Background: Dengue fever is a mosquito borne arboviral disease which is of global concern. It is endemic in tropical countries with annual incidence of 7.5 to 32.5 million cases. It commonly affects the young adults and paediatric cases of Dengue haemorrhagic fever has high mortality. The objective of this study was to assess the clinical and laboratory profile and outcomes of dengue fever in children of less than 18 years of age. The study was conducted for a period of one year during an outbreak, in a tertiary care hospital of Chennai, Tamilnadu, India.Methods: This was a prospective cross sectional study and 200 cases of dengue fever were enrolled and classified as per WHO guidelines. The clinical profile and demographic profile was recorded in a structured questionnaire form. Haematological parameters were recorded and followed till the day of discharge. The duration of stay was recorded and outcomes were noted.Results: A total of 200 cases with 113 males and 87 females, 177 non severe dengue cases and 23 severe cases of dengue fever were classified. The mean age of admission was 9 years and mean duration of stay in hospital was 4.61 days. Fever was most common presenting symptom (100%) and hepatomegaly (58.5%) was common clinical finding. Bleeding manifestations were seen in severe dengue cases. Statistical significance was seen in rise in SGOT levels, rise in haematocrit and pleural effusion with severe dengue cases and non-severe dengue cases. The case fatality rate was zero.Conclusions: Understanding the knowledge of presentations and associated features would help to predict the severity of the disease. In children, if symptoms like fever, pain, rashes, and vomiting are associated with Hepatomegaly and elevated SGOT in context of low total platelet count, a strong possibility of dengue fever is present, especially in an epidemic setting. Early suspicion and effective management can reduce the severity.
Background: Urinary tract infection (UTI) is one of the most common infections caused by bacterial pathogens seen mostly in developing countries. This study was done to assess the clinical and gram negative bacterial profile of pathogens causing urinary tract infection, which helps the clinician to diagnose early and give presumptive antibiotic to prevent complications.Methods: Specimen was collected in sterile, leak proof container by clean catch mid-stream technique. Isolation of uropathogens was performed by a surface streak procedure on both blood agar and Mac Conkey Agar (Himedia, India) using semi quantitative method by using standard loop technique and Identified as per standard CLSI guidelines. Antibiogram of the isolates was performed and read as per standard manufacturer’s instructions.Results: UTI was more common in female children than male, and half were in the age group 1-5 years. Fever is the most common presentation (58.6%) followed by dysuria (46.4%) abdominal pain (45%) and decreased appetite (23.6%). Escherichia coli was the most common (73.6%) isolate followed in order by Klebsiella sps (15.7%), Citrobacter sps (2.1%) Proteus sps (5%) and Pseudomonas sps (3.5%). Nitrofurantoin (86%) was the most sensitive antibiotic followed by cefexime (84.7%), gentamicin (82%) and ciprofloxacin (81%) for E. coli. Klebsiella was sensitive to gentamycin, ciprofloxacin. Greater degree of resistance was noted to ampicillin, cotrimoxazole and nalidixic acid.Conclusions: The common clinical feature assosciated with UTI was fever and commonest causative organism for UTI was E. coli. The appropriate antibiotic in-vitro were cefexime and gentamicin in this study. Higher degree of resistance was found in antibiotics such as amipicllin, cotrimioxazole, cephalexin, nalidixicacid.
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