scholarly journals Prognostic indicators associated with progresses of severe dengue

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262096
Author(s):  
Bùi Vũ Huy ◽  
Ngô Văn Toàn
Keyword(s):  
Platelet Count ◽  
Serum Albumin ◽  
White Blood Cells ◽  
Clinical Manifestations ◽  
Prognostic Indicators ◽  
Severe Dengue ◽  
Severe Bleeding ◽  
Tropical Diseases ◽  
Cross Sectional ◽  
Critical Phase

Background Dengue usually progress abnormally, especially in the critical phase. The main causes of death were shock, severe bleeding and organ failure. The aim of our study was to evaluate prognostic indicators of severe dengue according to the phases of the disease progression. Methods A cross-sectional study was conducted from July to December 2017 at the National Hospital for Tropical Diseases and the Hospital for Tropical Diseases of Ho Chi Minh City. 326 patients, aged 6 years and over, including 99/326 patients with severe dengue and 227/326 patients with non-severe dengue, hospitalized in the first 3 days of illness, confirmed Dengue virus by the RT-PCR assay have been registered for the study. Clinical manifestations were monitored daily. The hematocrit, white blood cells, platelet, serum albumin, ALT, AST, bilirubin, prothrombin time (PT%, PTs), fibrinogen, aPTT, INR and creatinine were evaluated at two times: febrile phase and critical phase. Results Independent factors associated with severe dengue were identified on multivariate logistic regression models. During the first 3 days of the disease, the prognostic indicators were platelet count ≤ 100 G/L (OR = 2.2; 95%CI: 1.2–3.9), or serum albumin < 35 g/L (OR = 3.3; 95%CI: 1.8–6.1). From day 4–6, the indicator were AST > 400 U/L (OR = 3.0; 95%CI: 1.1–7.9), ALT > 400 U/L (OR = 6.6; 95%CI: 1.7–24.6), albumin < 35 g/L (OR = 3.0; 95%CI: 1.5–5.9), and bilirubin total >17 μmol/L (OR = 4.6; 95%CI: 2.0–10.4). Conclusion To predict the risk of patients with severe dengue, prognostic laboratory indicators should be indicated consistent with the progression of the disease. During the first 3 days of illness, prognostic indicators should be platelet count, or serum albumin. From the 4th - 6th day of illness, prognostic indicators should be AST, ALT, albumin, or bilirubin total.

scholarly journals Epidemiological and Clinical Features of Dengue Infection in Adults in the 2017 Outbreak in Vietnam

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Bui Vu Huy ◽  
Le Nguyen Minh Hoa ◽  
Dang Thi Thuy ◽  
Nguyen Van Kinh ◽  
Ta Thi Dieu Ngan ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Dengue Fever ◽  
Clinical Features ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Warning Signs ◽  
Severe Dengue ◽  
Severe Bleeding ◽  
Cross Sectional ◽  
Number Of Patients

Purpose. The clinical features and laboratory results of dengue-infected adult patients admitted to the hospital during the 2017 outbreak were analyzed in this study. Method. This is a cross-sectional study. 2922 patients aged 18 years or more with dengue fever in National Hospital for Tropical Diseases (NHTD) in the North and Hospital for Tropical Disease (HTD) in the South of Vietnam were recruited in this study. Result. Patients were admitted in the hospital around the year and concentrated from August to December, in 53/63 (84.0%) provinces in Vietnam, and patients in all ages were affected. The number of patients with dengue fever was 1675 (57.3%), dengue with warning signs 914 (31.3%), and severe dengue 333 (11.4%), respectively. Among patients with severe dengue, severe plasma leakage and dengue shock account for 238 (8.1%), severe organ impairment 73 (2.5%), and severe bleeding 22 (0.75%). The rate of mortality was 0.8%, and the outcome of dengue patients is worse in the elderly and people with underlying diseases. Conclusion. The 2017 dengue outbreak occurred in a larger scale than in the previous years in terms of time, location, and number of patients. More elderly patients were infected by dengue in this outbreak, and this may contribute to the mortality rate. Clinical manifestations of dengue patients in Southern Vietnam are more typical than the northern, but the rate of severe dengue is not different. The mortality risk and underlying conditions associated with dengue-infected elderly patients are worthy of further investigations in the future.

scholarly journals Haematological Changes in Donors Post Apheresis

2021 ◽  
Author(s):  
. Nikhil ◽  
Subhashish Das ◽  
. Snigdha
Keyword(s):  
Platelet Count ◽  
Blood Cells ◽  
Complete Blood Count ◽  
White Blood Cells ◽  
Haemoglobin Concentration ◽  
Point Of View ◽  
Haematological Parameters ◽  
Cross Sectional ◽  
Wbc Count ◽  
Rbc Count

Introduction: The productivity, quality of platelet apheresis collection has improved because of the considerable advancement in the automated cell separators. Automated cell separators have lot of sizeable scientific advances, but the alertness has been centered to Platelet Concentrates (PCs) quality than on safety of donor. Aim: To find the changes in haematological parameters and the consequences of apheresis and plateletpheresis on donor’s health. Materials and Methods: It was observational cross-sectional study done in laboratory at RL Jalappa Blood Bank, Tamaka, Kolar, Karnataka, India. The study was done from March 2019 to August 2020. A total of 300 healthy donors (plateletpheresis donors) were involved in the study. The plateletpheresis (Haemonetics MCS), predonation and postdonation haematological parameters such as haemoglobin concentration, Haematocrit (Hct), platelet, white and red blood cell count were calculated in all donors. The samples for Complete Blood Count (CBC) were secured from the donors, at the beginning and end of the procedure. Postdonation haematological parameters such as platelet count, haemoglobin, haematocrit, White Blood Cells (WBC), Red Blood Cells (RBC) counts of the donor was inscribed and comparison was done with the pre donation haematological parameters. Quality control of all Single Donor Platelet (SDP) products was done. All donors were evaluated for adverse donor reactions. The mean pre and post plateletpheresis values comparison was done utilising paired t-test. Statistical analysis was accomplished utilising Statistical Package for the Social Sciences (SPSS) software version 16.0. Results: Platelet count, haemoglobin, WBC count, RBC count and haematocrit were jotted down from 262 donors and a significant decrease was noticed in these parameters postdonation. Donor parameter platelet count (lac/mL) value was decreased from 273.57-224.28 whereas WBC count (cu/mm) predonation value decreased from 9.91-8.86 Postdonation, haemoglobin (g/dL) value decreased from 14.46-12.91, haematocrit (%) decreased slightly from 45.19-44.19, RBC count (million/mm3) decreased from 5.21-5.01. This concluded that the values decreased postdonation. Conclusion: The study conducted was safe from donor’s point of view. SDP is very effective in treatment of thrombocytopenia and is safe from recipient’s point of view.

scholarly journals Management of Dengue in Children: An Update

2020 ◽  
Vol 35 (2) ◽  
pp. 162-178
Author(s):  
Mirza Md Ziaul Islam
Keyword(s):  
Fluid Resuscitation ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Therapeutic Index ◽  
Severe Dengue ◽  
Management Problem ◽  
Aggressive Fluid Resuscitation ◽  
Critical Phase ◽  
Plasma Leakage ◽  
Severity Of The Disease

Dengue viruses cause symptomatic infections or asymptomatic seroconversion. Symptomatic dengue infection is a systemic and dynamic disease. It has a wide clinical spectrum that includes both severe and non-severe clinical manifestations. Due to its dynamic nature, the severity of the disease will usually only be apparent around defervescence which often coincides with the onset of the critical phase. For a disease that is complex in its manifestations, management is relatively simple, inexpensive and very effective in saving lives, so long as correct and timely interventions are instituted. The main hemodynamic elements of dengue shock is hypovolemia with decreased vascular capacitance resulting from plasma leakage. Thus, the strategy of aggressive fluid resuscitation of septic shock is not applicable to severe dengue with plasma leakage. Volume replacement in children with dengue shock is a challenging management problem. Aggressive fluid resuscitation may indeed be harmful and should be limited to dengue shock with hypotension. There is a “narrow therapeutic index”; therefore, fluids have to be given timely, at the appropriate volume, rate, of the appropriate type (crystalloids, colloid and/or blood) and for the appropriate duration. Therein lies the challenge to physicians who are not familiar with the important practice of fluid titration through frequent and meticulous assessment. Progression of the disease through the critical phase should be tracked in hours of plasma leakage. Recognizing the cues to discontinue intravenous fluid therapy is just as important as knowing when to start it. Given time and hemodynamic stability, other issues such as thrombocytopenia, coagulopathy and raised liver enzymes will recover spontaneously or with supportive care. DS (Child) H J 2019; 35(2) : 162-178

scholarly journals Thrombocytopenia and Bleeding in Dengue Fever: A Cross-Sectional Study during a Dengue Outbreak in Burkina Faso

2021 ◽  
Vol 8 (1) ◽  
pp. 1-7
Author(s):  
Sawadogo Salam ◽  
Keyword(s):  
Platelet Count ◽  
Burkina Faso ◽  
Dengue Fever ◽  
Platelet Transfusion ◽  
Cross Sectional Study ◽  
Severe Bleeding ◽  
Sectional Study ◽  
Cross Sectional ◽  
Dengue Outbreak ◽  
Count Recovery

There was no significant increase in platelet count in transfused and not transfused patients, meaning that platelet transfusion had no longer benefit in reduction of clinical or severe bleeding or improvement in platelet count recovery

RESEARCH ON CLINICAL MANIFESTATIONS AND AEROBIC BACTERIA OF QUINSY IN HUE CENTRAL HOSPITAL AND HUE UNIVERSITY HOSPITAL

2012 ◽  
pp. 85-91
Author(s):  
Kim Tri Truong ◽  
Tu The Nguyen ◽  
Lam Phuoc Vo
Keyword(s):  
Antibiotic Prescription ◽  
White Blood Cells ◽  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Aerobic Bacteria ◽  
Sectional Study ◽  
Central Hospital ◽  
Cross Sectional ◽  
Bacteria Culture

Objectives: To identify the paraclinical and clinical mannifestations, aerobic bacteria and antibiogramme of quinsy. Materials and methods: Cross-sectional study was conducted upon 37 patients with quinsy at Hue Central hospital and Hue University Hospital. Results: Clinical and paraclinical symtoms: odynophagy 100%, dysphagy 91.9%. Having treatment with antibiotics before hospitalization 67.6%. White blood cells >15.109/l (54.1%). Positive bacteria culture is 48.6% in which streptococcus α hemolytic 57.9%, staphylococcus aureus 10.5%, streptococcus pneumoniae 10.5%. Antibiogramme: Sensitization: Gentamycin 100%, vancomycin 100%, cefuroxim 100%, ciprofloxacin 80%.Resistance: Erythromycin 60%, ampicillin 41.7%, cefalexin 40%, tetracyclin 40%, ceftriaxon 30.8%.Consclusions: The priority of antibiotic prescription for quinsy should be based on the frequency of bacteria found in bacteria culture and depending on antibiogramme to choose appropriate antibiotics.

scholarly journals A study of correlation of serum albumin with dengue severity

2020 ◽  
Vol 7 (5) ◽  
pp. 814
Author(s):  
Thyagaraj . ◽  
Sreedevi T.
Keyword(s):  
Virus Infection ◽  
Dengue Virus ◽  
Serum Albumin ◽  
Complete Blood Count ◽  
Tertiary Care ◽  
Severe Dengue ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Dengue Virus Infection ◽  
Cross Sectional

Background: Dengue viruses are flavivirus, which include four serotypes 1, 2, 3 and 4. Clinical expression of dengue virus infection vary from asymptomatic infection to severe dengue with shock. It is the most rapidly spreading vector borne disease in the world. An estimated 50 million dengue infections occur annually and approximately 2.5 billion people live in dengue endemic countries. The objective of this study was to predict the severity of Dengue illness by correlating the serum albumin levels.Methods: An observational cross-sectional study done on patients admitted in Basaveshwara Medical College and Research Institute, Chitradurga, Karnataka, a tertiary care Hospital. Patients with Dengue NS1 Ag or IgM positive are included in the study after meeting inclusion and exclusion criteria. Complete Blood count, serum albumin levels are estimated at the time of admission.Results: Study enrolled 100 patients with confirmed Dengue virus infection who were admitted to the hospital between July 2017 and December 2018. Serum samples taken within 24 hours of admission was used for biochemical tests. Out of 100 patients, 24 developed Severe Dengue. Cases of Severe Dengue had low levels of serum albumin. Multivariate analysis showed that early alterations of albumin i.e. out of 24 patients who developed severe dengue, 21 patients i.e. 92.7% had low albumin of <3gm/dlConclusions: Early changes in biochemical parameter, serum albumin can predict Severe Dengue in patients with Dengue febrile illness.

scholarly journals Double trouble: hemophagocytic lymphohistiocytosis in a child with Dengue fever

2019 ◽  
Vol 6 (6) ◽  
pp. 2675
Author(s):  
Minal Wade ◽  
Nusrat Inamdar ◽  
Baraturam Bhaisara ◽  
Anupama Mauskar
Keyword(s):  
Dengue Fever ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Clinical Situation ◽  
Severe Form ◽  
Adverse Outcomes ◽  
Severe Dengue ◽  
Severe Bleeding ◽  
Initial Symptoms ◽  
Critical Phase ◽  
Secondary Hemophagocytic Lymphohistiocytosis

The epidemic of Dengue is steadily increasing in more than 100 endemic countries. During critical phase, of this disease, shock with organ dysfunction and severe bleeding, can occur. Rarely, it can be further complicated by Hemophagocytic lymphohistiocytosis (HLH), which results from aberrant activation of immune mechanism. HLH is a rare, frequently fatal if untreated condition. It challenging to diagnose because initial symptoms mimic other conditions which are more common. Dengue induced Secondary Hemophagocytic lymphohistiocytosis (HLH), may be responsible for severe form of Dengue with adverse outcomes. We describe a case of an infant, with Dengue fever whose clinical situation deteriorated after being stable during initial phases of illness due to development of Secondary Hemophagocytic lymphohistiocytosis (HLH). The child had persistent fever, anemia, hepatomegaly with deranged coagulation which directed towards diagnosis of Secondary Hemophagocytic lymphohistiocytosis (HLH). We discuss the features of our case and its management to sensitize the clinicians to consider this condition in patients with severe Dengue fever.

scholarly journals Comparison of severity signs between patients with primary and secondary dengue infection during the 2016 Burkina Faso (West Africa) outbreak

2020 ◽  
Author(s):  
Eric Arnaud Diendéré ◽  
Apoline Kognimisson Sondo/Ouédraogo ◽  
ismael Diallo ◽  
Absetou Ky/Ba ◽  
Toussaint Rouamba ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Dengue Fever ◽  
Univariate Analysis ◽  
Dengue Infection ◽  
Cross Sectional Study ◽  
Severe Dengue ◽  
Severe Bleeding ◽  
Cross Sectional ◽  
Binary Dependent Variable ◽  
The Relationship

Abstract BackgroundThe factors that expose the severity of dengue are still controversial, particularly the relationship between severe dengue and secondary dengue. More importantly, the severity of dengue infection remains poorly studied in Africa. The objective of this study was to compare severity signs between patients with primary and secondary dengue infection during the 2016 dengue outbreak in Burkina Faso.MethodsThis was a cross-sectional study through a retrospective examination of patient medical records managed in Ouagadougou for dengue fever from 1 January 2015 to 31 December 2017. All health facilities with the capacity to perform dengue diagnosis in Ouagadougou were considered in the survey. Primary dengue was defined as the presence of AgNS1 and/or IgM and secondary dengue as the presence of IgG associated with one of these two markers. Patients with only IgG were excluded. Univariate and multivariable analyzes were performed using a logistic regression with dengue infection (primary or secondary dengue) as the binary dependent variable. The statistical significant level was set at 0.05.Results Of the 811 patients managed for dengue fever during the study period, 418 (51.5%) were male. Thirty-five patients (4.3%) had primary dengue infection (AgNS1 + and / or IgM + with negative IgG) and seven hundred seventy-six (776) patients (95.7%) had secondary dengue infection. 245 patients (30.2%) experienced severe signs. Renal failure (13.1%) was the main sign of severity, followed by severe bleeding (10.6%). In univariate analysis, severe bleeding were associated with primary dengue infection (OR = 2.65, 95%IC: 1.16 -6.03, p = 0.01). Twenty-four deaths (9.8%) were reported during the period. ConclusionSigns of gravity can occur during primary dengue fever. This study highlight the need to conduct more studies on the severity factors of dengue fever.

scholarly journals Clinical and diagnostic features of dengue haemorrhagic fever in children

2018 ◽  
Vol 5 (3) ◽  
pp. 791
Author(s):  
Gomathi Chenna Reddy ◽  
Nagendra K.
Keyword(s):  
Platelet Count ◽  
Serum Albumin ◽  
Liver Enzymes ◽  
Clinical Laboratory ◽  
Diagnostic Tools ◽  
Severe Bleeding ◽  
Bleeding Tendency ◽  
Clinical Expertise ◽  
Diagnostic Features ◽  
Immunological Parameters

Background: Diagnosis of dengue hemorrhagic fever (DHF) in children is based on clinical suspicion and prompting laboratory criteria.Methods: This prospective study in children (6 months-14 years) presenting with features of DHF aimed to identify symptoms and signs, laboratory parameters for in early detection and assessed the association between clinical, laboratory, immunological parameters and outcome.Results: Of 50 children, 26 were females, mean±SD age was 8.3±3.02 years; age group 8-12 years were affected the most (38.0%) and infants the least (4.0%). Fever (100%), followed by skin rash (56.0%), myalgia (52.0%) and head ache (48.0%) were the symptoms. Fever of 4-5 days (52.0%), high grade fever (84.0%) and of sudden onset (76.0%) were common. Ascitis was seen in nine. Peteche and malena (48.0%) were predominant manifestation of bleeding tendency (100%). Positive tourniquet test (48.0%) did not correlate with bleeding tendency. Lower levels of Hemoglobin (<12gms%, 100%), hematocrit (<40%, 98.0%), platelet count (<100000/mm3, 100%), serum albumin (76.0%), and abnormal liver enzymes (64.0%) along with prolonged prothrombin time (44.0%) and aPTT (18.05%) were noted. Ultrasound abdomen confirmed Pleural effusion (52.0%), ascitis (22.0%), Hepatomegaly (68.0%). Mean detection time was 4 days. Positive dengue IgM and IgG (60.0%), IgM (16%), and IgG (24%) were observed with increase of IgM in early phase.Conclusions: lower platelet count, raising haematocrit, increased liver enzymes with low serum albumin levels are early indicators. Prolonged PT and APTT are associated with severe bleeding manifestations. Apart from clinical expertise, chest X-ray, abdominal ultrasonogram are useful diagnostic tools. 

RESEARCH ON CLINICAL MANIFESTATIONS AND AEROBIC BACTERIA OF ACUTE TONSILITIS IN HUE CENTRAL HOSPITAL AND HUE UNIVERSITY HOSPITAL

2012 ◽  
pp. 30-37
Author(s):  
Kim Tri Truong ◽  
Tu The Nguyen ◽  
Lam Phuoc Vo
Keyword(s):  
Antibiotic Prescription ◽  
White Blood Cells ◽  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Aerobic Bacteria ◽  
Central Hospital ◽  
Cross Sectional ◽  
Group A ◽  
Bacteria Culture

Objective: To study the paraclinical and clinical mannifestations, aerobic bacteria and antibiogramme of acute tonsilitis. Materials and method: A cross-sectional study was conducted upon 34 patients with acute tonsilitis at Hue Central hospital and of Hue University Hospital. Results: Clinical and paraclinical characteristics: odynophagy 94.1%, tonsillar hyperaemia 88.2%. Having treatment with antibiotics before hospitalization 50%. White blood cells >10-15.109/l (58.8%). Positive bacteria culture is 67.6% in which streptococcus β hemolytic group (A) 25%, streptococcus α hemolytic 25%, hemophilus influenzae 25%. Antibiogramme: Sensitization: gentamycin 100%, cefuroxim 100%, ceftriaxone 93.8%, cefalexin 90.9%, vancomycin 86.7%; Resistance: Tetracyclin 85.7%, erythromycin 69.2%, ofloxacin 42.9%, ampicillin 33.3%, ciprofloxacin 33.3%. Consclusions: The priority of antibiotic prescription for acute tonsilitis should be based on the frequency of bacteria found in bacteria culture and depending on antibiogramme to choose appropriate antibiotics.

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