amphotericin B and its management before giving an infusion.

A cross-sectional study of clinical and laboratory characteristics of systemic lupus erythematosus in tribal region of Jharkhand at RIMS, Ranchi.

Objectives: Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease of unknown etiology, mainly affecting female of child-bearing age group. Clinical scenario of SLE is not well defined in east region of India, especially in tribal region of Jharkhand. This article is mainly focused on clinical and laboratory characteristics of SLE in tribal region of Jharkhand. Materials and Methods: This was an analytical cross-sectional single-centered study conducted at RIMS, Ranchi, a tertiary care center of Jharkhand, between November 2020 and October 2021. A total 50 patients were diagnosed as SLE based on Systemic Lupus International Collaborating Clinics criteria. Results: Forty-five (90%) of patients in our study were female, with female to male ratio of 9:1. The mean age of presentation was 26.78 ± 8.12. Constitutional symptoms were found in 96% of patients, followed by anemia in 90% of patients. Renal involvement was found in 74% of patients, followed by polyarthritis (72%), malar rash (60%), and neurological manifestations (40%). Anti-nuclear antibody, anti-dsDNA, and anti-Smith antibodies were found positive in 100%, 84%, and 80% of patients, respectively. Conclusions: Clinical characteristics of SLE as per our study would help the health care professionals in this region to identify the disease at early stage and initiate appropriate treatment.

Clinical and Laboratory Factors in Predicting Mortality Among COVID-19 RT-PCR Positive Patients: A Retrospective Observational Study From a Tertiary Care Center.

BACKGROUND: In coronavirus disease 2019 (COVID-19) patients, risk stratification based on clinical presentation, co-morbid illness, and combined laboratory parameters is essential to provide an adequate, timely intervention based on an individual's conditions to prevent mortality among cases. METHODS: A retrospective observational study was carried out from June to October 2020, including all reverse transcription-polymerase chain reaction (RT-PCR) positive COVID-19 non-survivors and control group survivors randomly selected after age and sex matching. Clinical and demographic information was collected from the medical records. Categorical variables were expressed by frequency and percentage. To explore the risk factors associated with mortality, univariable and multivariable logistic regression models were used. RESULTS AND DISCUSSIONS: All non-survivors (n = 100) and 100 survivors (out of 1,018) were analyzed. Male gender (67.4%) was the independent risk factor for COVID-19 infection. Advanced age group, diabetes, cardiovascular, neurological, and hypertensive co-morbidities were statistically associated with mortality. Cardiac arrest and acute kidney injury (AKI) were the most common complications. Mortality is significantly associated with lymphopenia and raised lactate dehydrogenase (LDH), as shown by higher odds. In addition, raised neutrophils, monocytes, aspartate aminotransferase (AST), serum creatinine, interleukin 6 (IL-6), and C-reactive protein (CRP) are also significantly associated with mortality. The most common causes of death were respiratory failure (84%) and acute respiratory distress syndrome (77%). Of the non-survivors, 92% received corticosteroids, 63% were on high-flow nasal cannula oxygen therapy, 29% were mechanically ventilated, and 29% received tocilizumab. CONCLUSION: Serial monitoring of neutrophils, lymphocytes, D-dimer, procalcitonin, AST, LDH, CRP, IL-6, serum creatinine, and albumin might provide a reliable and convenient method for classifying and predicting the severity and outcomes of patients with COVID-19.

Clinical and Laboratory Characteristics of Patients infected by Listeria monocytogenes at a Tertiary Hospital in Hefei City, China.

BACKGROUND: Human listeriosis is a severe foodborne infection caused by Listeria monocytogenes and the data of patients with this infection are largely limited for the Hefei population. PURPOSE: This is a retrospective study that evaluated the clinical and laboratory data of patients with listeriosis at a tertiary hospital in Hefei City. PATIENTS AND METHODS: A total of 24 listeriosis patients were admitted to the First Affiliated Hospital of Anhui Medical University from January 2003 to July 2021. Data from all patients were collected from the hospital's electronic medical records. RESULTS: The most common symptom of all patients was fever (91.7%), followed by altered consciousness (50.0%), rashes (45.8%), respiratory distress symptoms (37.5%), nuchal rigidity (29.2%), and headaches (20.8%). Laboratory results also indicated elevated C-reactive protein (CRP) (79.1%), hypoproteinemia (75.0%), anemia (62.5%), leukocytosis (45.8%), and neutrophilia (45.8%). The mean value of 5.1 µg/mL (SD, 3.8) for D-dimer (D-D) was significantly higher than the normal value ((0.00-0.50) µg/mL), while both altered consciousness (6 vs 4, P = 0.034) and headaches (4 vs 1, P = 0.036) occurred more frequently in the neurolisteriosis group compared with the bacteremia one. Additionally, the mean maximal body temperature (°C) (40.5 ± 0.7) as well as white blood cell (WBC) (15.3 vs 7.5 ×109/L, P = 0.014) and neutrophil (NEUT#) (13.2 vs 6.1 ×109/L, P = 0.026) counts of neurolisteriosis patients were higher than those of bacteremia (39.4 ± 0.4) (P = 0.001). Of all patients, four (50%) from the maternal-neonatal group remained uncured. CONCLUSION: Listeriosis is a rare disease with extremely variable clinical characteristics in Hefei City. Our data indicated that unexplained fever, altered consciousness, hypoproteinemia, anemia, elevated CRP and DD should be considered to assist diagnosis of listeriosis for early treatment interventions.

[The expert evaluation of the cases of death from burn disease during the delayed post-traumatic period]. / Ékspertnaia otsenka sluchaev smerti ot ozhogovoi bolezni v otdalennom posttravmaticheskom periode.

This article was designed to report the results of the comprehensive clinical and morphological analysis of the cases of death from the complications of burn disease based on the available medical documentation, the results of autopsies, and the data obtained in the histological and biochemical investigations. The study made it possible to reveal and identify the most typical, reliable, and stable intravital clinical and laboratory features of sepsis developing in burned individuals as well as postmortem pathomorphological and biochemical changes characterizing this condition supposed to be the immediate cause of death. The results of the study may be used to enhance the objectiveness and the level of evidence of expert conclusions concerning the cause of death of the patients presenting with burn disease and developing complications during its late period.

Mieloma múltiplo: características clínicas e laboratoriais ao diagnóstico e estudo prognóstico / Multiple myeloma: clinical and laboratory characteristics in the diagnosis and prognostic study

O mieloma múltiplo (MM) caracteriza-se por expansão clonal plasmocitária na medula óssea e produção de imunoglobulina monoclonal, promovendo progressivamente destruição óssea, falência renal, supressão da hematopoiética e infecções. A identificação de fatores clínicos e laboratoriais ao diagnóstico é importante para predizer sobrevida. O sistema de estadiamento de Durie e Salmon (1975) é o mais utilizado e baseia-se na correlação entre parâmetros clínico-laboratoriais à massa tumoral. A combinação de β2 microglobulina e albumina sérica resultou em um sistema de estadiamento simples e confiável, conhecido como Sistema Internacional de Estadiamento (ISS), que tem sido reconhecido atualmente. O objetivo deste trabalho foi analisar as características clínicas e laboratoriais, ao diagnóstico, de pacientes portadores de MM e estudo de sobrevida. Realizou-se estudo de coorte não concorrente de 101 pacientes portadores de MM atendidos no Serviço de Hematologia do Hospital das Clínicas da UFMG, que receberam diagnóstico no período de abril de 1994 a 31 de outubro de 2006, através da coleta de dados contidos em prontuários médicos. Os pacientes foram acompanhados até maio de 2007. Foi feita análise descritiva das características ao diagnóstico e estudo de sobrevida, utilizando-se análise univariada pela técnica do produto-limite de Kaplan & Meier e teste de Log-Rank para comparação das curvas; já na análise multivariada, utilizou-se regressão múltipla de Cox. A mediana de idade dos pacientes foi de 63 anos de idade, 47,5 por cento eram homens e 52,5 por cento mulheres, sendo 50,6 por cento brancos, 33,3 por cento negros e 16,1 por cento pardos. Manifestações clínicas mais comuns foram: dor óssea (83,2 por cento), fraqueza (70,3 por cento) e perda de peso (40,6 por cento). Radiografia de esqueleto mostrou alterações em 83,8 por cento dos casos. Em relação ao sistema de estadiamento proposto por Durie & Salmon, 63 (62,4 por cento) pacientes...

Multiple myeloma (MM) is characterized by plasmocyte expansion in the bone marrow and the production of monoclonal immunoglobulin, causing bone destruction, renal failure, hematopoietic suppression and infections. Identification of clinical and laboratory factors in the diagnosis are important to predict survival. The Dürie/Salmon staging system, used for the disease, is based on the correlation of clinical and laboratory parameters on tumoral mass. Studies of the combination of β2 microglobulin and albumin resulted in a simple staging system, known as the International Staging System (ISS), which is currently being used. The objectives of this work were to analyze clinical and laboratory characteristics in the diagnosis of MM patients and a study of survival. A non-competitive cohort study was performed of 101 MM patients attended in the Hematology Service/Hospital das Clínicas-UFMG who were diagnosed in the period of April 1994 to October 2006.A descriptive analysis of the characteristics at diagnosis and a study of survival were made. The descriptive analysis was achieved using the Kaplan-Meier technique and the Log-Rank test utilized for a comparison of survival curves. The Cox regression test was used for multivariate analysis. The average age of the patients was 63 years, 47.5 percent were men and 52.5 percent women, with 50.6 percent being white, 33.3 percent black and 16.1 percent mulattos. The most common clinical manifestations were: bone pain (83.2 percent) and weakness (70.3 percent). Radiographies of the skeleton showed alterations in 83.8 percent of the cases. In respect to the Dürie/Salmon staging system, 63 (62.4 percent) patients were in stage III, 32 (31.7 percent) in stage II and 6 (5.9 percent) in stage I. Using the ISS classification, 22 (30.1 percent) patients were in stage III, 31 (42.5 percent) in stage II and 20 (27.4 percent) in stage I. Overall survival was 66.52 months with a follow-up of 20 months. In...