Clinical approach, diagnosis and medical management of acute pancreatitis among patients attending tertiary care hospital in Prakasam district, Andhra Pradesh, India

Background: There has been an increase in the incidence of acute pancreatitis reported globally and despite of improvements in access to care and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality. The present study was aimed to assess the clinical profile of acute pancreatitis and to assess the efficacy of various severity indices in view of   outcome of patients. Methods: A hospital based prospective cross-sectional study was conducted from October 2022-March 2023 in Gastro and Liver care center in Ongole, Prakasam District, Andhra Pradesh India. All consecutive 72 patients with a diagnosis of acute pancreatitis were included in this study. Results: Out of total acute Pancreatitis cases   61 (84.7%) were males and 11 (15.3%) were females and acute abdominal pain (97.2%) and decreased appetite (95.8%) were the most common presenting complaints, 54.2% cases were due to Alcoholism, followed by hyperlipidemia with 20.8% and Gall stones 13.9%.  All 72 (100%) received pancreatic supplements, 68 (94.4%) were given pain killers, and 65 (90.3%) were taken anti-ulcer agents. Twenty-three (31.9%) patients with 0 to 3 points as per CTSI Score and 4-6 range points were observed in 47 (65.3%) pancreatitis patients. Maximum (40.3%) were improved on 2nd day, 22 (30.6%) were on 3rd day.  Positive correlation noticed between Amylase and in diagnosing acute Pancreatitis, it is significant at 0.05 level. Conclusions: Early assessment of the clinical severity and identification of patients at risk is important for early intensive management and timely intervention and to improve quality of life. So, it is mandatory to assess the clinical severity using different scoring systems. and appropriate treatment based on guidelines

Impact of mothers’ knowledge and support for sustaining exclusive breastfeeding

Background: Breast milk is the best milk for the baby. It is beneficial for the baby as well as the mother, family, and nation. In spite of an established fact, still, a very low percentage (44.2%) is implementing it. Objective: The objective of this study was to find out the knowledge, concerns, and difficulties in breastfeeding and the obstacles in the practicing breastfeeding. Materials and Methods: A cross-sectional study was done at pediatric clinics in Warangal. A total of 1010 lactating mothers who were presenting for regular check-ups were enrolled. After taking oral consent, mothers were interviewed through a predesigned questionnaire containing 50 questions on pre- and post-natal counseling received, and knowledge of exclusive breastfeeding, importance of skin-to-skin contact (SSC), and their educational status and hygiene. The entire session of interview was carried out in the optimum privacy to create a favorable environment of acquiring the data. Results: Of 1010 mothers enrolled, only 25.4% had received antenatal counseling, 15.8% had received postnatal counseling regarding exclusive breastfeeding, 56.4% followed exclusive breastfeeding (EBF), and SSC was maintained by only 2%, after delivery which played an important role in breastfeeding, p=0.000003 for antenatal counseling and EBF. Conclusion: More attention should be given in educating mothers when they conceive, regarding breastfeeding, its problems and skills, during their first visit to health-care professionals

Chapare mammarenavirus - a new deadly virus outbreak: a review

In 2003 an emerging mammarenavirus (formerly arenaviruses) was discovered in Bolivia and named Chapare (CHAPV). It was related to severe and fatal haemorrhagic fever, being similar in clinical features to Machupo (MACV). In mid-2019, CHAPV was the explanation for a cluster of 5 cases, two of them laboratory confirmed, three of them fatal. Reverse transcription polymerase chain reaction (RT-PCR) analysis and subsequent analysis of the entire virus S and L ribonucleic acid (RNA) segment sequences identified the virus as a member of the New World Clade B arenaviruses, which includes all the pathogenic South American arenaviruses. The virus was shown to be most closely associated with Sabia´ virus, but with 26% and 30% nucleotide difference within the S and L segments, and 26%, 28%, 15% and 22% aminoalkanoic acid differences for the L, Z, N, and GP proteins. LUJV, CHAPV, GTOV, and SABV, which are geographically restricted, have been associated with only a few to a few dozen cases. They are, therefore, relatively unimportant to clinicians compared to many other viruses that are usually co-endemic. However, MACV, JUNV, and especially LASV have caused large outbreaks (LASV has caused hundreds of thousands of infections per year). Visitors to countries in which these viruses are endemic, or war-fighters that are deployed to these countries, need to be aware of how to prevent and suspect a mammarenavirus infection