Clinicolaboratory profile and outcome of dengue fever cases in peak season of an academic year among pediatric population admitted to teaching hospital, Bangalore, Karnataka, India

Background: Dengue is a vector borne diseases with varied clinical manifestations, a major concern to public health globally. This study was done to describe the salient clinical as well as haematological profile of serologically confirmed cases of dengue fever and outcome in admitted cases.Methods: This was a prospective study conducted at major Government teaching Hospitals in Bangalore from July 2019 to December 2019. Total 164 cases of dengue fever were enrolled and classified as per WHO guidelines. The clinical profile and demographic profile was recorded in a structured questionnaire format. Haematological parameters on admission, duration of stay and outcomes were analysed. The outcomes of the cases were mentioned as improved and death.Results: In this study commonly affected age band was adolescents group (36.6%) without any sex predilection. Maximum number of dengue cases were presented with warning signs (87.5%), 14 (8.69%) cases without warning signs and 6 (3.72%) with severe dengue. Fever was the most common symptom (100%), followed by vomiting (58%) and abdominal pain (38.5%). NS1 antigen positive cases (61.5%). Severe Leukopenia was present in 57% of cases and Thrombocytopenia in all admitted patients (100%). Most of the cases were treated with antipyretics, oral fluids (46%) and IV fluids (53%), only single case received platelet transfusion. Duration of stay was more in severe dengue cases. Mortality of our study was 1.8%.Conclusions: Dengue presents with varied clinical features. Community awareness, early diagnosis and management and vector control measures needs to be strengthened in order to reduce the increasing number of dengue case. Both clinical, haematological parameters should be monitored for better outcome.

The strawberry tongue: What, how and where?

Morphological alteration of the dorsum of the tongue is seen in many disorders. These include alteration in color such as pallor and redness and surface alterations, giving rise to “balding,” “geographic tongue,” and the “strawberry tongue.” Iron deficiency anemia and vitamin B12/folic acid deficiency are the causes of balding/pallor and hyperemia (beefy red glossitis), respectively. Geographic tongue refers to a “map-like” appearance of the tongue seen in a host of disorders such as psoriasis and Reiter's disease. Strawberry tongue refers to the characteristic appearance of the tongue seen in certain disorders where it resembles the skin of a strawberry.

The strawberry tongue: What, how and where?

Morphological alteration of the dorsum of the tongue is seen in many disorders. These include alteration in color such as pallor and redness and surface alterations, giving rise to “balding,” “geographic tongue,” and the “strawberry tongue.” Iron deficiency anemia and vitamin B12/folic acid deficiency are the causes of balding/pallor and hyperemia (beefy red glossitis), respectively. Geographic tongue refers to a “map-like” appearance of the tongue seen in a host of disorders such as psoriasis and Reiter's disease. Strawberry tongue refers to the characteristic appearance of the tongue seen in certain disorders where it resembles the skin of a strawberry.

Anticoagulants in dermatology.

Anticoagulants are the cornerstone of treatment of venous thromboembolism associated with various medical conditions and surgical procedures. They act on different steps of the coagulation pathway and are broadly categorized into heparins, vitamin K antagonists, and inhibitors of thrombin and factor Xa. The classification is evolving as newer and better oral and parenteral anticoagulants are being added. Anticoagulants in dermatology are important not only for their therapeutic application in cutaneous thrombotic dermatoses such as livedoid vasculitis, purpura fulminans, superficial and deep venous thrombosis and others but also for their use in non‑thrombotic dermatoses such as lichen planus, recurrent oral aphthosis, chronic urticaria and several others. Further, the use of anticoagulants for any indication is associated with various adverse effects with dermatologic manifestations including specific reactions such as warfarin‑induced skin necrosis, heparin‑induced thrombocytopenia and anticoagulant‑associated cholesterol embolization syndrome.