Journal of Acute Disease
Issue 6,2023 Table of Contents
2023(6):215-218.
DOI: 10.4103/2221-6189.390388
Abstract:
Objective: To investigate the trend of mortality by COVID-19 before and after the national vaccination program using joinpoint regression analysis from 19 February 2020 to 5 September 2022.
Methods: In the present study, a joinpoint regression analysis of monthly collected data on confirmed deaths of COVID-19 in Iran from February 19, 2020 to September 5, 2022 was performed.
Results: After national vaccination in Iran, the trend of new monthly deaths due to COVID-19 was decreasing. The percentage of monthly changes from the beginning of the pandemic to the 19th month was 6.62% (95% CI: 1.1, 12.4), which had an increasing trend. From the 19th month to the end of the 31st month, the mortality trend was decreasing, and the percentage of monthly changes was –20.05% (95% CI: –8.3, –30.3) (P=0.002). The average percentage of monthly changes was –5% with a 95% CI of (–10.5, 0.9).
Conclusions: Along with other health measures, such as quarantine, wearing a mask, hand washing, social distancing, etc., national vaccination significantly reduces the mortality rate of COVID-19.
Objective: To investigate the trend of mortality by COVID-19 before and after the national vaccination program using joinpoint regression analysis from 19 February 2020 to 5 September 2022.
Methods: In the present study, a joinpoint regression analysis of monthly collected data on confirmed deaths of COVID-19 in Iran from February 19, 2020 to September 5, 2022 was performed.
Results: After national vaccination in Iran, the trend of new monthly deaths due to COVID-19 was decreasing. The percentage of monthly changes from the beginning of the pandemic to the 19th month was 6.62% (95% CI: 1.1, 12.4), which had an increasing trend. From the 19th month to the end of the 31st month, the mortality trend was decreasing, and the percentage of monthly changes was –20.05% (95% CI: –8.3, –30.3) (P=0.002). The average percentage of monthly changes was –5% with a 95% CI of (–10.5, 0.9).
Conclusions: Along with other health measures, such as quarantine, wearing a mask, hand washing, social distancing, etc., national vaccination significantly reduces the mortality rate of COVID-19.
2023(6):219-225.
DOI: 10.4103/2221-6189.390387
Abstract:
Objective: To investigate the trend of animal bites between 2015-2021 in Neyshabur, Iran.
Methods: In this cross-sectional descriptive study, data were retrieved from the vice-chancellery of the Neyshabur University of Medical Sciences. The data included person variables, place and time variables, and animal variables.
Results: There were 13 190 cases of animal bites and the trend was increasing during 2015-2020. Most injuries were caused by dogs (86%), most animal bites (76.6%) occurred in males, and 28.1% of all cases were farmers. The most common bitten parts were the lower limbs (64.8%), often reported as a scratch (83.4%). Most of the biting animals (67.9%) were not strays, and 83.3% of them had bitten their owners. No rabies death was reported during the study period.
Conclusions: The incidence of animal bites increases and is higher than the national statistics in Neyshabur, Iran. Serious attention and intervention should be given to control and prevent this health threat.
Objective: To investigate the trend of animal bites between 2015-2021 in Neyshabur, Iran.
Methods: In this cross-sectional descriptive study, data were retrieved from the vice-chancellery of the Neyshabur University of Medical Sciences. The data included person variables, place and time variables, and animal variables.
Results: There were 13 190 cases of animal bites and the trend was increasing during 2015-2020. Most injuries were caused by dogs (86%), most animal bites (76.6%) occurred in males, and 28.1% of all cases were farmers. The most common bitten parts were the lower limbs (64.8%), often reported as a scratch (83.4%). Most of the biting animals (67.9%) were not strays, and 83.3% of them had bitten their owners. No rabies death was reported during the study period.
Conclusions: The incidence of animal bites increases and is higher than the national statistics in Neyshabur, Iran. Serious attention and intervention should be given to control and prevent this health threat.
2023(6):226-232.
DOI: 10.4103/2221-6189.390384
Abstract:
Objective: To study the laboratory and clinical predictors of hemorrhagic manifestations in dengue virus-infected patients.
Methods: This was a single-center hospital-based prospective observational study. 200 Dengue seropositive patients were included in the study. A detailed clinical examination was done and comprehensive laboratory investigations were done. These parameters were compared between patients with and without hemorrhagic manifestations.
Results: Out of the 200 patients, 47 (23.5%) had bleeding. 64.5% Patients were males and 76.0% were under the age of 40 years. The most common presenting symptoms were fever (100.0%) followed by myalgia (77.0%), nausea and vomiting (56.0%). Leukocytosis, neutrophilia, thrombocytopenia, hyperbilirubinemia, transaminitis, decreased serum albumins, and raised D-dimer can serve as hematological, biochemical, and coagulation predictors of hemorrhagic manifestations for dengue.
Conclusions: Dengue is a tropical infection with various complications. Bleeding complications are one of them. Laboratory parameters like white blood cells, platelets, bilirubin level, liver enzymes, and D-dimer can help to identify patients at risk for bleeding. Early identification and appropriate management can save a lot of resources and lives.
Objective: To study the laboratory and clinical predictors of hemorrhagic manifestations in dengue virus-infected patients.
Methods: This was a single-center hospital-based prospective observational study. 200 Dengue seropositive patients were included in the study. A detailed clinical examination was done and comprehensive laboratory investigations were done. These parameters were compared between patients with and without hemorrhagic manifestations.
Results: Out of the 200 patients, 47 (23.5%) had bleeding. 64.5% Patients were males and 76.0% were under the age of 40 years. The most common presenting symptoms were fever (100.0%) followed by myalgia (77.0%), nausea and vomiting (56.0%). Leukocytosis, neutrophilia, thrombocytopenia, hyperbilirubinemia, transaminitis, decreased serum albumins, and raised D-dimer can serve as hematological, biochemical, and coagulation predictors of hemorrhagic manifestations for dengue.
Conclusions: Dengue is a tropical infection with various complications. Bleeding complications are one of them. Laboratory parameters like white blood cells, platelets, bilirubin level, liver enzymes, and D-dimer can help to identify patients at risk for bleeding. Early identification and appropriate management can save a lot of resources and lives.
2023(6):233-237.
DOI: 10.4103/2221-6189.390386
Abstract:
Objective: To determine the clinical profile of patients presenting with medication-related emergencies to the Emergency Department of our institute.
Methods: This was an observational study conducted between November 2018 and September 2020 at Bangalore Baptist Hospital, Karnataka. A total of 138 subjects who satisfied the inclusion criteria were included in the study. The severity of adverse drug reactions (ADR) is assessed based on the Hurwitz severity assessment scale of ADR. Glasgow coma scale at the time of presentation and source of medication were noted. The type of drug overdose, requirement of advanced airway and vasopressors, and the outcome were also assessed.
Results: Among medication-related emergencies (n=138) in our study, ADR contributed to 70.3% (n=97) of the study population, and drug overdose accounted for 29.7% (n=41). One-third of the ADR occurred in patients aged above 60 years. Most patients were hemodynamically stable and did not require vasopressors, or advanced airway in both groups. Most patients had Glasgow coma scale ranging from 13-15 in both groups. Nonsteroidal anti-inflammatory drugs were the most used medicine (17/41, 41.5%) and most medications were over the counter drugs (25/41, 61.0%) in the drug overdose group; meanwhile in the ADR group, anti-diabetic medication was the most used medicine (34/97, 35.1%) and most medications were prescribed in the ADR group (93/97, 95.9%).
Conclusions: Our study shows that ADR is the most common type of medication-related emergency.
Objective: To determine the clinical profile of patients presenting with medication-related emergencies to the Emergency Department of our institute.
Methods: This was an observational study conducted between November 2018 and September 2020 at Bangalore Baptist Hospital, Karnataka. A total of 138 subjects who satisfied the inclusion criteria were included in the study. The severity of adverse drug reactions (ADR) is assessed based on the Hurwitz severity assessment scale of ADR. Glasgow coma scale at the time of presentation and source of medication were noted. The type of drug overdose, requirement of advanced airway and vasopressors, and the outcome were also assessed.
Results: Among medication-related emergencies (n=138) in our study, ADR contributed to 70.3% (n=97) of the study population, and drug overdose accounted for 29.7% (n=41). One-third of the ADR occurred in patients aged above 60 years. Most patients were hemodynamically stable and did not require vasopressors, or advanced airway in both groups. Most patients had Glasgow coma scale ranging from 13-15 in both groups. Nonsteroidal anti-inflammatory drugs were the most used medicine (17/41, 41.5%) and most medications were over the counter drugs (25/41, 61.0%) in the drug overdose group; meanwhile in the ADR group, anti-diabetic medication was the most used medicine (34/97, 35.1%) and most medications were prescribed in the ADR group (93/97, 95.9%).
Conclusions: Our study shows that ADR is the most common type of medication-related emergency.
Manabendra Baidya
,
Sandeep Kumar Pandey
,
Hariom Kumar Solanki
,
Ankur Deep Singh
,
Samaksh Giri
,
Syed Altamash
2023(6):238-243.
DOI: 10.4103/2221-6189.390385
Abstract:
Objective: To explore risk factors for the development of pneumothorax in patients with COVID-19 during the second COVID-19 wave at a northern Indian level 2 health facility.
Methods: Patients suffering from SARS-CoV-2 infection during the second wave of the COVID-19 pandemic in India (January-June 2021) at a tertiary care teaching hospital and level 2 COVID care facility were included. Cases who suffered from SARS-CoV-2 infection but did not develop pneumothorax were selected as matched controls. All details regarding demographics, clinical presentation, treatment, and outcome were recorded in a semi-structured proforma.
Results: Eleven patients with COVID-19 developed pneumothorax during the study period and 40 controls were included in the study. Five cases were smokers in comparison to only two in the control group. Type 2 diabetes mellitus was the most common comorbidity among both groups. Median change in C-reactive protein overall for cases and controls were around +14.0 and – 41.9 and was statistically significant.
Conclusions: Inflammatory markers like C-reactive protein have significant correlations with the development of pneumothorax in COVID-19-infected patients. There is no sex predisposition to develop pneumothorax among patients with COVID-19.
Objective: To explore risk factors for the development of pneumothorax in patients with COVID-19 during the second COVID-19 wave at a northern Indian level 2 health facility.
Methods: Patients suffering from SARS-CoV-2 infection during the second wave of the COVID-19 pandemic in India (January-June 2021) at a tertiary care teaching hospital and level 2 COVID care facility were included. Cases who suffered from SARS-CoV-2 infection but did not develop pneumothorax were selected as matched controls. All details regarding demographics, clinical presentation, treatment, and outcome were recorded in a semi-structured proforma.
Results: Eleven patients with COVID-19 developed pneumothorax during the study period and 40 controls were included in the study. Five cases were smokers in comparison to only two in the control group. Type 2 diabetes mellitus was the most common comorbidity among both groups. Median change in C-reactive protein overall for cases and controls were around +14.0 and – 41.9 and was statistically significant.
Conclusions: Inflammatory markers like C-reactive protein have significant correlations with the development of pneumothorax in COVID-19-infected patients. There is no sex predisposition to develop pneumothorax among patients with COVID-19.
2023(6):244-249.
DOI: 10.4103/2221-6189.390389
Abstract:
Neurological symptoms of COVID-19 infection can be lethal if optimum intervention is not provided at the right time. However, it is extremely important to distinguish the non-specific symptoms of COVID-19 according to its severity directly or indirectly caused by the coronavirus. Here, we present five radiological case studies of COVID-19 to highlight the wide array of neurological manifestations associated with COVID-19.
Neurological symptoms of COVID-19 infection can be lethal if optimum intervention is not provided at the right time. However, it is extremely important to distinguish the non-specific symptoms of COVID-19 according to its severity directly or indirectly caused by the coronavirus. Here, we present five radiological case studies of COVID-19 to highlight the wide array of neurological manifestations associated with COVID-19.
2023(6):250-253.
DOI: 10.4103/2221-6189.390390
Abstract:
Rationale: Acute eosinophilic pneumonia (AEP) is an acute pulmonary illness caused by eosinophilic infiltration of the lung parenchyma. It can happen after using drugs such as daptomycin and minocycline. AEP induced by imipenem/cilastatin is a rare condition.
Patient’s Concern: A 45-year-old male patient, who previously suffered from a urinary tract infection and treated with imipenem/cilastatin antibiotic, was presented to us with acute respiratory distress, soon after the initiation of the antibiotic. Computed tomography identified pulmonary infiltrates in the upper and middle lung fields and eosinophils were found to account for 36% of differential count of the broncho-alveolar lavage fluid. He also developed peripheral eosinophilia as the disease progressed.
Diagnosis: AEP, secondary to imipenem/cilastatin therapy.
Interventions: Steroid therapy was administered and imipenem/cilastatin antibiotic was discontinued.
Outcomes: The patient improved completely following the therapy and had clear lung fields on follow-up.
Lessons: Imipenem/cilastatin is an uncommon cause of AEP and requires close monitoring during therapy.
Rationale: Acute eosinophilic pneumonia (AEP) is an acute pulmonary illness caused by eosinophilic infiltration of the lung parenchyma. It can happen after using drugs such as daptomycin and minocycline. AEP induced by imipenem/cilastatin is a rare condition.
Patient’s Concern: A 45-year-old male patient, who previously suffered from a urinary tract infection and treated with imipenem/cilastatin antibiotic, was presented to us with acute respiratory distress, soon after the initiation of the antibiotic. Computed tomography identified pulmonary infiltrates in the upper and middle lung fields and eosinophils were found to account for 36% of differential count of the broncho-alveolar lavage fluid. He also developed peripheral eosinophilia as the disease progressed.
Diagnosis: AEP, secondary to imipenem/cilastatin therapy.
Interventions: Steroid therapy was administered and imipenem/cilastatin antibiotic was discontinued.
Outcomes: The patient improved completely following the therapy and had clear lung fields on follow-up.
Lessons: Imipenem/cilastatin is an uncommon cause of AEP and requires close monitoring during therapy.
2023(6):254-254.
DOI: 10.4103/2221-6189.390391
Abstract:
2023(6):255-256.
DOI: 10.4103/2221-6189.390392
Abstract:
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