Dengue is one of the arthropod-borne (arbo) viral diseases transmitted by female mosquito Aedes aegypti. Dengue fever has a wide spectrum of clinical presentation ranging from flu-like illness to severe complicated stage of dengue hemorrhagic fever leading to mortality. This was a retrospective study conducted in a tertiary care hospital in Coastal Karnataka, South India, to know the correlation between the clinical presentation and haematological parameters in the paediatric cases presented with dengue symptoms. A total of 163 paediatric cases who presented fever and dengue-like illness were included in the study. Of which, 69 were confirmed dengue patients. Critical analysis showed that there was a significant difference in the haematological parameters like total leucocyte count, percent differential leucocyte count, and platelets count, in the erythrocyte sedimentation rate (P < 0.05 to 0.0001). Additionally, when compared to nondengue patients, even the liver function and renal function parameters were significantly deranged (P < 0.05 to 0.0001). Stratification based on NS1, IgG, and IgM showed significant alterations in the haematological, hepatic, and renal parameters. With respect to the treatment a small percentage of patients, that is, 8% (4 patients), required platelet transfusion as their counts went below 20,000/μL. Two patients succumbed to their illness while three required ICU stay.
A 12-year-old girl presented with a 15 × 15 cm, rapidly enlarging mass in left breast. Fine-needle aspiration cytology showed a benign proliferative breast lesion. Total excision of the mass was done preserving nipple and areola. Histopathology features were suggestive of giant fibroadenoma with benign phyllodes.
Objectives:To study the clinical profile and outcome of Japanese Encephalitis(JE) Methods: Prospective study was done in Vijayanagara Institute Medical Sciences hospital, Bellary, Karnataka. 233 patients below 12 years of age presented with acute encephalitic picture during the epidemic period formed the subjects and were worked up according to a predesigned protocol. CSF and serum samples were tested for JE specific IgM antibodies. Patients were followed up for 4 months to over one year. Results: The predominant age group was 5 to 12 years. Fever (94.84%), seizures (73.39%) and altered sensorium(91.84%) were the important presenting symptoms. Onset of illness was acute in 28.32% and subacute in 38.62% .CSF showed lymphocytosis and 45.06% had cell count of 6-50/cmm and in majority it was <200/cmm. 55.36% patients were positive for JE. Mortality was 22.74%. Deeper level of coma , respiratory irregularities and meningeal signs were associated with mortality. 147 patients survived the acute attack. Of that 40.85% completely recovered. Speech disturbance (47.61%), motor deficits (36.73%), behavioural disturbance (14.96%), involuntary movements (12.24%) and seizures (1.36%) were the morbidities. The deficits found to be gradually improving. Motor deficits and speech disturbances were found in 25.68% and 22.01% respectively at one year follow up. Conclusions:The characteristic clinical features of JE include fever, seizure, altered sensorium, aphasia, relative absence of cranial nerve involvement and irregular and rapidly changing motor and tone abnormality. Deeper level of coma, respiratory abnormalities and meningeal signs were associated with mortality. Speech disturbance and motor deficits were frequently encountered sequelae.
Background: The success in breast-feeding is dependent on early initiation and effective management of breast feeding problems during early postnatal days. Objectives: To identify breast feeding problems and their etiologies during early postnatal days until discharge from hospital. Methodology: Descriptive study done in a medical college hospital. One hundred and twenty mothers in early postnatal days were enrolled in the study. Sick mothers, sick neonates admitted in NICU for >24 hours and where breast-feeding was contraindicated were excluded. Data was collected by direct interview with the mother by the investigators and were entered in the proforma. The questionnaire contained general information of the mothers, self-reported and observed problems about breast feeding. The first interview was carried out within 12 hours of delivery after taking informed consent. Follow up interviews were done on 24 hourly basis until discharge. Data was analyzed statistically. Results: Mothers were aged between 22 to 40 years with more than half in 26-30 years range. Majority were homemakers and educated up to high school. 31(25.8%) were primi mothers. 64(53%) had vaginal and 56(47%) had caesarean deliveries. 61.6% of the mothers knew about colostrum and its benefits. Most (98.3%) of the mothers felt that there is a need for education about breast-feeding. Majority had initiated breast feeds within an hour or at least within 4 hours (LSCS mothers). Insufficiency of milk and problems with latching, positioning and sucking were some of the problems noted. Though most of the problems were resolved before discharge, few persisted until discharge. Perceived milk insufficiency, latching problems and breast problems were higher in primi and found to be statistically significant. Objective problems like poor positioning, sucking etc were higher among primi and caesarean mothers. Even problems that remained at discharge were also more among them. Conclusions: Most common problems were positioning, emphasizing the need for teaching/training. Primi and delivery by LSCS were found to have higher feeding problems emphasizing the need to focus on these high risk groups. Doi: 10.28991/SciMedJ-2020-0204-4 Full Text: PDF
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