by Ajay Khandal and D. Raghuraman
Case Report
Infectious diseases including Dengue illness remains the commonest cause of hospitalization in Indian settings. It is a significant global public health problem, with 2.5 billion world's population at risk and an estimated 50 to 390 million annual infections. Clinically, dengue illness manifestation varies from asymptomatic state to severe symptomatic disease. Symptomatic disease events in turn range from self-limiting dengue fever (DF) to severe dengue. Severe dengue, manifests as; dengue hemorrhagic fever (DHF), hypovolemic shock—dengue shock syndrome (DSS) or severe organ impairment. Thrombocytopenia is a common element to both dengue fever and severe dengue; and clinicians, unfortunately, tend to ‘react' to thrombocytopenia with platelet transfusions at predetermined platelet thresholds. Readily available lab parameters to guide the clinician of impending platelet recovery is needed, one such parameter gaining recent interest is Platelet Indices (PIs): mean platelet volume (MPV) and platelet distribution width (PDW). Serially observing mean platelet volume along with Platelets might be valuable, with a rising trend in MPV suggesting platelet and patient recovery.
American Journal of Clinical Medicine Research. 2017, 5(4), 59-63. DOI: 10.12691/ajcmr-5-4-5
Pub. Date: July 20, 2017
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by Riyadi Adrizain and Djatnika Setiabudi
Original Research
Dengue is the most rapidly spreading mosquito-borne viral disease worldwide with estimated 30-fold increase in incidence over the last five decades. The recent study had found an increase in the number of admissions of cases of dengue fever with reactive NS1 antigen. The aim of this study was to evaluate the utility of NS1 antigen as a diagnostic marker and to determine whether there is a higher risk of severe dengue infection for patient with positive NS1 antigen. This was a retrospective analysis study conducted in 7 referral Hospitals in Bandung, West Java, Indonesia. The medical records of all the individuals admitted to the Hospital from 1 January to 31 December 2015 were evaluated. We used a questionnaire as a tool for data collection consisted of the epidemiological, clinical manifestation, laboratory results and final diagnosis data that were collected during the period of hospitalizing. In 2015 there were 4.096 cases of dengue viral infection hospitalized. Most of the patients with positive NS1 antigen were admitted at early phase (0-2 days) and regular phase (3-5 days). Platelet count >100.000/mm3 was significantly associated with positive NS1Ag assay, while lower thrombocytopenia (platelet count <50.000/mm3) was significantly associated with positive IgM dengue antibody. Severe cases of dengue viral infection of DHF significantly more often happen on patient with IgM antibody dengue positive (P<0.005). NS1 Ag assay is useful, sensitive and specific for the diagnosis of dengue detection, with good sensitivity and specificity during acute phase when detectable antibodies still negative.
American Journal of Clinical Medicine Research. 2017, 5(4), 55-58. DOI: 10.12691/ajcmr-5-4-4
Pub. Date: July 18, 2017
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by Mohammedelhassan Ahmed Mohammedelhassan and Mamoun Magzoub
Original Research
Objective: Migraine is one of the most frequent disabling neurological conditions and very bad headache with a major impact on the patient's quality of life. The objective of this study was to evaluate the effectiveness of Prednisolone in treating migraine. Methods: A cross sectional, hospital-based study was conducted. All patients (1020) were received Prednisolone 0.5 mg/kg/day for 7 days followed by tapering by 1 tablet (5 mg) every 7 days. The patients were followed minimally for six months after receiving treatment.Results: All patients responded to the treatment and all their associated symptoms disappeared. We think this approach is the best one for treating migraine. Conclusion: We think that our approach is the best one in treating migraine, so our recommendation is to use steroids (Prednisolone tablets, in a dose of 0.5 mg / kg/day for 7 days, followed by tapering by 1 tablet (5 mg) every 7 days) as a protocol for the treatment of migraine. The individual dose adjustment is required in certain cases. From this study we conclude that, firstly we can say we have got the answer of the big question: what is migraine. Secondly, we think we present a nice explanation of the vascular phenomenon associated with migraine. Number third, we introduce new common symptom associated with migraine. Lastly we introduce new and effective treatment for migraine.
American Journal of Clinical Medicine Research. 2017, 5(4), 49-51. DOI: 10.12691/ajcmr-5-4-2
Pub. Date: July 11, 2017
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by Sudung O Pardede, Yunilasari and Darmawan B Setyanto
Original Research
Hypertension in adolescent has been often associated with other cardiovascular risk factors. Contributing factors of hypertension in adolescent are multifactorial. We aim to determine the prevalence of hypertension in adolescent and its potentially associated factors. A cross-sectional study involved 313 children aged 12-18 years, where were randomly selected from Junior High Schools in Central Jakarta. Information about family history, race/ethnic, birth weight, physical activity levels, smoking and consumption of alcohol was gathered by questionnaire. Body weight, height, and blood pressure were measured. Hypertension was defined according to the Fourth Report of National High Blood Pressure Education Programme Working Group on High Blood Pressure in Children and Adolescent. The study included 313 adolescents with mean age 13.97±1.02 years. Prevalence of hypertension was 9.6%. Bivariate analysis showed that family history of hypertension (parental hypertension; p = 0.012; CI 95% = 1,20-6,02) and overweight/obesity (p<0.001; CI 95% = 2,99-14,42) were significantly associated with hypertension. The multivariate analysis indicated that overweight/obese adolescents displayed six times more chance of having hypertension than adolescents with light/normal weight (OR = 6.5; CI 95% = 2.99-14.43). Gender, low birth weight, race/ethnic, physical activity, and smoking were not significantly associated with hypertension. The prevalence of hypertension in the sample studied was high. Overweight/obesity and family history of hypertension were significantly associated with hypertension. The prevention of overweight and obesity can decrease the prevalence of hypertension.
American Journal of Clinical Medicine Research. 2017, 5(4), 43-48. DOI: 10.12691/ajcmr-5-4-1
Pub. Date: July 07, 2017
12871 Views3738 Downloads