Fever Patients Research Articles

Comparison of platelet indices in dengue fever patients based on platelet transfusion: A prospective observational study in a tertiary care center.

Dengue fever is the most prevalent mosquito-borne viral disease in humans. Platelet indices (PIs) are given by the cell counters but are often not reported which is possibly due to under-recognition of the utility of these parameters. This study aimed to compare PIs in patients with dengue fever to assess their role in the outcome such as hospital stay and platelet transfusion requirements. Prospective observational study in a tertiary care center, Thrissur, Kerala. A group of 250 dengue patients was studied over a period of 18 months. The platelet parameters (platelet count, mean platelet volume [MPV], platelet distribution width [PDW], platelet large cell ratio [PLCR], plateletcrit [PCT] and immature platelet fraction [IPF]) were measured with Sysmex XN-1000 and followed up every 24 h. The clinical features, duration of hospital stay and platelet transfusion requirements details were collected. Independent t-test, Chi-square test, Karl Pearson correlation coefficient. A total of sample size was 250. The study showed normal PDW and MPV, low platelet count and PCT, and high PLCR and IPF in dengue patients. There were significant differences in PIs (lower platelet count and PCT, higher MPV, PDW, PLCR, and IPF) in comparison between dengue patients based on platelet transfusion. PIs may act as a predictive tool in the diagnosis and predicting outcomes in dengue fever. Low platelet count and PCT, high PDW, MPV, PLCR, and IPF in transfused dengue patients were found to be statistically significant. Clinicians need to be sensitized about the utility and limitations of these indices and rationalize the need for red cell and platelet transfusions in dengue.

A Cros Sectional Study on the Plateletcrit and Platelet Indices in Different Forms of Dengue Fever

Background: Dengue fever is a viral disease caused by four different serotypes of dengue viruses from DENV, transmitted mostly by the Aedes aegypti mosquito. The disease has history of many outbreaks mostly in tropic and sub-tropic countries, costing many lives annually, with millions in mild to complicated forms, bringing stress to health systems and economies of poor countries. Dengue epidemic occurred in Pakistan in 2010 with 257 deaths during the epidemic and prevalence of 16580 cases in Rawalpindi, repeated epidemic in 2015, 2017, 2018 and 2019 with higher prevalence. Objective: To determine the frequency of dengue hemorrhagic fever in patients of dengue fever and to compare mean platecrit and platelet indices in patients with or without dengue hemorrhagic fever due to dengue fever. Materials And Methods: The design of this study was an observational cross sectional study design. This study was conducted in the Department of Infectious Diseases, Holy Family Hospital, Rawalpindi and the duration of this study was 6 months after the approval of synopsis i.e 1st May 2021 to 30th Oct 2021. Patients fulfilling selection criteria were enrolled in the study from emergency of Department of Infectious Diseases, Holy Family Hospital Rawalpindi. Informed consent was taken. Then patients were evaluated and divided for severity score (annexure I). Reports were assessed for Platelet indices including platelet count, mean platelet volume, platelet distribution width (as per operational definition). All this information were recorded on proforma (attached). Results: Total 150 participants were enrolled in the study as per the inclusion criteria. Mean age in the study was 38.42+13.74 whereas there were 94 (62.7%) male and 56 (37.3%) female patients who were included in the study according to the inclusion criteria. Among 150 patients, 28 (18.7%) patients were presented with dengue hemorrhagic fever in patients of dengue fever. Mean Platecrit indices in patients with or without dengue hemorrhagic fever due to dengue fever in the study was 0.26+1.62 vs 0.08+0.02 (p-value 0.552) whereas mean platelet indices in patients with or without dengue hemorrhagic fever due to dengue fever in the study was 64.19+41.11 vs 78.10+32.74 (p-value 0.097). Practical Implication: To determine the frequency of dengue hemorrhagic fever in patients of dengue fever and to compare mean platecrit and platelet indices in patients with or without dengue hemorrhagic fever due to dengue fever Conclusion: The study concluded that different indices of platelets within different forms of dengue fever to assess the severity of the disease process may serve as an early indicator of disease progress and severity which will help to decide early intervention. Keywords: Dengue Fever, Hemorrhagic, Platelet, Indices, Serotypes, Epidemic, Participants

PREVALENCE AND ASSESSMENT OF PRESCRIPTION PATTERN ANALYSIS OF ACUTE FEBRILE ILLNESS PATIENTS IN TERTIARY CARE HOSPITAL: A PROSPECTIVE OBSERVATIONAL STUDY

Aim and Objective: Assessment of prescription patterns may help the identification of clinical use of drugs in fever patients. Rational use of drugs may control the utilization of selective drugs in acute febrile illness. Methodology: A Prospective observational study was conducted in the General Medicine department in tertiary care hospital. Wards inpatients and outpatients with or without past and personal history were included in the study. Results: A Total of 357 were admitted with fever patients. In this study, patients of the 21- 30 age group patients have shown more prevalence. A total of -357 patients who were prescribed antibiotics were included in the study. Out of 357 cases, female patients 148 (41.45%), and male patients 209(58.54%). in this study maximum number of diseases was found to be dengue 103(28.85%), Out of 1250 medications, the highly prescribed formulation was parenteral dosage forms 825 (66.00%). Conclusion: A specially designed protocol is important for fever patients before prescribing to the patients evaluation of fever with suitable criteria is required. In other words, without knowing the diagnosis or focus of the disease, treatment or medications does not stop the fever spikes.

Post-POEM Contrast-Enhanced Swallow Study: Is It Always Necessary?

BackgroundPeroral endoscopic myotomy (POEM) is rapidly becoming the procedure of choice for treating esophageal achalasia. In most centers, contrast-enhanced swallow studies (CESS) are routinely performed postoperatively to confirm mucosal integrity. The aim of this study was to determine the necessity of performing these studies routinely after POEM. MethodsA retrospective review of a prospectively maintained database of patients who underwent POEM between December 2012 and November 2020 was performed. All patients underwent a CESS on the first postoperative day. Medical records including vital signs, complete blood count, and POD-1 CESS were evaluated. ResultsOne hundred thirty-four consecutive patients were included in the study. Sixty-nine (51.49%) CESS showed abnormal findings; while most findings did not change the postoperative course, five (7.2%) demonstrated tunnel leaks, which did alter the overall management. Screening patients for fever, tachycardia, or leukocytosis on POD-1 had a 100% sensitivity and a 62% specificity for finding a clinically significant complication on CESS. ConclusionsThe study findings suggest that performing routine contrast-enhanced swallow studies on all patients is not necessary following POEM, as leaks can be screened for by clinical or laboratory abnormalities. Herein, we propose an algorithm based on objective measurable findings for the selection of patients who should undergo CESS.

Potential Hematological Predictors Assessing Severity in Patients Presenting with Dengue

Aim: To determine the potential hematological predictors and biochemical markers for assessing severity in patients presenting with dengue Methods: This descriptive study was conducted at Jinnah Medical College/ District Specialist Naseerullah Babar Memorial Hospital, Peshawar in the duration from March, 2022 to August, 2022 on 150 Dengue NS1 (ICT) positive patients. Hematological and biochemical markers were assessed among severe vs non-severe dengue fever patients. Hematological and biochemical markers were assessed by T-test with P < 0.05 as significant. Results: Hematocrit (%), AST (U/L) and ALT (U/L) levels were higher significantly in the severe dengue patients’ vs non-severe dengue fever patients, platelet (mcL) and White blood cells (mcL) were significantly lower in the severe dengue patients’ vs non-severe dengue fever patients. Conclusion: We conclude that Hematocrit (%), platelets count, White blood cells, Alanine transaminase (ALT) (U/L) and Aspartate aminotransferase (AST) (U/L) and are important hematological and biochemical predictors for assessing the severity of dengue. Keywords: Hematological markers, Biochemical markers, Dengue fever, Severity

Evaluation of Cardiac Arrhythmia Susceptibility in Pediatric Familial Mediterranean Fever Patients

Aim: Familial Mediterranean fever is an autoinflammatory disease characterized by attacks of inflammation. Despite treatment, there is evidence of subclinical persistence of inflammation with normal laboratory values. This study was conducted to investigate the cardiac effects of continued subclinical inflammation in children and the predisposition towards arrhythmia in familial Mediterranean fever.
 Materials and Methods: Age and sex-matched familial Mediterranean fever patients and healthy controls were compared in terms of demographic, laboratory, echocardiographic and electrocardiographic data. The patients with familial Mediterranean fever were grouped according to disease severity scores and compared in terms of electrocardiographic data that could indicate arrhythmogenesis. Correlation analysis was used to examine the relationship between the electrocardiographic measurements and the clinical and laboratory data. 
 Results: In the comparison of the two groups, no significant difference was found in the echocardiographic measurements in terms of left ventricular systolic and diastolic functions. According to these data, QT and Tp-e intervals were significantly longer in those with familial Mediterranean fever (p=0.002, p=0.046, respectively). When the patients were classified according to the 3 separate disease severity scores, QT dispersion in the moderate-severe disease group was significantly longer than in the mild disease group (p

Relationship between Age and Nutritional Status and Length of Stay of Typhoid Fever Patients at Dr. Soehadi Prijonegoro General Hospital, Sragen, Indonesia

Typhoid fever is one of the cases of infection that still tends to be high in Indonesia. There is a role for IgG antibodies in the clinical condition of typhoid fever patients. The immune status of an individual is largely determined by nutritional status and age. This study aimed to determine the relationship between age and nutritional status and length of stay of typhoid fever patients at Dr. Soehadi Prijonegoro General Hospital, Sragen, Indonesia. This study was an analytic observational study with a cross-sectional approach. A total of 106 subjects participated in this study. Univariate and bivariate analyses were performed on this study data using SPSS. There is a relationship between age and length of stay, where age over and/or equal to 30 years is at risk of getting longer care than patients who are less than 30 years old. This study also shows that there is no relationship between nutritional status and length of stay of typhoid fever patients.

Depression and the risk factors for isolated infectious disease fever patients in the hospital during the COVID-19.

To compare and analyze the incidence of anxiety and depression of infectious disease fever patients in hospitalized isolation and home isolation during the COVID-19 pandemic, as well as the risk factors for the negative emotions of hospitalized isolation patients. Forty isolated infectious disease fever patients in Baoding No.1 Hospital were randomly selected as the study group, and the other 40 isolated infectious disease fever patients at home were randomly selected as the control group from March 2020 to August 2020. The scores and prevalence of depression and anxiety between the two groups were compared and analyzed. The logistic regression analysis was used to judge and analyze the negative psychological factors of hospitalized isolation patients such as depression and anxiety. The HAMA and HAMD-17 scores of study group are significantly higher than those of control group (HAMA, p=0.00; HAMD-17, p=0.01). The prevalence of anxiety and depression in the study group was significantly higher than that in the control group (p=0.03, p=0.04). The gender (p=0.002), economic status (p=0.004) and isolation attitude (p=0.023) are the related factors of anxiety, among which economic status is the protective factor, while women and resistant attitude are the risk factors. Economic status (p=0.003) and isolation attitude (p=0.001) are the related factors of depression, among which economic status is the protective factor, and resistant attitude is the risk factor. The prevalence and severity of anxiety and depression in hospitalized isolation patients due to infectious disease fever are significantly higher than those of home isolation patients. The focus groups are women, with bad economic status and poor isolation attitude. Necessary psychological counseling and social support should be provided to these groups to reduce negative emotions and increase the experience of isolated patients.

LITERATURE REVIEW: GAMBARAN PEMERIKSAAN TES WIDAL DENGANPEMERIKSAAN PERTUMBUHAN KULTUR BAK-TERI SALMONELLA TYPHI PADA PASIEN DEMAM TIFOID ANAK

Typhoid fever is a systemic contamination because of Salmonella typhi micro organism, with unfold via the fecal-oral route. Currently, the diagnosis of typhoid fever in Indonesia remains broadly utilized by the Widal take a look at method. From a few data, the sensitivity and specificity values of the Widal take a look at aren't as accurate because the Tubex ™ take a look at. Therefore, this has a look at will investigate a literature assessment that examines the assessment of the Widal take a look at with blood culture in pediatric typhoid fever patients. The layout of this studies is a literature review. Search for posted articles on google schoolar the usage of decided on keywords, namely: evaluate of the Widal take a look at with exam of the boom of Salmonella typhi microorganism in kids with typhoid fever. Based at the assessment results, the av-erage fee of sensitivity is 69.5%, specificity is 67.9%, fantastic predictive fee is 37.9% and poor predictive fee is 86.0%. Widal's exam of the 11 calculated journals has a low common PPV fee and an excessive common NPV fee. Sensitivity and Specificity values are within side the variety of 60%. Conclusion primarily based totally on evaluations from sev-eral journals, the Widal take a look at can not be used to verify a prognosis however to rule out the opportunity of a diagnosis of different diseases

Disease severity and genotype-phenotype correlation in adult patients with familial Mediterranean fever.

To assess the relationships of disease severity with genotype and phenotype in adult familial Mediterranean fever patients. Two-hundred seventy-five patients included in the study were divided into four groups according to their mutations: Group 1, M694V homozygous; Group 2, M694V-other; Group 3, other-other; and Group 4, no meaningful gene variants. Disease severity was evaluated using the Pras disease severity score. The association between Pras scores and other possible predictors was assessed by the multiple linear regression analysis. In this study, 12.4% of all patients were in Group 1, 55.3% were in Group 2, 26.5% were in Group 3, and 5.8% were in Group 4. Pras scores were higher in Group 1 than in Groups 2, 3, and 4 (post hoc pairwise comparisons; P = .001, P < .001, and P = .001, respectively). Age at disease onset and age at diagnosis were found moderately and strongly correlated with Pras scores. Patients with moderate and severe disease were intensely involved in Group 1. Higher Pras scores, earlier age of symptoms and diagnosis, more frequent arthritis and erysipelas-like erythema, and higher colchicine dose are closely associated with M694V homozygous familial Mediterranean fever patients. These patients also have mostly moderate and severe disease severity.

Demographic Profile, Presenting Complaints and Clinical Findings of Dengue Fever Patients in a Tertiary Care Hospital of Bangladesh

Background &amp; Objective: Dengue is an important tropical infection caused by an arbovirus having four serotypes (DENV-1, DENV-2, DENV-3, DENV-4) transmitted through the bite of infected female Aedes mosquito. Dengue is a challenging disease with multisystemic, varied, atypical, and sometimes life-threatening presentations. It presents as varied clinical spectrum of dengue fever (DF), dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS) and expanded dengue syndrome (EDS) with atypical presentations, thus posing a diagnostic dilemma. Each year, thousands of dengue infections are reported and there are several outbreaks of dengue in several countries including Bangladesh and this imply the global importance of this infection. The objectives of this study were to determine the sociodemographic variables, presenting complaints and clinical findings of patient suffering from dengue fever during an epidemic outbreak.&#x0D; Methods: This hospital review analyzed the hospital records of dengue fever cases of BIRDEM General Hospital, Dhaka from June 2019 to December2019. Patients with suspected dengue fever attending at the outdoor/emergency or admitted indoor were taken as case. Data was collected from hospital records. Study protocol was approved by the Institutional Review Board and informed consent was taken from the subjects. All the relevant data regarding history and examination findings of the patients, the laboratory reports were collected. Statistical package for social science (SPSS) version 22, a computer-based software was used for all data entry and statistical analysis.&#x0D; Results: Total 292 dengue patients were enrolled in this study. Mean age of all patient was 35.63±15.22 years (11-85 year) with male predominance (54.8%). Maximum patients were hailed from urban residence (83.9%), non-smoker (73.6%), had active lifestyle (63.4%) and normal body mass index (68.5%). Overall, 65.1% patients had no comorbidity and 89.4% had no concurrent acute illness.Majority of the patients had high grade fever (76%) for 2-5 days (71%). Bodyache (63.7%), headache (42.1%), vomiting (41.1%), loose motion (16.8%) and abdominal pain (14.7%) were the top five chief complaints along with fever. Most of the patients had normal systolic (86.3%) and diastolic (92.5%) blood pressure.&#x0D; Conclusion: Although the results of this study cannot be generalized to other cities of Bangladesh, our findings will allow public health agencies in Bangladesh to concentrate their efforts to battle dengue and also suggests that monitoring where Aedes are found will help identify populations at risk". Our study will guide doctors of all level to early diagnose dengue patient and will help them to detect the severe cases early. So that early intervention can decrease the morbidity and mortality.

The role of closed-loop management of fever patients in a county-level medical community for the prevention and control of the post-coronavirus disease 2019 pandemic.

We built a closed-loop management model for patients with fever in a county-level medical community and explored the role of this model in post-coronavirus disease 2019 (COVID-19) epidemic prevention and control. The subjects included 83,791 patients with fever treated in designated hospitals between February 2020 and April 2021. A pre-hospital, in-hospital, and post-hospital management system for patients with fever in the county-level medical community was established to allow the closed-loop management of these patients. SPSS software (version 13.0) was used to analyze the methods of visiting the hospital, nucleic acid detection in the hospital, and location of the patients after the hospital visit. Chi-square tests were used to compare the methods of visiting and location after hospital visits between patients with and without an epidemiological history. The number of patients with fever in the fever clinic showed a logarithm change (R2 = 0.4710), accompanied by seasonal changes. The number of fever patients with an epidemiological history decreased logarithmically monthly (R2 = 0.8876). Among patients with fever, 99.64% sought medical treatment on their own, with relatively low proportions undergoing home quarantine and requiring centralized quarantine special vehicles. After visiting the fever clinics, 98.56% of patients isolated at home or were monitored, with small proportions of patients requiring hospital admission or centralized isolation. However, the proportions of patients with home and centralized isolation with epidemiology were relatively high, accounting for 20.55% and 27.40% of cases, respectively. Compared to the overall population of patients with fever, the difference was statistically significant (χ2 = 48.881, P = .000). The establishment of a closed-loop management model for patients with fever in a county-level medical community strengthened the management of these patients. No local cases occurred in Beilun District between March 2020 and April 2021. In the post-COVID-19 era, all medical institutions in the county-level medical community strengthened infectious disease pre-examination and triage and promoted the formation of a strategic pattern of initial diagnosis at the grassroots level, 2-way referral, upper and lower linkage, and joint epidemic prevention. This management was more conducive to COVID prevention and control by hierarchical management according to the presence or absence of an epidemiological history.

Genetic and Epigenetic Regulation of MEFV Gene and Their Impact on Clinical Outcome in Auto-Inflammatory Familial Mediterranean Fever Patients.

Epigenetic modifications play a pivotal role in autoimmune/inflammatory disorders and could establish a bridge between personalized medicine and disease epidemiological contexts. We sought to investigate the role of epigenetic modifications beside genetic alterations in the MEFV gene in familial Mediterranean fever (FMF). The study comprised 63 FMF patients diagnosed according to the Tel Hashomer criteria: 37 (58.7%) colchicine-responders, 26 (41.3%) non-responders, and 19 matched healthy controls. MEFV mutations were detected using a CE/IVD-labeled 4-230 FMF strip assay. DNA methylation of MEFV gene exon 2 was measured using bisulfite modification and related to pyrin level, phenotypic picture, MEFV mutations, disease severity, serum amyloid A (SAA), CRP, ESR, disease severity, and colchicine response. Our results showed that FMF patients exhibited significantly higher methylation percentage (p < 0.001) and lower pyrin levels (p < 0.001) compared to the control. The MEFV gene M694I mutation was the most commonly reported mutation (p < 0.004). High methylation percentage of the MEFV exon 2 and low pyrin concentration were correlated with disease severity, high SAA, ESR levels, H-pylori, and renal calculi. In conclusion, this study highlights the relation between high methylation percentage, reduced pyrin level, and different biomarkers in FMF, which underscores their role in the pathogenesis of FMF and could be considered as potential therapeutic targets.

Vitamin D Deficiency (VDD) and Susceptibility towards Severe Dengue Fever-A Prospective Cross-Sectional Study of Hospitalized Dengue Fever Patients from Lahore, Pakistan.

Dengue is a mosquito-borne flaviviral serious febrile illness, most common in the tropical and subtropical regions including Pakistan. Vitamin D is a strong immunomodulator affecting both the innate and adaptive immune responses and plays a pivotal role in pathogen-defense mechanisms. There has been considerable interest in the possible role of vitamin D in dengue viral (DENV) infection. In the present prospective cross-sectional study, we assessed a possible association between serum vitamin D deficiency (VDD) and susceptibility towards severe dengue fever (DF) illness. Serum vitamin D levels were measured at the time of hospitalization in 97 patients diagnosed with dengue fever (DF), dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS) at Mayo Hospital, King Edward Medical University, Lahore, PK, from 16 November 2021 to 15 January 2022. In terms of disease severity, 37 (38.1%) patients were DF, 52 (53.6%) were DHF grade 1 and 2, and 8 (8.2%) were DSS. The results revealed that most patients (75 (77.3%)) were vitamin-D-deficient (i.e., serum level < 20 ng/mL), including 27 (73.0%) in DF, 41 (78.8%) in DHF grade 1 and 2, and 7 (87.5%) in DSS. The degree of VDD was somewhat higher in DSS patients as compared to DF and DHF grade 1 and 2 patients. Overall, serum vitamin D levels ranged from 4.2 to 109.7 ng/mL, and the median (IQR) was in the VDD range, i.e., 12.2 (9.1, 17.8) ng/mL. Our results suggest that there may be a possible association between VDD and susceptibility towards severe dengue illness. Hence, maintaining sufficient vitamin D levels in the body either through diet or supplementation may help provide adequate immune protection against severe dengue fever illness. Further research is warranted.

Colchicine treatment can be discontinued in a selected group of pediatric FMF patients

ObjectivesFamilial Mediterranean Fever (FMF) patients are required to adhere to a life-long treatment with colchicine, primarily for preventing amyloidosis. As some patients may be asymptomatic for long periods of time, it remains unclear whether it is possible to discontinue colchicine treatment in a selective group of patients. We aimed to identify predictive characteristics for a successful cessation of colchicine therapy.MethodsOut of 646 FMF pediatric patients followed in our referral FMF clinic, colchicine treatment was discontinued in 51 patients. In this study we compared the genetic, demographic, and clinical characteristics between patients for whom a successful cessation of therapy was made (Group 1; n = 21) and patients for whom cessation of therapy was deemed a failure (Group 2; n = 30) and consequently had to resume colchicine therapy.ResultsPatients for whom a successful cessation of therapy was achieved had no biallelic pathogenic MEFV mutations, were less likely to have “severe attacks” (two or more FMF characteristic symptoms) (24% vs 80%; P = 0.000067) and did not require higher than 1 mg/day of colchicine, prior to the drug cessation. Remission duration under colchicine treatment was significantly higher in group 1 compared with group 2 (4.36 years ±2.12 vs 2.53 years ±2; P = 0.0036).ConclusionThis study supports the concept of colchicine free remission in a minority of FMF patients (3%). Holding treatment, under close monitoring, may be reasonable when selecting the appropriate patients.

Increased Prehospital Emergency Medical Service Time Interval and Nontransport Rate of Patients With Fever Using Emergency Medical Services Before and After COVID-19 in Busan, Korea.

In Korea, patients with fever have been preemptively isolated to isolation beds in the emergency department (ED) since the coronavirus disease 2019 (COVID-19) pandemic began. However, isolation beds were not always available, and transport delays or failure (nontransport), especially for infants, were reported in the media. Few studies have focused on delays and failure in transporting fever patients to the ED. Therefore, this study aimed to examine and compare the emergency medical service (EMS) time interval and nontransport rate of patients with fever using EMSs before and after COVID-19. This retrospective observational study analyzed the prehospital EMS time interval and nontransport rate of fever patients who contacted EMSs in Busan, South Korea, from March 1, 2019 to February 28, 2022, using emergency dispatch reports. All fever patients (≥ 37.5°C) who contacted EMSs during this study were included. The EMS time interval was defined as the time between the patient's EMS call and ED arrival time. Nontransport was defined as a case recorded as not being transported in the emergency dispatch reports. The study population of 2019 was compared to the population of 2020 and 2021 with the independent t-test, Mann-Whitney U test, and χ² test. As a subgroup, the EMS time intervals and nontransport rates of infants with fever were compared before and after COVID-19. A total of 554,186 patients accessed the EMS during the study period, and 46,253 patients with fever were included. The EMS time interval (mean ± standard deviation, minutes) of fever patients was 30.9 ± 29.9 in 2019, 46.8 ± 127.8 in 2020 (P < 0.001) and 45.9 ± 34.0 in 2021 (P < 0.001). The nontransport rate (%) was 4.4 in 2019, 20.6 in 2020 (P < 0.001), and 19.5 in 2021 (P < 0.001). For infants with fever, the EMS time interval was 27.6 ± 10.8 in 2019, 35.1 ± 15.4 in 2020 (P < 0.001), and 42.3 ± 20.5 in 2021 (P < 0.001), and the nontransport rate (%) was 2.6 in 2019, 25.0 in 2020, and 19.7 in 2021. After the emergence of COVID-19, in Busan, the EMS time interval of fever patients was delayed, and approximately 20% of fever patients were not transported. However, infants with fever had shorter EMS time intervals and higher nontransport rates than the overall study population. A comprehensive approach, including prehospital and hospital ED flow improvements, is required beyond increasing the number of isolation beds.

Clinical Profile of Patients of Acute Rheumatic Fever in a Specialized Center

Clinical Profile of Patients of Acute Rheumatic Fever in a Specialized Center

Antibiotic sensitivity profile of the Salmonella isolates in hospitalized children with enteric fever – A cross-sectional study

Background: Enteric fever is a major public health problem in developing countries like India. It affects all age groups but young children are at highest risk. Timely management with appropriate antimicrobial therapy can reduce both morbidity and mortality. In recent years, the emergence of antimicrobial resistance is a significant challenge. Therefore, this study was undertaken to study antibiotic sensitivity pattern of the Salmonella isolates. Aims and Objectives: The aims of this study were to estimate the prevalence of resistance to commonly used antibiotics in the Salmonella isolates. Materials and Methods: Children between 6 months and 14 years of age admitted for fever and whose blood culture was positive for Salmonella Typhi or Salmonella Paratyphi A, B, or C were included in the study over a period of 2 years (August 2018–July 2020). Results: There were 155 patients of enteric fever whose blood culture results were positive for S. Typhi/S. Paratyphi who were included in the study. Out of the 155 culture positive cases, S. Typhi was isolated in 135 (87.1%), S. Paratyphi A in 16 (10.3%) and S. Paratyphi B in 4 (2.6%) cases. All the 135 isolates of S. Typhi were sensitive to cephalosporins. High rate of sensitivity was noted for the first-line drugs – amoxicillin, ampicillin, and trimethoprim-sulfamethoxazole. All 16 isolates of S. Paratyphi A were sensitive to cephalosporins. All the isolates of S. Paratyphi B tested were sensitive to cephalosporins, azithromycin, nalidixic acid, and trimethoprim-sulfamethoxazole. Conclusion: At present, there is low prevalence of resistance to first-line drugs and third-generation cephalosporins and high resistance to fluoroquinolones, nalidixic acid, and azithromycin as noted in this region. Rational antibiotic selection should be based on sensitivity pattern to prevent emergence of resistant strains.

A hospital based analytical observational study to assess CRP levels in children with acute bronchiolitis

Aim: This study was aimed at assessing the frequency of elevated CRP in children with acute bronchiolitis and at comparing the clinical characteristics, laboratory and radiological findings, antibiotics use, and outcome according to CRP levels. Methods: This was a retrospective, cross-sectional, and analytical study where the medical records of all patients with a clinical impression of acute bronchiolitis who were admitted to the pediatric department for the period of one year were retrieved. During the study period, a total of 200 patients were admitted with a clinical presentation of acute bronchiolitis. 50 (25%) patients were excluded due to of unavailability of data of CRP levels. The remaining 150 (75%) patients were included in the study. Results: 85 (53.34%) patients were males. The most common clinical presentation was cough (120 (80%) patients) followed by fever (105 (70%) patients). Antibiotics were used in 80% patients. 6% patients required intensive care, 2% had surgical intervention, 2% required endotracheal intubation, and 1 (1%) died. Patients with high CRP were older at presentation (p

PS-P15-3: PATIENTS WITH GLOMERULONEPHRITIS IN REMISSION HAVE DECREASED ARTERIAL STIFFNESS COMPARED TO CKD PATIENTS

Background: Arterial stiffness is the hallmark of the vascular aging process, in which a disruption in collagen to elastin balance in the large arteries with decreased compliance of the central vasculature leads to excess cardiovascular morbidity. Carotid- Femoral Pulse wave velocity (PWV) is the preferred non-invasive way to quantify arterial stiffness. Apart from age, blood pressure, presence of long standing hypertension, diabetes or kidney impairment, inflammation has been quoted as an harbinger of arterial stiffness. However, in a prior work of our group we found Familial Mediterrenean Fever (FMF) patients to have a decreased PWV, possibly relaed to the relapsing-remitting type of the disease and a possible ptotective role of colchicine. Objective: To compare the PWV of patients with Glomerulonephritis (GN) in clinical remission to patients with non inflammatory CKD (either eGFR &lt; 60 or uACR above 30 mg/gram), mostly related to hypertension and diabetes. Methods: We prospectively collected data on 58 patients from our Nephrology and Hypertension Center, which either had non inflammatory CKD (30 patients) or a glomerular disease in partial or complete remission (28 patients). central (aortic) blood pressure and Pulse wave velocity (PWV) were measured using validated Sphygmocor XCEL ® device. Results: In a multivariate regession analysis adjusting for age, presence of hypertension, history of diabetes and creatinine values, having glomerular disease in remission was associated with a significant decrease in PWV (B- 3.262) indicating better arterial elasticity compared to CKD patients. Conclusion: Patients with glomerulonephritis in remission have better arterial elasticity compared to CKD patients, possibly similar to the general age and blood pressure matched population. This is in accordance with our findings in FMF patients, who were adherent to colchicine treatment and in clinical remission. It is possible that prior treatment with anti-inflammatory and immunomodulatory drugs carry a beneficial effect on vascular health.