Dengue / Dengue Hemorrhagic Fever

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Glossary

Petechiae - A small purplish spot on a body surface, such as the skin or a mucous membrane, caused by a minute hemorrhage

Purpura - A condition characterized by hemorrhages in the skin and mucous membranes that result in the appearance of purplish spots or patches

Epistaxis
- Nosebleed

Hematemesis
- Blood vomit

Thrombocytopenia
- An abnormal decrease in the number of platelets in circulatory blood

Immunohistochemistry
- Microscopic localization of specific antigens in tissues by staining with antibodies labeled with fluorescent or pigmented material.

Immunofluorescence - labeling of antibodies or antigens with fluorescent dyes especially for the purpose of demonstrating the presence of a particular antigen or antibody in a tissue preparation or smear

Polymerase Chain Reaction
- in vitro technique for rapidly synthesizing large quantities of a given DNA segment that involves separating the DNA into its two complementary strands, binding a primer to each single strand at the end of the given DNA segment where synthesis will start, using DNA polymerase to synthesize two-stranded DNA from each single strand, and repeating the process

Enzyme Immuno Assay
- An assay that uses an

enzyme
- Bound antibody to detect antigen

Analgesics
- Drugs that reduce pain.

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yousufmohammad

please inform if age is 54 women, High blood pressure and chronic disease, She has Fever and body pain.She is in ICU for three days.is it advised to get her discharged.Platelet count 1 lac. How severe dengue can be in her condition?
As my Mother in ICU>Please Reply

Dear Yousaf,with Hypertension,another chronic disease,and age above 50,the afebrile period is significant,the patient should be advised about the warning signs for plasma leakaga,i.e, the reduced BP,or reduced pulse pressure[the difference between the upper-systolic and lower-diastolic one,e.g. if it comes down to 100/90.the increased capillary refilling time, the tender liver,and or hemmhorages,reduced urinary output,blood in vomiting,altered mentation,increasing respiratory disconfort. All these may indicate her transition towards shock,which is actually far more important than platelts,particularly in absence of internal or external bleeding . Observe your patient for all this,and then decide about discharge. Regards . P-dopp Peoples Doctors @ facebook.

The platelet count is not the only important determinant of bleeding.


Indications for blood/platelet transfusion as recommended in clinical practice guidelines are:

In cases with significant clinical bleeding, which require blood transfusion. Usually bleeding is > 10% of total blood volume (> 6-8 ml/kg of ideal body weight)
In adults with underlying hypertension or coronary heart diseases and platelet 1.3-1.5, which is the result of liver failure: Major contributing factor for massive bleeding.
There is no evidence to support the use of blood components such as platelet concentrates, fresh frozen plasma or cryoprecipitate. Its use could contribute to fluid overload.

Important instructions for treatment of DHF as per WHO/SEARO guidelines:

If the patient’s condition becomes worse despite giving 20ml/kg/hr crystalloid solution for one hour, replace crystalloid solution with colloid solution such as Dextran or Plasma. As soon as improvement occurs, replace with crystalloid.


In case of severe bleeding; give blood transfusion @ 20ml/kg for two hours. Then give crystalloid IV fluids @ 10 ml/kg/hr for a short time (30 - 60 minutes) and later reduce the speed.


If hematocrit falls, give blood transfusion 10 ml/kg and then give crystalloid IV fluids at the rate of 10 ml/kg/hr. The volume of blood administered should be just enough to raise the red blood cell concentration to normal.

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