Journal of Applied Molecular Cell Biology


ISSN: 2412-2580
Short Key Title: J App Mol Cell Bio
DOI: http://dx.doi.org/10.21065/24122580
Start Year: 2014

CLINICAL REVIEW OF TYPHOID PATIENT PRESENTED IN LOCAL CLINICAL SETTING OF SARGODHA, PAKISTAN
Muhammad Azam, Hafiz Muhammad Najam-us-Saqib, Muhammad Talha Afzal and Muhammad Rehan
Faculty of Pharmacy, University of Sargodha, Sargodha 40100 Pakistan
Keywords: Typhoid Fever, Widal test, Antibiotic treatment, Disease wiped out
Abstract

The bacterium Salmonella typhus causes acute symptoms of typhoid following gastro intestinal complications. Thus, we have examined a 20 year-old boy, presented in District Head Quarter (DHQ) Hospital Sargodha, Pakistan suffering from high grade fever since last two weeks. He had typical signs of typhoid. The Salmonella typhus was confirmed by laboratory investigations- Widal test. He was then recommended Ciprofloxacin and Levofloxacin with other symptomatic medication. The cure rate and effectiveness of these antibiotics were outstanding. Thus, we can infer that, the treatment was correct and rational, because patient was absolutely recovered within a week.

Article Information

Identifiers and Pagination:
Year:2015
Volume:2
First Page:15
Last Page:18
Publisher Id:J App Mol Cell Bio (2015 ). 2. 15-18
Article History:
Received: June 13, 2015
Accepted:August 23, 2015
Collection year:2015
First Published:September 5, 2015

DISCUSSION

In this case, first physician thought it to be a normal fever but prescribed test as a prophylactic measure. Test reports showed the presence of Salmonella typhi, soit was typhoid fever which was leading towardsenduring condition. The patient was treated with ciprofloxacin and levofloxacin. These antibiotics are fluoroquinolones and have bactericidal effect. They inhibit the DNA synthesis of bacteria by inhibiting the DNA gyrase. They also harm the growing bones and cartilage so their use should be avoided in pregnant women and teenagers. The adverse effects of these drugs include soreness, burning and stinging in the arms and legs [1].

History indicates that typhoid fever is very infrequent in the established nations like USAbut it is more common in underdeveloped nations, especially in Africa, Asia and Latin America. Although it is rarely pragmatic in western world hospitals but infection with S. typhus is still a worldwide health problem. The World HealthOrganization (WHO) reviewed 22 million cases and 200,000 deaths per year global [6]. Vaccines are available for prevention of typhoid fever. There are three vaccines licensed but two of them are commercially accessible. At present, a life-attenuated vaccine strain (Ty21a) that surpluses the virulent Vi antigen and a parenteral Vipolysaccharide vaccine are used [7, 8]. A current Cochrane meta-analysis acknowledged 17 randomized judgmentsabout typhoid vaccines and showed that both the vaccines are alike effective. Three doses of the oral Ty21a vaccine provided 34 to 58% of protection rate. While30 to 70% of combined efficacy was presented by parenteral vaccine for two years [2].

In endemic countries, diagnosis of typhoid fever is often done by the clinical performance [7]. The investigative gold standard remains the bacterial culture especially from the bone marrow area [6]. The classical serologic test was first described in 1896 by Felix Widal(the Widal test). This agglutination assay uses theVi capsular and H, O (somatic) antigens in newer versions [4]. In general, within 7 to 10 days, a four-time upswing in the agglutinin concentration is well thought-out to be a positive test.As stated by the WHO forty years ago, host defense mechanismsare poorly understood for human typhoid infection and the nature of protective immunity is chiefly unidentified [5]. In an analysis about investigative tests for typhoid fever, Olopoenia et al. opined that in the endemic areas, the Widal test should only be reflected positivewhen a 4 times increase in concentration, observed within two to three weeks and disputes against the convenience of a single test [3]. The sanitary conditions of hospital were good, the staff was cooperative but pharmacists were not available for appropriate counseling of patients. The rampant countries are facing many challenges for the effective control and management of typhoid fever, comprising the setting up of prompt clinical diagnosis and corroboration, but now both S. typhusand S. paratyphoid are rapidly becoming resilient to commonly used antibiotics and this is a chief point to be worried about. This matter would entail a host of measures, including passable investments in safe water and hygiene facilities, public edification, control over antimicrobial recommending and over the counter trades, and huge scale vaccination schemes.

CONCLUSION

The treatment continued for 14 days, after which signs and symptoms got vanished. So it is concluded that ciprofloxacin and levofloxacin hasbrilliant efficiency and cure rate against typhoid fever. These drugs also have the ability to reduce the duration of disease by causing an early effervescence and also prevent the chances of any rapid relapse of the disease. Thepatient was fully recovered and it was a rational treatment.

ACKNOWLEDGMENT

We heartily acknowledge the kind support of;

1.       My teachers of University of Sargodha, Pakistan for providing an opportunity to compile this research study. 

2.       Dr. Asim Rafiq, Dr. AwaisUtra and other staff members of the hospital for collection of data and completion of our case study.


© 2016 The Author(s). This open access article is distributed under a Creative Commons Attribution (CC-BY) 4.0 license. You are free to: Share — copy and redistribute the material in any medium or format Adapt — remix, transform, and build upon the material for any purpose, even commercially. The licensor cannot revoke these freedoms as long as you follow the license terms. Under the following terms: Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. No additional restrictions You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits
Editor in Chief
Bruno Perillo  (PhD)
Istituto di Scienze dell, Alimentazione, Consiglio Nazionale delle Ricerche, via Roma, 52, 83100 Avellino, Italy.

Bibliography

Dr. Bruno Perillo PhD is associated with Istituto di Scienze dell, Alimentazione, Consiglio Nazionale delle Ricerche, via Roma, 52, 83100 Avellino, Italy. He has contributed in book chapter entitled “Analysis of posttranslational modifications in the control of chromatin plasticity observed at estrogen-responsive sites in human breast cancer cells” Methods Mol. Biol. 1204, 59-69. 2014. Whereas, his research work is published in renowned credible journals.  

Journal Highlights
Abbreviation: J App Mol Cell Bio
doi: http://dx.doi.org/10.21065/24122580
Frequency: Annual
Current Volume: 4 (2017)
Next volume: December, 2018 (Volume 5)
Back volumes: 1-4
Starting year: 2014
Nature: Online
Submission: Online
Language: English

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