scholarly journals Initial clinical and laboratory profiles to predict pediatric dengue infection severity

2018 ◽  
Vol 57 (6) ◽  
pp. 303
Author(s):  
Natharina Yolanda ◽  
Harris Alfan
Keyword(s):  
Pleural Effusion ◽  
Dengue Infection ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Severe Dengue ◽  
Inclusion Criteria ◽  
Spontaneous Bleeding ◽  
Cross Sectional ◽  
Clinical Profiles ◽  
Patient Presentation

Background. In dengue infection, it is difficult to differentiate mild and severe dengue prior to its critical phase. Ability to identify risk factors for severe dengue form patients’ initial presentation would help decrease the need of hospitalization, increase physicians’ awareness, and improve outcome.Objective. To predict pediatric dengue infection severity based on initial patient characteristics, routine clinical and laboratory profiles. Methods. This was a cross-sectional study based on medical records of children with dengue infection in Atma Jaya Hospital, Jakarta. Inclusion criteria were children aged 1 – 18 years old with proven dengue infection, hospitalized in Atma Jaya Hospital during January – December 2016. Clinical profiles and laboratory parameters at the time of patient presentation were extracted and analyzed in relationship with dengue severity. Result. Data collected was 110 patients with mean age 9.5 years old. Initial clinical profiles that significantly related to severe dengue were: age ≤5 years old (OR = 0.113, p = 0.001), hepatomegaly (OR = 2.643, p = 0.035), pleural effusion (OR = 9.545, p = 0.000), platelet ≤125,000/uL (OR = 0.201, p = 0.025), hyponatremia (OR = 10.139, p = 0.000) and AST >135 u/L (OR = 5.112, p = 0.014). Gender, duration of fever, additional symptoms, spontaneous bleeding, blood pressure, pulse pressure, hematocrit, leucocyte, random blood glucose, calcium, and ALT were not related significantly to dengue severity.Conclusion. Physician should be cautious in pediatric dengue patients presented in age younger than 5 years old, with hepatomegaly and/or pleural effusion, platelet below 125,000/uL, hyponatremia, and AST more than three times upper normal limit. These patients have higher risk of severe dengue than patients without those findings.

scholarly journals Initial clinical and laboratory profiles to predict pediatric dengue infection severity

2017 ◽  
Vol 57 (6) ◽  
pp. 303
Author(s):  
Natharina Yolanda ◽  
Harris Alfan
Keyword(s):  
Pleural Effusion ◽  
Dengue Infection ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Severe Dengue ◽  
Inclusion Criteria ◽  
Spontaneous Bleeding ◽  
Cross Sectional ◽  
Clinical Profiles ◽  
Patient Presentation

Background. In dengue infection, it is difficult to differentiate mild and severe dengue prior to its critical phase. Ability to identify risk factors for severe dengue form patients’ initial presentation would help decrease the need of hospitalization, increase physicians’ awareness, and improve outcome.Objective. To predict pediatric dengue infection severity based on initial patient characteristics, routine clinical and laboratory profiles. Methods. This was a cross-sectional study based on medical records of children with dengue infection in Atma Jaya Hospital, Jakarta. Inclusion criteria were children aged 1 – 18 years old with proven dengue infection, hospitalized in Atma Jaya Hospital during January – December 2016. Clinical profiles and laboratory parameters at the time of patient presentation were extracted and analyzed in relationship with dengue severity. Result. Data collected was 110 patients with mean age 9.5 years old. Initial clinical profiles that significantly related to severe dengue were: age ≤5 years old (OR = 0.113, p = 0.001), hepatomegaly (OR = 2.643, p = 0.035), pleural effusion (OR = 9.545, p = 0.000), platelet ≤125,000/uL (OR = 0.201, p = 0.025), hyponatremia (OR = 10.139, p = 0.000) and AST >135 u/L (OR = 5.112, p = 0.014). Gender, duration of fever, additional symptoms, spontaneous bleeding, blood pressure, pulse pressure, hematocrit, leucocyte, random blood glucose, calcium, and ALT were not related significantly to dengue severity.Conclusion. Physician should be cautious in pediatric dengue patients presented in age younger than 5 years old, with hepatomegaly and/or pleural effusion, platelet below 125,000/uL, hyponatremia, and AST more than three times upper normal limit. These patients have higher risk of severe dengue than patients without those findings.

Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta
Keyword(s):  
Pleural Effusion ◽  
Cross Sectional Study ◽  
Pleural Space ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
The Common ◽  
The Mean ◽  
Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

scholarly journals Quantitative NS1 antigen and the severity of dengue virus infections

2015 ◽  
Vol 55 (2) ◽  
pp. 87
Author(s):  
Ni Made Adi Purnami ◽  
Mohammad Juffrie ◽  
Made Gde Dwi Lingga Utama
Keyword(s):  
Clinical Course ◽  
Nonstructural Protein ◽  
Dengue Infection ◽  
Hemorrhagic Fever ◽  
Cross Sectional Study ◽  
Severe Dengue ◽  
Virus Infections ◽  
Cross Sectional ◽  
Nonstructural Protein 1 ◽  
Spearman Test

Background Dengue infection is one of the main cause ofmorbidity and mortality in children in Indonesia. Since it is knownthat earlier treatment and supportive therapies can decreased casefatality rate from dengue hemorrhagic fever (DHF), identificationof children who have risks to develop to DHF must be quicklyidentified, mainly in areas of endemic.Objective To find a correlation between increased quantitativesecreted nonstructural protein-1 (sNS1) with clinical course ofsevere dengue infections.Methods This was a cross-sectional study conducted on childrenwith dengue infections in Tropical Infections Division of ChildHealth Department, Sanglah Hospital, Denpasar. Detection ofthe dengue antigen was made by examining sNS1 quantitativeimmuno-assay. Analysis correlation of Spearman test was used tolook the relationship between increased quantitative sNS1 withclinical course of severe dengue infections.Results There was a positive relationship between quantitativesNS1 and clinical course of severe dengue infections with a valueof r = 0.903, P=0.001. Increased sNS1 level had a positivecorrelation with more severe dengue infections.Conclusions Quantitative sNS1 titer has a strong positivecorrelation with clinical course of severe dengue infections.

Epidemiology of Children with Severe Dengue Infection in Dr. Soetomo General Hospital

2020 ◽  
Vol 70 (4) ◽  
pp. 41-47
Author(s):  
Aulia Nur Fadilla ◽  
Dominicus Husada ◽  
Budi Utomo
Keyword(s):  
Dengue Infection ◽  
Age Groups ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Severe Dengue ◽  
Hospital Data ◽  
Cross Sectional ◽  
Severe Hemorrhage ◽  
Plasma Leakage ◽  
Moderate Malnutrition

Introduction: Dengue infection is endemic to Indonesia and remains a public health problem. Severe dengue infection can cause rapid death, especially in children. Aim: To determine the epidemiology of children with severe dengue infection in Dr. Soetomo Hospital. A cross-sectional study was conducted at the pediatric ward of Dr. Soetomo Hospital. Data were derived from medical records of children aged ≤18 years which hospitalized with severe dengue from March to April 2019. Of 135 children admitted with DHF, obtained 48 samples with characteristics >5–12 years old (72.9%), male (58.3%), residence Surabaya (89.6%), elementary school (60.3%), referral (81.3%), hospitalized ≤5 days (66.7%), day of illness ≥4 days (89.6%), moderate malnutrition (35.4%), had severe plasma leakage consisting of DHF grade III (73%) and IV (27%). Two patients died (4.2%). No patient with congenital disease and malignancy. This study is not in line with the tendency of shifted dengue incidence to older age groups (>15 years old) in Indonesia. All patients had severe plasma leakage. No severe dengue patient with severe hemorrhage and organ impairment. Most patients were male, had moderate malnutrition, from referral, day of illness ≥4 days, hospitalized ≤5 days.

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 Geographical distribution and spatio-temporal patterns of hospitalization due to dengue infection at a leading specialist hospital in Malaysia

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Gary K.K. Low ◽  
Panayoti Papapreponis ◽  
Ridzuan M. Isa ◽  
Seng Chiew Gan ◽  
Hui Yee Chee ◽  
...  
Keyword(s):  
Dengue Infection ◽  
Geographic Location ◽  
Cross Sectional Study ◽  
Severe Dengue ◽  
Standardized Incidence Ratio ◽  
Cross Sectional ◽  
Secondary Objective ◽  
The Mean ◽  
Spatio Temporal ◽  
Age Range

Increasing numbers of dengue infection worldwide have led to a rise in deaths due to complications caused by this disease. We present here a cross-sectional study of dengue patients who attended the Emergency and Trauma Department of Ampang Hospital, one of Malaysia’s leading specialist hospitals. The objective was to search for potential clustering of severe dengue, in space and/or time, among the annual admissions with the secondary objective to describe the spatio-temporal pattern of all dengue cases admitted to this hospital. The dengue status of the patients was confirmed serologically with the geographic location of the patients determined by residency, but not more specific than the street level. A total of 1165 dengue patients were included in the analysis using SaTScan software. The mean age of these patients was 27.8 years, with a standard deviation of 14.2 years and an age range from 1 to 77 years, among whom 54 (4.6%) were cases of severe dengue. A cluster of general dengue cases was identified occurring from October to December in the study year of 2015 but the inclusion of severe dengue in that cluster was not statistically significant (P=0.862). The standardized incidence ratio was 1.51. General presence of dengue cases was, however, detected to be concentrated at the end of the year, which should be useful for hospital planning and management if this pattern holds.

scholarly journals Dengue infection during pregnancy in Burkina Faso: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kongnimissom Apoline Sondo ◽  
Adama Ouattara ◽  
Eric Arnaud Diendéré ◽  
Ismaèl Diallo ◽  
Jacques Zoungrana ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Pregnant Women ◽  
Dengue Fever ◽  
Neonatal Mortality ◽  
Dengue Infection ◽  
Rapid Test ◽  
Cross Sectional Study ◽  
Severe Dengue ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background Dengue fever is prevalent in the world; in recent years, several outbreaks occurred in West Africa. It affects pregnant women. We aimed to assess the consequences of dengue fever on pregnant women and their fetuses during dengue epidemic in Burkina Faso. Methods We conducted a cross-sectional study from November 1, 2015 to January 31, 2017 in 15 public and private health facilities in Ouagadougou, using secondary data. Immunochromatographic rapid test Duo detecting specific antibodies, immunoglobin M/G and /or dengue non structural antigen1 virus was used to diagnose dengue cases. Results Out of 399 (48%) women registered during the study period, 25 (6%) were pregnant. The average age of pregnant women was 30 years, with 18 and 45 years as extremes. The main symptoms were fever (92%) and headache (92%). Nine patients (36%) had severe dengue characterized by bleeding (16%), neurological symptoms (16%) and acute respiratory distress (8%). Eight (32%) of the 25 women had early miscarriage and 8 (32%) women gave birth to viable fetuses. Among those with viable babies, 5 (20%) presented post-partum hemorrhage and 3 (12%) presented early delivery. The main fetal complications included 3 cases of acute fetal distress (12%). One case of maternal death (4%) and 4 cases of neonatal mortality (44.5%) were notified. Conclusion Dengue fever occurring during pregnancy increases maternal and neonatal mortality. Its severe complications require specific monitoring of pregnant women until delivery.

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 Background The 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.Methods This 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. Conclusion Signs 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 EXUDATIVE PLEURAL EFFUSION

2016 ◽  
Vol 23 (08) ◽  
pp. 970-974
Author(s):  
Nosheen Saifullah ◽  
Saifullah Baig ◽  
Niaz Hussain Soomro ◽  
Nadeem Rizvi
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Yield ◽  
Medical Center ◽  
Cross Sectional Study ◽  
Inclusion Criteria ◽  
Pleural Biopsy ◽  
Cross Sectional ◽  
Female Ratio ◽  
Specific Diagnosis ◽  
Male To Female

Objectives: To compare the pleuroscopic and closed pleural biopsy by Abramsneedle in terms of diagnostic yield and obtaining specific diagnosis in cases of exudative pleuraleffusion. Study Design: Cross sectional study. Period: August 2014 to February 2015. Setting:Department of Thoracic Medicine Jinnah Post Graduate Medical Center Karachi. Methodology:All patients with pleural effusion who were admitted and fulfilling the inclusion criteria wereincluded in the study .Closed pleural biopsy using Abrams needle followed by pleuroscopy witha flexible pleuroscope was performed from the same incision, in the same sitting. The sampleswere sent for histopathology. To control bias samples were coded as A and B and the codewas not known to the histopathologist. Results: Among 60 patients, Mean age was 42.85 yearswith ±18.2 standard deviation and male to female ratio was 1.6 :1. Specific diagnosis throughpleuroscopic biopsy had shown 27 (45%) cases of tuberculosis, 25 (41.7%) of adenocarcinoma,5 (8.3%) of chronic non specific inflammation, one (1.7%) case of lymphoma and 2 (3.3%)cases could not be reached for any diagnosis. Conclusion: Pleuroscopy has better yield thanthe Abrams needle biopsy in terms of both diagnostic yield and specific diagnosis

CLINICAL SYMPTOMS, BIOCHEMISTRY AND CYTOLOGY OF PLEURAL, PERITONEAL EFFUSIONS

2016 ◽  
pp. 66-71
Author(s):  
Van Mao Nguyen ◽  
Huyen Quynh Trang Pham
Keyword(s):  
Pleural Effusion ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
Malignant Cells ◽  
Sectional Study ◽  
Pleural Effusions ◽  
Cross Sectional ◽  
Breath Sounds ◽  
Peritoneal Effusion ◽  
Neutrophil Leukocytes

Background: The cytology and the support of clinical symptoms, biochemistry for diagnosis of the cases of effusions are very important. Objectives: - To describe some of clinical symptoms and biochemistry of effusions. - To compare the results between cytology and biochemistry by the causes of pleural, peritoneal fluids. Material & Method: A cross-sectional study to describe all of 47 patients with pleural, peritoneal effusions examinated by cytology in the Hospital of Hue University of Medicine and Pharmacy from April 2013 to January 2014. Results: In 47 cases with effusions, pleural effusion accounting for 55.32%, following peritoneal effusions 29.79% and 14.89% with both of them. The most common symptoms in patients with pleural effusions were diminished or absent tactile fremitus, dull percussion, diminished or absent breath sounds (100%), in patients with peritoneal effusions was ascites (95.24%). 100% cases with pleural effusions, 50% cases with peritoneal effusions and 80% cases with pleural and peritoneal effusions were exudates. The percentage of malignant cells in patients with pleural effusions was 26.92%, in peritoneal effusions was 28.57%, in pleural and peritoneal effusions was 42.86%. The percentage of detecting the malignant cells in patients with suspected cancer in the first test was 57.14%, in the second was 9.53% and 33.33% undetectable. Most of cases which had malignant cells and inflammatory were exudates, all of the cases which had a few cells were transudates. Besides, 7.5% cases which had high neutrophil leukocytes were transudates. Conclusion: Cytology should be carry out adding to the clinical examinations and biochemistry tests to have an exact diagnosis, especially for the malignant ones. For the case with suspected cancer, we should repeat cytology test one more time to increase the ability to detect malignant cells. Key words: Effusion, pleural effusion, peritoneal effusion, cytology, biochemistry

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