scholarly journals Bed side prognostic markers for dengue fever: serum lactate, base excess and central peripheral temperature gradient

2017 ◽  
Vol 4 (6) ◽  
pp. 2041 ◽  
Author(s):  
Najia Hassan ◽  
Sujaya Mukhopadhyay ◽  
Prasun Bhattacharjee ◽  
Rajshree Sinha
Keyword(s):  
Temperature Gradient ◽  
Dengue Fever ◽  
Base Excess ◽  
Hypovolemic Shock ◽  
Dengue Shock Syndrome ◽  
Serum Lactate ◽  
Rational Approach ◽  
P Value ◽  
Monitoring Method ◽  
Peripheral Temperature

Background: Dengue is a common systemic viral infection, which has achieved epidemic proportion in India. The manifestations are varied, is most often a simple febrile illness, but at times it can be severe with hypovolemic shock resulting from excessive plasma leakage. Dengue shock syndrome is potentially fatal, with mortality ranging from <1% to 10%. The key to a good clinical outcome is understanding and being alert to the clinical problems that arise during the different phases of the disease, leading to a rational approach in case management. Investigations which can help in prognostication if used sequentially can be very effective in management. Serum lactate, base excess and central peripheral temperature gradient are few such markers which can help in identifying at risk patients.Methods: In this study children in the age group of 6 months to 18 years, admitted in School of Medical Sciences and Research with complains of fever and found to be positive for dengue as per Ag/serology study were included. The study was done over a period of one year from August 2015 to August 2016. ABG/VBG for Serum lactate and base excess was done in all patients on confirmation of diagnosis of dengue and on progression of disease. Also, central and peripheral temperatures were measured.Results: A total of 524 patients were enrolled. 77.29% were of dengue fever. 14.50% of dengue hemorrhagic fever and 8.21% were of dengue shock syndrome. Mean central and peripheral temperature difference was found to be higher for patients with DSS than with DHF and DF. High Lactate levels was found to be 100% sensitive and specific for mortality, likewise decreasing base excess was found to be 84.62% sensitive and 90.56% specific for mortality. Cp-T difference had sensitivity of 100% and specificity of 96.59%. All three had p-value of 0.01 which is significant.Conclusions: A single ABG/VBG analysis can give values for Serum lactate and base excess both of which are very good indicators of intravascular fluid status and are easily available. Done sequentially, these tests can predict progression of dengue fever. Likewise, temperature gradient is not so expensive tool. Used properly, is very effective monitoring method.

scholarly journals Level of Vitamin D, TNF-Alpha and Calcium in Patients with Dengue Fever, Dengue Hemorrhagic Fever and Dengue Shock Syndrome

2018 ◽  
Vol 3 (10) ◽  
pp. 1-5
Author(s):  
Rabail Javed
Keyword(s):  
Vitamin D ◽  
Dengue Fever ◽  
Dengue Hemorrhagic Fever ◽  
Dengue Shock Syndrome ◽  
Hemorrhagic Fever ◽  
Tnf Alpha ◽  
P Value ◽  
Severity Of Disease ◽  
Vitamin D Levels ◽  
Tnf Α

Background: Vitamin D has been widely studied for its beneficial role in treating different diseases. Dengue epidemic has affected many house hold since last decade. Vitamin D seems a gate through in its treatment as it inhibits Th1 cytokine activities, responsible for the development of dengue complications.Objective: To determine the levels of vitamin D, TNF- α and calcium in patients with variation of dengue fever stages.Methods: A cross sectional analytical study conducted on dengue confirmed patients (fever, hemorrhagic, shock) admitted in tertiary care hospitals of Lahore (IRBNo.1165). After obtaining informed consent the study objectives were explained to the patients and data collected. Patients were classified into three groups (a) dengue fever (DF)  (b) dengue hemorrhagic fever(DHF) and (c) dengue shock syndrome (DSS) (40+30+10 cases). Serum from 5cc blood was stored at –20⁰ C until analysis. The data was analyzed using SPSS version 21.Results: The study was conducted in 4 hospitals of Lahore on 80 NS1confirmed cases (age: 5-70 years). The age difference, vitamin D and calcium levels were significant (p-values 0.030, 0.047 and 0.003 respectively). Calcium levels were lowest in DSS and significantly lower than DHF patients. Vitamin D levels were higher among those with higher severity of disease with p-value 0.031. The patients did not have significantly different TNF α levels. There were 90.0% of DSS cases that had TNF α levels > 100, (p-value 0.109).Conclusion: High levels of TNF-alpha are associated with dengue complications regardless of vitamin D levels and severity of disease.

scholarly journals Effect of co morbidities on the clinical outcome of Dengue fever

2019 ◽  
Vol 6 (3) ◽  
pp. 750
Author(s):  
Dhivya P. ◽  
Nagesh G. N. ◽  
Jayaramachandran S.
Keyword(s):  
Risk Factors ◽  
Clinical Outcome ◽  
Dengue Fever ◽  
Dengue Shock Syndrome ◽  
Viral Disease ◽  
P Value ◽  
Increased Risk ◽  
Specialized Care ◽  
Duration Of Hospitalization ◽  
Patients At Risk

Background: Dengue is the most rapidly spreading mosquito-borne viral disease in the world. A number of Dengue Haemorrhagic Fever (DHF) risk factors had been suggested. However, these risk factors may not be generalized to all populations and epidemics for screening and clinical management of patients at risk of developing DHF/ Dengue shock syndrome (DSS).Methods: A hospital based prospective case control study was done by taking 40 cases each of dengue fever with diabetes mellitus, hypertension, diabetes and hypertension and 30 cases of dengue with asthma/COPD and these patients were compared with controls of 100 patients with dengue fever but no comorbidities. All patients had Dengue serology NS1 or IgM positive.Results: Patients admitted with dengue fever with comorbidities had increased duration of hospitalization with P value of 0.012. The clinical outcome of the 250 patients. In the subgroup of dengue fever patients with DM and Dengue fever with DM and HTN, they were noted to have a 2.69 and 3.06 times increased risk effect of DHF.Conclusions: Dengue fever with DM or DM with HTN have a higher risk of developing DHF when compared with patients with dengue fever with no comorbidities. This finding helps us in triaging patients with comorbidities who develop dengue fever for specialized care and closer clinical monitoring.

scholarly journals A study of clinical and laboratory profile of dengue positive cases in hadoti region Rajasthan, India

2020 ◽  
Vol 8 (4) ◽  
pp. 1314
Author(s):  
Vijay Kumar Meena ◽  
Shyam Bihari Meena ◽  
S. R. Meena
Keyword(s):  
Dengue Fever ◽  
Bladder Wall ◽  
Dengue Shock Syndrome ◽  
Hemorrhagic Fever ◽  
Common Finding ◽  
Wall Thickening ◽  
P Value ◽  
Serum Aminotransferase ◽  
Female Ratio ◽  
Significant Difference

 Background: Dengue fever is one of the most common arboviral mediated outbreaks reported with increased prevalence year after year with considerable morbidity and mortality in hadoti region. the aim to study various clinical and laboratory manifestations of Dengue fever admitted in MBS Hospital KOTA, with a diagnosis of Dengue fever according to WHO protocol from December 2018 to January 2020.Methods: Prospective observational study was undertaken among adult patients. 132 patients were studied and analysed. And diagnosis was confirmed with Dengue IgM ELISA test. Other routine investigations done were routine hematological and biochemical investigations.Results: A total of 132 cases, out of which 95 cases of Dengue Fever (DF), 34 cases of dengue hemorrhagic fever and 3 cases of Dengue Shock syndrome, out of which Male: Female ratio was 2.1. and mean age of presentation was 37. Fever and myalgia were the most common finding (100%) followed by arthralgia and headache. Pruritus was found in 21 cases (15.9%) which carried a significant difference between DF and DHF (p value <0.05). Among the laboratory features, thrombocytopenia and hematocrit were found to be statistically significant in DHF patients (p value <0.05). Mean platelet count was 0.71 lakhs/mm3. Leukopenia in 40(30.3%) cases. Raised Serum Aminotransferase level, AST (>40 IU/L) was seen in 39 cases (29.54%.). Pleural effusion was seen in 4 cases (3%), of which 3 cases of DHF and 1 case of DSS. Ascites in 6 cases (4.8%), all cases belong to DHF. Gall bladder wall thickening was seen in 28 cases (21.21%) of which 20 cases (54.04%) were of DHF. Melena was the most common bleeding manifestation. Skin rash was found to be positive in 40.5% cases. Hess test was positive in 4 cases (10.8% of DHF).Conclusions: Incidence of dengue fever is on the rise in hadoti region and one of the most important differential diagnosis of patients presenting with fever during monsoon and post monsoon seasons.

COMPARATIVE STUDY OF THE KNOWLEDGE AND THE CURRENT PRACTISE AMONG THE EMERGENCY PHYSICIANS AND OTHER PHYSICIANS REGARDING THE ADMISSION CRITERIA OF DENGUE FEVER IN KOLKATA.

2021 ◽  
pp. 50-52
Author(s):  
Rukuzo Nyeka ◽  
Indraneel Dasgupta
Keyword(s):  
Dengue Fever ◽  
Dengue Shock Syndrome ◽  
Hemorrhagic Fever ◽  
Viral Disease ◽  
Research Centre ◽  
Admission Criteria ◽  
Emergency Physicians ◽  
Medicine Department ◽  
Validated Questionnaire ◽  
Surgery Department

Introduction: Dengue fever is a mosquito-borne viral disease caused by a avivirus. There are four distinct serotypes of dengue virus, namely DEN-1, 2, 3 and 4. Female Aedes aegypti and Aedes albopictus mosquitoes are the primary and secondary vectors in Malaysia, respectively. Evidently, dengue is the most rapidly spreading arboviral disease in the world. Aim: To know about the knowledge and current practice of the emergency physicians and other physicians regarding admission criteria of dengue fever in Kolkata. To preserve the resource and to prevent unnecessary utilization of hospital facilities during dengue epidemics by following up the proper criteria of admission for acute febrile patient suspecting of dengue fever/ dengue hemorrhagic fever/ dengue shock syndrome from the emergency department. Materials and methods: This is a questionnaire-based study and the study was conducted in peerless hospital and b.k roy research centre. The duration of the study was one year (from 1/01/2019- 31/12/2020). Apre validated questionnaire was distributed among the emergency physicians and other general physicians who deal with management of dengue patients and the responses so obtained were analysed. Total 125 participants were present in this study. Result: We found that 5(4.0%) doctors work in Cardiology department, 40(32.0%) doctors work in Emergency medicine department, 6(4.8%) doctors work in Gynecology department, 46(36.8%) doctors work in Medicine department, 8(6.4%) doctors work in Nephrology department, 8(6.4%) doctors work in Neurology department, 8(6.4%) doctors work in Orthopedic department and 4(3.2%) doctors work in Surgery department. Conclusion: However, a knowledge gap has been reported regarding important issues in clinical presentation, treatment, prevention, and control. Practices regarding frequent clinical monitoring were consistent with local and international guide-lines

Risk Factors Associated With Dengue Fever Outbreak in Taiz Governorate, Yemen, 2018: Case-control Study

2021 ◽  
Author(s):  
Abdulkareem Ali Hussein Nassar ◽  
Amr Abdulaziz Torbosh ◽  
Yassin Abdulmalik Mahyoub ◽  
Mohammed Abdullah Al Amad
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Case Control Study ◽  
Significant Risk ◽  
Case Fatality ◽  
Case Control ◽  
Case Definition ◽  
P Value ◽  
Factors Associated ◽  
Control Study

Abstract Background: Dengue Fever (DF) is a significant health problem in Yemen especially in the coastal areas. On November 6, 2018, Taiz governorates surveillance officer notified the Ministry of Public Health and Population on an increase in the number of suspected DF in Al Qahirah and Al Mudhaffar districts, Taiz governorate. On November 7, 2018, Field Epidemiology Training Program sent a team to perform an investigation. The aims were to confirm and describe the outbreak by person, place and time in Taiz governorate, and identify its risk factors.Methodology: Descriptive and case-control study (1:2 ratio) were conducted. WHO case definition was used to identify cases in Al Qahirah or Al Mudhaffar districts during August-November 2018. Control was selected from the same districts who did not suffer from DF. Predesigned questionnaire was used to collect data related to sociodemographic, behavioral and environmental characteristics. Bivariate and multivariate backward stepwise analyses were used. The adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated. A P value < 0.05 was considered as the cut point for statistically significant. Epi info version 7.2 was used.Results: A total of 50 DF cases were found. Almost 52% were males and 76% were <30 years of age. The overall attack rate was 1/10,000 of the population. Case fatality rate was 4%. In multivariate analysis, not working (aOR = 26.6, 95% CI: 6.8–104.7), not using mosquito repellent (aOR = 13.9, 95% CI:1.4–136.8), wearing short sleeves/pants (aOR = 27.3, 95% CI: 4.8–156.8), poor sanitation (aOR = 5.4, 95% CI: 1.4–20.3), presence of outdoor trees (aOR = 13.2, 95% CI: 2.8–63.0) and houses without window nets (aOR = 15.7, 95% CI: 3.9–63.4) were statistically significant risk factors associated with DF outbreak. Eleven 11 (58%) of blood samples were positive for DF IgM.Conclusions: DF outbreak in Al Qahirah and Al Mudhaffar districts, Taiz governorate was confirmed. This study provides evidence-based information regarding the identified risk factors that contributed to the occurrence of this outbreak. Raising community awareness on the importance of personal protection measures and improving the sanitation services are strongly recommended.

scholarly journals Mitochondrial Dysfunction in Early Diagnosed Autism Spectrum Disorder Children

2017 ◽  
Vol 26 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Shorifa Shahjadi ◽  
Arif Salam Khan ◽  
Mesbah Uddin Ahmed
Keyword(s):  
Autism Spectrum Disorder ◽  
Mitochondrial Dysfunction ◽  
Venous Blood ◽  
Autism Spectrum ◽  
Serum Lactate ◽  
Spectrum Disorder ◽  
Control Group ◽  
P Value ◽  
Blood Ammonia ◽  
Normal Children

Background: Mitochondrial dysfunction and abnormal brain bioenergetics can cause autism.Cellular function impairment due to mitochondrial dysfunction may cause cognitive impairment, language deficits and abnormal energy metabolism in autism.Objective: The aim of this study was to evaluate biochemical evidence of the mitochondrial dysfunction by measuring blood ammonia, serum lactate, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and creatinine kinase (CK) in autism spectrum disorder children.Methods: This observational type of analytical study with case-control design was conducted in the Department of Physiology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka. For this study, a total number of 20 Subjects were randomly selected, among which 10 were apparently healthy subjects (control group-A) for comparison and 10 were diagnosed children with autism spectrum disorder (study group-B). 5ml venous blood was collected from both groups for analysis serum CK, AST, ALT, lactate and blood ammonia. Blood ammonia, serum lactate, AST, ALT and CK level were estimated in all children by standard laboratory method. Independent sample‘t’ test was used for statistical analysis. P value <0.05 was accepted as significant. The mean of all the measured biochemical variables in normal children were within normal ranges.Result: Blood ammonia, serum lactate, AST, CK were found significantly higher in autism spectrum disorder children in comparison to control Conclusion: From the result of this study it may be concluded that mitochondrial dysfunction occur in autistic spectrum disorder children .J Dhaka Medical College, Vol. 26, No.1, April, 2017, Page 43-47

Danger of using core/peripheral temperature gradient as a guide to therapy in shock

1987 ◽  
Vol 15 (9) ◽  
pp. 850-852 ◽  
Author(s):  
IAN WOODS ◽  
ROBERT G. WILKINS ◽  
J. DENIS EDWARDS ◽  
PAUL D. MARTIN ◽  
E. BRIAN FARAGHER
Keyword(s):  
Temperature Gradient ◽  
Peripheral Temperature

scholarly journals Authors Response: Reflections on Afro-descendant origin and the outcome of dengue fever cases in Colombia.

2017 ◽  
pp. 99-100
Author(s):  
Jorge Humberto Rojas Palacios ◽  
Alberto Alzate ◽  
Héctor Jairo Martínez Romero ◽  
Alberto Ignacio Concha Eastman
Keyword(s):  
Natural History ◽  
Ethnic Group ◽  
Dengue Fever ◽  
Lower Risk ◽  
Hypovolemic Shock ◽  
Capillary Leakage ◽  
Dengue Disease ◽  
History Of

1. lightly concludes that the Afro-Colombian population presented a lower risk of complications compared to the non-Afro-Colombian population R / The course of the natural history of dengue disease, in Cases that make capillary leakage without adequate and timely management with hydration monitored and sustained for at least 48 hours, is towards the hypovolemic shock that is the main cause of other forms Serious and the route to death. The results in lethality do not reflect a higher volume of severe cases in the AfroColombian ethnic group compared to the Non AfroColombiana.

scholarly journals Tumbuhan Obat: Pendekatan Alternatif dalam Pengendalian Nyamuk Aedes aegypti dan Virus Dengue Penyebab Demam Dengue

2018 ◽  
Vol 4 (2) ◽  
pp. 83-90
Author(s):  
Ign Joko Suyono ◽  
Aditya K. Karim
Keyword(s):  
Medicinal Plant ◽  
Aedes Aegypti ◽  
Dengue Fever ◽  
Mosquito Control ◽  
Dengue Shock Syndrome ◽  
Viral Disease ◽  
Mosquito Vector ◽  
Major Health ◽  
Alternative Approach ◽  
Control And Prevention

Dengue is the most important emerging tropical viral disease of humans in the world today. Aedes aegypti is a major mosquito vector responsible for transmitting many viral diseases and this mosquito that spreads major health problems like dengue fever. The resistance of Ae. aegypti to insecticides is already widespread and represents a serious problem for programmes aimed at the control and prevention of dengue in tropical countries. The search for compounds extracted from medicinal plant preparations as alternatives insecticide for mosquito control is in immediate need. Alternative approach for control Ae. aegypti dan virus dengue using the medicinal plant will be discussed in this paper.Key words: Medicinal plant, Aedes aegypti, dengue fever, dengue haemorragi fever, dengue shock syndrome

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