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Background: Dengue viral infections are one of the most important mosquito borne diseases in the world. They may be asymptomatic or may give rise to undifferentiated fever, dengue fever (DF), dengue haemorrhagic fever (DHF), or de...
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Background: Dengue viral infections are one of the most important mosquito borne diseases in the world. They may be asymptomatic or may give rise to undifferentiated fever, dengue fever (DF), dengue haemorrhagic fever (DHF), or dengue shock syndrome (DSS). Early recognition and prompt initiation of appropriate treatment are vital if disease related morbidity and mortality are to be limited.1 Abdominal pain is one of the common symptoms of DF and severe pain abdomen is strongly associated with DHF. About 500 000 people with severe dengue fever require hospitalization each year out of which about 2.5% die.
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Dengue is an arboviral disease and occurs in tropical countries where over 2.5 billion people are at risk of infection. Each year an estimated 100 million cases of dengue fever (DF) occur and between 2.5 and 5 lakh cases of dengue...
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Dengue is an arboviral disease and occurs in tropical countries where over 2.5 billion people are at risk of infection. Each year an estimated 100 million cases of dengue fever (DF) occur and between 2.5 and 5 lakh cases of dengue hemorrhagic fever (DHF) are reported to WHO. Severe thrombocytopenia and increased vascular permeability are two major characteristics of DHF. A study was conducted to note the relationship between the platelet counts and severity of the disease in pediatric cases of dengue fever. Platelet counts were found to be predictive as well as recovery parameter of DF/DHF/DSS.
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Purpose: The purpose of the study was to explore determinants of outcome in adults with dengue hemorrhagic fever or dengue shock syndrome. Methods: We performed a multicenter, retrospective, observational study over a 2-year perio...
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Purpose: The purpose of the study was to explore determinants of outcome in adults with dengue hemorrhagic fever or dengue shock syndrome. Methods: We performed a multicenter, retrospective, observational study over a 2-year period in 3 intensive care units (ICUs) in Pune (India). Results: One hundred eighty-four adult patients were admitted to the ICU with a positive dengue immunoglobulin M test result; 43 met the World Health Organization criteria for dengue hemorrhagic fever or dengue shock syndrome. One patient who was transferred to another hospital and whose outcome was unknown was not included in the analysis. Of the 42 patients, 20 (48%) had multiorgan failure on ICU admission. The ICU mortality was 19% (8/42). Nonsurvivors were more likely than survivors to have cardiovascular (100% vs 12%), respiratory (88% vs 12%), or neurological (75% vs 12%) failure (all P < .01). Hematological failure was not associated with a higher risk of death. Cumulative fluid balance at 72 hours was more positive in nonsurvivors than in survivors (6.2 vs 3.5 L, P < .05). Serum albumin concentrations at ICU admission were lower in nonsurvivors than in survivors (2.9 ± 0.3 vs 3.4 ± 0.7 g/dL, P < .05). Conclusions: In our cohort, outcome from severe dengue was primarily related to nonhematological organ failure. Low serum albumin concentration on ICU admission and a more positive fluid balance at 72 hours were also associated with worse outcomes.
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BACKGROUND: Dengue fever, an emerging public health issue in Pakistan bears considerable morbidity and mortality. This descriptive cross sectional study was conducted to analyze clinical, hematological and serological characterist...
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BACKGROUND: Dengue fever, an emerging public health issue in Pakistan bears considerable morbidity and mortality. This descriptive cross sectional study was conducted to analyze clinical, hematological and serological characteristics of dengue fever variants and to identify biomarkers that predict its severity. METHODS: 105 dengue cases (>12 years) were selected after ethical approval from Rawal Institute of Health Sciences & Benazir Bhutto Hospital Rawalpindi over 6 months (July to Dec 2015). Patients having pre-existing hematological disorder, liver disease, malaria and typhoid co-infection were excluded. Demographic data, clinical findings, hematological and serological profile documented. Patients were classified as classic dengue fever (DF), dengue hemorrhagic (DHF) and dengue shock syndrome (DSS). Data analyzed via SPSS version 17. RESULTS: Among 105 cases, there were 79(75%) males and 26(25%) females. Mean age was 30 + 12.8 years and mean duration of symptoms 5 + 2 days. Dengue fever was found in 75(75%), dengue hemorrhagic fever 24(23%) and dengue shock syndrome 2(2%). Gender, mean age and duration of symptoms were comparable between DF, DHF and DSS. Common clinical features were fever (100%), headache (56%), muscle pain (43%), vomiting (43%), retro-orbital pain (23%), bleeding (12%) and hypotension (10%). Thrombocytopenia, leukopenia and pancytopenia were frequent in DHF vs. DF. Dengue NS-1 antigen positive in 71(90%) of DF cases vs 16(57%) DHF and 1(50%) DSS. Dengue-IgM positive in 32(47%) DF vs. 19(79%) DHF and 2(100%) DSS. Dengue -IgG detected in 33(42%) DF vs. 17(71%) DHF and 1(50%) DSS. 101(96%) dengue cases were treated successfully and one case expired. CONCLUSION: Dengue-IgG and IgM are better predictive variables for dengue hemorrhagic fever as compared to NS-1 antigen that predicts classic dengue fever. Utilizing these predictive variables, imminent severe dengue may be identified and with vigilant monitoring, fluid resuscitation and pre-hand arrangement of blood products we may reduce complications and mortality in high risk cases.
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Introduction: Dengue is the most common mosquito borne endemo-epidemic arboviral infection in many of the tropical andsubtropical regions of the world. In the last 50 years, an incidence has increased 30-fold with increasing geogr...
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Introduction: Dengue is the most common mosquito borne endemo-epidemic arboviral infection in many of the tropical andsubtropical regions of the world. In the last 50 years, an incidence has increased 30-fold with increasing geographic expansion to new countries and in the present decade from urban to rural settings. About 50 million dengue infections occur annually and approximately 2.5 billion people live in dengue endemic countries. Objectives: To analyze the clinical, biochemical and hematological parameters of dengue fever. Materials and Methods: A total of 100 patients collected from Medicine ward of Darbhanga Medical College & Hospital, Laheriasarai, Bihar. Results: A total of 100 patients admitted to our hospital with fever and immunoglobulin M dengue positive were studied. Outof 100 patients, 81 (81%) patients were diagnosed to have dengue fever. Conclusion: To conclude, in this study classical dengue fever was the most common clinical presentation followed by complicatedforms such as dengue hemorrhagic fever and dengue shock syndrome. Most of the patients presented with classical features such as fever myalgias, arthralgias, pain abdomen, vomiting, headache, rash, and bleeding manifestations. The treatment of dengue is mainly supportive. However, appropriate fluid management plays a major role in outcome of the disease.
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Background Global morbidities due to dengue viral infection increase yearly. The pediatric mortality rate from dengue shock syndrome (DSS) remains high. Early identification of the risk of recurrent shock may serve to increase awa...
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Background Global morbidities due to dengue viral infection increase yearly. The pediatric mortality rate from dengue shock syndrome (DSS) remains high. Early identification of the risk of recurrent shock may serve to increase awareness and reduce mortality. The Dengue Recurrent Shock Prediction Score (DRSPS) is a tool to predict recurrent shock in children with DSS, but the optimal cut-off point in our population is still unknown. Objective To assess the validity of the DRSPS by determining the optimal cut-off point that can be used in Indonesia Methods This cross-sectional prospective study was done at Sanglah Hospital, Denpasar, Bali, from January 2019. Risk of reccurent shock were classify based on DRSPS in all DSS patient, and they were observed whether they will experienced recurrent shock or not. Results Of 56 children with DSS, 27 subjects had recurrent shock and 29 subjects did not. The optimal DRSPS cut-off point was -189.9 for predicting recurrent shock, with 87.4% area under the curve (AUC), 81.5% sensitivity and 82.8% specificity. Conclusion The optimal cut-off point of DRSPS was -189.9 and it has good validity. The results of this study are expected not only to be used as the basis for further study, but to increase physician awareness in treating DSS patients.
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The clinical manifestations of dengue hemorrhagic fever (DHF) consist of three successive stages: febrile, toxic and convalescent. The toxic stage is the critical period, which may manifest as circulatory disturbance or even profo...
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The clinical manifestations of dengue hemorrhagic fever (DHF) consist of three successive stages: febrile, toxic and convalescent. The toxic stage is the critical period, which may manifest as circulatory disturbance or even profound shock in some patients. We attempted to determine predictors for the risk of dengue shock syndrome (DSS) during the febrile stage. One hundred one children with acute febrile illness were enrolled in the study, with a mean age of 11 years old. The diagnosis included dengue fever (DF) 21 cases, DHF grade I 30 cases, DHF grade II33 cases, DHF grades III and IV10 cases; children with other febrile illnesses (OFI) 7 cases were used as controls. Complete blood counts, coagulation tests, von Willebrand factor antigens (VWF:Ag) and ristocetin cofactor activity (VWF:Rcof) were determined daily during hospitalization and 2-4 weeks after discharge from the hospital. The results revealed any one of the following abnormal laboratory findings during the febrile stage served as a predictor for risk of DSS: increase in hematocrit >25%, a platelet count <40,000//il, an activated partial thromboplastin time >44 seconds, a prothrombin time >14 seconds, a thrombin time >16 seconds or a VWF:Ag or VWF:Rcof >210%. The relative risk ranged from 4.8 to 10.9. Simple laboratory investigations with complete blood count, coagulation test or the more sophisticated von Willebrand factor, are helpful in predicting the risk for DSS during the febrile stage.
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Dengue fever is a vector borne viral disease. It is more prevalent in Southeast Asia. The main symptoms include myalgia, nausea, vomiting and rash, hence, subsequently lead to dengue hemorrhagic fever and dengue shock syndrome. In...
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Dengue fever is a vector borne viral disease. It is more prevalent in Southeast Asia. The main symptoms include myalgia, nausea, vomiting and rash, hence, subsequently lead to dengue hemorrhagic fever and dengue shock syndrome. In the current report, we are presenting a case of a 50-year-old female patient who was presented in hospital with the symptoms of fever, vomiting, abdominal pain, productive cough and sore throat. Her serology came positive for dengue NSP1, and she was shifted to intensive care unit because of her aggravating condition. On day 4, the hepatitis E virus infection also was detected and she died after developing hepatic shock and multiorgan failure. This report states the superinfection of hepatitis E and dengue virus and highlights the significance of its early detection for better clinical management.
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Background: Fifty cases of fever, clinically suspected to be dengue were studied.Methods: Complete clinical, haematological evaluation and IgM capture assay was done.Result: 54% of patients clinically suspected to have dengue were...
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Background: Fifty cases of fever, clinically suspected to be dengue were studied.Methods: Complete clinical, haematological evaluation and IgM capture assay was done.Result: 54% of patients clinically suspected to have dengue were positive for IgM antibodies by enzyme-linked immunosorbentassay (ELISA). The commonest clinical feature was fever with rash (85%). Thrombocytopenia was seen in 19 % of patients only.One patient died of dengue shock syndrome (DSS).Conclusion: Out of the 27 cases of seropositive dengue there was one death due to dengue shock syndrome. Thrombocytopeniamay not always be a feature of dengue.
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