Jagadishkumar, Professor in the Division of Paediatrics, JSS Medical college, Mysore and Dr

Jagadishkumar, Professor in the Division of Paediatrics, JSS Medical college, Mysore and Dr. were randomly allocated, 30 to the study group and 31 to the control group, in an open labeled study. The study group received intravenous dexamethasone 8mg in the beginning followed by 4 mg every 8 h thereafter for Nuciferine 4 days and IV fluids whenever required. The control Group received only IV fluids and antipyretics whenever it was indicated. The daily measurement of platelet count was carried out in all individuals from the day of enrolment to the fourth day time of post treatment. Results: The baseline data (age, sex, and the mean period of the illness, Hb%, haematocrit, and platelets) were similar in both the groups. The analysis of variance (ANOVA) statistics showed a significant linear association of the mean platelet counts with the days in either group. The mean platelet counts increased continuously in both the groups from days 1 to 4: day time1 (0.687), day time2 (0.34), day time3 (0.530) and day time4 (0.844). There was no significant difference between the two groups. Summary: We conclude that at a high dose dexamethasone routine was not effective in achieving a higher rise in the platelet count Nuciferine in the acute stage of dengue fever strong class=”kwd-title” Keywords: Dengue fever, Thrombocytopenia, Dexamethasone, DHF, DSS Intro The Dengue illness is the most rapidly distributing mosquito-borne viral disease in the world and an estimated 50 million dengue infections are reported yearly [1]. The case fatality rates for the south-east Asian region are 1%, but in India, Indonesia and Myanmar, focal outbreaks have reported rates of 3-5% [1]. The pathogenesis of thrombocytopaenia in Dengue Fever (DF) has not been clearly comprehended. The increased peripheral destruction of the antibody coated platelets has been strongly suspected as the possible mechanism. The other modes include acute bone marrow suppression which leads to a megakaryocytic condition and enhanced platelet destruction by the reticuloendothelial system [2, 3]. Thrombocytopaenia is usually a constant manifestation in dengue fever, which often leads to life threatening Dengue Haemorrhagic Fever (DHF) and the Dengue Shock Syndrome (DSS). Both haemorrhagic diathesis and circulatory collapse are the fatal complications of the dengue contamination [4,5]. Thrombocytopaenia and bleeding tendencies are the common problems in dengue, which cause concern for the patients and the treating doctors [6]. Global attempts have been made to develop new treatment strategies to combat these fatal complications of the dengue contamination [7]. Steroids are Rabbit polyclonal to YSA1H used in the treatment of idiopathic thrombocytopaenic purpura to increase the platelet count, which is usually mediated by auto antibodies. This hypothesis would support the use of steroids in dengue fever [8]. You will find limited studies in the literature which have assessed the benefits and the risk of the corticosteroid therapy in the thrombocytopaenia in the dengue contamination. Numerous steroid regimens have been used and some of them have shown beneficial effects and some have shown no benefits. However, the Cochrane reviews have concluded that there is insufficient evidence on the use of steroids in DSS and DHF and they have advised large randomized trials [7]. Kularathnesam et al., conducted a survey to take the opinions of physicians and paediatricians around the management of the dengue contamination in Sri Lanka. It revealed that the World Health Organisation (WHO) guidelines were followed by only 16(45%) physicians and 6(40%) paediatricians in the management of DF and DHF and that steroids were used empirically in anticipation of bleeding diathesis [5]. Rajapakshe et al concluded in his study, that the possible effects of steroids on thrombocytopaenia and bleeding in dengue fever were unknown, even though they were used empirically [9]. A study which was carried out by Kularathne Sam et al., to evaluate Nuciferine the effect of low dose dexamethasone (Inj dexamethasone 4mg in the beginning followed by 2mg IV q8h for 4 days) in dengue fever with thrombocytopaenia on platelet count, concluded that there was no benefit.