International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
This document provides guidelines for the diagnosis and treatment of community-acquired pneumonia (CAP) in adults. It addresses 12 questions regarding best practices for diagnosis and management of CAP in both outpatient and inpatient settings. For each question, the document reviews the relevant evidence and provides treatment recommendations based on that evidence. The recommendations aim to optimize patient outcomes while minimizing unnecessary testing and promoting judicious antibiotic use.
1) Diabetes is identified as a risk factor for worse outcomes from COVID-19 based on studies from China. Mortality was 10% in COVID-19 patients with diabetes versus 2.5% for non-diabetic patients.
2) People with diabetes have an increased risk of severe COVID-19 infection due to defects in innate immunity from hyperglycemia and an increased inflammatory response.
3) The interaction between the SARS-CoV-2 virus and the renin-angiotensin-aldosterone system, which regulates blood pressure and fluid balance, may help explain the link between diabetes, hypertension, and increased COVID-19 severity. The virus relies on binding to ACE2 receptors to infect
This study characterized dengue infections in Pakistan by analyzing hematological and serological markers in 154 suspected dengue cases and 146 control patients with other febrile illnesses. NS1 antigen was detected in 55% of dengue cases, IgM antibodies in 30%, and both in 15%. Control groups primarily had malaria (71%) and enteric fever (20%). Hematological markers (platelet count, hematocrit, WBC) measured before and after treatment showed significant differences for platelet count and hematocrit but not WBC count between the groups. Analysis of clinical symptoms and serological/hematological markers helps diagnose dengue, assess prognosis, and inform prevention efforts to reduce morbidity, mortality and spread of the disease.
This review article discusses autoimmunity in dengue pathogenesis. It suggests that in addition to direct viral effects, immunopathogenesis, including aberrant immune activation and autoantibodies, plays a role in the development of severe dengue disease. Autoantibodies against endothelial cells, platelets, and coagulation molecules induced by dengue virus infection may lead to abnormal activation or dysfunction of these cells and molecules. Molecular mimicry, where dengue virus proteins mimic host proteins, could explain the cross-reactivity of autoantibodies induced during dengue virus infection. Understanding immunopathogenic mechanisms is important for developing a safe and effective dengue vaccine.
This document summarizes HIV-associated pulmonary hypertension (HIV-PAH). Some key points:
- The prevalence of HIV-PAH is estimated to be 0.5% of those with HIV infection based on a large French study. This could mean around 200,000 cases worldwide given the number living with HIV.
- HIV viral proteins like gp120 and nef may directly damage pulmonary endothelial cells, and the chronic inflammation in HIV could also induce PAH through growth factors. Additional risk factors like stimulant drug use may act as a "second hit".
- Survival for HIV-PAH is worse than for HIV alone, though it has improved with antiretroviral therapy. A low CD4
Evaluation of Cardiac Complications in Pateint Undergoing COVID 19 Treatment:...DrHeena tiwari
This study evaluated cardiac complications in 45 COVID-19 patients admitted to the intensive care unit. Electrocardiography and Holter monitoring found various arrhythmias in patients, with atrial fibrillation, premature ventricular contraction, and tachycardia being most common. The mortality rate of arrhythmias in COVID-19 patients was 17.77%. Although arrhythmias are not very frequent in COVID-19, they can be fatal and have a high mortality rate. Early detection of arrhythmias can help prevent deaths.
The document discusses kidney involvement in COVID-19 patients. It notes that acute kidney injury (AKI) occurs in 3-9% of early COVID-19 patients, rising to 19-50% of ICU patients. AKI is associated with higher mortality, between 35-90% among those with COVID-19. Pathological findings include collapsing glomerulopathy and acute tubular injury. Viral particles have been found in podocytes and tubular cells on postmortem and kidney biopsy studies.
This document provides guidelines for the diagnosis and treatment of community-acquired pneumonia (CAP) in adults. It addresses 12 questions regarding best practices for diagnosis and management of CAP in both outpatient and inpatient settings. For each question, the document reviews the relevant evidence and provides treatment recommendations based on that evidence. The recommendations aim to optimize patient outcomes while minimizing unnecessary testing and promoting judicious antibiotic use.
1) Diabetes is identified as a risk factor for worse outcomes from COVID-19 based on studies from China. Mortality was 10% in COVID-19 patients with diabetes versus 2.5% for non-diabetic patients.
2) People with diabetes have an increased risk of severe COVID-19 infection due to defects in innate immunity from hyperglycemia and an increased inflammatory response.
3) The interaction between the SARS-CoV-2 virus and the renin-angiotensin-aldosterone system, which regulates blood pressure and fluid balance, may help explain the link between diabetes, hypertension, and increased COVID-19 severity. The virus relies on binding to ACE2 receptors to infect
This study characterized dengue infections in Pakistan by analyzing hematological and serological markers in 154 suspected dengue cases and 146 control patients with other febrile illnesses. NS1 antigen was detected in 55% of dengue cases, IgM antibodies in 30%, and both in 15%. Control groups primarily had malaria (71%) and enteric fever (20%). Hematological markers (platelet count, hematocrit, WBC) measured before and after treatment showed significant differences for platelet count and hematocrit but not WBC count between the groups. Analysis of clinical symptoms and serological/hematological markers helps diagnose dengue, assess prognosis, and inform prevention efforts to reduce morbidity, mortality and spread of the disease.
This review article discusses autoimmunity in dengue pathogenesis. It suggests that in addition to direct viral effects, immunopathogenesis, including aberrant immune activation and autoantibodies, plays a role in the development of severe dengue disease. Autoantibodies against endothelial cells, platelets, and coagulation molecules induced by dengue virus infection may lead to abnormal activation or dysfunction of these cells and molecules. Molecular mimicry, where dengue virus proteins mimic host proteins, could explain the cross-reactivity of autoantibodies induced during dengue virus infection. Understanding immunopathogenic mechanisms is important for developing a safe and effective dengue vaccine.
This document summarizes HIV-associated pulmonary hypertension (HIV-PAH). Some key points:
- The prevalence of HIV-PAH is estimated to be 0.5% of those with HIV infection based on a large French study. This could mean around 200,000 cases worldwide given the number living with HIV.
- HIV viral proteins like gp120 and nef may directly damage pulmonary endothelial cells, and the chronic inflammation in HIV could also induce PAH through growth factors. Additional risk factors like stimulant drug use may act as a "second hit".
- Survival for HIV-PAH is worse than for HIV alone, though it has improved with antiretroviral therapy. A low CD4
Evaluation of Cardiac Complications in Pateint Undergoing COVID 19 Treatment:...DrHeena tiwari
This study evaluated cardiac complications in 45 COVID-19 patients admitted to the intensive care unit. Electrocardiography and Holter monitoring found various arrhythmias in patients, with atrial fibrillation, premature ventricular contraction, and tachycardia being most common. The mortality rate of arrhythmias in COVID-19 patients was 17.77%. Although arrhythmias are not very frequent in COVID-19, they can be fatal and have a high mortality rate. Early detection of arrhythmias can help prevent deaths.
The document discusses kidney involvement in COVID-19 patients. It notes that acute kidney injury (AKI) occurs in 3-9% of early COVID-19 patients, rising to 19-50% of ICU patients. AKI is associated with higher mortality, between 35-90% among those with COVID-19. Pathological findings include collapsing glomerulopathy and acute tubular injury. Viral particles have been found in podocytes and tubular cells on postmortem and kidney biopsy studies.
CNS Iinfection dengue, Teaching Slides, Dr M D Mohire, Kolhapur, Maharashtra,...Mahavir Mohire
1) A study of 210 patients with infectious acute encephalitis syndrome (AES) in India found that 62% had a specific etiological diagnosis. The most common causes were herpes virus (12 patients) and Japanese encephalitis virus (8 patients) for neurological AES, and scrub typhus (42 patients) and dengue virus (20 patients) for systemic AES.
2) Using a syndromic approach, neurological AES could be differentiated from systemic AES with 100% specificity based on the absence of myalgia or rash. Thalamic involvement on imaging predicted Japanese encephalitis with 100% specificity for neurological AES cases.
3) Targeted testing and treatment based on the syndromic approach substantially reduced
Study of Clinical and laboratory profile of dengue like illness in a tertiary...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This document provides guidelines for the clinical management of dengue fever, dengue hemorrhagic fever, and dengue shock syndrome. It begins with an introduction to dengue epidemiology in India, noting that all four dengue virus serotypes are present and outbreaks regularly occur between July and November. Chapter 2 discusses the epidemiological factors involved, including the dengue virus agent, the Aedes aegypti mosquito vector, and environmental factors that determine endemicity. Proper management of dengue cases is important given the lack of treatment or vaccine.
1. The document discusses SARS-CoV-2, the virus that causes COVID-19, including its transmission, clinical manifestations, risk factors, investigations, and management guidelines.
2. Key points include that SARS-CoV-2 is transmitted via droplets or contact and may cause asymptomatic to critical illness. Common symptoms include fever, cough and shortness of breath.
3. Older adults and those with pre-existing medical conditions are at higher risk for severe illness. Diagnosis is confirmed via RT-PCR testing of respiratory samples, while chest imaging may show pneumonia.
The document summarizes the link between hypertension (HTN) and COVID-19. It finds that approximately 22.5% of COVID-19 patients have HTN, making it the most common comorbidity. Patients with HTN who contract COVID-19 have a higher risk of severe outcomes like intensive care unit admission and death. The document also discusses how the renin-angiotensin-aldosterone system, which HTN medications target, may impact the interaction of the COVID-19 virus with the body. Specifically, angiotensin-converting enzyme 2 is utilized by the COVID-19 virus to enter cells and HTN medications like ACE inhibitors may alter ACE2 expression levels.
Upsurge of chikungunya cases in Uttar Pradesh, IndiaAhmad Ozair
Background & objectives: Chikungunya (CHIK) re-emerged in India in 2006 after a gap of three decades. In Uttar Pradesh (UP), <100 confirmed cases per million were reported during this outbreak. Based on an upsurge of CHIK cases at UP, this retrospective study was conducted to investigate clinical and serological profile of CHIK cases in UP. Methods: A retrospective study was done on all clinically suspected CHIK cases that had been tested by ELISA for anti-CHIK virus IgM antibodies from September 2012 to December 2017. Based on clinical features, a subset of patients had earlier been tested serologically for dengue and Japanese encephalitis (JE). Results: Of the 3240 cases enrolled, 771 (23.8%) were seropositive. Patients had a range of clinical manifestations with seropositivity highest in those exhibiting arthralgia with fever (40%), followed by fever of unknown origin (FUO) (22%), encephalitis (13%) and fever with rash (12%). Cases (total, seropositive) increased over 20-fold in 2016 (1389, 412) and 2017 (1619, 341), compared to 2012-2015. Nearly a third of dengue serology-positive cases and a fifth of JE serology-positive cases were co-positive for CHIKV. Interpretation & conclusions: Archival data from 2006-2011 and data from this study (2012-2017) indicated that UP experienced first CHIK outbreak in the decade in 2016, as part of a large-scale upsurge across northern India. CHIK should be considered as a differential diagnosis in patients presenting with fever of unknown origin or fever with rash or acute encephalitis, in addition to classical arthralgia.
The document discusses gastrointestinal manifestations and potential fecal-oral transmission of COVID-19. It notes that while respiratory symptoms are most common, diarrhea and other gastrointestinal symptoms have been reported. Mounting evidence suggests the virus can infect cells in the digestive system and be present in stool. This raises the possibility of fecal-oral transmission, making the digestive system an alternative infection route. More research is still needed to understand the virus's effects on the gastrointestinal system and liver.
This document discusses an approach to aquatic skin infections. It presents a case of a 45-year-old male with liver disease who developed severe leg pain and swelling after consuming raw oysters. He was diagnosed with Vibrio vulnificus infection based on blood and wound cultures. V. vulnificus is found in coastal waters and can cause serious soft tissue infections or sepsis, especially in individuals with liver disease or iron overload. Prompt treatment with antibiotics is needed but prognosis remains poor, with fatality rates over 50% for septicemia.
Cardiovascular Disease Associated with SARS-CoV-2 and HIV InfectionsInsideScientific
1) The document discusses a study presenting a new mouse model for severe COVID-19 disease.
2) The model shows lung infection and damage, as well as multi-organ impacts including thrombosis.
3) The study finds evidence that SARS-CoV-2 can directly infect and dysregulate endothelial cells in the lungs and other organs in this mouse model as well as nonhuman primates and humans.
Scrub typhus manifesting with intracerebral hemorrhage: Case report and revie...Ahmad Ozair
Scrub typhus (ST), hitherto absent from many parts of India, is now recently being recognized as a significant cause of morbidity and mortality throughout the country. Its diverse clinical presentations, low of the index of suspicion by the treating physician, and lack of diagnostic testing in many parts of the country result in delayed treatment, leading to a host of complications. We here report such a complication, where ST manifested with a large intracerebral hemorrhage, of which, to the best of our knowledge, only nine cases have been reported in the English language worldwide. Family physicians, who are the often first point of contact for treatment of febrile illness, as ST typically manifests, need to be aware of this entity to prevent such catastrophic consequences.
Guidelines on clinical management of Dengue Fever & Dengue Hemorrhagic SyndromePk Doctors
This document provides guidelines for the clinical management of dengue fever and dengue hemorrhagic fever in Sri Lanka. It begins with an overview of dengue illness, noting that dengue fever is usually a mild disease caused by primary infection, while dengue hemorrhagic fever is a more severe disease more commonly seen in secondary infections. It describes the typical features of dengue hemorrhagic fever including high fever, bleeding tendencies, hepatomegaly, and circulatory disturbance or shock in severe cases. The clinical course is also summarized, with the illness divided into febrile, critical, and convalescent phases.
Over 5 years, 5,029 acute febrile patients in Addis Ababa, Ethiopia were tested serologically for typhoid fever and typhus fever. 23% (1,121 patients) tested positive for typhus fever. The highest number of positive typhus cases was in patients aged 21-30 years old (37.6% of positive cases). Approximately 6% of febrile patients were co-infected with typhoid fever and typhus fever. The study found that multiple infections commonly occurred and resulted in more severe illness than single infections.
Study of clinical and etiological profile of community acquired pneumonia in ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The document discusses pneumonia treatment guidelines in Taiwan. It provides background on the etiology of community-acquired pneumonia (CAP) in Taiwan. It then summarizes the key changes between the 2018 and 2007 Taiwan pneumonia guidelines, including the use of a modified GRADE methodology, definitions of healthcare-associated pneumonia (HCAP) and pediatric pneumonia. The major sections of the 2018 guidelines covered CAP, hospital-acquired pneumonia (HAP), HCAP subdivided into nursing home-associated and hemodialysis-associated pneumonia, and pediatric pneumonia.
A trial of Lopinavir-Ritonavir in Adults Hospitalized with Sever COVID-19Valentina Corona
This randomized controlled trial studied 199 hospitalized adult patients with severe Covid-19 in Wuhan, China to evaluate if the drug combination lopinavir-ritonavir provided benefits beyond standard care. Patients received either lopinavir-ritonavir plus standard care or standard care alone. Treatment with lopinavir-ritonavir did not significantly reduce time to clinical improvement or mortality at 28 days compared to standard care. Gastrointestinal side effects were more common with lopinavir-ritonavir. The study found no clinical benefit to using lopinavir-ritonavir for severe Covid-19.
Outcome of 16 years of hemodialysis infection controlJAFAR ALSAID
The study analyzed the outcomes of a tight infection control protocol over 16 years in a hemodialysis unit. The protocol was successful in limiting hemodialysis-related bloodstream infections and admissions. Specifically:
- The rate of hemodialysis-related bloodstream infections was 0.003 per 100 patient months, far below the international reported rate of 0.75-4.4 infections per 100 patient months.
- The admission rate for hemodialysis-related bloodstream infections was 0.4 per 1000 patient years, much lower than the international rate of 108 admissions per 1000 patient years.
- Only 12 patients experienced hemodialysis-related bloodstream infections over nearly 19 years and
A Study Of Clinical And Laboratory Profile Of Dengue Fever In AJoe Andelija
This study analyzed the clinical and laboratory profiles of 150 adult patients diagnosed with dengue fever at a hospital in India over 5 months. Most patients were male between the ages of 21-40. The most common symptoms were fever, headache, myalgia, and abdominal pain. Bleeding manifestations occurred in 19% of patients, most commonly melena. Laboratory findings included thrombocytopenia in all patients and elevated hematocrit in 23% of patients. 21% of cases had severe dengue hemorrhagic fever/dengue shock syndrome. The study aims to better understand the characteristics of dengue patients to aid in diagnosis and management.
This document summarizes information on dengue fever in Pakistan. It discusses that dengue virus has four circulating serotypes that cause the disease. Non-structural glycoprotein NS-1 damages liver cells and activates the complement system, exacerbating the disease severity. Reverse transcription polymerase chain reaction and real-time PCR are commonly used diagnostic tests to detect the virus. Dengue incidence is highest in Pakistan from August to December and primarily affects males ages 13-35 years. All four serotypes circulate in Pakistan and secondary infections can cause more severe disease.
CNS Iinfection dengue, Teaching Slides, Dr M D Mohire, Kolhapur, Maharashtra,...Mahavir Mohire
1) A study of 210 patients with infectious acute encephalitis syndrome (AES) in India found that 62% had a specific etiological diagnosis. The most common causes were herpes virus (12 patients) and Japanese encephalitis virus (8 patients) for neurological AES, and scrub typhus (42 patients) and dengue virus (20 patients) for systemic AES.
2) Using a syndromic approach, neurological AES could be differentiated from systemic AES with 100% specificity based on the absence of myalgia or rash. Thalamic involvement on imaging predicted Japanese encephalitis with 100% specificity for neurological AES cases.
3) Targeted testing and treatment based on the syndromic approach substantially reduced
Study of Clinical and laboratory profile of dengue like illness in a tertiary...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This document provides guidelines for the clinical management of dengue fever, dengue hemorrhagic fever, and dengue shock syndrome. It begins with an introduction to dengue epidemiology in India, noting that all four dengue virus serotypes are present and outbreaks regularly occur between July and November. Chapter 2 discusses the epidemiological factors involved, including the dengue virus agent, the Aedes aegypti mosquito vector, and environmental factors that determine endemicity. Proper management of dengue cases is important given the lack of treatment or vaccine.
1. The document discusses SARS-CoV-2, the virus that causes COVID-19, including its transmission, clinical manifestations, risk factors, investigations, and management guidelines.
2. Key points include that SARS-CoV-2 is transmitted via droplets or contact and may cause asymptomatic to critical illness. Common symptoms include fever, cough and shortness of breath.
3. Older adults and those with pre-existing medical conditions are at higher risk for severe illness. Diagnosis is confirmed via RT-PCR testing of respiratory samples, while chest imaging may show pneumonia.
The document summarizes the link between hypertension (HTN) and COVID-19. It finds that approximately 22.5% of COVID-19 patients have HTN, making it the most common comorbidity. Patients with HTN who contract COVID-19 have a higher risk of severe outcomes like intensive care unit admission and death. The document also discusses how the renin-angiotensin-aldosterone system, which HTN medications target, may impact the interaction of the COVID-19 virus with the body. Specifically, angiotensin-converting enzyme 2 is utilized by the COVID-19 virus to enter cells and HTN medications like ACE inhibitors may alter ACE2 expression levels.
Upsurge of chikungunya cases in Uttar Pradesh, IndiaAhmad Ozair
Background & objectives: Chikungunya (CHIK) re-emerged in India in 2006 after a gap of three decades. In Uttar Pradesh (UP), <100 confirmed cases per million were reported during this outbreak. Based on an upsurge of CHIK cases at UP, this retrospective study was conducted to investigate clinical and serological profile of CHIK cases in UP. Methods: A retrospective study was done on all clinically suspected CHIK cases that had been tested by ELISA for anti-CHIK virus IgM antibodies from September 2012 to December 2017. Based on clinical features, a subset of patients had earlier been tested serologically for dengue and Japanese encephalitis (JE). Results: Of the 3240 cases enrolled, 771 (23.8%) were seropositive. Patients had a range of clinical manifestations with seropositivity highest in those exhibiting arthralgia with fever (40%), followed by fever of unknown origin (FUO) (22%), encephalitis (13%) and fever with rash (12%). Cases (total, seropositive) increased over 20-fold in 2016 (1389, 412) and 2017 (1619, 341), compared to 2012-2015. Nearly a third of dengue serology-positive cases and a fifth of JE serology-positive cases were co-positive for CHIKV. Interpretation & conclusions: Archival data from 2006-2011 and data from this study (2012-2017) indicated that UP experienced first CHIK outbreak in the decade in 2016, as part of a large-scale upsurge across northern India. CHIK should be considered as a differential diagnosis in patients presenting with fever of unknown origin or fever with rash or acute encephalitis, in addition to classical arthralgia.
The document discusses gastrointestinal manifestations and potential fecal-oral transmission of COVID-19. It notes that while respiratory symptoms are most common, diarrhea and other gastrointestinal symptoms have been reported. Mounting evidence suggests the virus can infect cells in the digestive system and be present in stool. This raises the possibility of fecal-oral transmission, making the digestive system an alternative infection route. More research is still needed to understand the virus's effects on the gastrointestinal system and liver.
This document discusses an approach to aquatic skin infections. It presents a case of a 45-year-old male with liver disease who developed severe leg pain and swelling after consuming raw oysters. He was diagnosed with Vibrio vulnificus infection based on blood and wound cultures. V. vulnificus is found in coastal waters and can cause serious soft tissue infections or sepsis, especially in individuals with liver disease or iron overload. Prompt treatment with antibiotics is needed but prognosis remains poor, with fatality rates over 50% for septicemia.
Cardiovascular Disease Associated with SARS-CoV-2 and HIV InfectionsInsideScientific
1) The document discusses a study presenting a new mouse model for severe COVID-19 disease.
2) The model shows lung infection and damage, as well as multi-organ impacts including thrombosis.
3) The study finds evidence that SARS-CoV-2 can directly infect and dysregulate endothelial cells in the lungs and other organs in this mouse model as well as nonhuman primates and humans.
Scrub typhus manifesting with intracerebral hemorrhage: Case report and revie...Ahmad Ozair
Scrub typhus (ST), hitherto absent from many parts of India, is now recently being recognized as a significant cause of morbidity and mortality throughout the country. Its diverse clinical presentations, low of the index of suspicion by the treating physician, and lack of diagnostic testing in many parts of the country result in delayed treatment, leading to a host of complications. We here report such a complication, where ST manifested with a large intracerebral hemorrhage, of which, to the best of our knowledge, only nine cases have been reported in the English language worldwide. Family physicians, who are the often first point of contact for treatment of febrile illness, as ST typically manifests, need to be aware of this entity to prevent such catastrophic consequences.
Guidelines on clinical management of Dengue Fever & Dengue Hemorrhagic SyndromePk Doctors
This document provides guidelines for the clinical management of dengue fever and dengue hemorrhagic fever in Sri Lanka. It begins with an overview of dengue illness, noting that dengue fever is usually a mild disease caused by primary infection, while dengue hemorrhagic fever is a more severe disease more commonly seen in secondary infections. It describes the typical features of dengue hemorrhagic fever including high fever, bleeding tendencies, hepatomegaly, and circulatory disturbance or shock in severe cases. The clinical course is also summarized, with the illness divided into febrile, critical, and convalescent phases.
Over 5 years, 5,029 acute febrile patients in Addis Ababa, Ethiopia were tested serologically for typhoid fever and typhus fever. 23% (1,121 patients) tested positive for typhus fever. The highest number of positive typhus cases was in patients aged 21-30 years old (37.6% of positive cases). Approximately 6% of febrile patients were co-infected with typhoid fever and typhus fever. The study found that multiple infections commonly occurred and resulted in more severe illness than single infections.
Study of clinical and etiological profile of community acquired pneumonia in ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The document discusses pneumonia treatment guidelines in Taiwan. It provides background on the etiology of community-acquired pneumonia (CAP) in Taiwan. It then summarizes the key changes between the 2018 and 2007 Taiwan pneumonia guidelines, including the use of a modified GRADE methodology, definitions of healthcare-associated pneumonia (HCAP) and pediatric pneumonia. The major sections of the 2018 guidelines covered CAP, hospital-acquired pneumonia (HAP), HCAP subdivided into nursing home-associated and hemodialysis-associated pneumonia, and pediatric pneumonia.
A trial of Lopinavir-Ritonavir in Adults Hospitalized with Sever COVID-19Valentina Corona
This randomized controlled trial studied 199 hospitalized adult patients with severe Covid-19 in Wuhan, China to evaluate if the drug combination lopinavir-ritonavir provided benefits beyond standard care. Patients received either lopinavir-ritonavir plus standard care or standard care alone. Treatment with lopinavir-ritonavir did not significantly reduce time to clinical improvement or mortality at 28 days compared to standard care. Gastrointestinal side effects were more common with lopinavir-ritonavir. The study found no clinical benefit to using lopinavir-ritonavir for severe Covid-19.
Outcome of 16 years of hemodialysis infection controlJAFAR ALSAID
The study analyzed the outcomes of a tight infection control protocol over 16 years in a hemodialysis unit. The protocol was successful in limiting hemodialysis-related bloodstream infections and admissions. Specifically:
- The rate of hemodialysis-related bloodstream infections was 0.003 per 100 patient months, far below the international reported rate of 0.75-4.4 infections per 100 patient months.
- The admission rate for hemodialysis-related bloodstream infections was 0.4 per 1000 patient years, much lower than the international rate of 108 admissions per 1000 patient years.
- Only 12 patients experienced hemodialysis-related bloodstream infections over nearly 19 years and
A Study Of Clinical And Laboratory Profile Of Dengue Fever In AJoe Andelija
This study analyzed the clinical and laboratory profiles of 150 adult patients diagnosed with dengue fever at a hospital in India over 5 months. Most patients were male between the ages of 21-40. The most common symptoms were fever, headache, myalgia, and abdominal pain. Bleeding manifestations occurred in 19% of patients, most commonly melena. Laboratory findings included thrombocytopenia in all patients and elevated hematocrit in 23% of patients. 21% of cases had severe dengue hemorrhagic fever/dengue shock syndrome. The study aims to better understand the characteristics of dengue patients to aid in diagnosis and management.
This document summarizes information on dengue fever in Pakistan. It discusses that dengue virus has four circulating serotypes that cause the disease. Non-structural glycoprotein NS-1 damages liver cells and activates the complement system, exacerbating the disease severity. Reverse transcription polymerase chain reaction and real-time PCR are commonly used diagnostic tests to detect the virus. Dengue incidence is highest in Pakistan from August to December and primarily affects males ages 13-35 years. All four serotypes circulate in Pakistan and secondary infections can cause more severe disease.
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 29th publication iosr jdms 3rd name
Dengue is a mosquito-borne viral disease that is widespread in tropical and subtropical regions. It affects nearly 100 million people annually. The disease is caused by the dengue virus, which has four serotypes. It is transmitted by the bite of infected Aedes mosquitoes. There is no vaccine available to prevent dengue. Treatment involves fluid replacement and pain management. Prevention focuses on reducing mosquito habitats and biting through the use of insect repellents, bed nets, and larviciding.
The document summarizes current methods for diagnosing dengue virus infection. It discusses the limitations of clinical diagnosis due to non-specific symptoms in early infection. Laboratory diagnostic methods include virus isolation through mosquito inoculation or cell culture, which is sensitive but requires specialized facilities. Reverse-transcriptase PCR detection of viral RNA in blood is now more widely used, as it is rapid, sensitive and specific. Both virus isolation and PCR can detect infection early in the viremic phase. Serological tests detect antibody response and are more useful later in infection or for secondary dengue diagnosis. Improved early diagnosis remains a challenge, especially with development of a dengue vaccine.
This document summarizes a study on the seroprevalence of typhoid fever among patients presenting with acute febrile illness at a clinical laboratory in Addis Ababa, Ethiopia from 2007 to 2011. A total of 5,029 patients were tested for typhoid using the Widal test. The results showed that 22% tested positive for typhoid. Males represented a higher percentage of patients (57%) compared to females (43%). The highest number of cases occurred in adults aged 20-40 years. Seasonally, more cases were seen in the spring and autumn months, with peaks in May and October. The number of cases increased each year from 2007 to 2011.
This study evaluated the prevalence of acute kidney injury (AKI) in 120 patients with confirmed dengue fever over one year at a hospital in India. The prevalence of AKI among these patients was found to be 27.5%. Several factors were analyzed to identify predictors of AKI in dengue patients, including demographics, severity of illness, laboratory values, and presence of complications. The majority of patients recovered and were discharged, while mortality was observed in 16.7% of cases. This research helps address the lack of data on renal involvement and AKI in dengue virus infection.
Dengue Fever-Related Cardiac manifestation in Ibn-Sina Hospital Mukalla, Hadh...asclepiuspdfs
This document summarizes a study on cardiac manifestations in patients hospitalized with dengue fever in Mukalla, Yemen. The study found that the most common cardiac manifestations were sinus tachycardia (39.4% of patients) and hypotension (18.37% of patients). Other less common findings included pulmonary congestion, bradycardia, and pericardial effusion. There was a close correlation between the severity of cardiac manifestations and the severity of dengue based on WHO classifications, with more severe cardiac issues seen in those with severe dengue. The most common causes of death in the study (10 patients) were refractory shock and other complications associated with severe dengue disease.
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This study analyzed 415 patients with brucellosis in Tehran, Iran between 1998-2005. Most patients were female, aged 20-40 years, and had symptoms for less than 2 months. The most common symptoms were sweating and fever, while the most frequent signs were fever, arthritis, and splenomegaly. The majority of patients consumed non-pasteurized dairy products. Rifampin plus cotrimoxazole was the most common treatment, but resulted in the highest relapse rate, while doxycycline and cotrimoxazole led to the fewest relapses. Relapse remained a complication even following appropriate treatment.
The Significance of Bacterial and Fungal Coinfection in the Setting of Viral ...Texas Children's Hospital
Keystone ECMO meeting 2018: To better characterize the frequency of bacterial and/or fungal coinfections in patients with viral pneumonias placed on ECMO and to understand their impact on mortality.
Background & objectives: In Odisha, several cases of dengue virus infection were detected for the first time in 2010, the importance of dengue as a serious mosquito-borne viral infection was felt only in 2011 with the reporting of many more positive cases. This retrospective three year study was done to find out the seroprevalence of dengue Igm antibody and to know the predominant serotype of dengue virus among the patients suspected to have dengue virus infection in a tertiary care hospital in southern Odisha, India.
Methods: Blood samples from clinically suspected dengue cases admitted in the Medicine and Paediatrics departments of a tertiary care hospital were collected. These were processed for detection of dengue specific IgM antibody, carried out by the ELISA method. Dengue IgM antibody positive serum samples were tested for serotypic identification.
Results: of the 5102 samples tested, 1074 (21.05 %) were positive for dengue IgM. Maximum numbers of cases were found in 2012. Majority (47.86 %) of cases were detected in the month of September. The most common affected age group was 11 to 20 yr. DENV1 and DENV2 were the detected serotypes.
Interpretation & conclusions: Rapid increase in the dengue cases in 2012 became a public health concern as majority of cases were affecting the young adolescents. Most of the cases were reported in post-monsoon period indicating a need for acceleration of vector control programmes prior to arrival of monsoon.
Key words Dengue virus - IgM antibody - seroprevalence - serotype - vector control
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A Study on Seroprevalence among Clinically Suspected Dengue Viral Infection u...BRNSSPublicationHubI
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IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
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D037022025
1. International Journal of Pharmaceutical Science Invention
ISSN (Online): 2319 – 6718, ISSN (Print): 2319 – 670X
www.ijpsi.org Volume 3 Issue 7 ‖ July 2014 ‖ PP.22-25
www.ijpsi.org 22 | Page
A Serological Study of Dengue and Hanta Virus in Acute
Febrile Patients in a Tertiary Care Hospital
1,
Tejashree.A , 2,
Thejaswini.H.S, 3,
Madhuri Kulkarni.
Department of Microbiology, JSS Medical College, Mysore- 570004, Karnataka, India.
ABSTRACT : The emerging viral diseases Haemorrhagic Fever with Renal Syndrome (HFRS) and Hanta virus
Cardiopulmonary Syndrome (HCPS) are a cause of global concern as they are increasingly reported from newer
regions of the world. Dengue also called classic dengue or break bone fever is a Flaviviral infection found in large
areas of tropical & subtropical region. Clinically, the febrile illness produced by Dengue virus, Leptospira serotype
& Hanta virus may be indistinguishable.
MATERIALS AND METHODS: A total of 1782 serum samples were tested from febrile patients for Dengue
NS1 Ag, Dengue IgG/IgM by Immunochromatographic Test (ICT) kit & 100 randomly selected serum samples were
tested for Hanta virus IgM/IgG ICT by SD Bioline. Other investigations included Hemoglobin estimation, Total &
Differential Leucocytes count, hematocrit, platelet count and Liver Function Test (LFT).
RESULTS: Out of 1782 serum samples tested, 79 patients (4.4%) tested positive for dengue serology. None of the
samples tested positive for Hanta virus IgG/IgM. To conclude, ICT helps for rapid diagnosis of Dengue & Hanta
virus infection.
KEYWORDS: Dengue fever & Hanta virus, Serology, ICT
I. INTRODUCTION:
Hanta viruses are enveloped viruses with negative sense single stranded RNA genome and belong to the
family Bunyaviridae1
. The emerging viral diseases Hemorrhagic fever with renal syndrome (HFRS) and
Hantavirus cardiopulmonary syndrome (HCPS) are a cause of global concern as they are increasingly reported
from newer regions of the world. Humans are accidental hosts and get infected by aerosols generated from
contaminated urine, faeces and saliva of infected rodents. The first Hantavirus isolate to be cultured,
Thottapalayam virus, is the only indigenous isolate from India, isolated from an insectivore in 1964 in Vellore,
South India. Research on Hantavirus in India has been slow but steady since 20052
. Serological investigations of
patients with febrile illness revealed presence of anti-Hantavirus IgM antibodies in 14.7% of them. The
seropositivity of Hantavirus infections in the general population is about 4% and people who live and work in close
proximity with rodents have a greater risk of acquiring Hantavirus infections. Hantavirus infection can appear
clinically uncharacteristic and may mimic other syndromes3
.This compounds the difficulties in diagnosing
Hantavirus infections in areas where the disease is not endemic and clinical cases may be sporadic4
. Further, less
pathogenic Hantaviruses may cause a greater amount of asymptomatic infections, as seen for HFRS in Europe and
Asia5
.
Dengue, also called classic dengue or break bone fever is a Flaviviral infection found in large areas of
tropical and subtropical regions6
. Dengue is a mosquito borne viral infection and is transmitted by Aedes aegypti
and Aedes albopictus7,8
. Four distinct serotypes of viruses DEN-1, DEN2, DEN3, and DEN-4 cause dengue8,9
.
Humans are the main amplifying hosts of virus. Dengue may be asymptomatic or may lead to undifferentiated
fever, dengue fever (DF) or dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). DHF and DSS
are leading causes of hospitalization and death especially among children8,10
. Dengue is the most important of the
Arboviral infections of humans8
. In India, epidemics are becoming more frequent11,12
. Involvement of younger age
group and increase in the frequency of epidemics are indicators of higher incidence of infection11
. If untreated,
mortality from complications of Dengue fever is as high as 20%, whereas if recognized early and managed
properly, mortality is less than 1%12
. Early diagnosis is essential and clinical suspicion is based on the frequency of
symptoms in the population13
.
Clinically, the febrile illness produced by dengue virus, leptospira serotypes and hanta viruses may be
indistinguishable14
. Mysore experienced an outbreak of dengue recently. Even now several cases of
thrombocytopenia are being detected daily by the clinicians.
2. A Serological Study Of Dengue And Hanta…
www.ijpsi.org 23 | Page
In this regard, an attempt is being made to detect the number of Dengue/Hanta virus cases in this region by using
rapid Immunochromatographic test which detects IgG/IgM antibodies for Dengue and Hanta virus and NS1
antigen for Dengue.
II. MATERIALS AND METHODS:
This study was carried out in the Department of Microbiology, JSS Hospital, Mysore from Jan 2012 to
Dec 2012 when there was an outbreak of Dengue fever. A total of 1782 serum samples were collected from febrile
patients. 100 random samples, which were Negative for Dengue antibodies were tested for IgG/IgM antibodies to
Hantavirus by ICT. The serum samples were tested for Dengue NS1 Ag, Dengue IgG/IgM Ab by ICT kit SD-
Bioline. The study group included children and adults presenting with fever, headache, vomiting and pain
abdomen. Laboratory investigations were carried out in these patients for Hemoglobin, total & differential
leucocyte count, hematocrit, platelet count and LFT.
III. RESULTS:
A total of 1782 serum sample were tested for Dengue IgG/IgM, NS1 Ag and 100 randomly selected
serum samples were tested for Hantavirus IgG/IgM by rapid ICT (SD-Bioline), 79 patients (4.4%) were positive
for Dengue serology. Among 79 patients, only 52 cases could be reviewed. Out of 52 patients, 34(65.38%) were
male and 18(34.6%) were female. Peak incidence of Dengue fever was found in the age group of 21-40 years
(39%). Table-1 shows the demographic profile. 20 of them tested positive for NS1 Ag, 11 of them had both IgG
and IgM as shown in Table-3. Out of 52 cases reviewed, 43(49%) of them had associated thrombocytopenia. 6 had
severe thrombocytopenia with platelet count <20,000/mm3
and had bleeding tendency. Frank bleeding
(Haematemesis) was seen in 2 cases. On clinical examination, the most common finding was Hepatomegaly. Other
findings included splenomegaly and 16 of them had both Hepatomegaly and splenomegaly. 9 of them had
epigastric tenderness. Other laboratory investigations revealed that a large population had mild anaemia and liver
enzymes were elevated in 30% of them who were seropositive.
None of the sample tested positive for Hanta virus IgG/IgM.
IV. DISCUSSION:
This is probably the first study in Karnataka performing the serological test of hanta virus. Clinically the
febrile illness produced by Dengue viruses, Leptospira serotypes and Hanta viruses may be indistinguishable10
.
As per WHO classification the proposed probable diagnosis – an acute febrile illness with two or more of the
following manifestations – headache, retro-orbital pain, arthralgia, rash, haemorrhagic manifestations, leucopenia
and positive IgM Ab test on serum samples collected five or more days after the onset of fever supports the
diagnosis of Dengue fever15
.
In our study, Dengue NS1 Ag, IgG/IgM Ab were detected by ICT by SD Bioline rapid kit test and Hanta virus
IgG/IgM by SD Bioline rapid (ICT) kit test.
A total of 1782 serum sample were tested for Dengue virus and 100 randomly selected serum sample for Hanta
virus. 79 patients (4.4%) were seropositive for Dengue virus, only 52 could be reviewed . A study conducted by
A.Chakravarti et.al showed 25% incidence of Dengue seropositivity16
.
In the present study, among 52 dengue seropositive cases, 20 of them tested positive only for NS1 Ag & 11 of them
had both IgG/IgM Ab for Dengue virus.
Detection of NS1 Ag is useful in the diagnosis of early stage of Dengue virus infection. The combined use of IgG
and IgM is an alternate strategy for the diagnosis of dengue virus infection, since sensitivity for secondary dengue
is improved and specificity for other infection is also improved17
.
In our study primary infection was detected in 20 patients and secondary infection in 11 patients. Higher incidence
of Dengue fever was seen in male patients (65.38%) than in female (34.6%). In this study Dengue fever was
common in the age group of 21-40years (39%) followed by 0-20years (35%).
Early in the infection, it may be difficult to differentiate DHF from other febrile illness. Later usually after 3 or 4
days, when thrombocytopenia and hemoconcentration are present DHF is easier to diagnose. Among these 52
patients, 43(82%) of them had thrombocytopenia. This prevalence is in accordance with the findings of Suma
Rao18
.
6 patients had severe thrombocytopenia <20000/mm3
and had bleeding tendency. Frank bleeding (Hematemesis)
was noted in 2 cases. Bleeding during DHF may result from a combination of factors such as thrombocytopenia,
coagulating defects and vasculopathy19
.
3. A Serological Study Of Dengue And Hanta…
www.ijpsi.org 24 | Page
Table -4 shows Correlation of Dengue with organomegaly & thrombocytopenia. Hepatomegaly was noted in 15
(29%) patients and splenomegaly in 3 (7%) patients and Hepatosplenomegaly in 16 (31%) patients. This study
coincided with the study conducted by S Chandy et.al which showed 42% incidence of hepatomegaly3
.
Table – 2 shows the clinical presentation of patients with dengue fever (seropositive).
Hanta virus infection can appear clinically uncharacteristic and may mimic other syndromes. This compounds the
difficulties in diagnosing Hanta virus infection in areas where the disease is not endemic and clinical cases may be
sporadic.19
.
In our study IgG/IgM Ab to Hanta virus was not detected.
The natural reservoirs of Hantavirus are small rodents and transmission to man is believed to occur via aerolized
excretions. The worldwide distribution of rodents known to harbor Hanta virus suggest great disease causing
potential20
. The Thottapalayam virus, which belongs to the same family, was first isolated from spleen of a shrew
capture in July 1964, in Vellore, India21
. Very few reports from India are available in this regard. The vicinity of
Mysore to Vellore may create an ecological predisposition for Hanta virus infection. In this regard an attempt was
made to study the serological evidence of hanta virus infection, by detecting anti-hanta virus IgG/IgM antibodies.
To conclude, ICT helps in rapid diagnosis of Dengue and Hanta virus infection and also reduces the mortality &
morbidity by starting early treatment. Hematological parameters like low platelet count is associated with
complications of Dengue fever.
Table I: Demographic profile
Total no. of patients tested for Dengue serology: 1782
No. of patients with positive Dengue serology: 79(4.4%)
No. of cases reviewed (n): 52
Table II: Presenting complaint on admission
No. of cases reviewed (n): 52
Symptoms Number(n=52) Percentage%
Fever 50 96%
Vomiting 18 34.6%
Headache 16 31%
Myalgia 11 21%
Joint pain with swelling 06 11%
Loose stools 08 15%
Pain abdomen 09 17%
Cough with expectoration 10 19%
Rash 01 02%
Table III: Dengue seropositive with thrombocytopenia. (52 cases reviewed)
Dengue Serology Thrombocytopenic(43) Non- Thrombocytopenic(09)
Number % Number %
NS1 Antigen 17 39 03 33
IgG 11 26 02 22
IgM 02 04 03 33
IgG+IgM 10 23 01 11
NS1+IgG 01 02 - -
NS1+IgM 01 02 - -
NS1+IgG+IgM 01 02 - -
Age in years Number(n=52) Percentage%
0 – 20 18 35%
21 – 40 20 39%
41 – 60 9 18%
>60 3 06%
4. A Serological Study Of Dengue And Hanta…
www.ijpsi.org 25 | Page
Table IV: Correlation of Dengue with Organomegaly & Thrombocytopenia
Thrombocytopenic(43) Non- Thrombocytopenic(09)
Number % Number %
Hepatosplenomegaly 14 33 02 22
Hepatomegaly 13 30 02 22
Splenomegaly 03 07 - -
No organomegaly 13 30 05 56
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