scholarly journals Relative bradycardia- indicator of severe dengue fever: a comparative study between PICU and ward patients

2021 ◽  
Vol 8 (5) ◽  
pp. 839
Author(s):  
Priyasha Tripathi ◽  
Priya Gogia ◽  
Surendra Singh Raghuwanshi
Keyword(s):  
Comparative Study ◽  
Dengue Fever ◽  
Clinical Features ◽  
Early Recognition ◽  
Limited Resource ◽  
Initial Assessment ◽  
Severe Dengue ◽  
Clinical Feature ◽  
Resource Limited ◽  
Almost All

Background: Mortality due to dengue fever during epidemics is very high with all the four serotypes actively found in India. It is very difficult to distinguish and manage illness of viral aetiologies based on initial clinical features. Bradycardia can be seen as notable clinical finding in severe dengue fever. Clinical features that can be used in the initial assessment of febrile patients are essential tools for physicians in limited resource settings. Awareness of bradycardia as an early indicator of severe dengue fever could help in the early recognition and potentially reduce morbidity and mortality.Methods: This is an observational comparative study of 40 dengue fever positive paediatric patients admitted in PICU and general ward. The study was conducted at Atal Bihar Vajpayee Govt Medical College, Vidisha from 20 August to 20 November 2020 (3 months).Results: Bradycardia, as a significant clinical feature was present in almost all PICU patients as compared to ward patients. It can be taken as a clinical marker of severity to prevent life threatening complications of dengue like shock and haemorrhage.Conclusions: With specific WHO guidelines to classify and treat dengue fever, we try to prevent its deadly consequences but in resource limited settings like ours, initial clinical judgement can prevent much causality and prepare us to foresee and timely manage the complications.

scholarly journals Clinicohaematological profile of dengue in children: a hospital based study

2017 ◽  
Vol 4 (4) ◽  
pp. 1340 ◽  
Author(s):  
Irshad Abdul Majeed ◽  
K. Shreedhara Avabratha ◽  
Lokesha R. Gowda ◽  
Sadia Syeda
Keyword(s):  
Dengue Fever ◽  
Early Recognition ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Haematological Parameters ◽  
Severe Dengue ◽  
Clinical Feature ◽  
Igm Elisa ◽  
Ns1 Antigen ◽  
Atypical Presentations

Background: Dengue fever is one of the most common arbo virus mediated outbreaks, being reported from different parts of the world. Now as the outbreaks are hitting different geographic locations, different clinical manifestations are being reported recently. The aim of this study is to document varied clinical manifestations and haematological parameters of dengue patients in a tertiary care centre.Methods: A total 130 cases of any of NS1 antigen, IgM card test positive or IgM ELISA positive dengue patients were included in this observational study. Clinical and haematological parameters were noted and analysed statistically.Results: Most common clinical feature was fever (100%) followed by headache (51.5%). Atypical features like seizures due to encephalitis was seen in a child with dengue. Seizure were present in 1.5% of cases, two children died due to severe dengue with shock and multi organ failure. In our study 26.92% of patients had thrombocytopenia. The mean Hb was 12.86 g/dl and platelet count was 104202/mm3.Conclusions: Fever and headache are the main features of dengue. However, one should be aware of different atypical presentations of dengue fever to diagnose and intervene timely. Early recognition of complication and timely intervention are required in the management of dengue cases. 

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 No clinical or biological difference between Chikungunya and Dengue Fever during the 2010 Gabonese outbreak

2012 ◽  
Vol 4 (1) ◽  
pp. 5 ◽  
Author(s):  
Dieudonne Nkoghe ◽  
Roland Fabrice Kassa Kassa ◽  
Ulrich Bisvigou ◽  
Mélanie Caron ◽  
Gilda Grard ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Comparative Study ◽  
Dengue Fever ◽  
Clinical Features ◽  
Biological Data ◽  
Statistical Analyses ◽  
P Value ◽  
Biological Difference ◽  
Hematological Disorders ◽  
Laboratory Confirmation

Chikungunya (CHIKV) and Dengue (DENV) viruses, both arboviruses, have caused multiple outbreaks worldwide. Their clinical features are poorly described in Africa and there is no comparative study, although Chikungunya is considered as a dengue-like disease. We conducted a comparative study of clinical and biological data from CHIKV and DENV positive patients during the 2010 Gabonese outbreak. Patients consulting with general symptoms and having laboratory confirmation for CHIKV or DENV were included. Clinical and biological data were recorded. Statistical analyses were performed using Epi Info. A P value < 0.05 was considered significant. In all, 270 CHIKV+, 53 DENV+ and 20 co-infected patients were included in the study. Headaches, hemorrhage, leukopenia and lymphopenia were significantly (P respectively 0.01, 0.001, 0.02 and 0.001) more frequent in DENV+ patients than in CHIKV+. There was no additive effect of the two viruses. These clinical and hematological disorders are non specific and cannot assist for the differential diagnosis. These diseases are clinically indistinguishable, and need for laboratory confirmation.

scholarly journals Acute Acalculous Cholecystitis in Dengue Fever: An Alert for Emergency Surgeons

2017 ◽  
Vol 6 (2) ◽  
pp. 124-126
Author(s):  
Fernando Spencer Netto ◽  
Julia R Scherer ◽  
Carla S de Oliveira
Keyword(s):  
Dengue Fever ◽  
Acalculous Cholecystitis ◽  
Viral Disease ◽  
Tertiary Hospital ◽  
Nonoperative Treatment ◽  
Initial Assessment ◽  
Severe Dengue ◽  
Acute Acalculous Cholecystitis ◽  
Abdominal Symptoms ◽  
Atypical Presentations

ABSTRACT Dengue fever is an acute viral disease, typical of tropical countries and endemic in Brazil, which can present abdominal symptoms and complications. One of its atypical presentations is acute acalculous cholecystitis (AAC), present in 6% of the severe cases. It is usually self-limited, and generally improves with nonoperative treatment. This is a case report of a patient transferred to a tertiary hospital for surgical evaluation of acute abdomen. She presented with significant abdominal findings (pain, nausea, and vomits), suggestive of acute cholecystitis. After initial assessment and examinations, the patient was diagnosed with severe dengue fever and AAC. The patient was treated conservatively and improved within 3 days. Physicians must be aware of ACC in patients with suspicious presentations in endemic areas for dengue fever. Surgery should be avoided once it is associated with significant postoperative complications and death. How to cite this article Becker MJ, Scherer JR, de Oliveira CS, Netto FS. Acute Acalculous Cholecystitis in Dengue Fever: An Alert for Emergency Surgeons. Panam J Trauma Crit Care Emerg Surg 2017;6(2):124-126.

scholarly journals Clinico-laboratory profile and outcome of dengue fever among children attending a tertiary care hospital of rural Telangana, India

2020 ◽  
Vol 7 (2) ◽  
pp. 382 ◽  
Author(s):  
V. Shekar ◽  
K. Praveen Kumar ◽  
C. Soren ◽  
K. Venkataramana Reddy ◽  
N. Dharani
Keyword(s):  
Dengue Fever ◽  
Tertiary Care Hospital ◽  
Early Recognition ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Warning Signs ◽  
Severe Dengue ◽  
Severe Thrombocytopenia ◽  
Care Hospital ◽  
Presenting Symptoms

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.

scholarly journals Clinical, laboratory and radiological profile of dengue among pediatric patients admitted in tertiary care hospital

2018 ◽  
Vol 5 (6) ◽  
pp. 2237
Author(s):  
Sangeetha Jairaj ◽  
Sridhar D. ◽  
Mettu Pradeep Reddy
Keyword(s):  
Dengue Fever ◽  
Urban Areas ◽  
Health Personnel ◽  
Clinical Laboratory ◽  
Early Recognition ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Severe Dengue ◽  
Care Hospital

Background: Dengue is found in tropical and subtropical regions around the world, predominantly in urban and semi-urban areas. Dengue mortality can be reduced by implementing early case detection and referral systems for patients; managing severe cases with appropriate treatment; reorienting health services to cope with dengue outbreaks; and training health personnel at all levels of the health system. Many studies that focus on the difference between the frequency of clinical findings in DHF and dengue shock syndrome (DSS) with respect to classical DF has been published. The objectives of the study were to assess signs and symptoms of dengue among patients with severe dengue and patients with dengue fever and to evaluate laboratory and radiological profile among dengue patients.Methods: This Hospital based cross sectional study was conducted on 70 seropositive cases, admitted in the Paediatrics Department of Gandhi hospital during the period of July to December 2017 for 6months. Data was analyzed by using SPPS Version 17 and student t test was used for inferential statistics.Results: Out of 70 cases 38 were presented with severe dengue and 32 presented with dengue fever. Average age of presentation is 7.24 years among severe dengue group, 5.52 years among dengue fever group. In group of severe dengue, 60.5% of the cases were female, which was insignificantly more as compared to 40.6% of the cases from group of dengue fever.Conclusions: All levels of health personnel must be aware of clinical signs and symptoms of all dengue types. Careful monitoring of unusual presentations early recognition severe manifestation and timely intervention can reduce disease specific mortality rate.

scholarly journals To study the clinical profile of dengue fever and to evolve a prognostic marker based on hematological parameters for severe dengue

2017 ◽  
Vol 4 (2) ◽  
pp. 538
Author(s):  
Shobhana Sivathanu ◽  
Kumar Manickam ◽  
Sowmya Sampath ◽  
Poornima Nagaraj ◽  
Sathish Kumar Sunder Kumar ◽  
...  
Keyword(s):  
Detailed Analysis ◽  
Dengue Fever ◽  
Prognostic Marker ◽  
Early Recognition ◽  
Hematological Parameters ◽  
Inverse Correlation ◽  
Clinical Findings ◽  
Severe Dengue ◽  
Simultaneous Increase ◽  
Hematological Profile

Background: Dengue fever is endemic to most parts of India and the clinical recognition of progression to severe dengue may become difficult in the absence of classical findings. Early recognition of shock or hemorrhage and appropriate management with fluids prevents morbidity/mortality to a great extent. In this study, we attempted to evolve a simple hematological prognostic marker for prediction of severe dengue.Methods: This retrospective descriptive study of 67 children was conducted in the Paediatric Department of a Government Medical College. The case records of all the patients with a diagnosis of dengue fever and Severe Dengue were analysed using a preset proforma. Besides the demographic and clinical findings a detailed analysis and comparison of hematological profile was done between cases of dengue fever and severe dengue. The data obtained was analysed statistically in order to arrive at a hematological marker to predict severe dengue. Results: Study population consisted of 67 children with 44 children with dengue fever,12 with DSS and 11 cases with DHF. Detailed analysis of hematological profile of severe dengue showed striking neutrophilia and monocytosis besides thrombocytopenia. Neutrophilia was seen in 78% and monocytosis was prevalent in 91% of cases of severe dengue. Monocytosis with thrombocytopenia was consistently seen during shock/hemorrhage. During recovery the fall of monocytes was accompanied by simultaneous increase in platelets in this group. This inverse relation was found to be statistically significant (p <0.05) Such a significant inverse correlation was not seen in dengue fever group (p >0.05).Conclusions: Monocytosis and neutophilia are consistent features of dengue fever. There is an inverse correlation of monocytosis with thrombocytopenia in severe dengue during shock/hemorrhage which recovers on clinical improvement. Thus monocytosis with thrombocytopenia can be used as a prognostic marker to predict severe dengue.

scholarly journals Independent Evaluation of Two Prototype Immunochromatographic Tests for Dengue Fever Developed by InBios

2021 ◽  
Author(s):  
Hua-Wei Chen ◽  
Tania D Maldonado ◽  
Cheng-Rei Lee ◽  
Maya Williams ◽  
Gabriel N Defang ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Severe Dengue ◽  
Clinical Samples ◽  
Dengue Disease ◽  
Resource Limited ◽  
Traditional Format ◽  
Global Presence ◽  
Specialized Equipment ◽  
Overall Performance ◽  
Set Up

ABSTRACT Introduction Dengue fever, caused by any of the four dengue viruses (DENV1–4), is endemic in more than 100 countries around the world. Each year, up to 400 million people get infected with dengue virus. It is one of the most important arthropod-borne viral diseases. Dengue’s global presence poses a medical threat to deploying military personnel and their dependents. An accurate diagnosis followed by attentive supportive care can improve outcomes in patients with severe dengue disease. Dengue diagnostic tests based on PCR and ELISA platforms have been developed and cleared by the U.S. FDA. However, these diagnostic assays are laborious and usually require highly trained personnel and specialized equipment, which presents a significant challenge when conducting operations in austere and resource-constrained areas. InBios International, Inc. (Seattle, WA) has developed two rapid and instrument-free immunochromatographic test prototype devices (multiplex and traditional formats) for dengue diagnosis. Materials and Methods To determine the performance of the InBios immunochromatographic tests, 183 clinical samples were tested on both prototype devices. Both assays were performed without any instruments and the results were read in 20 minutes. Results The traditional format had better overall performance (sensitivity: 97.4%; specificity: 90%) than the multiplex format (sensitivity: 86.9%; specificity: 63.3%). The traditional format was superior in serotype-specific detection with 100% overall sensitivity for DENV1, DENV3, and DENV4 and 93.3% sensitivity for DENV2 compared to the multiplex format (91.7%, 78.3%, 83.3%, and 96.3% for DENV1, 2, 3, and 4, respectively). The traditional format was easier to read than the multiplex format. The multiplex format was simpler and faster to set up than the traditional format. Conclusions The InBios traditional format had a better overall performance and readability profile than the multiplex format, while the multiplex format was easier to set up. Both formats were highly sensitive and specific, were easy to perform, and did not require sophisticated equipment. They are ideal for use in resource-limited settings where dengue is endemic. Based on our overall assessment, the traditional format should be considered for further development and used in the upcoming multicenter clinical trial toward FDA clearance.

scholarly journals Native α-Synuclein, 3-Nitrotyrosine Proteins, and Patterns of Nitro-α-Synuclein-Immunoreactive Inclusions in Saliva and Submandibulary Gland in Parkinson’s Disease

Antioxidants ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 715
Author(s):  
Emilio Fernández-Espejo ◽  
Fernando Rodríguez de Fonseca ◽  
Juan Suárez ◽  
Eduardo Tolosa ◽  
Dolores Vilas ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Nervous System ◽  
Clinical Features ◽  
Clinical Feature ◽  
Similar Concentration ◽  
Duct Cells ◽  
Nitrative Stress ◽  
Salivary Concentration

Background. Salivary α-synuclein (aSyn) and its nitrated form, or 3-nitrotyrosine-α-synuclein (3-NT-αSyn), hold promise as biomarkers for idiopathic Parkinson’s disease (IPD). Nitrative stress that is characterized by an excess of 3-nitrotyrosine proteins (3-NT-proteins) has been proposed as a pathogenic mechanism in IPD. The objective is to study the pathological role of native αSyn, 3-NT-αSyn, and 3-NT-proteins in the saliva and submandibulary glands of patients with IPD. Methods. The salivary and serum αSyn and 3-NT-proteins concentration is evaluated with ELISA in patients and controls. Correlations of αSyn and 3-NT-proteins content with clinical features of the disease are examined. Immunohistochemical 3-NT-αSyn expression in submandibulary gland sections is analyzed. Results. (a) Salivary concentration and saliva/serum ratios of native αSyn and 3-NT-proteins are similar in patients and controls; (b) salivary αSyn and 3-NT-proteins do not correlate with any clinical feature; and (c) three patterns of 3-NT-αSyn-positive inclusions are observed on histological sections: rounded “Lewy-type” aggregates of 10–25 µm in diameter, coarse deposits with varied morphology, and spheroid inclusions or bodies of 3–5 µm in diameter. “Lewy-type” and coarse inclusions are observed in the interlobular connective tissue of the gland, and small-sized bodies are located within the cytoplasm of duct cells. “Lewy-type” inclusions are only observed in patients, and the remaining patterns of inclusions are observed in both the patients and controls. Conclusions. The patients’ saliva presents a similar concentration of native αSyn and 3-nitrotyrosine-proteins than that of the controls, and no correlations with clinical features are found. These findings preclude the utility of native αSyn in the saliva as a biomarker, and they indicate the absence of nitrative stress in the saliva and serum of patients. As regards nitrated αSyn, “Lewy-type” inclusions expressing 3-NT-αSyn are observed in the patients, not the controls—a novel finding that suggests that a biopsy of the submandibulary gland, if proven safe, could be a useful technique for diagnosing IPD. Finally, to our knowledge, this is also the first description of 3-NT-αSyn-immunoreactive intracytoplasmic bodies in cells that are located outside the nervous system. These intracytoplasmic bodies are present in duct cells of submandibulary gland sections from all subjects regardless of their pathology, and they can represent an aging or involutional change. Further immunostaining studies with different antibodies and larger samples are needed to validate the data.

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