A Prospective Observational Study of Spectrum of Tropical Infections in Pregnancy in a Tertiary Care Hospital in Mumbai, Maharashtra

Background and aims: Pregnancy is associated with several hormonal and mechanical changes in the body. The tropical infections that most commonly affect pregnant females are malaria, dengue, leptospirosis and typhoid. These tropical infections cause many medical complications in pregnancy by causing anemia, thrombocytopenia, bleeding and inflammatory reactions. Therefore, we conducted a study to evaluate the clinical presentation, complications and outcome of tropical infections in pregnancy. Material and methods: The present study was conducted at a tertiary care hospital in Mumbai, Maharashtra over a period of 1½ year (January 2018 to June 2019) after getting approval from Institutional Ethics Committee. In this study, 250 pregnant patients admitted in medicine ward, obstetrics and gynecology ward, and ICU with symptoms and signs of tropical infections and age more than 18 years, who gave written informed consent, were included. Results: The most common age group amongst the study population was 20 to 24 years (41.6%), followed by 25 to 29 years (40%) and 30 to 35 years (18.4%). Most of the study population had gestational age of 1 to 12 weeks (61.6%), followed by 13 to 28 weeks (31.6%) and more than 28 weeks (6.8%). Most of the study population had parity 2 (46.8%), followed by parity 1 (43.2%), parity 3 (6.8%) and parity 4 (3.2%). The most common clinical features amongst the study population was fever (62%), followed by headache (32.8%), nausea (30.8%), pain in abdomen (26.4%) and petechiae (26%). The most common infections amongst the study population were malaria (11.2%), dengue (8%), leptospirosis (6%) and enteric fever (5.2%). The most common medical complications were bleeding due to thrombocytopenia (TCP) (6.8%), followed by serositis (5.2%), ARDS (4.4%), meningitis (2.8%), subconjunctival hemorrhage (2.8%) and encephalitis (1.4%). Complicated infections were seen in 30% of the study population. Conclusion: All pregnant women must be evaluated at primary care centers properly in their antenatal visits for their parity status and any associated risk factors and diseases. By doing this, we can reduce many tropical infections, complications and maternal mortality in early stage of pregnancy

A Prospective Observational Study of Spectrum of Tropical Infections in Pregnancy in a Tertiary Care Hospital in Mumbai, Maharashtra

Background and aims: Pregnancy is associated with several hormonal and mechanical changes in the body. The tropical infections that most commonly affect pregnant females are malaria, dengue, leptospirosis and typhoid. These tropical infections cause many medical complications in pregnancy by causing anemia, thrombocytopenia, bleeding and inflammatory reactions. Therefore, we conducted a study to evaluate the clinical presentation, complications and outcome of tropical infections in pregnancy. Material and methods: The present study was conducted at a tertiary care hospital in Mumbai, Maharashtra over a period of 1½ year (January 2018 to June 2019) after getting approval from Institutional Ethics Committee. In this study, 250 pregnant patients admitted in medicine ward, obstetrics and gynecology ward, and ICU with symptoms and signs of tropical infections and age more than 18 years, who gave written informed consent, were included. Results: The most common age group amongst the study population was 20 to 24 years (41.6%), followed by 25 to 29 years (40%) and 30 to 35 years (18.4%). Most of the study population had gestational age of 1 to 12 weeks (61.6%), followed by 13 to 28 weeks (31.6%) and more than 28 weeks (6.8%). Most of the study population had parity 2 (46.8%), followed by parity 1 (43.2%), parity 3 (6.8%) and parity 4 (3.2%). The most common clinical features amongst the study population was fever (62%), followed by headache (32.8%), nausea (30.8%), pain in abdomen (26.4%) and petechiae (26%). The most common infections amongst the study population were malaria (11.2%), dengue (8%), leptospirosis (6%) and enteric fever (5.2%). The most common medical complications were bleeding due to thrombocytopenia (TCP) (6.8%), followed by serositis (5.2%), ARDS (4.4%), meningitis (2.8%), subconjunctival hemorrhage (2.8%) and encephalitis (1.4%). Complicated infections were seen in 30% of the study population. Conclusion: All pregnant women must be evaluated at primary care centers properly in their antenatal visits for their parity status and any associated risk factors and diseases. By doing this, we can reduce many tropical infections, complications and maternal mortality in early stage of pregnancy

A study of carotid intima media thickness (CIMT) in cases of ischemic stroke

Background: Measurement of Carotid Intima Media Thickness (CIMT) by carotid doppler is a non-invasive, safe and inexpensive investigation. CIMT may predict ischaemic stroke. However, the data about the usefulness of CIMT as a predictor in Indian scenario is relatively less. The primary objective of the present study was to determine utility of CIMT as a predictor of ischemic stroke.Methods: This study was a case control study carried out at a tertiary care institute. The study included fifty cases of ischaemic stroke. Fifty age and sex matched controls were selected who were not relatives of cases.Results: A detailed history of cases and controls was taken. They were subjected to routine investigations; blood sugars and lipid profile were sent.  CIMT was measured by doing carotid doppler study on both sided carotid arteries. The results were analysed.Conclusions: From this study, we concluded that there is increase in CIMT in patients of ischemic stroke. Age, gender and side of the vessel had no significant effect on CIMT. It was concluded that CIMT value has a direct correlation with ischemic stroke. Thus, Carotid intima media thickness can be used as a non-invasive predictor of future ischemic stroke incidence.</jats:p

Study of electrolytes in patients of Dengue in a tertiary care hospital in India

Background: Dengue is a mosquito borne viral infection. It is the most common arboviral disease globally. In the year 2017, India had 1,53,635 cases of dengue with 226 deaths. Electrolyte disturbances reported in dengue infection are hyponatremia, hypokalaemia and hyperchloremia. Considering the serious nature of effects of dyselectrolytemias and high incidence of dengue in India, it is necessary to have a thorough understanding about electrolyte disturbances in Dengue, so as to predict, diagnose and treat them accordingly.Methods: This study was performed in a tertiary care centre in Mumbai, India. The study was a prospective observational cross-sectional study. 150 Patients diagnosed with Dengue were enrolled for the study. Patients’ demographic data, clinical history, examination findings and investigations including electrolyte values were recorded and analysed.Results: A higher incidence of dengue was seen in young age group among admitted patients (74%). Hyponatremia (45.33%) and Hypokalaemia (10.60%) were more commonly observed than hypernatremia (3.33%) and hyperkalaemia (3.33%). Hypochloraemia (6.66%) was seen slightly more than hyperchloraemia (6.00%). Fever was Present in 98.66%, retro orbital headache in 86.66%, vomiting in 56.00%, joint pain in 69.00%, lethargy in 70.66%, breathlessness in 36.00%, bleeding in 8.66%, abdominal pain /tenderness in 18.00%. 85.00% had low platelet count, 30.66% had low hemoglobin and 36.66% had leucopenia. Haematocrit was found to be less in 27.33% and high in 1.33%.Conclusions: From the above results we concluded that, there is a need to have a degree of suspicion about dyselectrolytemias while managing patients with Dengue. Also, patients need to be subjected to necessary lab investigations early during management so that if abnormalities are found, they can be promptly and appropriately managed as some of these abnormalities may lead to increased severity as well as mortality.</jats:p

Hematological and hepatic profile of dengue patients presenting to a tertiary care hospital in Mumbai

Objective: To assess the pattern of hematological and hepatic involvement in patients of dengue fever. Methods: This study was performed in a tertiary care center in Mumbai, India. 142 patients diagnosed with dengue who were admitted between January 2016 to December 2017 enrolled for the study. Patients Demographic data, clinical history, examination findings, and investigations including complete blood count and liver profile were done. Results: Highest incidence of dengue was seen in the age group of 21-30. More males were affected than females. Highest incidence was seen in monsoon months in Mumbai (August-September). Commonest symptom was fever followed by rigor, chills, bodyache and headache. Altered sensorium was the rarest. In investigations thrombocytopenia was the commonest followed by raised AST and ALT. Conclusion: As Dengue causes significant mortality and morbidity,there is excess burden on healthcare infrastructure of metro cities in India, knowing about the disease behavior is of paramount importance. Doing simple and easily available investigations can be vital in predicting disease severity and need of inpatient and intensive care in Dengue patients

Hematological and hepatic profile of dengue patients presenting to a tertiary care hospital in Mumbai

Objective: To assess the pattern of hematological and hepatic involvement in patients of dengue fever. Methods: This study was performed in a tertiary care center in Mumbai, India. 142 patients diagnosed with dengue who were admitted between January 2016 to December 2017 enrolled for the study. Patients Demographic data, clinical history, examination findings, and investigations including complete blood count and liver profile were done. Results: Highest incidence of dengue was seen in the age group of 21-30. More males were affected than females. Highest incidence was seen in monsoon months in Mumbai (August-September). Commonest symptom was fever followed by rigor, chills, bodyache and headache. Altered sensorium was the rarest. In investigations thrombocytopenia was the commonest followed by raised AST and ALT. Conclusion: As Dengue causes significant mortality and morbidity,there is excess burden on healthcare infrastructure of metro cities in India, knowing about the disease behavior is of paramount importance. Doing simple and easily available investigations can be vital in predicting disease severity and need of inpatient and intensive care in Dengue patients.</jats:p