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TITLE:

INCIDENCE OF BIOCHEMICAL AND HEMATOLOGICAL CHANGES OCCURING IN CHILDREN ADMITTED IN HOSPITAL WITH TYPHOID FEVER

AUTHORS:

Dr Sehrish Asad, Dr Mariyam Fayyaz, Dr Tanzeela Khan

ABSTRACT:

In typhoid fever biochemical and Hematological changes due to multi-organ involvement are very common. Objective: The aim of this analysis was to assess the severity and frequency of the changes in children due to typhoid fever admitted in the hospital. Study Design: A hospital based descriptive study. Place and Duration: In the Pediatric Department of Holy Family Hospital, Rawalpindi for one year duration from November 2017 to November 2018. Methodology: The study included clinical information, demographic data, biochemical and hematological changes noted in each child selected for study. Children with positive Salmonella typhi culture in the blood were selected for the study. The complete liver function tests, blood count, urea, blood cultures, malaria parasites, coagulation profile and electrolytes for all patients have been performed. Children with obvious hematological changes in bone marrow examination, whereas patients with normal ALT were tested for hepatitis serology (A, B and C). Results: A total of 75 children with typhoid fever were included in the study. The average age ± standard deviation of the children involved in the study was 10.2 ± 4.7 years and the males were 81.3% and females were 17.96%. The most common blood variations noted in investigations; thrombocytopenia (40%), anemia (61.3%), leukopenia (4%) and leukocytosis (10.6%). However, among biochemical changes; elevated AST (62.7%), ALT (73.3%), alkaline phosphatase (44%), bilirubin (30.6%), blood urea (12%) and prothrombin time (57.3) but found that albumin was lower than 40%. Children with elevated ALT had a high incidence of thrombocytopenia (p <0.03), alkaline phosphatase (p <0.02), increased serum bilirubin (p <0.04) and PT (p <0.05). Serum ALT serum bilirubin was 3 mg / dl 10.3%> and the duration of prothrombin was 3 seconds greater than 8% of patients who checked it, 8% was> 10 times higher than normal levels. After the biochemical and hematological changes returned to the normal range, all children were discharged in a healthy manner. Conclusion: Typhoid fever causes significant hematological changes and also liver dysfunction. Liver involvement was linked with high frequency of extra-hepatic problems. Rather than high frequency and serious problems noted in blood and liver involvement, these changes are acute and appropriate antimicrobial therapy resolve these issues. Key words: Hematology, Typhoid fever, changes, biochemistry.

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