RESUMO
The aim of this study was to determine the clinical characteristics and poor prognostic factors associated with high mortality in dengue encephalopathy. Fifteen patients with confirmed dengue infections, who developed encephalopathy, were recruited from two tertiary care hospitals in Colombo, Sri Lanka. Among the factors that contributed to encephalopathy were: Acute liver failure (73%), electrolyte imbalances (80%) and shock (40%). Five (33.3%) patients developed seizures. Disseminated intravascular coagulation was seen in five (33.3%). Secondary bacterial infections were observed in 8 (53.3%) of our patients. The overall mortality rate was 47%.
Assuntos
Adulto , Infecções Bacterianas/complicações , Encefalopatias/diagnóstico , Criança , Pré-Escolar , Estudos de Coortes , Dengue/complicações , Dengue Grave/complicações , Coagulação Intravascular Disseminada/complicações , Feminino , Humanos , Lactente , Falência Hepática Aguda/complicações , Masculino , Pessoa de Meia-Idade , Prognóstico , Convulsões/complicações , Choque/complicações , Sri Lanka , Desequilíbrio Hidroeletrolítico/complicaçõesRESUMO
Bleeding from oesophageal varices is the commonest cause of significant upper gastrointestinal bleeding in Sri Lanka. Endoscopic band ligation is an effective method in the management of varices. But the cost of banding equipment is high, unaffordable for a majority of our patients. We have devised a cheap method to carry out banding of varices. Banding of varices using this technique was carried out in 235 patients. In the patients who were followed up, there was a reduction in the size of varices across all grades of varices. No complications due to banding were noted, and only 10 patients developed re-bleeding. Since the initial experience on efficacy and safety of this technique is encouraging, we believe that its widespread adoption in Sri Lanka would be cost effective and life-saving.