Abstract
ABSTRACT
 BACKGROUND & OBJECTIVE: Pakistan has been facing frequent dengue fever epidemics for the last decade. The current study aims at various complications of dengue fever and their association with age, gender, serology, duration, and symptoms.
 METHODOLOGY: This cross-sectional study was conducted at the Medicine department, RIHS Islamabad, over eight months of duration after ethical approval. The dult indoor dengue fever cases were selected by consecutive sampling and informed consent obtained. Cases with malaria co-infection, hematological disease, and severe systemic illness were excluded. The symptoms, hematological counts, serology (dengue NS-1, IgG, and IgM), liver function tests, coagulation profile, pneumonia, and pericardial effusion, were documented. Data were analyzed by SPSS V-22.
 RESULTS: Among 75 cases, 19(25%) were females and 56(75%) males. The mean age was 33.5+12.7. The mean duration of symptoms was 5.4+2.0 days. Dengue NS-1 was positive in 45(60%), IgM in 22(29%), and IgG in 8(11%). Symptoms observed were fever 97%, headache 53%, pain abdomen 35%, vomiting 48%, rash 17%, and body aches 39%. Complicated Dengue fever was seen in 21(28%). Complications include gum bleed 12%, liver impairment 6.6%, gastrointestinal bleed 5%, per-vaginal bleed 4%, epistaxis 4%, hematuria 3%; pleural effusion, ascites and pneumonia 2.6% each, pericardial effusion 1.3% and one expiry. Age, gender, dengue serology, and hematological profile wasn’t found to be associated with complications.
 CONCLUSION: Complications are frequent in indoor dengue cases that include hemorrhagic complications, liver impairment, effusions, and pneumonia. Early presentation to the hospital may be helpful to screen for impending complications with improved morbidity and better patient care.
Highlights
Dengue fever is a vector-borne viral disease transmitted by Aedes Aegypti
The current study aims to evaluate the frequency of various complications observed in the dengue cases and the possible associations with demographic features, duration of symptoms, serology, and symptoms
Gender and age weren't found to be associated with complicated dengue fever (p>0.05)
Summary
Dengue fever is a vector-borne viral disease transmitted by Aedes Aegypti. It has been estimated that 390 million dengue cases are reported annually all over the world . [1] The first epidemic of Dengue fever was observed in Pakistan in 1992 in Karachi . [2] For the last 5 years, in almost every fall season, epidemics are observed in Punjab, KPK and Sindh and Kashmir areas of Pakistan . [3] A variety of symptoms are seen in dengue fever, including high-grade fever, headache, retro-orbital pain, rash, nausea, vomiting, abdominal pain, bleeding, hypotension, and shock . [4] The variants of dengue fever include classic dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS). The current study aims to evaluate the frequency of various complications observed in the dengue cases and the possible associations with demographic features, duration of symptoms, serology, and symptoms. The results will be helpful to compare data with regional and international studies The spectrum of these complications with respect to particular age groups, gender, and other. The current study aims at various complications of dengue fever and their association with age, gender, serology, duration, and symptoms. The symptoms, hematological counts, serology (dengue NS-1, IgG, and IgM), liver function tests, coagulation profile, pneumonia, and pericardial effusion, were documented. Gender, dengue serology, and hematological profile wasn't found to be associated with complications. CONCLUSION: Complications are frequent in indoor dengue cases that include hemorrhagic complications, liver impairment, effusions, and pneumonia.
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