Dengue Fever Patients Research Articles

Dengue virus is involved in insulin resistance via the downregulation of IRS-1 by inducing TNF-α secretion

During the epidemic, the individuals with underlying diseases usually have a higher rate of mortality. Diabetes is highly prevalent worldwide, making it a frequent comorbidity in dengue fever patients. Therefore, understanding the relationship between dengue virus (DENV) infection and diabetes is important. We first demonstrated that DENV-3 infection down-regulated the expression of IRS-1. In vitro, treatment of HepG2 cells with TNF-α inhibitors and siRNA proved that after DENV-3 infection in HepG2 cells, cellular TNF-α secretion was increased, which negatively regulated IRS-1, thereby leading to an insulin-resistant state. In vivo, DENV-3 induced insulin resistance (IR) in hepatocytes by promoting the secretion of TNF-α and inhibiting the expression of IRS-1 was proved. In vivo approaches also showed that after DENV-3 infection, TNF-α levels in the serum of C57BL/6 mice with insulin resistance increased, and upon TNF-α antagonist III treatment, IRS-1 expression in the liver, reduced by infection, was upregulated. In addition, transcriptomic analysis revealed more negative regulatory events in the insulin receptor signaling pathway after DENV-3 infection. This is the first report of a link between DENV-3 infection and insulin resistance, and it lays a foundation for further research.

Pattern of clinical presentation, lab findings and mortality risk among patients of dengue fever admitted in pediatric intensive care unit in a tertiary care centre in South-east Rajasthan

Background: India is one of the 7 identified countries in south-east Asia region regularly reporting dengue fever outbreaks. Dengue can present with varying degrees of severity of illness in Indian children, present study is aimed at studying the clinical presentation lab findings and mortality risk among patients of dengue fever admitted in PICU in a tertiary care centre in South-east Rajasthan. Methods: It is a retrospective observational study. All dengue seropositive patients admitted in PICU from August 2021 to October 2021 were included in the study. Patients were classified based on National Vector Borne Disease Control Program (NVBDCP). Clinical presentation laboratory findings and mortality risk among patient were studied. esults: Out of 61 patients with dengue, 28(46%) were males and 33(54%) were females. Fever was present in 100% cases followed by GI symptoms vomiting(54.1%), pain abdomen(52.5%) and bleeding manifestations(26.2%) were common presenting complaints. On examination common findings were conjunctival congestion (57%) , hepatomegaly (44%) and flushing (26%). Among complications hypotension/shock (51%) was the commonest followed by hemorrhage (31%), pleural effusion and hepatitis each 21%. Most common bleeding manifestation was melena (19%). Most common affected age group was between10-15 years (42.6%).

Hematological and hepatic profile of dengue patients presenting to a tertiary care hospital in Mumbai

Objective: To assess the pattern of hematological and hepatic involvement in patients of dengue fever. Methods: This study was performed in a tertiary care center in Mumbai, India. 142 patients diagnosed with dengue who were admitted between January 2016 to December 2017 enrolled for the study. Patients Demographic data, clinical history, examination findings, and investigations including complete blood count and liver profile were done. Results: Highest incidence of dengue was seen in the age group of 21-30. More males were affected than females. Highest incidence was seen in monsoon months in Mumbai (August-September). Commonest symptom was fever followed by rigor, chills, bodyache and headache. Altered sensorium was the rarest. In investigations thrombocytopenia was the commonest followed by raised AST and ALT. Conclusion: As Dengue causes significant mortality and morbidity,there is excess burden on healthcare infrastructure of metro cities in India, knowing about the disease behavior is of paramount importance. Doing simple and easily available investigations can be vital in predicting disease severity and need of inpatient and intensive care in Dengue patients.

Economic burden of dengue fever in China: A retrospective research study.

BackgroundDengue fever has been a significant public health challenge in China. This will be particularly important in the context of global warming, frequent international travels, and urbanization with increasing city size and population movement. In order to design relevant prevention and control strategies and allocate health resources reasonably, this study evaluated the economic burden of dengue fever in China in 2019.MethodsThe economic burden of dengue fever patients was calculated from both family and the organisation perspectives. A survey was conducted among 1,027 dengue fever patients in Zhejiang, Chongqing, and Yunnan Provinces. Treatment expenses, lost working days, and insurance reimbursement expenses information were collected to estimate the total economic burden of dengue fever patients in 2019. The expenditures related to dengue fever prevention and control from government, Center for Disease Control and Prevention (CDC), communities and subdistrict offices of 30 counties (or districts) in Zhejiang Province and Chongqing City were also collected.ResultsThe direct, indirect and total economic burden for dengue fever patients in 2019 in the three Provinces were about 36,927,380.00 Chinese Yuan (CNY), 10,579,572.00 CNY and 46,805,064.00 CNY, respectively. The costs for prevention and control of dengue fever for the counties (or districts) without cases, counties (or districts) with imported cases, and counties (or districts) with local cases are 205,800.00 CNY, 731,180.00 CNY and 6,934,378.00 CNY, respectively. The total investment of dengue fever prevention and control in the 30 counties in China in 2019 was approximately 3,166,660,240.00 CNY.ConclusionThe economic burden of dengue fever patients is relatively high, and medical insurance coverage should be increased to lighten patients’ direct medical economic burden. At the same time, the results suggests that China should increase funding for primary health service institutions to prevent dengue fever transmission.

CORRELATION OF CARDIAC MANIFESTATIONS IN DENGUE

Objectives: This study was done to study the prevalence of cardiac manifestations of dengue fever in patients presenting to our hospital and to find out the correlation of cardiac manifestations with the warning signs of dengue infection The study was conducted at Government Villupuram Medical College and Hospital,a tertiary careMethods: hospital in the month of July to December 2021. One hundred consecutive patients aged 15 years or more with positive dengue serology were interviewed and examined. ECG was done for all patients and selected patients underwent echo evaluation and troponin testing. The data was analyzed using statistical significance tests Thirty-three patientsResults: had no warning signs, 59 patients had one warning sign or the other. Eight patients had severe dengue. The minimum pulse rate was 32/ minute. The most common cardiac abnormalities noted were rhythm abnormalities of which the commonest was sinus bradycardia, found in 34 percent. There was statistically significant correlation between cardiac manifestations and all the warning signs except persistent vomiting. Among severe dengue, fluid accumulation causing respiratory distress was found to have a significant correlation with the cardiac manifestations The mostConclusions: common cardiac manifestations noted were transient rhythm abnormalities, of which sinus bradycardia was the commonest. There was no evidence of Myocarditis in any of the patients .There was statistically significant correlation between cardiac manifestations and all the warning signs except persistent vomiting. Among severe dengue, fluid accumulation causing respiratory distress was found to have a significant correlation with the cardiac manifestations.

PREVALENCE AND SPECTRUM OF OPHTHALMIC MANIFESTATIONS OF DENGUE: OUR EXPERIENCE IN A NORTH INDIAN TERTIARY CARE INSTITUTE

Objective: This article puts forward various ocular findings and its prevalence in hospitalized patients with confirmed Dengue serology. The aim is to spread awareness about these findings and call for complete eye examination in patients of dengue fever so that the ocular findings are not missed. Methods: This is a cross-sectional study, conducted on confirmed cases of 112 dengue patients in Dengue isolation ward in a tertiary care hospital, Government Medical College, Patiala, India, during and after the monsoon season. Results: Various fundus findings in dengue fever seen in our study are Dot blot hemorrhages, cotton wool spots, macular hemorrhages, macular edema, Roth spots, vascular sheathing, hard exudates, and sub-conjunctival hemorrhage. Cumulative prevalence of these findings was 9.82% in hospitalized patients of dengue fever. Blurring of vision was also a common symptom. Conclusion: Ocular findings do occur in dengue fever, along with other systemic manifestations such as fever, headache, myalgia, arthralgia, retro-orbital pain, hemorrhagic fever, and shock syndrome. Ocular examination should be undertaken in all patients with dengue fever so that these findings are not missed. Further studies are needed to ascertain its pathophysiology.

Simple clinical and laboratory predictors to improve empirical treatment strategies in areas of high scrub typhus and dengue endemicity, central Vietnam.

BackgroundDengue fever is highly endemic in Vietnam, but scrub typhus—although recognized as an endemic disease—remains underappreciated. These diseases together are likely to account for more than half of the acute undifferentiated fever burden in Vietnam. Scrub typhus (ST) is a bacterial disease requiring antimicrobial treatment, while dengue fever (DF) is of viral etiology and does not. The access to adequate diagnostics and the current understanding of empirical treatment strategies for both illnesses remain limited. In this study we aimed to contribute to the clinical decision process in the management of these two important etiologies of febrile illness in Vietnam.MethodsUsing retrospective data from 221 PCR-confirmed scrub typhus cases and 387 NS1 protein positive dengue fever patients admitted to five hospitals in Khanh Hoa province (central Vietnam), we defined predictive characteristics for both diseases that support simple clinical decision making with potential to inform decision algorithms in future. We developed models to discriminate scrub typhus from dengue fever using multivariable logistic regression (M-LR) and classification and regression trees (CART). Regression trees were developed for the entire data set initially and pruned, based on cross-validation. Regression models were developed in a training data set involving 60% of the total sample and validated in the complementary subsample. Probability cut points for the distinction between scrub typhus and dengue fever were chosen to maximise the sum of sensitivity and specificity.ResultsUsing M-LR, following seven predictors were identified, that reliably differentiate ST from DF; eschar, regional lymphadenopathy, an occupation in nature, increased days of fever on admission, increased neutrophil count, decreased ratio of neutrophils/lymphocytes, and age over 40. Sensitivity and specificity of predictions based on these seven factors reached 93.7% and 99.5%, respectively. When excluding the “eschar” variable, the values dropped to 76.3% and 92.3%, respectively.The CART model generated one further variable; increased days of fever on admission, when eschar was included, the sensitivity and specificity was 95% and 96.9%, respectively. The model without eschar involved the following six variables; regional lymphadenopathy, increased days of fever on admission, increased neutrophil count, increased lymphocyte count, platelet count ≥ 47 G/L and age over 28 years as predictors of ST and provided a sensitivity of 77.4% and a specificity of 90.7%.ConclusionsThe generated algorithms contribute to differentiating scrub typhus from dengue fever using basic clinical and laboratory parameters, supporting clinical decision making in areas where dengue and scrub typhus are co-endemic in Vietnam.

W077 Correlation between thrombocytopenia and serum aminotransferases level in dengue fever patient

W077 Correlation between thrombocytopenia and serum aminotransferases level in dengue fever patient

Dermatological Manifestations in Dengue Fever

Objective: To assess the frequency of skin & mucosal manifestations in dengue fever patients. Study design: Cross-sectional study. Place and duration of study: Patients admitted in dermatology & medicine departments of Akhtar Saeed Trust Hospital Lahore were included in the study. Method of study: This cross-sectional study was conducted in departments of dermatology & medicine at Akhtar Saeed Trust Hospital Lahore for a period of 3 months from Separation 3021 till December 2021. After taking consent a total of 60 patients of suspected dengue fever were enrolled for this study. Their demographic data was noted down with skin & mucosal findings in a predesigned performa. Their frequencies were calculated & analysed in SPSS version 11. Results: Out of 60 patients, 38 patients (63.3%) were males & 22 patients (36.6%) were females. Mean age of patients was 35.20 years. 13 patients (21.6%) had no skin findings and 47 patients (78.4%) had skin findings. The commonest skin finding was pruritus present in 24 patients (40%), followed by facial flushing in 15 patients (25%). Petechial rash and burning sensation were found in 7 patients (11.6%). Among the mucosal findings, eye involvement was the commonest present in 15 patients (25%). Conclusion: Cutaneous and mucosal manifestations are an important part of dengue fever. These findings also help in assessing the disease progress. Key words: Dengue fever, cutaneous manifestations.

Ultrasound Findings in Dengue Fever: A Single Center Study

Dengue fever is the most quickly spreading and transmitted mosquito bite disease, with an annual incidence of around 50 million people. Plasma leakage during dengue fever results in the development of serious consequences. Objective: To determine the ultrasonography findings used for diagnosing plasma leakage in patients managed with diagnosis of dengue fever Study Design: Cross sectional descriptive study Setting: Department of Radiologist, Bahawal victoria hospital Bahawalpur. Duration of Study: 4 months (August to November, 2021) Methodlogy: All the patients of dengue fever admitted in the dengue isolation ward of the hospital, diagnosed using anti-dengue serology were enrolled to be included in the study after a written informed consent from the parents or attendants. All these patients were sent to a consultant radiologist for ultrasound abdomen to look for ascites, pleural effusion, gall bladder thickness, liver size, hepatomegaly, spleen size and splenomegaly. Results: Dengue fever is one of the most frequent diseases in our region of the globe. It manifests itself in a variety of ways, but early detection and treatment can help to reduce case fatality rates. This demonstrates the ultrasonography results that might be observed in Dengue Fever patients showing capillary leakage are seen in around thirty percent of the patients. Further studies should be done to correlate ultrasonography findings with the severity of dengue. Conclusion: Dengue fever is one of the most frequent diseases in our region of the globe. It manifests itself in a variety of ways, but early detection and treatment can help to reduce case fatality rates. This demonstrates the ultrasonography results that might be observed in Dengue Fever patients showing capillary leakage are seen in around thirty percent of the patients. Further studies should be done to correlate ultrasonography findings with the severity of dengue. Keywords: Dengue, splenomegaly, Ultrasonography, Ascites, Pleural effusion, Gall bladder thickness

Clinical and Laboratory Features of Dengue Fever Patients in Riau, Indonesia

Clinical and Laboratory Features of Dengue Fever Patients in Riau, Indonesia

To determine the correlation of severity of thrombocytopenia, with vitamin B12 deficiency in patients of dengue fever

Objective: To determine the correlation between the severity of thrombocytopenia, hospital stay, hematological, & biochemical parameter with vitamin B12 deficiency, &role of vitamin B12 supplementation in patients of dengue fever. Methodology: 100 dengue patient were included in the study. All baseline parameter were examined along with platelet count and vitamin B12 level. Results: platelets count and vitamin B12 were low in dengue patient and platelet count is positively correlated with vitamin b 12 level.(r=0.57, p value < 0.05). Conclusion: a significant positive correlation between the severity of thrombocytopenia &vitamin B12 deficiency was observed. Vitamin B12 supplementation improved the hematological and biochemical parameters also having a significant association with platelet recovery in the form of less requirement of random donor platelets transfusion.

Ophthalmic manifestations in seropositive dengue fever patients during epidemics caused by predominantly different dengue serotypes

PurposeDengue fever (DF) epidemics in Singapore in 2005–2006 and 2007 were caused predominantly by dengue virus serotypes 1 (DENV-1) and 2 (DENV-2) respectively. We investigated the prevalence of ophthalmic manifestations during these consecutive epidemics. MethodsSeropositive DF patients admitted to the hospital during two separate dengue epidemics were enrolled from June 2005 to December 2007. Demographic, ophthalmic, and laboratory data were collected. The primary outcome measures were differences in ophthalmic and laboratory features across the two epidemics. Factors associated with increased risk of developing various DF-related ophthalmic manifestations were the secondary outcome measures. ResultsOf the 115 patients enrolled, 109 (94.7%; 33 in 2005–2006 and 76 in 2007) completed the eye screening protocol. Majority of patients were Chinese (65, 59.6%) and males (81, 74.3%). The mean age was 40.8 years (range, 18–87). Colour vision impairment (12 vs 14 [36.4% vs 18.7%]; P ​= ​0.04), cotton wool spots (10 vs 3 [30.3% vs 3.9%]; P ​< ​0.001), bleeding diathesis (7 vs 3 [21.2% vs 3.9%]; P ​= ​0.004) and abnormal liver function (mean alanine amino-transferase [150.2 U/L vs 68.28 U/L; P ​= ​0.001], mean aspartate amino-transferase [196.86 U/L vs 99.53 U/L; P ​= ​0.002], total protein [68.43 ​g/L vs 72.27 ​g/L; P ​= ​0.016], serum albumin [36.86 ​g/L vs 40.5 ​g/L; P ​= ​0.001]) were noted more often in DF epidemics predominantly caused by DENV-1 compared to DENV-2. ConclusionsA higher prevalence of colour vision impairment, cotton wool spots, bleeding diathesis, and abnormal liver function was found in DF epidemics predominantly caused by DENV-1 compared to DENV-2.

Dynamic Changes of Platelet and Factors Related Dengue Haemorrhagic Fever: A Retrospective Study in Indonesian.

Dengue is a viral infection caused by the dengue virus (DENV). Dengue infection is a self-limited acute febrile illness caused by four serotypes of DENV (DENV-1~4). Early recognition of high-risk patients would be helpful to reduce mortality rates and prevent severe dengue. Our study aimed to identify factors related to dengue hemorrhagic fever (DHF) based on admission-day data, and further to understand the distribution of biochemical laboratory data in dengue patients. This retrospective study was conducted in hospitals in Yogyakarta city, Indonesia, and involved febrile patients who were admitted to the hospital with a diagnosis of dengue during 2018 and 2020. Logistic regression models were used to identify variables related to DHF. In this study, 1087 patients were included as suspected dengue patients, among them 468 had dengue fever (DF) and 619 had DHF. Over half of the DHF patients were males (55.9%) with an average age of 17.9 years, and with a secondary infection (71.3%). By a multivariate analysis, on-admission laboratory data of thrombocytopenia and hemoglobin showed significant association with DHF. Furthermore, DHF patients had significantly prolonged hospitalizations compared to DF patients. In conclusion, on-admission platelet counts and hemoglobin laboratory data are useful as predictors of DHF especially for suspected dengue patients with the limitations of diagnostic tests.

Association of Gallbladder Wall Thickening and Haematocrit Values with Severity in Patients of Dengue Fever

BACKGROUND The word “dengue” originates from the Bantu phrase Ka- dinga pepo, meaning “cramp-like seizure”. Breakbone fever viruses are enclosed in the family Flaviviridae and the virus has four serotypes through-about to as Dengue virus-1, DV-2, DV-3, and DV-4. Breakbone fever virus is a ribonucleic acid virus, encapsulated and is positive-stranded and consists of 3 structural macromolecule genes that encrypt the nucleocapsid or core (c) macromolecule, a membrane-associated (M) macromolecule, an engulfed (E) conjugated protein and 7 non-structural (NS) proteins. Dengue virus is principally transmitted by the dipteron / Aedes aegypti mosquito, two-winged insects and conjointly by the Asian tiger mosquito. The purpose of this study was to find an association of gall bladder wall thickening and haematocrit values with severity in patients with dengue fever admitted to Mahatma Gandhi Medical College &amp; Hospital, Sitapura, Jaipur (a tertiary care unit). METHODS It was a hospital-based observational study, conducted on all patients who were positive for dengue NS1 Antigen and IgM serology &amp; who visited the Department of General Medicine in Mahatma Gandhi Medical College &amp; Hospital, Sitapura, Jaipur from January 2020 to June 2021 were included in the study. All data were collected and analyzed by EPI-info software. RESULTS The association between gall bladder thickness and PCV was found statistically significant. Associations between PCV and prognosis and that of gall bladder thickness and prognosis were also found statistically significant. CONCLUSIONS We concluded that gall bladder wall thickness and haematocrit values are significant contributors to the assessment of the severity of dengue fever. The main advantage of this method is that it is a fast and easily approachable method and can be easily practised in most centres.

Association of Abnormal Coagulation Tests in Dengue Fever with Clinical Outcomes of The Patients

Objective: To assess the coagulation test abnormalities (prothrombin time, activated partial thromboplastin time and fibrin degradation products) in dengue fever patients and its impact on clinical outcomes of the patient.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Hematology Department, Pakistan Naval Ship Shifa Hospital, Karachi Pakistan, from Aug 2016 to Feb 2017.&#x0D; Methodology: A total of 135, serologically proven positive dengue-infected IgM cases, based on enzyme-linked immunesorbent assay, were included in the study. Prothrombin time, activated partial thromboplastin time, and fibrin degradation products levels were measured on STA Compact Max® (STAGO) and SysmexCA-1500. Clinical Outcomes of the patient were noted.&#x0D; Results: At the time of admission, elevated prothrombin time was observed in 8(5.6%) cases and remained high at the time of discharge (p-value 0.008). Elevated activated partial thromboplastin time was observed in 57 (42.2%) cases at admission whereas, at discharge, it was observed in 56 (41.5%) cases. Increased level (&gt;5) of fibrin degradation products was seen in 30 (22.2%) cases while at the time of discharge increased level of fibrin degradation products was observed in 25 (18.5%) cases (pvalue 0.007). Out of 135 patients, mortality was observed in two cases and the remaining 133 (98.52%) survived and were discharged.&#x0D; Conclusion: In conclusion, prothrombin time, activated partial thromboplastin time, and fibrin degradation products can be labeled as early predictors of disease severity and their derangements are associated with clinical outcome in dengue infection.

The Role of Angiopoietin-2 on Plasma Leakage in the Critical Phase and Convalescence of Dengue Virus Infection in Children

Abstract&#x0D; Background: The worst complication of dengue haemorrhagic fever (DHF) that lead to death is hypovolemic shock due to plasma leakage from intravascular to extravascular space caused by endothelial dysfunction. This study is aimed to analyze the difference of Ang-2 level in dengue haemorrhagic fever patients related to plasma leakage between critical phase and convalescence.&#x0D; &#x0D; Aim: One hundred and ten children with DHF confirmed serologically with positive IgM anti-dengue or IgM and IgG anti-dengue were recruited in this study. We examine the clinical manifestations, laboratory parameters (platelet count, AST and ALT levels), and molecular test (Ang-2). The molecular indicator was tested by Enzyme-Linked Immunosorbent Assay (ELISA). Data were collected between July – November 2019. This is an observational study with cross-sectional comparative design.&#x0D; &#x0D; Results: In our study, we found correlation of clinical symptoms (abdominal pain, persistent vomit, and hepatomegaly) with the occurrence of plasma leakage in DHF patients. We also found that Ang-2 level is significantly higher in children with DHF during critical phase compared to convalescence (p&lt; 0.01).&#x0D; &#x0D; Conclusion: There is a significant difference of Ang-2 level in DHF patients during critical phase and convalescence.&#x0D; &#x0D; Keywords: Dengue hemorrhagic fever, children, Ang-2, critical phase, convalescence

An Overview of the Theory of Planned Behavior Approach in Nursing Care for Dengue Fever Patients

BACKGROUND: The surge in cases of dengue hemorrhagic fever that occurred in East Sumba, Indonesia, in early 2019, required nurses to take a fast and appropriate attitude in dealing with patients. Professional nursing care is the basis in nursing services to overcome patient problems. AIM: This study aimed to obtain an overview of nursing care in dengue fever patients using the theory of planned behavior approach. METHODS: This study used a comparative non-experimental design with two approaches: A cross-sectional approach in the first stage and secondary data analysis in the second stage. This study was conducted in 2019 with 45 nurses determined by simple random sampling. Data were collected using questionnaires and observation sheets and analyzed with partial least square. RESULTS: Behavioral beliefs, evaluation of behavioral beliefs, normative beliefs, and motivation to comply with the majority of respondents are in the excellent range. Almost all respondents have a desire or intention to document complete nursing care, which is influenced by attitudes toward subjective behavior and norms, while perceived behavior control does not affect nurses’ intentions. CONCLUSION: Based on the theory of planned behavior, nurses carry out nursing care as a form of professional obligation, and its quality is determined by the nurse’s intention to behave.

Prediction of Acute Renal Failure in Dengue Fever Patients

Background: Dengue virus (DENV) infection is caused by an arboviral strain and is transmitted by the mosquito Aedes aegypti which is found in Sudan especially Red Sea and Kassala states in the east. The disease is known to cause renal disturbances and a thorough understanding of that will potentially help in the prediction, diagnosis and treatment of the disease. Methods: This study is a prospective observational cross sectional study conducted in the Eastern Sudan College of Medical Science and Technology and Port Sudan Teaching Hospital. 200 confirmed Dengue virus infected patients along with 200 healthy appearing adults (control) were enrolled for the study. Statistical analysis was carried out after the collection of patients’ demographic, clinical, and investigational data including serum urea and creatinine values. Ethical approval was obtained from the ministry of health, Red Sea state and informed written consent was obtained from each participant. Results: The highest incidence of DENV infection was observed in individuals of the middle age group (29%). Elevated blood urea levels were detected in 10 (5%) patients while elevated creatinine levels were seen in 17 (8.5%) patients. Although fallen within reference ranges found in the literature, mean blood urea and creatinine values differed significantly between patients and controls and between different categories of the disease. Mean blood urea concentration showed a statistically significant difference between the control (22.3 mg/dl) and the test (28.4 mg/dl) (P value < 0.001). Similarly, mean serum creatinine in the control (0.70 mg/dl) differed significantly (P value < 0.001) from test (0.94 mg/dl). Clinically, fever was present in 97.5% of patients, headache in 95.5%, joints pain in 71%, lethargy in 67%, vomiting in 49%, skin rash in 40%, abdominal pain in 24% and bleeding in 17.5%. Conclusion: We strongly conclude that renal involvement is not uncommon in Dengue fever and that blood urea and creatinine evaluation should be considered in the counseling of DENV infection patients. Patients need to be subjected to necessary laboratory investigations associated with acute kidney injury to decrease the rate of morbidity and mortality associated with the disease.

Assessment of behavioral risk factors for dengue: A Case–Control study from Pune

Introduction: Dengue cases continue to be reported every year in India despite various measures being taken for the prevention. In the absence of an effective vaccine and a specific treatment, protective behavior at individual level is of paramount importance. This case–control study was undertaken to find the association of some important behavioral risk factors with dengue fever. Methods: The study included all consecutive patients of dengue fever >15 years of age visiting a tertiary care hospital in Pune during 2018 confirmed by laboratory investigation as cases. Healthy individuals living in the same locality as cases were selected as controls. Cases and controls were interviewed using a pretested semistructured questionnaire called Dengue Risk Assessment to Initiate Control to collect information on behaviors for increased vulnerability to dengue infection. Relevant data were collected and compiled using Microsoft Excel and the data were analyzed using Statistical Package for the Social Sciences version 20 (IBM, USA). Results: A total of 30 cases (mean age 30.2, standard deviation [SD] 9.2) and 60 controls (mean age 30.08, SD 7.7) were recruited in the study. The results showed that cases were more likely to have certain behaviors associated with dengue than controls, namely, not practicing container management at home during the last 2 weeks (odds ratio [OR] = 3.57 and 95% confidence interval [CI]: 1.20–10.63), not using repellents (OR = 2.89 and 95% CI: 1.16–7.19), not wearing full-sleeve shirt/trousers (OR = 6.14 and 95% CI: 1.75–23.8), and absence of source reduction practices in the surrounding area (OR = 8.84 and 95% CI: 1.10–71.42). A significantly larger proportion of cases had lower practice scores (≤7) for dengue prevention than controls (OR = 5.20 and 95% CI: 1.41–19.23). Conclusion: This study found that odds of not practicing conventional personal protective measures and container management were higher among dengue fever individuals than controls.