Scrub typhus caused by Orientia tsutsugamushi is an important cause for fever of unknown origin in endemic areas including India. The vasculitis associated with the disease leads to a variety of clinical manifestations. However, the joint involvement is quite rare and not reported in children. We present severe arthritis of hip joint associated with scrub typhus causing a diagnostic and management challenges in a 4-year-old girl.
Background: Wilson disease is an inherited disorder of copper metabolism characterised by cirrhosis of the liver, bilateral degeneration of basal ganglia and pigmented rings in the periphery of cornea. The clinical features vary considerably. Early diagnosis and prompt treatment favours good prognosis. Objectives: To study the clinical and biochemical features of children with Wilson disease and the outcome after therapy at one year follow up.
Introduction: Sepsis is a major causes of mortality and morbidity among children. An effective and accurate biochemical marker is needed which can support or exclude the diagnosis of sepsis. Objective: To study the platelet indices in children with sepsis and their relation to the outcome Method: A prospective observational study was conducted in a tertiary care centre from southern India from October 2015 to July 2017. Children aged 1 month to 18 years of age with sepsis, as per the definition of International Paediatric Sepsis Consensus Conference 2005, were included in the study. Children with no infection were taken as controls. Children with haematological malignancies, known platelet disorders, haemolytic anaemia and children with a history of recent blood transfusions or splenectomy were excluded from the study. History and physical examination findings were noted in a pre-designed proforma. Platelet indices were measured using an automated blood counter, Beckman Coulter LH780 series. Counts done at the time of admission and prior to discharge or death were taken for analysis. Mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) values were compared with standard normal values. Severity of thrombocytopenia was classified as mild (50,000-150,000/cu mm), moderate (20,000-50,000/cu mm) and severe (<20,000 or <50,000/cu mm with clinical bleeding) for the study purpose. Mean and median were used for data with normal and nonnormal distribution. Mann-Whitney was used for analysis of continuous variables. Chi-square was used for categorical variables. Analysis of mean was done using independent t-test. Data was analysed using SPSS version 21. Study protocol was approved by Institutional Ethics Committee
Objective: To study the clinical profile, severity, outcome and risk factors for H1N1 influenza infection in children <18 years. Method: Children <18 years admitted to the Paediatric Department of our hospital and confirmed to have H1N1pdm2009 influenza infection from December 2016 to November 2017 were included. We reviewed the case sheets of the study population and captured the required data. Illness was classified as mild, progressive or severe illness and treated as per CDC guidelines. Outcome measures analysed included-mortality, duration of ICU / hospital stay, need for oxygen supplementation or assistive ventilation. Results: Our study involved analysis of 31 children. We found clustering of cases from 1-5 years accounting for 56% with no sex predilection. We observed a bimodal seasonal peak in incidence of infection from December to February (32%) and June to August (42%). Malnutrition was most common risk factor affecting 15/31 (48.4%) children followed by pre-existing medical illness 10/31 (30%). Risk stratification done as per CDC recommended guidelines showed the majority of the children (64.5%) manifesting as mild illness. Chest x-ray showed bilateral non-homogeneous peri-hilar opacities with air bronchogram in 19 (61%) children. Seven (22%) children required admission to ICU, 6 (20%) required oxygen therapy and 1 required noninvasive ventilation. Two children had developed hypotension requiring inotropes. No mortality was observed in the current study.
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