scholarly journals Chikungunya outbreak in Bangladesh (2017): sociodemographic and clinical characteristics of patients from three hotspots

2022 ◽  
Vol 50 (1) ◽  
Author(s):  
Mohammad Robed Amin ◽  
Mohammad Jahid Hasan ◽  
Md. Abdullah Saeed Khan ◽  
Md Abdur Rafi ◽  
Rafiqul Islam ◽  
...  

Abstract Background Chikungunya is a severely debilitating disease. Bangladesh witnessed one of the largest outbreaks in 2017. Here, we described the clinical profile of the chikungunya outbreak in Bangladesh and its heterogeneity across three hotspots. Methods This was a descriptive cross-sectional study of 432 individuals interviewed from the outpatient department of three study sites (Dhaka, Chittagong, and Sitakundu Upazilla of Bangladesh) after confirmation by the study physicians. Both laboratory-confirmed cases and probable cases were recruited between July and October 2017. Results Of all, 18% (79) were laboratory confirmed, and 353 82% (335) were probable cases. The male:female ratio was almost equal (1.09:1), and the predominant age group was 18–59 years. The mean age of the presentation was 36.07 ± 13.62 (SD) years. Fever and arthralgia were the most common presentations and were present in > 95% of cases. Other frequent symptoms were fatigue, myalgia, headache, nausea, and vomiting. Approximately half of the patients had arthritis and erythematous rash. Arthritis was predominant in Chittagong city, while maculopapular rash was not observed in Sitakunda city. However, fatigue, nausea, and vomiting are more common among patients in Dhaka city. Significant heterogeneity of clinical manifestations was present across the three hotspots (p < 0.05 for all). Both confirmed and probable cases shared similar characteristics except muscle ache (p = 0.22) and rash (p = 0.37). Conclusion The clinical profile of chikungunya virus-induced disease displays significant location-related heterogeneity in Bangladesh during a large outbreak. Although the causes of such differences are unclear, improved public and medical personnel education on this condition may lead to earlier diagnosis and treatment.

2019 ◽  
Vol 19 (1) ◽  
pp. 29-34
Author(s):  
Andi Airina Binti A Agus ◽  
Dominicus Husada ◽  
Pudji Lestari

Abstract. Background Diphtheria is a vaccine-preventable disease and is eradicated mostly in developed countries. But the prevalence of diphtheria cases still remains endemic in developing countries such as Indonesia, mainly in East Java. Purpose: To study the clinical profile and epidemiological aspects of diphtheria cases admitted in Ruang Isolasi Khusus RSUD Dr. Soetomo in 2015. Method: This research is a hospital-based, cross-sectional study. The samples are all patients admitted in Ruang Isolasi Khusus RSUD Dr Soetomo with the diagnosis of diphtheria in 2015. Results: There were 23 diphtheria cases reported in Ruang Isolasi Khusus RSUD Dr. Soetomo in 2015. The most prevalent age group was 6 until 10 years old (56.52%) and the most common gender was male (57%). Most of the patients came from a non-endemic area (82.61%) and most of them are not fully vaccinated (73.91%). There are more unknowledgeable mothers (91%) about DPT immunization. The most prevalent clinical manifestations are fever, dysphagia and pseudomembrane (100%). Tonsillar diphtheria (86.96%) was the most prevalent type of diphtheria presented. There were no complications and mortality reported and the main managements used were isolation (100%), antibiotics (100%) and anti diphteria serum (82.61%). Conclusion: There is an age shift in the occurrence of diphtheria to 6 until 10 years of age. The immunization coverage especially the booster dose is still low among the patients. Less knowledge about DPT immunization contributes to low childhood immunization coverage. No complications and mortality reported.


2020 ◽  
Vol 23 (269) ◽  
pp. 4731-4740
Author(s):  
Stefane Vieira Nobre ◽  
José Adelmo Da Silva Filho ◽  
Natália Bastos Ferreira Tavares ◽  
Thiáskara Ramile Caldas Leite ◽  
Raimundo Monteiro da Silva Neto ◽  
...  

The aim of the study was to characterize the sociodemographic and clinical profile of patients with hemophilia followed at a Regional Blood Center. Epidemiological cross-sectional study with data collection by document analysis with 30 records from a Regional Blood Center in the Center-South region of Ceará. Statistical analysis was performed using Microsoft Office Excel® 2016 software. The work was approved by the Research Ethics Committee. There was a predominance of males (27), aged 20 to 59 years, single marital status, incomplete elementary education, residing in rural areas and income below 01 minimum wage. As for the clinical profile, hemophilia A in severe form, has a sedentary lifestyle, with a history of transfusion procedures. Most have two or more associated clinical manifestations. With the prevalence pointed out among the participants, the need for comprehensive and equitable assistance is evident, with an emphasis on nursing actions.


2020 ◽  
Vol 103 (5) ◽  
pp. 465-471

Background: Hyponatremia is associated with unfavorable outcomes in many cases. The mainstay of hyponatremia treatment depends on its symptoms and etiology. However, etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia have been rarely reported. Objective: To analyze and report etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia. Materials and Methods: In the present cross-sectional study, the authors enrolled hospitalized patients with hyponatremia who had consulted a nephrologist between October 1, 2017, and October 31, 2018. Their baseline characteristics and clinical manifestations were recorded. Etiologies were confirmed by the attending nephrology staff. Factors associated with severe symptomatic hyponatremia were evaluated using logistic regression analysis. Results: One hundred patients were included in this study. The syndrome of inappropriate antidiuresis (SIAD), hypovolemia, and hydrochlorothiazide use were the leading hyponatremia etiologies. Hyponatremia etiologies differed between patients with community-acquired hyponatremia (n=50) and those with hospital-associated hyponatremia (n=50). Patients with communityacquired hyponatremia were older, presented with a higher frequency of severe symptomatic hyponatremia, and showed lower SNa-levels. Low SNa-levels were significantly associated with severe symptomatic hyponatremia (p=0.014). Conclusion: Hyponatremia remains an important health problem. SIAD, hypovolemia, and hydrochlorothiazide use are among the leading etiologies of hyponatremia. Low SNa-levels are associated with severe symptomatic hyponatremia; thus, physicians should pay close attention to low SNa-levels in hospitalized patients. Keywords: Hyponatremia, Symptomatic Hyponatremia, Community-acquired hyponatremia, Hospital-associated hyponatremia


2021 ◽  
Author(s):  
Cong Luo ◽  
Lei Chen ◽  
Qi Xu ◽  
Jingjing Li ◽  
Qing Wei ◽  
...  

Abstract Background Chemotherapy-induced nausea and vomiting (CINV) is a common symptom in patients who undergoing chemotherapy, it is very important to control CINV to maintain dose intensity and patients' quality of life. To analyze the current situation of CINV for the tumor patients who undergoing chemotherapy, we used a cross-sectional survey to assess CINV status in those patients, and whether the drugs used by doctors in each department met the guidelines, and compared the incidence of acute and delayed CINV overall post-chemotherapy periods. Methods This was a single-center, cross-sectional retrospective study of patients with chemotherapy discharged from different departments of Zhejiang Cancer Hospital in China. Participants reported the occurrence, severity, and impact on daily life of nausea and vomiting from the day of chemotherapy administration up to 5 days, and physicians collected the clinical data from the medical records. Results Data were collected from 875 responses totally. In this study, the overall incidence rate of CINV was 44.34%, acute CINV was 24.57%, and delayed CINV was 39.66%. 19.89% patients had both acute and delayed CINV. The consistency rates of antiemetic with guideline in different departments showed significant gap between the actual usage of drugs and the recommended guidelines (P=0.001). In 875 patients, 518 patients received guideline recommended antiemetic regimen, the CINV rates of complete control (CC), defined as the absence of any symptoms, were 61.58%. While the CC rates in other 357 patients were 47.06%(P<0.001). Conclusion Overall, clinician adherence to antiemetic guideline recommendations in different departments remained poorly characterized with varying degrees. Future studies should focus on the complete rate as a primary end point rather than complete remission. The standardized management of CINV in patients need to be further strengthened and doctors need to use drugs more regularly to reduce the occurrence of CINV in patients.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Iman Ahmed Ragab ◽  
Shereen Mohamed Abd El-Ghany ◽  
Tarek Mostafa Kamal ◽  
Ghada Samir Abd El-Halim Elsayed

Abstract Background β-thalassemia syndromes involve a collection of extremely diverse phenotypes. The term β-thalassemia intermedia (β-TI) was suggested to describe patients who had clinical manifestations that are too severe to be termed minor thalassemia yet too mild to be termed major thalassemia. However, there remains substantial overlap between the three conditions. Aim of the Work To evaluate the variable clinical phenotypes among pediatric patients with βTI and to study the phenotype / genotype correlation with the encountered β-chain mutations. Patients and Methods A cross-sectional study was conducted on 37 Egyptian children and adolescents with TI following up regularly in the Pediatric Hematology clinic – Ain Shams University. Detailed Clinical evaluation and laboratory investigations were done. Reverse hybridization PCR based assay covering beta globin Mediterranean mutations onto specific biotinylated primers, was done. Results IVS 1.6 (T&gt;C) was the most frequent mutation detected in 20 patients and 31 alleles (47.7%), followed by IVS 1.110 (G&gt;A) detected in 7 patients and 8 alleles (12.31%), followed by IVS 1.1 (G&gt;A) and CD27 knossos (G&gt;T), each was detected in 6 patients and 6 alleles (9.23%). β+β+ was the most frequent genotype (54%), followed by β+β/β°β (21.6%) and β°β+ (13.5%). 60% of β°β+ patients had TDT(Transfusion dependent thalassemia), while 87.5% of β + β/β°β patients and 55% of β + β+ patients had NTDT ((Non transfusion dependent thalassemia). Conclusion Inheritance of mild β+ thalassemia mutations among Egyptian children; as IVS 1.6 (T&gt;C) and IVS 1.110 (G&gt;A) is the most frequent contributor to TI phenotype in either homozygous or compound heterozygous states. Patients with the same underlying genotype presented variable phenotypes with different degrees of severity.


2021 ◽  
Vol 9 (1) ◽  
pp. 57
Author(s):  
Ni Made Mertaniasih ◽  
I Gede Yogi Prema Ananda ◽  
Soedarsono Soedarsono ◽  
Deby Kusumaningrum

Tuberculosis diagnosis is an important component in decreasing TB incidence and prevalence. Because of the difficulty to collect sputum in some cases, urine specimens are used as it is easier to garner. One of the biomarkers in urine that can be used to diagnose pulmonary TB is IP-10, which can be represented by the CXCL10 gene. The study aims to determine the accuracy of diagnosis based on detection of the CXCL10 gene in urine as a biomarker for the patients with suspected pulmonary TB in Dr. Soetomo Hospital in Surabaya from November 2019 until March 2020. Thus, this is an observative laboratory research with a cross-sectional study. CXCL10 gene was examined using PCR for 36 urine samples, and then, the data, together with the medical records of clinical manifestations of pulmonary TB, GeneXpert MTB /RIF, blood count, and thorax radiograph, were processed using IBM SPSS Statistics 26. The results of the GeneXpert MTB/RIF and thorax radiograph criteria show positive results of pulmonary TB, which were 44.4% and 69.4% respectively. CXCL10 gene was not found in all urine of healthy people (negative), while 2.8% (1/36 samples) positive CXCL10 gene was found in a patient with positive GeneXpert, also with negative clinical manifestations and urine culture. In this study, the accuracy of diagnosis based on detection of the CXCL10 gene in urine for diagnosis of active pulmonary TB was 2.8%. Future research is needed to improve the methods, among them are bigger size of urine samples and clearer medical history of patients. 


Author(s):  
Vanja Jovanovic ◽  
Jelena Maric ◽  
Dejan Jovanovic

AbstractBackground/Aim. It has been noticed that doctors who regularly perform ultrasound examinations have different clinical manifestations of musculoskeletal disorders. The aim of this research is to examine the level of knowledge of ultrasonographers regarding preventative measures and health consequences of the forced body positions during work.Subjects and methods. The total of 75 doctors of both genders, aged 31-50 years, who use ultrasound diagnostics participated in the research. The research was conducted throughout 2016, as a cross-sectional study, with the aid of a structured questionaire.Results. The total of 60% subjects either rarely use the break during working hours or do not have a break at all. The participants most commonly use the movable monitor and the ability to wrap the cable around their arm (73,3%). This percentage is similar in all age groups. The respondents most often stated that they walk daily (41,3%), with no differences among age groups. 25% of the respondents negate any spine related pains, while over a half said that they experience pain in one segment of the spinal column (cervical, thoracic or lumbar), regardless of the age group. 52% said that they serch for information on their own accord, while 36% stated that they are not at all informed. Only in less than 10% of cases is information provided by the authorities in the institution where the participants are employed, and during regular health examinations, information is given by the designated doctor in 2,7% of cases.Conclusion. The respondents implement the recommendations regarding safe work and other preventative measures to a very small extent, regardless of gender and age. Most of the respondents experience pain in the spine and joints, which can be related to the work in ultrasound diagnostics. Additionally, doctors are not well-informed regarding the preventative measures.


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