Shrestha Sanjeeb, Karn Mitesh, Regmi Sanjib Mani, Nagila Amar, Pahari Sandip
Department of Biochemistry, Gandaki Medical College Teaching Hospital and Research Center, Pokhara, 33700, Nepal.
School of Medicine, Gandaki Medical College Teaching Hospital and Research Center, Pokhara, 33700, Nepal.
Ann Med Surg (Lond). 2022 Jun 11;79:103922. doi: 10.1016/j.amsu.2022.103922. eCollection 2022 Jul.
Brucellosis is the commonest zoonotic disease worldwide and a common public health problem in Nepal. Because of the highly variable clinical presentation and non-specific manifestations, it remains a big challenge for clinicians from developing countries. Brucellosis has a tropism for the reticuloendothelial system, the liver is frequently involved. There is a paucity of data about the laboratory and clinical findings of human Brucellosis from Nepal. To address this knowledge gap, we conducted this study to find out the clinical profile and biochemical abnormalities of patients with brucellosis at a tertiary-care teaching hospital in western Nepal.
A cross-sectional study was carried out at Gandaki Medical College Teaching Hospital, Pokhara, Nepal. All patients admitted to the in-patient department of our hospital with probable or definitive diagnoses of brucellosis were included. We excluded those who did not consent to their participation in our study, those who were under 18 years of age, and those who had deranged liver function due to other pre-existing illnesses. Descriptive statistics were used to analyze the data in terms of demography, clinical manifestations, and laboratory parameters.
There was a total of 40 confirmed cases of Brucellosis (age: 18-66 years) during the study period. More than half (55%, n = 22) of the study participants were males and most of them lived in a rural setting (77.5%, n = 31). Most of them (70%, n = 28) gave history of ingestion of high-risk food. The commonest clinical findings were fever with/out chills (90%, n = 36) followed by nausea/vomiting (72.5%, n = 29), headache (40%, n = 16) and malaise (37.5, n = 15). Liver function was deranged in a majority of the patients, the common parameters being Alkaline phosphatase in 96% (n = 38) cases, followed by SGOT (62.5%, n = 25), leukocytosis (57.5%, n = 23), total bilirubin (52.5%, n = 21) and SGPT (37.5%, n = 15). Characteristic increment (more than two folds of the upper limit of normal) was observed for alkaline phosphatase.
The reticuloendothelial system is frequently involved in brucellosis. Notable changes were observed in liver function and hematological parameters in a majority of the participants in our study. These findings highlight the need for the implementation of effective control programs to address this problem in the Nepalese context.
布鲁氏菌病是全球最常见的人畜共患病，也是尼泊尔常见的公共卫生问题。由于临床表现高度可变且无特异性，这对发展中国家的临床医生来说仍是一项巨大挑战。布鲁氏菌病易侵袭网状内皮系统，肝脏常受累。关于尼泊尔人类布鲁氏菌病的实验室和临床发现的数据匮乏。为填补这一知识空白，我们在尼泊尔西部的一家三级护理教学医院开展了本研究，以了解布鲁氏菌病患者的临床特征和生化异常情况。
在尼泊尔博卡拉的甘达基医学院教学医院进行了一项横断面研究。纳入所有入住我院住院部且确诊或疑似布鲁氏菌病的患者。我们排除了那些不同意参与本研究的患者、18岁以下的患者以及因其他既往疾病导致肝功能紊乱的患者。使用描述性统计分析人口统计学、临床表现和实验室参数方面的数据。
在研究期间，共有40例确诊的布鲁氏菌病病例（年龄：18 - 66岁）。超过一半（55%，n = 22）的研究参与者为男性，且大多数居住在农村地区（77.5%，n = 31）。他们中的大多数（70%，n = 28）有摄入高风险食物的病史。最常见的临床发现是发热伴/不伴寒战（90%？，n = 36），其次是恶心/呕吐（72.5%，n = 29）、头痛（40%，n = 16）和不适（37.5%，n = 15）。大多数患者肝功能紊乱，常见参数为碱性磷酸酶升高的占96%（n = 38），其次是谷草转氨酶（62.5%，n = 25）、白细胞增多（57.5%，n = 23）、总胆红素升高（52.5%，n = 21）和谷丙转氨酶升高（37.5%，n = 15）。碱性磷酸酶出现特征性升高（超过正常上限的两倍）。
网状内皮系统在布鲁氏菌病中常受累。在我们研究的大多数参与者中，观察到肝功能和血液学参数有显著变化。这些发现凸显了在尼泊尔实施有效控制项目以解决这一问题的必要性。 ？疑似原文有误，90%后括号内应为n = 36
