scholarly journals Clinical and laboratory profile and outcome of dengue cases among children attending a tertiary care hospital of South India

2017 ◽  
Vol 4 (3) ◽  
pp. 1074 ◽  
Author(s):  
Punith Patak Nagaram ◽  
Prathima Piduru ◽  
Venkata Krishna Munagala ◽  
Vishnu Vandana Matli

Background: Dengue fever is an arboviral disease which is endemic in tropical countries and is of major concern with its morbidity and mortality. WHO classified dengue into three categories: undifferentiated fever, dengue fever (DF) and dengue haemorrhagic fever (DHF). Severe dengue is also regularly observed during primary infection of infants born to dengue-immune mothers. The objective of present study was to assess the clinical profile, laboratory profile and associated risk factors related to outcome of children less than 15 years of age. The outcome of the children and their management protocols were also assessed in the study.Methods: A prospective cross sectional study with 174 confirmed cases of dengue in children <15 years were enrolled and classified as per WHO guidelines. The demographic data, clinical history, laboratory parameters were noted in a separate questionnaire form. Hematological parameters were noted, chest x-ray, ultra-sonogram in required cases was done and observations noted. Cases were managed as per WHO protocol and risk factors were observed. The outcomes of the cases were noted as discharge or death of the case.Results: A total of 174 children with 149 non-severe dengue and 25 severe dengue cases with 95 males and 79 females were enrolled in the study. 6-10 years was the most common age group. The mean age of children admitted with severe dengue fever was 5.81yrs.and without severe dengue fever was 7yrs.The mean duration of hospitalization was 5.21 days in severe dengue and 3.4 days in non-severe dengue cases. Fever was the most common presenting symptom and hepatomegaly was the common clinical finding in the study.  Bleeding manifestations were seen in cases of severe dengue with raised haematocrit levels, raised SGOT levels and severe thrombocytopenia. Pleural effusion and gall bladder wall thickening with ascites was seen in severe dengue cases. Management was by administration of colloids and crystalloids.Conclusions: Dengue is a dreadful fever among pediatric age group which needs to be considered with great caution in management.  Understanding the risk factors helps in predicting the mortality which helps in management and better outcome of the fever. 

2020 ◽  
Vol 7 (8) ◽  
pp. 1747
Author(s):  
Minakshi Bhat ◽  
Anjali Otiv

Background: Dengue fever is a mosquito born arboviral illness endemic in tropical countries and causes significant mortality and morbidity due to lack of definitive treatment. The objective of this study was to assess the clinical and laboratory profile of confirmed cases of dengue in children up to 12 years of age and also to charactrise the risk factors for severe dengue.Methods: This is a descriptive, observational, retrospective study done in the Department of Pediatrics, Terna Medical College, Nerul, Navi Mumbai, India.   Medical records of all children up to 12 years of age diagnosed to have dengue   were reviewed.  Their clinical and laboratory profile were recorded in a pro forma and analyzed. All cases were classified as per WHO guidelines into non severe and severe dengue cases.Results: Among the 117 confirmed dengue cases, (84.6%) had non severe dengue and (15.4%) had severe dengue. The most common age group affected was 9-12 years (45.3%) with a male to female ratio of 2.4:1. Fever was the most common clinical feature seen in all cases followed by headache (83%), myalgia (81%), ascites (24.7%), vomiting (17.9%). Clinical signs of ascitis, hepatomegally, gastrointestinal bleeding, pleural effusion and shock were predominantly associated with severe dengue cases. Laboratory parameters showed leukopenia in 58.1% and thrombocytopenia (platelet counts <20,000/cumm3) in16.2% cases. Elevated liver enzymes, raised hematocrit (36.3%) and coagulation abnormalities were seen in over 50% dengue cases and were significantly associated with severe dengue dengue.Conclusions: Knowledge of clinical   and laboratory profile of dengue cases of a particular area will help in early prediction of risk factors for severe dengue resulting in favourable outcome of such cases.


2016 ◽  
Vol 4 (1) ◽  
pp. 110 ◽  
Author(s):  
Natwar Lal Sharma ◽  
Vasuki Balasubramanyam ◽  
Jithendra Kandati ◽  
Munilakshmi Ponugoti

Background: Dengue fever is a mosquito borne arboviral disease which is of global concern. It is endemic in tropical countries with annual incidence of 7.5 to 32.5 million cases. It commonly affects the young adults and paediatric cases of Dengue haemorrhagic fever has high mortality. The objective of this study was to assess the clinical and laboratory profile and outcomes of dengue fever in children of less than 18 years of age. The study was conducted for a period of one year during an outbreak, in a tertiary care hospital of Chennai, Tamilnadu, India.Methods: This was a prospective cross sectional study and 200 cases of dengue fever were enrolled and classified as per WHO guidelines. The clinical profile and demographic profile was recorded in a structured questionnaire form. Haematological parameters were recorded and followed till the day of discharge. The duration of stay was recorded and outcomes were noted.Results: A total of 200 cases with 113 males and 87 females, 177 non severe dengue cases and 23 severe cases of dengue fever were classified. The mean age of admission was 9 years and mean duration of stay in hospital was 4.61 days. Fever was most common presenting symptom (100%) and hepatomegaly (58.5%) was common clinical finding. Bleeding manifestations were seen in severe dengue cases. Statistical significance was seen in rise in SGOT levels, rise in haematocrit and pleural effusion with severe dengue cases and non-severe dengue cases. The case fatality rate was zero.Conclusions: Understanding the knowledge of presentations and associated features would help to predict the severity of the disease. In children, if symptoms like fever, pain, rashes, and vomiting are associated with Hepatomegaly and elevated SGOT in context of low total platelet count, a strong possibility of dengue fever is present, especially in an epidemic setting. Early suspicion and effective management can reduce the severity.


2020 ◽  
Vol 7 (2) ◽  
pp. 382 ◽  
Author(s):  
V. Shekar ◽  
K. Praveen Kumar ◽  
C. Soren ◽  
K. Venkataramana Reddy ◽  
N. Dharani

Background: Dengue is a self-limiting, vector-borne disease transmitted by Aedes mosquito, causing a major public health threat globally. The objective of this study is to assess the clinical profile and outcome of the dengue infection in children less than 14 years of age September 2018 to August 2019 at the Pediatric Department of S.V.S. Medical College, the tertiary care hospital in Mahabubnagar, Telanagana.Methods: Prospective study of 82 hospitalized children of <14 years with the diagnosis of dengue illness. Children with diagnosis of dengue were classified further in to two groups as per WHO guidelines, Non-severe dengue fever (probable dengue, dengue with warning signs) and ‘Severe Dengue’ (Dengue Haemorrhagic Fever and/or Dengue Shock Syndrome (DHF/DSS). A separate questionnaire form used for documenting clinical history, laboratory parameters. Haematological parameters were noted, chest x-ray, ultra-sonogram in required cases was done. Children were managed as per WHO protocol. The outcomes of the cases were mentioned as discharge, left against medical advice and death.Results: A total of 82 children with dengue were divided in to 55(67%) non severe dengue and 27(33%) severe dengue with males 56(68.2%) and females 26(31.7%). The most common age of presentation was between 6-10 years 34(41.5%). Fever 73(89%) was the most common presenting symptoms. Pleural effusion and hepatomegaly were the commonest clinical findings 28(34.1%) each, which were more among the severe dengue patients. Gall bladder edema 29(35.3%) was the most common ultra-sonogram finding. Significant elevation of transaminases (SGOP, SGPT) was seen in 39(47.5%). Severe thrombocytopenia was observed in 22(26.8%) children. Management was by administration of colloids and crystalloids.Conclusions: Dengue is a global problem. Presenting features include high grade fever, vomiting, abdominal pain, skin rash. Early recognition of symptoms and proper management can reduce the mortality.


Author(s):  
Santosh R. Goudar ◽  
Heshweaanth R. D. ◽  
Jobin Mathew ◽  
Vipul Agarwal ◽  
Rohith George

Background: Dengue is a mosquito-borne infectious disease of the tropical and subtropical countries which is rapidly becoming a global burden. It is caused by any of the four serotypes of dengue virus. Dengue disease presentation varies from mild fever with myalgia and fatigability to severe conditions of dengue haemorrhagic fever and shock syndrome. This study describes the clinical features, laboratory parameters and outcomes of the dengue fever patients during the monsoon season in a tertiary care hospital.Methods: This is retrospective, single centre study carried out at Yenepoya medical college and hospital (YMCH), Mangalore a coastal town in southern India. All patients who were adults (aged>16 years), positive for rapid (NS1 antigen) test or dengue IgM Elisa and admitted from 1-5-2019 to 31-9-2019 (monsoon season) were included in this study. Data was collected from the medical records of YMCH.Results: The male to female ratio of patients in this study was about 4:1. About 70.1% belonged to the age group between 16-35 years. The predominant symptoms on admission were fever, headache, myalgia, nausea and vomiting, abdominal pain, loose stools, bleeding manifestations and skin rashes. Average days of hospitalization are 5.88 days (SD 2.94). Thrombocytopenia leukopenia raised hematocrit and transaminases are the commonly observed laboratory findings. Ascites, pleural effusion, gall bladder wall edema, sepsis, bradycardia, hypotension, ARDS, and acute kidney injury are the complications observed during the illness. Mortality rate in this study is 1.9%.Conclusions: As seen in this study dengue fever is predominantly affecting the younger age group. The early confirmation of diagnosis, identifying the warning signs and prompt supportive management will help in preventing the further complications and in reducing the mortality. Increased public awareness and vector control measures are important factors to be taken into consideration in the prevention of dengue.


2017 ◽  
Vol 03 (02) ◽  
pp. E76-E81 ◽  
Author(s):  
Jitendra Parmar ◽  
Chander Mohan ◽  
Maulik Vora

Abstract Background Dengue fever is a major public health problem with an increased incidence in recent years. Gall bladder wall thickening has been reported as one of the most common findings in dengue fever. There is a paucity of literature regarding the various patterns of gall bladder wall thickening in dengue fever and their significance in predicting the severity of disease. Methodology and Significant Findings Out of 93 seropositive patients included in the study, 54 patients with dengue fever had gall bladder wall thickening. 4 patterns of gall bladder wall thickening are demonstrated in this study. A uniform echogenic pattern in 20 patients, striated or tram track pattern in 11 patients, an asymmetric pattern in 2 patients and a honeycombing pattern in 21 patients. The range of patterns of wall thickening included normal wall thickening or uniform echogenic wall thickening in DF without warning signs, a striated or tram track pattern, and a honeycomb pattern in severe DF. Serial ultrasound done on consecutive alternate days revealed a change in the pattern of gall bladder wall thickening according to the severity of disease. Conclusion The present study revealed 4 distinct patterns of gall bladder wall thickening. The uniform echogenic pattern was found to be more prevalent in dengue fever without warning signs, while the honeycomb pattern was found to be more prevalent in severe dengue fever. A change in the pattern of gall bladder wall thickening on subsequent serial ultrasound can predict the severity of the disease.


2019 ◽  
Vol 6 (3) ◽  
pp. 1194
Author(s):  
Belgin Premkumar ◽  
Baburaj S. ◽  
Margaret Hepzibah N. ◽  
Misha K. P. ◽  
Binu Abraham

Background: Dengue fever is the most rapidly spreading mosquito-borne viral disease in the world.Incidence has increased 230-fold with increasing geographic expansion with potential for further spread. The rapidly expanding global footprint of dengue is a public health challenge with an economic burden. This study’s objective is to assess the outbreak of epidemic of dengue fever in a tertiary care children hospital and to describe their socio-demographic, clinical outcome and serological profile.Methods: It is an observational descriptive study conducted for a period of 1 year in less than 12 years old children in a tertiary care hospital at Southern Tamil Nadu.Results: Among the 360 children admitted with dengue fever, there were 198 boys (55%) and 162 (45%) were girls. Maximum incidence of dengue incidence was seen in infants less than 1 year (25%). The highest number of cases were admitted during September and October. The most common affected age group was less than 3 years with 179 (49%). Among the cases, 297 (82%) were of severe dengue which constitute dengue haemorrhagic fever-183(38%) and Dengue shock syndrome 114 (62%). Serological analysis showed NS1 Ag was positive in 144 children (40%), Dengue IgM was positive in 54 children (15%), both IgM and IgG positive in 126 children (35%) and IgG was positive in 36 children (10%). Out of the total children admitted with dengue fever, the case fatality was 0.5% (2 children).Conclusions: This study highlights the importance of WHO clinical criteria for early diagnosis of severe dengue. Moreover, the early and intensive management reduces the mortality significantly.


2018 ◽  
Vol 5 (6) ◽  
pp. 2265 ◽  
Author(s):  
Senthil Kumar K. ◽  
Rajendran N. K. ◽  
Ajith Brabhukumar C.

Background: In India, dengue epidemics are becoming more frequent (WHO, 2008). The majority of dengue viral infections are self-limiting, but complications may cause high morbidity and mortality. The objective of this study is to assess the clinical profile of the dengue infection in children less than 15 years of age and to evaluate the outcomes of dengue fever from March 2017 to July 2017 at the Pediatric Department of Karuna Medical College, the tertiary care hospital in Palakkad.Methods: In this retrospective study, medical records were reviewed and analyzed. Patients with suspected dengue infection were classified further into 2 groups, Dengue fever (probable dengue, dengue with warning signs) and ‘Severe Dengue’ (dengue hemorrhagic fever and/or dengue shock syndrome (DHF/DSS) according to WHO.Results: A total of 77 cases were classified into 67 (87%) non-severe and 10 (13%) severe dengue cases. The most common age of presentation was above 10 yrs. The mean age of admission was 8.9 yrs. The most common presenting symptom was fever seen in 93% followed by vomiting in 68%. Elevation in Aspartate transaminase (SGOT) and thrombocytopenia were found in 32.4 %.Conclusions: High grade fever, vomiting, abdominal pain and skin rash with normal or low platelet count were the presenting features. Early diagnosis, monitoring and prompt supportive management can reduce mortality.


2017 ◽  
Vol 4 (2) ◽  
pp. 464
Author(s):  
Poornima Shankar ◽  
Prarthana B.

Background: Dengue fever (DF) is the arboviral infection with the largest incidence worldwide. Clinical expression of dengue virus infection varies from no symptoms to severe dengue with shock. It is the most rapidly spreading vector borne disease in the world. Nearly 100 million cases of Dengue fever and between 250,000 and 500,000 cases of severe dengue are annually reported to the WHO. The objective of this study was to study aims at determining the LDH and serum albumin levels as early parameter to predict the severity of Dengue illness.Methods: A observational clinical study conducted at K.I.M.S hospital, Bangalore, Karnataka, a tertiary care hospital. Children admitted in KIMS Hospital, Bangalore, Karnataka, a tertiary care hospital, Serum LDH and serum albumin levels are measured using the blood sample taken on the 3rd day of fever after confirmation of dengue fever (NS1 Ag- positive).Results: Study enrolled 150 patients with confirmed infection of Dengue virus who were admitted to paediatric unit between July 2014 and December 2016. Serum samples taken 72-96 hours within onset of fever were used for biochemical tests. Of 150 patients, 40 developed Severe Dengue (SD). Cases of SD had higher levels of lactate dehydrogenase (LDH) and low levels of serum albumin. Multivariate analysis showed that early alterations of LDH levels i.e.  Out of 40 patients who developed severe dengue, 37 patients i.e. 92.7% had raised levels of LDH with levels more than >600 IU and<3 levels of serum albumin 13 patients i.e 32.5% of severe dengue cases with P value of < 0.001, which showed significant association.Conclusions: Early alterations of biochemical parameter like LDH and serum albumin can predict Severe Dengue in patients with acute dengue illness.


2020 ◽  
Vol 7 (7) ◽  
pp. 1619
Author(s):  
Md. Wahiduzzaman Mazumder ◽  
Maimuna Sayeed ◽  
Md. Benzamin ◽  
Mahfuza Chowdhury

Background: Constipation is a common problem throughout childhood. It is important to be fully aware of the factors involved in developing constipation in children. There are few published articles on childhood constipation in Bangladesh. In this study, our aim was to evaluate demography and probable/potential risk factors for functional constipation in Bangladeshi children.Methods: The study was carried out among 179 children from May 2018 to June 2019 in the department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU) both indoor and outdoor basis. Children with constipation who fulfilled the ROME III criteria were evaluated for demography and probable/potential risk factors of constipation.Results: A total of 179 subjects were included in the final analysis. Among them, 54.75% were boys and 45.25% were girls. Constipation was found more in the age group above 5 years (56.42%), then in 2 to 5 years age group (33.52%) and lower in below 2 years of age (10.6%). Constipation was more among children living in urban area (55.3%) than in rural area (44.69%). Constipation was the presenting complaint in 76.54% subjects, other complaints were abdominal pain (47.49%), anorexia (24.02%), vomiting (19.56%). Diet low in fiber (72.63%) was found as the most common potential risk factor, other factors were ingestion of cow’s milk (32.96%), not having regular meals with parents (19.55%), consumption of junk foods (28.49%). Staying with grandparents (16.76%), living in hostel or madrasa / residential religious institute (5.03%), long period of academic activity, [homework (10.61%) / tutor and coaching (7.26%)], unhygienic toilet in school (6.14%) were also found to be probable associated factors in this study.Conclusions: Functional constipation was found more in boy’s and above five year age group. Low dietary fiber, consumption of cow’s milk and junk food, unwillingness to use toilets in school, long time in academic activity, were found to be potential underlying risk factors of constipation.


2021 ◽  
Vol 15 (2) ◽  
pp. 65-68
Author(s):  
Sharmistha Roy ◽  
Mosammat Mira Pervin ◽  
Mohd Mejbahul Bahar ◽  
Samiron Kumar Mondal ◽  
Md Tariq Hasan

Breast cancer is one of the common cancers in women that causes financial health burden and or death in Bangladesh. Economically we are slowly rising from low to middle income country, which is changing our women's lifestyle. Risk factors of breast cancer include lifestyle factors like- age at first childbirth, parity, using oral contraceptives, BMI; which are also changing in our women. This study will look at our current incidence and patient profile of breast cancer patient. This is a retrospective study done in BIRDEM General Hospital. One hundred patient presenting with breast lump during the period of September 2018 -May 2019 were selected by purposive sampling. In <30 years age group 2 (13.6%) patient had cancer, 41% at <40 years, 53% in 51-60 , 83% in 61-70 age group. Thirty four out of 100 breast lump patient were diagnosed with cancer. Eleven had early cancer, 20 had locally advanced cancer, 3 presented with metastasis. In our study risk factor assessment did not show significant increase risk of in patients who are having cancer compared to those having benign breast disease with similar risk factors. The big number of advance and metastatic breast cancers in our study indicates self-breast examination and breast cancer screening program is still inadequate. Further research is required to find out breast cancer biology and pathogenesis rather than blindly accusing urbanized life style. Faridpur Med. Coll. J. 2020;15(2): 65-68


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