Gene/Protein Disease Symptom Drug Enzyme Compound
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 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dengue fever (DF) and Dengue hemorrhagic fever (DHF) are widespread in Southeast Asia. An outbreak of DF/DHF in Delhi in 2003 started during September, reached its peak in October-November, and lasted until early December. This study describes the clinical and laboratory data of the 185 cases of DF/DHF admitted to Lok Nayak Hospital, New Delhi. The mean age of the patients was 26 +/- 10 years. Fever was present in all the cases with an average duration of fever being 4.5 +/- 1.2 days with headache (61.6%), backache, (57.8%), vomiting (50.8%) and abdominal pain (21%) being the other presenting complaints. Hemorrhagic manifestations in the form of a positive tourniquet test (21%), gum bleeding and epistaxis (40%), hematemesis (22%), skin rashes (20%) and melena (14%) were also observed. Hepatomegaly and splenomegaly were observed in 10% and 5% of cases, respectively. Laboratory investigations revealed thrombocytopenia (with a platelet count of < 100,000/microl) in about 61.39% of cases, Leukopenia (WBC <3,000/mm2) and hemoconcentration (Hct >20% of expected for age and sex) were found in 68% and 52% of the cases, respectively. The mortality rate was 2.7%. Despite widespread measures taken to control outbreaks of DF, it caused major outbreaks. More stringent measures in the form of vector control, improved sanitation and health education are needed to decrease morbidity, mortality and health care costs caused by a preventable disease.
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PMID:The 2003 outbreak of Dengue fever in Delhi, India. 1643 42

Chikungunya fever is a viral disease transmitted to humans by the bite of infected Aedes aegypti mosquito. Like malaria and dengue, this infection has almost become endemic in India, especially central and south India. Symptoms of sudden onset of fever, chills, headache, nausea, vomiting, joint pain with or without swelling, low back pain, and rash are very similar to those of dengue but, unlike dengue, there is no hemorrhagic or shock syndrome form. Chikungunya is a self-limiting illness with no specific treatment. Travellers visiting endemic areas should be careful and take precautions to see that they are not bitten by mosquitoes.
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PMID:Chikungunya. 1725 33

Hepatic manifestations are described as unusual complications of dengue and may lead to severe and potentially lethal conditions. Liver abnormalities in 41 patients diagnosed with dengue hemorrhagic fever in Campo Grande, Mato Grosso do Sul, Brazil, between January 1 and March 31, 2002, were evaluated. All were serologically positive for dengue in laboratory tests (IgM ELISA). ALT alterations were observed in 61% (25/41) and AST alterations in 80.5% (33/41), but there were no statistically significant differences between the various clinical forms. The range in ALT levels was 14-547 U/l and in AST levels was 11-298 U/l. Nausea and/or vomiting were reported by 90% (37/41) of the patients; 46.3% (19/41) had abdominal pain and 10% (3/29) presented hepatomegaly at clinical examination. The patients' ages ranged from 18 to 88 years; 23 (56%) were female and 18 (44%) were male.
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PMID:[Liver involvement in patients with dengue hemorrhagic fever: a rare phenomenon?]. 1730 99

We report 12 patients [5 males, mean age 28 years (SD 4.6)] presenting with clinical features suggestive of acute appendicitis who were later diagnosed as having dengue fever (DF). Seven were admitted to hospital by surgeons and then referred to physicians due to thrombocytopenia (one of them following appendicectomy). Five were admitted to medical wards and then referred to surgeons due to abdominal pain. The mean time from onset of fever to abdominal pain was 2.2 d (SD 0.9). Clinical features included: right iliac fossa tenderness in 12 patients, rebound tenderness in nine, vomiting in nine, erythematous rash in eight, arthralgia/myalgia in eight, headache in six, diarrhea in three and palatal petechiae in three. All patients had C-reactive protein <12mg/l, and DF was confirmed serologically. Leucocytopenia and thrombocytopenia occurred by the third or fourth day of illness in all patients. Seven had free fluid around the appendix on abdominal ultrasound. The mean duration of abdominal symptoms and signs was 1.8 d (SD 1.3). DF may present with features suggestive of acute appendicitis in dengue-endemic areas. A carefully obtained history, clinical examination and a full blood count done on the third or fourth day of illness may help to differentiate DF from acute bacterial appendicitis.
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PMID:Dengue fever mimicking acute appendicitis. 1736 95

Dengue fever (DF), caused by dengue viruses, presents classic dengue fever, dengue hemorrhagic fever, and dengue shock syndrome. A young man presented with 5 days history of fever, body aches, headache, vomiting and one day history of drowsiness and a generalized tonic clonic fit. He was afebrile and hypotensive with platelets count of 24 x 109/l, and serum IgM DENV positive. Computerized tomography scan of the brain revealed intracerebral haemorrhages in both cerebral hemispheres. He was managed with supportive care and 20% mannitol infusion, his headache and drowsiness rapidly improved. Platelet count rose to 60 x 109/l on 2nd day and 199 x 109/l on 7th day of admission. He remained afebrile during hospital stay and was discharged from hospital on 8th day of admission, when he was almost asymptomatic.
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PMID:Neurological manifestations as presenting feature in dengue Fever. 1746 88

This is the first report of the largest epidemic of dengue hemorrhagic fever (DHF) virus infection (2006) with IgM-confirmed cases from Karachi, Pakistan. Medical records of 172 IgM-positive patients were reviewed retrospectively for demographic, clinical and laboratory data. Patients were categorized into dengue fever (DF) and DHF according to the WHO severity grading scale. The mean+/-SD age of the patients was 25.9+/-12.8 years, 55.8% were males and the hemoconcentration was recorded in a small number of patients [10 (7.0%)]. Male gender [odds ratio (OR)=14.7, P=0.003), positive history of vomiting (OR=4.3, P=0.047), thrombocytopenia at presentation (OR=225.2, P<0.001) and monocytosis (OR=5.8, P=0.030) were independently associated with DHF, but not with DF. Five cases (2.9%) had a fatal outcome, with a male-to-female ratio of 1:4. Three were from a pediatric group (<15 years). Pulmonary hemorrhages, disseminated intravascular coagulation and cerebral edema preceded death in these patients. The results have highlighted significant findings, such as adult susceptibility to DHF, pronounced abdominal symptoms and lack of hemoconcentration at time of presentation in the study population. These findings may play an important role in the case definitions of future studies from this part of the world.
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PMID:Dengue outbreak in Karachi, Pakistan, 2006: experience at a tertiary care center. 1770 59

A retrospective study was conducted among patients with dengue infection admitted to Rayong Hospital during September 2004-September 2005. Data were collected from medical charts and outpatient records created when the patients came to the hospital. Of the patients diagnosed with dengue, only 301 who met the WHO criteria for dengue fever and DHF/DSS were selected. The study cohort was comprised of 147 children (76 males, 71 females) and 154 adults (71 males, 83 females), with an overall mean age of 17.6 years. Some adult clinical symptoms were different from the children. Headache and myalgia were more common among adults (p < 0.05), but cough, vomiting, abdominal pain, and rash were more common among children (p < 0.05). Among the major bleeding symptoms, epistaxis (nasal bleeding) was more common in children (p = 0.012) and gum bleeding was more common in adults (p < 0.001). Myalgia was more likely in less severe grades of infection. Adults showed some different clinical manifestations of dengue infection from children. It is necessary for health personnel to take these differences into consideration when seeing probable cases of dengue infection.
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PMID:Clinical features and differences between child and adult dengue infections in Rayong Province, southeast Thailand. 1856 10

The present work is a prospective, observational, hospital based study on 100 sero positive cases of dengue infection, admitted to Dhaka Children Hospital, Dhaka, Bangladesh during the period 2000 -2001. The patients were in the age group 8 months to 14 years with a mean age of 8.3 years. The serological tests were performed by rapid strip test. Primary dengue infection (only Ig M positive) was observed in 15% cases while rest 85% were secondary dengue infection (either Ig G or both Ig M and Ig G positive). Classical dengue fever (DF) was noted in 11% patients and 89% children presented with dengue hemorrhagic fever / dengue shock syndrome (DHF / DSS). Common clinical presentations were fever, headache, retro- orbital pain, arthralgia / bone pain, vomiting, abdominal pain and bleeding manifestations. Other presentations were tachycardia, bradycardia, hypotension, hepatomegaly, splenomegaly, pleural effusion, ascites, thrombocytopenia and high hematocrit values. The incidences of tachycardia, hypotension, hepatomegaly, high hematocrit and thrombocytopenia were significantly higher in DHF / DSS cases. The tourniquet test was positive in significantly higher percentage of DF cases. The tourniquet test and thrombocytopenia did not correlate well with other bleeding manifestations suggesting alternate pathogenesis for bleeding. In an epidemic setting, if a child presents with fever, vomiting, musculoskeletal pain and bleeding along with hepatomegaly, low platelet count and high hematocrit, a strong possibility of DHF/ DSS should be kept.
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PMID:Clinical and laboratory profile of dengue infection in children. 1860 66

We describe six serology-positive dengue patients presenting sporadically over 8 years, who lapsed into coma and showed generalized irregular slow waves in consecutive electroencephalograms (EEG) in the absence of any structural brain damage. The mean age was 41 years (range 16-65). All had fever, headache and vomiting for 3 days (range 2-4) on admission and developed coma after 24 h. Five patients developed generalized convulsions and two showed generalized paroxysmal spike-wave discharges in the EEG. All regained normal consciousness within 36 h. In two patients, slow waves in the EEG persisted for 6 and 18 months.
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PMID:A case series of dengue fever with altered consciousness and electroencephalogram changes in Sri Lanka. 1918 46

We aimed to identify clinical features that would be useful for case detection and the appropriate timing of investigations and hospital admissions in patients with short-duration fever, suspected to be dengue fever (DF). Of 928 adult patients with short-duration fever admitted to Colombo North Teaching Hospital, Sri Lanka during February-June 2004, one in four were randomly selected for assessment of the severity of six clinical features: headache, body aches, vomiting, retro-orbital pain, generalised weakness (scale 0-9) and skin erythema (grade 1-5). There were 148 DF patients (95 males, mean age+/-SD: 28+/-12 years) and 54 non-DF patients as controls (44 males, mean age+/-SD: 25+/-11 years). All symptoms assessed (cut-off >or=5) and skin erythema (>or=grade 2) had a good positive predictive value for DF. However, erythema had the best negative predictive value, helping to differentiate DF from other short-duration fevers. More than 95% of patients with dengue had a platelet count above 50000/microl until the third day of illness. The platelet counts were significantly reduced when erythema, fever, vomiting and generalised weakness were persistent. In conclusion, erythema elicited by hand impression may help in the prediction of DF, and follow-up blood counts are indicated when symptoms persist.
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PMID:A clinical guide for early detection of dengue fever and timing of investigations to detect patients likely to develop complications. 1880 91


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