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Background Dengue infections caused by the four antigenically distinct dengue virus serotypes (DENV1, DENV2, DENV3, DENV4) of the family Flaviviridae are the most major arboviral diseases in humans in terms of geographic spread, morbidity, and mortality. Objective: The study was conducted to assess serum lactate in cases of dengue and correlate it with severity in dengue infection. Methodology: A prospective observational study was carried out among indoor patients admitted to the general medicine department of the tertiary care hospital SMIMER Surat. The study's duration was 15 to 18 months. Result: our study found out of total 154 cases; majority of cases were belonged from 83(53.90%) cases were from less than 30 years. male was contributed 96 (62.34%), majority of cases had duration of fever 39(25.32%), 66 (42.66%) case had high LDH, comparison of serum lactate dehydrogenase with severity of dengue mean lactate dehydrogenase of dengue without severity was mean was 148.45 and SD 11.81, while in severe dengue mean serum lactate dehydrogenase 388.23 and SD 99.47 with p value 0.001 which was statically significant. Conclusion According to this study, it is preferable to monitor serial lactate levels as opposed to using a single lactate number.
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Background: Millions are infected with dengue every year.' Early diagnosis of dengue infection is important for proper treatment of DHF and DSS to avoid fatal outcome. Thrombocytopenia is a common hematological abnormality in dengue, which demands platelet transfusion in most of the severe dengue cases. Platelet transfusion though life-saving has its own hazards. Hence, we can use some new parameter like immature platelet fraction (IPF) which is a measure of reticulated platelets that reflects the rate of thrombopoiesis. The risk of platelet transfusion may be decreased by rapid identification of immature platelet fraction. This study was performed to establish reference of IPF values for the assessment of thrombopoiesis.Methods: Blood samples from 150 children were obtained on day of illness 3, 5 and 7. The IPF is identified by sysmex XE2100 hematology analyser in the reticulocyte channel using a fluorescent dye and a carefully designed gating system and counted by a special software termed IPF master7. IPF values against platelet count were assessed separately on day 3, 5 and 7.Results: The reference intervals of IPF > 8 % and IPF < 8 % were assessed against platelet count. Increase in IPF favored increase in platelet count on day 5 which was statistically significant with the p value <0.001.Conclusions: A rapid and inexpensive automated measurement of IPF can be integrated as a standard parameter to evaluate the thrombopoietic state of the bone marrow. From the study it can be concluded that IPF is an important predictor of increase in platelet count.' Increase in IPF>8 % suggests that platelet count will be increased in next 24 to 48hrs indicating that further blood transfusion will not be required.
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Dengue, a serious viral infection caused by the mosquito vector, Aedes aegyptii, affects about 390 million people annually from more than 125 countries across the globe. However, until now, there is no reliable clinical or laboratory indicator to accurately predict the development of dengue severity. Here, we explored critical pathophysiological determinants like IL8, circulating immune complex (CIC) and cryoglobulin in dengue-infected patients for identification of novel dengue severity biomarker(s). Totally, 100 clinically suspected dengue cases were tested by NS1 ELISA and MAC ELISA for dengue virus aetiology. For control, 49 healthy volunteers were included. Blood profiling (complete hemogram and liver function test) of patient population were done using automated cell counter and standard auto analyzer based biochemical analysis. Serum CIC was quantified by PEG precipitation. Serum cryoglobulins were estimated by Folin assay. Levels of serum IL-8 were assessed by standard sandwich ELISA kits. Patient CIC were further characterized by SDS Gel electrophoresis. Forty per cent of the cases tested positive, of which 11 patients had severe clinical manifestation. The mean ±SEM of cryoglobulin concentration for DHF, DF, and HC were 1.30±0.31, 0.59±0.08 and 0.143±0.009 μg/μl, respectively. Thus, DHF and DF patients have shown 9- and 2.2-fold increase in cryoglobulin levels; and 18- and 5-fold increased CIC, respectively compared to HC patients. The mean ±SEM of CIC-PEG index for DHF, DF and HC were 491±41.22, 146±14.19 and 27.98±2.56, respectively. Raised levels of IL8 titers were also found in all 11 DHF patients. Peak levels of CIC, cryoglobulin and IL8 titers were associated with thrombocytopenia. SDS PAGE analysis of CIC from DHF revealed the presence of at least six protein bands that were not observed in samples from DF and HC. Prediction efficacy of IL8, CIC and cryoglobulin for DHF was determined using the receiver operator characteristic curve (ROC). The area under the curve was 1.00 for IL8, 0.99 for CIC and 0.74 for cryoglobulins. Overall, the results suggest that CIC, IL-8 and cryoglobulins may serve as important laboratory parameters to monitor dengue infection progression.
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Background & objectives: Dengue is one of the most important Arboviral diseases in man with outbreaks in Southeast Asia and India. We report a retrospective analysis of the dengue positivity in the referred samples for three years period (2006 to 2008) at the Department of Virology, King Institute of Preventive Medicine, Chennai, Tamil Nadu, India. Methods: Serum samples from 1593 suspected cases (968 male and 625 female) were obtained. Of the 1593 cases screened, 1204 (75.5%) were paediatric cases and 389 (24.4%) adults. The samples were subjected to MAC ELISA and IgG ELISA. Results: Of the 968 patients, 686 (43.0%) were positive, of which 579 (84.0%) were in the paediatric age group (<14 yr) and 107 (15.5%) were adults. The IgM positivity being 356 (36.7%) in males and 330 (52.8%) in females. Of the 686 positives, 113 (16.47%) were positive for both IgM and IgG denoting secondary infection. There was a noticeable increased occurrence during the cooler months and during the monsoon and post-monsoon months. Interpretation & conclusions: The dengue IgM seropositivity among the suspected cases indicates active dengue virus activity. Increase in the probable secondary infections especially in a country like ours where multiple serotypes are prevalent raises concern over probable increase in the incidence of the more serious DHF/DSS. Studies need to be done to identify circulating serotypes of dengue virus to design preventive strategies.