ABSTRACT
Background: Thrombocytopenia is the hallmark laboratory finding in dengue fever and leads to bleeding manifestations when reduced markedly. So, this causes panic amongst the patient and relatives about the possibility of severity and leading to various complications including bleeding tendencies. Platelet transfusion is the only definitive treatment and it is indicated only in severe cases with bleeding manifestations. Prophylactic platelet transfusion is not much useful unless it’s reduced below 10,000cells/cumm. Carica papaya leaf extract (CPLE) are believed to have some role in improving platelets and its role is unclear. Hence, this study is taken up to evaluate the role of CPLE in improving dengue thrombocytopenia.Methods: Total 500 patients were included in the study; out of which 380 were males and 120 were females. Patients of dengue fever with thrombocytopenia (Platelet count <1, 50,000 cells/cumm) matching inclusion criteria were included in the study. After the inclusion, patients were randomized into two groups. Study group and control group by simple randomization (even/odd method). The study group treated with CPLE 1100mg three times daily for five days along with symptomatic and supportive treatment. The control group was given only symptomatic and supportive treatment. The average platelet count, average duration of stay and transfusion requirement of platelets were compared using student ‘t’ test.Results: Increased platelet counts were noted early in the treated group than the controlled group. The average duration of hospital stay was 5.42±0.98 days in study group and 7.2±0.97 days in controlled group. The requirement of platelets is more in control group than study group and it was statistically significant.Conclusions: Carica papaya leaf extract tablets can be used in patients with dengue thrombocytopenia with clear advantages over control group
ABSTRACT
Background: Paraquat is most common insecticide compound used for suicidal consumption in rural part of the Karnataka next to organo-phosphorous compound. It produces various local and systemic manifestations in the early course. It is very notorious to cause multi-organ dysfunction and mortality within 24 hours in severe amount of consumption. Lack of specific antidote and high-quality evidence based medicine makes the management of paraquat poisoning challenging. Hence, we took up the study to evaluate the clinical features, course and management option for the poisoning.Methods: It is an observational study conducted at HIMS, Hassan. History was collected from patient and bystanders. Clinical features, laboratory parameters were noted regularly and frequently. Patient’s complications were identified initially and treated accordingly. All the data collected were tabulated and statistically analysed.Results: Out of 110 patients, 72 were females and 38 were males; most of them were in the age group of 30-40 years. Mild poisoning was noted in 30, moderate in 56 and 24 patients were severe. Most common symptom was nausea and signs were oral cavity ulcers followed by tachycardia and tachypnoea. The overall mortality was 72%, 18% were recovered fully and 10% patients left against medical advice.Conclusions: Since there is a lack of antidote management of paraquat is challenging. Early gastric lavage, aggressive fluids, IV methyl prednisolone and N-Acetyl-Cysteine is beneficial.