scholarly journals Discharging dengue fever patients with low platelets can be safe

2020 ◽  
Vol 19 (4) ◽  
pp. 760-762
Author(s):  
Navin Kumar Devaraj
Keyword(s):  
Physical Examination ◽  
Hospital Admission ◽  
Dengue Fever ◽  
Medical Science ◽  
Interesting Case ◽  
Warning Signs ◽  
Platelet Level ◽  
Loss Of Appetite

This is an interesting case of Mr MS who presented with 7 days of fever, loss of appetite and lethargy. Physical examination was unremarkable. Investigation revealed a very low platelet of 11 x 109/L and haematocrit of 46%. He was managed as outpatient and recovered well despite this alarming low platelet level, proving not all dengue fever patients ,especially those with no warning signs and clinically well, needs hospital admission. Bangladesh Journal of Medical Science Vol.19(4) 2020 p.760-762

Ayurvedic management of Ischemic Gangrene due to Diabetes Mellitus - A Case Report

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Vikram S. ◽  
Saraswathi Devi H.N.
Keyword(s):  
Diabetes Mellitus ◽  
Upper Limb ◽  
Medical Science ◽  
Limb Ischemia ◽  
Interesting Case ◽  
Therapeutic Interventions ◽  
Acute Ischemia ◽  
Arterial Circulation ◽  
Ct Angiogram ◽  
Choice Of Treatment

Medical science says that ischemia is a common complication in Diabetes, especially in the lower limb but this is a case presenting ischemic changes in upper limb which is unique and also in such type of acute ischemia amputation is the only choice of treatment to save the life of patient from septicaemia. Such a rare and interesting case was taken at Sri Sri Ayurveda Hospital and handled by proper Ayurvedic line of treatment by which circulation is re-established which saved both limb and life of patient. A patient by name Sundaramma, 62yr Female, visited Sri Sri Ayurveda Hospital on 29/2/2016 with a diagnosis of Right upper limb Ischemia with Diabetes Mellitus and Active TB. The main symptoms were severe pain and burning sensation in Right hand and forearm, discolouration of fingers with ulcers, Bluish black discolouration over right thumb, necrosis, pus dischargeand stiffness, associated with difficulty in movement of right arm, shoulder joint, elbow joint, palm and fingers. Diagnosed as Right Upper Limb Ischemia with Diabetes Mellitus and active TB. Therapeutic interventions like Right upper limb Doppler and CT angiogram were done. Such a complicated case was taken at Sri Sri Ayurveda Hospital, and carefully handled by Ayurvedic methods of management, which was ended up by preventing amputation of the limb and also achieving the re-establishment of arterial circulation.

scholarly journals 1405. Clinical and laboratory features of fatal dengue fever in children: a case-control study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S710-S711
Author(s):  
Dolores E Freire ◽  
Jeniffer D Olaya ◽  
Michael Hawkes
Keyword(s):  
Dengue Fever ◽  
Case Control Study ◽  
Dengue Infection ◽  
Healthcare Providers ◽  
Case Control ◽  
Warning Signs ◽  
Total Leukocyte Count ◽  
Retrospective Case ◽  
Time To Death ◽  
Control Study

Abstract Background Dengue fever (DF) is a mosquito-borne illness that causes significant morbidity and mortality in tropical climates. This study compared the clinical features of fatal DF cases to severe non-fatal, and non-severe controls in Ecuador. Methods Retrospective case-control study of children (1 month to 15 years) hospitalized with serologically-confirmed DF in Guayaquil, Ecuador from 2013 to 2017. Cases of severe, fatal (SF) DF were compared to two control groups: (1) severe DF survivors (SS); and (2) patients with dengue with warning signs (DWS), matched 3:1 to cases for age, sex, and admission date. Observational trial profile Results 1051 patients were admitted with suspected DF and 552 were IgM-positive. Patients were classified as SF (n=11), SS (n=30), or DWS (n=511) (Figure1). Among SF cases, median age was 9.6 years (IQR 5.5-11), 7 (64%) were male, and median time to death was 1.5 days (IQR 0.8-4.0). (Table 1) SF cases had a median of 3 (Range 0-5) encounters with healthcare providers prior to presentation, compared to 2 (Range 0-5, p=0.02) for SS and 2 (Range 0-3, p=0.02) for DWS. Physical findings more common in SF cases than controls included: higher weight, tachycardia, tachypnea, delayed capillary refill, and hepatomegaly (p< 0.05 for all comparisons). Neurological manifestations were more prevalent in the SF group: 9/11 (82%) patients compared to 15/30 (50%, p=0.09) in SS and 7/33 (21%, p< 0.01) in DWS. Total leukocyte count (7.8x103/µL versus 4.5x103/µL, p=0.03) and absolute neutrophil count (5.1x103/µL versus 2.1x103/µL, p=0.03) were higher in SF cases than DWS controls. Fewer SF patients received intravenous dextrose than SS controls (27% versus 70%, p=0.03) (Table 2). Admission characteristics of children with dengue fever Management and outcome Conclusion Delayed recognition by healthcare workers, higher weight, vital sign abnormalities, hepatomegaly, neurological symptoms, leukocytosis, neutrophilia, and lack of dextrose in intravenous solutions were associated with mortality in children with DF. These findings have implications for optimizing the diagnosis and management of severe pediatric dengue infection. Disclosures All Authors: No reported disclosures

scholarly journals Patterns of Gall Bladder Wall Thickening in Dengue Fever: A Mirror of the Severity of Disease

2017 ◽  
Vol 03 (02) ◽  
pp. E76-E81 ◽  
Author(s):  
Jitendra Parmar ◽  
Chander Mohan ◽  
Maulik Vora
Keyword(s):  
Gall Bladder ◽  
Dengue Fever ◽  
Bladder Wall ◽  
Warning Signs ◽  
Severe Dengue ◽  
Wall Thickening ◽  
Severity Of Disease ◽  
Gall Bladder Wall ◽  
Track Pattern ◽  
Honeycomb Pattern

Abstract Background Dengue fever is a major public health problem with an increased incidence in recent years. Gall bladder wall thickening has been reported as one of the most common findings in dengue fever. There is a paucity of literature regarding the various patterns of gall bladder wall thickening in dengue fever and their significance in predicting the severity of disease. Methodology and Significant Findings Out of 93 seropositive patients included in the study, 54 patients with dengue fever had gall bladder wall thickening. 4 patterns of gall bladder wall thickening are demonstrated in this study. A uniform echogenic pattern in 20 patients, striated or tram track pattern in 11 patients, an asymmetric pattern in 2 patients and a honeycombing pattern in 21 patients. The range of patterns of wall thickening included normal wall thickening or uniform echogenic wall thickening in DF without warning signs, a striated or tram track pattern, and a honeycomb pattern in severe DF. Serial ultrasound done on consecutive alternate days revealed a change in the pattern of gall bladder wall thickening according to the severity of disease. Conclusion The present study revealed 4 distinct patterns of gall bladder wall thickening. The uniform echogenic pattern was found to be more prevalent in dengue fever without warning signs, while the honeycomb pattern was found to be more prevalent in severe dengue fever. A change in the pattern of gall bladder wall thickening on subsequent serial ultrasound can predict the severity of the disease.

scholarly journals Clinical profile of dengue fever in children: analysis of 2017 outbreak from Central Kerala, India

2018 ◽  
Vol 5 (6) ◽  
pp. 2265 ◽  
Author(s):  
Senthil Kumar K. ◽  
Rajendran N. K. ◽  
Ajith Brabhukumar C.
Keyword(s):  
Dengue Fever ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Warning Signs ◽  
Clinical Profile ◽  
Severe Dengue ◽  
High Morbidity ◽  
Care Hospital ◽  
High Grade Fever

Background: In India, dengue epidemics are becoming more frequent (WHO, 2008). The majority of dengue viral infections are self-limiting, but complications may cause high morbidity and mortality. The objective of this study is to assess the clinical profile of the dengue infection in children less than 15 years of age and to evaluate the outcomes of dengue fever from March 2017 to July 2017 at the Pediatric Department of Karuna Medical College, the tertiary care hospital in Palakkad.Methods: In this retrospective study, medical records were reviewed and analyzed. Patients with suspected dengue infection were classified further into 2 groups, Dengue fever (probable dengue, dengue with warning signs) and ‘Severe Dengue’ (dengue hemorrhagic fever and/or dengue shock syndrome (DHF/DSS) according to WHO.Results: A total of 77 cases were classified into 67 (87%) non-severe and 10 (13%) severe dengue cases. The most common age of presentation was above 10 yrs. The mean age of admission was 8.9 yrs. The most common presenting symptom was fever seen in 93% followed by vomiting in 68%. Elevation in Aspartate transaminase (SGOT) and thrombocytopenia were found in 32.4 %.Conclusions: High grade fever, vomiting, abdominal pain and skin rash with normal or low platelet count were the presenting features. Early diagnosis, monitoring and prompt supportive management can reduce mortality.

scholarly journals Misfortune never comes singly - the first case of COVID-19 with rupture of thoracic aortic aneurysm

2020 ◽  
Author(s):  
Kun Zhao ◽  
Zhang Cao ◽  
Changju Zhu ◽  
Yi Zhang ◽  
Feifan Chen
Keyword(s):  
Aortic Aneurysm ◽  
Severe Acute Respiratory Syndrome ◽  
Hospital Admission ◽  
Thoracic Aortic Aneurysm ◽  
Warning Signs ◽  
Cytokine Storm ◽  
Case Presentation ◽  
First Case

Abstract Background: SARS-CoV-2 is a newly discovered virus, leading COVID-19 a global threaten nowadays. Case Presentation: The first case of a patient with a thoracic aortic aneurysm (TAA) that became infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported here. The patient died suddenly from a ruptured aorta 19 h after hospital admission. Conclusion: COVID-19 patients with TAA should attract the highest vigilance as COVID-19 might expedite the process of TAA rupture through cytokine storm syndrome, leading to rapid death with little or no warning signs.

Otorrhoea

2020 ◽  
Vol 13 (5) ◽  
pp. 281-288
Author(s):  
Mark Newton ◽  
Paraskevi Tsirevelou
Keyword(s):  
Primary Care ◽  
Cerebrospinal Fluid ◽  
Physical Examination ◽  
Hospital Admission ◽  
Secondary Care ◽  
Common Causes ◽  
Management Guidance ◽  
Throat Symptom ◽  
The Common ◽  
Nose And Throat

The discharging ear, also known as otorrhoea, is a common ear, nose and throat symptom and defined as drainage or flow exiting the ear. The discharge can be wax, blood, pus, mucus, or cerebrospinal fluid. The underlying cause can usually be determined from the history and physical examination. Most patients with otorrhoea can be managed within primary care and do not require referral or hospital admission. This article considers the common causes of a discharging ear, appropriate management, guidance for referral of patients to secondary care and some key take home points.

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.

Dengue fever in travellers: are we missing warning signs of severe dengue in a non‐endemic setting?

2016 ◽  
Vol 204 (7) ◽  
pp. 267-267 ◽  
Author(s):  
Alex Tai ◽  
Roselle Robosa ◽  
Alexander A Padiglione ◽  
Chamila Dalpatadu ◽  
Tony M Korman
Keyword(s):  
Dengue Fever ◽  
Warning Signs ◽  
Severe Dengue ◽  
Endemic Setting

Antenatal diagnosis of achondroplasia

2013 ◽  
Vol 13 (1) ◽  
pp. 84-87 ◽  
Author(s):  
K Dhungel ◽  
MK Gupta ◽  
K Ahmad ◽  
S Ansari ◽  
RK Rauniyar
Keyword(s):  
Antenatal Diagnosis ◽  
Medical Science ◽  
Interesting Case ◽  
Skeletal Survey ◽  
Term Pregnancy ◽  
Femur Length ◽  
Biparietal Diameter ◽  
Ultrasound Assessment

We report a interesting case of antenatal diagnosis of achondrpoplasia in a young multigravida who presented with term pregnancy for routine ultrasound assessment which revealed a single, live intrauterine fetus with a discrepancy between femur length (FL) and biparietal diameter (BPD), narrowing of the interpeduncular distance. The diagnosis of achondroplasia was made with a sonological skeletal survey and findings were correlated with radiological skeletal survey after the baby was delivered. DOI: http://dx.doi.org/10.3329/bjms.v13i1.17443 Bangladesh Journal of Medical Science Vol. 13 No. 01 January2014: 84-87

scholarly journals Clinical Profiles of Dengue Infection during an Outbreak in Northern India

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Anish Laul ◽  
Poonam Laul ◽  
Vamsi Merugumala ◽  
Ravi Pathak ◽  
Urvashi Miglani ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Dengue Infection ◽  
Dengue Shock Syndrome ◽  
Acalculous Cholecystitis ◽  
Signs And Symptoms ◽  
Hemorrhagic Fever ◽  
Warning Signs ◽  
Mosquito Vector ◽  
Diagnostic Dilemma ◽  
Atypical Presentations

Introduction.Dengue fever is an arboviral disease, which is transmitted by mosquito vector and presents as varied clinical spectrum of dengue fever (DF), dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS), and expanded dengue syndrome (EDS) with atypical presentations, thus posing a diagnostic dilemma. Unless we are aware of these presentations, diagnosis as well as early initiation of treatment becomes difficult. We studied the various clinical presentations of dengue infection during an outbreak of disease in 2015.Materials and Methods. A total of 115 confirmed cases of dengue infection from Department of Medicine of Deen Dayal Upadhyay Hospital, New Delhi, were enrolled in this observational study.Results.The common signs and symptoms of dengue infection were fever, headache, body ache, backache, retro-orbital pain, bleeding manifestations, and rash in 100%, 87%, 86%, 58%, 41%, 21%, and 21%, respectively. Nonspecific or warning signs and symptoms included vomiting, weakness, abdominal pain, breathlessness, vertigo, sweating, and syncope. Other possible signs and symptoms of coinfections, comorbidities, or complications included diarrhea, sore throat, and neurological manifestations. There were seven patients with coinfections and four with comorbidities. The final diagnosis of these patients was DF (73%), DHF (16.5%), DSS (1.7%), and EDS (4.3%). Among EDS patients, the atypical presentations included encephalopathy, lateral rectus nerve palsy, acalculous cholecystitis, and myocarditis. Four patients required ICU care and there was no death in this study.Conclusion. Knowledge of atypical presentations is a must for early diagnosis and timely intervention to prevent life-threatening complications.

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