scholarly journals Severe Dengue: Lessons learnt from an observational study

2020 ◽  
Vol 64 (3) ◽  
pp. 169
Author(s):  
SubhashK Todi
Keyword(s):  
Observational Study ◽  
Severe Dengue ◽  
Lessons Learnt

scholarly journals Can serum ferritin levels predict the severity of dengue early?: an observational study

2019 ◽  
Vol 7 (3) ◽  
pp. 876
Author(s):  
Velammal Petchiappan ◽  
Thaha Mohammed Hussain ◽  
Saravanan Thangavelu
Keyword(s):  
Platelet Count ◽  
Clinical Practice ◽  
Observational Study ◽  
Hospital Stay ◽  
Serum Ferritin ◽  
Early Recognition ◽  
Dengue Infection ◽  
Elevated Serum ◽  
Severe Dengue ◽  
Elderly Subjects

Background: Dengue infection is a major public health threat; early recognition is crucial to improve the survival in severe dengue. Although there are various biomarkers to predict the severity of dengue, they are not routinely used in clinical practice for prognostication. We analyzed whether serum ferritin can be used to predict the severity at an earlier stage.Methods: A hospital based prospective observational study was done involving 119 dengue cases diagnosed by positive NS1 antigen or dengue specific serology (capture ELISA). Serum ferritin was measured in all at the time of diagnosis. Clinical and platelet count monitoring was done daily; classified as severe and non-severe according to 2009 WHO criteria.Results: Out of 119, 5 developed severe dengue; patients with severe dengue had significantly lower median platelet count (p<0.0001); higher ferritin levels (p=0.03) and hospital stay (p<0.0001) than non-severe group. Age had a significant negative co-relation with platelet count (r= -0.427; p<0.0001); positive correlation with ferritin levels (r=0.16; p=0.08) and hospital stay (r= 0.26; p=0.004) indicating that elderly subjects are at risk of severe disease. Serum ferritin levels negatively correlated with the platelet count (r= -0.51 p<0.001). High ferritin levels in severe cases are noted from day 4 of clinical illness.Conclusions: Elevated serum ferritin levels can be used as a potential early prognostic marker to predict the severity of dengue infection in clinical practice.

scholarly journals Predictors of Major Bleeding and Mortality in Dengue Infection: A Retrospective Observational Study in a Tertiary Care Centre in South India

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Kevin John John ◽  
Karthik Gunasekaran ◽  
John Davis Prasad ◽  
Divya Mathew ◽  
Sohini Das ◽  
...  
Keyword(s):  
Observational Study ◽  
Major Bleeding ◽  
South India ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Retrospective Observational Study ◽  
Total Leukocyte Count ◽  
Severe Dengue ◽  
Elderly Age ◽  
Tertiary Care Centre

We conducted a retrospective observational study to describe the clinical profile and outcomes of patients admitted with a diagnosis of dengue fever in a tertiary hospital in South India. A total of 159 patients admitted from April 2014 to October 2018 were included in the study. Vomiting (70.4%), myalgia (60.4%), headache (42.1%), abdominal pain (38.4%), bleeding (38%), and rash (37.1%) were the most common symptoms at presentation. The mean duration of hospital stay was 4.9 days (SD ± 2.4), and the median cost was INR 19,708 ($285) (IQR INR 12,968–32,056 ($188–$305)). Major bleeding was associated with elevated SGOT and SGPT, severe dengue, and secondary dengue. Mortality was associated with elderly age; elevated total leukocyte count, serum bilirubin, serum creatinine, SGOT, and SGPT; and high SOFA score. In view of these observations, we recommend stratifying patients according to the WHO classification of dengue and avoiding the use of thrombocytopenia as a single marker of the severity of the illness.

scholarly journals 2654. Myocarditis in Dengue: A Prospective Observational Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S928-S929
Author(s):  
Manish Soneja ◽  
Manasvini Bhatt ◽  
Faraz A Farooqui ◽  
Naval K Vikram ◽  
Ashutosh Biswas ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Fluid Overload ◽  
Fluid Management ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Hemodynamic Instability ◽  
Warning Signs ◽  
Severe Dengue ◽  
Cardiac Enzymes

Abstract Background Cardiac involvement in dengue fever is underdiagnosed due to low index of suspicion and overlapping clinical manifestations of capillary leak associated with dengue. The frequency of subclinical dengue myocarditis and its relative contribution to the hemodynamic instability in severe dengue needs to be explored. We studied the prevalence of myocarditis and clinical outcomes among admitted patients with dengue. Methods A prospective observational study was carried out in admitted patients with age between 18 and 65 years having confirmed dengue (NS1/IgM ELISA). Patients with electrolyte abnormalities or on medications affecting heat rhythm/ rate, pre-existing heart disease were excluded. The baseline demographic, clinical and laboratory parameters were collected. A baseline ECG was done and repeated every second day. Trop-I and NT-proBNP were done at baseline and repeated only if elevated at baseline or there were ECG changes. The cardiac enzymes were measured using enzyme-linked fluorescent assay (VIDAS, bioMérieux, France). Patients with elevated enzymes underwent 2-dimensional echocardiography. Diagnosis of myocarditis was as per ESC 2013 criteria. Fluid management was as per WHO guidelines (2009). Results A total of 183 patients were recruited with median age of 29 years (IQR 21, 37) and 31% were females. Dengue with warning signs was present in 80 (44%) and severe dengue in 45 (25%) patients. Cardiac enzymes were elevated in 27 (15%) patients (cTnI in 25, NT-proBNP in 22). Among these 27 patients, 11 [6% (2.6–9.4, 95% CI)] had echo evidence and diagnosed as having myocarditis according to ESC 2013 criteria (Figure 1). Clinical features of fluid overload were more common in myocarditis group [8 (73%) vs 4 (2%), P = Overall, 5 (2.7%) patients expired, all of them had myocarditis (5/11 = 45%). These patients had severe dengue, 2 patients developed hospital-acquired pneumonia and 1 had malaria co-infection. Among patients with raised enzymes and normal echo (n = 16), 3 patients developed clinical signs of fluid overload compared with only 1 out of 156 patients without raised enzymes (P &lt; 0.01). Conclusion Myocarditis in admitted patients with dengue is not uncommon [6% (2.6–9.4, 95% CI)] and may lead to a complicated disease course. Disclosures All authors: No reported disclosures.

scholarly journals Lung Ultrasound Findings of Patients with Dengue Infection: A Prospective Observational Study

2021 ◽  
Author(s):  
Hiroshi Koyama ◽  
Wirongrong Chierakul ◽  
Prakaykaew Charunwatthana ◽  
Natpatou Sanguanwongse ◽  
Benjaluck Phonrat ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Lung Ultrasound ◽  
Dengue Infection ◽  
Severe Dengue ◽  
Pleural Effusions ◽  
Ultrasound Findings ◽  
Chest X Ray ◽  
Pulmonary Changes ◽  
Convalescence Phase

Lung ultrasound (LUS) is performed for several conditions and is a more sensitive method of detecting pathological pulmonary changes than chest X-ray. Therefore, LUS for individuals with dengue could be an important tool for the early detection of pleural effusions and pulmonary edema signifying capillary plasma leakage, which is the hallmark of severe dengue pathophysiology. We conducted a prospective observational study of pulmonary changes identifiable with LUS in dengue patients admitted to the Hospital for Tropical Diseases in Mahidol University, Bangkok, and the Bamrasnaradura Infectious Diseases Institute, Nonthaburi, Thailand. The LUS findings were described according to standard criteria, including the presence of A, B1, B2, and C patterns in eight chest regions and the presence of pleural effusions. From November 2017 to April 2018, 50 patients with dengue were included in the study. LUS was performed during the Shonna febrile phase for nine patients (18%) and during the critical-convalescence phase for 41 patients (82%). A total of 33 patients (66%) had at least one abnormality discovered using LUS. Abnormal LUS findings were observed more frequently during the critical-convalescence phase (N = 30/41; 73%) than during the febrile phase (N = 3/9; 33%) (P = 0.047). Abnormal aeration patterns were observed in 31 patients (62%). Only B patterns with only multiple B lines were observed in 21 patients (42%); of these patients, three had already exhibited these during the febrile phase (N = 3). C patterns (N = 10; 24%), pleural effusion (N = 10; 24%), and subpleural abnormalities (N = 11; 27%) were observed only during the critical-convalescence phase. LUS can detect signs of capillary leakage, including interstitial edema and pleural effusions, early during the course of dengue.

scholarly journals Severe dengue categories as research endpoints—Results from a prospective observational study in hospitalised dengue patients

2020 ◽  
Vol 14 (3) ◽  
pp. e0008076 ◽  
Author(s):  
Kerstin D. Rosenberger ◽  
Neal Alexander ◽  
Eric Martinez ◽  
Lucy C. S. Lum ◽  
Carl-Erik Dempfle ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Severe Dengue

scholarly journals Understanding immunopathology of severe dengue: lessons learnt from sepsis

2020 ◽  
Vol 43 ◽  
pp. 41-49
Author(s):  
José A Aguilar-Briseño ◽  
Jill Moser ◽  
Izabela A Rodenhuis-Zybert
Keyword(s):  
Severe Dengue ◽  
Lessons Learnt

Wearable monitors for patients following discharge from an intensive care unit: practical lessons learnt from an observational study

2016 ◽  
Vol 72 (8) ◽  
pp. 1851-1862 ◽  
Author(s):  
Emma Jeffs ◽  
Sarah Vollam ◽  
J. Duncan Young ◽  
Lois Horsington ◽  
Breda Lynch ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Lessons Learnt

scholarly journals Clinical research nurses perspective on recruitment challenges and lessons learnt from a large multi-site observational study

2022 ◽  
pp. 174498712110437
Author(s):  
Ambreen Imran ◽  
Sithembinkosi Mpofu ◽  
Sharon Marie Weldon
Keyword(s):  
Observational Study ◽  
Clinical Research ◽  
Statistical Significance ◽  
Time Frame ◽  
Work And Family ◽  
Sample Collection ◽  
Lessons Learnt ◽  
Recruitment Challenges ◽  
Research Nurses ◽  
Time Required

Background Recruitment of large numbers of study participants within a designated time frame for multi-site clinical research studies is a significant challenge faced by researchers. If a study does not manage to recruit targeted number of participants, it could have a significant impact on the statistical significance of the research. Purpose This paper highlights the challenges of recruitment for a large multi-site UK-based tuberculosis observational study ‘PREDICT’. Methods It uses a case study analysis from the research nurses perspective, and descriptive information retrieved from non-recruitment log forms to understand reasons for potential recruits not participating. Results Some of the main challenges to recruitment included patients not attending their clinic appointments, time required to obtain site-specific permissions and courier timings for blood sample collection. This paper also outlines key reasons for potential recruits who did not participate. Some of the common barriers to participation for non-recruited participants were work and family commitments, additional blood tests and language barriers. Conclusion Successful strategies which were implemented to overcome some of the challenges during the study are presented. This paper, therefore, aims to present the challenges faced, lessons learnt and successful strategies implemented to inform the planning of similar longitudinal studies of this scale in future.

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