Dengue Fever Patients Research Articles

Diagnostic Significance of Hematological Parameters and C- Reactive Protein in Dengue Viral Infection: A Retrospective Cross-Sectional Study

Background: Dengue fever continues to pose significant challenges in public health, particularly within developing countries where it remains endemic. The ability to distinguish dengue infection from other febrile illnesses and assess its severity is crucial. The analysis of hematological parameters and inflammatory biomarkers, particularly C-reactive protein (CRP), offers valuable insights into the disease's progression. Objective: This study aimed to delineate the severity of dengue fever through detailed evaluation of complete blood count (CBC) and CRP levels, and to establish a correlation between these markers and the clinical severity of the infection. Methods: In this retrospective cross-sectional study, 135 suspected dengue fever patients from the City University of Science and Information Technology Peshawar were screened using the immune-chromatographic technique (ICT). Among them, 50 individuals (37%) tested positive for dengue. Both CBC and CRP levels were measured, with data analyzed using the statistical package SPSS version 22.0. The study spanned demographic data collection, gender and age distribution assessment, and detailed analysis of hematological parameters alongside CRP to predict disease severity. Results: Among the confirmed cases, the gender ratio skewed towards males (60%) compared to females (40%), with the most affected age group being 15-25 years (34%). Leukopenia was identified in 58% of patients with a mean WBC count of 2.62 × 10^9/L, neutrophilia in 66% with a mean neutrophil percentage of 80.15%, and lymphopenia in 56% with a mean lymphocyte percentage of 10.28%. Thrombocytopenia was observed in 76% of the cases. Elevated CRP levels were found in 88% of patients, with a mean CRP value of 23.10, indicating a strong predictive correlation with disease severity (p-value= 0.001). Conclusion: The study reaffirms the role of CBC and CRP levels in the clinical assessment of dengue fever, with both markers being indicative of infection severity. These findings can aid in the early detection and management of dengue fever, potentially guiding decisions regarding the necessity of hospitalization.

Ketepatan Pengkodean Diagnosis Demam Berdarah Dengue Berdasarkan Hasil Pemeriksaan Klinis di Rumah Sakit Singaparna Medika Citrautama

One of the supporting units in the hospital, namely medical records, is a manual / electronic record carried out by health care providers such as diagnosis. One of the medical record activities is to code the disease. Coding is the provision of alphanumeric symbols carried out by the coder. The diagnosis coding provided must be correct in accordance with the codes listed in ICD-10, the correct coding will affect hospital health financing. The research was conducted at Medika Citra Utama Hospital. This study aims to describe the coding procedures and accuracy of disease diagnosis using a cross sectional design. The population of cases in this study were medical records of dengue haemorrhagic fever patients from January to December 2022. The number of samples was 98 medical records. The sampling technique used was simple random sampling. The results of the study of diagnosis coding procedures carried out by the coder have not been in accordance with the steps that have been determined by ICD-10 volume 2 due to the busyness of officers in carrying out other activities and there are 78.6% of medical records that are appropriate and in accordance with the results of clinical examinations, 21.4% of medical records that are not appropriate and do not match the results of clinical examinations resulting in pending claims at the hospital. The conclusion of this study is that coder officers are expected to do coding referring to ICD-Volume 2 and pay attention to clinical examination in order to get accurate coding so that hospital claims are claimed on time.

Dengue Hemorrhagic Fever: Risk Factors in Pakistani Cohort

Background: Dengue fever is a mosquito-borne infectious disease with potential complications such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) and has fatality risk of greater than 20% if left untreated. There is lot of heterogeneity in factors predicting development of DHF in different populations. Objective: To determine clinical, biochemical and radiological parameters associated with risk of developing DHF in Pakistani population. Methods: This prospective observational study was conducted in Jinnah Hospital Lahore from October 2022 to December 2022. 180 patients with confirmed Dengue fever were included. Detailed history, clinical examination and laboratory/radiological investigations were performed. Patients were followed for development of DHF. Univariate analysis followed by logistic regression analysis was used to determine independent predictors for DHF. Results: Among 180 patients with Dengue fever with mean age of 33.04 (+14.12) and male to female ratio of 1.53/1 (109/71), we identified presence of mucosal bleeding {OR 4.7 (95% CI 2.05-10.78)p value <0.000}, abdominal pain {OR 2.73 (95% CI 1.17-4.38)p value 0.013}, persistent vomiting {OR 3.09 (95% CI 1.51-6.34)p value 0.002}, tender right hypochondrium {OR 3.98 (95% CI 1.94-8.16) p value <0.000} and presence of peri-cholecystic fluid {OR 7.78 (95% CI 3.25-18.63)p value < 0.000} to be significantly associated with risk of developing DHF with 83.6% accuracy on logistic regression analysis. Conclusion: Mucosal bleeding, right hypochondrium pain, persistent vomiting and presence of peri-cholecystic fluid in a patient of dengue fever predict risk of developing dengue hemorrhagic fever.

Longitudinal serum profiling in Dengue fever patients with different severities by using multiplex flavivirus antigen microarrays

Dengue fever is one of the most common arbovirus-infected diseases and typically progresses through the febrile, critical, and convalescent phases. While most Dengue Fever patients have mild symptoms, a few develop severe symptoms due to hyperimmune responses. However, the role of the humoral responses during the Dengue fever progression, especially in severe cases, is still unclear. Here, we developed multiplex Flavivirus Antigen Microarrays (FAMs) for profiling antibody specificities in different infection phases and Dengue fever severities. The FAMs comprised 17 nonstructural and envelope proteins from Flaviviruses that frequently infect humans, e.g., 4 serotypes of Dengue viruses, Zika virus, Japanese encephalitis virus, West Nile virus, Yellow fever virus, and Tick-borne encephalitis virus. We collected serum samples from Dengue fever patients with different degrees of severity, including mild (n = 17), hospitalized non-severe (n = 21), and severe (n = 19), during febrile (Day < 7) and convalescent (Day > 7) phases. We simultaneously profiled the serum IgG and IgM against multiple antigens on the FAMs to demonstrate the immunological signatures in Dengue fever patients with different severities and two infection stages. Compared to febrile phase, the convalescent phase of mild but not hospitalized cases exhibiting evoked Dengue-specific IgM. In IgG profiling, the convalescent phase showed generally higher immune responses compared to febrile phase. Moreover, in the febrile phase, the hospitalized patients displayed higher IgG levels against 4 serotypes of Dengue viruses, Zika virus, and West Nile virus compared to mild patients, suggesting early and strong humoral responses. This study provides a valuable tool for monitoring antibody specificities and advances our understanding of humoral responses along with Dengue fever severities.

The Mathematical Modeling of the Host-Virus Interaction in Dengue Virus Infection: A Quantitative Study.

Infectious diseases, such as Dengue fever, pose a significant public health threat. Developing a reliable mathematical model plays a crucial role in quantitatively elucidating the kinetic characteristics of antibody-virus interactions. By integrating previous models and incorporating the antibody dynamic theory, we have constructed a novel and robust model that can accurately simulate the dynamics of antibodies and viruses based on a comprehensive understanding of immunology principles. It explicitly formulates the viral clearance effect of antibodies, along with the positive feedback stimulation of virus-antibody complexes on antibody regeneration. In addition to providing quantitative insights into the dynamics of antibodies and viruses, the model exhibits a high degree of accuracy in capturing the kinetics of viruses and antibodies in Dengue fever patients. This model offers a valuable solution to modeling the differences between primary and secondary Dengue infections concerning IgM/IgG antibodies. Furthermore, it demonstrates that a faster removal rate of antibody-virus complexes might lead to a higher peak viral loading and worse clinical symptom. Moreover, it provides a reasonable explanation for the antibody-dependent enhancement of heterogeneous Dengue infections. Ultimately, this model serves as a foundation for constructing an optimal mathematical model to combat various infectious diseases in the future.

THE RELATION BETWEEN THE NEUTROFIL LYMPHOCYTE RATIO (NLR) AND THE DEGREE OF DENGUE HEMORRHAGIC FEVER IN THE INPATIENT INSTALLATION OF ARI CANTI HOSPITAL FOR THE PERIOD OF APRIL 2022 – MAY 2023

Dengue Hemorrhagic Fever is caused by dengue virus infection which can cause death and cause an outbreak. Neutrophil lymphocyte ratio (NLR) is one of the cheap laboratory parameters and can predict plasma leakage in the critical period of dengue hemorrhagic fever. This study aims to determine the profile of dengue hemorrhagic fever patients and the relationship between the neutrophil lymphocyte ratio and the degree of dengue hemorrhagic fever in patients treated at Ari Canti Hospital for the period April 2022 – May 2023. This research is a retrospective analytical study with a cross-sectional approach using secondary data from archives at the Ari Canti Hospital Inpatient Installation for the period April 2022-May 2023. Data collection in the form of gender, age, neutrophil lymphocyte ratio and degree of dengue hemorrhagic fever was carried out using the convenient purposive sampling method. This study shows that the highest age group is the 26-35-year age group 35.7%, the highest gender is male 55.3% with cases of dengue hemorrhagic fever without shock 89.2% and a neutrophil lymphocyte ratio (NLR) of &gt;2 as much as 64.2%. The result of Mann Whitney non-parametric test, showed that p value &lt;0.0001. There is a significant relationship between NLR and the degree of dengue hemorrhagic fever in patients hospitalized at Ari Canti Hospital in April 2022, May 2023.&#x0D; Keywords : dengue virus., dengue hemorrhagic fever., hospitalization., neutrophil lymphocyte ratio

Role of granulocyte colony stimulating factor (G-CSF) in dengue patients with severe thrombocytopenia.

To determine the effects of granulocyte colony-stimulating factor in improving platelet count in patients with dengue fever. The retrospective, cross-sectional study was conducted at Northwest General Hospital and Research Centre, Peshawar, Pakistan, between January 2021 and October 2022, and comprised dengue fever inpatients regardless of age and gender who received granulocyte colony-stimulating factor subcutaneously. The impact of colony-stimulating factor on platelet and white blood cell counts as well as any unfavourable consequences was assessed. Convenient sampling was used and a structured format was used for data collection. Data was analysed using SPSS 21. Of the 100 patients, 67(67%) were males and 33(33%) were females. The largest age group was that of >55 years 31(31%), fever was present in all the 100(100%) cases, bleeding in 18(18%) and platelet count <30,000 in 83(83%) cases. Dengue fever was confirmed by rapid dengue nonstructural protein 1 antigen in 76(76%) cases, dengue immunoglobulin G antibody test 28(28%), and immunoglobulin M antibody test in 31(31%) cases. Overall, 72(72%) patients received only one dose of granulocyte colony-stimulating factor. Post-administration, a substantial rise in the median platelet and white blood cell counts was seen compared to the baseline (p<0.05) on day 2. Granulocyte colony-stimulating factor helped increase platelet and white blood cell counts quickly in dengue fever patients.

HEMATOLOGY PROFILES AND DISEASE SEVERITY OF PEDIATRIC DENGUE VIRUS INFECTION AT A TERTIARY HOSPITAL IN SURABAYA, INDONESIA

Highlights Dengue virus infections exhibit a spectrum of clinical manifestations, ranging from asymptomatic cases to severe disease, with the potential for fatalities if not managed effectively. Hematology factors significantly contribute to the severity of dengue virus infection. Abstract Background: The escalating incidence of dengue cases in Surabaya, Indonesia, underscores the imperative to comprehend the hematology profiles and disease severity in pediatric patients affected by dengue virus infections (DVI). As the prevalence of DVI continues to surge, understanding the nuanced clinical manifestations becomes paramount for effective management and mitigation of the disease burden. Objective: This study aimed to characterize the hematology profiles and the disease severity of dengue virus infections (DVI) among pediatric patients hospitalized at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia throughout 2019. Material and Method: A retrospective descriptive cross-sectional study was conducted using secondary data from medical records. Pediatric patients aged six months to 18 years were enrolled. A total sampling method comprised 67 patients meeting the inclusion criteria. Result: Severe thrombocytopenia was most commonly observed in dengue hemorrhagic fever (DHF) III cases (36.4%), while leukopenia was predominant in DF cases (42.2%). High hematocrit levels were more prevalent in DHF III cases (27.3%), and high hemoglobin levels were most frequently identified in DHF II and DHF III cases (33% in each case). Significant differences in DVI severity were observed in platelets and hemoglobin levels (p=0.0002 and p=0.0066, respectively) but not in leukocyte and hematocrit levels. Conclusion: Mild thrombocytopenia was prevalent in Dengue Fever (DF), while severe thrombocytopenia was most prevalent in Dengue Hemorrhagic Fever (DHF) grade III. Leukopenia was prominent in DF patients, and platelets and hemoglobin levels varied across severity of DVI. These findings provide insights for improved clinical management and diagnostic criteria refinement.

Thrombocytopenia in Dengue Fever and Its Correlation with Serum Vitamin B12 Level

Background: The most prevalent and significant arboviral disease affecting humans is dengue. It is spread by the Aedes genus of mosquitoes, which are common in tropical and subtropical regions of the world. Thrombocytopenia occurs commonly among patients suffering from dengue fever, making them more prone to hemorrhagic complications. The predisposing factors leading to thrombocytopenia and bleeding manifestations after dengue infection are not well-known Objective: We attempted to determine the frequency of thrombocytopenia and its co-relation with serum vitamin B12 levels among dengue patients. Methods: This Cross-sectional study after taking approval from the hospital ethical committee was carried out at the Department of Medicine PNS Rahat Hospital from 01/06/2022 to 30/11/2022 over six months. A total of 145 diagnosed patients suffering from dengue fever fulfilling the inclusion criteria were enrolled. Patients with concomitant sepsis, malignancy, autoimmune disorder, hematological disorder, and drugs causing thrombocytopenia were not included in the study. Precise history and bio data were entered in the Pro forma. Patients were investigated for CBC, VIT B12 LEVEL, and other routine investigations. SPSS v27 was used for data analysis. P-value≤0.05 was considered as significant. Results: Out of a total of 145 patients, 78 (53.8%) were males and 64 (46.2%) were females With a mean age of 38.22±15.93 years.139 patients (95%) had thrombocytopenia with variable severity, and platelet count is positively correlated with serum vitamin B12 Level (p=0.000). Conclusion: Dengue fever patients with thrombocytopenia were found to have vitamin B12 deficiency. Thrombocytopenic patients may require more platelet transfusion and longer hospitalizations.

Uncovering the knowledge gap: A web-based survey of healthcare providers' understanding and management of dengue fever in East Azerbaijan, Iran.

Dengue fever (DF) is increasingly recognized as one of the world's major mosquito-borne diseases and causes significant morbidity and mortality in tropical and subtropical countries. Appropriate and timely diagnosis and risk stratification for severe disease are crucial in the appropriate management of this illness. Healthcare providers (HCPs) play a key role in dengue fever diagnosis, management and prevention. The present study was conducted to determine the knowledge, attitudes and practices (KAP) among HCPs in East Azerbaijan Province, Iran. A cross-sectional survey among 948 HCPs, using a structured questionnaire, was conducted in East Azerbaijan Province from May to July 2022. Data analysis was undertaken using descriptive methods, the Chi-square test or Fisher's exact test, and logistic regression. A P-value <0.05 was considered for statistical significance. Out of the 948 (68.5% female) respondents, 227 were physicians and 721 were health professionals. The knowledge level of DF was found to be largely inadequate in the present study population (80.4%). The physician vs. health professional were a significant factor in differentiating attitude scores. The mean practice score regarding DF prevention and control measures among respondents was 8.40±1.97. The findings call for urgent continuous education and training courses to increase KAP levels and increased capacity and capability for DF prevention and control. This is of outmost importance for the first point of care of DF patients.

PENGARUH TANAMAN HERBAL TERHADAP PENINGKATAN KADAR TROMBOSIT PADA ANAK DEMAM BERDARAH DENGUE (DBD)

Dengue hemorrhagic fever is a disease caused by the dengue virus where the virus has 4 variations, namely DEN-1, DEN-2, DEN-3, DEN-4. Dengue virus infection is mediated by a vector in the form of the Aedes aegypti mosquito which is widely spread throughout tropical areas, one of which is Indonesia. Independent actions that can be taken during home treatment using herbal plants. This literature review aims to determine the effect of herbal plants on increasing platelet levels in children. Qualitative research with a literature review approach with a search method using an electronic data base. The inclusion criteria used were using an intervention journal to overcome the problem of dengue fever using herbal remedies that can be accessed in full text. Based on a literature review in 4 journals, namely herbal plant therapy, namely the administration of Angkak, guava juice, date palm juice, and boiled papaya leaves, as an effort to increase platelet levels in dengue fever patients. The approach used is to collect and analyze research articles regarding herbal plants on increasing platelet levels in children. Articles were collected through the electronic database EBSCO and Google Schoolar using the keywords: herbal plants, dengue fever, platelets and children. The criteria for articles used are those published in the period between 2011-2022.

Pemodelan Kadar Hemoglobin pada Pasien Demam Berdarah di Kota Samarinda Menggunakan Regresi Semiparametrik Spline Truncated

This article discusses the innovation of statistical modeling in regression analysis with a semiparametric approach applied to health data. Regression analysis is a method in statistics that takes a lot of roles in statistical modeling. Regression analysis is used to model the relationship between the independent variable (x) and the dependent variable (y). There are three approaches to regression analysis, namely parametric, nonparametric, and a combination of the two, namely semiparametric. Semiparametric regression is used when the dependent variable has a known relationship with some of the independent variables and has an unknown pattern of a relationship with some of the other independent variables. The purpose of this study was to model hemoglobin levels in dengue fever patients, with the independent variables used being the number of hematocrits (x1) and the number of leukocytes (x2). The method used is spline truncated semiparametric regression. The truncated spline estimator was chosen for the nonparametric component because it has many advantages in modeling, one of which is being able to model patterns where the form of the relationship is unknown. The parameter estimation used is the maximum estimation. Selection of the optimal knot point using Generalized Cross-Validation (GCV). Based on the results of the analysis, the truncated spline semiparametric regression model was obtained which was applied to the hemoglobin level data in a model with three knots which have a coefficient of determination of 89.074%. Based on the results of testing the hypothesis simultaneously, it can be concluded that simultaneously the independent variable has a significant effect on the dependent variable. In the partial test, it is concluded that the variables x1 and x2 have a significant influence on the dependent variable y .

Analisis Jumlah Trombosit Dan Leukosit Pada Pasien Dengue Hemorrhagic Fever (DHF) Di Rumah Sakit Umum Daerah Kabupaten Barru

Dengue hemorrhagic fever (DHF) is a chronic fever disease caused by infection with the dengue virus which is transmitted through the bite of the Aedes aegypti and Aedes albopictus mosquitoes. Laboratory abnormalities that are often found in DHF patients are thrombocytopenia and leukopenia. This study aims to determine the results of examination of platelet and leukocyte counts in dengue hemorrhagic fever (DHF) patients. This study used a descriptive design with the population being all dengue hemorrhagic fever (DHF) patients at the Barru District General Hospital. The sample consisted of 30 DHF patients whose platelet and leukocyte counts were checked using a hematology analyzer for 3 consecutive days of hospitalization. The sampling technique in this research is the purposive sampling method. The results of the study showed that there were 30 DHF patients consisting of 14 (47%) men and 16 (53%) women with the highest age found `DHF being 8 - 12 years old, 10 people (33.33%). On the first day of hospitalization, 29 people experienced thrombocytopenia and 1 person had normal platelets. On the second day of hospitalization, 25 people experienced thrombocytopenia and 5 people had normal platelets. On the third day of hospitalization, 11 people experienced thrombocytopenia and 19 people had normal platelets. On the first day of hospitalization, 17 people experienced leukopenia, 11 people had normal leukocytes and 2 people had leukocytosis. On the second day of hospitalization, 8 people experienced leukopenia and 22 people had normal leukocytes. On the third day of hospitalization, 3 people experienced leukopenia and 27 people had normal leukocytes. This study shows that the majority of DHF patients experience thrombocytopenia while the platelet count tends to be normal.

PENGETAHUAN, KUALITAS HIDUP DAN BIAYA SAKIT PASIEN DENGUE DI RS PKU MUHAMMADIYAH GAMPING

The incidence of dengue virus infection in the D.I. Yogyakarta reached 3,618 cases in 2020. Based on its clinical manifestations, dengue virus infection is divided into Dengue Fever (DF), Dengue Haemorrhagic Fever (DHF), and Dengue Shock Syndrome (DSS). This study aims to identify the level of knowledge, quality of life, and costs of dengue patients at PKU Muhammadiyah Gamping Hospital from March 2021 to October 2021. This study used a cross-sectional design. The measurement of the patient's knowledge level used a questionnaire knowledge of dengue, while the quality of life was assessed using EQ-5D-5L for adult patients and EQ-5D-Y for pediatric patients. The cost of illness data from the hospital finance database. This study involved 31 respondents with the characteristics aged 16-40 years (54.84%), male (87.1%), using BPJS insurance (80.65%), and an average length of stay of 4 days (51.61%). The patient's level of knowledge about dengue, knowledge of dengue prevention, and dengue prevention behavior reached 74.20% (sufficient), 74.20% (sufficient), and 77.42% (sufficient) respectively. The quality of life of dengue patients reached 100% and 85.2% in DF patients, while the DHF patients felt a few anxious/depressed (sad). The average cost of illness in DF patients was Rp. 2,796,386 and Rp. 3,378,537 in DHF patients.

Complement receptor type 1 and 2 (CR1 and CR2) gene polymorphisms and plasma protein levels are associated with the Dengue disease severity

The pathological outcome of dengue disease results from complex interactions between dengue virus (DENV) and host genetics and immune response. Complement receptor types 1 and 2 (CR1 and CR2) mediate complement activation through the alternative pathway. This study investigated the possible association of genetic polymorphisms and plasma levels of CR1 and CR2 with dengue disease. A total of 267 dengue patients and 133 healthy controls were recruited for this study. CR1 and CR2 gene polymorphisms were analyzed by Sanger sequencing, while plasma CR1 and CR2 levels were measured by ELISA. The frequency of the CR1 minor allele rs6691117G was lower in dengue patients and those with severe dengue compared to healthy controls. Plasma CR1 and CR2 levels were decreased in dengue patients compared to healthy controls (P < 0.0001) and were associated with platelet counts. CR1 levels were lower in dengue patients with warning signs (DWS) compared to those without DWS, while CR2 levels were decreased according to the severity of the disease and after 5 days (T1) and 8 days (T2) of follow-up. CR2 levels were decreased in dengue patients positive for anti-DENV IgG and IgM and patients with bleeding and could discriminate DWS and SD from dengue fever patients (AUC = 0.66). In conclusion, this study revealed a reduction in CR2 levels in dengue patients and that the CR1 SNP rs6691117A/G is associated with the dengue severity. The correlation of CR2 levels with platelet counts suggests that CR2 could be an additional biomarker for the prognosis of severe dengue disease.

Unmasking the Hidden Threat of Cardiac Involvement in Dengue Fever: A Critical Longitudinal Study.

Dengue fever (DF) arises from the dengue virus (DENV), a common viral illness transmitted by arthropods. This medical condition has the potential to result in severe complications, including but not limited to liver failure, disseminated intravascular coagulation, dengue encephalopathy, myocarditis, acute renal failure, and hemolytic uremic syndrome. Evaluating cardiac manifestations in dengue is crucial for timely intervention and intensive care to save patients' lives. A longitudinal study involved 104 dengue fever patients admitted to the Department of Medicine at New Civil Hospital, Surat, between May 2021 and October 2021, to identify potential cardiac involvement. The study found that out of the 104 patients, 28 (26.92%) showed cardiac involvement based on clinical manifestations. Among these patients, 28 (26.92%) exhibited abnormal ECG results, and 39 (37.50%) showed elevated creatine kinase-MB (CK-MB) levels. Of the 28 patients who showed ECG changes, 14 (50%) displayed abnormal 2D-echocardiography (ECHO) results. The most common electrocardiographic anomaly was a T-wave inversion in V1-V4. The predominant 2D-ECHO finding was mild pericardial effusion. Cardiac involvement in dengue presents atypically and can lead to conditions like myocarditis, arrhythmias, cardiac failure, or shock. Assessing cardiac manifestations in dengue patients is pivotal for appropriate management.

Serotype-specific Differences among Patients of Dengue Fever Admitted to a Tertiary Care Hospital in Western Maharashtra

Abstract Context: Dengue is the most prevalent vector-borne disease affecting 100–400 million individuals every year. Dengue virus (DENV) has four main serotypes (DENV 1-4) with a 5th one being discovered in Malaysia in 2013. Previous studies have shown DENV 2 and DENV 3 to be the predominant serotypes in the region. Aim: We planned to carry out the serotyping of the DENV from the sera of admitted patients to determine the prevailing serotype between October 2022 and December 2022 and study their clinical and laboratory parameters. Materials and Methods: All patients admitted to our hospital with an acute febrile illness of 2–7-day duration with a positive dengue serology (NS1 antigen or dengue immunoglobulin M antibody positivity by rapid immunochromatographic card test) were recruited for the study and underwent typing of dengue serotypes by multiplex reverse transcription-polymerase chain reaction (RT-PCR). Results: Out of 131 patients, 118 were positive for DENV infection by multiplex RT-PCR. 34.7% had DENV 1, 60.2% had DENV 2, and 5.1% had DENV 3, whereas no cases for DENV 4 were found. The most common clinical features across all serotypes were fever, headache, nausea, and vomiting. DENV 2 infection was significantly associated with severe thrombocytopenia (P = 0.010). 71.18% of cases had raised liver transaminases without any significant differences among serotypes. Seven cases had coinfection of dengue and chikungunya virus. Conclusion: DENV 2 seems to be the prevalent serotype among patients admitted with dengue fever in Western Maharashtra.

Characterization of soluble TLR2 and CD14 levels during acute dengue virus infection

Dengue virus infection results in a broad spectrum of diseases ranging from mild dengue fever (DF) to severe dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Hitherto, there is no consensus biomarker for the prediction of severe dengue disease in patients. Yet, early identification of patients who progress to severe dengue is pivotal for better clinical management. We have recently reported that an increased frequency of classical (CD14 ++CD16−) monocytes with sustained high TLR2 expression in acutely infected dengue patients correlates with severe dengue development. Here, we hypothesized that the relatively lower TLR2 and CD14 expression in mild dengue patients is due to the shedding of their soluble forms (sTLR2 and sCD14) and that these could be used as indicators of disease progression. Therefore, using commercial sandwich ELISAs, we evaluated the release of sTLR2 and sCD14 by peripheral blood mononuclear cells (PBMCs) in response to in vitro dengue virus (DENV) infection and assessed their levels in acute-phase plasma of 109 dengue patients. We show that while both sTLR2 and sCD14 are released by PBMCs in response to DENV infection in vitro, their co-circulation in an acute phase of the disease is not always apparent. In fact, sTLR2 was found only in 20% of patients irrespective of disease status. In contrast, sCD14 levels were detected in all patients and were significantly elevated in DF patients when compared to DHF patients and age-matched healthy donors. Altogether, our results suggest that sCD14 may help in identifying patients at risk of severe dengue at hospital admittance.

Skrining Fitokimia Polifenol Ekstrak Etanol Daun Ubi Jalar Kuning (Ipomea batatas) dari Madiun

Yellow sweet potato (Ipomoea batatas L.) leaves are an easy source of polyphenols because they are often not used after harvest. This leaf began to be used as an herbal ingredient or alternative treatment for the community, empirically showing improvement in conditions and symptoms in Dengue Fever patients. This study determined the content of secondary metabolites from yellow sweet potato leaves. Methods: Research using laboratory testing methods was carried out at the Herbal Materia Medika Laboratory in Batu. Yellow-green sweet potato leaves, as much as 200 grams were collected from the Madiun, East Java. It was extracted by maceration using 2L of ethanol 96% for 2 days and evaporated in a vacuum rotary evaporator to thick extract. Furthermore, phytochemical screening tests were carried out. Results: The results of this study indicated that the yellow sweet potato leaves contained of Alkaloids, Flavonoids, Tannins, Saponins, Terpenoids, Triterpenoids, and Phenols. So the yellow sweet potato leaves are very representative as herbal products.

SEROPREVALANCE OF CHIKUNGUNYA IN DENGUE NEGATIVE SAMPLES AT A TERTIARY CARE HOSPITAL – A HIDDEN BURDEN

Chikungunya fever is an arthropod-borne viral disease. Chikungunya and Dengue have a common vector and shows similar clinical presentation. Even though Chikungunya virus infection is self-limiting and less lethal, more than 30% of affected individuals will have post chikungunya chronic polyarthralgia which will affect the patient's quality of life. Reverse transcriptase polymerase chain reaction has high sensitivity and specicity in diagnosis but Enzyme linked immunosorbent assay looks more economical and it provides diagnostic information as well as insights into immune response to CHIKV infection. This is a prospective study conducted from July 2022 to December 2022 in a tertiary care center. Blood samples were collected from the patients presented with acute febrile illness. The samples which were negative for dengue by serological methods were subjected to IgM capture ELISA for chikungunya. Total of 773 samples were negative for dengue fever in patients with acute febrile illness during the study period. These samples were subjected to IgM capture ELISA for Chikungunya. Out of 773 samples 75 samples were positive for chikungunya virus. Total prevalence in the study was 9.7%. Our Study has shown equal sex distribution. Majority of the patients are from urban places. More positive cases were reported in the month of September. Our study has shown that Chikungunya fever is the most important viral illness to be considered in cases of acute febrile illness especially in endemic areas like India, where it goes undetected because evaluation will be more towards dengue fever rather than CHIKV infection. Timely and appropriate management can prevent the complications due to chikungunya and can assist in the prediction and control of outbreaks.