Online ISSN: 2515-8260

Keywords : Fever


Study of usefulness of Weil-Felix test as a simple diagnostic tool for diagnosis of rickettsial fever

Dr. Varun B Kusagur, Dr. Manasa KB

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1382-1387

Background: Rickettsial infections are the most covert re-emerging infections in present
times. They are incapacitating and notoriously difficult to diagnose, Weil-Felix (WF) test is
classic serological test which is widely available but not widely acceptable because of its low
sensitivity and specificity. Present study was aimed to study of usefulness of Weil-Felix test
as a simple diagnostic tool for diagnosis of rickettsial fever.
Material and Methods: Present study was single-center, prospective, observational study,
conducted in children < 18 years age, hospitalized with fever and presence of one or more of
the following clinical features: Rash, edema, eschar, hepatosplenomegaly, lymphadenopathy
OR had history of contact with pets or live stocks and history of tick-bite.
Results: In the present study maximum number of cases were from school going age group
(53.5%), male (67.4%), from Rural Areas (88.4%) & Tick bite could be demonstrated in
44.2% cases. Based on clinical features Lymphadenopathy was seen mainly 86.00%,
followed by maculopapular rash (76.7%), rash appearing 48-96 hrs. after fever (72.10%),
conjunctival congestion (55.80%), hepatomegaly (48.80%), rash on palms & soles, pedal
edema (34.9%) & purpura (14%). Out of 43 suspected cases, Weil-Felix test was positive in
31 cases (72.1%) and Negative in 12 cases (27.90%).
Conclusion: Rickettsial disease must be strongly suspected with a triad of fever, rash and
lymphadenopathy or having history of tick exposure/ bite and when the cause of fever cannot
be established. Weil Felix test can be carried out for early detection of suspicious casein
resource limited set up.

An Observational Study to Correlate the Clinical Profile with Laboratory Investigations and Radiological Findings in Dengue Fever at Tertiary Care Center

Ramesh Chand Sharma, Mamta Meena

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10467-10472

Background: The demographic pattern and the trend of disease (dengue fever) are
largely changing everyyear through the past decade.Early recognition and prompt
initiation of appropriate management is vital. The aim of this study to correlate the
clinical profile with laboratory investigations and radiological findings in dengue fever
at tertiary care center.
Materials& Methods: A cross sectional study done on 50 children less than 12 years of
age with clinical signs and symptoms of Dengue- any acute febrile illness in department
of Pediatrics, RUHS College of Medical Sciences, Jaipur, Rajasthan, India during one
year period. For all suspected dengue fever, the IgM ELISA qualitative test was done at
our hospital. Children positive for IgM dengue were taken up for study and followed up
for clinical profile.Labinvestigations carried out in these patients include CBC,
Haemoglobin, renal functiontest, Liver function test and Dengue IgM serology. Chest X
ray was taken todemonstrate pleural effusion. Children positive for IgM were followed
up for the clinicalprofile and outcome.
Results: Our study showed that the larger number of cases was in 6 to 12 years.).Males
were affected slightly more than females in total and also insubgroupsexceptin DHF
III.Itwas not significant (P>0.05).The mean duration of fever was 6.23 days.Pleural
effusion was seen 6 patients, of which more cases in dengue feverwith warning sign.
Abdominal tenderness was seen in 46% of cases, highest in denguefever with warning
signs and lowest in mild dengue which is statistically significant.Ascites was seen in 20
% of cases, highest in dengue fever with warning signs andDHF IV. Hepatomegaly was
seen in 30%, highest in DHF IV and lowest in mild dengue which is statistically
significant. The splenomegaly was seen in 4% of cases. AST was elevated in 36% of
cases. More in DHFIII & DHFIV cases, but it is not statistically significant. ALT was
increased in 30% of cases. More elevated cases are in DHFIII which was also not
significant.

“Socio-demographic profile and treatment Outcome of Covid-19 Patients attending Covid Hospitals of Datia, M.P. INDIA’’

Adhikari P., Kumar Sanjeev, Swami Piyush, Gupta Shubhanshu, Tiwari R.

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1815-1823

Background- In December 2019, a series of pneumonia cases were identified with presumptive viral origin in Wuhan, China, the virus was initially designated as the novel coronavirus (2019-nCoV), later WHO renamed  as Corona Virus Disease 2019 (COVID-19).
Objective- To describe the sociodemographic profile & Treatment Outcome of Covid -19 Patients attending Covid Hospitals of Datia district of  M.P.
Methods -it was descriptive, cross sectional observational  study  conducted among COVID-19 positive cases admitted & managed at  Covid  hospitals (DCH & DCHC) affiliated to  Government Medical College Datia ,M.P. from 1st  April 2020 to 15th  December 2020. Data was collected regarding age ,sex, Occupation, Residence and Treatment Outcome of Covid 19 patients and analysed accordingly with the help of EpiInfo software.
Results- The mean age of the patients was found 37.69±16.74 years. 65.7% of patients were belonged to a middle age group & male sex. Only 23.14% belongs to peripheral area& remaining were of urban area.  Out of total 1620 positive patients, 78.76% patients were admitted & remaining were advised for home isolation. 92.47% had been discharged &cured ,only 1.72 % patients were up referred and only 0.39 % death had been occurred among of all admitted patients.
Conclusion-As only 1.72 % patients were up referred and 0.39 % death had been occurred among of all admitted patients which shows a good quality care of covid patients and  may be also be due to mainly middle aged patients were found infected with covid -19 without any more significant co morbid conditions

Fever in Children: How Knowledge, Attitude and Belief among Healthcare Community can Affect Assessment.

Riyadi Adrizain; Cory Primaturia; Raisa Mentari Moeis; Djatnika Setiabudi; Alex Chairulfatah

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 2361-2369

Background: The study was aimed to assess the knowledge of healthcare provider and the correlation of the healthcare providers’ educational degree toward fever management in children.
Method: This study was conducted among healthcare-community using a questionnaire as the primary data. Descriptive statistical analyses were performed by using percentage and the correlation of their degree toward fever was analyzed by the chi-square test with statistically significant p values of < 0.05.
Result: Questions 1-17 about basic science were answered correctly by more than 80%, except those regarding non-shivering thermogenesis in neonates showing that the residents and medical students group got better results than the specialists and medical doctors (61%; 68.8%; vs 84.7%; 83.3, respectively Chi-square, p = 0.039 (p < 0.05)). While questions 18-25 about fever management in children, around half of the subjects answered correctly following the recommendations.
Conclusion: The subjects’ educational degree influenced their knowledge, attitudes, and beliefs regarding the fever management in children

Association of bacterial/viral infections withneutrophil-lymphocyte ratio, monocyte-lymphocyte ratio, and platelet-lymphocyte ratio in patients presenting with fever

Tri Yulia Rini; Satriawan Abadi; Sudirman Katu; Syakib Bakri; Haerani Rasyid; Hasyim Kasim; Andi Fachruddin; Risna Halim; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 1500-1509

Background of the Study: Bacterial and Viral infections are often hard to be distinguished in daily clinical practice. Biological markers obtained from a routine examination play an important role to minimize time in providing diagnose and giving therapy. Recently, the use of Neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) is greatly considered to differentiate types of infection found in the patients presenting with fever.
Method: This study uses prospective cohort study design and involves patients presenting with fever who are admitted to the ICU. The initial NLR, MLR, and PLR is examined and categorized into types of infection found. The ANOVA test and t-test are performed to find out the difference among study groups with the value of α = 0,05.
Result : This study involves 207 patients (92 male patients [44%]) presenting with fever with the average age of 45,6 ± 14,6 years old. The majority of cases (135 cases [66,5%]) in patients with fever results from bacterial infection; The study also finds 47 cases (34,8%) of typhoid fever and 30 cases (22,2%) of pulmonary tuberculosis. Dengue hemorrhagic fever (DHF) is the most commonly found viral infection with 52 cases (76,4%). The significant diagnose of bacterial infection shows higher value of NLR and MLR than that of viral infection (P < 0,001); Urinary tract infection has the highest value of NLR and MLR, amounting to 9,4 ± 3,6 and 0,23 ± 0,20, respectively. In general, the value of PLR is lower than that of viral infection (P < 0,001).
Conclusion: Neutrophil-lymphocyte ratio, MLR and PLR have benefit to predict diagnosis for the patients presenting with a fever. Bacterial infection is associated with the high value of NLR and MLR, and PLR generally has a lower value in viral infection cases.