Furosemide infusion in children with dengue fever and hypoxemia

Objectives

To study the role of furosemide infusion in the management of Acute respiratory distress syndrome (ARDS) associated with dengue fever.

Methods

Children between the ages of 1 month to 18 years, who fulfilled the WHO clinical criteria for dengue infection and American European Consensus Criteria criteria for ARDS with Dengue IgM positivity, were evaluated. Patients were studied as group D (receiving diuretic therapy alone) and group B (both ventilation and diuretics), and compared to a historical control group V (ventilation alone). Furosemide infusion was administered at 0.05–0.1 mg/kg/hour for 48 hours, maintaining a urine output of 2–4 mL/kg/hour.

Results

There was a significant difference in survival in the three groups. Significant difference was noted between pre- and postintervention arterial blood gases with respect to PCO₂ (P=0.02), pO₂ (P=0.003), PaO₂/FaO₂ ratio (P<0.001) and alveolar-arteriolar oxygen gradient (P=0.002).

Conclusion

Diuretic infusion improves outcome in dengue with ARDS.     

Depression and the heart

Cardio Vascular disease (CVD) as well as depression are both highly prevalent disorders and both of them cause a significant decrease in quality of life and increase the economic burden for the patient. Depressed individuals are more likely to develop angina, fatal or non-fatal myocardial infarction, than those who are not depressed. Over the past decade, evidence has accumulated to suggest that depression may be a risk factor for cardiac mortality in patients with established coronary artery disease (CAD). The 'vicious cycle' linking CVD to major depression and depression to CVD, deserves greater attention from both cardio-vascular and psychiatric investigators.(1).     

Prevalence of hepatitis C virus in a selected geographical area of northern India: a population based survey

Background and Aim

Epidemiological data on hepatitis C virus (HCV) infection from India are scanty. We conducted a population-based seroepidemiologic survey to estimate the prevalence of hepatitis C in Punjab state of northern India.

Methods

A house-to-house survey was conducted in a defined population of 26,273 subjects. Information was gathered according to a predesigned questionnaire with socio-demographic characteristics (age, gender and substance abuse), family history of HCV infection, general health status, associated co-infection, immunization history and potential risk factors for HCV transmission. At the time of clinical evaluation, blood was tested for anti-HCV and those found positive were tested for HCV RNA.

Results

Among 5,258 subjects screened, 272 were found to be anti-HCV positive (prevalence rate of 5.2?%); highest prevalence being noticed in 41?C60?years age group. Anti-HCV positive rate were not different among males and females. Sixty-seven subjects (1.3?%) were found to be HBsAg positive; four of these being co-infected (5.9?%). Various risk factors for acquiring HCV infection identified were history of surgery, dental treatment and unprotected sex. Other associations were strong family history of HCV positivity, alcohol consumption and diabetes mellitus.

Conclusion

Chronic HCV infection is a major health problem in Punjab; it appears to be more common than HBV infection. Exercising safe health care related procedures should be emphasized in our country as main modes of transmission of infection identified were related to these.