Regional variation and clinical manifestations of acute dengue infection observed at a tertiary care hospital of district Rawalpindi

Objectives: To assess the regional variation and clinical manifestations of acute dengue infection amongst the patients who presented to a tertiary care hospital of Rawalpindi

Study design: A Descriptive study

Place and duration: Study was carried out at Microbiology Department of Holy Family Hospital, Rawalpindi Medical College, Rawalpindi, from 1st August 2010 to 30th March 2011

Methodology: A simple random sampling technique was adopted for all the suspected cases of acute dengue, admitted in the dengue ward of Holy Family Hospital, Rawalpindi. Their blood samples were taken and analyzed by ELISA test for the detection of antidengue antibodies [IgM]

Results: A total of 30.2% [n=104] patients were diagnosed positive by ELISA test. The frequency of dengue fever [DF] in males was 68.2% [n=71] and in females it was 31.7% [n=33]. The incidence of dengue fever was high in Rawalpindi [30.2%] and Chakwaal [30.1%]. The most common clinical manifestations were high grade continuous fever [>10[degree]F] seen in 88.4% [n=92], followed by retro-orbital headache 65.3% [n=68], epigastric pain 65.3% [n=68], arthralgias 63.4% [n=66] and myalgias 50% [n=52]

Conclusion: The incidence of Dengue fever is high in Rawalpindi and Chakwaal. The most common clinical manifestations of acute DF include high grade continuous fever along with retro-orbital headache, epigastric pain, myalgias and arthralgias

diagnostic and management options of naegleria fowleri amebic infection

The source of Naegleria fowleri [N. fowleri] Infection is via direct contact with poorly chlorinated or contaminated water. It can easily be acquired during swimming or face wash with contaminated water through inhalation of Naegleria cysts. The mortality rate with N. fowleri or 'brain-eating amoeba1 has been estimated to be as high as 98%

The exact prevalence of N. fowleri infection in Pakistan cannot be assessed because of limited National data. The clinical manifestations usually mimic meningitis and hydrocephalous, thus, remained the main reason for under reporting of these cases

Therefore, there is a dire need to adopt proper diagnostic approaches through cerebrospinal fluid [CSF] microscopic examination and molecular detection by polymerization chain reaction [PCR] studies in all the suspected cases. Moreover an aggressive combination therapy with Amphotericin B, rifampicin and miconazole can be helpful to reduce the high mortality rate form the said infection