Hemorrhagic Fever Patients Research Articles

Relationship Between Community Behavior And Dengue Hemorrhagic Fever Incidence

According to DHF incidence data obtained from the Madiun City Health Profile, there were 48 cases and one death in 2021, an increase in cases of 212 cases with one death in 2022, and there were still 144 cases with one death in 2023. The purpose of this study is to determine the relationship between community behavior and the incidence of dengue hemorrhagic fever in the Manguharjo Health Center Working Area, Madiun City. This study has used quantitative research with a case-control research design. The study population was all dengue hemorrhagic fever patients recorded in medical records in Winongo and Nambangan Lor Villages with a period of January 2023-16 February 2024, totaling 29 cases. The sample used was 54 respondents, with 27 cases and 27 controls. The sampling technique used was purposive sampling, with the inclusion criteria of the case being that the patient had suffered from DHF disease, while the exclusion criteria were that the patient moved residence when the study was conducted. The Data analysis used was a univariate and bivariate analysis using the Chi-Square test. The results show that there is a relationship between the presence of hanging clothes p-value of 0.013 with an odds ratio of 5.091, there is no relationship between the distance from house to house p-value of 0.420 and an odds ratio of 2.841, and there a relationship between the implementation of eradication to prevent dengue fever transmission p-value of 0.029 and an odds ratio of 4.038. The variable with the highest risk for dengue hemorrhagic fever is the presence of hanging clothes. At the same time, the variable that has the most minor risk is the distance between houses. Therefore, it is expected that the Manguharjo Health Center can educate and counsel the community on implementing mosquito’s nest eradication to prevent transmission and minimize dengue cases.

Predictors of Mortality in Crimean-Congo Hemorrhagic Fever Patients Admitted at a Tertiary Care Hospital in Pakistan over the Last 10 Years: A Case-Control Study.

The objective was to identify predictors of mortality in hospitalized patients with Crimean-Congo hemorrhagic fever (CCHF). A case-control study was conducted on patients hospitalized with CCHF from 2012 to 2022. Risk factors for mortality in CCHF patients were analyzed using logistic regression. A total of 86 patients with a median age of 36 years (interquartile range [IQR], 27-36 years) were included, and the majority were males (78, 90.7%). Thirty-one patients (36%) were cases, whereas 55 (64%) were control patients. Based on univariate logistic regression analysis, patients who were in an age group of ≥40 years (odds ratio [OR]: 4.85; 95% CI: 1.8-12.4) or with presence of gum bleeding (OR: 2.66; 95% CI: 1.0-6.8), unit increase in white blood cell count (WBC) (OR: 1.09; 95% CI: 1.00-1.07), serum glutamate-pyruvate transaminase of ≥500 U/L (OR: 3.68; 95% CI: 1.4-9.3), serum glutamic-oxaloacetic transaminase (SGOT) of ≥1,000 U/L (OR: 8.72; 95% CI: 2.6-28.3), prothrombin time (PT) of ≥120 seconds (OR: 9.85; 95% CI: 3.2-29.8), international normalized ratio of ≥5 (OR: 15.8; 95% CI: 2.0-125.3), or acute respiratory distress syndrome (ARDS) (OR: 28.27; 95% CI: 5.84-136.9) were found to be significantly associated with mortality in CCHF. Factors found to be independently associated with mortality on multivariate analysis included ARDS (adjusted OR [aOR]: 27.7; 95% CI: 4.0-190.5), unit increase in WBC (aOR: 1.02; 95% CI: 1.02-1.26), SGOT of ≥1,000 U/L (aOR: 23.6; 95% CI: 2.32-241.7), and PT of ≥120 seconds (OR: 10.2; 95% CI: 2.00-52.4). CCHF is a rare but fatal disease, and patients with ARDS and increased WBC, high SGOT level, and increased PT indicative of liver injury and coagulopathy at the time of hospitalization are at high risk for mortality.

Hubungan Antara Pemeriksaan Antibodi IgG Dengan Uji SGOT SGPT Pada Pasien Demam Berdarah Dengue Di RSU Sinar Kasih Purwokerto

Dengue Hemorrhagic Fever (DHF) is a disease caused by infection with the dengue virus which is transmitted through the bite of the Aedes aegypti mosquito. The main clinical manifestations of this disease can be an increase in body temperature ≥ 38°C for 2 - 7 days, bleeding which is usually preceded by the appearance of red spots (petechiae), headache, joint pain accompanied by leukopenia, lymphadenopathy, thrombocytopenia and hemorrhagic diathesis. Liver dysfunction is one of the consequences of dengue infection that often occurs in patients. The liver is the target organ of the dengue virus which often appears in the form of hepatomegaly and a mild-moderate increase in aminotransferase enzyme levels although jaundice and acute liver failure are rare. Dengue patients have an increase in SGOT and SGPT levels. This study aims to determine whether there is a relationship between dengue IgG levels and SGOT and SGPT in Dengue Hemorrhagic Fever patients at RSU Sinar Kasih Purwokerto. The type of research used is an analytical study with a cross-sectional approach. Sampling was carried out using a consecutive sampling technique. Results were obtained from 100 samples with normal SGOT SGPT examination results, namely 10 patients and high results, namely 90 patients. The results of SGOT and SGPT examinations in dengue IgG positive patients increased >3 times which was included in category B and there was a significant relationship between SGOT and SGPT levels in Dengue IgG positive patients, with a p-value of 0.000, indicating a strong relationship between SGOT levels and SGPT with IgG examination results.

Investigation of hsa-miR-1908 and hsa-miR-144 Expression Levels in Crimean-Congo Hemorrhagic Fever Patients

Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne zoonotic viral disease. MicroRNAs (miRNAs), which play an important role in the regulation of gene expression, are involved in many processes essential for cell life such as development, differentiation, survival, apoptosis and aging. If miRNAs fail to fulfill their functions, they cause susceptibility to many diseases, including viral infections or cause the disease to be experienced in different clinical situations, such as severe or mild. In this study, we aimed to determine the expression levels of hsa-miR-144 and hsa-miR-1908 in CCHF patients and to compare the results in different clinical courses of CCHF disease. In this study, expression levels of hsa-miR-144 and hsa-miR-1908 were detected by quantitative reverse transcription polymerase chain reaction (RT-qPCR) in blood samples obtained from 60 CCHF patients and 40 healthy individuals. We also investigated the differences in the expression levels of the microRNAs between patients with severe and non-severe disease or between patients who died and survived. Quantitative polymerase chain reaction data were uploaded to the "Data Analysis Center" (Qiagen, Germany) and analyzed using the ΔΔCq (ΔΔCt) method. p value was calculated according to Student's t test for genes in the study groups. The expression level of hsa-miR-144 decreased (fold change= 0.09) and the expression level of hsa-miR-1908 increased 1.44-fold in CCHF patients compared to the control group. The expression of hsa-miR-144 and hsa-miR-1908 increased 2 and 2.36-fold, respectively, in severe patients compared to non-severe patients. The expression levels of hsa-miR-144 and hsa-miR-1908 were 16.3- and 14.3-fold higher, respectively, in fatal cases compared to surviving patients and these results were statistically significant. In addition, the expression level of hsa-miR-144 was significantly decreased in patients with low leukocyte counts and the expression level of hsa-miR-1908 was significantly increased in patients with prolonged prothrombin time (PT). This is the first study in the literature investigating the expression level of hsa-miR-1908 in CCHF patients. In conclusion, the data of this study suggest that hsa-miR-144 and hsa-miR-1908 may be important biomarkers in predicting the prognosis and clinical course of CCHF disease.

Assessment of Serum Beta 2-Microglobulin Levels in Crimean-Congo Hemorrhagic Fever Patients: Implications for Immune Activation and Disease Pathogenesis

Crimean-Congo Hemorrhagic Fever (CCHF) presents a spectrum of clinical manifestations, ranging from asymptomatic cases to severe, life-threatening conditions. Despite extensive research on CCHF pathogenesis, comprehensive understanding remains elusive. Our investigation focused on assessing serum beta 2-microglobulin (β2M) levels in CCHF patients, aiming to elucidate its potential as an immune activation marker and its involvement in disease pathogenesis. The study enrolled 45 CCHF patients and 45 healthy volunteers as a control group. Serum β2M levels were quantified using the immunoturbidimetric analysis method. The patient group was divided into two groups, mild and moderate-severe, using scoring systems. The mean β2M values for the control, mild, and moderate-severe patient groups were 2.27±0.50, 4.37±1.29, and 5.82±2.62 mg/L, respectively (p<0.001). Positive correlations were noted between β2M concentrations and markers such as BUN, creatinine, uric acid, creatine kinase, and aPTT (p<0.001, r=0.684; p<0.001, r=0.602; p=0.003, r=0.439; p=0.008, r=0.392; p=0.019, r=0.348, respectively). Conversely, negative correlations were observed with total protein, albumin, and platelet count (p=0.021, r=-0.342; p=0.003, r=-0.434; p=0.048, r=-0.296, respectively). The findings suggest a prominent inflammatory response in CCHF, indicated by elevated β2M levels, implying its potential role in the molecular mechanisms of the disease

Factors associated with prolonged length of stay in dengue hemorrhagic fever patients at Wangaya Hospital, Denpasar, Bali

Background: Dengue hemorrhagic fever (DHF) is a vector bone disease which is being a serious public health concern in tropical and sub-tropical countries around the world. A high number of dengue cases are reported annually in Bali. Prolonged hospital stays affect the high cost of dengue treatment. The aim of the study was to analyze the factors associated with prolonged lengths of stay in dengue hemorrhagic fever patients. Methods: This study was an analytic observational study with a retrospective study design. The data was collected from the medical records of DHF patients at Wangaya Hospital between January - May 2024. The data analysis method used was the Chi square test as a bivariate test. Results: A total of 152 subjects, mostly DHF patients, were male (54.61%), <40 years old (73.68%), without comorbid disease (71.05%), without low food intake (56.58%), and with a length of stay ≥4 days (66.45%). Most of the patients (>50%) had clinical symptoms of fever (100%), headache (91.45%), and myalgia (83.55%). A statistically significant association was found between comorbid disease and prolonged length of hospital stay with a p value of 0.039 (p<0.05), and low food intake showed a significant association with prolonged length of stay with a p value of 0.001 (p<0.05). Conclusions: This study identified that comorbid disease and low food intake were factors associated with prolonged lengths of stay in DHF patients. Findings of this study may still prove beneficial for physicians to do early identification of DHF patients who have high risk factors for prolonged hospitalization, which can be an effective tool to combat the increasing disease burden.

Exploring free amino acid profiles in Crimean-Congo hemorrhagic fever patients: Implications for disease progression.

This study investigated the intricate interplay between Crimean-Congo hemorrhagic fever virus infection and alterations in amino acid metabolism. The primary aim is to elucidate the impact of Crimean-Congo hemorrhagic fever (CCHF) on specific amino acid concentrations and identify potential metabolic markers associated with viral infection. One hundred ninety individuals participated in this study, comprising 115 CCHF patients, 30 CCHF negative patients, and 45 healthy controls. Liquid chromatography-tandem mass spectrometry techniques were employed to quantify amino acid concentrations. The amino acid metabolic profiles in CCHF patients exhibit substantial distinctions from those in the control group. Patients highlight distinct metabolic reprogramming, notably characterized by arginine, histidine, taurine, glutamic acid, and glutamine metabolism shifts. These changes have been associated with the underlying molecular mechanisms of the disease. Exploring novel therapeutic and diagnostic strategies addressing specific amino acids may offer potential means to mitigate the severity of the disease.

HUBUNGAN IgG DAN IgM DENGUE TERHADAP JUMLAH TROMBOSIT PADA PASIEN DEMAM BERDARAH DENGUE DI RUMAH SAKIT PENDIDIKAN PROF.dr.CHAIRUDDIN PANUSUNAN LUBIS UNIVERSITAS SUMATERA UTARA

The immune responses that play a role in DHF cases are Immunoglobulin M (IgM) and Immunoglobulin G (IgG). In primary Dengue infection, IgM begins to form and is detected on the third to fifth day, whereas in secondary Dengue infection, IgG levels will increase and then remain in the human body with low titers for life. Thrombocytopenia occurs in DHF patients due to antigen-antibody reactions and activation of the complement system which causes deposition of IgM and IgG immune cells on the surface of platelet cells. This causes reticuloendothelial cells to destroy platelets so that DHF patients will experience thrombocytopenia. To find out the analysis of dengue IgG and IgM examination on the results of platelet counts in dengue hemorrhagic fever patients at Prof. Teaching Hospital. dr. Chairuddin Panusunan Lubis, University of North Sumatra. The research used is descriptive quantitative. The examination method used is Dengue IgG and IgM Dengue Rapid Test, Platelet Count Examination using a Hematology Analyzer. The number of respondents is 11 samples taken by total sampling technique. Based on the results of a study of Dengue IgG and IgM in Dengue Hemorrhagic Fever patients at Prof. Teaching Hospital. dr. Chairuddin Panusunan Lubis, University of North Sumatra who had IgG + and IgM levels - more, namely 10 (92%) patients, IgG - and IgM + as many as 1 (8%) patients. Based on the number of platelets obtained in Dengue Hemorrhagic Fever patients at Prof. Teaching Hospital. dr. Chairuddin Panusunan Lubisa, University of North Sumatra, which decreased by 9 patients, and there were some who had normal platelet counts of 2 patients. There is no relationship between Dengue IgG and IgM on platelet count in Dengue Hemorrhagic Fever patients.

OUTBREAK OF DENGUE VIRUS SEROTYPES IN DENGUE HEMORRHAGIC FEVER PATIENTS OF PESHAWAR PAKISTAN

Abstract Background: Dengue is the most critical medical problem in tropical and sub-tropical locales of the world transmitted by the bite of the mosquito Aedesaegypti. Dengue virus (DENV) is categorized into 4 serotypes i.e. DENV1, DENV2, DENV3, and DENV4. The role of dengue virus (DENV) serotypes in the causation of primary Dengue hemorrhagic fever (DHF) among dengue patients are not well studied in Pakistan. This research aimed to determine the association of DENV serotypes with DHF in dengue hemorrhagic fever patients of district Peshawar Pakistan. Methods: A total of 200 blood samples were collected from DF and DHF patients. All of the samples were considered to be positive by NS1 Elisa. RNA was extracted with an RNA kit (TRIzol, USA) using the manufacturer protocol. The extracted RNA was then converted into cDNA by using Revert AID Reverse transcriptase (Thermofisher scientific) the target region for transcription and Amplification is a c-prM region which was amplified by Regular PCR and by using Nested PCR, the DENV serotypes (1-4) (Thermofisher scientific) was identified by using serotypes specific primers (TS1, TS2, TS3, and TS4) the samples was run through gel electrophoresis and then read the product size. Results: a total of 164 (82%) samples were considered to be positive by both NS1 Elisa and RT-PCR while 36 (18%) were negative by RT-PCR. the study population consists of 60% male and 40% female. Within positive samples, 40 patients have DHF of which 24 (15%) were male and 16 (10%) were females. Most of the affected patients have an age range between 10-30 years followed by 30-40 years. All of the DHF patients were primary patients and had no previous dengue fever history. By using Serotype-specific primers all the DHF samples were positive for Serotype-2 (DENV2). This shows that DENV2 was primarily associated with DHF Conclusion: DENV2 is the dominant serotype in the Dengue outbreak in affected patients of Peshawar.

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.

The Prognosis of Crimean-congo Hemorrhagic Fever in Thiqar City, South of Iraq, in 100 Cases over 2022

Background:: The study of Crimean-Congo hemorrhagic fever (CCHF) worldwide is of low rate as it is an uncommon disease. The outbreak in Iraq in 2022 is high. Aim:: To study the prognosis of hemorrhagic fever patients in Thi-Qar governorate, where the highest rate of the disease is, so that we might expect the fat of the disease. : Patients and Methods: A descriptive cases series of cross-section studies that included all patients with severe or life-threatening Crimean-Congo hemorrhagic fever(CCHF) PCR-positive cases (out of the total 100) admitted and followed up in AL-Hussain Teaching Hospital in 2022. To study patients' features that indicate the prognostic factors of the disease. Results:: All cases proved to be CCHF by PCR were 100 patients of variable severity, 14 cases were admitted to intensive care units (ICU), 13 patients died, 2 pregnant ladies were infected with CCHF unfortunately died, 16 children admitted to hospital 2 of them died and 14 cases completely cured. The most serious cases are intrapulmonary hemorrhage and neuropsychiatric presentation. Conclusion:: There are many clinical and laboratory prognostic markers. The riskiest clinical bad prognostic factor is the neuropsychiatric and pulmonary hemorrhage and CCHF in pregnant ladies.

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 >2 as much as 64.2%. The result of Mann Whitney non-parametric test, showed that p value <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.
 Keywords : dengue virus., dengue hemorrhagic fever., hospitalization., neutrophil lymphocyte ratio

Evaluation of hearing levels in Crimean Congo Hemorrhagic Fever with audiological and electrophysiological tests

Objective : Crimean-Congo Hemorrhagic Fever (CCHF) is a tick-borne viral disease, and Sensorineural Hearing Loss (SNHL) arises from pathologies in the cochlea or retrocochlear pathways. Viral infections, including Crimean-Congo Hemorrhagic Fever , are considered possible etiological factors for Sensorineural Hearing Loss, as endothelial damage in Crimean-Congo Hemorrhagic Fever may impair inner ear blood flow. This study aimed to differentiate between cochlear and retrocochlear hearing loss in patients with Crimean-Congo Hemorrhagic Fever and assess the reliability of Auditory Steady-State Response (ASSR) testing by comparing its results with pure-tone audiometry. Material and method: The study included 30 Crimean-Congo Hemorrhagic Fever patients (Group CCHF) and 30 healthy controls (Group C). Hearing measurements were conducted using pure tone audiometry, otoacoustic emissions, tympanometry, and Auditory Steady-State Response before the patients’ discharge. Data were analyzed using SPSS 22.0. Results: The results showed no significant difference in audiometric thresholds between the right and left ears of Group CCHF at various frequencies. However, Auditory Steady-State Response results at 1000, 2000, and 4000 Hz in the right ear and at all tested frequencies in the left ear revealed significant differences between groups (p < 0.05). Conclusion: While this study did not establish a clear link between Crimean-Congo Hemorrhagic Fever and Sensorineural Hearing Loss, it suggests the need for further research with larger samples and testing during both the active and recovery phases of Crimean-Congo Hemorrhagic Fever. Key words: Crimean Congo hemorrhagic fever; audiometry; otoacoustic emissions, tympanometry; auditory steady state response; hearing loss.

Evaluation of epidemiological, clinical, laboratory and treatment characteristics of Crimen Congo hemorrhagic fever patients: Results of a 10-year analysis.

Crimean-Congo hemorrhagic fever (CCHF) is a viral zoonosis transmitted by ticks and may have an acute and severe course with fever, bleeding, muscle aches, headache, diarrhea, weakness, and similar non-specific symptoms. This study aimed to determine the distribution of CCHF cases in Amasya province, which is endemic for this disease, according to districts, epidemiological, clinical, laboratory, and treatment characteristics. The characteristics of 88 CCHF cases over 18 who were admitted to our clinic and treated between January 2013 and January 2023 were evaluated retrospectively. Demographic data such as age, gender, occupation, district of residence, history of tick contact, the incubation period of the disease, period of development of the disease (months, years), length of hospital stay, symptoms, physical examination and laboratory findings, blood product replacement therapies applied, recovery and mortality status of the patients were reached by scanning the patient files. The mean age (±standard deviation) of 88 cases was 48±18 years, and 53 (60.2%) were male. Of the patients, 68 (77.3%) were engaged in farming and animal husbandry, and 79 (89.7%) lived in villages and hamlets. Tasova district had the highest frequency of cases, with 29 (32.9%) patients. June was the most common month for the disease, with 31 (35.2%) cases. The most common symptom on admission was fatigue, with a rate of 93%. Other symptoms included myalgia and arthralgia (83.2%), fever (65%), headache (64.4%), nausea-vomiting (43.5%), conjunctival hyperemia (35.2%), and diarrhea (21.7%). In clinical follow-up, bleeding was missed in 15 (17.04%) patients. On admission to the hospital, there were elevated levels of thrombocytopenia (92%), leukopenia (84.1%), aspartate aminotransferase and alanine aminotransferase (86.3%), creatinine phosphokinase (71.6%), and lactate dehydrogenase (76.1%). None of the patients were given ribavirin treatment. Our mortality rate was 3.40% with three patients. Amasya is an endemic area for CCHF with all its districts. In our province's spring and summer months, tick contact history and the farming-livestock profession should be questioned in patients with fever complaints in clinic admissions, especially emergency services. In the case of the detection of thrombocytopenia in these patients, CCHF should be kept in mind.

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.

The Relationship of Fever Onset with NS1 Examination Results, IgM, and IgG in Dengue Hemorrhagic Fever Patients

Fever onset represents the average number of days from the beginning of fever symptoms to the time when IgM and IgG examinations are conducted. Determining the right timing for these examinations can significantly impact their accuracy. In November 2021, there was a notable surge in cases of Dengue Hemorrhagic Fever at the Karawang Health Center, Sukabumi. This study aimed to investigate the relationship between the duration of fever and the results of dengue antigen and antibody tests. The research employed a descriptive analysis with a cross-sectional approach, and a sample of 50 individuals was gathered through consecutive sampling. The data was then analyzed using the Chi-Square test. The study revealed a positive correlation between the duration of fever and the outcomes of the NS1 and IgG Dengue examinations (p<0.05), highlighting the significance of timing when conducting these tests. NS1 was predominantly detected within the first three days of fever, while IgG showed reactivity after more than five days of fever. These findings underscore the importance of timing when conducting these tests and interpreting their results.

The Association of De Ritis Ratio with the Severity of Crimean–Congo Hemorrhagic Fever

Aim: This study aimed to present the characteristics and poor prognostic factors of Crimean–Congo hemorrhagic fever (CCHF) patients. Materials & methods: Adult patients (>18 years) with CCHF were included in this retrospective study. Demographics, risk scores and laboratory findings of survivors and nonsurvivors were compared. Results: Fifteen (9.2%) of 163 CCHF patients were nonsurvivors and had a higher Severity Score Index (p < 0.001), Severity Grade Score (p < 0.001) and De Ritis ratio (aspartate transaminase/alanine transaminase) (p < 0.001). De Ritis ratio was >3 in 10.1% of survivors and 53.3% of nonsurvivors (p < 0.001). In multivariate analysis, De Ritis ratio >3 (OR: 5.428, p = 0.045) and SGS (OR: 1.776, p = 0.005) were found as predictive factors. Conclusion: De Ritis ratio may predict prognosis in combination with severity risk scores in CCHF.

Risk Factors and Secondary Infections in Dengue Hemorrhagic Fever Patients

Risk Factors and Secondary Infections in Dengue Hemorrhagic Fever Patients

Association of pattern of thrombocytopenia and serology with timings of plasma leakage in patients of dengue hemorrhagic fever during dengue epidemic 2019 – an experience from Rawalpindi Medical University: A cross sectional study.

Objective: To find the association between the patters of thrombocytopenia with the timings and patterns of plasma leakage in patients presenting with dengue hemorrhagic fever (DHF) during the dengue epidemic of 2019, in Rawalpindi city. Study Design: Cross-sectional study. Setting: Department of Medicine, District Headquarter Hospital, Rawalpindi, Pakistan. Period: August to November 2019. Material & Methods: In which patients who were labelled and managed as DHF on the basis of clinical presentation, positive serology and ultrasonic evidence of plasma leakage were included. Demographic profile, clinical features with duration of illness, laboratory investigations including serological markers (NS1, IgG and IgG) and ultrasonic findings were recorded on a self-structured performa and data was analyzed using SPSS v23.0. Results: Two hundred and ninety five patients with DHF were enrolled in the study. There were 2012 males and 83 females (male to female ration of 2.5:1). Mean age of all participants was 32.83 years. 50.5% of the cases were primary infection (based on serology), whereas 38.3% were secondary infection and 11.2% were triple negative infection. In 81.1% of the cases, plasma leakage occurred on the 4th to 7th day of illness. In these cases, platelet count was <40,000 cells/mm³ in 13.6% cases, between 40,000 cells/mm³ - 80,000 cells/mm³ in 50.8% cases and greater than 80,000 cells/mm³ in 35.5% cases. Amongst the 17.8% of cases where plasma leakage occurred between 8th to 10th days, 56.6% had platelet count greater than 80,000 cells/mm³, 22.6% has platelet count between 40,000 cells/mm³- 80,000 cells/mm³ and 20.8% had platelet count of less than 40,000 cells/mm³. Conclusion: Most people had plasma leakage at day 4-7 of illness, so needed more critical monitoring and admission at 4th to 7th day of illness, plasma leakage was observed more commonly in primary as compared to secondary infections and mostly at the day of leakage, platelet count was between 40,000 cells/mm³- 80,000 cells/mm³. Strict monitoring is required from the 4th day of illness to detect early signs of leakage to decrease the mortality and complications by dengue infection.

An evaluation of the laboratory and clinical data of the Crimean-Congo hemorrhagic fever patients during the Covid-19 pandemic

In this study, the purpose was to investigate the demographic, laboratory, and clinical characteristics of the Crimean-Congo Hemorrhagic Fever (CCHF) cases that were treated in our hospital during the Coronavirus disease-2019 (COVID-19) pandemic. It was also investigated whether the patients hospitalized with a provisional diagnosis of CCHF who tested negative for CCHF PCR were infected with COVID-19. In our study, data (epidemiological, clinical, laboratory, prognosis) from 38 patients diagnosed with CCHF through reverse-transcriptase polymerase chain reaction (PCR) and viral-RNA and/or Immunoglobulin M antibodies using ELISA between May 2020 and November 2022 were investigated retrospectively. Of all the patients, 23 were CCHF PCR (+) and 15 were CCHF PCR (-).15 (65.2%) of PCR (+) patients and 9 (60%) of PCR (-) patients were engaged in farming. 65.2% of PCR (+) and 26.7% of PCR (-) patients presented with a history of tick bites. 21 (91.3%) of PCR (+) and 12 (80%) of PCR (-) patients had a history of rural living. Among the PCR (+) patients, 65.2%, 17.4%, and 17.4% received treatment for CCHF in 2022, 2021, and 2020 respectively. 87% of PCR (+) and 60% of PCR (-) patients were discharged after full recovery. The most common symptoms were fever, diffuse body ache, weakness, and headache. Significant differences were found between PCR (+) and PCR (-) patients in terms of leukocytes, LDH, INR, NEU, PLT, fibrinogen, and NLR values. 3 patients hospitalized with a provisional diagnosis of CCHF tested negative for CCHF PCR and positive for COVID-19 PCR. Thoracic CT, clinical, and laboratory findings of these patients showed no differences from the other patients. The possibility of misdiagnosis should be considered in CCHF and COVID-19 infections due to their similar symptoms and indications. Extensive multicentric studies need to be conducted to investigate the causes of the increased number of CCHF cases during the pandemic.