scholarly journals Liver Function Derangement and Bleeding Morbidity in Dengue Fever and Dengue Haemorrhagic Fever in a tertiary Hospital in Bangladesh

2021 ◽  
Vol 33 (1) ◽  
pp. 44-51
Author(s):  
Md Arifuzzaman ◽  
- Amiruzzaman ◽  
Md Saddam Hossain ◽  
Naylla Islam ◽  
Abdullah Al Noman ◽  
...  

Background: Dengue is a major international health concern that is prevalent in tropical and sub tropical countries. Study of dengue infection and its Liver complications are scarce from countries like India. This study was done to assess the frequency and spectrum of liver dysfunction and bleeding morbidity in Dengue infection patients. Methods: A Cross sectional prospective observational study was performed in the of Department of Medicine Sir Salimullah Medical College Mitford Hospital. All the inpatients who were diagnosed with dengue infection between July 2015 to July 2016 were included in this study. A total of 70 patients were included in the study. Results: Patients were classified as classical dengue fever (DF) 61.5.% dengue haemorrhagic fever (DHF) 38.5%. The mean age was 28.607±10.45 years in DF group and 26.78±11.78 years in DHF group and male: female ratio was 3:1. Deranged serum glutamic-oxaloacetic transaminase (SGOT) and/or Serum glutamic pyruvic transaminase (SGPT) was present in most of the patients. Elevation of ALT level occured more in DHF group patient (81%) than DF group (46%). Out of 70 patient 28(40%) patient were within normal value. 42 (60%) patient had elevated ALT level which is statistically significant (p value-<0.05)..The degree of rise of SGOT, SGPT,and Bilirubin was significantly more in DHF and DSS, as compared to DF. About bleeding morbidity, purpura was a mentionable finding 29(41%) but gum bleeding 15(21%), echymosis 14(20%), are less in both DF and DHF group. Major bleeding like hematomesis 5 (7%), melaena 4 (5%) and haematuria 1 (1%) also occured in both group of patients. Conclusion: Liver dysfunction in the form of raised SGPT was seen in almost all patients. Preferentially high SGOT may serve as an early indicator of dengue infection while high values of bilirubin, SGOT, SGPT,may be an indicator of severe disease and poor prognosis. Bangladesh J Medicine July 2022; 33(1) : 44-51

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Randula Ranawaka ◽  
Chamara Jayamanne ◽  
Kavinda Dayasiri ◽  
Dinuka Samaranayake ◽  
Udara Sandakelum ◽  
...  

Pathogenesis of dengue haemorrhagic fever is not fully understood, but it is thought that there is antibody enhancement during the secondary infection, which causes severe dengue haemorrhagic fever (DHF). Therefore, patients who have DHF should have a documented history of symptomatic dengue infection in the past. A retrospective descriptive-analytical study was conducted at the University Paediatric Unit at Lady Ridgeway Hospital for Children, Colombo, Sri Lanka. All children who had fulfilled the criteria for DHF admitted to the unit from April 2018 to September 2018 were recruited into the study. Relevant data were collected from bed head tickets. One hundred and eighty-four children were included in the final analysis. Thirty-three (17.9%) had a past history of documented symptomatic dengue infection, while 82.1% did not have a documented dengue infection. Twelve patients had dengue shock syndrome, and none of them had previously documented symptomatic dengue fever. Dextran was used in 96 patients in the critical phase. Twelve (42%) patients with past documented symptomatic dengue fever needed dextran while 84 (54.9%) patients without a documented past history of dengue fever needed dextran. In our clinical observation, we noticed that children with DHF mostly did not have a documented symptomatic prior dengue infection, while those with a documented symptomatic prior infection had a milder subsequent illness. In fact, the majority (82.1%) of patients with DHF did not have documented previous symptomatic dengue infection. It was also observed that the clinical course of subsequent dengue infection was less severe in patients with previously documented symptomatic dengue fever. This finding should be further evaluated in a larger scale study minimizing the all-confounding factors. This fact is more important in selecting recipients for vaccines against the dengue virus, which are supposed to produce immunity against the virus without causing the severe disease.


Author(s):  
Surendra Kumar ◽  
Rajkumar Lakhiwal ◽  
Vinod Aswal ◽  
Suresh Gajraj ◽  
Ishan Patel ◽  
...  

Background: Dengue is a major international health concern that is prevalent in tropical and sub-tropical countries. It is 2nd most common arthropod borne disease in India. There are certain clinical features that are associated with Dengue in addition of the classical features. Previously organ impairment has been only considered under set up of severe disease. On the recent years, several studies have suggested the possibility of early involvement of the liver in dengue. Further due to its atypical presentation often dengue missed out as a differential diagnosis.Methods: A total of 50 patients were selected to be a part of study after applying inclusion and exclusion criteria. Only those patients were included in the study who had classical features of dengue- fever with chills, body ache, headache, rash, bleeding manifestations and thrombocytopenia and had a positive ELISA test i.e. IgM antibodies against dengue virus. Patients who had malaria and enteric fever were excluded from the study. All patients were subjected to a detailed history and a thorough clinical examination. A complete blood count, liver function tests, renal function tests, chest X-ray and USG abdomen were also done.Results: An analysis of 50 patients suffering from dengue showed liver dysfunction was present in all patients. Vomiting was an important symptom present upto 70% of patients. SGOT levels were higher than SGPT levels. Hepatosplenomegaly and ascitis were also present in significant number of patients. An analysis of these patients revealed that patients typically demonstrate high grade fever, body ache, rash, thrombocytopenia and bleeding tendency, there were other features such as liver dysfunction including a preferential rise of SGOT, hepatosplenomegaly, ascitis, pleural effusion and leucopoenia.Conclusions: This study showed that dengue fever was seen in the third decade and that AST and ALT levels were raised in the majority of these patients. It was also found that AST levels were more than ALT levels. So, AST and ALT can be a useful early marker to assess the severity of the disease which can thus lead to early recognition of high risk cases. The presence of raised liver enzymes in all patients, ascitis, hepatosplenomegaly, elevation of SGOT more than SGPT, should be kept in mind when evaluating patients with suspected dengue.


1970 ◽  
Vol 33 (2) ◽  
pp. 55-58 ◽  
Author(s):  
ABM Shahidul Alam ◽  
S Anwar Sadat ◽  
Zakaria Swapan ◽  
Aftab U Ahmed ◽  
Md Nazmul Karim ◽  
...  

Background: Dengue infection has become endemic in Bangladesh since it hasbeen broken out in June 2000. Although children are the usual victim of dengueinfection, there is paucity of published data regarding dengue infection in children inour country.Objectives: This study was designed to document the presenting features and outcomeof Dengue infection in children.Materials and Methods: This cross sectional study was done among the childrenhaving Dengue infection. Fifty four consecutive patients were enrolled. Purposivesampling was done. In every patient a detailed history was taken. Clinical examinationsand relevant investigations were done. Data were collected in a predesigned structuredquestionnaire. Data were analyzed with the help of descriptive statistics and Chisquare(x2) Test.Results: The mean age of the patients was 6.5±3.5 years with equal male and femaleratio. Among 54 patients, 40.7% presented with dengue fever (DF), the rest (59.3%)presented with dengue haemorrhagic fever (DHF). Most of the patients presented withhigh grade continued type of fever (75.9%), followed by abdominal pain (59.3%),vomiting (57.4%). Itchy rash and fever were the most important characteristic signs(75.9% each). Flushed appearance observed in 68.4% and 59.3% patients showedbleeding manifestation of which sub-conjunctival haemorrage was the commonestform (33.3%). Leucopenia were present in only 9.3% of the patients. Platelet countless than 100×109/L were found in 68.5% patients. Tourniquet test was positive in31.5% of cases. All of the patients had packed cell volume (PCV) less than 45%.Raised serum alanine aminotransferase (ALT) was observed in 40.7% of children.IgM and/or IgG antibodies for dengue virus were positive in 96.29% patients. Majority(94%) of the patients completely recovered from the disease and only 6% died.Conclusion: High grade continued fever, vomiting with abdominal pain and itchy skinrash (with normal platelet count) were the presenting features. Commonest form ofbleeding manifestation was subconjunctival haemorrhage. Bleeding manifestationhad a significant association with the degree of thrombocytopenia but no corelationwas observed with tourniquet test positivity.Key words: Dengue fever (DF); dengue haemorrhagic fever (DHF); paediatric.DOI: 10.3329/bjch.v33i2.5678Bangladesh Journal of Child Health 2009; Vol.33(2): 55-58


2021 ◽  
Vol 3 (1) ◽  
pp. 289-300

Introduction: Dengue fever is an acute febrile illness with a significant public health concern in tropical and subtropical countries. Population knowledge and practice play an essential role in the transmission and prevention of the disease. This study aims to evaluate the level of knowledge, attitudes, and practice regarding dengue fever among Malaysian university students. Methods: A cross-sectional descriptive study was conducted in twenty-five randomly selected universities across Malaysia. A total of 1520 respondents were approached by simple random sampling method. A previously validated and published questionnaire was used with little modification. The associations between the level of knowledge, Attitudes, and practice with different risk factors were calculated statistically and the significant association was considered with a p-value <0.05. Results: The data were analysed and showed that most of the students (56.3%, 46.2%, and 43.3%) has a moderate level of knowledge, attitude, and practice respectively toward dengue infection among the respondents. The result shows a significant association between the level of practice and knowledge (p-value <0.001) as well as between the level of practice and attitudes (p-value <0.001). Conclusion: The significant association between the practice and knowledge along with attitudes indicates the more knowledge and attitudes lead to better practice. This study highlighted the important role of university students in dengue prevention-based programs. They should be exposed more to improve and transfer their knowledge and attitude to other community population to reduce the incidence of dengue not only in Malaysia but globally.


2005 ◽  
Vol 133 (3) ◽  
pp. 503-507 ◽  
Author(s):  
S. ANANTAPREECHA ◽  
S. CHANAMA ◽  
A. A-NUEGOONPIPAT ◽  
S. NAEMKHUNTHOT ◽  
A. SA-NGASANG ◽  
...  

Serological and virological features of dengue fever (DF) and dengue haemorrhagic fever (DHF) in Thailand were analysed in 2715 patients from 1999 to 2002. The illness was caused by DEN-1 in 45%, DEN-2 in 32%, DEN-3 in 18% and DEN-4 in 5% of patients. Almost all of the DHF cases caused by DEN-2 and DEN-4 were in secondary infection, while approximately 20% of the DHF cases caused by DEN-1 and DEN-3 were in primary infection. Male[ratio ]female ratio and age distribution were not different among four serotypes in primary and secondary infections. These results indicate that DEN-1 and DEN-3 induce DHF in both primary and secondary infections, and suggest that DEN-2 and DEN-4 in Thailand are less likely to cause DHF in primary infections.


e-CliniC ◽  
2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Andrea Livina ◽  
Linda W. A. Rotty ◽  
Lucia Panda

Abstract: Dengue fever (DF) and dengue haemorrhagic fever (DHF), an infection disease who still become a health problem in Indonesia. There was increasing cases reported in Indonesia from 2011 to 2012. Thrombocytopenia and plasma leakage signed by haemoconcentration are important indicator in dengue. Bleeding manifestation appears as clinical symptom of DF and DHF that increases mortality ratio of dengue infection. The aim of this study is toinvestigatethe correlation of thrombocytopenia and hematocrit tobleeding manifestation of dengue fever and dengue haemorrhagic fever.This study is retrospective cross-sectional. Forty two men and thirty five women were evaluated in this study, fifty nine of them were diagnosedas DF and eighteen of them were diagnosed asDHF. The correlation of thrombocytes to hematocrit used nonparametric Spearman test, the result were significant with p=0,000 and r=-0,183. The correlation of thrombocytes to the occurrence of bleeding manifestation and hematocrit to the occurrence of bleeding manifestation, both were not significant, with p=0,714 and p=0,153. This study suggest that there were a very weak correlation between thrombocytes and hematocrit and no correlation between thrombocytopenia and hematocrit with bleeding manifestation. Keywords: Dengue Fever, Dengue Haemorrhagic Fever, Thrombocytopenia, Hematocrit, and Bleeding Manifestation.   Abstrak: Demam dengue (DD) dan demam berdarah dengue (DBD) merupakan penyakit infeksi yang masih menjadi masalah kesehatan di Indonesia. Telah dilaporkan terdapat peningkatan jumlah kasus di Indonesiadari tahun 2011 ke tahun 2012. Berdasarkan kriteria laboratorium WHO, jumlah trombosit yang rendah (trombositopenia) dan kebocoran plasma yang ditandai dengan hemokosentrasi merupakan indikator penting pada DD dan DBD. Gejala klinis DD dan DBD dapat disertai dengan manifestasi perdarahan yang akan meningkatkan rasio mortalitas penderita infeksi dengue. Penelitian yang bertujuan untuk mengetahui hubungan trombositopenia dan hematokrit dengan manifestasi perdarahan pada penderita demam dengue dan demam berdarah dengue ini menggunakanmetode retrospektif dengan studi cross-sectional.Sampel pada penelitian ini terdiri dari 42 orang laki-laki dan 35 orang perempuan. Penderita DD berjumlah 59 orang dan penderita DBD berjumlah 18 orang. Uji nonparametrik Spearman terhadap trombosit dan hematokrit mendapat hasil signifikan (p=0,000 ; r=-0,183). Uji nonparametrik Spearman terhadap trombosit dan manifestasi perdarahan mendapat hasil yang tidak signifikan (p=0,714). Uji nonparametrik Spearman terhadap hematokrit dan manifestasi perdarahan mendapat hasil yang tidak signifikan (p=0,153). Dapat disimpulkan bahwa terdapat korelasi yang sangat lemah antara trombosit dan hematokrit, tidak terdapat hubungan yang bermakna antara trombositopenia dan hematokrit dengan manifestasi perdarahan. Kata kunci:Demam Dengue, Demam Berdarah Dengue, Trombositopenia, Hematokrit, dan Manifestasi Perdarahan.


Cephalalgia ◽  
2006 ◽  
Vol 26 (7) ◽  
pp. 879-882 ◽  
Author(s):  
RB Domingues ◽  
GW Kuster ◽  
FL Onuki de Castro ◽  
VA Souza ◽  
JE Levi ◽  
...  

The aim of this study was to describe the frequency and features of headache among patients with confirmed dengue virus infection and to compare the headache features in patients with dengue fever and dengue haemorrhagic fever, primary and secondary dengue infection, and patients with and without neurological involvement. Patients with classic dengue fever had a more intense headache than those with the more severe form of the disease, dengue haemorrhagic fever.


2019 ◽  
Vol 7 (14) ◽  
pp. 2221-2225 ◽  
Author(s):  
Mutiara ◽  
Stephen C. L. Koh ◽  
Adang Bachtiar ◽  
Herman Hariman

BACKGROUND: Dengue fever is the most serious consequence of mosquito-borne infection worldwide. The pathophysiology of DHF in human is complex, which involve endothelial cell activation and impaired endothelial barrier leading to plasma leakage triggering the activation of the haemostatic system. The increased vascular permeability may lead to hypovolemia, hypotension and shock, which is life-threatening. AIM: The objective of the study was to determine the effects of dengue haemorrhagic fever on the vascular endothelium. METHODS: Fifty patients (males 34, females 16), were recruited, Grade 1 (n = 41), Grade 2 (n = 6), Grade 3 (n = 2) and Grade 4 (n = 1) DHF. Blood sampling was performed at the febrile, defervescence and convalescent phases for the determination of haemoglobin, haematocrit, platelets, prothrombin fragment F1 + 2, Von Willebrand Factor (VWF), vascular endothelial growth factor (VEGF) and D-dimer levels. Fifteen normal subjects were recruited to serve as normal controls. RESULTS: The patients aged between 4 and 54 years old. Grades 1 & 2 DHF showed no significant differences in the parameters studied. However, thrombocytopenia, elevated F1 + 2, VWF, VEGF and D-dimer levels were evident in febrile, defervescence and convalescent phases suggesting endothelial activation and plasma leakage. Pleural effusion was observed only in severe DHF. The three patients with Grades 3 and 4 DHF had similar study results. No mortality was recorded in the study. CONCLUSION: In dengue haemorrhagic fever, the vascular endothelium is activated, causing plasma leakage triggering the activation of the haemostatic system creating a hypercoagulable and enhanced fibrinolytic state evident by marked fibrinolysis.


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