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Volume 9, Issue 4 (Fall 2023)
Abstract
Aims: Scrub typhus (ST) is an important cause of acute undifferentiated febrile illness. ST is caused by Orientia tsutsugamushi transmitted by the bite of a trombiculid mite. It is endemic in East Asia, the South Pacific, and the Indian subcontinent. In India, ST accounts for about 23% of all febrile illnesses. This study aimed to assess the clinical profile of ST and associated risk factors.
Materials & Methods: This cross-sectional study was conducted on 47 participants in the general medicine department of a tertiary medical college hospital in Coimbatore, south India from January 2020 to June 2021. All the participants suffered from fever and diagnosed with ST based on seropositivity of IgM enzyme linked immunosorbent assay (ELISA). Complete blood count, renal and liver function tests, and chest X-ray were performed. All the participants were admitted to the hospital and followed up.
Findings: The participants' age ranged from 18-80 years with a mean age of 48.40 years. Most ST cases occurred during January (48.9%). Fever was the common symptom (95.7%), while eschar was reported in only 19.1% of the individuals. Thrombocytopenia was detected in 12.8% of ST patients. Hypoalbuminemia was reported in 80% of those with hepatic dysfunction, and anemia was present in 28% of those with acute kidney injury.
Conclusion: This disease could present as a severe illness even in non-ICU (intensive care units) settings, and a high degree of suspicion is necessary for diagnosing and treating ST patients in endemic areas.
Volume 10, Issue 1 (Winter 2024)
Abstract
Background: This study aimed to evaluate serum levels of interleukin-6 (IL-6) and D-dimer and their association with morbidity and mortality in elderly coronavirus disease-19 (COVID-19) patients and to assess their clinical outcomes.
Materials & Methods: This retrospective observational study was conducted on elderly COVID-19 patients (≥60 years) diagnosed via reverse transcription-polymerase chain reaction (RT-PCR) or radiological tests in a South Indian tertiary care hospital. Data encompassed demographics, comorbidities, symptoms, IL-6 and D-dimer levels, oxygen (O2) requirement, duration of hospital stay, and outcomes. Statistical analysis involved Chi-square test. A p-value of < .05 was considered statistically significant.
Findings: Among 1448 screened patients, 1380 patients with a mean age of 68.85±6.985 years were included in this study, of whom 61.67% were male. The mortality rate was 12.1% in males and 11% in females. Fever, cough, hypertension, and diabetes were common in most of the patients. The mean D-dimer and IL-6 levels were 2.687±5.189 mg/L fibrinogen equivalent units (FEU) and 95.72±335.62 pg/mL, respectively. Elevated D-dimer (71%) and IL-6 (87.7%) levels were significantly associated with oxygen requirement, morbidity, and mortality (p= .000). Sub-group analysis revealed a significant association between D-dimer and IL-6 levels and O2 requirement and mortality in diabetic and hypertensive patients (p= .000).
Conclusion: Serum IL-6 and D-dimer levels are significantly associated with morbidity and mortality in elderly COVID-19 patients. Elevated levels of these biomarkers also influence O2 requirement and mortality in patients with comorbidities, suggesting their potential use in risk stratification and management strategies for this vulnerable population.
