Severity of hepatitis & it's correlation with dengue hemorrhagic fever: Experience from a tertiary care hospital

Background: Dengue fever and dengue hemorrhagic fever is one of the most frequent febrile viral infections in our community as well as among patients admitted in Internal Medicine Department. This study examined the extent of hepatic involvement in dengue hemorrhagic fever Objectives: To evaluate the incidence of hepatic involvement and its correlation in dengue syndromes. Design: This Cross-sectional observational study done in Internal Medicine Department of BIRDEM General Hospital. Method: A total 50 patients were included in this study who was serologically positive dengue fever patients (IgM ± IgG). These patients were admitted to Internal Medicine Department of BIRDEM General Hospital from July, 2011 to December 2011. Hepatic transaminases (AST and ALT) of these patients were measured and correlation was seen by standard methods. Informed written consent was taken from patients. Results: Total number of patients was 50; their mean age was 45.98±18.37 years. Male: Female ratio was 1:1.85. Common co-morbidities were DM (48%) and hypertension (26%), CKD (8%) and bronchial asthma (6%). Among the 50 patients 23 had CD (Classical Dengue), 20 had DHF (Dengue Hemorrhagic Fever) grade 1, six had DHF grade 2 and one had DHF grade 3. Mean AST among CD and Grade 1, 2, 3 DHF were 58.48±8.99, 96.65±9.06, 217±31.82, 296.00 respectively. Mean ALT among CD and grade 1, 2, 3 DHF were 52.39±9.08, 88.10±13.14, 181.67±12.11 respectively. There was significant difference between AST (P value ˂0.001) and ALT (P value ˂0.001) in each group of patients. It was observed that rise of AST and ALT was significantly higher in grade 1, 2 and 3 when compared with CD. AST and ALT was higher in grade 2 then grade 1 DHF patients. Conclusion: Rise of hepatic transaminases is common in patients with dengue syndromes. There is significant rise in AST then ALT. The rising pattern of these enzymes correlates with severity of dengue syndromes Bangladesh Crit Care J September 2020; 8(2): 76-80

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Treating Malignancy: Four-Year Experience in Internal Medicine Department, BIRDEM General Hospital

BIRDEM Medical Journal ◽

10.3329/birdem.v6i2.31294 ◽

2017 ◽

Vol 6 (2) ◽

pp. 107-111

Author(s):

Rene Suzan Claude Sarker ◽

Md Raziur Rahman ◽

Samira Rahat Afroze ◽

Muhammad Abdur Rahim ◽

Khwaja Nazim Uddin

Keyword(s):

Internal Medicine ◽

Cancer Patients ◽

General Hospital ◽

Diabetic Group ◽

P Value ◽

Diabetic Patients ◽

Medicine Department ◽

Internal Medicine Department ◽

Radiology Reports ◽

Number Of Patients

Background: Cancer prevalence in diabetic patients in Bangladesh seems to be increasing as case detection of both diseases are far more than before. Till date no statistical data of diabetic patients with malignancy is available in Bangladesh. Treating both diabetes and malignancy in the same patient is challenging and sometimes requires multidisciplinary support. For such cases BIRDEM General Hospital offers supportive facilities including intensive care, chemotherapy, surgical intervention and oncology day care.Methods: This cross-sectional, observational study was carried out from January 2012 to June 2016 which included cancer patients irrespective of their diabetic status admitted in Internal Medicine Department of BIRDEM General Hospital. With prior informed consent of the patients, data were collected and statistical analysis was done using professional SPSS version 17.0 windows based program.Results: Total number of cancer patients was 114, whose diagnoses were confirmed by histopathological evidence (biopsy/FNAC), radiology reports and cancer markers, as appropriate. Among them 64 (56.1%) were male and 50 (43.9%) were female patients. Age of most of the patients was between 41-60 years (65, 57%). Mean age was 55.16 years in diabetic group and 44.47 years in non-diabetic group. Glycemic status revealed that most of the patients were diabetic (80, 70.2%). Among other co-morbid conditions, hypertension and ischemic heart disease were predominant (17 and 9 cases respectively). Prevalence of more than one comorbidites were marked in the diabetic group (33 cases, p value >0.001). Twenty one categories of malignancies were diagnosed during this study period. Majority of cases were lymphoma (21,18.4%), carcinoma breast (17,14.9%), carcinoma uterus and/or cervix (13,11.4%) and leukaemia (10,8.8%). Common clinical features included palpable lump (21,18.4%), lymphadenopathy (16,14%), anaemia (9,7.9%) and pain (8,7%). The number of patients presenting with multiple signs/symptoms were also significant (32,28.1%). Most patients were treated with chemotherapy (54,47.4%). Many cases warranted a combined approach (46,40.4%). Treatment response showed good response in 57(50%) cases. In 16 patients (14%) condition deteriorated and death occurred in 8 cases (7%). Even after repeated and empathic counseling we lost follow up of 15 cases (13.2%).Conclusion: The scenario becomes complicated when a diabetic patient develops malignancy and vice versa. Complications can arise from either spectrum of the diseases. Managing such cases are often challenging and require multi-disciplinary support. Management outcome of these cases so far in Internal Medicine Department, BIRDEM General Hospital shows a promising future.Birdem Med J 2016; 6(2): 107-111

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DETERMINANTS OF HEALTH PREVENTION OF DENGUE HEMORRHAGIC FEVER

Journal of Research in Public Health Sciences ◽

10.33486/jrphs.v1i2.21 ◽

2019 ◽

Vol 1 (2) ◽

Author(s):

Hendrikus Nara Kwureh

Keyword(s):

Dengue Fever ◽

Dengue Hemorrhagic Fever ◽

Community Health Center ◽

Sampling Technique ◽

Hemorrhagic Fever ◽

P Value ◽

Cross Sectional ◽

Prevention Effort ◽

Health Officer ◽

Information Media

Dengue hemorrhagic fever (DHF) is one of the infectious diseases transmitted by mosquito bites that are found in tropical and subtropical areas around the world. The high cases of dengue fever show a lack of prevention efforts against dengue hemorrhagic fever. The purpose of this research is to know the factors related to dengue fever prevention efforts (DHF) in Kapuas Kanan Hulu Village Working Area of Durian River Community Health Center in 2018. This research method is quantitative with a cross sectional approach. The sampling technique uses Sample Random Sampling. The sample used was 97 families. The results showed that there was a correlation between education and prevention of DHF in Kelurahan Kapuas Kanan Hulu Sintang District in 2018 with p value of 0.012. OR = 3,150, there is correlation between knowledge with prevention effort of DHF in Kelurahan Kapuas Kanan Hulu Kabupaten Sintang 2018 with p value equal to 0,025. OR = 2,786, there is correlation between attitude and prevention of DHF in Kelurahan Kapuas Kanan Hulu Kabupaten Sintang 2018 with p value 0,007. OR = 3,411, There is no correlation between information media with prevention effort of DHF in Kelurahan Kapuas Kanan Hulu Kabupaten Sintang 2018 with p value 0,907. OR = 0,877, There is correlation between health officer support and prevention effort of DHF in Kelurahan Kapuas Kanan Hulu Kabupaten Sintang 2018 with p value 0,004. OR = 3,700. Suggestions are expected for the community to carry out routine prevention of dengue hemorrhagic fever, both for those who have suffered from Dengue Hemorrhagic Fever or who have never suffered so as to reduce the incidence of Dengue Hemorrhagic Fever in the Kapuas Kanan Hulu Village.

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Socio-demographic characteristics and treatment outcome of patients with malignancy and type 2 diabetes

Bangladesh Journal of Medicine ◽

10.3329/bjmed.v28i2.33355 ◽

2018 ◽

Vol 28 (2) ◽

pp. 70-74

Author(s):

Md Raziur Rahman ◽

Samira Rahat Afroze ◽

Rene Suzan Claude Sarker ◽

Muhammad Abdur Rahim ◽

Khwaja Nazim Uddin

Keyword(s):

Internal Medicine ◽

Type 2 Diabetes ◽

General Hospital ◽

Response To Treatment ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Medicine Department ◽

Internal Medicine Department ◽

Radiology Reports

Background: In Bangladesh prevalence of malignancy in diabetic patients seems to be increasing as case detection of both diseases are far more than before. No statistical data of diabetic patients with malignancy is currently available in Bangladesh. Treatment of both diabetes and malignancy in the same patient is challenging for the physician and requires multidisciplinary support. For such cases BIRDEM General Hospital offers supportive facilities including intensive care, chemotherapy, surgical intervention and oncology day care.Methods : This is a cross-sectional observational study carried out from January 2011 to June 2016 which included adult diabetic patients with malignancy admitted in Internal Medicine Department of BIRDEM General Hospital. With prior informed consent of the patients, data were collected and statistical analysis was done using professional SPSS version 17.0 windows based program.Results : Total number of type 2 diabetic patients with malignancy was 80. Among them 49 (61.3%) were male and 31 (37.7%) were female patients. Almost two-third of the patients was between 41-60 years (63.8%). More than half of the patients belonged to urban settings (42, 52.5%) followed by sub-urban area (27, 33.7%). Smoking was the commonest (23.8%) among the risk factors. Family history for malignancy and exposure to occupational hazards were present in 11.3% and 7.5% cases respectively. Among co-morbid conditions, hypertension and ischemic heart disease were predominant. Twenty categories of malignancies were confirmed by histopathological evidence, radiology reports and cancer markers. The commonest malignancy in male and female was lymphoma and carcinoma breast respectively. Most patients were treated with chemotherapy (48.8%) and combined approach was required in 36.3% cases. Good response to treatment was observed in 46.3% cases, 15% patients deteriorated and death occurred in 6.3% cases.Conclusion : Type 2 diabetes and malignancy individually have their own consequences. When co-existing, patients require a holistic approach. Complications can arise from either spectrum of the diseases. If managed promptly and adequately, outcome of such cases is encouraging. Management outcome of these cases so far in Internal Medicine Department, BIRDEM General Hospital shows a promising future.Bangladesh J Medicine Jul 2017; 28(2) : 70-74

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The Association between Obesity and Severity of Dengue Hemorrhagic Fever in Children at Wangaya General Hospital

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.660 ◽

2019 ◽

Vol 7 (15) ◽

pp. 2444-2446

Author(s):

Bella Kurnia ◽

I Wayan Bikin Suryawan

Keyword(s):

Logistic Regression ◽

Dengue Virus ◽

General Hospital ◽

Dengue Hemorrhagic Fever ◽

Febrile Illness ◽

Dengue Shock Syndrome ◽

Binary Logistic Regression ◽

Hemorrhagic Fever ◽

P Value ◽

Binary Logistic Regression Analysis

BACKGROUND: Dengue is a mosquito-borne disease caused by any one of four closely related Dengue virus (DENV 1-4). The clinical sign Dengue virus infection can vary from mild (mild febrile illness), Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF) to Dengue Hemorrhagic Fever with shock (Dengue Shock Syndrome, DSS). AIM: This study was designed to determine the relationship of obesity with the severity of Dengue Hemorrhagic Fever in children. METHODS: It is a case-control study. The data of patients were retrospectively collected from the Department of Child Health at the Wangaya General Hospital between March 2019 to May 2019. It uses consecutive sampling. The total sample of 22 children with DHF with shock and 22 children with DHF without shock were investigated. Statistical analysis has been performed by SPSS Statistics 20.0 for Mac (IBM Corp., Armonk, New York, USA). DHF positive results were compared by the Chi-square test and binary logistic regression. RESULTS: Prevalence of DHF with shock is fifty per cent's and DHF without shock is 50%. Prevalence of obesity is 40.9%. The result of binary logistic regression analysis of obesity in children and the severity of DHF was significantly correlated with P-value 0.004 and OR = 7.734. CONCLUSION: Obesity is associated with the severity of Dengue Hemorrhagic fever in children.

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

European Journal of Engineering Research and Science ◽

10.24018/ejers.2018.3.10.897 ◽

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.

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Empirical Antibiotic Therapy Assessment of Patients diagnosed with Sepsis in Intermediate Care Ward of Internal Medicine Department of Dr. Soetomo General Hospital according to Gyssens Method

Oceana Biomedicina Journal ◽

10.30649/obj.v1i2.17 ◽

2018 ◽

Vol 1 (2) ◽

pp. 69

Author(s):

Ronald Pratama Adiwinoto ◽

Florentina Sustini ◽

Hardiono Hardiono ◽

Agung Dwi Wahyu Widodo ◽

Boerhan Hidajat ◽

...

Keyword(s):

Internal Medicine ◽

General Hospital ◽

Antimicrobial Therapy ◽

Medical Records ◽

Intermediate Care ◽

Medicine Department ◽

Internal Medicine Department ◽

Therapy Assessment ◽

Empirical Antimicrobial Therapy ◽

Care Ward

Rational empirical antimicrobial therapy is an important component of sepsis patient management. This study aimed to assess the rationality of empirical antimicrobial therapy in patients diagnosed with sepsis admitted in intermediate care ward of internal medicine department (RPI) of Dr. Soetomo General Hospital from January 2016 to July 2017. Medical records of 91 patients diagnosed with sepsis were collected and studied retrospectively in period from July 2017 to November 2017. 91 (85.05%) medical records from 107 sepsis patients were evaluated. Cultures and antimicrobial sensitivity tests were carried out in 21 (23.07%) patients. 14 patients yielded positive culture results, 9 of which were MDRO positive with ESBL as resistant marker. Empirical antibiotic therapies for these patients were reviewed according to Gyssens method.73 (80.2%) of 91 patients were deemed receiving appropriate empirical antibiotic therapies. Ceftriaxone IV injection as monotherapy or combination therapy were the most common empirical antibiotic therapies (82 in 91 patients, 90.1%), despite local microbiologic flora and antibiogram show most pathogens were resistant to ceftriaxone. Mortality rate in this study was high, 92.3% (84 patients died) despite rational empirical antibiotic therapies were high. This study concluded that empirical antibiotic therapies in sepsis patients according to guidelines adopted in Soetomo General Hospital, albeit deemed rational, was no longer appropriate according to local antibiogram issued by microbiological department of Soetomo General Hospital. Keywords: Empirical Antibiotics Therapy, Gyssens criteria, Intermediate Care Ward, Sepsis, Septic Shock

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PENGARUH PELATIHAN PENGENDALIAN VEKTOR DEMAM BERDARAH TERHADAP MAYA INDEX PADA SISWA SEKOLAH DASAR DI MAJALENGKA

Jurnal Ilmu dan Teknologi Kesehatan ◽

10.33666/jitk.v11i1.271 ◽

2020 ◽

Vol 11 (1) ◽

Author(s):

Wawan Kurniawan

Keyword(s):

Vector Control ◽

Dengue Fever ◽

Dengue Hemorrhagic Fever ◽

Intervention Group ◽

Hemorrhagic Fever ◽

Control Group ◽

Control Group Design ◽

Group Design ◽

Quasi Experimental ◽

Dengue Vector Control

ABSTRAK Latar belakang: Demam Berdarah Dengue (DBD) disebabkan oleh virus Dengue dapat menyebabkan kematian. Pencegahan DBD yang dianggap paling tepat adalah Pemberantasan Sarang Nyamuk (PSN). Penelitian ini bertujuan untuk mengetahui pengaruh pelatihan pengendalian vektor Demam Berdarah pada siswa sekolah dasar terhadap Maya Index di Majalengka. Metode: Penelitian ini menggunakan desain quasi experiment (pretest-posttest control group design). Sebanyak 4 sekolah terpilih sebagai kelompok intervensi dan 4 sekolah lainnya sebagai kontrol. Subyek penelitian adalah siswa kelas IV-VI yang terdiri dari 171 siswa pada kelompok intervensi dan 163 pada kelompok kontrol. Instrumen yang digunakan adalah formulir pemantauan jentik berkala. Hasil: Jumlah rumah dengan kategori Maya Index tinggi berkurang dari 27,5% menjadi 9,4%. Terjadi penurunan angka BRI kategori tinggi pada kelompok intervensi dari 20,5% menjadi 1,8%. Pada kelompok kontrol tidak terjadi penurunan angka BRI kategori tinggi (22,1%), sebaliknya terjadi penurunan kategori rendah dari 34,4% menjadi 3,7%. Tidak terjadi penurunan angka HRI pada kelompok intervensi maupun kontrol. Kesimpulan: Pelatihan pengendalian vektor Demam Berdarah dapat menurunkan nilai BRI dan Maya Index, tetapi tidak berpengaruh terhadap nilai HRI. Tidak adanya perubahan nilai HRI menunjukkan bahwa kebersihan dan sanitasi lingkungan merupakan faktor yang berpengaruh terhadap probabilitas kejadian demam berdarah. Kata Kunci : Demam Berdarah, Maya Index, pelatihan, pengendalian vektor ABSTRACT Background: Dengue Hemorrhagic Fever (DHF) caused by Dengue virus could cause death. The most appropriate prevention of Dengue is eradication of mosquito nests (PSN). This study aims to determine the effect of Dengue vector control training on elementary students towards Maya Index in Majalengka. Method: This study used quasi-experimental design (pretest-posttest control group design). A total of 4 schools were selected as intervention groups and 4 other schools as controls. The subjects were students in grades IV-VI consisting of 171 students in the intervention group and 163 in the control group. The instrument used was periodic larva monitoring form. Results: The number of houses with a high Maya Index category in the intervention group decreased from 27.5% to 9.4%. There was a decrease in the high BRI category in the intervention group from 20.5% to 1.8%. In the control group, there was no decrease in the high BRI category (22.1%), on the contrary, there was a decrease in the low category from 34.4% to 3.7%. There was no decrease in HRI rates both of intervention or control groups. Conclusion: Dengue Fever vector control training could decrease the value of BRI and Maya Index, but does not affect the value of HRI. The absence of changes in HRI indicate that environmental hygiene and sanitation are factors that influence the probability of dengue fever occurrence. Keywords: Dengue Hemorrhagic Fever, Maya Index, training, vector control

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