An Interesting Endocrine Cause of Pyrexia of Unknown Origin: A Case Report and Review of Literature

Pyrexia of unknown origin (PUO) is one of the most challenging medical problems. Endocrine causes of PUO are rare. Fever is common in a few endocrine disorders (e.g., thyroid storm, adrenal crisis and pheochromocytoma). However, PUO as the sole presenting feature is very rare with only a few reported cases in the literature. We present the case of a middle-aged male who came to us with PUO, weight loss and loss of appetite. The unusual symptomatology like loss of appetite, altered bowel habits made diagnosis difficult. This case highlights the importance of considering thyroid disorder in the differential diagnosis of PUO. Abnormal thyroid function may be an early clue for diagnosis.

Viral Load-based Evaluation of the Sensitivity of Antigen-based Rapid Detection Assay for SARS-CoV-2

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a global public health problem. The real-time reverse transcription-polymerase chain reaction (RT-PCR) is the gold standard test for the detection of SARS-CoV-2. However, the assay requires hours to get the final results. Therefore, antigen-based rapid assays are being used extensively to reduce the time. We have evaluated the performance of the antigen-based rapid test for the detection of SARS-CoV-2 virus in comparison with RT-PCR. Materials and methods: Nasopharyngeal and throat swabs were collected from 366 suspected patients of COVID-19 visiting our institute and subjected to qualitative RT-PCR and antigen-based rapid assays to detect the presence of SARS-CoV-2 virus. The sensitivity and specificity of the antigen-based assay were calculated in comparison with RT-PCR. Results: Compared with RT-PCR, sensitivity and specificity of the antigen-based rapid assay were observed to be 70.5% and 98.6%, respectively, in comparison with RT-PCR. However, the sensitivity of antigen-based rapid assay varied significantly with decreasing viral load. The sensitivity of the rapid antigen assay was equivalent to RT-PCR (23/23, 100%) at a higher viral load (Ct value 15�). In contrast, the antigen assay could only detect 3/21 (14.28%) samples with Ct value >30. Conclusion: The antigen-based assay could assist in the rapid screening of a large population. However, the rapid antigen assay might not detect early stages of infection represented by low viral load. Therefore, the antigen-based assay could not replace RT-PCR testing. The study reiterates that all antigen-based negative tests should be confirmed by RT-PCR.

2D Echocardiographic Findings, NT-ProBNP Levels, and Outcomes in Dyspnoeic Patients: Results from the Pro-BNP Investigation of Dyspnoea in the Emergency Department- a Single Centre Experience

Background: Dyspnoeic in the emergency department with multiple co-morbidities is a diagnostic challenge. Approximately 15-20% of acute dyspneic in the Emergency Department due to ADHF (acute decompensated heart failure) are misdiagnosed. B-type peptide (BNP) and its amino-terminal fragment (NT-proBNP) accurately identify HF in dyspnoeic patients. In the general population with dyspnoea, plasma pro-BNP concentrations are increased in left ventricular dilatation, hypertrophy, systolic dysfunction, or diastolic dysfunction but are unaffected by pulmonary dysfunction. Aims and Objectives: To study the relation between NT pro-BNP & echocardiographic findings in acute dyspnoeic patients, and the relation between NT pro-BNP and In-hospital Mortality. Materials and Methods: Source of data- Patients admitted to the Emergency Room or cardiac intensive care unit with a history of acute dyspnea in a tertiary cardiac care center in south India, meeting inclusion & exclusion criteria, were studied. Results: The study population is predominantly constituted of the elderly population. The most common co-morbid condition was hypertension. The present study uses an NT pro BNP level of 900pg/ml as the cut-off level. 78 patients were positive for the test. Echocardiography showed that 58% had LV systolic dysfunction, 60% had diastolic dysfunction. 42 patients had EF >55%, 10 patients between 55-45%, 33 patients between 44-30% and 15 patients had EF < 30%. Mortality rate was 6% in the whole study population. However, Mortality was seen in only NT pro-BNP positive group it was not statistically significant (p=0.46). Conclusions: NT pro-BNP correlates well with the worsening of LV systolic function; as the EF decreases, NT pro-BNP increases. Increase in NT pro-BNP levels has to be interpreted in the clinical context, and it is not a substitute for echocardiography for assessing cardiac abnormalities and dysfunction.

Dual Clinical Collaborator: A Pragmatic Role of nurses from developing countries

Collaboration is crucial in Professional nursing practice. Nurses act as a liaison between physicians and patients and their family members. Thus, it is vital to define the collaborative role of nurses in developing countries. The authors discuss pragmatic nurses' role by adopting the Dual Clinical Collaborator model to ensure offering the quality of care to their clients. Nursing is a healthcare profession that focuses on the care of individuals and their families to help them recover from illness and maintain optimal health and quality of life.(1) Health Care Professionals (HCPs) work together to provide quality health care and accomplish common goals. As healthcare delivery is becoming more complex, collaboration among healthcare workers and the patient can be a path to improve the quality of healthcare services. According to Walker and Avant's method, the conceptual definition of collaboration in nursing is an intra professional or interprofessional process by which nurses come together and form a team to solve patient care or healthcare system problem with members of the team respectfully sharing knowledge and resources.(2) Thus, collaboration is crucial in everyday professional nursing practice and should be considered a core value of nursing.(3)

Effect of Paribhadra Paneeyakshara in Mutraghata Caused by Benign Prostatic Hyperplasia- A Case Report

Benign Prostatic Hyperplasia is a troublesome disease that bothers the population of ageing men by decreasing their quality of life. It is an abnormal growth involving the submucosal glands of prostate. The disease interferes with the normal daily activities and sleep pattern and hence is a matter of concern to the medical field. The symptoms of Benign Prostatic Hyperplasia closely coincide with the symptoms of Mutraghata (urinary obstruction) explained in Ayurveda. When taking the obstructive pathology into consideration, Paneeyakshara Prayoga (alkali for internal administration) is classically mentioned as a treatment option. This work is a case study on the effect of Paneeyakshara prepared out of Paribhadra (Erythrina indica) which is a drug possessing Vatakaphahara (alleviate Vata and Kapha Dosha) and Shophahara Karma (pacify inflammatory swellings) in Mutraghata caused by Benign Prostatic Hyperplasia. A 66-year-old male who presented with the signs and symptoms of Benign Prostatic Hyperplasia was administered with 500 mg of Paribhadra Paneeyakshara with 1 gram of Guda (jaggery), morning and evening, half an hour before food for a period of 45 days. Assessment was done before and after treatment based on the IPSS (International Prostate Symptom Score) of the American Urological Association and the Ultrasound abdomen findings. The post- interventional assessment showed a lowered IPS Score and reduced USG parameters indicating the efficacy of Paribhadra Paneeyakshara in reducing Mutraghata caused by Benign Prostatic Hyperplasia.

A comparative study of primary cellulitis and its local complications in lower limbs in diabetics and non-diabetics through the new Amit Jain’s staging system from India

Background: The objective of the study was to validate Amit Jain’s staging system for cellulitis in diabetic and non-diabetic lower limbs and to predict the outcomes associated with cellulitis and surgical procedures done in them.Methods: We conducted a prospective study in department of surgery at Raja Rajeswari Medical College and Hospital Bengaluru, India. The study period was from December 2018 to November 2019. Statistical analysis was done using SPSS 22 and R environment ver.3.2.2.Results: A total of 36 patients were included in this study of which 21 were diabetics and were in placed in group A and 15 were non diabetics and placed in group B. 83.3% of the patients were males. 73.3% of non-diabetics had stage 1 cellulitis and 33.3% of diabetics had stage 1 and 2 each. 47.2% of patients underwent debridement and it was significantly common in diabetics (p=0.037) and also it was common in higher stages of cellulitis (p=0.001). 8.3% had amputation in this series. All the major amputations were done in stage 4 cellulitis (p=0.002).Conclusions: In this validation study, it can be seen that cellulitis is common in both diabetics and non-diabetics but it is severe in diabetic patients. Stage 3 was more common in diabetics compared to non-diabetics. Amit Jain’s staging system of cellulitis is a simple, easy, practical, focal classification that guides therapy and predicts amputation.

Primary ileal volvulus: a rare cause of small intestinal obstruction

A 50-year-old lady presented to us in the emergency department with history of acute abdominal pain and vomiting since the past 24 hours. Abdominal examination showed tenderness and guarding in the hypogastrium, lumbar and right iliac fossa region. Initial diagnosis of ruptured appendicitis was considered but exploratory laparotomy gave us an intra-operative surprise. Small bowel volvulus is extremely rare in clinical practice and their symptoms are usually nonspecific. The diagnosis is typically confirmed at surgery most of the time just like in this case. No etiology of this volvulus was found in this patient. Ileal volvulus carries a significant risk of mortality. Awareness of this condition among surgeons will help to reduce the morbidity and mortality associated with this unusual form of intestinal obstruction.

Assessment of knowledge, attitude and practices of universal precautions among medical and nursing students

Background: Universal precautions is an approach to infection control to treat all human blood and certain human body fluids as if they were known to be infectious for HIV, HBV and other bloodborne pathogens. The CDC recommends Standard Precautions for the care of all patients, regardless of their diagnosis or presumed infection status. Health care personals are at risk of being exposed to blood-borne pathogens. The aim of the study to determine the knowledge, attitude and practice of medical and nursing students towards universal precautions.Methods: A cross-sectional survey was carried out at S. S. Institute of Medical Sciences and Research Centre, Davangere, Karnataka. The participants were medical and Nursing undergraduate students. A questionnaire was prepared based on the WHO and CDC guidelines on Universal Precautions and was validated and pre-tested before finalization. Degree of knowledge was ascertained by means of yes-no questions on each item being evaluated.Results: All students were aware of Universal precautions, but soundness of their knowledge is very poor. Compliance in Universal precautions is good to average in nursing students but poor to average in medical students.Conclusions: It can be concluded that interventions to improve Universal precautions among medical students, nursing students urgently needed. So, there is a need for developing strategies to promote the use of Universal precautions which take into account behaviour change and accuracy of knowledge including its integration into practice. Teaching universal precautions early in their curriculum is necessary for better learning and practices during their posting.

Clinicopathological And Radiological Comparison Of Adenomyosis In Hysterectomy Patients - A Retrospective Study

BACKGROUND : Hysterectomy - The most commonly performed gynaecological surgery throughout the worldAIMS AND OBJECTIVES :This study aims at comparing the clinical, radiological and histopathological diagnosis of adenomyosis in hysterectomy patients.MATERIALS AND METHODS : A retrospective study was done on the 120 hysterectomy specimens received from August 2018 – August 2019 at the Pathology department in Ahalia Diabetes hospital. RESULTS AND DISCUSSION :Our study shows 100% of the clinical and radiological cases of adenomyosis and combined leiomyoma with adenomyosis were diagnosed by the histopathological examination.

Clonal similarities and sequence-type diversity of invasive and carriage Streptococcus pneumoniae in India among children under 5 Years

Background: Pneumococcal pneumonia is one of the major causes of mortality in children less than 5 years in Asia, especially in India. Available PCVs have less serotype coverage in India compared to western countries. Moreover, the baseline pneumococcal serotype and sequence type data is limited and available data doesn't represent the entire India. With this background we aimed to characterize invasive and carriage isolates of S. pneumoniae from a tertiary care hospital in South India. Materials and Methods: A total of 221 S. pneumoniae isolates, invasive (n=138) and carriage (n=83) between the time period of 2012-2018 were included. Isolates was identified and confirmed using standard laboratory protocols. Serotyping was performed by Customized sequential multiplex PCR and MLST as described in www.pubmlst.org. Results: The major serotypes were 19F, 6B, 14, 6A and 19A and the sequence types (ST) were ST63, 236 and 230. Predominant STs in invasive was ST 63 whereas in carriage were ST4894 and 1701. High level ST diversity in carriage was observed. Majority of the STs were SLVs or DLVs of previously reported STs or PMEN clones. Phylogenetic analyses of the STs revealed gradual expansion of three PMEN CCs CC320, 63 and 230. Conclusion: The vaccine serotypes were the predominant ones found to be associated with IPD, PMEN clones, new STs and antimicrobial resistance. Accordingly, PCV13 is expected to provide invasive serotype coverage of 75% in Indian children less than 5 years. This study provides baseline serotype and sequence type data prior to the introduction of PCV in South India.

Estimation of superoxide dismutase levels in saliva and gingival crevicular fluid among smokers and non-smokers in periodontitis patients - an observational study

Background: Smoking, which is an important risk factor for periodontitis, induces oxidative stress in the body and causes an imbalance between reactive oxygen species (ROS) and antioxidants, such as superoxide dismutase (SOD). The present study was done to quantify and compare the level of SOD enzyme levels in gingival crevicular fluid (GCF) and saliva among smokers and nonsmokers. Methodology: One hundred and thirty-five individuals in the age range of 20­55 years, including 45 light smokers, 45 heavy smokers, and 45 nonsmokers (controls), were selected and the clinical parameters recorded were plaque index, probing depth, and attachment loss. Smokers were divided into light smokers (<10 cigarettes/day) and heavy smokers (>10 cigarettes/day) and into three subgroups: healthy, mild periodontitis, and moderate periodontitis. GCF and saliva samples were collected then SOD levels were analyzed using spectrophotometric assay. Results: The mean levels of SOD in the GCF and saliva of smokers were decreased compared to controls. Intra- and inter-group analyses showed a significant reduction in the levels of SOD in the GCF and saliva of heavy smokers compared to light smokers and the control group. Conclusions: There was a progressive reduction in SOD levels from healthy nonsmokers to light smokers to heavy smokers

Clinical relevance of cagA and vacA and association with mucosal findings in Helicobacter pylori-infected individuals from Chennai, South India

Helicobacter pylori is associated with a spectrum of severe gastrointestinal conditions. In this study, an attempt was made to correlate endoscopic mucosal patterns with H. pylori infection and examine the pathogenic potential of the strains. Among the 147 dyspeptic individuals studied, 42.2% were H. pylori infected. Association of H. pylori with type 3 and 4 mucosal patterns (P = 0.001) and intestinal metaplasia (P = 0.012) was seen. vacA was associated with histological (P = 0.014) and endoscopy findings (P = 0.009). Association of mucosal patterns with H. pylori infection could be useful for clinicians to decide on the need for eradication therapy.

Adverse drug effects monitoring of amlodipine in a tertiary care hospital

Background: Amlodipine have been widely used drug for the treatment of Hypertension. It has many beneficial effects and less side effects. But, only very few adverse effects of Amlodipine have been documented and many were not reported. So, this study will bring out the possible adverse effect of Amlodipine.Methods: This study included 100 patients with hypertension who are taking amlodipine only. Patients who were willing to participate in the study were given a questionnaire containing demographic data and adverse drug profile of amlodipine. The symptoms of adverse drug reaction were documented. They were also asked about the other symptoms they are having, other than the questionnaire. The causality assessment was done by WHO assessment scale and severity by using modified Hartwig seigel severity assessment scale.Results: This study showed that most of the patients belong to 51-60 years age group. Mostly they were females, and many were having disease for less than a year. Most of the patients developed adverse drug reaction. Many patients had more than one adverse drug reaction. The commonest adverse effect were fatigue, palpitation, dizziness, insomnia, headache, joint pain, light-headedness, somnolence, nausea, flushing abdominal pain, tremor, leg pain, neck pain, back pain and edema. The adverse drug reaction(ADRs) mostly belongs to possible category and were mild.Conclusions: Most of the patients who were taking amlodipine had atleast one adverse drug reaction during their treatment period. It is mild, needs dose adjustment and healthy life style modification.

Patients Satisfaction with Diagnostic MRI Services in Teaching Tertiary Care Hospital in Telangana

Introduction: The health care industry is undergoing transformation to meet the demands of the patients. Hospitals are shifting from viewing patients as illiterates and with little health care choice, to that of educated consumer who has wider health care choices. Patient satisfaction is regarded as an important indicator of quality of care and survey is one of the tools for measuring consumer experiences in the hospital. Objective: To study “Patients‟ perceived satisfaction with diagnostic MRI services” in a Teaching hospital situated in Hyderabad. Materials and methods: A cross–sectional survey, conducted in 200 respondents attending hospital for MRI investigation. Pilot tested, pre-structured, self-completion questionnaire is used to collect data. The data isanalyzed using SPSS (statistical package for social sciences version 10.0.2). Results: The result showed that 79% (n=158) were males and 21% (n=42) females. Among two hundred respondents 54 (27%) were outpatients, 77 (38.5%) inpatients of same hospital, 50 (25%) subjects from private nursing homes, 9 (4.5%) patients from other hospitals and 10 persons not responded. Overall 74.5% of the patients satisfied with the waiting time, 80.5%, 77.5% and 86.5% of the patients satisfied with guidance to reach MRI facility, staff behaviour and staff communication respectively. 85.5% opined that utilization of waiting time by providing information regarding MRI is useful, and 62% of them requested to have trained personnel by their side during the procedure. Conclusion: Hospital administration shall take feedback from patients and their attendants and identify deficiencies and drawbacks in providing services and improve them to their satisfaction which in turn increases indirect publicity of the hospital.

Dengue virus infection.

Dengue, an illness caused by dengue virus (an arbovirus), is one of the neglected tropical diseases.1 The infection is endemic in more than 100 countries. Of the estimated 390 million dengue viral infections that occur worldwide annually,2 around 1% require hospital admission.3 Since the isolation of the dengue virus in India in 1945, an upsurge has been reported in the number of cases,2 with 99 913 cases during 2015.4 Although the mortality rate of dengue is low (0.3%–0.4%),1 large financial resources required for its control5 pose a huge challenge in developing countries such as India. The dengue virus has four serotypes (DENV 1–4) and a fifth one has been reported recently.6 The most common vectors for this virus are female Aedes aegypti (A. aegypti) mosquitoes; other mosquito species that are known to transmit this virus include Aedes albopictus, Aedes polynesiensis, and Aedes niveus. Outbreaks of dengue are seasonal as the climate influences the survival of this vector.7 Transmission of dengue is facilitated by the increase in urbanization, air travel, global trade, and use of materials that support collection of water, e.g. non-biodegradable plastic products, paper cups, coconut shells, air coolers, flower pots and discarded tyres. Water collected in any receptacle makes for breeding of mosquitoes.3 Illness caused by dengue virus infection ranges from the asymptomatic non-specific viral variety to the life-threatening dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). The typical dengue illness has three phases.3 The incubation period is followed by a febrile phase with high-grade fever accompanied by facial flushing, myalgia, arthralgia and retro-orbital pain. The ‘critical phase’ may have complications such as plasma leakage, shock and end-organ dysfunction. The ‘recovery phase’ is characterized by the resolution of symptoms and return of extravasated fluid into the intravascular compartment. Circulatory fluid overload and pulmonary oedema can occur during this period, especially in patients with comorbid conditions and due to overzealous administration of intravenous fluids.8 ‘Expanded dengue syndrome’ in some people may unusually manifest with severe involvement of organs, such as the heart, liver, kidneys and brain.1

Preparation, in vitro Characterization of Transdermal Patch Containing Atenolol and Hydrochlorothiazide: A Combinational Approach.

Background: In the present days, the prevalence of hypertension is potentially increasing. To overcome the effects of this disease, a complex therapeutic regimen is often introduced, but the patient compliance is always questionable. Methodology: To improve patient compliance, a novel approach has to be implemented. Hence, the present study was designed to develop a transdermal patch containing Atenolol and hydrochlorothiazide in combination using blends of different polymeric combinations such as hydroxypropyl methyl cellulose, sodium alginate, and polyethylene glycol. The patches were subjected to physicochemical tests and in-vitro drug release study. Results: Good results were obtained in all the evaluated parameters. The drug release of all formulation followed zero order kinetics. The medicated films also went through primary skin irritation test and the results showed that the films were non-irritant. Conclusion: The developed transdermal delivery system containing Atenolol & hydrochlorothiazide might be a milestone in the combinational therapy of hypertension.

In Silico-based Study of Cytochrome P450 and Multidrug Resistance Protein 1 from Docking Perspective to Understand Kidney Failure.

Background: The need to identify causes of drug induced kidney failure has been underscored by International Conference on Harmonization (ICH) regulated agencies. In our earlier studies on adverse drug reaction (ADR) reported in Canada Vigilance Adverse Reaction Online Database it was observed that drugs azathioprine, clozaril/clozapine, diclofenac sodium, diflucan/ fluconazole, furosemide, indomethacin, metformin, micardis/ telmisartan, viread/tenofovir, and zyprexa/olanzapine lead to kidney failure. Method: Attempts have been made to understand the physiological process via bioinformatics perspective. This was done by active site identification for cytochrome P450 along with multidrug resistance protein 1 (MRP1). Docking against the drugs in these proteins that are categorically involved in drug binding based on their pharmacological actions are as per drug bank annotations. Results: Cytochrome P450 2C19 protein showed better interactions with drug indomethacin with a maximum score of -119.2 kcal/mol followed by drug clozaril with a score of -102.5 kcal/mol. This was finally followed by of drug zyprexa with a score of -101.0 kcal/mol. The residues which are actively involved with the drug indomethacin include Arg97 and Arg433. Drug clozaril shows interaction with Ala297. For drug zyprexa the residues like Arg97, Ala297 and Cys435 interact with the protein. For MRP1, even though it showed better binding scores for drugs azathioprine, indomethacin, diflucan and furosemide. But still, they are not able to interact within the pocket, leaving it empty during docking studies. Conclusion: Through this study, it was possible to identify active site pocket in the related proteins and the interacting amino acid residues of cytochrome P450 that may contribute to drug induced kidney failure.

Hyperandrogenism-insulin resistance-acanthosis nigricans syndrome with PCOS and Hashimoto’s thyroiditis: case report.

Female hyperandrogenism is a frequent motive of consultation. It is revealed by hirsutism, acne or seborrhea, and disorders in menstruation cycle combined or not with virilisation signs. Several etiologies are incriminated but the hyperandrogenism-insulin resistance-acanthosis nigricans syndrome is rare. A 21-year female, having had a three-year-old secondary amenorrhea, known case of hypothyroidism since 4 years on medication. The exam revealed a patient, hypertensive with blood pressure at 170/110 mmHg with a Body Mass Index (BMI) at 40.08 (Obese Class-3, as per WHO 2004) and a waist measurement of 106cm, a severe hirsutism assessed to be 27 according to Ferriman and Gallwey scale, acanthosis nigricans behind the neck and elbows. The assessment carried out revealed testosteronemia at 1.07 ng/mL, which is more than twice the upper normal of the laboratory. Imaging studies revealed enlarged right adrenal gland, hepatomegaly with fatty infiltration of grade-1 also bilateral polycystic ovaries. The retained diagnosis is HAIR-AN syndrome with polycystic ovaries, hypertension, type-II diabetes mellitus, hypothyroidism since last 4-years and dyslipidemia and was provided with metformin 500 mg thrice daily, spironolactone 25 mg twice daily, atorvastatin 20 mg once daily, telmisartan 20 mg once daily with continuation of eltroxin 50 Mcg for hypothyroidism. To our knowledge this is the first case report of HAIR-AN syndrome in 21 year old female associated with Hashimoto’s thyroiditis, dyslipidaemia, hypertension and type-2-diabetes and this case also highlights about early diagnosis and management of HAIR-AN Syndrome with PCOS and Hashimoto’s thyroiditis which could help prevent long-term sequalae such as cardiovascular disease and endometrial cancer and with the advent of knowledge and availability of health resources we can prevent long-term adverse effects (threefold) on health of women. This woman should be observed for these ailments in later life.

Effects of alcohol on micronucleus in human exfoliated buccal cells.

Background: Oral cancer is the most common malignancy in nearly half of Indian population. The main causes of oral carcinoma are tobacco, alcohol, poor diet and infective agents. These agents damage the chromosomes to form several secondary nuclei known as micronuclei. This study identifies the occurrence of micronuclei and also evaluates the frequency of micronuclei in stained smears of oral exfoliative cells from healthy subjects and alcoholic subjectsMaterials and methods: A total number of 60 alcoholic subjects were referred to the Department of Anatomy, SRM Medical College and Research Center, SRM Nagar for micronucleus assay from the Department of Dentistry. Equal numbers of controls were included with normal looking oral cavities. Results: Out of 60 alcoholic subjects 43 showed presence of micronuclei and out of 60 control subjects, only 6 showed micronuclei. With these observations, alcohol is one of the predisposing factors of oral carcinoma.Conclusion: It is evident from our present study, it is clear that in alcohol consumption, the buccal mucosa, which are at high risk for development of oral cancer, show an increase in the MN frequencies.

Therapeutic Potential of Carica Papaya L. Leaf Extract in Treatment of Dengue Patients.

Carica papaya leaf extracts are known to have many beneficial medicinal properties. Recent studies have claimed possible beneficial effects of Carica papaya leaf extracts in treating patients with dengue infection. The present study aims to evaluate the therapeutic potential of Carica papaya leaf extracts in treating dengue patients. Carica papaya leaf extracts were given to dengue infected patients and their blood samples were daily monitored. Polyserositis condition of the patients was analysed by ultrasonography before and after the completion of Carica papaya leaf extract treatment. Repeated Measures ANOVA and descriptive measures such as mean, standard error values were calculated. Before the administration of Carica papaya leaf extracts the patients had a low WBC and platelet counts. After the administration of Carica papaya leaf extracts there was a good amount of increase in the counts of WBC and platelets (p<0.05) in all the patients and the patients started recovering from dengue infection. Ultrasonographic findings revealed clearance in pleural ascites, pericardiac effusion and peritoneal ascites. Blood analysis reports, ultrasonographic findings, statistical results and patients recovery from dengue infection clearly shows the therapeutic role of Carica papaya leaf extracts in treating dengue infected patients. Further studies are necessary for identification of the compounds present in Carica papaya leaf extract and exploring their therapeutic role in curing dengue infection.