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Increasing Trends of Leptospirosis in Northern India: A Clinico-Epidemiological Study  [PDF]
Sunil Sethi ,Navneet Sharma,Nandita Kakkar,Juhi Taneja,Shiv Sekhar Chatterjee,Surinder Singh Banga,Meera Sharma
PLOS Neglected Tropical Diseases , 2010, DOI: 10.1371/journal.pntd.0000579
Abstract: Background Leptospirosis, a zoonosis associated with potentially fatal consequences, has long been a grossly underreported disease in India. There is no accurate estimate of the problem of leptospirosis in non-endemic areas such as north India. Methods/Principal Findings In order to understand the clinical spectrum and risk factors associated with leptospirosis, we carried out a retrospective study in patients with acute febrile illness in north India over the last 5 years (January 2004 to December 2008). There was increased incidence of leptospirosis (11.7% in 2004 to 20.5% in 2008) as diagnosed by IgM ELISA and microscopic agglutination titer in paired acute and convalescent sera. The disease showed a peak during the rainy season (August and September). We followed up 86 cases of leptospirosis regarding their epidemiological pattern, clinical features, laboratory parameters, complications, therapy, and outcome. Mean age of patients was 32.6 years (2.5 years to 78 years) and males (57%) outnumbered females (43%). Infestation of dwellings with rats (53.7%), working in farm lands (44.2%), and contact with animals (62.1%) were commonly observed epidemiological risk factors. Outdoor workers including farmers (32.6%), labourers (11.6%), para-military personnel (2.3%), and sweepers (1.2%) were commonly affected. Modified Faine's criteria could diagnose 76 cases (88.3%). Renal failure (60.5%), respiratory failure (20.9%), the neuroleptospirosis (11.6%), and disseminated intravascular coagulation (DIC) (11.6%) were the commonest complications. Five patients died, giving a case fatality rate of 5.9%. Conclusions/Significance There has been a rapid rise in the incidence of leptospirosis in north India. Severe complications such as renal failure, respiratory failure, neuroleptospirosis, and DIC are being seen with increasing frequency. Increased awareness among physicians, and early diagnosis and treatment, may reduce mortality due to leptospirosis.
Clinico-epidemiological features of the hospitalized patients with 2009 pandemic influenza A (H1N1) virus infection in Saurashtra region, India (September, 2009 to February, 2010)  [cached]
Chudasama Rajesh,Patel Umed,Verma Pramod,Amin Chikitsa
Lung India , 2011,
Abstract: Background: The first case of 2009 pandemic influenza A (H1N1) virus infection in India was reported in May, 2009 and in Saurashtra region in August, 2009. We describe the clinico-epidemiological characteristics of patients who were hospitalized with 2009 influenza A (H1N1) infection in Saurashtra region. Materials and Methods: From September, 2009 to February, 2010, we observed 274 persons infected with 2009 influenza A (H1N1) virus who were admitted in different hospitals in Rajkot city. Real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) testing was used to confirm infection; the clinico-epidemiological features of the disease were closely monitored. Results: Of 274 patients, median age was 29.5 years, and 51.5% were males. Only 1.1% patients had recent travel history to infected region. Median time of five days was observed from onset of illness to influenza A (H1N1) diagnosis, while median time of six days reported for hospital stay. All admitted patients received oseltamivir drug, but only 16.1% received it within two days of onset of illness. One fourth of admitted patients were expired. The most common symptoms were cough (96.7%), fever (92%), sore throat and shortness of breathing, and coexisting conditions including diabetes mellitus (9.9%), hypertension (8.8%), chronic pulmonary diseases (5.5%) and pregnancy (5.5%) (P<0.05). Pneumonia was reported in 93% patients with chest radiography. Conclusion: We have demonstrated that infection-related illness affects both children and adults with survival of 74% patients. The median time from onset of illness to virus detection with use of real-time RT-PCR is five days. Pregnancy is found as a significant (P<0.05) risk factor for severe disease.
Clinico-epidemiological profile of HIV/TB coinfected patients in Vadodara, Gujarat  [cached]
Ghiya Ragini,Naik Eknath,Casanas Beata,Izurieta Ricardo
Indian Journal of Sexually Transmitted Diseases , 2009,
Abstract: Introduction: The HIV epidemic has posed major, almost insurmountable, challenges to tuberculosis control efforts across the world. This study analyzes the prevalence and disease profile of HIV/AIDS coinfection in Vadodara, Gujarat, India. Materials and Methods: This study was conducted in the HIV Referral Clinic at Vadodara, India. Using convenience sampling method, 246 HIV-positive patients coinfected with tuberculosis were enrolled. A detailed history of every case was taken followed by a thorough physical examination. Baseline and follow up laboratory and radiological investigations were carried out as appropriately warranted. Results: Out of 500 HIV positive patients who presented to the clinic during the study period, 246 (49.2%) were coinfected with tuberculosis. Out of 246 coinfected cases, 35(14.2%) presented with demonstrable and documented tuberculosis whereas in 211(85.8%) cases, tuberculosis was extemporaneously detected by actively screening the patients. Sixty nine percent of patients were males, while 10.5% of cases were below fifteen years of age. The majority (68%) of patients had manifestations of extrapulmonary tuberculosis; but pulmonary tuberculosis, which is a more common presentation in HIV-negative cases, was present in only fifty five percent of this segment of the population. Abdominal tuberculosis was the most common site (74%) amongst extrapulmonary tuberculosis involvement, followed by clinically palpable lymph nodes (22%) and pleural effusion (17%). Conclusion: The prevalence of tuberculosis in HIV-positive patients in this study (49%) was substantially higher than that reported in previous studies. However, this could be attributed to a selection and/or a diagnosis bias. This study used abdominal ultrasound for the diagnosis of tuberculosis which might have obviously increased the prevalence. Moreover, these cases were not confirmed by biopsy or other definitive TB diagnostic methods.
Clinico epidemiological study of pitted keratolysis  [cached]
Naik Chandra,Singh Gurcharan
Indian Journal of Dermatology , 2007,
Abstract: Background: Pitted keratolysis is a common dermatological condition. However, very few studies are available on the clinical characteristics and epidemiological features of this disorder from India and abroad. Materials and Methods: Fifty patients from rural area of Kolar at Sri R.L.J.H. and S.N.R. Hospital, presenting with clinically distinctive lesions of pitted keratolysis were included in the study. Cases were interviewed with particular emphasis on triggering factors and findings were recorded. Investigations like Gram′s stain, culture studies, Wood′s ultraviolet light examination, histopathology etc, was done in selected cases to ascertain the clinical diagnosis. Results: Age of the patients varied from 20 to 40 years in 52% with male preponderance in 82% of cases. Duration of the disease varied from 15 days to five years, most of the patients were bare-footed farmers (62% of cases). Hyperhidrosis and pruritus were most frequently observed symptoms in 70% and 60% of patients. Most of the patients presented with the characteristic pits which varied from 1 to 50 in number in 56 % of cases, located predominantly on the pressure bearing areas in 92% of cases and depth of the pits varied from 1 to 2 mm in 60% of cases. Associated skin conditions recorded in present study were fissuring of soles in 38%, psoriasis 10%, dermatophyte infections in 6%, planter warts 6% and Corynebacterial triad and corn in 2% of patients each. Discussion: Affection of bare-footed individuals, male preponderance, presence of hyperhidrosis and occurrence of lesions over pressure bearing areas of soles, observed in the present study were consistent with earlier studies on the subject. However, pruritus as commonest presenting symptom reported by 60% patients in the present study, has not been documented in the previous studies. Conclusion: Pitted keratolysis is fairly common in bare footed male farmers of rural India. The condition is predominantly seen over the pressure bearing areas of sole and hyperhidrosis is common precipitating factor. Pruritus, a common presenting symptom observed in this study has not been reported earlier.
Clinico epidemiological study of pityriasis alba  [cached]
Vinod Sujatha,Singh Gurcharan,Dash K,Grover Sanjiv
Indian Journal of Dermatology, Venereology and Leprology , 2002,
Abstract: Even though pityriasis alba is commonly encountered in dermatological practice, there is paucity of Indian studies on the subject. A clinico epidermiological study was carried out in 200 patients attending the skin department of Command Hospital, Air Force, Bangalore. Atopic background was detected in 85.5% of cases. Bacterial and fungal culture studies failed to reveal any infective aetiology. Helmenthiasis and iron deficiency anaemia were detected in 15.5% and 16.5% of patients respectively. However no other nutritional deficiency was observed in the present study. Majority (84.5%) of patients had lesions of less than 6 months duration at the time of presentation. Face was involved in 91% of patients and generalized pityriasis alba was observed in 3 patients, all of them being infants. Pigmenting pityriasis alba was observed in 7 patients. Hyperkeratosis, parokeratosis, ocanthosis, spongiosis and perivasculor infiltration were the consistent histological features of pityriasis alba.
Chronic folliculitis - A clinico-epidemiological study
Prasad PVS,Anandhi V,Jaya M
Indian Journal of Dermatology, Venereology and Leprology , 1997,
Abstract: 50 male patients, diagnosed to have chronic folliculitis of legs (CFL), were included in a clinico epidemiological study. CFL affected predominantly young adults of the age group of 16 - 25 years. Severe pruritus was associated in 86% of patients with CFL, and this symptom preceded the onset of new lesions. Follicular papules were seen more often than pustules in 58% of patients. Staphylococcus aureus was isolated in 72.5%. The lesions were confined to both legs in 50%, extending upto thigh in 28% and in legs, thighs and forearms in 10% of individuals studied.
Clinico-epidemiological study of HIV patients in Trivandrum
Nair S,Moorty K,Suprakasan S
Indian Journal of Dermatology, Venereology and Leprology , 2003,
Abstract: A retrospective descriptive study of 121 HIV patients in the Department was carried out. The male/female ratio was 2.3:1. The maximum number of patients were seen in age group 21 - 40(77.68%). Skilled workes constituted the maximum (13.2%). Sexual route was the commonest mode of transmission (78.5%). Cutaneous manifestations were present in 57% of patients, oral condidiasis being the commonest (16.5%). Pulmonary tuberculosis was the commonest systemic manifestation (13.2%). 37 patients (30.57%) had other STD′s, syphilis being the commonest (12.39%). 22 patients had AIDS defining conditions.
Clinico-Epidemiological Profile of Female Breast Cancers and Its Important Correlates: A Hospital Based Study
Agrawal Kapil H, Rajderkar SS
National Journal of Community Medicine , 2012,
Abstract: Background: Breast cancer is second most frequent cancers in females in India. Public health prevention measures requires an understanding of burden of disease and its epidemiology including risk factors. Aims: To study the clinico-epidemiological profile of breast cancer by conducting a detailed enquiry into its qualitative and quantitative magnitude. Study design and Setting: Hospital-based, cross-sectional study conducted at Shri Siddhivinayak Ganapati Cancer Hospital, Miraj, Maharashtra. Material and Methods: Pre-structured and pilot tested questionnaire was administered to all one hundred and twenty three (123) confirmed cases of female breast cancer cases diagnosed in the hospital from March 2005 to February 2006) to undertsand their clinico-epidemiological profile. Statistical analysis used: Standard deviation, mean, mode and median were applied to select observations. Results: Majority of the female breast cancer cases were above 40 years of age. Mean age of the patients was found to be 51 years with Standard deviation (SD) of 14 years.97% cases were married. Mean age of menarche was 12.35 years (SD 1.25).Mean age at 1st full term pregnancy was 23.1 years (SD 2.56).2% cases were nullipara.45% women were in menopause. Only 8% subjects had history of taking oral contraceptive pills. Familial breast cancer was uncommon. Lump in breast was the dominant symptom. Most common histology was infiltrating ductal carcinoma. Majority of the subjects presented in advanced stages of disease. Conclusion: Majority of the female breast cancer cases were infiltrating ductal carcinoma and were presented in advanced stages of disease. One fourth of all cases were below forty years of age.
Clinico-epidemiological and socio-behavioral study of people living with HIV/AIDS  [cached]
Khan M,Sehgal A
Indian Journal of Psychological Medicine , 2010,
Abstract: Although India is in the grip of HIV/AIDS epidemic, not much information is available on clinico-epidemiological and socio-behavioral aspects of people living with HIV/AIDS (PLWHA). This study analyzed these features using standard methodologies in 82 HIV sero-positives, AIDS patients attending ART clinic of three major government hospitals of Delhi. Majority of the patients (73%) were found to be young (<40 years) and married (79%). As high as 91.5% came from low socio-economic class and more than 95% acquired HIV transmission through heterosexual routes. A large proportion (63%) of these patients reported an extremely high level of anxiety, moderate level of stress and a borderline level of clinical depression. While most of the patients (72%) were well-adjusted with the ART, the rest of the patients reported difference in making adjustment with the treatment schedules. The study suggests that counseling and supportive therapy could play a pivotal role in controlling anxiety, stress, depression and rehabilitating people with HIV/AIDS.
Vitiligo: Compendium of clinico-epidemiological features
Sehgal Virendra,Srivastava Govind
Indian Journal of Dermatology, Venereology and Leprology , 2007,
Abstract: Vitiligo, an autoimmune disorder characterized by localized and / or generalized depigmentation of the skin and / or mucous membranes, is a well-recognized entity. The imperatives of its epidemiology both in rural India and in global reckoning have been highlighted frequently. Its morphology is striking and is characterized by asymptomatic ivory / chalky white macule(s) that may be frequently surrounded by a prominent pigmented border, the ′trichrome vitiligo′. However vitiligo may have morphological variations in the form of: trichrome, quadri-chrome, penta-chrome, blue and inflammatory vitiligo. Its current topographical classification into segmental, zosteriform and nonsegmental, areata, vulgaris, acrofacialis and mucosal represent its well acclaimed presentations. Its adult and childhood onset is well appreciated as also its presentation in males and females. Occasionally, it may be possible to identify triggering factors. Vitiligo may be associated with cutaneous, ocular and systemic disorders, the details of which are discussed in this article.
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