RESUMO
Background Bangladesh saw its most severe dengue outbreak in 2019, with the highest number of deaths reported. This study investigated the clinical characteristics, severity spectrum, and potential outcomes of dengue in patients admitted to a tertiary care institution in Dhaka. Methods This prospective observational study was done between May 2019 to April 2020. A total of 478 nonstructural protein 1 (NS1) antigen positive confirmed dengue cases were finally enrolled. The dengue patient's stratification and severity grading were performed according to the World Health Organization (WHO) dengue guidelines, for diagnosis, treatment, prevention, and control (2009). In addition, in-hospital outcomes were assessed in terms of mortality. Results The patient's mean age was 33.90±15.82 (SD) years. The male-to-female ratio was 1.23:1. In addition to fever, the most common symptoms were myalgia (67.78%) and rashes (58.58%). According to WHO classification 33.90% of patients (n=162) were in group A, 49.40% (n=236) were in group B, and 16.70% (n=80) were in group C. The overall mortality was 1.23% in groups A, 2.97% in group B, and 11.25% in group C. The mortality was higher in the more severe group with statistical significance (p<0.001). The mean hospital stay time was significantly less in the surviving group (survival vs. death: 3.07±1.78 vs. 5.61±3.13 SD {days}, p<0.001). Leukopenia and thrombocytopenia were commonly seen in all of the severity groups. Conclusion Dengue epidemics are increasing in Bangladesh. Many group B and C cases are fatal. To reduce mortality and morbidity, health care providers must remain alert. This challenge requires public health interventions and hospital readiness.
RESUMO
Snake venom toxins have been reportedly used as a rich source of a number of proteins of biotechnological interest due to their wide range of effects on haemostasis. These effects vary greatly: coagulant, anticoagulant, platelet-activating, anti-platelet, fibrinolytic and hemorrhagic, in either enzymatic or non-enzymatic pathways. Agkistrodon venom contains a variety of proteins that possess antiplatelet activities. This study presents recent development in our laboratory to produce and purify antiplatelet proteins derived from Agkistrodon blomhoffi ussuriensiss nake venom. Different matrices of HPLC (size exclusion, ion exchange and affinity chromatography) were employed for purifying the proteins and their biological and biochemical properties were characterized by SDSPAGE, 2-D electrophoresis, platelet aggregation assay and enzyme activity assay.A purified disintegrin was a single chain glycoprotein with Mr of 13 kDа and рІ 4.7, whereas PLA2 had Mr of 14 kDa and pI of 4.17. A dose-dependent activity curve analysis shows that the platelet aggregation inhibitory activity of disintegrin and PLA2 in the rabbit plateletrich plasma were ID50 of 0.25 μМ and 0.65 μМ, respectively. Bioprocesses to produce and purify active antiplatelet agents from A. blomhoffi ussuriensis venom have been developed, using modern liquid chromatography matrices. Ongoing work to optimize large-scale production process is being undertaken.
