Scrub typhus is a zoonosis caused by the pathogen Orientia tsutsugamushi(O.tsvtsugamushi). The disease has significant prevalence in eastern and Southeast Asia.Usually presenting as an acute febrile illness,the diagno...Scrub typhus is a zoonosis caused by the pathogen Orientia tsutsugamushi(O.tsvtsugamushi). The disease has significant prevalence in eastern and Southeast Asia.Usually presenting as an acute febrile illness,the diagnosis is often missed because of similarities with oilier tropical febrile infections.Many unusual manifestations are present,and these are described in this review,together with an outline of current knowledge of pathophysiology.Awareness of these unusual clinical manifestations will help the clinician to arrive at an early diagnosis,resulting in early administration of appropriate antibiotics.Prognostic indicators for severe disease have not yet been clearly established.展开更多
Objective:To determine whether blood nitrite levels are elevated in patients with leptospirosis. Methods:Male patients Fulfilling clinical and epidemiological criteria for a diagnosis of leptospirosis were recruited.T...Objective:To determine whether blood nitrite levels are elevated in patients with leptospirosis. Methods:Male patients Fulfilling clinical and epidemiological criteria for a diagnosis of leptospirosis were recruited.Those with MAT title of≥400 together with those seroconverting to a titer of≥200 were included in the analysis.Serum nitrite levels were measured in these patients and age.sex matched healthy controls.Results:Patients from 3 hospitals(n=75) were screened during a 3 month period from 28th June to 3rd September 2009,of whom 20 were eligible for the study.Serum nilrile levels were found to be significantly higher in patients with acute leptospirosis[n=20.(0.359±0.229)μM]compared to controls[(n= 13.(0.216±0.051)μM] (P=0.014).A significant correlation was also observed between the MAT titre and the day of illness (r = 0.547;P【0.0001).Conclusions:Serum nitrite levels are higher in patients with acute leptospirosis compared to age and sex matched controls.No correlation could be assessed with severity of illness,as sample size was inadequate to determine this.展开更多
This review concentrates on different aspects of malaria chemoprophylaxis,namely drug combinations,resistance,impact of malaria prevention in pregnancy and cost effectiveness. A MEDLINE search was performed for all ar...This review concentrates on different aspects of malaria chemoprophylaxis,namely drug combinations,resistance,impact of malaria prevention in pregnancy and cost effectiveness. A MEDLINE search was performed for all articles with the key word ’Malaria’ in the title field and ’Prophylaxis’ in any field.The search was restricted to articles published in English within the last decade(1999-2009).Data sources included review articles published in core clinical journals,cohort studies,interventional studies,case control studies and cross sectional analyses. The mechanism of action,trial evidence of efficacy,side effects and geographical distribution of resistance is discussed for each prophylactic drug regimen.Impact of prophylaxis in pregnancy and the cost considerations are discussed under two separate sub topics.展开更多
文摘Scrub typhus is a zoonosis caused by the pathogen Orientia tsutsugamushi(O.tsvtsugamushi). The disease has significant prevalence in eastern and Southeast Asia.Usually presenting as an acute febrile illness,the diagnosis is often missed because of similarities with oilier tropical febrile infections.Many unusual manifestations are present,and these are described in this review,together with an outline of current knowledge of pathophysiology.Awareness of these unusual clinical manifestations will help the clinician to arrive at an early diagnosis,resulting in early administration of appropriate antibiotics.Prognostic indicators for severe disease have not yet been clearly established.
文摘Objective:To determine whether blood nitrite levels are elevated in patients with leptospirosis. Methods:Male patients Fulfilling clinical and epidemiological criteria for a diagnosis of leptospirosis were recruited.Those with MAT title of≥400 together with those seroconverting to a titer of≥200 were included in the analysis.Serum nitrite levels were measured in these patients and age.sex matched healthy controls.Results:Patients from 3 hospitals(n=75) were screened during a 3 month period from 28th June to 3rd September 2009,of whom 20 were eligible for the study.Serum nilrile levels were found to be significantly higher in patients with acute leptospirosis[n=20.(0.359±0.229)μM]compared to controls[(n= 13.(0.216±0.051)μM] (P=0.014).A significant correlation was also observed between the MAT titre and the day of illness (r = 0.547;P【0.0001).Conclusions:Serum nitrite levels are higher in patients with acute leptospirosis compared to age and sex matched controls.No correlation could be assessed with severity of illness,as sample size was inadequate to determine this.
文摘This review concentrates on different aspects of malaria chemoprophylaxis,namely drug combinations,resistance,impact of malaria prevention in pregnancy and cost effectiveness. A MEDLINE search was performed for all articles with the key word ’Malaria’ in the title field and ’Prophylaxis’ in any field.The search was restricted to articles published in English within the last decade(1999-2009).Data sources included review articles published in core clinical journals,cohort studies,interventional studies,case control studies and cross sectional analyses. The mechanism of action,trial evidence of efficacy,side effects and geographical distribution of resistance is discussed for each prophylactic drug regimen.Impact of prophylaxis in pregnancy and the cost considerations are discussed under two separate sub topics.
