The causes of persistent fever in sub-Saharan Africa are enormous and unraveling the diagnosis could be a daunting task when investigations for common infective and non-infective conditions and treatment response to the most logical differential diagnoses have proved disappointing. We report the case of a 29 year old Nigerian medical practitioner with recurrent high grade fever, petechie and body weakness for over three weeks, whose condition remained largely undiagnosed after rigorous laboratory investigations. He received numerous antimicrobials without remission of fever but withdrawal of all medications was associated with cessation of fever which left us wondering if it was a case of drug fever. The possibility of drug fever should be entertained in patients being investigated for fever of unknown origin who have received several medications without change in the height and pattern of fever.
{"title":"Fever of Unknown Origin in a Nigerian Doctor: An unusual case","authors":"O. Onodugo, M. Iroezindu","doi":"10.5580/2cf8","DOIUrl":"https://doi.org/10.5580/2cf8","url":null,"abstract":"The causes of persistent fever in sub-Saharan Africa are enormous and unraveling the diagnosis could be a daunting task when investigations for common infective and non-infective conditions and treatment response to the most logical differential diagnoses have proved disappointing. We report the case of a 29 year old Nigerian medical practitioner with recurrent high grade fever, petechie and body weakness for over three weeks, whose condition remained largely undiagnosed after rigorous laboratory investigations. He received numerous antimicrobials without remission of fever but withdrawal of all medications was associated with cessation of fever which left us wondering if it was a case of drug fever. The possibility of drug fever should be entertained in patients being investigated for fever of unknown origin who have received several medications without change in the height and pattern of fever.","PeriodicalId":331725,"journal":{"name":"The Internet Journal of Tropical Medicine","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127879896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashutosh Sharma, V. Mehrotra, G. Awasthi, Madhu Rawat
Background: The study of increase Lipoprotein (a) [Lp[a]] is an important risk factor for coronary heart disease (CHD). Lp[a] levels in different populations can help in identifying the high risk group requiring aggressive medical treatment. Many studies have been conducted in India and abroad for screening population for higher Lp[a] levels related to CHD. However no study has yet been done on Uttarakhand population in particular Dehradun for screening of Lp[a] on CHD. Methods: A total of 600 serum samples including 200 rural, 200 urban and 200 suburban populations Dehradun district with various age groups and sex were evaluated.50% among above patients were identified with myocardial Infarction. The estimation of serum Lp[a] was done and data obtained was statistically analyzed. Results: The analysis of Lp[a]values showed that it differed significantly between the genders and among age-groups, but no significant variation was observed among localities (strata).
{"title":"Association Of Lipoprotein [A] In Genders, Age And Lifestyle Related To Coronary Heart Disease In The Dehradun Population.","authors":"Ashutosh Sharma, V. Mehrotra, G. Awasthi, Madhu Rawat","doi":"10.5580/2bee","DOIUrl":"https://doi.org/10.5580/2bee","url":null,"abstract":"Background: The study of increase Lipoprotein (a) [Lp[a]] is an important risk factor for coronary heart disease (CHD). Lp[a] levels in different populations can help in identifying the high risk group requiring aggressive medical treatment. Many studies have been conducted in India and abroad for screening population for higher Lp[a] levels related to CHD. However no study has yet been done on Uttarakhand population in particular Dehradun for screening of Lp[a] on CHD. Methods: A total of 600 serum samples including 200 rural, 200 urban and 200 suburban populations Dehradun district with various age groups and sex were evaluated.50% among above patients were identified with myocardial Infarction. The estimation of serum Lp[a] was done and data obtained was statistically analyzed. Results: The analysis of Lp[a]values showed that it differed significantly between the genders and among age-groups, but no significant variation was observed among localities (strata).","PeriodicalId":331725,"journal":{"name":"The Internet Journal of Tropical Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125772127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lymphatic filariasis is endemic in Nigeria, but the level of endemicity is unknown because many areas in the country remain unstudied. The Nigeria Lymphatic Filariasis Elimination Program (NLFEP) has set an ambitious target of 2015 to eliminate this disease. The success of this program depends on the use of an inexpensive, easy, and simple method to both identify and treat endemic communities. Hydrocoele is one of the chronic symptoms of lymphatic filariasis that is surgically treated in major hospitals in areas where the disease is endemic. Hydrocelectomy has been used as an index to determine the prevalence of lymphatic filariasis in certain endemic communities. The aim of this work is to determine the prevalence of hydrocelectomy in hospitals to assess the occurrence and spread of lymphatic filariasis in Kano State, Nigeria. To accomplish this goal, the prevalence of hydrocelectomy was investigated from 1994–2003 in 20 hospitals spread across eight of the nine Zonal Health Centers (ZHCs) in Kano State. The data obtained were analyzed using simple frequencies and percentages with respect to the specific hospital examined, patient age and type of hydrocoele on which hydrocelectomy was performed. Of 54,943 surgeries performed in 20 hospitals, 1,271 (2.31%) were hydrocelectomies. The prevalence of hydrocelectomy among the hospitals and ZHC cases ranged from 59 (0.16%) to 121 (29.4%) and from 59 (0.16%) to 325 (12.9%), respectively. The frequency of hydrocelectomy cases showed an initial rise with patient age, reaching a peak at the older age groups and then dropping thereafter. Although the overall prevalence of hydrocelectomy is generally low, its prevalence in all the hospitals surveyed strongly suggests that lymphatic filariasis may be prevalent and widespread throughout the state. However, none reflection of the domicile of the patients coupled with poor record taking/keeping and storage made it impossible to use the results in selecting villages for further epidemiological studies. Therefore there is need to develop a standard and sustainable system of taking and keeping records; and storage in Kano State hospitals for effective planning and research.
{"title":"Hydrocelectomy As An Indicator For The Occurrence And Spread Of Lymphatic Filariasis In Kano State, Nigeria","authors":"M. Dogara, H. I. Nock, R. I. Agbede, I. Ndams","doi":"10.5580/2b3e","DOIUrl":"https://doi.org/10.5580/2b3e","url":null,"abstract":"Lymphatic filariasis is endemic in Nigeria, but the level of endemicity is unknown because many areas in the country remain unstudied. The Nigeria Lymphatic Filariasis Elimination Program (NLFEP) has set an ambitious target of 2015 to eliminate this disease. The success of this program depends on the use of an inexpensive, easy, and simple method to both identify and treat endemic communities. Hydrocoele is one of the chronic symptoms of lymphatic filariasis that is surgically treated in major hospitals in areas where the disease is endemic. Hydrocelectomy has been used as an index to determine the prevalence of lymphatic filariasis in certain endemic communities. The aim of this work is to determine the prevalence of hydrocelectomy in hospitals to assess the occurrence and spread of lymphatic filariasis in Kano State, Nigeria. To accomplish this goal, the prevalence of hydrocelectomy was investigated from 1994–2003 in 20 hospitals spread across eight of the nine Zonal Health Centers (ZHCs) in Kano State. The data obtained were analyzed using simple frequencies and percentages with respect to the specific hospital examined, patient age and type of hydrocoele on which hydrocelectomy was performed. Of 54,943 surgeries performed in 20 hospitals, 1,271 (2.31%) were hydrocelectomies. The prevalence of hydrocelectomy among the hospitals and ZHC cases ranged from 59 (0.16%) to 121 (29.4%) and from 59 (0.16%) to 325 (12.9%), respectively. The frequency of hydrocelectomy cases showed an initial rise with patient age, reaching a peak at the older age groups and then dropping thereafter. Although the overall prevalence of hydrocelectomy is generally low, its prevalence in all the hospitals surveyed strongly suggests that lymphatic filariasis may be prevalent and widespread throughout the state. However, none reflection of the domicile of the patients coupled with poor record taking/keeping and storage made it impossible to use the results in selecting villages for further epidemiological studies. Therefore there is need to develop a standard and sustainable system of taking and keeping records; and storage in Kano State hospitals for effective planning and research.","PeriodicalId":331725,"journal":{"name":"The Internet Journal of Tropical Medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128475199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Dogara, H. I. Nock, R. I. Agbede, Shehu Iliya Ndams, Kumbur Kwaghga Joseph
The Nigeria Lymphatic Filariasis Elimination Programme (NLFEP) has set 2015 to eliminate the disease in the country. The success of this programme depends on identifying and treating endemic communities. Unfortunately, information on the distribution and nature of the disease from many parts of the country is lacking. This study aims at determining the distribution and nature of the disease in three selected villages in Kano State, Nigeria. Based on the results of an earlier survey of elephantiasis in 44 local government areas (LGAs) of Kano State, three villages; Marke, Gunduwa and Buda from DawakinTofa, Gabasawa and Garko LGAs respectively were selected for this study. A house-to-house census was undertaken to obtain the demographic information of the selected villages. The prevalence of the disease was determined by clinical and parasitological examinations. The clinical examination identified symptoms of adenolymphangitis (ADL), hydrocoeles and elephantiasis among the population of three villages. The Thick Blood Film (TBF) method was used to screen volunteers for the presence of Wuchereria bancrofti. The results showed that 43(1.5%) of the 2790 males examined had hydrocoele. The prevalence increased with age reaching a peak in the 60 69 year age group before it drops at 70+ year age group. However, the difference in prevalence between the age groups at P 0.05) between hydrocoele and the presence of W. bancrofti microfilaria in the villages. The overall prevalence for the three villages is 58(1.1%). Lymphatic filariasis is endemic in the three villages which is above the 1% level of endemicity recommended for selecting endemic communities for the mass drug administration (MDA) to eradicate the disease.
{"title":"Prevalence Of Lymphatic Filariasis In Three Villages In Kano State, Nigeria","authors":"M. Dogara, H. I. Nock, R. I. Agbede, Shehu Iliya Ndams, Kumbur Kwaghga Joseph","doi":"10.5580/2b3d","DOIUrl":"https://doi.org/10.5580/2b3d","url":null,"abstract":"The Nigeria Lymphatic Filariasis Elimination Programme (NLFEP) has set 2015 to eliminate the disease in the country. The success of this programme depends on identifying and treating endemic communities. Unfortunately, information on the distribution and nature of the disease from many parts of the country is lacking. This study aims at determining the distribution and nature of the disease in three selected villages in Kano State, Nigeria. Based on the results of an earlier survey of elephantiasis in 44 local government areas (LGAs) of Kano State, three villages; Marke, Gunduwa and Buda from DawakinTofa, Gabasawa and Garko LGAs respectively were selected for this study. A house-to-house census was undertaken to obtain the demographic information of the selected villages. The prevalence of the disease was determined by clinical and parasitological examinations. The clinical examination identified symptoms of adenolymphangitis (ADL), hydrocoeles and elephantiasis among the population of three villages. The Thick Blood Film (TBF) method was used to screen volunteers for the presence of Wuchereria bancrofti. The results showed that 43(1.5%) of the 2790 males examined had hydrocoele. The prevalence increased with age reaching a peak in the 60 69 year age group before it drops at 70+ year age group. However, the difference in prevalence between the age groups at P 0.05) between hydrocoele and the presence of W. bancrofti microfilaria in the villages. The overall prevalence for the three villages is 58(1.1%). Lymphatic filariasis is endemic in the three villages which is above the 1% level of endemicity recommended for selecting endemic communities for the mass drug administration (MDA) to eradicate the disease.","PeriodicalId":331725,"journal":{"name":"The Internet Journal of Tropical Medicine","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133038984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Described first by Seeberi in 1900, Rhinosporidiosis is caused by Rhinosporidium seeberi. It involves nasal mucosa, and is seen in both humans and animals. It is a waterborne disease endemic to the Indian subcontinent. It is also common in Nepal in the Terai belt, but a review of the literature did not reveal any study with respect to the clinicopathological profile of Rhinosporidiosis. OBJECTIVES: To study the clinicopathological profile of Rhinosporidiosis in eastern Nepal. METHODOLOGY: The study included 84 cases of Rhinosporidiosis over a period of 4 years. All were diagnosed on a clinical basis. All subjects were treated surgically by wide excision and electrocautery, and the specimens were sent for histopatholgical examination. Dapsone was given to all patients with recurrence. Subjects were followed up for complications, outcome and recurrence. OBSERVATION: The study was carried out over a period of 4 years with patients being between 7 and 54 years of age. The disease has a male preponderance with an average duration of symptoms of 4 years. All patients had a history of bathing in rivers or ponds that were also used by their cattle. 19 cases were recurrent.CONCLUSION: The study reflects the endemicity of this disease in eastern Nepal and related border areas adjoining India. It is rare in the hilly region of Nepal. High incidence is particularly noticed in those bathing in ponds accessed by cattle, and raising public awareness regarding this disease would go a long way in decreasing its incidence.
{"title":"Rhinosprodiosis: Analysis Of Cases Presenting To A Tertiary Care Hospital In Nepal","authors":"S. Bhandary, V. Natesh, S. Chettri, Arvind Kumar","doi":"10.5580/2b70","DOIUrl":"https://doi.org/10.5580/2b70","url":null,"abstract":"BACKGROUND: Described first by Seeberi in 1900, Rhinosporidiosis is caused by Rhinosporidium seeberi. It involves nasal mucosa, and is seen in both humans and animals. It is a waterborne disease endemic to the Indian subcontinent. It is also common in Nepal in the Terai belt, but a review of the literature did not reveal any study with respect to the clinicopathological profile of Rhinosporidiosis. OBJECTIVES: To study the clinicopathological profile of Rhinosporidiosis in eastern Nepal. METHODOLOGY: The study included 84 cases of Rhinosporidiosis over a period of 4 years. All were diagnosed on a clinical basis. All subjects were treated surgically by wide excision and electrocautery, and the specimens were sent for histopatholgical examination. Dapsone was given to all patients with recurrence. Subjects were followed up for complications, outcome and recurrence. OBSERVATION: The study was carried out over a period of 4 years with patients being between 7 and 54 years of age. The disease has a male preponderance with an average duration of symptoms of 4 years. All patients had a history of bathing in rivers or ponds that were also used by their cattle. 19 cases were recurrent.CONCLUSION: The study reflects the endemicity of this disease in eastern Nepal and related border areas adjoining India. It is rare in the hilly region of Nepal. High incidence is particularly noticed in those bathing in ponds accessed by cattle, and raising public awareness regarding this disease would go a long way in decreasing its incidence.","PeriodicalId":331725,"journal":{"name":"The Internet Journal of Tropical Medicine","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126042446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohd Altaf Mir, R. A. Mir, Mohsin Manzoor, Biant Singh Bali
Hydatid disease is a zoonotic parasitic infection caused mainly by Echinococcus granulosus and is a common disease in this part of the world. However, primary splenic hydatidosis is rare. A case is described in a 45 year old female who presented with left upper quadrant swelling and pain. Ultrasonography revealed a hydatid cyst towards upper pole of spleen. A Computed Tomography confirmed the primary splenic hydatid cyst of 7.5cm × 7cm without internal septations and calcification. Serological tests were positive for hydatid disease. An elective splenectomy was performed successfully.
{"title":"Primary Splenic Hydatidosis: A Case Report","authors":"Mohd Altaf Mir, R. A. Mir, Mohsin Manzoor, Biant Singh Bali","doi":"10.5580/2abf","DOIUrl":"https://doi.org/10.5580/2abf","url":null,"abstract":"Hydatid disease is a zoonotic parasitic infection caused mainly by Echinococcus granulosus and is a common disease in this part of the world. However, primary splenic hydatidosis is rare. A case is described in a 45 year old female who presented with left upper quadrant swelling and pain. Ultrasonography revealed a hydatid cyst towards upper pole of spleen. A Computed Tomography confirmed the primary splenic hydatid cyst of 7.5cm × 7cm without internal septations and calcification. Serological tests were positive for hydatid disease. An elective splenectomy was performed successfully.","PeriodicalId":331725,"journal":{"name":"The Internet Journal of Tropical Medicine","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133677843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shushrutha in ancient medicine described a condition, “Vidari” under mouth and throat diseases. He noticed a progressive narrowing of mouth, depigmentation of oral mucosa & pain on taking food. Schwart in 1952, described five Indian women from East Africa with “Atrophia idiopathica (tropica) mucosae oris”. In 1953, SG Joshi coined the term Oral submucous Fibrosis for a similar condition. The disease predominantly affects people of South-East Asian origin. We describe a case of a 9 year old child with this condition.
{"title":"Oral Submucous Fibrosis In A Young Boy","authors":"S. Setia, C. Kapoor, A. Manchanda","doi":"10.5580/fc2","DOIUrl":"https://doi.org/10.5580/fc2","url":null,"abstract":"Shushrutha in ancient medicine described a condition, “Vidari” under mouth and throat diseases. He noticed a progressive narrowing of mouth, depigmentation of oral mucosa & pain on taking food. Schwart in 1952, described five Indian women from East Africa with “Atrophia idiopathica (tropica) mucosae oris”. In 1953, SG Joshi coined the term Oral submucous Fibrosis for a similar condition. The disease predominantly affects people of South-East Asian origin. We describe a case of a 9 year old child with this condition.","PeriodicalId":331725,"journal":{"name":"The Internet Journal of Tropical Medicine","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130868849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sameer R. Verma, S. Sahai, P. Gupta, A. Munshi, S. Verma, P. Goyal
Objective–This study was done to assess the aetiological spectrum of obstructive jaundice as well as common clinical findings and relevance of laboratory and radiological imaging investigations.Methods: A prospective study of 110 patients with obstructive jaundice confirmed by thorough history and physical examination, biochemical tests and radiological investigations was done with final confirmation of diagnosis on histopathology. The data was analyzed using SOFA analytical software ver 0.9.24.Results: Out of 110 patients 62 (56%) were male and 48 (44%) were female. The mean age of the study population was 50.4 years (range 3–85 years). Malignant obstructive was more common than benign (62.73% Vs 47.27%). Abdominal pain and clay coloured stools were more frequent in patients with malignant disease. Carcinoma (Ca) of the head of pancreas was commonest aetiology 37/110 (33.63%) followed by Choledocholithiasis 32/110 (29%), Ca gall bladder 20/110 (18.18%), periampullary carcinoma 6/110 (5.45%), cholangiocarcinoma 4/110 (3.64%), CBD stricture 3/110 (2.73%), acute pancreatitis 3/110 (2.73%) and choledochal cyst 3/110(2.73%). and HCC(1.8%). Regarding etiology of the obstruction, the accuracy of ultrasound, CT scan, MRCP and ERCP was 87.3%, 92.7%, 90% and 100%, respectively. The sensitivities of USG, CT, MRCP and ERCP in the diagnosis of benign disease were 85.3%, 84.6%, 92.3% and 100%, respectively, whereas specificities were 88.4%, 94.2%, 86% and 100%, respectively. Sensitivities for diagnosis of malignant disease were 88.4 %, 94.2 %, 86 % and 100% for USG, CT, MRCP and ERCP respectively whereas specificities were 85.3%, 85%, 92% and 100% respectively.Conclusion: Malignant obstructive jaundice is predominant in males compared to females. Benign obstruction is seen at a comparatively younger age group compared to malignant (Mean age 38.6yrsVs 58.7yrs). Carcinoma of head of pancreas and choledocholithiais were the commonest malignant and benign etiology respectively. Ultrasound and CT have high diagnostic accuracy, sensitivities and specificities and along with MRCP have largely confined the role of invasive cholangiography (ERCP/PTC) to therapeutic/palliative procedures in biliary obstruction.
目的:本研究评估梗阻性黄疸的病因谱、常见临床表现以及实验室和放射影像学检查的相关性。方法:对110例梗阻性黄疸患者进行前瞻性研究，经详细的病史、体格检查、生化检查和影像学检查证实，最终通过组织病理学确诊。采用SOFA分析软件0.9.24进行数据分析。结果:110例患者中，男性62例(56%)，女性48例(44%)。研究人群的平均年龄为50.4岁(范围3-85岁)。恶性梗阻性病变较良性多见(62.73% Vs 47.27%)。腹痛和泥色便多见于恶性疾病患者。胰头癌(Ca)最常见，为37/110(33.63%)，其次为胆总管结石32/110(29%)、胆囊癌20/110(18.18%)、壶腹周围癌6/110(5.45%)、胆管癌4/110(3.64%)、CBD狭窄3/110(2.73%)、急性胰腺炎3/110(2.73%)、胆总管囊肿3/110(2.73%)。和肝细胞癌(1.8%)。对于梗阻的病因，超声、CT、MRCP、ERCP的准确率分别为87.3%、92.7%、90%、100%。USG、CT、MRCP和ERCP诊断良性病变的敏感性分别为85.3%、84.6%、92.3%和100%，特异性分别为88.4%、94.2%、86%和100%。USG、CT、MRCP和ERCP对恶性疾病诊断的敏感性分别为88.4%、94.2%、86%和100%，特异性分别为85.3%、85%、92%和100%。结论:恶性梗阻性黄疸男性居多，女性居多。与恶性梗阻相比，良性梗阻出现在相对年轻的年龄组(平均年龄38.6岁vs . 58.7岁)。恶性和良性病因分别为胰头癌和胆总管结石。超声和CT具有较高的诊断准确性、敏感性和特异性，并与MRCP一起，在很大程度上限制了侵入性胆道造影(ERCP/PTC)在胆道梗阻中的治疗/姑息性手术中的作用。
{"title":"Obstructive Jaundice- Aetiological Spectrum, Clinical, Biochemical And Radiological Evaluation At A Tertiary Care Teaching Hospital.","authors":"Sameer R. Verma, S. Sahai, P. Gupta, A. Munshi, S. Verma, P. Goyal","doi":"10.5580/272b","DOIUrl":"https://doi.org/10.5580/272b","url":null,"abstract":"Objective–This study was done to assess the aetiological spectrum of obstructive jaundice as well as common clinical findings and relevance of laboratory and radiological imaging investigations.Methods: A prospective study of 110 patients with obstructive jaundice confirmed by thorough history and physical examination, biochemical tests and radiological investigations was done with final confirmation of diagnosis on histopathology. The data was analyzed using SOFA analytical software ver 0.9.24.Results: Out of 110 patients 62 (56%) were male and 48 (44%) were female. The mean age of the study population was 50.4 years (range 3–85 years). Malignant obstructive was more common than benign (62.73% Vs 47.27%). Abdominal pain and clay coloured stools were more frequent in patients with malignant disease. Carcinoma (Ca) of the head of pancreas was commonest aetiology 37/110 (33.63%) followed by Choledocholithiasis 32/110 (29%), Ca gall bladder 20/110 (18.18%), periampullary carcinoma 6/110 (5.45%), cholangiocarcinoma 4/110 (3.64%), CBD stricture 3/110 (2.73%), acute pancreatitis 3/110 (2.73%) and choledochal cyst 3/110(2.73%). and HCC(1.8%). Regarding etiology of the obstruction, the accuracy of ultrasound, CT scan, MRCP and ERCP was 87.3%, 92.7%, 90% and 100%, respectively. The sensitivities of USG, CT, MRCP and ERCP in the diagnosis of benign disease were 85.3%, 84.6%, 92.3% and 100%, respectively, whereas specificities were 88.4%, 94.2%, 86% and 100%, respectively. Sensitivities for diagnosis of malignant disease were 88.4 %, 94.2 %, 86 % and 100% for USG, CT, MRCP and ERCP respectively whereas specificities were 85.3%, 85%, 92% and 100% respectively.Conclusion: Malignant obstructive jaundice is predominant in males compared to females. Benign obstruction is seen at a comparatively younger age group compared to malignant (Mean age 38.6yrsVs 58.7yrs). Carcinoma of head of pancreas and choledocholithiais were the commonest malignant and benign etiology respectively. Ultrasound and CT have high diagnostic accuracy, sensitivities and specificities and along with MRCP have largely confined the role of invasive cholangiography (ERCP/PTC) to therapeutic/palliative procedures in biliary obstruction.","PeriodicalId":331725,"journal":{"name":"The Internet Journal of Tropical Medicine","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132112906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In schistosomiasis infection, the disease is managed by exposing the definitive host to a dose of Praziquantel. However, Praziquantelis still not reaching the majority of those who most need it due to its high cost and there is possibility of drug resistance, hence need for alternatives. Antischistosomal effects of crude Solanum incanum and Carica papaya extacts were studied. Patterns on immune response, worm recovery, gross pathology in vivo and cercaricidal killing in vitro of Schistosoma mansoni was observed. In vivo S. mansoni infections were treated with two doses of 150 mg/kg of Solanum incanum or Carica papaya (methanol or aqueous) extracts and a treatment control of 450 mg/kg of Praziquantel. Various concentrations of plant extracts were used in cercaricidal assay. Carica papaya, showed highly reduced pathology, elevated immune responses and least time in destroying cercariae. On the other hand, S. incanum had the highest reduction in worm counts, similar to Praziquantel. Further studies are required to isolate the active compound(s) and determine mechanism(s) of their action.
{"title":"Antischistosomal Effects Of Solanum Incanum And Carica Papaya Crude Extracts On The Parasite Schistosoma Mansoni In Vivo And In Vitro","authors":"Susy Muchika, H. Kutima, R. Maranga, D. Yole","doi":"10.5580/10e4","DOIUrl":"https://doi.org/10.5580/10e4","url":null,"abstract":"In schistosomiasis infection, the disease is managed by exposing the definitive host to a dose of Praziquantel. However, Praziquantelis still not reaching the majority of those who most need it due to its high cost and there is possibility of drug resistance, hence need for alternatives. Antischistosomal effects of crude Solanum incanum and Carica papaya extacts were studied. Patterns on immune response, worm recovery, gross pathology in vivo and cercaricidal killing in vitro of Schistosoma mansoni was observed. In vivo S. mansoni infections were treated with two doses of 150 mg/kg of Solanum incanum or Carica papaya (methanol or aqueous) extracts and a treatment control of 450 mg/kg of Praziquantel. Various concentrations of plant extracts were used in cercaricidal assay. Carica papaya, showed highly reduced pathology, elevated immune responses and least time in destroying cercariae. On the other hand, S. incanum had the highest reduction in worm counts, similar to Praziquantel. Further studies are required to isolate the active compound(s) and determine mechanism(s) of their action.","PeriodicalId":331725,"journal":{"name":"The Internet Journal of Tropical Medicine","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127203881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. EzeagwunaD, E. EmeleF, Agbakoba Nr, N. OgbuaguC, M. EkejinduI, M. OrjiN
Malaria and typhoid fever are life threatening illnesses of tropical and subtropical regions of the world with almost similar clinical manifestations. An investigation on the relationship between malaria parasitaemia and widal positivity was carried out among 100 patients who consulted doctors at the general out patients department of the Nnamdi Azikiwe Teaching Hospital, Nnewi . Blood samples were collected from patients who manifested clinical symptoms of malaria/typhoid fever . Thick blood films were made and stained with Giemsa staining technique for malaria parasite while tube agglutination test was carried out for widal positivity. Blood , urine and stool samples of patients with high widal titre were cultured in appropriate media. 41.02% of the patients were malaria parasite and widal test positive (somatic antigen) while 27.27% were positive for flagellar antigen. There were occurrence of mixed reaction in widal test among the patients tested. There was no significant relationship between malaria parasitaemia and reactivity of serum with typhoid fever (p<.05). No Salmonella species was isolated from the body fluids cultured. The poor performance of widal test in some laboratories, instant conclusion and poor interpretation of results by prescribers should be checked and base line titre of each location determined.
{"title":"Investigating The Relationship Between Malaria Parasitaemia And Widal Positivity","authors":"A. EzeagwunaD, E. EmeleF, Agbakoba Nr, N. OgbuaguC, M. EkejinduI, M. OrjiN","doi":"10.5580/13fb","DOIUrl":"https://doi.org/10.5580/13fb","url":null,"abstract":"Malaria and typhoid fever are life threatening illnesses of tropical and subtropical regions of the world with almost similar clinical manifestations. An investigation on the relationship between malaria parasitaemia and widal positivity was carried out among 100 patients who consulted doctors at the general out patients department of the Nnamdi Azikiwe Teaching Hospital, Nnewi . Blood samples were collected from patients who manifested clinical symptoms of malaria/typhoid fever . Thick blood films were made and stained with Giemsa staining technique for malaria parasite while tube agglutination test was carried out for widal positivity. Blood , urine and stool samples of patients with high widal titre were cultured in appropriate media. 41.02% of the patients were malaria parasite and widal test positive (somatic antigen) while 27.27% were positive for flagellar antigen. There were occurrence of mixed reaction in widal test among the patients tested. There was no significant relationship between malaria parasitaemia and reactivity of serum with typhoid fever (p<.05). No Salmonella species was isolated from the body fluids cultured. The poor performance of widal test in some laboratories, instant conclusion and poor interpretation of results by prescribers should be checked and base line titre of each location determined.","PeriodicalId":331725,"journal":{"name":"The Internet Journal of Tropical Medicine","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129428263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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