Publications by authors named "Hardik D Desai"

15 Publications

  • Page 1 of 1

Symptomatic reinfection with COVID-19: A first from Western India.

J Family Med Prim Care 2021 Mar 8;10(3):1496-1498. Epub 2021 Apr 8.

Graduate Medical Doctor, Gujarat Adani Institute of Medical Sciences, Affiliated to K S K V University, Bhuj, Gujarat, India.

The reinfection of recovered COVID-19 patient is one of the major concerns worldwide. Here we report a case of previously recovered patient from Covid-19 who presented with symptomatic reinfection beyond 3 months. We report a case of 58 year old female patient who after presenting with symptomatic episode of RT-PCR confirmed COVID-19 in April 2020, presented with a new symptomatic infection by SARS-CoV-2 four months later. These 2 episodes of infection were caused by different sources as evident from her epidemiological correlates. This is the first epidemiologically, RAT, RT-PCR and antibody confirmed COVID-19 case of re-infection of SARS CoV-2 reported from Western India.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_2002_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140233PMC
March 2021

Prevalence and cross states comparison of case fatality rate and recovery rate of COVID 19/SARS-COV-2 in India.

J Family Med Prim Care 2021 Jan 30;10(1):475-480. Epub 2021 Jan 30.

Graduate Medical Doctor, Gujarat Adani Institute of Medical Sciences and K.S.K.V. University, Bhuj-Kutch, Gujarat, India.

Background And Aim: CFR and RR are important indicator of disease pandemic. As of now no data is available about cross-states analysis of these. We aimed to evaluate CFR and RR of COVID-19 across majorly affected States in India.

Method: We observed and compared data of confirmed COVID-19 cases, number of deaths, number of recovered/discharged cases and calculated CFR and RR across majorly affected States/UT in India from official database of Government of India, State Government official bulletin, accurate database worldometer.

Results: The data showed that Gujarat, Madhya Pradesh, West Bengal reported highest CFR on 8th April, 22nd April, 6th May, 1st June 2020 (95% CI 4.91 - 6.99). Kerala showed encouraging recovery rates 24.32%, 70.31%, 93.24%, 45.81% on 8th and 22nd April, 6th May and 1st June 2020 respectively. India had an average estimated weekly Recovery rate of newly discharged/recovered cases was 32.68% from 19th March to 1st June 2020. (95% CI 20- 45.4%). (The Recovery rate across India was 80.83% as on 22nd September 2020.).

Conclusion: The CFR of a disease varies greatly in different regions of the same Country and is influenced by numerous factors such as health control policies, medical standards, and detection efficiency and protocols apart from number of screening tests done. This comparison discusses need of evaluating policies with optimal reporting of medical history of affected persons when comparing COVID-19 case and fatality rates in different regions of the Country.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_1088_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132753PMC
January 2021

Demographic and clinico-radiological profile on High-Resolution Computerized Tomography (HRCT) thorax in mild or asymptomatic clinically suspected COVID-19 patients in high-endemicity area of India-Can HRCT be the first screening tool? -The DECRYPTION study.

Indian J Radiol Imaging 2021 Jan 23;31(Suppl 1):S122-S127. Epub 2021 Jan 23.

Gujarat Adani Institute of Medical Sciences, Affiliated to K S K V University, Bhuj, Gujarat, India.

Background: With COVID-19 cases rising, despite CT chest being of value in diagnosis and prognostication in COVID-19, its role in mild or asymptomatic suspected COVID-19, before RT-PCR test is lacking.

Method: This is a retrospective observational study involving asymptomatic or mildly symptomatic clinically suspected COVID-19 infection in a high endemicity area. Of 2532 HRCT chest database, 376 eligible cases were analyzed for clinico-radiological correlation for CT findings based CORADS and CT severity score between positive vs negative group.

Results: Of 376, 186 (48.46%) had COVID-19 features on HRCT in mild and asymptomatic suspected patients. 98 (26.06%) had CO-RARDS - 5, 88 (23.40%) had CO-RADS - 4. 48 (12.76%), 128 (34.04%), 14 (3.72%) had CO-RADS score of 3,2,1, respectively. Positive CT findings were more likely beyond 3 days of symptoms compared to those presenting earlier {days: (Mean) 4.2 vs 2.76} Positive CT was significantly associated with patients with anosmia and dyspnea. The common presenting symptoms were Fever 196 (52.12%) and followed by sore throat in 173 (46.01%). The common HRCT findings were Ground glass opacity (GGO) (74.60%), followed by Lymphadenopathy (LN) (27.92%). LN which was more prevalent in symptomatic patients {99/343 (28.86%) vs {6/33 (18.18%)} asymptomatics (: 0.04)}. Consolidation was significantly more in asymptomatics with COPD (: 0.004). 6 (3.22%) patients had CT score >17/25.

Conclusion: Chest HRCT picked 48.46% positive cases in mildly symptomatic and asymptomatic patients of which 3.22% had severe involvement (>17). Being a noninvasive, rapid, sensitive, low risk of cross infection with high reproducibility, chest CT is worth evaluating as screening modality even in asymptomatic and mildly symptomatic clinically suspected COVID-19.
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http://dx.doi.org/10.4103/ijri.IJRI_796_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996708PMC
January 2021

Clinicobiochemical Parameters and Predictors of Liver Disease in Hospitalized Asian Indian Pregnant Women in a Tertiary Care Center in Northern India.

Cureus 2021 Feb 17;13(2):e13405. Epub 2021 Feb 17.

Medicine, C U Shah Medical College, Surendranagar, IND.

Introduction  During pregnancy, liver dysfunction is more frequent than expected and may require specialized care. For the early diagnosis, it is important to determine if changes in liver physiology may develop into liver disease. Liver disease during pregnancy may require intervention from a hepatologist for adequate monitoring of mother-fetus health outcomes. This study was aimed to evaluate the clinical profile and predictors of maternal mortality in patients with liver diseases among Asian-Indian-females. Methods We conducted a prospective, open-label, consecutive all-comers study of 2,663 pregnant Asian Indian women admitted in the hospital, which included 92 with liver dysfunction. The medical aspects of the pregnancy were then followed prospectively with laboratory and clinical data during the hospital stay and analyzed. The current study was approved by the Institutional Ethical Committee. Results We found that 92 out of 2,663 patients had liver dysfunction with a prevalence of 3.45%. Fifty-four (58.7%) patients had icterus followed by fever in 23 (25.0%), hypertension in 22 (23.9%), central nervous system manifestations in 21 (22.8%), abdominal pain in 19 (20.6%), vomiting in 19 (20.6%), and pruritus in six (6.5%). Predictors of maternal mortality were icterus (p = 0.04), hepatomegaly (p = 0.04), presenting serum-bilirubin greater than 10 milligram% (mg%) (p = 0.008). The most common etiology was acute viral hepatitis (45.6%), followed by a hypertensive disorder of pregnancy (29.3%), acute fatty liver of pregnancy (1.1%), cholestatic jaundice (9.8%), hyperemesis gravidarum (2.2%), septicemic hepatitis (3.3%), dengue immunoglobulin M (IgM), and plasmodium vivax malaria antigen positive in (2.2%) each. Four patients (4.3%) were leptospira IgM reactive and had co-infection with hepatitis E virus. There was one patient (1.1%) with underlying chronic liver disease. Idiopathic liver disease was present in 5.4% of patients. Conclusion Liver disease is relatively common in Indian pregnant women. It is associated with high maternal and perinatal mortality, even in a tertiary referral center. When managing pregnancy in a tertiary care center, for adequate follow-up of the disease and to prevent adverse consequences for mother and child, it is important to discard liver alterations early. For this purpose, liver disease during pregnancy needs early diagnosis for proper management. Furthermore, it is difficult to manage patients with preexisting liver disease, and it may require specialized intervention from a hepatologist and a gastroenterologist.
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http://dx.doi.org/10.7759/cureus.13405DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7978133PMC
February 2021

Role of Self-Measured Home Blood Pressure Monitoring (HBPM) and Effectiveness of Telemedicine During the Era of COVID-19 Pandemic.

SN Compr Clin Med 2021 Mar 10:1-3. Epub 2021 Mar 10.

Graduate Medical Education, Gujarat Adani Institute of Medical Sciences, Affiliated to K.S.K.V University, Bhuj, 370001 Gujarat India.

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http://dx.doi.org/10.1007/s42399-021-00852-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7943330PMC
March 2021

Predictors of Mortality Amongst Tocilizumab Administered COVID-19 Asian Indians: A Predictive Study From a Tertiary Care Centre.

Cureus 2021 Feb 4;13(2):e13116. Epub 2021 Feb 4.

Graduate Medical Education, Gujarat Adani Institute of Medical Sciences, Bhuj, IND.

Introduction Hyper-cytokinemia is a dreaded complication of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection and an important predictor of mortality in coronavirus disease 2019 (COVID-19). The current evidence at best is still ambiguous for use of tocilizumab in cytokine storm in COVID-19. Moreover, the factors that are associated with beneficial response from tocilizumab are unknown in COVID-19. We aimed to study the clinical outcomes especially mortality vis-à-vis clinical and laboratory characteristics of patients administered tocilizumab and identify predictors of mortality benefits amongst deceased vs recovered COVID-19 patients. Methods The present study is a retrospective observation of the demographic, clinical, and biological data of all the consecutive patients treated with tocilizumab for COVID-19 pneumonia at the COVID tertiary care centre from July 2020 to October 2020 at Ahmedabad, India. We compared the deceased group with those who recovered/discharged and evaluated patient-level demographics, clinical attributes, and laboratory investigations available to identify subgroups in whom tocilizumab reduced mortality. Results Of the 112 patients included, the mean (SD) age was 56.84 ± 13.56 years and 80 (71.4%) were male. There were 97 (86.6%) patients in the survivors and 15 (13.39%) in the deceased group. Deceased were older than the recovered group (mean: 66.14, SD: 14.41 vs mean: 55.36, SD: 12.98; p=0.04). Hypertension (33.03%) was the commonest comorbidity observed. Mortality was significantly higher in patients with cancer and type-2 diabetes (p=0.05 and p=0.01, respectively). Level of D-dimer and lactate dehydrogenase (LDH) showed trends towards significance as a predictor of mortality (p=0.07 and p=0.08, respectively) not reaching significance. D-dimer level > 5,000 nanograms per millilitre (ng/mL) was the significant predictor of subsequent deaths (p<0.0001). Fourteen patients reported adverse events of tocilizumab. Patients who developed in-hospital complications (such as septic or vasodilatory shock and/or sepsis, acute kidney injury, multiorgan dysfunction) had significantly higher mortality (p<0.0001, p=0.009, and p=0.03, respectively). Conclusion Tocilizumab might be more beneficial in younger patients without sepsis/ septic shock, acute kidney injury, multiorgan dysfunction, and who were non-ventilated. The predictors of mortality amongst Asian Indians treated with tocilizumab were older patients, the presence of type-2 diabetes, cancer, in-hospital complication (such as acute kidney injury, sepsis/septic shock, multiorgan dysfunction), higher D-dimer > 5,000 ng/mL. A larger study with pre-defined inclusion cut-offs of these variables may aid in defining patient's characteristics of Asian Indians who may benefit from tocilizumab in COVID-19.
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http://dx.doi.org/10.7759/cureus.13116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7939533PMC
February 2021

Laparoscopic Hemostasis of Intractable Delayed Postpartum Hemorrhage.

Cureus 2021 Jan 25;13(1):e12892. Epub 2021 Jan 25.

Internal Medicine, Gujarat Adani Institute of Medical Sciences, Bhuj, IND.

Postpartum hemorrhage (PPH) is associated with considerable morbidity and mortality, particularly when relaparotomy is necessary. The etiology of spontaneous intractable PPH in a hemodynamically stable patient is poorly understood and remains open to speculation. Secondary, or delayed, PPH is usually defined as the excessive bleeding from the genital tract, with a loss of 500 ml or more of blood occurring after the first 24 hours after delivery until the sixth week of puerperium. In this report, we present three cases of severe, diffuse postpartum bleeding unresponsive to conventional hemostatic measures, which were successfully managed laparoscopically at our center. In all three cases, hemostasis was accomplished by using a laparoscopic procedure: with the excision of cervical stump bleeding in the first case, bilateral uterine artery ligation accompanied by laparoscopic hysterectomy in the second case, and bilateral internal iliac artery ligation in the third case.
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http://dx.doi.org/10.7759/cureus.12892DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903204PMC
January 2021

A Rare Case of Varicella-Zoster Virus Reactivation Following Recovery From COVID-19.

Cureus 2021 Jan 1;13(1):e12423. Epub 2021 Jan 1.

Graduate Medical Education, BJ Medical College, Ahmedabad, IND.

In patients with coronavirus disease 2019 (COVID-19), various cutaneous symptoms have been observed. Herpes zoster (HZ) is an infectious skin disease caused by the varicella-zoster virus (VZV) that, after a primary chickenpox infection, persists dormant in the dorsal root ganglia of cutaneous nerves. Unusual prolonged dermatological symptoms from recovered COVID-19 patients have rarely been recorded. In this report, we describe a case of HZ following recovery from COVID-19.
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http://dx.doi.org/10.7759/cureus.12423DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7849932PMC
January 2021

Predictors of Arterial Stiffness Amongst the 24-Hour Ambulatory Blood Pressure Variables in Hypertensive Patients.

Cureus 2020 Dec 21;12(12):e12207. Epub 2020 Dec 21.

Cardiology, Medanta Hospital, Gurgaon, IND.

Objective The objective of the study is to identify the predominant determinants of arterial stiffness as assessed by pulse-wave-velocity (PVW) amongst various 24-hour ambulatory blood pressure monitoring (ABPM) parameters in Indian hypertensive subjects. Method Subjects of both genders between 18-60 years with hypertension and who were either drug naïve or on stable anti-hypertensive treatment for at least three months were included in the study. All subjects underwent clinical evaluation with a medical history, biochemical investigations, and assessment of arterial stiffness by PWV along with 24-hour ABPM. Results We found the males were younger than females amongst hypertensive cohort (41.53 ± 10.89 years vs. 52.2 ± 5.17 years, respectively; p=0.001) and had shorter duration of hypertension (41.42 ± 49.14 months vs. 87.8 ± 74.55 months, respectively; p=0.012) and had lower 24-hour average pulse pressure (aPP; 49.1 ± 7.8 mm Hg vs. 57.83 ± 8.92 mm Hg, respectively; p=0.001) at baseline. Younger people (<40-years) as compared to those >40-years of age had the lower carotid-femoral (cf) PWV (972.8 ± 125.0 cm/sec vs. 1165.0 ± 208.4 cm/sec, respectively; p=0.001) and average brachial-ankle (ba) PWV (1413.7 ± 160.4 cm/sec and 1640.0 ± 227.1 cm/sec, respectively; p=0.001). Bivariate analysis revealed that amongst all the 24-hour ABPM parameters, 24-hour aPP had the strongest correlation (r=0.414, p=0.003) with arterial stiffness as assessed by PWV. Also, statistically significant correlation was found in age group <40 years between cf-PWV and both 24-hour aPP (r=0.54, p=0.025) as well as night-time aPP (r=0.59, p=0.013) Conclusion We conclude that 24-hour aPP showed the strongest correlation with arterial stiffness parameters and best correlated with arterial stiffness variables amongst 24-hour ABPM parameters, especially amongst subjects <40 years of age. The pulsatile blood pressure (BP) was a better predictor of aortic PWV than the continuous part of BP.
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http://dx.doi.org/10.7759/cureus.12207DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7818675PMC
December 2020

Takotsubo Syndrome a Rare Entity in COVID-19: a Systemic Review-Focus on Biomarkers, Imaging, Treatment, and Outcome.

SN Compr Clin Med 2021 Jan 11:1-11. Epub 2021 Jan 11.

Smt NHL Municipal Medical College, Ahmedabad, India.

Takotsubo syndrome(TTS) is attributed to catecholamine surge, which is also observed in COVID-19 disease due to the cytokine storm. We performed a systematic literature search using PubMed, Embase, and the Cochrane Central Register of Controlled Trials retrospectively to identify COVID-19-associated TTS case reports and evaluated patient-level demographics, laboratory markers clinical attributes, treatment given, and outcomes. There are 27 cases reported of TTS associated with COVID-19 infection of which 44.5% were male. Reported median age was 57 years (IQR: 39-65) and 62.95 years (IQR: 50.5-73.5) in case series and individual patients' cases in database, respectively. The time interval from the symptom onset to TTS diagnosis was median 6.5 days (IQR: 1.0-8.0) in case series and 6.7 days (IQR: 4-10) in individual patients' database. The median LVEF was 36% (IQR: 35-37) and 38.15%(IQR: 30-42.5%-[male: 40.33% (IQR: 33-44.2)] and female [37.15% (IQR: 30-40)] in case series and individual-patients' database, respectively. Troponin was elevated in all patients except one patient. 77.2% patients of TTS with COVID-19 had an elevated C-reactive protein and/or D-dimer. Twelve out of 22 (54.5%) patients developed cardiac complication such as cardiogenic-shock, atrial fibrillation, acute heart failure, supraventricular tachycardia, and biventricular heart failure. Nineteen out of 26 (73.07%) patients were discharged, and three were hospitalized due to acute respiratory distress syndrome and needed extracorporeal membrane oxygenation or ongoing maternal age. There were 4 (14.8%) mortality. There was no major gender difference observed in development of TTS in COVID-19 unlike COVID-19 per se. Older median age group for TTS in COVID-19 patients irrespective of cardiovascular comorbidities and gender probably reflects age as an independent risk factor. Patients who developed TTS had higher mortality rate especially if they developed cardiogenic shock.
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http://dx.doi.org/10.1007/s42399-021-00743-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7799869PMC
January 2021

Prevalence and Patterns of Obstructive Sleep Apnea in Asian Indians With Congestive Heart Failure.

Cureus 2020 Nov 11;12(11):e11438. Epub 2020 Nov 11.

Interventional Cardiology, Tagore Hospital & Heart Care Centre Private Limited, Jalandhar, IND.

Background Sleep-disordered breathing (SDB) has a potential association with the pathogenesis of congestive heart failure (CHF). We assessed the prevalence and patterns of obstructive sleep apnea (OSA) in patients presenting with CHF. Method This was a prospective, observational, all-comers study of consecutive 77 confirmed cases of CHF. All these patients were clinically assessed and evaluated for OSA with sleep study after routine blood testing, electrocardiogram (ECG), chest X-ray, and echocardiography. Results Of 77 patients with CHF 38 (49.4%) had apnea-hypopnea index (AHI) <5 while 39 (50.6%) had AHI >5. Of these 39, 37 (94.8%) patients showed the clinical features of OSA. The majority (64.9%) of them were males. The majority of OSA (64.9%) had coronary artery disease (CAD) (p<0.05) as the etiology of CHF, followed by dilated cardiomyopathy (32.4%) and valvular heart disease (2.7%). The prevalence of OSA was higher amongst New York Heart Association (NYHA) class 2 (51.4%) as compared to NYHA class 3 (37.8%) and NYHA class 4 (10.8%). There were 12 (32.8%) patients, each having OSA with a heart rate between 71 and 80 bpm and 81 and 90 bpm. Twenty-two (59.5%) had systolic blood pressure (BP) more than 120 mmHg and 20 (54.1%) had diastolic BP more than 80 mmHg. The majority (64.9%) patients had the lowest O saturation between 80% and 90%. A significantly large number of patients (62.2%) had ejection fraction 21%-30% (p<0.05). The majority (62.16%) of patients with OSA had AHI between 5 and 15. With 5-15 AHI, 20 (87%) patients with OSA had a snoring, tiredness, observed apnea, high BP, BMI, age, neck circumference, and male gender (STOP-Bang) score between 3 and 7 with AHI 5-15 (p<0.05). Conclusions In our cohort, the prevalence of OSA in CHF was 50.6%. Predictors of OSA in CHF were left ventricular ejection fraction (LVEF) 20%-30% and NYHA class 2. The majority had AHI between 5 and 15. Sleep apnea screening should be routinely implemented in the evaluation and follow-up of heart failure patients.
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http://dx.doi.org/10.7759/cureus.11438DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732783PMC
November 2020

A Case of Hemolytic Anemia With Acute Myocarditis and Cardiogenic Shock: A Rare Presentation of COVID-19.

Cureus 2020 Sep 25;12(9):e10657. Epub 2020 Sep 25.

Graduate Medical Education, Gujarat Adani Institute of Medical Sciences, Bhuj, IND.

Coronavirus disease 2019 (COVID-19) cases are on the rise globally, and mortality- and survival-related data are emerging every day. In addition, upcoming reports are suggestive of increased risk of cardiac ailments in high-risk patients. In the context of cardiac involvement, acute myocarditis has become one of the unexplored areas in COVID-19 patients, which could influence the long-term outcomes. In this report, we present a rare case that warrants further study on the subject due to the paucity of data in the literature. To date, no case of severe hemolytic anemias with stress cardiomyopathy/acute myocarditis in a patient of COVID-19 has been formally reported in the literature. The bedside echocardiogram had shown a possibility of acute myocarditis. The patient's marked left ventricular (LV) functional recovery without coronary intervention further corroborates the same. Clinicians should be aware of the diversity of cardiovascular/hematological complications, as well as focused cardiac ultrasound study and the importance of echocardiography as a good screening modality for cardiovascular and hematological complications of COVID-19 infection.
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http://dx.doi.org/10.7759/cureus.10657DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7587209PMC
September 2020

COVID-19 pandemic induced stress cardiomyopathy: A literature review.

Int J Cardiol Heart Vasc 2020 Dec 8;31:100628. Epub 2020 Sep 8.

Graduate Medical Doctor, Shri M.P Shah Medical College, Jamnagar, India.

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http://dx.doi.org/10.1016/j.ijcha.2020.100628DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476902PMC
December 2020

Takotsubo syndrome a rare entity in patients with COVID-19: An updated review of case-reports and case-series.

Int J Cardiol Heart Vasc 2020 Aug 23;29:100604. Epub 2020 Jul 23.

Associate Professor of Cardiology, Department of Cardiology, U.N. Mehta Institute of Cardiology and Research Center, Affiliated to B.J Medical College, Ahmedabad, India.

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http://dx.doi.org/10.1016/j.ijcha.2020.100604DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7377718PMC
August 2020

Clinical-biochemical profile and etiology of acute viral hepatitis in hospitalized young adults at tertiary care center.

J Family Med Prim Care 2020 Jan 28;9(1):247-252. Epub 2020 Jan 28.

Department of Microbiology, Dr. N D Desai Medical College, Nadiad, Gujarat, India.

Background: Acute viral hepatitis (AVH) is a major health concern in developing nations like India in regard to morbidity and mortality.

Objective: To identify incidence, clinical presentation, laboratory abnormalities, severity, and complication of AVH in young adults.

Materials And Methods: A prospective study was conducted from August 2016 to August 2018 among 70 young adult patients of AVH at Civil Hospital, Ahmedabad. Data on clinical presentation, laboratory values, complication, and severity were obtained, and analysis was performed.

Results: Hepatitis E viral (HEV) infection was seen in 70% case and was more common in age group of 21-30 years followed by Hepatitis B and Hepatitis A, 15.8% and 12.8% case respectively. Most common presenting symptom was jaundice in 80-85% of patients followed by anorexia 65.7% and nausea and vomiting 57.1% of patients. Most common clinical sign was icterus followed by hepatomegaly. Total serum bilirubin and serum SGOT elevated in all cases. Acute liver failure was seen in seven cases. Six cases were due to hepatitis E and one case was due to hepatitis A. Acute kidney injury was present in seven cases. Coagulopathy was found to be major complication in 25.7% cases.

Conclusion: HEV is the major etiological agent of AVH in young adults. It is not possible to differentiate viral hepatitis based on clinical features and biochemical parameters. However, cholestasis is found to be significantly associated with hepatitis-E infection.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_727_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7014869PMC
January 2020
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