Clinicopathological Profile and Outcome of Dengue Fever: A Tertiary Care Hospital Experience

Introduction: Diverse manifestation of recent dengue outbreak has posed a challenge to pre-existing nature of dengue virus infection and management. This study was designed to observe clinicopathological profile and analyze the diverse presentation and outcome of dengue syndrome in recent outbreak in Bangladesh. Methods: This was a hospital based observational study, carried out in Medicine department of Combined Military Hospital (CMH) Dhaka cantonment in between May and September 2019. Total 300 laboratory-confirmed dengue cases aged more than 11 years presenting within 7 days of symptom onset were studied. Patients who presented 7 days after the onset of symptoms or those who were transferred to other hospitals were excluded from study. Results: Total patients were 300 with male predominance (187, 62.3%) and mean age±SD was 37.6±7.5years with age range 12 to76 years; common presentations were fever (300, 100%),headache (265, 88.3%), skin rash (197, 65.7%), bodyache (186, 62.0%),vomiting (152, 50.7%), diarrhoea (65, 21.7%),abdominal pain (58, 19.3%), and bleeding manifestation (36, 12.0). Eighty four (28%) patient had classical dengue fever (DF), 61 (20.3%) had dengue haemorrhagic fever (DHF), 45(15%) had dengue shock syndrome (DSS) and 110(36.7%) had expanded dengue syndrome(EDS). Relevant investigations showed 157(52.3%) patients had leukopenia,18(6%) had leukocytosis, 254(84.7%) had thrombocytopenia with lowest platelet count 1x109/L,135(45%) had abnormal ALT, 110(36.7%) had abnormal AST, 84(28%) had hyponatraemia,43(14.3%) had AKI,125(41.7%) had pleural effusion with 36(12%) bilateral;102(34%) had ascites, 25(8.3%) developed acalculous cholecystitis;7(2.3%) patient developed cerebrovascular accident. Eighteen (6%) patients required mechanical ventilation and 15 (5%) patients required haemodialysis. Regarding outcome, 5 (1.7%) patients died and 295 (98.3%) patients survived. Conclusion: Dengue fever was presented with common as well as other features and involved a number of organs including liver, kidneys, brain, pleura, peritoneum, and gall bladder and had diverse manifestations and adverse outcome. J Bangladesh Coll Phys Surg 2021; 39: 213-219

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A study on the outbreak of dengue fever in a tertiary care children’s hospital in southern Tamil Nadu, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20192011 ◽

2019 ◽

Vol 6 (3) ◽

pp. 1194

Author(s):

Belgin Premkumar ◽

Baburaj S. ◽

Margaret Hepzibah N. ◽

Misha K. P. ◽

Binu Abraham

Keyword(s):

Dengue Fever ◽

Tamil Nadu ◽

Tertiary Care ◽

Case Fatality ◽

Dengue Shock Syndrome ◽

Viral Disease ◽

Severe Dengue ◽

Care Hospital ◽

Clinical Criteria ◽

Public Health Challenge

Background: Dengue fever is the most rapidly spreading mosquito-borne viral disease in the world.Incidence has increased 230-fold with increasing geographic expansion with potential for further spread. The rapidly expanding global footprint of dengue is a public health challenge with an economic burden. This study’s objective is to assess the outbreak of epidemic of dengue fever in a tertiary care children hospital and to describe their socio-demographic, clinical outcome and serological profile.Methods: It is an observational descriptive study conducted for a period of 1 year in less than 12 years old children in a tertiary care hospital at Southern Tamil Nadu.Results: Among the 360 children admitted with dengue fever, there were 198 boys (55%) and 162 (45%) were girls. Maximum incidence of dengue incidence was seen in infants less than 1 year (25%). The highest number of cases were admitted during September and October. The most common affected age group was less than 3 years with 179 (49%). Among the cases, 297 (82%) were of severe dengue which constitute dengue haemorrhagic fever-183(38%) and Dengue shock syndrome 114 (62%). Serological analysis showed NS1 Ag was positive in 144 children (40%), Dengue IgM was positive in 54 children (15%), both IgM and IgG positive in 126 children (35%) and IgG was positive in 36 children (10%). Out of the total children admitted with dengue fever, the case fatality was 0.5% (2 children).Conclusions: This study highlights the importance of WHO clinical criteria for early diagnosis of severe dengue. Moreover, the early and intensive management reduces the mortality significantly.

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CLINICAL AND HEMATOLOGICAL PROFILE OF PATIENTS WITH DENGUE FEVER AT A TERTIARY CARE HOSPITAL – AN OBSERVATIONAL STUDY

Mediterranean Journal of Hematology and Infectious Diseases ◽

10.4084/mjhid.2018.021 ◽

2018 ◽

Vol 10 (1) ◽

pp. e2018021 ◽

Cited By ~ 1

Author(s):

Vishal Vishnu Tewari ◽

Kunal Tewari ◽

Ritu Mehta

Keyword(s):

Dengue Fever ◽

Tertiary Care ◽

Dengue Shock Syndrome ◽

Hemorrhagic Fever ◽

Annual Data ◽

Care Hospital ◽

Igg Antibody ◽

Hematological Profile ◽

Ns1 Antigen ◽

Duration Of Hospitalization

AbstractBackground: Dengue is a major health issue with seasonal rise in dengue fever cases imposing an additional burden on hospitals, necessitating bolstering of services in the emergency department, laboratory with creation of additional dengue fever wards.Objectives: To study the clinical and hematological profile of dengue fever cases presenting to a hospital.Methods: Patients with fever and other signs of dengue with either positive NS1 antigen test or IgM or IgG antibody were included. Age, gender, clinical presentation, platelet count and hematocrit were noted and patients classified as dengue fever (DF), dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). Duration of hospitalization, bleeding manifestations, requirement for platelet component support and mortality were recorded.Results: There were 443 adults and 57 children between 6 months to 77 year age. NS1 was positive in 115 patients (23%). Fever (99.8%) and severe bodyache (97.4%) were the commonest presentation. DF was seen in 484 (96.8 %), DHF in 10 (2%) and DSS in 6 cases (1.2%). OPD treatment was needed in 412 (82%) and hospitalization in 88 (18%). Intravenous fluid resuscitation was needed in 16 (3.2%) patients. Thrombocytopenia was seen in 335 (67%) patients at presentation. Platelet transfusion was needed in 46 (9.2%). PRC transfusion was given in 3 patients with DF and 10 of DHF. Death occurred in 03 DSS and 2 DHF patients. Conclusions: Majority of DF cases can be managed on OPD basis. DHF and DSS carry high mortality. Hospitals can analyze annual data for resource allocation for capacity expansion.

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FACTORS PREDICTING MORBIDITY IN PATIENTS WITH DENGUE FEVER IN A TERTIARY CARE HOSPITAL

Mediterranean Journal of Hematology and Infectious Diseases ◽

10.4084/mjhid.2013.014 ◽

2013 ◽

Vol 5 (1) ◽

pp. e2013014 ◽

Cited By ~ 11

Author(s):

Muhammad Imran Hasan Khan ◽

Eram Anwar ◽

Adnan Agha ◽

Noha Saleh ◽

Ehsan Ullah ◽

...

Keyword(s):

Risk Factors ◽

Dengue Fever ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Dengue Shock Syndrome ◽

Hemorrhagic Fever ◽

Denv Infection ◽

Care Hospital ◽

Factors Associated ◽

Logistics Regression

Introduction: Dengue virus (DENV) affects over half the world’s population in 112 countries, and dengue fever (DF) is the second largest arthropod borne infectious global hazard after malaria with complications like Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS) accounting for significant morbidity and mortality world over. Pakistan is significantly affected with DENV infection and to-date no study identifying risk factors associated with complications of DF has been done. Methods: 997 confirmed cases of DF were collected in a tertiary care hospital in Lahore, Pakistan and their clinical and biochemical data were collected. Univariate, multivariate and logistics regression analysis was performed to identify risk factors associated with development of DHF and DSS. Results: Bleeding OR 70.7 (CI 38.4-129.9), deranged liver function test OR 1.9 (CI 0.97-0.99), platelet count on admission less than 50,000 x109/L OR 0.16 (CI 0.13-0.19), presence of urinary red blood cells OR 1.4 (CI 0.179-0.900) and presence of urinary protein OR 1.1 (CI 0.191-0.974) were related to development of DHF and DSS.

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Clinico-epidemiological profile of paediatric dengue patients in a tertiary care hospital: a retrospective study in Visakhapatnam, Andhra Pradesh, India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20204739 ◽

2020 ◽

Vol 7 (11) ◽

pp. 4424

Author(s):

Chilakala Padmavathy ◽

B. Devi Madhavi ◽

S. Suneetha ◽

Suresh Babu Chaduvula

Keyword(s):

Abdominal Pain ◽

Dengue Fever ◽

Tertiary Care ◽

Dengue Shock Syndrome ◽

Hemorrhagic Fever ◽

Viral Disease ◽

Care Hospital ◽

Age Group ◽

Hospital Data ◽

Cross Sectional

Background: Dengue is a mosquito borne viral disease in the world with unpredictable clinical course and outcome. Though it is self-limiting in most of patients, the dengue hemorrhagic stage and dengue shock syndrome are life threatening.Methods: It is a retrospective cross-sectional observational record-based study conducted in King George Hospital in Andhra Medical College, Visakhapatnam, AP, India. Upon clinical suspicion, Dengue fever was confirmed by NS 1 antigen and/or Dengue antibody IgM, IgG in KGH laboratory in patients who were admitted in the hospital data was collected from records after ethical committee approval. Data of pediatric dengue positive cases in the age group ranging between 0-14 years from January 2018 - November 2018 were reviewed.Results: In this study the highest percentage of age group was found between 0-5 years. Fever was present in 100% cases, abdominal pain in 47% cases, rash, nausea/vomiting were found in 37%, headache in 12.35%, myalgia/ arthralgia or backache in 13.48%, retro orbital pain in <1% cases. Dengue fever (DF) was found in 46 % cases, dengue hemorrhagic fever (DHF) in 50% and dengue shock syndrome (DSS) in 3.9 cases.Conclusions: The study found among these 50% developed DHF and 46% DF and 3.9% DSS. Early admissions of pediatric cases can prevent major complications like DHF and DSS. The predominant complaints found were fever, vomiting and abdominal pain in paediatric group.

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GENERAL SURGEONS

The Professional Medical Journal ◽

10.29309/tpmj/2016.23.08.1669 ◽

2016 ◽

Vol 23 (08) ◽

pp. 959-963

Author(s):

Abdul Qayyum ◽

Hamzullah Khan

Keyword(s):

Acute Abdomen ◽

Open Cholecystectomy ◽

Tertiary Care ◽

Care Hospital ◽

Legal Cases ◽

Surgical Interventions ◽

Surgical Emergencies ◽

Study Results ◽

General Surgeons ◽

Age Range

Objectives: The objectives of this study were to find out the frequency ofsurgical cases and types of surgical interventions in a tertiary care hospital of Peshawar. StudyDesign: Descriptive observational study Period: Jan to June 2015. Setting: Surgical “D” Unitof Medical Teaching institution, Lady Reading Hospital Peshawar. Material and methods:Relevant information’s were recorded on a pre-designed proforma prepared in accordancewith the objectives of the study. Results: A total of 842 patients who were admitted in the MTILRHSurgical D Unit were enrolled in the study irrespective of age, gender and geographicalrepresentation. Out of total 58% were males and 42% females. The age range of patient wasfrom 2 years to 92 years the maximum. The mean of age with SD was 30 years +3.5 SD. Modeof age was 27 years. The frequency of surgical cases presentation (via emergency or outdoordepartment) were; Acute appendicitis 26%, cholilithiasis 17%, acute abdomen 9.2%, fire arminjuries/medico-legal cases 3.3%, peri-anal problems (pilonodal sinuses, hemorrhoids, fistula,anal fissure) 8.8%, Hernia (RIH& LIH 13%), carcinoma cases (stomach, rectum, pancreas) 1.5%,diabetic foot 3%, intestinal perforation & ileostomy 2.8%, etc. The frequency of types of surgicalprocedures were; The frequency of types of surgical procedures were; Open appendicectomy25%, Exploration laprotomy 8.4%, debridement 2%, Peri anal surgeries (EUA, Haemorridictomy,anal dilatation, fistulectomy 9.4%), hernirraphy and hernitomy 16%, open cholecystectomy 13%,laproscopic cholecystectomy 4.4%, orchiodectomy & orchidopexy 5%, and colostomy reversal2.2% etc. 2% patients managed conservatively. Eight patients expired during the treatment(1%). 97% discharged satisfactorily. There were 2 medico-legal cases that after dischargedwent in law in forces custody. Conclusion: The commonest cause of seeking surgical carewas acute abdomen, FAI/MLC, cholilithiases, perianal disorders, hernia and testicular/scrotalproblem are major surgical emergencies that we receive in our unit. In response the major typesof surgical interventions are appendicectomy, Exploration laprotomy, open cholecystectomy,laproscopic cholecystectomy, hernirraphy and hernitomy, orchiodectomy &orchidopexy andcolostomies. There is 1% moratlity rate as observed.

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Importance of Platelet Count and Hematocrit in Dengue Fever in Children

Bangladesh Journal of Child Health ◽

10.3329/bjch.v44i2.51129 ◽

2021 ◽

Vol 44 (2) ◽

pp. 74-77

Author(s):

Farhana Rahat ◽

Morsheda Khanam ◽

Kazi Iman ◽

UK Ghosh ◽

NK Ghosh

Keyword(s):

Platelet Count ◽

Dengue Fever ◽

Dengue Hemorrhagic Fever ◽

Dengue Infection ◽

Tertiary Care ◽

Dengue Shock Syndrome ◽

Hemorrhagic Fever ◽

Warning Signs ◽

Care Hospital ◽

Pediatric Age Group

Background: Dengue fever has become one of the most important public health concerns now a day due to increasing complications and fatal outcomes. Dengue hemorrhagic fever and dengue shock syndrome are life threatening but reversible complications of dengue fever. Objectives: This study was performed to evaluate the relationship between platelet count and hematocrit with the severity of dengue infection in pediatric age group. Materials & Methods: This was a prospective observational study which included 280 dengue seropositive children of 1 month to 15 years, conducted during 1st June to 30th November, 2018 in a tertiary care hospital of Dhaka. Results: Out of 280 dengue cases, 187(66.78%) had thrombocytopenia and 88(47%) had raised hematocrit. Among the thrombocytopenic patients 44% had dengue fever, 47% had dengue hemorrhagic fever and 9% dengue shock syndrome. A significant co-relation was observed between the severities of thrombocytopenia and raised hematocrit with the appearance of dengue warning signs in case of dengue hemorrhagic fever. Conclusion: Thrombocytopenia and raised hematocrit were related to the severity of dengue hemorrhagic fever. Bangladesh J Child Health 2020; VOL 44 (2) :74-77

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A comparative study of in clinico-pathological profile in dengue shock syndrome versus other types children's at tertiary health care center

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174138 ◽

2017 ◽

Vol 5 (10) ◽

pp. 4330

Author(s):

Bhavesh Shah ◽

Deepa Sachin Phirke

Keyword(s):

Health Care ◽

Acute Kidney Injury ◽

Dengue Fever ◽

Tertiary Care ◽

Kidney Injury ◽

Dengue Shock Syndrome ◽

Total Leukocyte Count ◽

Care Hospital ◽

Health Care Center ◽

Significant Difference

Background: Dengue a mosquito borne arboviral disease is caused by one of the serotypes of dengue virus (DEN-1, DEN-2, Den-3, DEN-4) belonging to the family Flaviviridae. The objective of this study was to study clinco-pathological profile of Dengue shock syndrome versus Other types children's at tertiary health care center.Methods: This was Cross sectional observational study was conducted in a tertiary care hospital in the Department of Pediatrics after obtaining approval from the institutional Ethical Committee. The study was carried out over a period of one & half years from January 2015 to June 2016 Statistical analysis done by Chi-square, ANOVA, Paired t test SPSS version 22 (IBM SPSS Statistics, Somers NY, USA) was used to analyze data.Results: Mean age of patients were 8.08±2.72 years, majority of cases were females (51.9%) and 48.1% were males, the clinical features like hepatomegaly, Ascites Pleural Effusion significantly present in DSS (P<0.001). In the study, there was no significant difference in symptoms and severity of dengue fever except for convulsion Thrombocytopenia (platelet<1lakh/cmm) was observed in 74% of cases, leucopenia (total leukocyte count <4000/cmm) was observed in 56% of cases, haemocrit more than 40 was observed in 21.27% cases. Dengue shock syndrome had acute kidney injury, CCF and encephalopathy. This observation of complications between dengue severity was statistically significant. There was significant difference in haematocrit values between three diagnoses of dengue fever from day 1 till day 4. Initially higher haematocrit was observed in Dengue shock syndrome, later goes on decreasing.Conclusions: It can be concluded from our study that significantly dengue shock syndrome had acute kidney injury, CCF and encephalopathy. There was significant difference in hematocrit values between three diagnoses of dengue fever from day 1 till day 4. Initially higher hematocrit was observed in dengue shock syndrome.

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Study on Dengue fever in children: A Tertiary care hospital during dengue out-break

Z H Sikder Women’s Medical College Journal ◽

10.47648/zhswmcj.2019.v0101.01 ◽

2019 ◽

Vol 1 (Number 1) ◽

pp. 6-9

Author(s):

Tamanna Begum ◽

Sadika Kadir ◽

Khayerul Islam ◽

Rafiqul Islam ◽

Romela Yeasmin ◽

...

Keyword(s):

Dengue Fever ◽

Tertiary Care ◽

Warning Sign ◽

Care Hospital ◽

Male Predominance ◽

Dengue Outbreak ◽

Test Kit ◽

Wide Range ◽

The Common ◽

Body Ache

This is a prospective observational study conducted in the department of Paediatrics from June to August 2019 during the time of dengue outbreak. All children age up to 14 years with either positive NSI antigen or serological Gg, IgM test Kit or ELISA methods were taken into the study. Total 39 cases were enrolled in this study. Mean age was 7.2 ± 2 years, majority were in the age group of 5-10 years (51%) followed by <5 years (38%),> 10 years (35%) respectively. Male predominance was observed in this study (69.20%). Most of the patient admitted in August (73%), then July (33%) and June (15%) during dengue outbreak. The common symptoms were fever100%, rashes (6.8%), body ache (25% and warning sign like vomiting (45%) and others. Among the enrolled cases dengue fever was (75%) than DHF (7.5%), DSS (2.5%) respectively. About 75% were NSI positive and 2.5% were 1gM ±IgG. Thrombocytopenia present in100% cases, among them 38% with plate <15000.Lowest limit was >20-30 thousands (5%) cases. All patient was treated with IVF, platelet was transfused in 20%, FFP was given (20%). Dengue has wide range of symptoms mild to severe. Complication is rare platelet transfusion is not randomly required despite of thrombocytopenia. Supportive treatment and patient monitor are very important in management of Dengue.

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EXPERIENCE OF SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS-2 (SARS-COV-2) - COVID-19 AT A TERTIARY CARE HOSPITAL IN QUETTA, BALUCHISTAN

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i6.6422 ◽

2021 ◽

Vol 71 (6) ◽

pp. 2152-56

Author(s):

Naveed Asif ◽

Shahzeb Ahmed Satti ◽

Alveena Younas ◽

Mehwish Gilani ◽

Waqas Shaikh ◽

...

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Signs And Symptoms ◽

Military Hospital ◽

Nasopharyngeal Swab ◽

Care Hospital ◽

Male Predominance ◽

Wide Range ◽

Study Participants

Objective: To share the experience of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)-COVID-19 at a tertiary care hospital in Quetta, Baluchistan. Study Design: Cross-sectional study. Place and Duration of Study: Department of Pathology, Combined Military Hospital Quetta, from Mar to Dec 2020. Methodology: This study included 14,741 study participants presenting to CMH Quetta with signs and symptoms of Coronavirus Disease-19 (COVID-19) and others undergoing COVID-19 PCR for screening purpose. Nasopharyngeal swab collected from these study participants were tested for COVID-19 viral RNA by real-time Reverse Transcription Polymerase Chain reaction (RT-PCR) assay. Results: Out of these 14,741 study participants, 1886 (12.7%) were found to be SARS-CoV-2 PCR positive. Among 1886 study participants, 1503 (80%) were males while 383 (20%) were females. Mean age of the study participants was 36 ± 14 years. Most frequent clinical presentations were body aches (96.5%), fever (94.1%), cough (66.8%) and loss of appetite (68.2%). Around 67 (3.5%) positive study participants were asymptomatic. Conclusion: In this study, we observed male predominance but severity of signs and symptoms among female study participants. SARS-COVID-19 caused disease with wide range of clinical spectrum and disease can be fatal as well.

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