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Dengue (pronounced as Dengii) fever is caused by a virus. Four types of viruses called DENV 1 to 4 are seen. These are spread while a mosquito (Aedes egypticus) is biting a human being. This mosquito bites during the day and breeds in stagnant water. It is widespread throughout india and south east asia. About 400 million cases occur every year in the world.
Most of the infections do not produce symptoms. About ¼ may cause fever usually in children and young adults. Dengue infection can recur if a person is infected with the same type of virus as immunity decreases with time.
Common manifestations :
These begin 3-14 days after the bite. The symptoms are
Fever with temp of > 38.5 o C
Headache, pain behind the eyes
Pain in the back (at times severe : break bone fever)
Pain in the abdomen or chest
Mild pain in the joints.
All symptoms need not occur simultaneously. The doctors or patient may notice a pink rash which fades temporarily on pressing the area. In severe cases vomiting , tiredness, abdominal pains may start.
Pin point like bright red spots or blotches of reddish areas may occur. Complicated cases are called Dengue Hemorrhagic Fever (DHF) or Dengue Shock Syndrome (DSS).
In DHF Bleeding may occur from nose, in stools or vomits or periods may be heavy in woman. Bleeding may be very heavy at times. Abdomen and Chest collect fluids (called ascites and pleural effusion).
In DSS life threatening situation occurs with fall in blood pressure and involvement of other vital organs. Blood pressure (systolic) is below 80 mm Hg in children under 5 yrs and < 90 mm in those older then 5 yrs.
Laboratory Tests :
In blood counts platelets and WBCs may be low. Hb may rise in DHF due to leakage of plasma under the skin or in lungs and abdomen.
Dengue is diagnosed by Direct tests showing Virus particle or its part (antigen or genome), or indirect tests (IgG and IgM antibodies in serum). Direct tests are more accurate but costlier.
Milder cases require only symptomatic treatment. In complicated cases hospitalisation and monitoring of platelets, bleeding, blood pressure, vital organ function is carried out.
Patients may require IV fluids, Blood and their components (platelets etc) After a critical phase of 24 to 48 hrs, patient may start recovering. Prevention of Dengue is by antimosquito measures and preventing mosquito bites esp in young children and adults.
For patients suffering from type II /adult onset diabetes :In type II diabetes, diagnosis is often late (after the disease has already been present for some time). In early days T2DM (short for the adult type of diabetes) are often without symptoms. Hence the delay in diagnosis. This means complications will be seen early after diagnosis. Foot Care :
Foot disease in diabetes may lead to difficulty in walking, pain and may lead to infections. If neglected amputation may be required.
Inspect feet with a mirror before going to sleep every night.
Use well fitting shoewear.
Do not walk bare feet even in the house.
Socks should be clean and correct size.
In case of deformities of feet, special shoes can be worn. Eye Care :
It is nowadays the commonest cause of blindness throughout the world. Continue Reading ~ Second Medical Opinion / Advice
Nephrotic Syndrome Kidneys receive approximately 1 liter of blood every minute. Of this, about 100 ml gets filtered in the kidney. This contains, small molecules and few large molecules. This is due to the intricate cellular structure that prevents proteins from getting filtered into the urinary space. A derangement of this filter results in passage of heavy amounts of proteins in urine. This condition is called HeavyProteinuria or Nephrotic syndrome or Nephrosis. Definition:
In the urine, the protein excretion is > 3.5 gm/day or in children, it is >50mg/kg of body weight. In most cases, the serum albumin is <3gm/dl (normal>4), and passage of lipids in the urine. The lipids in the blood increase and swelling of face and feet also occur. Causes of Nephrotic Syndrome:
In children, most cases are due to Minimal Change Disease, FSGS, MPGN etc. In adults, most cases are due to primary illness while upto 30% may be due to secondary illness. Clinical Features:
Apart from Edema, ther…
Asthma or Bronchial Asthma is a common disease. About 75 % cases start in childhood before 10 years of age. A large no of patients stop having symptoms at the time of puberty and some may again have the disease in the later years. It is uncommon after 50 years of age. It can be troublesome, disabling and if not treated properly may be dangerous.
The disease results from heightened reactivity of the airways in response to irritants, allergens, fumes and at times exercise. It is typically intermittent and a person feels well when there is no ongoing attack of asthma. Symptoms:
Symptoms of asthma are shortness of breath, difficulty in breathing, cough and whistling sounds during breathing. These symptoms may also be seen in a no of heart, lung or infective conditions. Hence the diagnosis is usually made by experienced doctors after a few episodes have occurred!
The important markers of the disease are rapid reversibility of the signs and symptoms with appropriate treatment or spontaneousl…