Hemophagocytic lymphohistiocytosis (HLH) is an hyperinflammatory state resulting from increased secretion of proinflammatory cytokines, which are responsible for clinical, biological and cytological ...manifestations.
The aim of our study is to describe the epidemiological, clinical, biological, etiological and evolutionary profile of HLH in Tunisia.
A retrospective study that involved patients, with images of hemophagocytosis in myelograms analyzed at the laboratory of biological hematology of the University Hospital "Hédi-Chaker" of Sfax-Tunisia, followed at these departments: hematology, internal medicine, department of infectious-diseases and department of gastroenterology, (June2017- May2021). First, we identified all patients with hemophagocytosis images. Secondly, we selected the patients who fulfilled the diagnostic criteria of the HLH-2004-score.
Nineteen patients were included in this study. Nine men and 10 women with a mean age of 37.95 years. Fever was present in all patients. Organomegaly was described in 74% of cases. The most frequent cytopenia was anemia (100%). Hypertriglyceridemia was noted in 79% of cases and hyperferritinemia (> 500 ng/mL) was ubiquitous. In myelogram, 68% of patients had slides showing numerous or very numerous images of hemophagocytosis. The infectious pathology was the most common cause of HLH (42%). No cause was found in 10% of cases. The corticosteroid therapy at a dose of 1 mg/kg/day was prescribed in 89% of our patients. The overall evolution was favorable in 58% of cases. The mortality was not associated with the causal pathology (p=0.218).
Secondary HLH is likely to be under-recognized, which contributes to its high morbidity and mortality. Early recognition is crucial for any reasonable attempt at curative therapy.
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Background and purpose: Older adults with chronic diseases are at higher risk for infectious diseases, especially COVID-19. The aim of this study was to investigate the clinical manifestations in ...aged people with COVID-19 in Mazandaran province between March 2020 and September 2021. Materials and methods: In a retrospective descriptive study, we studied demographic information, symptoms, and clinical manifestations of all patients over 60 years of age with COVID-19 admitted to medical centers affiliated with Mazandaran University of Medical Sciences. The checklist provided by the Ministry of Health and Medical Education available in the Medical Care Monitoring Center (MCMC) of the province was used. Results: Totally, 40804 older adults were hospitalized, including 21405 (52.36%) women. Most of the patients aged 60-75 years old (68%). In 49%, the time from the onset of symptoms to hospitalization was less than five days. Respiratory diseases (34%), heart disease and hypertension (25%), and diabetes (20.99%) were the most common underlying diseases. The main clinical symptoms were cough (26.43%), respiratory distress (26.33%), and fever (22.77%). The mortality rate was 12.08% (n= 4930). Conclusion: According to this study, chronic diseases in older population worsens the symptoms of COVID-19, which is consistent with other age groups. Care and intervention measures, such as self-care education could be of great benefit in promoting the health of aged people.
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Background: The clinical diagnosis of allergic rhinitis requires comprehensive data from the history and physical examination. Despite being a substantial component of the diagnosis for allergic ...rhinitis, there is a paucity of studies about clinical signs of allergic rhinitis in Indonesia. This study aimed to describe the clinical signs in allergic rhinitis patients at Dr. Hasan Sadikin General Hospital Bandung.Methods: This cross-sectional study was conducted at Dr. Hasan Sadikin General Hospital Bandung in 2021, including secondary data of patients with allergic rhinitis from medical records registered from 2017 to 2021. Data of the characteristics, clinical signs, and allergic rhinitis comorbidities were collected and presented in tables.Results: The most common clinical sign was turbinate hypertrophy (74%), followed by pale nasal mucosa (59%) and clear nasal discharge (59%). The most prevalent comorbidities were chronic rhinosinusitis, adenoid hypertrophy, and asthma.Conclusions: The clinical signs observed from allergic rhinitis patients may vary, with the most common findings, including nasal turbinate hypertrophy, pale nasal mucosa, and clear nasal discharge. The findings may help the clinicians to diagnose allergic rhinitis needed for therapy management.
African swine fever (ASF) is one of the most important infectious diseases of swine and has major negative consequences for affected countries. ASF is present in many sub-Saharan countries, Sardinia ...and several countries of eastern and central Europe, where its continuous spread has the swine industry on heightened alert. ASF is a complex disease for which no vaccine or treatment is available, so its control is based on early detection and rapid control of spread. For a robust and reliable early detection programme it is essential to be able to recognize the clinical signs and pathological changes of ASF, keeping in mind that in most cases the first introductions don't show high mortality nor characteristic clinical signs or lesions, but fever and some hemorrhagic lymph nodes. Knowledge of the main characteristics of this infection, including its current distribution and routes of transmission, is also essential for preventing and controlling ASF. This review addresses each of these topics and aims to update knowledge of the disease in order to improve early detection of ASF in the field and allow implementation of public health programmes.
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Feline panleukopenia (FPL) is a viral infectious disease caused by the feline panleukopenia virus (FPV) that affects cats of all ages. Clinical symptoms that appear in each individual cat vary ...greatly, depending on age, immune status, and the presence or absence of secondary infection. The aim of this research was to diagnose the FPL based on clinical signs and polymerase chain reaction (PCR) in cat with various ages. This study used 15 cats that showed one of clinical symptoms including lethargy, anorexia, fever, diarrhea, and vomiting. All cats were examined physically and by PCR of blood, then analyzed descriptively. The results showed that 10/15 (66.7%) cats were <7 months, 4/15 (26.7%) were 7-12 months, and 1/15 (6.6%) was >1 year old. Identification by PCR showed that 100% of the samples positive, so that all of cats diagnosed FPL. Clinical signs that commonly appeared in this study included anorexia (80%), fever (80%), vomiting (73.3%), lethargy (66.7%), and diarrhea (40%). Young cats <7 months commonly showed anorexia, fever, vomiting, and lethargy, cats aged 7-12 months commonly showed anorexia, fever, vomiting, and diarrhea, cat aged >12 months experienced anorexia and vomiting. Concluded that the predominant clinical symptoms of FPL in young cats were anorexia, fever, vomiting and lethargy, whereas in adult cats anorexia, fever, vomiting, and diarrhea. Clinical symptoms can be used for initial screening of FPL, but the causative diagnosis needs to be determined by polymerase chain reaction.
Background and Aims: Coronavirus disease 2019 (COVID-19) is an emerging disease, whose first case was reported in December 2019, and rapidly affected the world. Therefore, the present study was ...conducted to investigate the frequency and factors associated with morbidity and mortality due to COVID -19 in Ghaen, Iran.
Materials and Methods: This retrospective descriptive-analytical study used the information sources of the portal of Shohada Ghaen Hospital, Gaen, Iran, from March 2020 to December 2021, which was collected from 1,124 patients with suspected respiratory infection referring to the hospital. Data using Chi-square and Fisher's exact test for univariate relationships. Moreover, two-way logistic regression was used to investigate the causal relationships, and P<0.05 was considered statistically significant.
Results: In this study, the mean age of participants (n=1,124) was obtained at 51.6±24.5 years, and 546 (48.6%) subjects had a positive COVID-19 test by reverse transcription polymerase chain reaction, among whom 65 (11.9%) cases passed away. Clinical symptoms of body aches, coughs, diarrhea, and shortness of breath were associated with a positive COVID-19 test. It was also revealed that habitat, diabetes, cardiovascular and lung diseases, age, and job were risk factors of COVID-19 infection, and hospitalization in the ICU and age were identified as risk factors for COVID-19-caused death (P<0.05).
Conclusion: In the present study, cough and shortness of breath were found to be the most frequent symptoms among patients and deceased individuals. Since these symptoms may be associated with a worse prognosis, they require the special attention of medical staff. The findings of this study also showed that the elderly were more at risk of death from this disease than other age groups, which increased the need for more education and attention to this group of society.
Cattle diarrhea poses a significant risk to the global livestock sector, leading to considerable economic setbacks and impacting the well-being of animals. This research aimed to assess the clinical ...and hematological changes associated with idiopathic diarrhea in cattle in the Baghabari area of the Sirajganj District of Bangladesh. The study involved surveying dairy cattle to record their case history, followed by the collection and measurement of hematological indices in those suffering from idiopathic diarrhea. The survey identified 39 diarrheic crossbred cattle (2 males and 37 females), ranging in age from 1 month to 11 years. The findings revealed a higher prevalence of diarrheal cases in cows (94.87%) compared to oxen (5.13%), particularly among pregnant cows (64.86%). The most common historical observations included repeat breeding (81.08%), abortion (78.38%), decreased milk production (43.24%), fever (15.64%), and congenital defects (17.95%) in diarrheic cattle. Hematological analyses indicated a significant increase in lymphocyte and immunoglobulin levels, while eosinophil, basophil, and red blood cell distribution width levels were notably lower in diarrheic cattle compared to healthy ones. However, other hematological parameters remained unaffected. In summary, the study suggests that bovine diarrhea may influence hematological profiles and body physiology, with the extent depending on the disease’s etiology and complexity.
Dirofilaria immitis
is a nematode that can cause a disease that may present clinical signs from severe to absent. When dogs are symptomatic, the clinical signs are cardiorespiratory and nonspecific, ...which may be misleading. This study aimed to demonstrate the clinical presentations to cardiac care by evaluating 26 dogs subjected to clinical examination, complete blood count (CBC), specific tests for
D. immitis
infection, chest radiography, and echocardiography. Among them, 11 (42.3%) dogs were infected and 15 (57.7%) were non-infected. Most dogs presented with coughing (65.4%) and abnormal lung sounds (81%) independent of infection. Murmur at the tricuspid focus was present in 26.9% of the dogs, of which 57.1% were infected. Echocardiography revealed tricuspid regurgitation in 30.8% of the dogs and pulmonary regurgitation in 46.1%, of which 37.5% and 50% were infected, respectively. Worms were detected by echocardiography in 45.5% of the infected dogs. The x-rays showed that the bronchial pattern was present in 45.5% of the infected dogs and in 46.7% of the non-infected dogs. The interstitial pattern was present in 18.2% of the infected animals, in contrast to 6.7% of the non-infected dogs. The CBC results for all dogs were within the reference range, except for platelets. Although similar, the percentage of dogs with thrombocytopenia was higher among infected dogs (36.4%) than among the non-infected (6.7%). These results reinforce that due to the non-specific signs of infection, it is mandatory to perform parasitological assays when evaluating dogs presenting with cardiopulmonary signs.
Background: Juvenile idiopathic arthritis is the most common rheumatic disease in children, which includes a group of disorders that all have a common clinical manifestation of arthritis. The aim of ...this study was evaluation of the clinical and laboratory symptoms of children with idiopathic arthritis who treated with intravenous methylprednisolone pulse. Methods: This study is a descriptive cross-sectional study of 20 years in Imam Khomeini Hospital from 1993 to 2013. Information of 202 hospitalized patients diagnosed with JIA who had files, containing demographic, clinical and laboratory data were recorded. The software 17spss was used for data statistically analyzed. Results: The mean age of patients was 6.98±3.65 years. After treatment in all age and sex groups, the mean of Hb and HCT increased significantly and WBC and PLT decreased significantly. Mean CRP and ESR decreased significantly. Mean alkaline phosphatase was significantly reduced in boys. There were no significant changes in AST and ALT. At Ca and K levels, the decrease was significant. There was significant increase in Na. Ca level in boys and K level in girls decreased and Na level in boys increased significantly. Serum sodium also increased significantly in the group over ten years, potassium in the group of five to ten years and calcium in the group up to 5 years and over ten years decreased significantly. FBS did not change significantly. Blood pressure increased significantly. In this study, the highest joint involvement related to knee joint that was 89.7% and the lowest joint involvement related to neck joint that was 7.4%, which ultimately improved significantly By 76.7% in response to treatment. Conclusion: Due to its availability, improving patient function and reducing clinical symptoms, this treatment is recommended. However, the need for further studies and consultation of other specialists, including cardiovascular counseling, seems necessary.
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