scholarly journals Prognosis factors for dengue shock syndrome in children

2021 ◽  
Vol 6 (1) ◽  
pp. 033-037
Author(s):  
Ningrum Eka Fitri Sari

Background: Varied clinical manifestations, complex pathogenesis, and different viral serotypes make it difficult to predict the course of dengue disease. Many studies have been conducted on the prognostic factors for the occurrence of dengue shock syndrome (SSD), but all use the 2017 World Health Organization (WHO) guidelines.  Aim: This study aims to determine the prognostic factors for the occurrence of SSD based on WHO guidelines in 2011.  Method: Retrospective study using medical record data of pediatric patients aged 0 to <18 years with a diagnosis of dengue fever dengue (DHF), SSD, and expanded dengue syndrome (EDS) that meet WHO criteria in 2011 at the reputable database from 2017 to December 2020. Independent variables, namely gender, age, nutritional status, secondary dengue infection, leukopenia, abdominal pain, gastrointestinal bleeding, hepatomegaly, and plasma leakage. Shock is the dependent variable. Multivariate analysis using logistic regression analysis.  Results: Subjects who met the study criteria were 145 patients, 52 (35.8%) of whom had SSD. Five of 52 SSD patients went into shock during hospitalization. The bivariate analysis yielded significant factors including, malnutrition, overnutrition and obesity, gastrointestinal bleeding, hemoconcentration, ascites, leukocytes 5,000 mm 3, encephalopathy, enzyme elevation heart, and overload. The results of multivariate analysis showed that hemoconcentration variables and elevated liver enzymes were factors of SSD Prognosis.  Conclusion: Hemoconcentration and elevated liver enzymes are prognostic factors for SSD. 

2018 ◽  
Vol 24 (8) ◽  
pp. 6221-6224
Author(s):  
Hindra Irawan Satari ◽  
Rossy Agus Mardani ◽  
Hartono Gunardi

Various clinical manifestations, complex pathogenesis and different virus serotypes in diverse area make us difficult to predict course of disease, even the child admitted in early. Prognostic factors are very important to predict cases progressing to become DSS. Dengue shock syndrome (DSS) occurs in 15.53% of Dengue hemorrhagic fever (DHF) patients with 7.81% mortality rate. Aim: To explore the prognostic factors of shock in hospitalized DHF children regarding the new 2011 WHO dengue virus infection classification guideline. This was a retrospective study using medical records of children age below 18 years old with WHO fulfilled grade 1 and 2 DHF diagnosis from January 2013–December 2016 in Child Health Department of Dr. Cipto Mangunkusumo Hospital, Jakarta. Independent variables were sex, age, nutritional status, secondary dengue infection, leucopenia, abdominal tenderness, gastrointestinal bleeding, hepatomegaly and plasma leakage. Shock was dependent variable. Multivariate analysis was done by using logistic regresion analysis. There were 98 DHF subjects, 5 subjects became DSS during hospitalization. DSS subject characteristics were age of >5 years old, female, malnutrition, abdominal tenderness, hemoconcentration ≥20%, secondary dengue infection, leucocyte ≥5.000 mm3 and thrombocyte <50.000 mm3. Multivaryate analysis showed malnutrition and hepatomegaly were prognosis factors of DSS. Malnutrition and hepatomegaly were prognotic factors of dengue shock syndrome. Clinicians should be more aware with these factors when managed hospitalized DHF patients.


2021 ◽  
Vol 9 (B) ◽  
pp. 497-502
Author(s):  
Rentha Monica Simamora ◽  
Muhammad Vitanata Arfijanto ◽  
Musofa Rusli ◽  
Budi Utomo ◽  
Cennikon Pakpahan ◽  
...  

BACKGROUND: The morbidity and mortality rates due to human immunodeficiency virus (HIV) infection are still high despite various and advanced efforts in the management given for HIV/AIDS patients. AIM: This study proposed that clinical signs and laboratory parameters could be expected to predict the patient’s mortality. METHODS: This retrospective study was done by collecting 408 medical records of adult HIV/AIDS inpatients at a tertiary hospital in Surabaya from January 1, 2017, to December 31, 2019. Bivariate analysis using Chi-square test was carried out on nine variables, which were Glasgow Coma Scale (GCS) <15, hypotension, PaO2/FiO2 <400 mmHg, elevated liver enzymes, hemoglobin levels <10 mg/dl, platelet count <150,000/mm3, eGFR <60 ml/min/1.73 m2, albumin levels <3.5 mg/dl, and body mass index (BMI) <18.5 kg/m2. Variables which met the criteria would be included in the multivariate analysis using logistic regression. RESULTS: Based on bivariate analysis, mortality was found to be significantly associated with GCS <15, hypotension, PaO2/FiO2, elevated liver enzymes, platelet count <100,000 mm3, eGFR <60 ml/1.73kg/m2, albumin levels <3.5 mgdl, and BMI <18.5 kg/m2. However, based on multivariate analysis, there were five variables which were found to be able to independently predict the patients’ mortality, those were GCS <15 (OR 11.625), hypotension (OR 6.062), PaO2/FiO2< 400 mmHg (OR 7.794), eGFR <60 ml/min/1.73 m2 (OR 2.646), and albumin levels <3.5 mg/dl (OR 4.091). CONCLUSION: GCS <15, hypotension, PaO2/FiO2 <400 mmHg, eGFR <60 ml/1.73g/m2, and albumin levels <3.5 mg/dl were found as the independent risk factors which could predict the hospitalized HIV/AIDS patients’ mortality.


2019 ◽  
Vol 65 (6) ◽  
pp. 603-608
Author(s):  
Sarah Buntubatu ◽  
Endy P Prawirohartono ◽  
Eggi Arguni

Abstract Awareness of cardiac involvement in dengue infection has potentially valuable management implications. To determine the prevalence of myocarditis in dengue severity, we conducted prospective study of paediatric dengue illness at Dr. Sardjito General Hospital, a tertiary hospital in Yogyakarta, Indonesia, from period of July 2015 to May 2016. World Health Organization (WHO) Dengue Guideline 2011 classification system was used. Diagnosis of dengue infection was made based on either by dengue serology and/or NS1 test. Myocarditis was assessed based on elevation of cardiac enzymes, as creatine kinase (CK), creatine kinase-MB (CK-MB), Troponin I (TnI) and by electrocardiography (ECG). Proportion between groups was compared using the Fisher’s exact test. We analysed 50 children with diagnosis of dengue fever (DF), 12 of dengue haemorrhagic fever (DHF) and 23 of dengue shock syndrome (DSS). Myocarditis diagnosed in 53%, 75% and 96% of DF, DHF and DSS, respectively. We found that myocarditis was more prevalent significantly in DSS than DF (p = 0.003).


2020 ◽  
Vol 10 ◽  
Author(s):  
Weidong Tian ◽  
Jingdian Liu ◽  
Kai Zhao ◽  
Junwen Wang ◽  
Wei Jiang ◽  
...  

ObjectiveWHO grade III meningiomas are highly aggressive and lethal. However, there is a paucity of clinical information because of a low incidence rate, and little is known for prognostic factors. The aim of this work is to analyze clinical characteristics and prognosis in patients diagnosed as WHO grade III meningiomas.Methods36 patients with WHO grade III meningiomas were enrolled in this study. Data on gender, age, clinical presentation, preoperative Karnofsky Performance Status (KPS), histopathologic features, tumor size, location, radiologic findings, postoperative radiotherapy (RT), surgical treatment, and prognosis were retrospectively analyzed. Progression-free survival (PFS) and overall survival (OS) were evaluated using the Kaplan-Meier method. Univariate and multivariate analysis were conducted by the Cox regression model.ResultsMedian PFS is 20 months and median OS is 36 months in 36 patients with WHO grade III meningiomas. Patients with secondary tumors which transformed from low grade meningomas had lower PFS (p=0.0014) compared with primary group. Multivariate analysis revealed that tumors location (PFS, p=0.016; OS, p=0.013), Ki-67 index (PFS, p=0.004; OS, p&lt;0.001) and postoperative radiotherapy (PFS, p=0.006; OS, p&lt;0.001) were associated with prognosis.ConclusionWHO grade III meningiomas which progressed from low grade meningiomas were more prone to have recurrences or progression. Tumors location and Ki-67 index can be employed to predict patient outcomes. Adjuvant radiotherapy after surgery can significantly improve patient prognosis.


Author(s):  
Umi S. Intansari ◽  
Usi Sukorini ◽  
Shanti Ika Sari

Dengue infection is a major health problem in the world, including Indonesia. Clinical manifestations of dengue infection varywidely, from asymptomatic until dengue shock syndrome (DSS). Antibody Dependent Enhancement (ADE) hypothesis that states thatnon-neutralizing antibodies in secondary dengue infection may enhance dengue infection via Fcγ receptors is still controversial. Clinicalresearch shows that not all secondary infections manifest as DHF/DSS, but nearly all DHF/DSS cases are caused by secondary infection.Allegedly, the expression of Fcγ has an effect on this incident. This study is an observational analytical study with a cross sectional designto determine the expression of FcγRII (CD32) monocytes in patients with primary and secondary dengue infection. CD32 of monocyteswas measured using FACS Calibur with lyse no wash technique. Primary and secondary dengue infection were determined by IgM/IgGoptical density ratio using ELISA capture method. The ratio of IgM/IgG ≥1.2 was considered as primary infection, while the ratio <1.2was considered as secondary infection. Twenty primary and 32 secondary dengue infection patients in acute phase of dengue infectionpartisipated in this study. Expressions of Fcγ RII (CD32) monocytes were significantly lower in primary than secondary dengue infection(187.825±31.584 vs 218.598±43.414 MFI; p=0.008). CD32 expressions were higher in day 3 compared to day 4 of fever.


2020 ◽  
Vol 20 (6) ◽  
Author(s):  
Amir Saeed ◽  
Eslam Shorafa ◽  
Iraj Shahramian ◽  
Mahdi Afshari ◽  
Mehrdad Salahifard ◽  
...  

: Coronavirus disease 2019 (COVID-19) first emerged in Wuhan, China, in December 2019. Then, it spread to the whole world so that THE World Health Organization (WHO) declared a worldwide pandemic on March 11, 2020. Coronavirus disease 2019 is a novel and mysterious infectious disease that causes respiratory illness, multiorgan failure (MOF), and death. Although pediatric COVID-19 accounts for a small percentage of patients and is often milder than in adults, it can progress to severe disease in some cases. Liver involvement in COVID-19 and its severity have not been clearly investigated. In this paper, we present an 11-year-old boy admitted to a Pediatric Intensive Care Unit (PICU) with COVID-19 diagnosis in combination with elevated liver enzymes and bilirubin.


2020 ◽  
Vol 13 (12) ◽  
pp. e239315
Author(s):  
Lokesh Tiwari ◽  
Shashank Shekhar ◽  
Anmol Bansal ◽  
Pradeep Kumar

COVID-19, caused by SARS-CoV-2, has spread globally. Coinfection with other endemic viruses is likely to complicate the clinical presentation and outcome. Information on clinical manifestations and management strategies on COVID-19 coinfection with endemic diseases in children is yet to evolve. The risk of dengue infection exists in 129 countries and it is endemic in more than 100 countries. The SARS-CoV-2 pandemic might overlap with the dengue epidemics in tropical countries. We report the first paediatric case to the best of our knowledge of COVID-19 encephalitis with dengue shock syndrome. This clinical syndrome could be attributed to serological cross-reactivity, incidental coinfection or perhaps a warning for dengue-endemic regions to face the unique challenge of differentiating and managing two disease entities together. Enhanced understanding of potential COVID-19 and dengue coinfection warrants immediate attention of researchers and international health policy makers.


2020 ◽  
Vol 8 (1) ◽  
pp. 108
Author(s):  
Maddipatla Sushma ◽  
M. V. Nagabhushana ◽  
M. Dharaneedhar Reddy

Background: To identify various manifestations of dengue fever, complications, and to measure their association with laboratory findings.Methods: 100 cases of suspected adults between 20-70 years of age with clinical features suggestive of dengue infection and patients presenting with fever of acute onset (<2 weeks), pain abdomen, vomiting, rash, flushed appearance and bleeding manifestation were studied. All cases were followed up for the clinical and laboratory parameters and treated according to WHO guidelines.Results: 36 were classified as classical dengue fever, 33 as dengue haemorrhagic fever (DHF), 15 as dengue shock syndrome (DSS), and 16 as dengue-like illness (DLI) and the common age group was 30-40 year (50%). Most (66%) of the patients were male. The common presenting symptoms was fever 65%, vomiting (40%), abdominal pain (40%), myalgia (7%), etc. Hepatomegaly (53%), ascites (1%), splenomegaly (8%) was noted. The mean platelet in the present study was 41870 cells/cu mm. Elevated liver enzymes and elevated serum creatinine was found in complicated forms of disease. The prothrombin time ranged from 11-60 sec with a mean of 19.5 sec.Conclusions: The treatment of dengue is mainly supportive, but early institution and meticulous monitoring are the important steps for positive outcome. Much more awareness, vigilance and research in the diagnostic modalities are further needed to avoid unnecessary panic and platelet transfusions.


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