Background: Dengue infection is a major public health threat; early recognition is crucial to improve the survival in severe dengue. Although there are various biomarkers to predict the severity of dengue, they are not routinely used in clinical practice for prognostication. We analyzed whether serum ferritin can be used to predict the severity at an earlier stage.Methods: A hospital based prospective observational study was done involving 119 dengue cases diagnosed by positive NS1 antigen or dengue specific serology (capture ELISA). Serum ferritin was measured in all at the time of diagnosis. Clinical and platelet count monitoring was done daily; classified as severe and non-severe according to 2009 WHO criteria.Results: Out of 119, 5 developed severe dengue; patients with severe dengue had significantly lower median platelet count (p<0.0001); higher ferritin levels (p=0.03) and hospital stay (p<0.0001) than non-severe group. Age had a significant negative co-relation with platelet count (r= -0.427; p<0.0001); positive correlation with ferritin levels (r=0.16; p=0.08) and hospital stay (r= 0.26; p=0.004) indicating that elderly subjects are at risk of severe disease. Serum ferritin levels negatively correlated with the platelet count (r= -0.51 p<0.001). High ferritin levels in severe cases are noted from day 4 of clinical illness.Conclusions: Elevated serum ferritin levels can be used as a potential early prognostic marker to predict the severity of dengue infection in clinical practice.
Background: While Immunofluorescence assay remains the gold standard for the detection of ANA, Immunoprofile by ELISA is being increasingly utilized in view of easy availability and quick results. The study was done to find out whether ANA profile results are comparable with IFA.Methods: About 100 patients who had undergone both immunofluorescence and Immunoprofile were included. Immunofluorescence correlation with profile and their correlation with the disease were analyzed; sensitivity, specificity and predictive values were calculated.Results: ANA was positive in 78% by immunofluorescence; 73% by ANA profile. 22 patients in whom ANA IFA was negative were picked up by ANA profile. 27 patients who were not detected by ANA profile were tested positive by IFA. ANA testing by immuno profile had a sensitivity of 65% with a positive predictive value of 69% when compared with IFA. Immunofluorescence pattern and ANA profile correlated with the diagnosed disease in 63% and 49% respectively. Immunofluorescence pattern correlated with the ANA profile in only 35% of the study subjects. On correlation with the disease, ANA profile scored less compared to ANA-IFA with a sensitivity and specificity of 46% each; positive predictive value of 59%; negative predictive value of 33%. On analysis of individual disease, ANA profile is as good as IFA in SLE and scleroderma in terms of sensitivity. In Sjogren’s syndrome and MCTD, specificity and positive predictive value of ANA profile is high.Conclusions: ANA IFA performs better than immunoprofile in the diagnosis of autoimmune diseases.
Background: Poorly controlled diabetes mellitus as indicated by elevated glycated haemoglobin (HbA1c) levels is associated with increased cardiovascular risk. C–reactive protein (CRP), an important cardiovascular risk factor, is elevated in diabetics with poor glycaemic control than those with good control. The present study assessed the correlation between HbA1c and CRP levels.Methods: A prospective study was conducted in thirty type 2 diabetic patients irrespective of the disease duration and treatment; those with established target organ damage were excluded. HbA1c and hsCRP levels were measured at baseline; sugars were monitored monthly and medications optimised; at the end of six months HbA1c and hsCRP levels were measured.Results: Mean age of the study subjects was 58.7±8.6 years; At the baseline, all had poor glycaemic control (HbA1c >7%); 15 had hsCRP >3 mg/L. At the end of 6 months, 5 achieved good glycaemic control (HbA1c <7%); 10 had hsCRP >3 mg/L. Baseline median hsCRP was 3.33 mg/L (0.68, 15.9) and at the end of 6 months it was 2.08 mg/L (0.48, 9.12). Mean HbA1c at baseline and end line was 10.6±1.55% and 8.43±1.84% respectively. There was significant reduction in both the mean HbA1c and median hsCRP at the end of 6 months (p <0.001). Positive correlation was observed between HbA1c and CRP at baseline (r=0.32, p=0.10). However, this was not observed at the end of 6 months.Conclusions: There is positive correlation between the level of glycaemic control (HbA1c) and CRP levels; Better glycaemic control results in significant reduction in the hsCRP levels.
Introduction:: Stroke is a global health problem. Studies have shown that serum albumin level is an independent predictor of ischemic stroke outcome. In the present study we compared the serum albumin and the volume of infarct with the clinical outcome.
IntroductionMeningitis is a clinical syndrome characterised by infl ammation of the meninges surrounding the brain and the spinal cord. The classic triad of meningitis consists of fever, headache and neck stiffness. 1 Meningitis can be of infective or noninfective aetiology, occurring in any age group, with extremes of age being the most severely affected. The immune-compromised state also has high mortality and morbidity. The overall case fatality rate of bacterial meningitis in adult patients is around 30%. [2][3][4] Although encephalitis by definition involves the brain parenchyma, it may also involve the meninges as well, which is termed as 'meningoencephalitis'. From an epidemiologic and pathophysiologic perspective, encephalitis is distinct from meningitis, though on clinical evaluation both can coexist. The clinical presentation is encephalopathy with diffuse or focal neurological symptoms, including behavioural and personality changes, decreased level of consciousness, neck pain/ stiffness, photophobia, lethargy, generalised or focal seizures, acute confusion or amnesic states, and fl accid paralysis. 5 Organisms responsible for bacterial meningitis are Streptococcus pneumoniae, Neisseria meningitis, Group B streptococci, Listeria monocytogens and Haemophilus infl uenza type b. Most patients recover completely if appropriate antibiotic therapy is instituted promptly. Mycobacterium tuberculosis is another major cause, especially in developing countries. Tuberculous meningitis is a critical disease in terms of fatal outcome and permanent sequelae, requiring rapid diagnosis and treatment. 6 The term aseptic meningitis is used for all types of infl ammation of the brain meninges not caused by pusproducing bacteria. It is usually a benign syndrome. Viral and aseptic meningitis are terms used interchangeably as, not only viruses are a major cause, other noninfective causes are equally attributable to the development of meningitis. Worldwide causes of viral meningitis include enterovirus, herpes, mumps, measles and HIV, with enterovirus being the most common cause of viral meningitis.In the emergency setting differentiating bacterial meningitis from other causes, such as fungal, tuberculous, viral, Background Although there are numerous studies on meningitis and encephalitis separately, literature on meningoencephalitis is sparse. In this study we analysed the clinical pro le of meningoencephalitis and its clinical outcome.Methods Fifty adults diagnosed with meningoencephalitis from July 2014 to July 2015 in a tertiary care hospital in South India were studied prospectively and their clinical presentation, aetiology and outcome were analysed.Results Among 50 patients, 33 (66%) were male; 39 (78%) were <50 years of age. Fever was the most common presenting symptom in 41 out of 50 patients (82%), followed by headache (74%) and altered sensorium (62%); only 18 patients (36%) had all three classical symptoms. Twenty-eight out of 50 patients (56%) did not have neck stiffness. A majority of patients had acute-to-subac...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.