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Dr Saurabh Kashyap

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  • 1. Inflow Of Diphtheria Cases In a Tertiary Care Centre
    Prof. J.V Singh, Head
    Deptt. of Community Medicine
    CSM Medical University UP,
    Lucknow
    Dr. Saurabh Kashyap, JR-1
    Deptt. of Community Medicine
    CSM Medical University UP,
    Lucknow
  • 2. Introduction
    Diphtheria is an acute respiratory tract illness, caused by Cornynebacteriumdiphtheriae, a facultative anaerobic gram positive bacterium. It is characterized by sore throat, low fever, and an adherent membrane (a pseudo membrane)on the tonsils, pharynx,and/or nasal cavity. A milder form of diphtheria can be restricted to the skin. Uncommon consequences include myocarditis (about 20% cases)and peripheral neuropathy(about 10% of cases).
  • 3. Introduction Contd……
    The current definition of diphtheria used by the Centers for Disease Control and Prevention (CDC) is based on both laboratory and clinical criteria.
    Laboratory criteria
    • Isolation of Corynebacteriumdiphtheriae from a clinical specimen, or
    • 4. Histopathologic diagnosis of diphtheria
    Clinical criteria
    • Upper respiratory tract illness with sore throat
    • 5. Low-grade fever (>103°F is rare)
    • 6. An adherent pseudomembrane of the tonsil(s), pharynx, and/or nose.
    Case classification
    • Probable: a clinically compatible case that is not laboratory-confirmed and is not epidemiologically linked to a laboratory-confirmed case
    • 7. Confirmed: a clinically compatible case that is either laboratory-confirmed or epidemiologically linked to a laboratory-confirmed case
  • Objectives
    To study the inflow of diphtheria cases in a tertiary care hospital in last two months.
    To study the distribution of diphtheria cases (residence, age, sex, socioeconomic status, immunization pattern, occupation, education, religion and habitat).
  • 8. METHODOLOGY
    Study site: The Department of Pediatrics CSMMU, Lucknow.
    Study design: A Case-series study
    Study duration: 2 months from 1st August to 30th September 2010.
    Study population: Clinically suspected case of diphtheria admitted in the hospital.
  • 9. RESULTS AND OBSERVATIONS
  • 10. Table-1: District Wise Distribution Of Diphtheria Cases And Vaccination Status
  • 11. District wise distribution of the studied diphtheria cases and actual immunisation coverage (DLHS-3 2007-08)
  • 12. Table 2: Age and Sex Distribution of Diphtheria Cases
  • 13. Table 3: Socio-economic and Immunization status of Diphtheria cases
  • 14. Table 4: Bio-social profile of families of the diphtheria cases
  • 15. HABITAT OF DIPHTHERIA CASES
  • 16. Conclusion
    The maximum cases were seen above 1 yr of age, out of which 33.63% were of above the age of 5 yrs.
    Maximum number of diphtheria cases (29.20%)were from Lucknow district.
    Majority (49.56%) of cases were unimmunized and 39.82%were partially immunized.
    87% of the diphtheria cases were from rural background.
    The study shows predominance of diphtheria cases among males(59.30%) as compared to that of females(40.70%).
  • 17. Conclusion……
    6. The number of diphtheria cases were more in lower socioeconomic class(74.34%) followed by lower middle class(17.70%).
    7. Hindus were affected more(70.80%) than any other religion.
    8. In 43.36% cases the Head of the family were illiterate.
    9. 4 cases died while on treatment , out of which 1 died of rare complication (cardiomyopathy).
    10. 2 patient left the hospital against medical advice and rest were discharged following improvement.
  • 18. Thank you

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