Dengue

Hello friends,

My name is Dr Subhendu Gupta. Today I want to share some thoughts about dengue because we are seeing a lot of cases of dengue in our day to day practice in our OPD and in in-patient. Dendue is although a viral illness but it can cause a lot of morbidity and sometimes mortality. But I just want to assure everybody by this video that there is nothing to be afraid of this illness. Dengue is usually can be asymptomatic that may not have fever or it can present with fever and certain symptoms which could be alarming. We should all be very aware of what is a dangerous type of dengue and what is dengue fever which can be treated at home. A normal viral fever with bodyache and headache and decrease oral appetite is something which can be treated at home? Because this is not differentiated from any other viral. But certain signs we should always be very aware which could be dengue fever requiring admission in hospital. These signs are repeated vomiting abdominal pain cold hands and very lethargy and unable to take orally. Decrease urine output is also an indication for admission. Absolute indication when we see in the lab so humlog platelets jab ak lakh se kam hotey hain tabhi patient ko admit karna chahate hain.

 Less than one lakh also those patients who have a very rapidly falling platelet count on serial investigation require admission otherwise most of the patients still can be managed at home. Ap ka to jo hain agar ghar pe bhi if you keep on taking a lot of liquids like coconut water kanji dal ka pani chawal ka pani so apka hydration thik rahata hain mainly apka hydration thik rahata hain the chances of your falling very sick and requiring intravenous saline will be less. So what we do to those patient who require admission. Admission karke hamara sirf ensure yehi karna hota hain patient ke vital stable rahe. Humlog bar bar serial monitoring karte hain platelet count TLC or PCV ka aur patient ko fluid therapy dete hain jo ki isotonic fluid hota hain aur uska purpose sirf yehi rahata hain ki body ka volume maintain rahey. Kya pathology hain dengue mein fluids dene ki – reason yehi hota hain ki there is lot of leakage. Permeability bar jati hai vessels ki or bohut leakage hota hain extravessels mein jiski wajey se shock jaisey symptoms ho sakte hain. Aur us mein phir rapidly falling platelet count hota hain so what is very important what my key message again I am trying to say ke agar kahata hain ki specially dengue mein apna liquid intake charake baccho ke mamle mein thorasa difficult ho jata hain kyonke bachhe in sab cheeso ko aur avoid karta hain aur hum jab force karte hain to vomiting shuru ho jati hain.

So rasta yeh hain ki if you keep on taking small amounts of liquid spoon se hum dete rahe bland liquids de usually kya hota hain ke humey lagta hain ke hum juices pila denge to jaldi bachha thik ho jayega ya phir bohut sari aur bhi cheesey hain platelet baraney ki liye boley jatey hain wo denge to jaldi thik ho jayega. But ussey hota yeh hain ki gastritis barti hain aur vomiting bar jati hain. To humey high concentrated liquids nahi dene hain, humko dene hain jaise clear aur light liquids taki bachhe ka oral intake thik rahe aur vomiting na ho. So what happens again by coming back what happens in the hospitalized patient. Hospitalized patient mein humlog serial monitoring karte rahate hain aur hum yeh ensure kar lete hain ki platelet count bohut teji se fall nahi kar Raha, PCV bohut tezi se bar nehi raha that is haematocrit to phir humlog jo hain patient ko wohi home based treatment samjhake bhej dete hain. Dengue ke liye koi aisi dawai nahi hain there is no such medicine till date which can really change the course of the disease. Disease apnea p ati hain aur apna time pura karke chali jati hain.

Humey sirf ensure karna hain ap apna course of the period mein bohut jyada sick na ho jay. There are many myths regarding dengue ki dengue patient ko agar hum papita khila denge agar hum dengue ke patient ko hum weed grass de denge dengue patient ko agar hum jo hain bohut sarey fal jaise kiwi wagera de denge to bohut jaldi patient thik ho jaata hain. Aisa abhi tak scientifically nahi dekha gaya hain and kisi bhi study mein it is not proven ki any of these things actually help. Bohut sari Ayurvedic Homeopathic preparation bhi ati hain but scientifically abhi tak jo hain kisiko prove nahi kiya hain ki these medicine actually help. So again we should avoid medication at all in dengue. Specially for dengue hume koi bhi dawai lene se avoid karna chahiye. Humey sirf fever ki dawai deni hoti hain, uski bhi limit hoti hain aksar humlog bhabuk hoke bohut high power dawaiya dena chahate hain aur bachhe ka fever turant utarneke liye ghar mein kisi bataya hota hain so aisi dawaiya de dete hain jo ki NSAID group mein atey hain.

NSAIDS group should not be given and only Paracetamol is recommended that too maximum jo Paracetamol kisi bachhe ko de sakte hain who 60 milligram per kg ke hisab se chobis ghante mein de sakte hain. Apko pata hona chahiye ke itna den eke bawajut fever ayega aur fever rahega. Because the disease will take its own course. But to avoid the complication we should now not give more than this required amount. I have tried to concise a very big disease in very few words. I might have missed some important points. And always e are all learning about this profession and every disease. If you have got any questions any queries regarding Dengue and dengue fever my name is Dr. Subhendu Gupta. 

Thank you!