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BACKGROUND AND OBJECTIVE: Cutaneous Leishmaniasis (CL) is a dermal manifestation caused by various species of Leishmania. This is the most common Leishmanial syndrome seen worldwide and is emerging as and threatens to become an uncontrollable disease. The present study was planned to understand the current epidemiology of CL in the conventionally endemic area of Bikaner, Rajasthan. Species characterization was also done. MATERIAL AND METHODS: The diagnostic modalities used in the study were microscopy, histopathologic examination, antigen testing and confirmation and species characterization by PCR. Field evaluation of the new antigen detection kit approved by FDA in 2016 CL Detect™ IC-RDT was done and its results compared with other available diagnostic tests. RESULTS: A total of 14 cases with 25 skin lesions presented to the Skin OPD during the six month study period (January to June 2018). Out of these, 5 were males and 9 were females, average age being 32 yrs. Students and housewives of poor socio economic group were the most frequently affected groups. Lesions were found on the exposed areas of the body, mainly on the upper limbs and facial region. Majority of them were ulcerated plaques. Out of 14 cases under study, antigen test confirmed 7 positives; thereby yielding a positive rate of 50% against 71.4% for microscopy, 72.7% for PCR and a mere 38.5% for histopathology. Species characterization revealed Leishmania tropica as the causative organism. INTERPRETATION AND CONCLUSION: The study indicates that the number of cases have declined substantially over the past decade in Bikaner. Despite being the oldest technique used, microscopy still is a good option for diagnosis. Combined with PCR, diagnostic accuracy and hence utility is increased multifold. In its current form, IC-RDT may not be very useful.
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BACKGROUND: Malaria is the most prevalent infectious diseases in the world. This study aims to assess the correlation of hepatorenal dysfunction in malaria patients in pediatric age group. MATERIALS AND METHODOLOGY: This study was conducted on patients of malaria admitted in the Department of Paediatrics, PBM hospital, Bikaner (Rajasthan), during resurgence of various outbreaks of malaria in the year 2011 and 2012. The diagnosis of malaria was confirmed by examination of thick and thin smear/optimal test; malarial hepatic and renal patients were included in the study. RESULTS: The mean age of patients with hepatic and/or renal dysfunction in malaria was 5-10 years and preponderance of males. Association between hepatic and renal dysfunction was significant as 9 (40.9%) in 22 patients with serum bilirubin >3 mg/dl had renal failure in Plasmodium falciparum (PF) and 5 (71.43%) out of 7 patients in mixed (Plasmodium vivax [PV] and PF) patients. This association was not significant in PV as 6 (10.52%) out of 57 patient with serum bilirubin >3 mg/dl had renal failure. CONCLUSION: The specific reason for presenting our observation is to develop awareness regarding the early complications of malaria and to prevent them prompt action can be taken.
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A total of 715 faecal sampleswere collected fromdairy animals ofeight tehsils ofBikaner district, Rajasthan during March 2015 to January 2016. An overall prevalence rate of 54.12 % was recorded for gastrointestinal helminthoses with highly statistical difference among dairy animals (p < 0.01). Quantitative analysis revealed mild to high severity of strongyle and Strongyloides sp. infections in cattle population, respectively whereas, mild severities of same infections were reported from the buffalo population of the region. Seasonal analysis revealed a non-significant difference with highest prevalence in rainy season (59.18 %). The tehsil wise analysis revealed a significant difference (p < 0.05) among tehsils with highest prevalence in Chhatargarh (69.70 %). Multivariate binary regression model revealed rainy season as the most favorable season and Chattargarh as the tehsil with maximum risk for GI helminth infections.On coproculture of positive samples, the nematode infections in decreasing order of prevalence were Haemonchus sp. (36.33 %); Oesophagostomum sp. (26.33 %); Strongyloides sp. (13.67 %); Trichostrongylus sp. (11.67 %); Bunostomum sp. (7.33 %) and Cooperia sp. (4.67 %). Thebaseline data on the prevalence of various GI Helminths of dairy animals generated in the current study would be of immense help in formulating control strategies against infections inBikaner district.
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OBJECTIVES: This study was carried out to determine the incidence, clinical features, etiology and outcome of functional and intrinsic acute kidney injury (AKI) in preterm neonates. METHODS: This is a prospective observational study on premature infants admitted to the neonatal intensive care unit (NICU) over an eight month period. All biochemical parameters of renal function tests were monitored and statically analyzed. RESULTS: The study included 450 infants; of them 300 were inborn and 150 infants were outborn and transported to the NICU. Mean gestational age, weight, and age at the time of AKI diagnosis were 32.3 weeks, 1.66âkg and 3.23 days respectively. The male: female ratio was 1.84:1. Incidence of AKI was higher in low birth weight babies. Sluggishness and refusal for feed were most common symptoms. Birth asphyxia and septicemia were the most common early and late cause of AKI. Hyponatremia was the most common electrolyte disturbance. The incidences of AKI, functional renal failure, and intrinsic renal failure were 12%, 48.14%, and 51.85% respectively. CONCLUSIONS: AKI is not uncommon in preterm infants. The early recognition and aggressive management of episodes of shock which often precede AKI could be life-saving.
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Lesión Renal Aguda/epidemiología , Lesión Renal Aguda/etiología , Lesión Renal Aguda/fisiopatología , Asfixia Neonatal/complicaciones , Femenino , Edad Gestacional , Hospitalización , Humanos , Hiponatremia/etiología , Incidencia , Recien Nacido con Peso al Nacer Extremadamente Bajo , Recién Nacido de Bajo Peso , Recién Nacido , Recien Nacido Prematuro , Recién Nacido de muy Bajo Peso , Unidades de Cuidado Intensivo Neonatal , Masculino , Mortalidad , Sepsis Neonatal/complicaciones , Estudios Prospectivos , Factores de Riesgo , Distribución por SexoRESUMEN
BACKGROUND: Neonatal sonography of the brain is now an essential part of newborn care, particularly in high risk and unstable premature infants. Cranial ultrasound is the most available and easily repeatable imaging technique for the neonatal brain showing brain development and the most frequently occurring forms of cerebral injury in the preterm and terms. This study aims to assess the importance of cranial ultrasound as an investigatory modality for high-risk neonates and to find out the morphology of various cerebral lesions and correlate clinically. METHODOLOGY: An observational correlation clinical study was conducted at Sardar Patel Medical College, Bikaner involving 100 high-risk neonates admitted to Neonatal Intensive Care Unit (NICU) who was subjected to neurosonography on selected days as per protocol. Perinatal details were recorded, and clinical examination with appropriate investigations was done. The cranial ultrasound was done, and morphology of various findings was studied and recorded. Clinical correlation with cranial ultrasound findings and follow-up was done. RESULTS: On cranial ultrasound, 38% of neonates had abnormal findings. Twelve percent of these had evidence of intracranial bleed, 13% periventricular echogenicity, 7% had ventriculomegaly, 2% had cerebral edema, and 1% had leukomalacia. Three neonates had findings suggestive of simple cyst in middle cranial fossa, agenesis of corpus callosum, and choroid plexus cyst. CONCLUSIONS: Cranial ultrasonography is the best point of care neuroimaging method available for high-risk neonates. It is critical as an investigatory modality in NICU and effectively documents morphology of cerebral damage.