DISSERTATION
KAMINENI INSTITUTE OF MEDICAL SCIENCES
SREEPURAM
NARKETPALLY
Department of GENERAL MEDICINE
TOPIC:
RESOLVING DIAGNOSTIC AND THERAPEUTIC UNCERTAINTIES AND IMPROVING OUTCOMES IN PATIENTS WITH POORLY DIFFERENTIATED FEVER
BY
Dr.A.Nishitha
Post graduate in general medicine department
KAMINENI INSTITUTE OF MEDICAL SCIENCES
KALOJI NARAYANA RAO UNIVERSITY OF Health sciences
Warangal
GUIDE:
DR. RAKESH BISWAS (MBBS MD GENERAL MEDICINE)
Prof and HOD OF GENERAL MEDICINE DEPARTMENT
KAMINENI INSTITUTE OF MEDICAL SCIENCES
NARKETPALLY
PROBLEM STATEMENT:
1.Diagnosing the cause of acute febrile illness in resource-limited settings is important—to give the correct antimicrobials to patients who need them, to prevent unnecessary antimicrobial use, to detect emerging infectious diseases early
2. By this study how far can we reduce misuse of medications and localising the source of infection
AIM:
To reduce diagnostic uncertainity of acute febrile illness
OBJECTIVES:
1. To assess various clinical characteristics of fever patterns and uncertainity and localisation of fever
2. To reduce the misuse of antimicrobials
PATIENTS AND METHODS:
PLACE OF STUDY: GENERAL MEDICINE DEPARTMENT, KAMINENI INSTITUTE OF MEDICAL SCIENCES
STUDY PERIOD: November 2022- October 2024
STUDY DESIGN: Observational qualitative prospective study
STUDY DESIGN –
It is a Prospective Observational Study.
STUDY PERIOD – over 2 years
SAMPLE SIZE - 100 patients
SAMPLE POPULATION -Patients of age 18-50 yrs attending Medicine Department in kamineni institute of medical sciences
INCLUSION CRITERIA:
1. Written informed consent from each patient or legal guardian prior to enrollment.
Patients Age 18 to 50 years
2. Recent-onset fever (within one to five days) when the diagnostic uncertainty is high.
3. Symptoms commonly suggestive of self-limiting flu like illnesses such as myalgia, arthralgia with commonly known symptoms such as generalised body pains, frontal headache, cold associated with chills and rigor, cough etc
•The study will be submitted for approval by the ethics committee
of Kamineni Institute of Medical Sciences, Narketpally.
•All patient satisfying the inclusion criteria will be enrolled in the
study.
•A written informed consent will be taken from the patients prior to
the start of the study
EXCLUSION CRITERIA:
1. Patient below 18 years of age(minors)
2. Patients not capable of giving consent (mentally ill patients)
3. Patients not willing to give consent for study
CONSENT:
Written and informed consent in local language will be obtained prior to enrollment in study.
INVESTIGATIONS:
•HEMOGRAM
•Fever charting
•BLOOD CULTURE
•URINE CULTURE
•ESR
•CRP
•X- ray
•STOOL FOR FECAL LEUKOCYTE COUNT (in selected patients)
•Malaria smear and dengue IgM,IgG, NS1 tests in selected patients after observing patterns of fever
•Viral Serological tests
•CSF in selected patients
CONSENT FORM
I resident of have been explained about my condition by
the physician and also the nature and purpose of this study. My questions about the above
have been answered in satisfactory manner.
I HAVE READ AND UNDERSTOOD THIS DOCUMENT AND I VOLUNTEER TO BE A
PART OF THIS STUDY.
I NOT BEING FULLY CONVERSANT IN ENGLISH THE CONTENTS OF THIS
DOCUMENT WERE EXPLAINED TO ME IN TELUGU/HINDI.
I HEREBY GIVE MY CONSENT.
Patient’s signature
Date
Time
అ"మతి పత్రము
నేను/మేము అన' రో)యొక్క బంధువులం రో) సంబంధిత సమాచార పత్రము
అందించిన సమాచారాన్ని చదివి అర్థం చేసుకున్నాను మరియునేను అర్థం
చేసుకునే Iషలో అధ్యయన ప్రయోజనం మరియుస్వIవాన్ని వివరించారు.
నేను అధ్యయనం నుం ఎటువంటి ప్రయోజనం పొందలేనని మరియుఏ
సమయంలో అయినా అధ్యయనంనుం వైదొలిa హక్కును నేను కలి)ఉన్నానని నాకు
తెలుసు.
నేను అధ్యయనంలో పాల్గొనేందుకు ఇష్టపూర్వకం' అంరిస్తున్నాన.
సంతకం/బొటనవేలిముద్ పేరు :
STUDY TOOLS –
1. Digital Thermometer.
2. Fever charting.
PROFORMA
Serial No.
• Name:
• Age:
• Occupation:
• Address :
• OP NO./IP NO.
• D.O.A:
• D.O.D
•Febrile illness and associated features
•Use of antimicrobials due to uncertainity of fever type
•HEMOGRAM
•FEVER CHART
BLOOD CULTURE
•URINE CULTURE
•ESR
•CRP
•X- ray
•STOOL FOR FECAL LEUKOCYTE COUNT (in selected patients)
•Malaria smear and dengue IgM,IgG, NS1 tests in selected patients after observing patterns of fever
•Viral Serological tests
•CSF in selected patients
FOR EXAMPLE:
->And also reducing the use of antimicrobial drugs in uncertain febrile illness
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