CARDIAC MANIFESTATIONS OF DENGUE FEVER IN CHILDREN

2021 ◽  
pp. 15-18
Author(s):  
Gaurav Choudhary ◽  
Yograj Khinchi ◽  
Chaman R Verma ◽  
Bhagwan Sahai Natani ◽  
Rakesh Bilwal ◽  
...  
Keyword(s):  
Public Health ◽  
Dengue Fever ◽  
Public Health Problem ◽  
Warning Signs ◽  
Severe Dengue ◽  
Inclusion Criteria ◽  
Medical Sciences ◽  
Dengue Virus Serotypes ◽  
Dengue With Warning Signs ◽  
Cardiac Manifestations

Introduction: Dengue fever represents a signicant public health problem in tropical and subtropical regions. 70% of total cases are from Asia, especially India. Caused by 4 dengue virus serotypes( DENV-1, DENV-2 DENV-3 and DENV-4), DENV-2 being the most prevalent in India. Incidence and range of cardiac manifestations in dengue fever vary widely. Aims & objectives: To study the incidence and range of cardiac manifestations of dengue fever in children. Material & methods:This is an observational study, conducted in department of pediatrics at National Institute of Medical Sciences & Research, Jaipur in study period of 18 months. A total of 94 patients were included in the study fullling the inclusion criteria. Results: The overall incidence of cardiac manifestations was found to be 31.9%. The incidence of cardiac manifestations in dengue without warning signs was 4.4%, in dengue with warning signs was 52.5% and in severe dengue was 77.7%. Conclusion: Incidence of cardiac manifestations increases with increase in disease severity

scholarly journals Serum sodium level in dengue infected children: a retrospective study

2018 ◽  
Vol 5 (5) ◽  
pp. 1801
Author(s):  
Reshma Raj ◽  
Rashmi Alva
Keyword(s):  
Dengue Fever ◽  
Serum Sodium ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Warning Signs ◽  
Severe Dengue ◽  
Dengue With Warning Signs ◽  
Group B

Background: Dengue fever is one of the most common arbo virus mediated outbreaks, being reported from different parts of the world. Now as the outbreaks are hitting different geographic locations, different clinical manifestations are being reported recently. Aim of this study is to document the serum Sodium level in dengue infected children in a tertiary care centre.Methods: A total 128 cases of NS1 antigen, IgM positive or ELISA positive dengue patients were included in this observational study and analyzed.Results: The serum Sodium level in dengue varies according to the different groups. In group A (dengue with no warning signs) the serum Sodium level was normal, whereas in case of group B (dengue with warning signs), there was significant hyponatremia. In group C, severe dengue the serum Sodium was normalConclusions: Mild hyponatremia is a common electrolyte disturbance in patients with dengue with warning signs. Hence, the lower the serum Sodium levels the higher is the incidence of complications associated with dengue fever.

scholarly journals Serum ionic calcium levels and hypocalcemia in dengue fever in children and its correlation with its severity: case control study

2019 ◽  
Vol 6 (3) ◽  
pp. 1289
Author(s):  
V. G. Manjunath ◽  
Sruthi Balla ◽  
Jagadish Kumar
Keyword(s):  
Dengue Fever ◽  
Case Control Study ◽  
Case Control ◽  
Warning Signs ◽  
Severe Dengue ◽  
Case Group ◽  
Major Health Problem ◽  
Ionic Calcium ◽  
Dengue With Warning Signs ◽  
Control Study

Background: Dengue fever (DF) is a major health problem, 90% of dengue hemorrhagic fever (DHF) occurring in children <5 years and mortality of 2.5%. Abnormalities like metabolic acidosis, hyponatremia and hypocalcemia can occur in severe dengue especially in dengue shock patients. Alterations in calcium homeostasis, may play a role in the pathogenesis of dengue shock. Objectives is to evaluate serum ionic calcium (Ca2+) levels in children aged 1-18yrs with dengue fever and correlate it with severity and outcomeMethods: The study was prospective hospital based case-control study. Case group had 75 children with dengue fever with equal number of controls. Cases were classified according to WHO classification. Serum Ca2+ levels were estimated within 24 hours of admission.Results: Majority of children with dengue were in the age-group of 6-15 years (71.4%). Out of 75 cases,16% were dengue without warning signs, 54.7% dengue with warning signs and 29.3% were severe dengue cases. Mean Ca2+ level (in mmol/l) was 1.2009 (±0.09) among controls and 1.0911 (±0.10) in dengue cases (p=0.0001). Mean Ca2+ level in dengue without warning signs was 1.0950 mmol/l, dengue with warning signs was 1.1088 mmol/l and severe dengue was 1.0559 mmol/l. Mean Ca2+ level in severe dengue was significantly lower compared to dengue with warning signs (p=0.04). Hypocalcemia was seen in 56% of dengue cases but only 14% among controls. Seven children with severe dengue who died had hypocalemia.Conclusions: Hypocalcemia is common in dengue fever. Lower levels of ionic calcium correlate with severity of dengue illness and may be considered as a prognostic indicator of poor outcome.

FACTORS PREDICTING SEVERITY OF ILLNESS IN DENGUE FEVER: AN OBSERVATIONAL STUDY

2021 ◽  
pp. 54-55
Author(s):  
Abhay John Gray ◽  
Sheela Mathew ◽  
Gayathri R ◽  
Akhila Arya ◽  
Aswathy MA ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Ldl Cholesterol ◽  
Severe Disease ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Severity Of Illness ◽  
Warning Signs ◽  
Severe Dengue ◽  
Detailed History ◽  
Dengue With Warning Signs

Introduction: Dengue is a systemic viral infection caused by the virus from genus Flaviviridae. Dengue infection has got a wide clinical spectrum that includes both severe and non-severe clinical manifestations. The group progressing from non-severe to severe disease is difcult to dene. Early detection and access to proper medical care signicantly lower fatality rates and would help to reduce the burden of hospital stay and economy loss. Objectives: To study the inammatory markers predicting the severity of dengue infection. Methods: 250 diagnosed patients were evaluated with detailed history, physical examination and blood investigations. Inammatory markers associated with severity of dengue were studied. Observations and conclusions- 97 patients (39%) had dengue without warning signs, 62(25%) had dengue with warning signs, 63(25%) had severe dengue and 28(11%) had expanded dengue. Low CRP, ESR, HDL and LDL cholesterol were observed in dengue fever, without any statistical signicance. Ferritin levels more than 1000 and triglyceride more than 200 was signicantly associated with severity of dengue.

scholarly journals Clinical and laboratory profile of dengue fever in children from a tertiary care centre of Gandaki Province, Nepal

2020 ◽  
Vol 13 (2) ◽  
pp. 173-177
Author(s):  
Namrata K.C. ◽  
Krishna Bahadur Thapa ◽  
Nirmala Shrestha ◽  
Shankar Paudel ◽  
Chandra Bahadur Pun
Keyword(s):  
Dengue Fever ◽  
Tertiary Care ◽  
Stable Condition ◽  
Public Health Problem ◽  
Warning Signs ◽  
Severe Dengue ◽  
Warning Sign ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Laboratory Findings

Introduction: Dengue, the arthropod borne viral disease is serious public health problem in Nepal. The clinical diagnosis of dengue has become challenging in children as it is presented with nonspecific symptoms. The objective of present study was to assess different clinical presentations and outcomes of dengue fever in tertiary care centre. Methods: A record based observational cross-sectional study was carried out on all dengue positive patients of aged 11 months to 15 years presented in Gandaki Medical College from July to November 2019. Total 74 patients with history of fever with dengue seropositive were included in the study. All the clinical and haematological findings were recorded in semi-structured questionnaire form. Results: Of 74 patients 40 (54.1%) males and 34 (45.9%) were females. Fiftyone (68.9%) were cases of dengue without warning sign, 18 (24.3%) were dengue with warning signs and 5(6.8%) cases had severe dengue symptoms. Most of the patients (78.38%) were from Kaski district. Fever (100%) was the most common clinical presentation followed by headache (36.5%), vomiting (25.7%), and retro orbital pain (20.3%). Common laboratory findings included thrombocytopenia (59.4%) and leukopenia (35.1%). Among 74 cases, 68 were in stable condition and treated in OPD or in ward, and 6 were admitted in ICU of which one developed warning signs and other 5 had severe dengue. All the enrolled children recovered well and there was no mortality during this period. Conclusions: Fever, headache, vomiting, thrombocytopenia and leukopenia were most common presentation of dengue fever among children. Appropriate clinico-laboratory diagnosis and management is relatively simple, inexpensive and very effective in saving lives as long as correct and timely interventions are instituted.  

“CLINICAL PROFILE AND PREDICTORS OF ILLNESS SEVERITY IN CHILDREN WITH DENGUE FEVER”

2021 ◽  
pp. 41-43
Author(s):  
Manoj Kumar Ram ◽  
Bankey Bihari Singh
Keyword(s):  
Dengue Fever ◽  
Pediatric Population ◽  
Severe Disease ◽  
Dengue Infection ◽  
Warning Signs ◽  
Severe Dengue ◽  
Capillary Leak ◽  
Laboratory Parameters ◽  
Ns1 Antigen ◽  
Dengue With Warning Signs

BACKGROUND & OBJECTIVES: Dengue illness has become exceedingly common over the last few years globally. Due to their unique characteristics, incidence as well as mortality is higher in pediatric population as compared to adults. This study was undertaken to study clinical pattern of dengue fever in children and to identify factors predicting a more severe disease. METHODS: We conducted this hospital based prospective study at A.N.M.M.C.H, Gaya, Bihar over 2 years from January 2016- December 2017. Children >1 month and <15 years age with fever ≥ 3 days and symptoms suggestive of Dengue infection were included and evaluated for dengue infection by testing for NS1 antigen, IgM and IgG against Dengue infection. Children were classied into 3 clinical groups: Dengue without warning signs (DWWS), Dengue with warning signs (DWS) and severe Dengue (SD) as per WHO classication. Clinical and laboratory parameters were compared in the 3 groups. RESULTS: 114 children with Dengue were studied. 62 (54.4%) were males as compared to 52 (45.6%) females. 41 (36%) had DWWS, 53 (46.5%) had DWS and 20 (17.5%) had SD. Mean age was 74.1 months (SD 18.2 months) and mean weight was 21.4 kg (S.D 5.1 kg). Common symptoms were fever (100%), myalgia (76.6%), chills (62.3%), nausea/ vomiting (63.2%) and rash (53.5%). Common signs were ushed appearance (36.8%), positive Hess test (27.2%), bleeding manifestation (13.2%) and hypotension (36.8%). Laboratory investigations revealed anaemia (18.4%), thrombocytopenia (81.6%), Leucopenia (69.3%), elevated transaminase (41.2%), abnormal RFT (5.3%). 27.1% had prolonged aPTT while 21% had prolonged PT. Nausea/vomiting, bleeding, oliguria, capillary leak and liver enlargement (>2 cm) were signicantly more common in severe dengue (p<0.05) whereas rash was commoner in non severe dengue. Lab parameters signicantly more common in SD included rising hematocrit, falling platelets, high urea/creatinine/ALT and hypoalbuminemia & hypocholesterolemia. CONCLUSIONS: DF affects children irrespective of age. Symptoms more common in SD were nausea/vomiting, bleeding and decreased urine. Signs commoner in SD were features of capillary leak and hepatomegaly (>2 cm). Rising hematocrit, falling platelets, high urea, creatinine and ALT but hypoalbuminemia and low cholesterol were found to be statistically signicant laboratory parameters associated with SD.

scholarly journals Clinical correlation of cardiac functions and troponin I and CPK-MB in dengue fever in children

2020 ◽  
Vol 7 (3) ◽  
pp. 576
Author(s):  
Devanand G. Chaudhary ◽  
Shyam Srinivasan ◽  
Nita R. Sutay
Keyword(s):  
Ejection Fraction ◽  
Dengue Fever ◽  
Biochemical Markers ◽  
Troponin I ◽  
Warning Signs ◽  
Clinical Profile ◽  
Severe Dengue ◽  
P Value ◽  
Cardiac Functions ◽  
Dengue With Warning Signs

Background: Dengue is the most rapidly spreading mosquito-borne viral disease in the World. The spectrum of manifestations includes mild fever to severe and life-threatening disease, though uncommon complications such as myocarditis have also been reported in many cases. We conducted this study to analyze association between Clinical Profile, Cardiac Functions and Troponin I and CPK-MB (cardiac biochemical markers) in children with Dengue Fever. Aims and objectives of the study was the association between Clinical Profile, Cardiac Functions and Troponin I and CPK-MB (cardiac biochemical markers) in children with Dengue Fever.Methods: This was a prospective observational study in which 80 paediatric patients who were hospitalized anddiagnosed to be having Dengue fever were included. All patients were stratified into either of the 3 groups- Dengue without warning signs, Dengue with warning signs and severe Dengue. A detailed history and thorough clinical examination were done for all patients. A complete blood count, electrolytes, hepatic and renal function tests were done in all children. Cardiac function was assessed by 2D Echo, CPK-MB and Troponin-I, p value less than 0.05 was taken as statistically significant.Results: Of the 80 studied cases there were 53 (66.25%) males and 27 (33.75%) females with a M:F ratio of 1.9:1. Dengue with and without warning signs was seen in 27.5% and 60% cases respectively whereas severe dengue was seen in 12.5% cases. The ejection fraction was comparable across the 3 groups. On 2D echo ejection fraction was 62.95%, 63.21% and 65.1% in cases with warning signs, without warning signs and severe dengue respectively. Additionally, ECG abnormalities were seen in 8.75% patients. All 80 patients had a normal CPK-MB and Troponin-I levels.Conclusions: Cardiac markers (CPK-MB and Troponin-I) remain unaffected during Dengue illness and do not have significant correlation between Dengue without warning signs, Dengue with warning signs and severe Dengue.

scholarly journals Clinical profile, laboratory investigations and outcome in dengue positive children in south India

2020 ◽  
Vol 11 (SPL2) ◽  
pp. 175-180
Author(s):  
Radha Kumar ◽  
Ganthimathi Sekhar ◽  
Ananthi N ◽  
Kalyani M
Keyword(s):  
Dengue Fever ◽  
Viral Infections ◽  
Monsoon Season ◽  
Severity Of Illness ◽  
Severe Infection ◽  
Warning Signs ◽  
Severe Dengue ◽  
Presenting Symptoms ◽  
Wide Range ◽  
Dengue With Warning Signs

Dengue fever is one of the most commonly occurring mosquito borne-viral illnesses that has a wide range of presentation in children and is common during the monsoon season. The severity of illness ranges from mild undifferentiated fever, dengue with warning signs, severe dengue fever and dengue fever with organ dysfunction. The symptoms of dengue may be easily mistaken for those of flu or other viral infections. Contrary to other fevers, complications in dengue occur during the phase of defervescence and can be life threatening in children due to shock or profuse hemorrhage. 55 dengue positive children who were diagnosed by dengue antigen detection or dengue antibody positive were included in the study. Most of children were above 10 years and the commonest presenting symptoms were fever, headache, body pain, nausea, anorexia, abdominal pain and vomiting. Most of the children presented with two or more warning signs like persistent vomiting, thrombocytopenia, increasing hematocrit and hepatomegaly. Few children developed features of early shock, which was diagnosed early and treated effectively. All the children responded well to treatment measures and recovered well during hospital stay. Having a high of suspicion and careful monitoring of children is crucial for reducing occurrence of complications and death due to this severe infection.

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.

COMMUNITY KNOWLEDGE OF DENGUE FEVER IN ALLAMA IQBAL TOWN, LAHORE

2020 ◽  
pp. 52-58
Author(s):  
OJS Admin
Keyword(s):  
Public Health ◽  
Dengue Fever ◽  
Dengue Hemorrhagic Fever ◽  
Health Problem ◽  
Public Health Problem ◽  
Hemorrhagic Fever ◽  
Community Knowledge

Globally, dengue is an emerging serious public health problem with a million infections occurring annually including significant number of dengue hemorrhagic fever cases.

Severity and costs associated with hospitalization for dengue in public and private hospitals of Surat city, Gujarat, India, 2017–2018

2019 ◽  
Vol 113 (11) ◽  
pp. 661-669 ◽  
Author(s):  
Viral R Bajwala ◽  
Denny John ◽  
T Daniel Rajasekar ◽  
Manoj V Murhekar
Keyword(s):  
Urban Areas ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Warning Signs ◽  
World Health ◽  
Severe Dengue ◽  
Major Public Health Problem ◽  
Private Hospitals ◽  
Government Hospitals ◽  
The Cost

Abstract Background Dengue is major public health problem in India, especially in urban areas. We conducted a study to estimate the severity and costs of treatment among hospitalized dengue patients in Surat city, Gujarat, India. Methods We reviewed the medical records of dengue patients hospitalized in five tertiary care facilities (private [n=2], semi-government [n=2] and government [n=1]) between April 2017 and March 2018. We used the World Health Organization 2009 classification to classify the severity of dengue. A resource utilization approach was used to estimate the cost of illness in US dollars (US$) (inflation adjusted to 2018) from a quasi-societal perspective (excluding non-medical cost) for dengue hospitalization. Results Of the 732 hospitalized dengue patients, 44.7% had no warning symptoms, 39.5% had warning signs and 15.8% had severe dengue. The mean cost of hospitalization was US$86.9±170.7. The cost of hospitalization was 28.8 times higher in private hospitals compared with government hospitals. Consultant charges in private hospitals, laboratory investigations in semi-government hospitals and registration with admission charges in government hospitals accounted for 27.3%, 39.4% and 53% of the direct cost in these facilities, respectively. Conclusions A better triage system for hospitalization, subsidizing costs in the public sector and cost capping in the private sector can help to reduce the cost of hospitalization due to dengue so as to ensure affordability for larger portion of the society for universal health coverage.

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