Search results for “fever

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30 articles
Model Based Research Open Access

Mathematical Modelling of Typhoid Fever Transmission Dynamics and Intervention Impact in Harare, Zimbabwe (2018–2020)

Dec 2025 DOI 10.14302/issn.2643-2811.jmbr-25-5731
Mukeredzi InnocentCorresponding author

Background Typhoid fever remains a significant public health issue in Harare City, Zimbabwe, exacerbated by recurrent outbreaks between 2018 and 2020. Key challenges, including inadequate water supply and sanitation infrastructure, high population density, and limited healthcare access, have intensified the disease burden. Understanding the key transmission drivers and assessing the impact of various interventions are essential for informing policy and health strategies. Objectives This study aimed to: 1: To predict future trends in typhoid fever cases Harare City typhoid hot areas. 2: To develop a mathematical model to simulate the spread of typhoid fever incidence under different intervention scenarios and recommend evidence-based strategies for reducing the disease burden in Harare City. Methods A dynamic compartmental SIR-based model, adapted from the Pitzer Vaccine Effectiveness (VE) framework, was employed to simulate disease transmission. This model accounted for both short-cycle (human-to-human) and long-cycle (environmental) transmission pathways. Data from Harare City (2018–2020) were used for model calibration and forecasting, and sensitivity analysis was performed to assess the impact of different intervention levels. Findings The model identified inadequate sanitation, contaminated water sources, and low health- seeking behaviors as primary drivers of typhoid transmission. In the absence of interventions, the model projected a sustained high rate of transmission. However, treatment and WASH interventions could reduce the disease burden by 50–60%, while combined strategies incorporating vaccination and education led to an 80% reduction in cases. Sensitivity analysis indicated that treatment and WASH interventions were particularly impactful at moderate coverage levels. Conclusion Mathematical modeling effectively demonstrated the multifactorial drivers of typhoid fever transmission in Harare. Integrated interventions that combine WASH, vaccination, treatment, and education present the most promising approach for long-term control of the disease. The findings offer a solid, data-driven foundation for public health decision-making and resource allocation.

A Systematic Review of Dengue Fever and Dengue-Associated Neurological Conditions Was Conducted in an Attempt to Better Understand This Disease

Jun 2024 DOI 10.14302/issn.2374-9431.jbd-24-5077
Isea RaúlCorresponding author

Dengue is a global arbovirus disease primarily carried by Aedes aegypti and Aedes albopictus mosquitoes. It has four serotypes (DENV1, DENV2, DENV3, and DENV4) and is classified into distinct genotypes. The epidemic is complicated by immunological interactions and viral lineage turnover. Neurological problems are commonly associated with DENV2 and DENV3, with DENV2 displaying the most severe symptoms. Direct viral invasion, host-mediated immune system reactions, or host-mediated metabolic alterations can all result in dengue-related neurological issues. The three dengue vaccinations and the significance of meta-analyses for genetic data will also be covered. Finally, establish a connection with the microRNAs associated with dengue fever, creating new opportunities for the creation of dengue treatment regimens involving microRNAs.

Diseases Open Access

Prevalence of Typhoid and Paratyphoid fever in a tertiary care hospital of Kathmandu valley

Feb 2023 DOI 10.14302/issn.2997-1977.jd-22-4378
Gautam KirtikaCorresponding author

Typhoid or enteric fever is caused by Salmonella serotype typhi and paratyphi. It is one of the major public health problem in developing countries including Nepal. In recent years, increased urbanization and growing population within Kathmandu valley, attributed mainly to improper sanitary condition and fecal contamination of drinking water. These all factors contributes to a very high prevalence of typhoid fever through out the country. Methods This study was laboratory based study carried out six month period from march 2017 to August 2017 at microbiology lab in Nepal Medical college. Results and conclusion In the present study, the prevalence of enteric fever is mainly caused by Salmonella. Typhi than Salmonella Paratyphi A was observed.

Parasite Research Open Access

Malaria and Typhoid Fever Coinfection in the Hospital University of Bobo-Dioulasso, Burkina Faso

Dec 2019 DOI 10.14302/issn.2690-6759.jpar-19-3081
Ibrahim SangaréCorresponding author Institut Supérieur des Sciences de la Santé, Université Nazi BONI, Bobo-Dioulasso, Burkina Faso

Malaria and typhoid fever are two endemic infectious diseases in developing tropical countries including Burkina Faso. There are two distinct infectious diseases with many similar clinical signs. In each sanitary area, it is important to describe the "typhomalaria" epidemiology to elaborate adequate diagnosis algorithm and efficient treatment protocol. A cross-sectional study was carried out from July to October 2014 in the lab department of University Hospital Souro SANOU, Bobo-Dioulasso. All microscopy positive malaria during the study period was included. Serodiagnosis of Widal and Felix was performed systematically in all Plasmodium spmalaria cases. Titers of antibodies anti-agglutinin O equal or higher than 1/400 and/or 1/800 for anti-agglutinin H antibodies were considered positive for Salmonella sp. A total of 283 malaria cases were included in this study, majority falciparum malaria. In this malaria cases, 91 patients were seropositive for Salmonella sp. "Typhomalaria" co-infection prevalence was 34.3% (CI 95% (28.8%; 40.1%)). The patient with the normal hemoglobin rate had the highest prevalence of co-infection (46.7% versus 30.9; p=0.02). Malaria and typhoid fever co-infection was high (approximately 1/3 of malaria cases) in University hospital of Bobo-Dioulasso. This study revealed the need to explore typhoid fever in malaria confirmed cases, especially in persistent fevers and non-anemic situation despite adapting antimalarial treatment.

A Rare Cause of Fever of Unknown Origin: Reverse Shapiro’s Syndrome

Mar 2019 DOI 10.14302/issn.2474-3585.jpmc-19-2655
Gedik HabipCorresponding author Department of Infectious Diseases and Clinical Microbiology, Ministry of Health Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey

Reverse Shapiro’s syndrome is described as unexplained hyperthermia coexisting with agenesis of the corpus callosum. Its pathophysiology dwells on the role of dopaminergic hypersensitivity caused by hypothalamic dysfunction. Until now, only 5 cases have been described in the literature as reverse Shapiro’s syndrome. We present a case of a 6-month-old girl who is now the sixth patient described in the literature. A 6-month-old female patient was admitted to the pediatrics unit for fever of unknown origin. Her fever occurred 2-3 times a day on average between 38°C and 39.5°C, and lasted for 1-2 hours. The fever was not diurnal, and antipyretics or staying in an air-conditioned room had no effect. She also had 2 convulsions during her hospital stay. Cranial magnetic resonance imaging (MRI) was requested owing to the patient’s convulsion history and retarded development. The cranial MRI showed diffuse hypoplasia of the corpus callosum in the midline sagittal T2-weighted image. T1-weighted imaging showed hypointensity due to delayed myelination of the genu of the corpus callosum (Figure 2, white arrow), which should normally appear hyperintense like the posterior limb of the internal capsule. Although dopamine agonists and serotonin agonists are recommended for the treatment, the rate of response to medical treatment is very low. Our patient did not benefit from cyproheptadine and methyl prednisolone.

Lenalidomide-Induced High Grade Fever in a Patient with Multiple Myeloma: A Case Report

Mar 2019 DOI 10.14302/issn.2641-5518.jcci-19-2664
ElGohary GhadaCorresponding author Department of Adult Hematology/Internal Medicine, Ain Shams University Hospitals, College Of Medicine, Cairo, Egypt

Lenalidomide is a second generation immunomodulatory agent and a potent analogue of thalidomide that is FDA approved mainly for the treatment of multiple myeloma (MM) and transfusion-dependent anemia due to low or intermediate-1- risk myelodysplastic syndromes (MDS) associated with 5q deletion among other indications. Through its action on the immune system, lenalidomide alters the production of different cytokines ultimately resulting in immune activation against tumors. This immune activation may lead to collateral immune toxicities like fever, angioedema, Stevens-Johnson syndrome, tumor flare and others. Here we report a case of lenalidomide-induced high grade fever in a patient with MM and we summarize the literature about the physiology of such reaction and how to mitigate this adverse event.

Evidence for the Absence of La Crosse Virus, Rift Valley Fever Virus, and Bunyamwera Virus in Korean Domestic Pigs

Oct 2017 DOI 10.14302/issn.2641-9181.ijnr-17-1778
Chung Hee-ChunCorresponding author Department of Veterinary Medicine Virology Laboratory, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Korea.

A surveillance study reports no detection of targeted bunyaviruses in domestic pigs in Korea. Methods, sampling frame, and assay limits are described to contextualize interpretation and surveillance value.

Haematological Disturbances in Dengue Haemorrhagic Fever - its Pathogenesis and Management Perspectives

Jan 2015 DOI 10.14302/issn.2372-6601.jhor-14-381
H Sellahewa KolithaCorresponding author Dr Neville Fernando Teaching Hospital, Millenium Drive, Malabe, Sri lanka

Haemorrhage is common to both dengue fever (DF) and dengue haemorrhagic fever (DHF). Thrombocytopaenia is exceedingly common, while prolonged partial thromboplastin time and reduced fibrinogen concentration are the other abnormal haemostatic indices evident from early in the disease course. These haematological abnormalities correlate better with the timing and severity of plasma leakage rather than the clinical haemorrhagic manifestations. Blood products including prophylactic platelet transfusions are hardly required in the management of DHF. Judicious fluid therapy is the most effective intervention to prevent complications and bleeding in DHF. Concealed haemorrhage is an important complication requiring early recognition and blood transfusions to improve outcomes. Understanding the pathogenesis of coagulopathy and the significance of altered haemostatic indices, and its co-relation to disease severity and phase of DHF, is essential for appropriate interventions particularly when DHF co-exists in patients on mandatory anticoagulation for prosthetic heart valves and atrial fibrillation.

Iatrogenic Extra-Capsular Extension of Knee Septic Arthritis Via Intra-Articular Joint Injection

May 2025 DOI 10.14302/issn.2694-2283.jsem-25-5529
Al-saeed NawafCorresponding author

Background Septic arthritis is a potentially limb or life-threatening joint infection that requires prompt recognition and intervention to reduce morbidity and mortality. While intra-articular joint injections are commonly performed for osteoarthritis and other arthropathies, they carry a rare but significant risk of iatrogenic infection, particularly when performed in the presence of unrecognized joint or periarticular infection. Case Presentation We report a case of a 52-year-old female with a history of traumatic brain injury and chronic right knee pain who developed severe knee swelling, pain, and systemic symptoms following an intra-articular corticosteroid injection performed without ultrasound evaluation/guidance. Post-procedure, she presented with fever, elevated inflammatory markers, and purulent knee effusion. Operative washout revealed a purulent tract extending from the knee joint capsule to the lateral thigh. Cultures from joint aspiration and intraoperative samples grew Streptococcus dysgalactiae. Blood cultures were negative. The patient reported frequent cat scratches to the affected knee and described an unusual sensation of the injection needle tracking laterally during the joint injection. She was treated with surgical drainage and a four-week course of amoxicillin, with full clinical recovery. Discussion This case highlights an unusual presentation of septic arthritis with extra-capsular extension likely due to iatrogenic needle tracking during joint injection. The causative organism, S. dysgalactiae, is an uncommon pathogen in septic arthritis, and the presumed source was contiguous spread from untreated cellulitis, possibly related to cat scratches/bites. The absence of predisposing comorbidities and negative blood cultures further support a local rather than hematogenous source. The case emphasizes the importance of thorough clinical evaluation and consideration of infection prior to joint injections, as well as the potential benefits of ultrasound guidance to minimize procedural complications. Conclusion Careful history, physical examination, and appropriate imaging are essential prior to joint interventions to avoid iatrogenic complications. This case illustrates the rare but serious risk of extra-capsular extension of septic arthritis following intra-articular injection and emphasizes the need for vigilance in identifying underlying infection before proceeding with invasive procedures.

Fecal Shedding, Antimicrobial Resistance and In Vitro Biofilm formation on Simulated Gallstones by Salmonella Typhi Isolated from Typhoid Cases and Asymptomatic Carriers in Nairobi, Kenya

Apr 2024 DOI 10.14302/issn.2690-4721.ijcm-24-5030
S. Gunn* JohnCorresponding author

Typhoid fever, caused by the human restricted pathogen Salmonella Typhi, remains a major global public health concern. Even after successful treatment, approximately 3-5% of patients with typhoid fail to clear the bacteria within one year and become chronic carriers. Most typhoid carriers have gallstones in their gallbladder, and biofilm formation on gallstones is highly correlated with chronic carriage. This study’s goal was to identify asymptomatic typhoid carriers in an endemic setting in Kenya, and to compare acute versus chronic isolates. A cohort of typhoid fever patients identified through blood and/or stool culture, and their household contacts, were followed up after treatment to detect longitudinal S. Typhi stool shedding. An abdominal ultrasound scan was used to identify individuals with gallstones. A total of 32 index patients and 32 household contacts were successfully followed-up. Gallstones were detected in 4 cases and 1 household contact. The duration of S. Typhi shedding was significantly longer in individuals with gallstones compared to those without, P<0.001. Eighty-three (83) S. Typhi strains were tested for susceptibility to commonly used antimicrobials and examined by in vitro biofilm formation assays. Out of 37 infected individuals, 32.4% had infections caused by multidrug resistant (MDR) S. Typhi strains and only 18.9% were infected by susceptible strains. Non-MDR strains formed significantly better biofilms in vitro than the MDR strains (P<0.001). This study provides data on S. Typhi chronic carriage that will influence public health approaches aimed at reducing typhoid transmission and the burden of infection.

Family Medicine Open Access

Antibiotic Prescribing Practices for Upper Respiratory Tract Infection Among Clinical Officers at Kiambu County

Mar 2024 DOI 10.14302/issn.2640-690X.jfm-24-5016
Murigi KevinCorresponding author

Background Antibiotics are the most prescribed medications worldwide. Global consumption rose by 65% in 76 low and middle-income countries between the years 2000 and 2015. According to the World Health Organization, improper administration of antibiotics occurs in over 60% of people with upper respiratory tract infections. Inadvertent antibiotic use has been identified as a contributor to antimicrobial resistance. Outpatient antibiotic use accounts for around 80-90% of all antibiotic use in patients. Clinical officers are non-physician healthcare workers who have received less training, have a more restricted scope of practice than physicians. Clinical officers are key service providers in this country especially at the primary healthcare level. Objective The study assessed the factors that influence antibiotic prescribing for upper respiratory tract infections by clinical officers. Method A prospective study was carried out at 20 public hospitals in Kiambu County, on 36 clinical officers and 600 patient prescriptions. The parameters measured were patient factors, prescriber factors, institutional factors and how they affected the antibiotic prescribing practices by either being rational or irrational. Rational prescribing was identified as prescribing the right drug, at the right frequency, in the right duration, right dose for the right indication. Prescriptions were considered irrational if they did not satisfy any of the rational indices. Data was collected via a questionnaire from the clinical officers while WHO prescription checklist was used to collect data from patient encounters. Data was analyzed using Statistical Package for Social Sciences version 22.0 (SPSS v22.0) with P-value, Confidence Interval and Odds Ratio. Results A total of 600 patient encounters were recorded and 79.8% of the 479 encounters had an antibiotic prescription for URTI, 91% of the antibiotics prescribed were the right dose, 98% had the right frequency, 75% had the right duration, and only 23% had the right indication. Patients above 65 years were more likely to receive an antibiotic prescription OR 3.98 CI 0.91,17.41 P=0.17 compared to children under 12 years old. Males were more likely to receive an antibiotic, but this was not significant OR 1.06 CI 0.70, 1.59 P=0.79. A total of 28 (4.6%) patients had fever, and all received antibiotics. A total of 36 clinical officers were sampled and only 5 (13.8%) were found to have rational prescriptions (P=0.63), prescriber age (P=0.92), prescriber level of education (P=0.99) and prescriber work experience (P=0.22) were not associated with antibiotic prescription. As per institutional factors, availability of antibiotics (P=0.026) and availability of prescription guidelines (P=0.012) were associated with rational prescription of antibiotics. Conclusion The study indicated that there was a high antibiotic prescription rate deviating from the WHO standard. It demonstrated that most antibiotic prescriptions were irrational.

A Review on Monkey Pox: Role of One Health Approach Against Monkey Pox

Oct 2023 DOI 10.14302/issn.2641-4538.jphi-23-4622
Geinoro Alleyo TarikuCorresponding author

The Ortho-poxvirus virus, which causes monkey pox, is a member of the Poxviridae genus. It was initially found in primates. In 1970, the Democratic Republic of the Congo reported the first instance of monkey pox. From there, it spread to a number of countries both inside and outside of Africa. There are two genetic varieties of monkey pox, which have been spread to people through respiratory droplets, and touch with objects contaminated by an affected person and consequently is often encountered in work situations. Among the countries with the worst effects are Nigeria and the Democratic Republic of the Congo. Non-human primates, rats, squirrel, and or mice are just a few of the creatures that can become infected by monkey pox. Although the origins of monkey pox infections are unknown, rodents from Africa and non-human primates like monkeys may contain the viruses and infect humans. Monkey pox is more likely to naturally infect rodents. Monkey pox has symptoms and lesions that are difficult to distinguish from smallpox in its clinical manifestations. Fever, chills, migraines, tiredness, tonia, swollen lymph nodes, back pain, and myalgia are some of the clinical symptoms of monkey-pox. A few examples of diagnostic tests include immune-fluorescent antibody assays, enzyme-linked immune-sorbent assays, and real-time polymerase chain reactions. A specialized vaccine that offers complete protection against by them on key-pox virus exists, yet there is no specific therapy for human monkey infection and interaction with the vaccinia virus. Smallpox vaccination can give cross-immunity with partial protection against infection and a reduction in symptom severity. Unfortunately, community health effects in the view of one health approach has not been addressed in vast. Therefore, the objectives of this review paper are to discuss the community health effects of monkey pox and to emphasize the role of one health approach against monkey pox.

Deficiency of Adenosine Deaminase Type 2 (ADA2) DADA2 Masquerade as Lupus

Aug 2023
Almabadi BayanCorresponding author

DADA2 (deficiency of adenosine deaminase type 2) is an autoinflammatory autosomal recessive disease resulting from biallelic loss of function mutations in ADA2 gene. Clinical presentation and age of onset vary widely even among related patients, and variability of symptoms and severity manifestations include bone marrow failure, autoinflammation, immunodeficiency and vasculitis. Here, we report a case of young male with adult onset DADA2, who presented with fever, lower limbs skin rash, joint pain, and anemia resembling systemic lupus erythematous (SLE). DADA2 has an extremely variable clinical phenotype. It was described into three categories: inflammatory/vascular, immune dysregulation, and hematologic. However, the data is scant in describing autoimmunity phenotype in DADA2 and further studies are required to investigate the clinical correlation and presence of autoantibodies. We recommend genetic testing in cases with lupus-like disease especially if there is consanguinity between parents and family history of vasculitis.

Pyrexia And Liver Injury After A Second SARS-CoV-2 Vaccination: Macrophage Activation Manifested In Liver

Aug 2023 DOI 10.14302/issn.2692-1537.ijcv-23-4679
Ryu TomikoCorresponding author

Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-Co V-2) has contributed to control of the coronavirus disease 2019 (COVID-19). On the other side, vaccination of SARS-CoV-2 could trigger autoimmune or inflammatory diseases. We present a 50-year-old female with well-controlled optic neuromyelitis with prednisolone (PSL) maintained at a dose of 2.5 mg/day. She ran a fever and liver injury was indicated 5 weeks after a second COVID-19 vaccination (BNT162b2 mRNA/Pfizer ). Liver biopsy showed accumulation of macrophages around the central veins, identified using anti-CD68 antibodies. As the treatment, cyclosporine A improved liver injury. COVID- 19 vaccination may have triggered liver inflammation due to cytokine storm via macrophage activation in the liver.

Diseases Open Access

Epidemio-Clinical Profile of Acute Diarrhea in Children From 0 To 5 Years and Prevalence of Rotavirus Before and After the Introduction of the Rotasiil Vaccine in the Democratic Republic of Congo.

Jul 2023 DOI 10.14302/issn.2997-1977.jd-23-4588
Mboko Byamungu FreddyCorresponding author

Introduction Acute diarrhea remains one of the major health problems in developing countries. According to the WHO, rotavirus contributes to approximately 40% hospitalizations and is the leading cause of severe diarrhea in children 0-5 years old. The objective was to determine the prevalence of rotavirus and the sociodemographic and clinical profile among children with diarrhea in 4 hospitals in the DRC. Methods This study is documentary, retrospective and analytical taking two periods, before and after introduction of the vaccine, i.e. January 2017 to December 2018 and January 2020 to December 2021 in 4 hospitals, i.e. 2 in Kinshasa and 2 in Lubumbashi. Results Total 1872 children, 924 (49.4%) of whom were enrolled before the introduction of the vaccine and 948 (50.6%) after. Only 1737 had performed serology, of which 875 (50.4%) were rotavirus positive and 862 (49.6%) were negative. Positive results, a reduction of 30.6% is noted since the introduction of the vaccine. The predominant age range was 6 to 11 months. The male gender was predominant at 56.7%. Diarrhea was found in 88.5%, vomiting in 73.7% and fever in 73.9%. Before vaccination, the risk was more: 11 times to have diarrhea, 9-10 times the frequency between 3-10 times a day, 9 times vomiting, 2 times fever and 2 times to have a positive result. Conclusion From this study, we note a reduction frequency due to diarrhea unlike previous years, probably attributable to the vaccine.

Parasite Research Open Access

Epidemiological Profile of Intestinal Protozoan Infection in Dakar, Senegal: Results from Hospital-Based Survey

Dec 2022 DOI 10.14302/issn.2690-6759.jpar-22-4382
Sylla KhadimeCorresponding author Département de Parasitologie-Mycologie Faculté de Médecine, Pharmacie et Odontologie, Université Cheikh Anta Diop de Dakar, Sénégal.

Background  Intestinal parasitic infections, especially intestinal protozoan parasites remain significant public health problem in Senegal. Several studies have demonstrated the endemicity of the diseases. The study was carried out with the objective of assessing the epidemiolocal profile of intestinal protozoan infection diagnosed among patients attending to Fann University Hospital in Dakar, Senegal. Materials and Method A retrospective study was conducted from 2016 to 2020. Samples were collected from patients attending to the laboratory for parasitological confirmation. Fresh stool samples were observed using direct examination, formal-ether concentration method and modified Zeilh Nielsen staining method. Descriptive analysis was performed using Stata MP 16 software. The significance level was set at 5%. Results Among 3825 patients selected in the study, 1009 were found with at least one intestinal protozoan parasite representing an overall prevalence of 26.4% (CI 95% (24.7– 28)). Mono-parasitic and di-parasitic infection represent 81.6% and 18.2% respectively while polyparasitism was observed in 26 patients representing 2,6%. Among positive samples, 16 (8.7%) were associated with helminths. Blastocystis sp. (40.8%), Entamoeba Coli (38.2%), Endolimax nana (8.2%) and Giardia intestinalis (8.1%) were mainly observed. Trophozoites Entamoeba histolytica was observed with 2.3%. Frequency of intestinal protozoa was higher in the 15 – 30 age group (28.3%) and in male group (26.9%). The parasite carriage was most important during the wet season comparing the dry season (p = 0.65). Asymptomatic patients (29.5%) were more infected than symptomatic patients (23.5%) (p <10-3). The main clinical symptoms were diarrhea, abdominal pain, dysenteric syndrome, fever, dyspeptic disorders, and vomiting. Conclusion These results showed that intestinal protozoan infections remain prevalent in Senegal with a high proportion of asymptomatic who constitute an important reservoir of parasites. Effective control strategies such as water supply, hands washing, and mass deworming campaign could reduce the prevalence of these diseases.

Metabolic Complications of Diabetics Admitted in Emergency at the Souro-Sanou University Hospital Center, Bobo-Dioulasso (CHUSS)

Apr 2022 DOI 10.14302/issn.2379-7835.ijn-22-4155
Salissou Seck Mbaye MBAYECorresponding author Cardiology Department of the Yalgado Ouédraogo University Hospital, Ouagadougou (Burkina Faso)

The diabetic is most of the time admitted in emergency for acute complications. An inventory of these complications will guide promotional programs aimed at preventing the occurrence of these complications. This study was conducted with the aim of identifying acute complications and decompensation factors in diabetics admitted in emergency to the Souro Sanou University Hospital Center (CHUSS).It was an observational study, of descriptive transversal type, with prospective collection for 4 months. It concerned diabetics admitted to the medical and surgical emergency departments of the CHUSS. A total of 90 diabetics were included in the study. The average age was 58.81 ± 14.7 years. Type 2 diabetes accounted for 85.6% of cases. The diagnosis of diabetes was known in 74.4% of cases. The reasons for consultation were dominated by impaired conscientiousness and fever, 54.4% and 50% respectively. Metabolic complications were found in 44.4% of patients. They were dominated by hypoglycemia, which accounted for 55.3% of cases. Dietary error was the main decompensation factor in cases of hypoglycemia and was reported in 71.4% of cases. Metabolic complications are common in diabetics admitted in emergency at the CHUSS. Decompensation factors are mostly preventable.  

Duodenocolic Fistula: A Rare Complication of Gastrointestinal Tuberculosis

Mar 2022 DOI 10.14302/issn.2641-5518.jcci-22-4096
Iñaki L. Garcia JulianCorresponding author Gastroenterology Fellow, De La Salle University Medical Center

Introduction Benign duodenocolic fistula (DCF), also known as a non-malignant fistula between the duodenum and colon, with or without cecum-involvement, is an unusual complication of different gastrointestinal (GI) diseases 12. Case This is a case of a 28-year-old Filipino female who presented with periumbilical pain for five months, with associated anorexia, fever, and weight loss. Biopsy showed chronic granulomatous inflammation with caseation necrosis and Langhan’s type giant cells consistent with tuberculous etiology (Figure 6 and Figure 7). Category I Anti-TB treatment for six months was started and the service planned to repeat both colonoscopy and CT-scan after the initial round of anti-TB treatment. Conclusion Benign duodenocolic fistula in the form of extrapulmonary TB is a rare GI finding that is triggered by inflammatory processes. Proper management in this case was to treat the underlying TB infection which is endemic in the Philippines.

Analgesic and Anti-Pyretic Activities of the Root Bark of Rutidea Parviflora (Rubiaceae)

Apr 2021 DOI 10.14302/issn.2328-0182.japst-21-3778
Okiemute Rosa Johnson-AjinwoCorresponding author Department of Pharmaceutical and Medicinal Chemistry, Faculty of Pharmaceutical Sciences, University of Port Harcourt, Nigeria.

This study aims at investigating the antipyretic activity of different solvent fractions of the root bark of Rutideaparviflora(Rubiaceae). This plant is used ethno-botanically by the people of Ethiope East-West Local Government Area of Delta State, Nigeria to treat various ailments such as inflammation, fever and pain. This necessitated this research to validate its local use, due to the scanty literature and information present about this plant. It has also shown some anti-cancer and anti-inflammatory activity in previous researches. The present study is a randomized control study. Acetic acid induced writhing was employed for analgesic testing. Acetic acid was used to induce writhing in Wistar rats which were divided into fourteen (14) groups. The groups were administered extracts and fractions of the plant (200 mg/kg and 400 mg/kg). The animals were observed for number of writing movements and the percentage writhing was calculated. Baker’s yeast induced pyrexia was employed for the antipyretic testing. The animal groups were administered extracts and fractions of the plant (200 mg/kg and 400 mg/kg), with Paracetamol as the standard drug (100 mg/kg) and Normal saline (control) for both experiments. The body temperature of the rats was measured rectally over a period of five (5) hours. All values of P<0.05 were taken as significant. The organic extract, aqueous extract and various fractions (n-hexane, ethyl-acetate, n-butanol and aqueous) produced significant inhibition of writhing responses and pyrexia in a dose dependent manner and time dependent manner respectively. The aqueous extract at a dose of 400mg/kg showed the greatest reduction in writhing, 91.58% compared to the standard drug (paracetamol) which may suggest that the fraction possesses better efficacy than paracetamol as an analgesic. The observed activities could be attributed to these bioactive compounds: Palmatine, Urs-12-ene-24-oic-3-oxo-methyl ester and Gallic acid contained in R. parviflora.

Cell Therapy as an Alternative approach for COVID-19 Infection Consequences: A Non-Systematic Review

Jan 2021 DOI 10.14302/issn.2692-1537.ijcv-20-3685
Elkhenany HodaCorresponding author Department of Surgery, Faculty of Veterinary Medicine, Alexandria University, Alexandria, Egypt.

The current uncontrollable outbreak of novel coronavirus (COVID-19) has unleashed severe global consequences in all aspects of life and society, bringing the whole world to a complete halt and has modeled significant threats to the global economy. The COVID-19 infection manifests with flu-like symptoms such as cough, cold, and fever resulting in acute respiratory distress syndrome (ARDS), lung dysfunction, and other systemic complications in critical patients are creating panic across the globe. However, the licensed vaccine has started to show up; some resulted in side effects that would limit its possibility in some circumstances as allergic personnel, for example. Moreover, the production and approval of new drugs is a very complicated process and takes a long time. On the other hand, stem cells have gone the extra mile and intensively investigated at preclinical and clinical studies in various degenerative diseases, including infectious ones. Stem cells are proposed as a broad-spectrum therapeutic agent, which may suppress the exaggerated immune response and promote endogenous repair by enhancing COVID-19 infected lung microenvironment. Also, stem cells have different application manners, either direct transplantation, exosome transplantation, or drug delivery of specific cytokines or nanoparticles with antiviral property by engineering stem cells. This review discusses and summarizes the possible emerging role of cell-based therapy, especially stem cell therapy, as an alternative promising therapeutic option for the treatment and control of novel COVID-19 and its potential role in tissue rejuvenation after COVID-19 infection.

Assessment of Self Medication Practice and Drugs Storage Among South Sudanese Community in Addis Ababa, Ethiopia

Sep 2020 DOI 10.14302/issn.2328-0182.japst-20-3526
Bekele AnbessaCorresponding author Pharmacy School, Health Institute, Jimma University, Ethiopia

Background Self-medication (SM) can be defined as the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms. A number of individuals in developing countries do not attend physicians for their illnesses; instead they commonly use self-medication. Self-medication could be using drugs existing in home like over the counter (OCT) drugs, traditional medicine, prescription only drug. Self-medication is not always bad, hence for the over the counter drugs it is beneficial. Inappropriate storage and use of medicines at home could have a direct influence on public health, the environment and the health-care services and it increases the risk of self-medication. Objective To assess the practice of self-medication and drug storage among South Sudanese community in Addis Ababa. Materials and Methods A cross sectional study design was conducted in Addis Ababa city from April 22 to April 26/2019. Data was collected by semi structure-questionnaire consisting questions on general demographic, socio-economic as well as on perceived illness/ symptoms in the past four weeks and actions taken for it. The data collected was screened before it is analyzed. Data analysis was done by using calculator. Results From the total 297 respondents 286 (96.2%) had reported self-medication in the last one month before the study period. The most common types of ailments for which the respondents reported to have practiced self-medication were cough, cold and sore throat 90(30.3%), followed by headache 66(22.2%), diarrhea 52(17.5%) ,abdominal pain 47(15.8%), fever 21(7.07%) and vomiting 10(3.3%). The reasons given for self-medication were; the illness was minor 226(76%) and previous experiences with similar ailments 31 (10.4%) were found to be the two major reasons given by the respondents for self-medication in this study. The majority of the respondents 242(81.4%) who practiced self-medication obtained information on self-medication from friends and 29(9.7%) obtained information from family members. The most frequently used group of drugs used for self-medication were analgesics/antipyretics 177(59.5%) and antimicrobial which account 75(25.2%) each followed by antihelmenthics 24(8.08%).The main source of drugs for SM was in pharmacy 220(74.07%) followed by leftover drugs 41(13.8%) while drug retail outlet, and neighbors and relatives were the suppliers to 12.13% respondents each. Conclusion and Recommendation A significant number of respondents (96.2%) use S/M from those perceived illness. Majority of the self-medicated individuals used due to minor illness. The most common category of drugs used was analgesics/antipyretics and antimicrobials. And the reason reported for using S/M was minor illness and previous experience with the illness. Most of respondents obtained drugs easily from pharmacy. So, pharmacies are the major sources of drugs used for S/M. The increased of drugs storage to treat similar illness/symptom and drugs left over from previous use contribute to the increase in the S/M practice. Common drugs store reported by respondents who store modern drugs were analgesic/antipyretic. Most of the respondents stored the drug in locked cabinets. A lot is need to be done in educating the public including the health care providers on the type of illnesses that can be self-diagnosed and self-treated, the type of drugs to be used for S/M, and the proper use of drugs. During dispensing of drugs emphasis should be given to all drug consumers and dispenser because of resistance and side effects of drug is the main challenging problem even in the world. Food, Medicines and Healthcare Administration and Control Authority (FMHACA) needs to effectively implement laws on drug handling and dispensing so as to take necessary measures on illegal providers of drugs.

Management of Plastıc Bronchıtıs in Chıldren: A Case Report and Lıterature Revıew

Jun 2020 DOI 10.14302/issn.2474-3585.jpmc-20-3416
Sarper Erikci VolkanCorresponding author Sağlık Bilimleri University, Department of Pediatric Surgery, Tepecik Training Hospital, Izmir, Turkey

Plastic bronchitis (PB) is a rare disease characterized by the presence of mucofibrinous plugs which may occlude and conform the shape of tracheobronchial tree. These casts are exteremely cohesive. Most common presenting symptoms include cough, fever and dyspnea and if the cohesive casts occlude the airway totally life-threatening complications and even death may occur. The aim of treatment is to remove the casts and adress the symptoms. In this study a 6-year-old boy with PB is presented. In addition to medical treatment obstructing casts were removed via rigid bronchoscope. It is aimed to review the clinical and radiographic features and choices of treatment in this disease.

A Meningeal Syndrome Revealing A Tetanus in A Togolese: Case Report and Review of the Literature

Aug 2019 DOI 10.14302/issn.2470-5020.jnrt-19-2983
Léhleng AGBACorresponding author Neurology Department, University Hospital Center of Kara, Kara University, PoBox 18 Kara (Togo)

Although it is a vaccine-preventable disease, tetanus is frequently found in sub-Saharan Africa. Because of its rarity, this disease poses two problems for doctors of the 21st century: to make early diagnosis in order to refer patients to appropriate care structures, and to continue to ensure correct prevention of an affection that few current doctors have met. In it generalized form, the diagnosis of tetanus is easy, but when the beginning is localized, tetanus can be change with other diseases leading to a diagnostic wandering and a delay of adequate management. We report a case of tetanus in an 18-year-old male, who was received for neck pain and stiffness of the neck with a positive Kernig sign associated to fever since 48 hours. Initially treated for meningitis, the patient will develop at day 3 of hospitalization, the signs of generalized tetanus which led to evoked the diagnosis of tetanus. This diagnosis was reinforced by the notion of a rusty nail injury to the soles of the right foot 3 weeks before hospitalization and the absence of anti-tetanus vaccination. After using tetanus serum and vaccination with antibiotics (Metronidazole and Penicillin) and Diazepam in association with stripping of the wound under the foot, the patient was improved. This case illustrates that any neurological sign with the first trismus must evoke until proof of the contrary, a tetanus especially in case of association with a wound even if the immunization schedule is up to date.

Essential Oils from Plants

Dec 2018 DOI 10.14302/issn.2576-6694.jbbs-18-2489
Butnariu MonicaCorresponding author Banat’s University of Agricultural Sciences and Veterinary Medicine “King Michael I of Romania” from Timisoara, Timis, Romania

Essential oils, called volatile oils or ethereal oils, are natural metabolic secretions of plants, the role of which is not yet fully understood by science. Some specialists consider them to be true plant hormones, fluid manifestations of the immune system of plants, in the sense that they contribute to the removal of pests, attracting, instead, pollinating agents, which are some insects and birds. Small, light–colored spherical structures, is, in fact, modified filaments, which behave like some secretory glands of essential volatile oils. They are the ones who give the fragrance of the aromatic plant and have, in the case of salvation, medicinal curative properties, such as fever reduction, blood cleansing, and relieving pain. Essential oils are products isolated from plants or organs through a physical process that have a certain volatility (higher or lower) and possesses an agreeable odour characteristic of the source from which they originate. They are also known as volatile or essential oils and their name are usually given by the popular name of the plant from which they are extracted. The most important characteristic of these mixtures, which also gives the special economic value, is the specific smell. This is the basis for their use in perfumery, cosmetics and the food industry. Many essential oils have special therapeutic qualities, some of which have been known and used since antiquity. 

Fungal Diversity Open Access

Saccharomyces Kluyveri Fungemia in a Patient with Human Immunodeficiency Virus Infection

Nov 2018 DOI 10.14302/issn.2766-869X.jfd-18-2276
Cheikhrouhou FatmaCorresponding author Mycology and parasitology Laboratory- Habib Bourguiba hospital 3029 Sfax -Tunisia.

We report a case of a young woman with acquired immune deficiency syndrome admitted with fever and abdominal pain. Saccharomyces kluyveri was isolated in blood culture. She was successfully treated with fluconazole. This case demonstrates the pathogenicity of Saccharomyces Kluyveri in immunocompromised host.

Safety, Tolerability, Efficacy and Logistics of Administration of Three Types of Therapeutic Feeds to Children with Severe Acute Malnutrition (SAM)

Aug 2018 DOI 10.14302/issn.2379-7835.ijn-18-2262
Mrudula PhadkeCorresponding author Sr. Adv. NHM, Mumbai, India

Objective: To analyse safety, tolerability, efficacy and logistic issues related to administration of 3 types of therapeutic feeds to children with severe acute malnutrition (SAM) from tribal district of Nandurbar, Maharashtra. Design: A three arm open label, block randomized trial using 3 therapeutic feeds i.e. commercially available ready to use therapeutic feed (C-RUTF), locally prepared ready to use therapeutic feed ( L-RUTF) & amylase rich food(ARF) was given to 1092 tribal children of SAM in Nandurbar District, Maharashtra, India during 2014-2015. Setting: Tribal district of Nandurbar, Maharashtra. Participants: 1092 children of SAM, 766 on C-RUTF, 184 on L-RUTF & 143 on ARF followed on treatment for 8 weeks. Outcomes: The recovery rates in the three groups, any untoward effects during treatment and logistic aspects of procurement, delivery, storage & administration of therapeutic feeds. Results: Total number of children with SAM were 1092. Gr 1 – Out of 765 children of SAM, 404 (52.8%) recovered on C-RUTF. Gr 2 – 80 (43.5%) recovered out of 184 on L-RUTF. Gr 3 – 64 (44.8%) recovered on ARF at the end of 8 weeks of treatment, the difference being statistically significant between C-RUTF & others. Out of 38 children on C-RUTF, it was observed that 1 had diarrhoea, 1 had vomiting, 1 had fever, 4 children reported more activity in terms of playfulness, more speaking & smiling. 31 children had nothing specific to report. Out of 34 children on L-RUTF, 6 children reported diarrhoea, 1 had vomiting & 4 children reported fever. 3 children reported more activity. 23 children had nothing specific to report. Out of 19 children on ARF, 1 had diarrhoea, 1 had vomiting, 1 had fever, 3 reported more activity. 13 had nothing specific to report. Untoward effects were noted in 3 out of 38 (7.89%) in C-RUTF group, 11 out of 34 (32.35%) in L-RUTF group and 3 out of 19 (15.7%) in ARF group. Conclusion: C-RUTF was found to be more efficacious, with least untoward effects, easy to administer and was more palatable when compared to L-RUTF & ARF.

Evaluation of Crest Guideline Validity for Diagnosis of Non-Facial Cellulites

Jun 2016 DOI 10.14302/issn.2471-2175.jdrt-15-836
Abiri SamanehCorresponding author Department of Emergency, Iran University of Medical University, Tehran, Iran.

Cellulitis is an acute, spreading pyogenic inflammation of the dermis and subcutaneous tissue, usually complicating a wound, ulcer, or dermatosis. Inappropriate diagnosis of cellulitis is a problem and would need prospective rather than retrospective studies to quantify the extent. There is one national guideline for the management of patients with cellulitis. The aim of this study is to determine the validity of Crest guideline in the patients with non-facial cellulitis. This prospective cohort study was conducted on all Adult patients with cellulites who were admitted at Resole-Akram and Sina emergency department between November 2013 and January 2014. Based on admission duration, the patients were randomly divided into two groups including primary and secondary outcome, <24-hours or >24-hours admission, respectively. Out of 89 admitted patients, 55% were hospitalized over 24 hours and 20% of them had significant systemic symptoms. The most patients (n= 42) had either systemically ill or systemically well or class II followed by classes I (n=28), III (n=18), and IV (n=1). There was significant relevancy between age, fever, PR, infected organ, leukocytosis, diabetes mellitus, IUDA, human bite, and primary outcome. In conclusion, factors associated with admission were age, presence of multiple comorbid conditions, diabetes mellitus, human bite, IUDA, infected organ, leukocytosis and fever. These results showed that the decision in the emergency department was mostly the same as Crest guideline and the prospection of admission and discharge of these patients was almost according to the educations of Crest guideline.

Nephrology Advances Open Access

Acute Bilateral Hydro Nephrosis after the Use of Dapagliflozin

Feb 2016 DOI 10.14302/issn.2574-4488.jna-15-712
Bernieh BassamCorresponding author Nephrology, Department of Internal Medicine, Tawam Hospital, Al-Ain, United Arab Emirates.

Background Dapagliflozin; the new oral hypoglycemic agent; is a sodium-glucose cotransporter-2 (SGLT2) inhibitor that acts by inhibiting glucose reabsorption in the proximal tubule of the nephron. Main reported side effects are osmotic diuresis, dehydration, urinary tract and genital infections. Here, we report a case of acute bilateral hydronephrosis after the introduction of dapagliflozin. Case Presentation A 52 year old nurse lady, with 15 year history of type2 diabetes mellitus (T2 DM) complicated by type4-renal tubular acidosis, hypertension, proteinuria, and hyperlipidemia. Patient had two episodes of UTI’s in 2011 required full urologic work up, were successfully treated with simple courses of oral antibiotics. CT pyelography done in 2011 was normal. Dapagliflozin was added to her therapeutic regimen in March 2015. Results Within 48 hours after starting dapagliflozin, she reported increased urine output. Ten days later; she developed severe bilateral loin and lower back pain, followed by suprapubic pain, dysuria and fever. Urine analysis and cultures confirmed E. coli urosepsis. Renal US revealed echogenic kidneys with 12 mm bilateral hydronephrosis, normal ureters and urinary bladder. Discontinuation of dapagliflozin in April 2015 resulted in resolution of symptoms. Repeat CT of the abdomen in July 2015 revealed no hydro nephrosis. Conclusions This is the first case report of reversible bilateral hydronephrosis after the use of dapagliflozin. The cause of hydronephrosis, could be explained by over-diuresis and/or by the unmasking of underlying subclinical obstruction in both uretero-pelvic junctions (UPJ).

Pseudotumor Tuberculosis Of Liver: A Rare Entity

Feb 2015 DOI 10.14302/issn.2578-2371.jslr-14-539
Soufi MehdiCorresponding author Department of digestive Surgery, Faculty of medicine Oujda, University Mohammed first, Oujda -Morocco

We present a rare case of a 46-year-old man who presented with recurrent fever and abdominal pain without other symptoms. Laboratory data were no specific for diagnosis. Abdominal imaging revealed a pseudotumor liver. A diagnosis of isolated liver tuberculosis with abscess component was confirmed with US-guided liver biopsy and histopathological examination. The patient received antibacillous drugs with success.

Socio-Economic and Demographic Pattern of HIV Occurrence Amongst Attendees in a Tertiary Care Hospital in Eastern India.

Nov 2013 DOI 10.14302/issn.2324-7339.jcrhap-13-266
Chandra Sadhukhan ProvashCorresponding author I. C. M. R. Virus Unit Kolkata, I.D and B.G Hospital Campus, GB-4 (East Wing), 1st Floor, 57, Dr. Suresh Chandra Banerjee Road, Beliaghata, Kolkata-700010

Objective: Toanalyze the socio-economic pattern amongst HIV patients in eastern and north-eastern India as measured by different parameters such as educational status, wealth, marital status, sexual behaviour. Methods: This study involved 650 HIV seropositive individuals enrolled in a HIV Apex Clinic in a tertiary care hospital in Kolkata, India during 2006 to 2011. Socio-demographic data were obtained while keeping the names of HIV seropositive individual’s names confidential. HIV testing was done according to the guidelines of NACO, India. Diagnoses of different common opportunistic infections were also done. Results: Out of the 650 individuals, 53% reported to have presenting symptoms of low grade fever, 21% had weight loss, general weakness and malaise. 13% reported to have frequent skin rashes, 13% ported to severe seizures and lack of coordination. 41.07 % of them had an income ranging from Rs1000 - 1500 per month. These individuals mainly were daily workers, labourers who work in per day income basis. 44.13% (89 out of 202) of the females were married at a young age, 65 (32.17%) were widowed whose husbands succumbed to HIV. Assessment of the educational qualifications reveals that those individuals affected reveals that 65% of the males received education till standard VIII, 25% received elementary education till standard IV. Conclusion: The study highlights the sectors of the socio-economic class who need more attention to tackle the HIV burden. The analysis of the socio-economic status reveals the low income and lack of education are main contributing factors towards the spread of this disease in this region.

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