RESUMO
Background: Dengue fever is the most rapidly spreading mosquito borne viral disease worldwide. It is estimated that the incidence has increased 30-fold over the last five decades. Recently, the reappearance of dengue in the pediatric population is a matter of concern among pediatricians, especially due to the presence of atypical features, leading to delayed diagnosis. There are few studies regarding the changing trendof paediatric dengue patients due to under reporting of the cases.Material & Methods:This prospective study was conducted among forty-five paediatric dengue patients below 15 years of age(n=45)at MH Samorita Hospital & Medical College, Dhaka over a period of 6 months from July 2021 to December 2021. Neonates and patients with co-infection were not included in the study. All clinical and laboratory details were collected during their hospital stay in a structured questionare form.Results:Forty-five paediatric dengue patients below 15 years of age were enrolled in the study (n=45). Out of the 45 cases 35 patients were non-severe dengue (undifferentiated fever, dengue fever with warning signs, and dengue fever without warning signs) and 10 patients were of severe dengue (DHF and DSS) according to WHO guidelines. The male to female ratio was 1.6: 1 in our study group. The majority of the cases 25 (55.5%) were within 6 to 10 years of age. Patients having features of severe dengue were also seen mostly (17.7%) in this age group. The mean age of hospitalized patients was 8.9 years. In our study there were 16 patients (35.6%) with classical dengue fever, 23 (51.1%) patients with dengue hemorrhagic fever without shock and 6 patients (13.3%) with features of dengue shock syndrome. Atypical clinical features were seen in 17 cases (37.8%). The most common atypical features found in twelve children were acalculous cholecystitis (26.7%). Renal impairment and hepatitis were present in 17.8% and 13.3% of patients. Among neurological manifestations two patients (4.4%) developed impaired consciousness and one patient (2.2%) had seizure. Conclusion:Atypical manifestations of DF can be fatal in many paediatric patients. There should be a high index ofsuspicion among clinicians for timely detection and management of atypicalmanifestation of severe dengue infection to prevent mortality.
RESUMO
Chronic periodontitis is a common disease, which occurs as an outcome of tooth supporting tissue's inflammation [periodontal ligament and gums], initiated by the exposure of the periodontium to dental plaque. By the action of various toxic products liberated from pathogenic plaque bacteria there is periodontal destruction, as well as hosts inflammatory responses elicited against plaque bacteria and their products. Inflammatory processes can be considered as the most essential functional part of pathophysiology of atherosclerosis resulting in cardiovascular disease [CVD]. Elevated levels of C -reactive Protein [CRP] have been associated with CVD and regarded as indeperident determinant of atherosclerosis. This study has been carried out to assess the possible relationship between chronic peri-odontitis and CVD determinants. This cross sectional study involved a total of 100 subjects including 50 chronic periodontitis patients and 50 healthy controls between the ages of 35 - 40 years. The patients were obtained from de-Montmorency College of Dentistry, Lahore. A detailed personal history, past medical and dental history was taken. Patients of chronic periodontitis were selected using Community Periodontal Index of Treatment Needs [CPITN], according to inclusion and exclusion criteria. Blood sample were drawn and CRP was measured by using standard enzyme linked immunosorbent assay [EL1SA] method. These parameters were compared in chronic periodontitis patients with age and gender matched healthy controls, to observe the significance of difference. The results of this study showed that serum CRP which was a strong independent risk jnarker of CVD is statistically significantly elevated in chronic periodontitis patients as compared with age and gender matched healthy controls. The correlation between serum CRP and severity of chronic periodontitis was also highly significant. The results of this study suggest that elevated CRP in chronic periodontitis patients may predispose them to the development of early atherosclerosis. Because of the significant association of elevated inflammatory mediators with CVD, their determination may help to improve the prediction and prevention of CVD in chronic periodontitis patients as well as these results is expected to bring awareness in people about oral hygiene