Background: Dengue is a debilitating arthropod-borne viral (arboviral) disease in humans. To improve diagnostics for patients with dengue so that they can receive effective treatments at earliest. In addition, a better understanding of clinical and biochemical study of dengue cases, effective measures can be aimed for the prevention and control of dengue epidemics.Methods: A retrospective clinical and laboratory study was undertaken among admitted patients in the Department of Physiology at Katihar Medical College and Hospital, Katihar, Kosi region of Bihar, India. Forty-two (42) patients admitted over a period of two years, with laboratory results for NS1 antigen and or /IgM positive, for dengue fever, were taken in the study. Clinical features, haematological and biochemical parameters were noted.Results: Out of the 42 patients, 38 patients were male (90.4%) and 4 patients were female (9.6%). Pyrexia was the major symptom (100%) followed by splitting headache (90.40%), myalgia (76.19%), conjunctival redness (50.00%), skin rash (42.80%), abdominal pain (30.95%), hepatosplenomegaly (28.57) ascites (26.19%) and retro orbital pain (19.04%). Severe thrombocytopenia (69.51%), leukopenia (20.19%) and elevated serum SGOT and SGPT (88.54%) were observed.Conclusions: Dengue infection is increasing proportional to increased urbanization and compromised sanitation measures. Fever associated with headache, retro orbital pain, erythematous morbilliform rash, conjunctival redness and itching in palms and soles along with thrombocytopenia, leukopenia, elevated SGPT should prompt a clinician on the possibility of dengue infection.
Background: The level of ascitic fluid total protein (AFTP) is used to differentiate between transudative and exudative ascites. Ascites patients having portal hypertension are considered to be transudative in nature. The traditional transudate/exudate system of ascitic fluid classification based on ascitic fluid total protein concentration is sometimes misleading in patients of ascites with portal hypertension. Now a days SAAG (serum ascites albumin gradient) has become more acceptable in differentiating patients presenting with ascites due to portal hypertension. The objective of this prospective study was to correlate serum ascites albumin gradient with ascitic fluid total protein in patients of ascites having portal hypertension.Methods: 100 cases of ascites are selected randomly. All the provisional diagnosis are confirmed with the help of different biochemical, pathological and radiological investigations.Results: SAAG (≥1.1gm/dl) was more sensitive and specific (94% and 90% respectively) than ascitic fluid total protein concentration of <2.5 gm/dl (78% and 50% respectively) in detecting portal hypertension and had higher positive and negative predicative values (97% and 82% respectively) compared to AFTP concentration (85% and 38% respectively).Conclusions: Considering the advantages of measuring the serum-ascites albumin gradient in illuminating the pathogenesis of ascites and the ease with which this test can be done, it is suggested that this parameter should replace the traditional parameter of ascitic fluid total protein level in the routine analysis of ascites fluid and classification of ascites.
BACKGROUNDLymph nodes are among the organs most commonly biopsied for diagnostic purposes. Their frequent involvement in regional and systemic diseases and their accessibility make the morphologic study of lymph node an important aspect of pathology. In a poor country like ours where the burden of health cost is on the patient him/herself, biopsy as a first line of investigation is a financial problem.The main objective of this study is to determine the reliability of fine needle aspiration cytology of peripheral lymph nodes and to arrive at a diagnosis by correlative study with histopathology.
Background: In India, where majority of the population lives by agriculture and linked occupations in rural areas despite of rapid increase in urban population, the pulmonary function is expected to vary between smokers and non-smokers.Methods: This study was carried out in the rural population of Katihar, Bihar in 100 participants. Prior consent was obtained from the Ethical committee for the study. Computerized spirometer RMS Helios 701 was used for the study.Results: This study was done for a better understanding of effects of smoking in the rural population of Katihar. In rural non-smokers, the observed value of pulmonary functions in mean±standard deviation, FVC was 3.28±1.04 litres, FEV1 was 2.72±0.97 litres, FEV1% was 85.24±28.24, PEFR was 7.8±1.98 litres/minute, FEF25-75% was 4.28±0.99 litres. The observed value of pulmonary functions in rural smoker population in mean±standard deviation, FVC was 2.56±0.86 litres, FEV1 was 2.21±0.96 litres, FEV1% was 86.00±23.73, PEFR was 5.65±2.18 litres/minute, FEF25-75% was 3.34±1.37 litres.Conclusions: The comparative study of pulmonary function between rural smokers and rural non-smokers showed significant decreased value (p value < 0.05) in smokers of rural population.
Background: Acute rheumatic fever (ARF) is a multisystem disease resulting from an autoimmune reaction to infection with group A beta haemolytic streptococcus. Acute rheumatic fever commonly occurs between 5-14 years of age.1 The major concern relating to acute rheumatic fever is often not the episode itself but the long-term consequences of damage to heart valves (Rheumatic heart disease (RHD) that often results from recurrent episodes of acute rheumatic fever. Rheumatic heart disease (RHD) continues to be a major public health problem and a common cause of morbidity and mortality in many parts of India.2Methods: 50 consecutive patients admitted with the diagnosis of acute rheumatic fever in Medicine Department, Katihar Medical College and Hospital, Bihar, India were studied. A detailed clinical history of these patients including presenting symptoms were noted. Physical examination of all systems was done and a diagnosis of acte rheumatic fever was made according to WHO Criteria (2002-2003) for the diagnosis of rheumatic fever and rheumatic heart disease (Based on the Revised Jones Criteria). Echocardiography of all 50 patients were done.Results: Mean age of patients diagnosed with ARF was 14.20±7.02 years. Out of 50 patients, 32 (64%) were female and 18 (36%) were male. Joint pain was the commonest presenting complain, 35 (70%) patients, followed by fever in 21 (42%) patients. Among Jones major manifestations 36 (72%) cases had carditis, 32 (64%) had arthritis, 6 (12%) had subcutaneous nodules, 5 (10%) had erythema marginatum and5(10%) had Sydenham’s chorea. In patients with carditis, 25 (69.44%) had mitral regurgitation (MR) only while 10 (27.77%) had MR with aortic regurgitation (AR) and 1 (2.77%) patient had organic tricuspid regurgitation (TR) with mitral regurgitation and aortic regurgitation. Out of 36 patients with carditis, 10 (27.77%) patients did not have any clinical evidence of carditis and were detected by echocardiography only.Conclusions: Commonest complain in patients with rheumatic fever was joint pain followed by fever. In patients with carditis, all had mitral regurgitation(MR), with 1/3rd of these patients having associated aortic regurgitation(AR). 1/3rd of patients with carditis were detected by echo only and therefore, echo should be included in diagnostic criteria for acute rheumatic fever. None of the patients who developed rheumatic fever was on penicillin prophylaxis.
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