Online ISSN: 2515-8260

Keywords : Fever


Prevalence of Rota virus gastroenteritis among immunised and non immunised children below 5 years

Vidhya Shankari, Shajahan R A, Deepa S N, Anjali Ann Chacko, Ebin Roshan Paul, R.C. Krishna Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 2625-2630

Background: To assess the prevalence of Rota virus gastroenteritis among immunised and unimmunised children below 5 years and to assess the prevalence of complications among Rotaviral gastroenteritis.
Materials and Methods: Eighty- six cases of gastroenteritis in children aged less than 5 years were enrolled and demographic data of each patient, immunization history, clinical history and other relevant information was collected. Stool collection was done and sample was processed in special media, Wilson blair and alkaline peptone water. All the samples were tested for Rota virus. Prevalence of complications in rotaviral gastroenteritis assessed using clinical examination and radiological and laboratory parameters.
Results: Out of 86 patients, Rota virus was seen in 46, parasites in 24, bacteria in 10 and unknown in 6 cases. The difference was significant (P< 0.05). Among the total 46 children with rotaviral gastroenteritis, 10 were immunised for rotavirus and 36 were unimmunised. The difference was statistically significant(P <0.05). There were 25 males and 21 females among Rota virus positive cases. The difference was non- significant (P> 0.05) (Table II). Rota virus positive and Rota virus negative cases, duration of diarrhea was 0-4 days in 5 and 8, 5 days in 7 and 20, 6-7 days in 34 and 12. Vomiting was seen in 30 and 24. Duration of vomiting in days (1) was seen in 10 and 18, (2) in 22 and 12 and (3) in 14 and 10. Fever was seen in 34 and 15 and blood in stools seen in 20 and 10 cases . Dehydration was mild in 14 and 18, moderate in 6 and 10, severe in 10 and 8 and very severe in 16 and 4 respectively. Children with rotaviral gastroenteritis  had higher rate of intussusception presenting in 12 out of 46 children whereas children with non rotaviral gastroenteritis had only one case of intussusception among 40. The prevalence of complications was more in rotaviral gastroenteritis than others. The difference was significant (P< 0.05) (Table III, graph I).Duration of stay in the hospital was 10 days in average for rotaviral gastroenteritis when compared to other infectious causes where the stay was 5 days in average. The difference was statistically significant (p<0.05).
Conclusion: There was high prevalence of Rota virus infection in  unimmunised children less than 5 years with gastroenteritis and the prevalence of complications were high among rotaviral affected children. In conclusion, rotaviral vaccination prevents gastroenteritis associated with severe complications which affect the quality of life in children below 5 years.

Effect of health education on mothers' understanding of nutritional needs of children with fever

Prakash Naregal; Vaishali R Mohite; Mahadeo Shinde; Ajit Pawar; Prabhuswami Hiremath; Samir K Choudhari

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 1659-1666

Background: Fever is a typical symptom of common childhood health concerns, leading parents to seek medical attention for their children.
The purpose of this study is to evaluate the effect of health education on mothers' understanding of how to best care for their children while they are ill with a fever.
Methods: The study used a one-group pre-and post-test strategy for research. The mothers of children aged six and up admitted to the paediatric ward of a selected Karad tertiary care hospital constitute the study population. It was permissible to pick a sample of moms of children with fever using a non-probability purposive sampling technique. One hundred childbearing women were chosen from the Krishna hospital in Karad. In order to gather information, a formal questionnaire was used. The purpose of the pre-test was to gauge mothers' preexisting knowledge on the topic of food for children with fever. After 7 days of pre-testing, we repeated the knowledge quiz to see how much of the initial knowledge gained from the structured health education had stuck.
Result: After receiving systematic health education, 60% of moms improved to a sufficient level of knowledge. For mothers, the mean pre-test score on diet knowledge was 5.83; the post-test score was 14.6, and the paired "t" test value was 13.9. This improvement was statistically significant at the 0.0001 level.
Conclusion: Most mothers lacked information about what to feed their children with fever prior to receiving health education, so it's important that ongoing health education programmes emphasise the importance of a healthy diet for kids when they're sick. This will help prevent further complications and ensure that kids stay healthy in the long run

Drug Resistant Tuberculosis – Clinical profile and Resistance pattern in tertiary care teaching hospital.

Dr Chandrashekar, Dr Arun M, Dr Basavaraj Machnur, Dr Rohit Dixit

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 548-554

Background: This drug resistant TB is a growing concern around the world. It accounts for huge financial and public health burden. Though drug resistant TB is not new to India but proper surveillance and treatment remains the mainstay in tackling this global problem. The primary objective was to study the clinical profile and drug resistance pattern of TB patients. The Secondary objective was to effectively diagnose and treat the DR TB.
Methodology: It was a cross sectional observational study conducted at department of General medicine at Raichur Institute of Medical Sciences (RIMS), Raichur. All the patients of Drug resistant tuberculosis (DR TB) who attended RIMS were included in the study. All the patients with drug resistance pattern were included in the study after taking their consent. Statistical analysis was done using SPSS Ver 21.
Results: A total of 552 TB cases were screened for drug resistance. Out of them 39 were found to drug resistant TB. The mean age of presentation in males was 39.92 years and in females it was 36.08 years. Patients who completed higher education and who were employed were more in number compared to others. All the classical symptoms of TB like cough with expectoration, fever, shortness of breath was seen in these patients. Among the 39 DR TB patients, 30 patients had previously suffered from TB. Out of these 30 patients, 18 (60%) were defaulters, 7 (23%) were irregular and 4 (14%) were treatment failure. Thirty two (82.05%) patient showed resistance to either Rifampicin or INH and remaining 7 (17.95%) patients showed resistance to both rifampicin and INH.
Conclusion: Drug resistance was predominantly mono resistance to either rifampicin or INH but MDR TB were also seen. Patients were educated regarding treatment compliance

A study of clinical profile of community acquired pneumonia at a tertiary care hospital

Dr. Sireeshkumar CH; Dr. Vilas Honnakatti; Dr. Pratap Budhya

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1453-1458

Causes of CAP include bacteria, viruses, fungi, and parasites. After achieving a correctdiagnosis,thesecondstepistodefineifthepatientwill receive outpatient treatment or hospitalization. Ours was a clinical, prospective, observational and open study. The study subjects were community acquired Pneumonia patients admitted with signs and symptoms suggestive of Pneumonia. After obtaining a detailed history, complete general physical examination and clinical examination the patients were subjected to relevant investigations. The complete data was collected in specially designed case recording form and transferred into a Master chart which is then subjected to statistical analysis.We studied 100 cases of Pneumonia, out of which 5 patients presented with Confusion, 69 patients presented with raised Blood Urea Nitrogen,11 patients with raised Respiratory rate, and 9 patients with Hypotension. CURB AGE score of 0 was observed in 26 patients, score 1 in 22 patients, score 2 in 24 patients, score 3 in 20 patients, score 4 in 2 patients, score 5 in 4 patients and score 6 in 2 patients. Prognosis was good in patients aged less than 50 years and those without any comorbidity. Fever was the most common symptom of presentation.

“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 4, Pages 3107-3115

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.

Prevalence of urinary tract infections in febrile children admitted in tertiary care institute of Uttar Pradesh

Dr. Thakur Vikrant Anand, Dr. Vaibhav Jain, Dr. Mohd. Waseeque Khan, Dr. Shiba

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2736-2741

Background: Urinary Tract Infections (UTI) are a common cause of fever and are one of the most common bacterial infections seen in children. It is the most common reason that make under 5 children visit Emergency/Outpatient departments. The reported rate of recurrent UTI is around 12- 30% with risk greater in Infants < 6 months, severe vesico-ureteric reflux and abnormal nuclear renal scans at time of first infection.
Material and Method: Cross-sectional study was carried out among 378 children in age group of two months to six years who were admitted in Pediatrics ward of tertiary care hospital with complaint of Fever. A pre-designed, structured questionnaire was used to collect information from participants which included demographic data, clinical presentation and clinical examination findings. The diagnosis of Urinary Tract Infection was confirmed by urine culture. The collected information was entered in Microsoft-Excel 2007 Software. Data was analyzed by using SPSS software version 17.0.
Results: The prevalence of Urinary Tract Infection in the present study came out to be 11.9%. The age group and sex of child was found to have statistically significant association with Urinary Tract Infection. Pain in abdomen/back/flank, burning micturition and increased urine frequency were also having statistically significant association with Urinary Tract Infection. On Urine microscopy examination, occasional pus cells were observed in 3.97% children, less than 5/hpf pus cells were observed in 8.73%, 5-10/hpf pus cells were observed in 6.35% children whereas plenty of pus cells were observed in 12.7% children.
Conclusions: The prevalence of UTI was less in children less than 2 years of age. Females had a higher prevalence of UTI as compared to males.

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.

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.

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.