Résumé
Background: Dengue is a self-limiting, vector-borne disease transmitted by Aedes mosquito, causing a major public health threat globally. The objective of this study is to assess the clinical profile and outcome of the dengue infection in children less than 14 years of age September 2018 to August 2019 at the Pediatric Department of S.V.S. Medical College, the tertiary care hospital in Mahabubnagar, Telanagana.Methods: Prospective study of 82 hospitalized children of <14 years with the diagnosis of dengue illness. Children with diagnosis of dengue were classified further in to two groups as per WHO guidelines, Non-severe dengue fever (probable dengue, dengue with warning signs) and 'Severe Dengue' (Dengue Haemorrhagic Fever and/or Dengue Shock Syndrome (DHF/DSS). A separate questionnaire form used for documenting clinical history, laboratory parameters. Haematological parameters were noted, chest x-ray, ultra-sonogram in required cases was done. Children were managed as per WHO protocol. The outcomes of the cases were mentioned as discharge, left against medical advice and death.Results: A total of 82 children with dengue were divided in to 55(67%) non severe dengue and 27(33%) severe dengue with males 56(68.2%) and females 26(31.7%). The most common age of presentation was between 6-10 years 34(41.5%). Fever 73(89%) was the most common presenting symptoms. Pleural effusion and hepatomegaly were the commonest clinical findings 28(34.1%) each, which were more among the severe dengue patients. Gall bladder edema 29(35.3%) was the most common ultra-sonogram finding. Significant elevation of transaminases (SGOP, SGPT) was seen in 39(47.5%). Severe thrombocytopenia was observed in 22(26.8%) children. Management was by administration of colloids and crystalloids.Conclusions: Dengue is a global problem. Presenting features include high grade fever, vomiting, abdominal pain, skin rash. Early recognition of symptoms and proper management can reduce the mortality.
Résumé
Os autores relatam os resultados obtidos com o tratamento cirúrgico de fraturas diafisárias do fêmur em crianças, utilizando o pino de Steinmann intramedular, no período de janeiro de 1981 a dezembro de 1986, efetuando no Serviço de Ortopedia e Traumatologia do Hospital Municipal Miguel Couto do Rio de Janeiro. A principal opçäo pelo tratamento cirúrgico deveu-se ao baixo nível sócio-econômico de nossos pacientes, pos, quando submetidos ao tratamento clássico convencional (traçäo seguida de imobilizaçäo gessada, freqüentemente, ao retornarem para revisäo ambulatorial, apresentavam desvios importantes no foco da fratura, por terem deambulado com o aparelho gessado. Concluem que o tratamento cirúrgico apresenta bons resultados e que o tratamento conservador näo consegue evitar os desvios rotacionais ou angulares, às vezes grosseiros. Os achados quanto ao hipercrescimento ou encurtamento femural da regiäo acometida säo compatíveis com os encontrados na literatura