Dengue fever lowers platelets and symptoms, causes, and treatments of Dengue Fever

Dengue fever lowers platelets and  symptoms, causes, and treatments of Dengue Fever

Blood is the body's most efficient transporter and is primarily responsible for supplying vital nutrients and oxygen to cells and removing waste from cells. The main components of blood are: white blood cells (WBCs/leukocytes), red blood cells (RBCs/erythrocytes), and platelets (thrombocytes). Under normal physiological conditions, the number of blood components is within a certain range and any abnormality in these numbers indicates altered physiology. Generally, RBCs are responsible for delivering oxygen to the cells. A condition with a low number of RBCs is called anemia and is characterized by low hemoglobin levels. This condition can be caused by a number of factors, including dietary factors, such as hereditary thalassemia and alcoholism. WBCs are cells of the immune system that are involved in combating an infection and defending the body. 

Their levels often increase in the case of different levels of infection where certain immunodeficiency diseases such as HIV infection are reduced. Platelets are irregularly shaped, colorless bodies present in the blood. Their sticky surface allows them to clot the blood with other substances to provide hemostasis, a physiological process for examining bleeding. An increase in platelet count is called thrombocytosis, and results in the formation of blood clots, which can interfere with normal blood flow to any organ, while a decrease is called thrombocytopenia, which causes excessive bleeding resulting in Bleeding occurs.

Typically, a healthy person has 150,000 to 450,000 platelets per microliter (L) of blood. Compared to thrombosis, thrombocytopenia (low platelet count) is more common and can be caused by decreased platelet production, increased destruction, or side effects of drugs such as chemotherapy (drug toxicity). Thrombocytopenia is often characterized by a platelet count of less than 50,000 per liter of blood. Symptoms of thrombocytopenia include rash, purpura on the forehead, pinpoint hemorrhages, nose bleeds, and bleeding gums. Common treatments include corticosteroids that increase platelet production along with lithium carbonate or folate which increases bone marrow production of platelets. In extreme cases, platelet transfusion is the only option in life-threatening situations. 

All treatment options have their drawbacks. Some disadvantages include severe toxicity and immunosuppressive effects of corticosteroids, renal toxicity of lithium, and severe patient dissatisfaction with platelet transfusions. Alternative therapies such as herbal therapy with low platelet count should be considered which are relatively free from toxic side effects of allopathic medicines.

Herbal medicine: An alternative medicine for low blood count:

Herbal medicines have been used for centuries to treat various ailments; Recently, medical research is trying to understand the exact ingredients of herbal ingredients that help in curing diseases. As far as blood count is concerned, there are many herbal remedies that are available and known to be effective. One such common remedy is based on papaya leaf herbs.

Papaya Tree:

The papaya plant, known biologically as Carica papaya, grows in most tropical countries. In some regions, it is called the "medicinal plant" or "the melon of health" because of its high nutrient content. Phytochemical studies of papaya reveal highly complex biochemical constituents, including papain (protease), carpine (anthelmintic alkaloid), lycopene, synergine, carcin (glycosides), vitamins A and C.

Although the papaya fruit is known for its laxative effect, the leaf is used primarily for bites, rash, stinging, and burns, and as a folk medicine for contraception and abortion due to its ability to induce uterine contractions. used as. Papaya is also effective in curing dengue fever. Recent studies have shown that papaya leaves have some anti-proliferative effects against cancer cells in addition to nephro-protective and antibacterial effects. More importantly, papaya leaves have been shown to be effective in increasing the platelet count.

The increase in blood count by the papaya plant is well established in many regions, including Australia, South America, the Philippines, and Africa, and has shown proven results in a rapid increase in platelet counts. The main parts used for medicine are the leaves and the stem. The green leaves and stalks are washed with water and crushed to obtain the extract, which is taken fresh for a few weeks until the platelet count returns to normal. Effects on platelet count were observed within 2 to 6 weeks of use.

What is platelets, why is it important

Let's find out what platelets are at the beginning. There are two main components of blood. A blood cell. Another is the watery part of the blood, the plasma. There are three types of cells in our blood. Red blood cells, white blood cells and microglia. The function of this molecule is to clot the blood. It is the most important ingredient in blood clots. So if it is cut somewhere so that there is no excessive bleeding, platelets are important for that. When the platelets decrease, go below a certain level, some symptoms are seen. Red rash appears under the skin. Bleeding can occur through the gums of the teeth. Blood may flow through the nose. Excess blood can come out with periods in women. There may also be bleeding in the brain. However, in very rare cases. And if it is cut somewhere, someone gets spots.
Sometimes the platelets decrease

Dengue fever lowers platelets. Hepatitis B is also reduced. Some virus attacks are also reduced. Such as in Corona. In addition, platelets are reduced in blood cancer (leukemia). If other cancers spread to the bone marrow, platelets may also decrease. The effect of chemotherapy is to reduce platelets. Also reduced in radiotherapy. Also reduced with some antibiotics. Some autoimmune diseases like ITP also decrease. In these cases, the antibodies that are made in the body destroy the platelets.

When you realize that the platelets have decreased

In case of any symptoms, the patient should go to the doctor immediately. In case of children, if there is red rash on the body, if there are black spots on the joints of the body, care should be taken. And if there is bleeding in the brain, then the patient becomes unconscious. So the symptoms are noticeable. The normal range of platelets is one and a half lakh to four and a half lakh. Even if there is one lakh, there is no problem. Nothing happens in 50 thousand. However, if it goes below lakhs, a doctor's advice should be taken. If it goes below 50 thousand, active treatment will be required. Bleeding is basically below 10 thousand. Only then did the doctors separate the platelets.

When to go to the doctor?

If symptoms of platelet depletion appear physically, you should see a doctor. If you have dengue fever and your platelets are less than 50,000, you have to be hospitalized. If it is less than 30,000, you have to take platelets, you have to be mentally prepared.

When platelets increase

In many diseases the platelets increase. Then blood can clot in the veins or arteries. Then there is a stroke, there is a heart attack. Blood clots can cause terrible things to happen. It's deadly bad. If the platelets are more than 9 lakh, you should talk to a hematologist and take medicine. However, due to the increase in platelets, accidents are very rare.

What will increase platelets?

At the moment doctors have no information on which foods will increase platelets. For several years, doctors have been saying that eating papaya and papaya leaf juice increases platelets. But there is no big article behind it, there is no evidence. However, some studies have shown that papaya increases platelets. This is the case with diabetes. If you have diabetes, you can eat karla. There is no harm in this. However, many believe that playing karla is beneficial in controlling diabetes. Although it has no scientific basis. Just eat nutritious food. Eat Vitamin C, Vitamin B Complex, Vitamin K, E. Eating leafy vegetables, colorful fruits will keep the blood components in the right amount better.

Dengue, corona, or influenza, understand how

Now all three are running together; Although the number of Covid-19 patients is relatively low. A common feature of dengue is that the body will ache with fever and runny nose. As the pain in the body and eyes, cold-cough is less, we think at the beginning that we are infected with dengue. And if there is a cold-cough, if there is no pain in the body, I think of influenza and Covid-19. Initially the symptoms of these two are the same. At least that is the case with mild symptoms. And if the covid is severe, it can be seen by lowering the level of oxygen saturation. 

Influenza, on the other hand, does not cause rashes. The rest helps us to understand the levels of different components of the blood. In addition, the patient's history (history), such as someone in the family recently had a cold is thought of covid. In the case of dengue, other members of the same family are initially thought to have dengue if they have pain. If I am confused as to what actually happened, then I am asked to check for diabetes, kidney function. However, if in doubt, dengue and covid should be tested. Because, if you have covid, there is one thing to take care of yourself, which is not necessary in case of common cold.

What to do in case of fever, especially during this coronavirus epidemic?

To be tested. In some cases, people with dengue can come to the hospital with cold and cough. However, that number is low. So we can't say at the outset what happened. The patient's history helps us, and the test confirms the disease. In Kovid, the results of RT-PCR test are 'False Negative' in 32 to 35 percent of the cases. In that case, follow-up of the person, CT scan helps to understand whether it has really been covid.

What is the risk of fever in children and pregnant women now?

 With few exceptions children do not have any serious problems. But pregnant women are more affected. In this case they have to be hospitalized; Even if mild symptoms.

Now many people panic when they have a fever. What to do in this case?

 There is nothing to panic about. It has to be faced. Now there is a cure for all this. If they seek medical help quickly, they will come to a conclusion about the disease. Must be in contact with the doctor at all times.

Do you need to be particularly aware of food initially because of fever? What else should we be aware of?

They have nothing to do with food. But now there is typhoid and jaundice, which are spread through waterborne diseases and food. For this you need to drink sterile water. Even if you have a fever with diarrhea, if you have it continuously for six to seven days, you have to worry, it could be typhoid. In such cases, if there is fever with headache, there is no cold-cough. When jaundice occurs, appetite decreases and urine turns yellow.

You have been receiving treatment for a long time. Have you noticed indifference in people with fever? What does your experience say?

We Bengalis are indifferent to fever. They are not health conscious. Don't want to give it importance. But in the current season, when the three (Covid 19, Dengue and Influenza Fever) are going on together, we should know what happened. As the doctors should know, the Ministry of Health should also understand these.

What do you think should be done to raise awareness about fever?

The media can help. In addition, there should be proper disease surveillance. For example, the incidence of fever is higher in any part of Dhaka. In that case, the survey in that particular area is urgent. And the health officials will go there and make the people aware. Again, if typhoid is caught in a certain area, it should be checked whether there is any problem in the water there. There is a need for two things — health awareness and disease surveillance, through which we need to know the cause of the disease, how it is happening in an area.

Case study of Dengue Fever (Study in Bangladesh)

Their irreparable loss a little late

Khadija, 10, attended a government primary school in Jurain, the capital. The only child of the parents, the girl got fever on September 8. At first the fever was 101 degrees, but the parents thought it might be a normal fever. The treatment is started according to the prescription of the local doctor. However, after four days of fever, severe abdominal pain started and Khadija was diagnosed with dengue.

On the morning of September 12, Khadija was admitted to Sir Salimullah Medical College and Mitford Hospital in Old Dhaka and started treatment in the dengue ward. However, with Khadija's blood platelet depletion, other physical complications began. Khadija died the next day while undergoing treatment. The Asad-Ruby Khatun couple are almost mad after losing their only child.

Khadija's father Asad told Prothom Alo, "Dengue has taken away the life of the girl. I took treatment immediately after catching the fever. I brought my daughter to Mitford Hospital as soon as she was diagnosed with dengue. But I could not save the girl. '

Khadija’s mother Ruby said, ‘The girl will have to lose forever like dengue fever, not even in the imagination. This dengue has ruined our golden world. '

Dengue has become a new terror in the Corona epidemic which has not continued for more than a year and a half. This year, 63 people have died of dengue, like Jurain's little Khadija. Talking to the relatives of the victims, it was learned that most of them stayed at home for the first two or three days after contracting the fever. Dengue was not tested. However, when the fever level is 103 to 105 degrees, platelets in the blood are reduced, physical weakness occurs, then dengue is tested. Some stay at home even after coming dengue positive. Most patients go to the hospital at the last minute. However, they did not get better treatment. He died at the hospital.

According to several specialist doctors, if fever occurs at this time, it should be seriously tested for dengue and corona. If dengue is positive, you have to go to the hospital immediately. Because, after being infected with dengue, many people face various physical complications. It is only possible to know the effect of the test on the patient's body. Then it is possible for the doctor to give the correct prescription.
Brigadier General Kazi Rashid-un-Nabi, director of Mitford Hospital, told Prothom Alo: "We have been treating dengue patients at our hospital since last January. Most of the dengue patients are returning home after getting better treatment. However, 22 dengue patients have already died in our hospital. Reviewing their data, it is seen that they were brought to the hospital too late, many of them were in critical condition at that time. Therefore, fever, headache, rash, nausea, etc. should be treated in the hospital as soon as the symptoms appear. It greatly reduces the risk of death.

More than 18,000 people have been infected with dengue. The majority of the infected patients (63 percent) have been treated at various hospitals in Dhaka. Of those who died, 6 percent were treated at various hospitals in the city. Earlier in 2019, more than one lakh people were infected with dengue. The government's Institute of Epidemiology, Disease Control and Research (IEDCR) confirmed that 146 people died of dengue that year.

Nuruzzaman was the only earner

Nuruzzaman from Shariatpur came to the capital 15 years ago and lived with his three daughters and wife at Mir Hazaribagh in Jatrabari. He worked in a factory and ran his family. Nuruzzaman came down with fever on September 10. He bought medicine from a local pharmacy and took it. Later, when the temperature dropped to 105 degrees, he tested positive for dengue at a local private clinic. Also admitted to the local clinic. However, he was taken to Mitford Hospital on September 13 after suffering from various physical complications including low platelet count. Nuruzzaman died there the next day.

Nuruzzaman was the only earner in the family. The family is now completely lost due to the sudden departure of that person.

Nuruzzaman's cousin said. Hassan said in the first light, ‘After the fever, he didn’t care at first. If the fever does not subside even after taking the medicine, dengue test is done. After catching dengue, I took my brother to the hospital. After that I could not save my brother even after running around a lot. Now the family may have to leave Dhaka. There is no food, where will the rent come from? '

Shahjadi's fever was 105 degrees
Housewife Shahjadi Begum lived in Khilgaon area of   the capital with her husband, a son and a daughter. When the fever started on July 26, he did not take any medicine on the first day. The temperature rose to 105 degrees. Then Shahjadi bought medicine from the local pharmacy and took it. Dengue is tested to reduce fever. He was receiving treatment from home even after being diagnosed with dengue. However, due to low platelet and hemoglobin levels, Shahzadi was admitted to Mitford Hospital on August 31. The next day, Shahjadi died while undergoing treatment in the dengue ward.

Shahjadi's relatives said. Swapan said, "We did not understand that Mami had dengue. When the fever increased, dengue was detected in the test. He was brought to the hospital but could not be saved in the end.

The course of dengue is divided into three stages: fever, severe and recovery.  Symptoms at this stage include high fever (above 40 degrees Celsius) and pain and headache. May cause nausea and vomiting. In 50-80% of cases, rashes appear on the body.

In some cases, the disease progresses to a critical stage. During this time, plasma is released which causes fluid to accumulate in the chest and abdominal cavity. Fluid from the circulatory system and reduced blood supply to vital organs can also result. Dengue shock syndrome and dengue hemorrhagic fever are less than 5% of all dengue cases. The complex phase usually occurs in children and your adults.

In the recovery phase, the leaking fluid is reabsorbed. A second rash may appear in the recovery phase. Fluid overload can also occur and in some cases reduce the level of consciousness or convulsions. Feelings of fatigue will last for weeks.

There are no antiviral drugs to treat dengue. The goal of treatment is to maintain a proper balance of fluids in the body and relieve symptoms. 

There is no approved vaccine for dengue. However, work is underway on a vaccine and drug that directly targets the dengue virus. The declining mosquito population eliminates breeding grounds and limits the risk of bites, seeks to prevent the use of pesticides and repel mosquitoes and the use of protective clothing.

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