Background:
Scrub typhus is a reemerging zoonosis, which presents as acute febrile illness. Very few paediatric prospective studies on this disease are reported from Eastern India. This prospective observational study was carried out to study the clinical presentation, diagnosis, complications and immediate outcome of Scrub typhus in paediatric population in a tertiary care hospital from Eastern India.
Material and Methods:
Totally 209 cases between 1 month and 18 years of age were included. Clinical manifestations, laboratory parameters and immediate outcome of all patients were recorded. All the data were collected and plotted in Microsoft Excel master chart. Continuous data were presented as mean ± standard deviation (SD) and categorical data as frequency and percentage. All the data analysis was performed using statistical software IBM Statistical Package for the Social Sciences (SPSS) version 20.0.
Results:
Highest number of cases (41.1%) were found between 1 year and 5 years age group. Fever was the presenting complaint in all cases. Other common symptoms were cough (34%), pain abdomen (23.4%), vomiting (23%), seizure (11.5%) and altered sensorium (9.6%). Hepatomegaly was found in 56.5% and splenomegaly in 39.7% cases. Eschar was found in 27.3% cases. C-reactive protein was elevated (>10 mg/L) in 93.3% children. Other complications were pneumonitis (20.6%), meningoencephalitis (12.4%), septic shock (8.6%), acute respiratory distress syndrome (5.7%), myocarditis (4.8%) and acute kidney injury (4.3%). Mortality was low (1%).
Conclusion:
Scrub typhus is not uncommon in paediatric population and it must be considered as a close differential diagnosis of any acute febrile illness even when classical clinical presentations are not found. Early treatment results in favourable outcome.
Background: Osteopenia of prematurity, commonly called as metabolic bone disease (MBD), is mostly described in preterm babies (< 36weeks) with very low birth weight (VLBW). This condition is characterized by a reduction in bone mineral content (osteopenia), with or without rachitic changes, and is caused by several nutritional and biomechanical factors. Objective: To determine the incidence of osteopenia of prematurity among high risk preterm VLBW babies and also to document changes in biochemical parameters including serum calcium, serum phosphate, serum alkaline phosphate (ALP) and serum creatinine in the above cases. Material and method: This prospective observational study includes all the very low birth weight babies born fromNovember 2012 to July 2014. Present study comprised of 60 VLBW neonates of which 10 were <28weeks, 32 were 28-31week and 18 were 31-34weeks of gestation. Estimations of biochemical parameters were done at 2 nd week of birth and again at 6 th week to detect the incidence of osteopenia. Result: There was a significant decrease inserum calcium and serum phosphorous level where asserum ALP documented a significant increase in preterm neonates when compared to control. 14 of 60 VLBW babies developed osteopenia of prematurity at 6 th week of life. Conclusion: As observed in the present study, gestational age, birth weight and ALP are considered to be significant risk factors and are associated with osteopenia. So early detection of this condition by monitoring of biochemical parameters in high-risk cases minimizes the development of osteopeniaand prevent future complications of osteopenia.
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