CLINICAL PROFILE OF DENGUE FEVER IN KANYAKUMARI GOVERNMENT MEDICAL COLLEGE- A STUDY FROM KANYAKUMARI, INDIA
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 1
Abstract
BACKGROUND Dengue infection is viral infection with different clinical presentation. This study was conducted in Kanyakumari Government Medical College Hospital, Asaripallam, Tamil Nadu, to study the various clinical profile and polyserositis involvement in dengue. MATERIALS AND METHODS The clinical profile and polyserositis involvement in dengue infection were determined by the retrospective study of all dengue infection in Kanyakumari Government Medical College Hospital, Asaripallam, Nagercoil, Tamilnadu. It was a retrospective study. All probable cases that had high-grade fever, lymphadenopathy, hepatomegaly, features of hock or haemorrhage and so forth and were admitted with provisional diagnosis of dengue fever were taken into account. All patients with positive dengue tests, either NS1 antigen, IgM, IgG antibody rapid serological test kit or ELISA were taken into the study group. As the duration of history of fever might be fallacious, the patients were subjected to all three serological tests. Patients who were positive for malaria, meningitis and enteric fever were excluded from the study. The whole number of patients included in our study was 40 (𝑛=40). RESULTS In this study, it was found that the bleeding manifestation had no correlation with thrombocytopenia, hepatomegaly and raised SGOT. All 40 patients had fever and they were treated with antipyretics (paracetamol) in appropriate doses. Patients who presented with warning signs and stable vital signs were initially encouraged to take oral fluids; if they were not tolerated, intravenous fluids were started according to the WHO guidelines. CONCLUSION Dengue is an important arboviral infection in tropical countries.1 Global incidence of dengue fever has increased dramatically in the recent decades. There are very few studies based on the revised new dengue classification. In our study, the total number of cases analysed was 40, out of which 28 (70%) were categorised as cases of non-severe dengue, which included both undifferentiated fever and Dengue Fever (DF) (both with and without warning signs) and 12 (30%) were cases of severe dengue (DHF grades 1-4). The maximum numbers of cases were seen in the group 25-34 years of age (32.5%) followed by 15-24 years (27.5%), 35-44 years (25%) and 45-55 years (15%). There was significant difference in male:female ratio in our study (2.3:1). Covered dress used by females may be a cause for the fewer incidences.2 Increased admissions in the rainy and winter seasons can be explained by breeding season of mosquitoes, which is similar to previous studies. Duration of hospitalisation was more in case of severe dengue patients.3 Various factors apart from thrombocytopenia lead to bleeding in dengue. They are decreased platelet function, fibrinogen consumption, prolongation of PT/PTT and vasculopathy. In our study, in the majority of the patients, tourniquet test was found to be negative, whereas studies in other countries, especially Southeast Asian countries, report tourniquet test positivity as the commonest bleeding manifestation.4 Low proportion of positive tourniquet test in Indian studies maybe due to the darker skin colour in Indians. The most consistent finding was hepatomegaly, which was similar to many other studies.5 Among the various clinical findings, hypotension, pleural effusion and respiratory distress were notable and were analogous to other studies.6 In our study, thrombocytopenia was seen in 37 (97.5%) of cases. Evidence of haemoconcentration is not seen in our study group. In some DF patients, the rise of PCV could have been due to dehydration as a result of poor intake and vomiting. This differs from the pattern seen in viral hepatitis. Rise in PT/ aPTT also depicts severity of disease. Ascites was the most common presentations. USG of abdomen revealed ascites in 10 (37%) of cases.
Authors and Affiliations
Brinda J, Chandrashekar Madhu, Sankar Selvaraj, John Christopher Ponnaian, Benitta Mary Redleene, Lekshmi Reghunath, Kumaran Rajendren
Keywords
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- EP ID EP211012
- DOI 10.18410/jebmh/2017/8
- Views 119
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