Journal of Acute Disease

133-139

Authors: Shivcharan Jelia, Banwari Lal, Divya Airan

Objective: To study the value of some biochemical indicators and Peradeniya Organophosphate Poisoning scale in prediction and prognosis of organophosphorus poisoning. Methods: This was a hospital-based prospective, observational study. Various biochemical tests viz. complete blood count, random blood sugar, liver and renal function tests, creatine phosphokinase, and electrolytes were performed. Patients were assessed based on the Peradeniya Organophosphate Poisoning scale. All the patients were followed till the end point like recovery/death. Results: Out of the 100 patients, 72% were males and 28% were females. The majority of the patients were farmers and 21 to 30 years of age. Suicidal was the most common manner (92, 92%). Based on the Peradeniya Organophosphate Poisoning scale, 47% were mild, 34% moderate, and 19% severe. Serum creatinine, creatine phosphokinase, serum glutamic-oxaloacetic transaminase, serum glutamic pyruvic transaminase, and alkaline phosphatase levels showed a significant correlation with severity. Conclusions: Some biochemical indicators such as creatine phosphokinase, alkaline phosphatase can be used as prognostic markers of organophosphorus poisoning. The Peradeniya Organophosphate Poisoning scale can be used for assessing severity of the poisoning.

145-150

Authors: Sanjeev Sengupta, Ashish Kumar Shukla, Kunal Kishore, Jitesh Goel, Amlan Ghosh

Objective: To investigate demography, etiology, and clinical profile and to analyze the outcomes of patients presenting with febrile encephalopathy at a tertiary care center in Eastern India. Methods: This retrospective, observational study included a total of 50 patients (>18 years) who presented with fever and encephalopathy. All patients underwent blood analysis; culture test for blood, urine, sputum, cerebrospinal fluid, and other body fluids; chest and abdominal ultrasonography; neuroimaging; polymerase chain reaction test, and other relevant tests as and when applicable. Results: The mean age of all enrolled patients was (58.0±16.0) years with male to female ratio of 1.27:1. Viral encephalitis was diagnosed in 16 (32%) patients, sepsis-associated encephalitis in 14 (28%), bacterial meningoencephalitis in 8 (16%) and tuberculosis meningoencephalitis in 5 (10%). The mean hospital stay was 10 (4, 17) days. At 6-month follow-up, 10 (20%) patients died, 10 (20%)patients recovered with sequelae (cognitive impairment, critical careneuropathy, etc.), and 30 (60%) patients recovered without sequelae. A statistically significant association was noted between GlasgowComa Scale (<8) and mortality rate (P=0.02). Conclusions: Primary central nervous system infection is the mostfrequent etiology of febrile encephalopathy and viral encephalitisis the most common etiological cause. Accurate, systematic, timelydiagnosis and management are prime factors to reduce mortality andmorbidity.

157-162

Authors: Hamed Karami, Fatemeh Jafari, Ali Khani Jeihooni, Sanaz Amiri, Tahereh Hashemifard, Asadollah Niknam

Objective: To investigate the epidemiological situation of animal bites in Rostam city of Fars province. Methods: This is a cross-sectional study. Cases of animal bites registered in health centers of Rostam city of Fars province from the beginning of 2014 to 2020 were analyzed using the census method. The tool for collecting information was the portal of the Ministry of Health and the registration offices of people who were referred to the rabies center. Results: A total of 628 cases of animal bites registered in health centers of Rostam city of Fars province from the beginning of 2014 to 2020. The mean age of the injured was (31.3 ± 20.2) years. Of the total injured cases, 414 (65.9%) were male, and 491 (78.2%) lived in villages. Most of the cases were bitten by dogs (n=420, 66.8%) and the upper limb was involved in 280 (55.2%) cases. In addition, an increasing trend was observed in the incidence of animal bites from 2015 to 2020. Conclusions: The incidence of animal bites in Rostam City is high, and most of the cases occur in rural areas. Considering the injuries caused by animal bites, the risk of rabies transmission, and the high costs of vaccination and serum therapy, it is necessary to hold control, educational, and vaccination programs.

169-172

Authors: Reena Singh, Naimish Patel, Nidhi Mehta, Gaurav Singh, Nirav Patel

Objective: To evaluate the complications of central venous catheterization (CVC). Methods: A prospective, observational study was conducted at a tertiary care center in India from December 2018 to September 2020. Critically ill patients (aged ≥18 years) in the intensive care unit undergoing CVC procedures were included in the study. Baseline demographics and detailed medical history were recorded. Chest X-rays and electrocardiography were performed on all the patients. Complications associated with CVC were recorded. Results: A total of 100 patients with the indication for centralvenous catheter insertion were included. The majority (81%) of the patients were inserted with CVC at the right internal jugular vein. Complications such as arterial puncture (2%), hematoma (4%), blood clot formation (4%), catheter kinking (3%), thoracic injury(1%), thrombophlebitis (6%), sepsis (9%) and nerve injury (1%)were reported. Conclusions: Though central venous access is preferred in management of critically ill patients, it has its risks. However, early recognition and prompt management of complications may reduce mortality and morbidity. Physicians and intensive care unit intensivists should be vigilant for central venous catheter-related complications. Suitable site selection, operator experience, and proper catheter maintenance are associated with optimal outcomes.