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The dengue fever season which is usually synonymous with the monsoons in India is showing no signs of abating. The numbers are much higher in cities like Delhi and Mumbai, whose already overworked hospitals and civic bodies are struggling to contain the ailment and treat the ill.
Dr Arvind Aggarwal, senior consultant, internal medicine at the Sri Balaji Action Medical Institute, Delhi has something to say about the disease, why it won?t go away and how people should pay more attention to the onset of the fever:
Is there any significant change in the disease trend this year? Are the elderly or people with lower immunity likelier to suffer from dengue?
This year we are seeing a large number of healthy young adults, especially teenagers suffering from the ailment. The reason for this is that they are more likely to travel or stay outdoors as compared to aged people or immune compromised people. Normally, every family tries to keep their homes free of mosquitoes and maintain hygiene when people go out, they are likelier to be bitten by dengue-carrying mosquitoes. (Read: Dengue fever: Symptoms, medication and prevention)
What are the symptoms of dengue fever? How can people recognise it early?
The most glaring symptoms are high-grade fever, chills, severe headache and pain behind the eyes (retro-orbital pain), severe headaches and body aches. After the second day of onset of the aforementioned symptoms, they may even start vomiting or feel extremely restless. In many patients we can diagnose the disease in a day itself, but in some cases people stay home when they have fever and self-medicate. Only when it becomes very severe and they are not able to bear the headaches and retro-orbital pain do they come to a doctor.
It is important that we recognise the possibility of a patient possibly suffering from dengue. Even doctors should take these complaints seriously. This is important because if it is diagnosed early the complications are much lower and can be handled effectively. (Read: Can papaya leaves help cure dengue?)
Should all patients presenting with high fever be aggressively tested for dengue?
Yes, it is essential that physicians have a high suspicion of dengue fever, especially in these two months when it is epidemic.
What are the tests that are done to detect the presence of dengue?
A test called NS1 (a test for the presence of the viral antigen) and other tests for the antibodies against the dengue virus can be done. The NS1 test is more accurate on the first seven days of the infection. If the patient comes to us after seven days, then we perform serological tests, where we test for the presence of theantibodies against the virus. Since these antibodies are produced by the body only after five to seven days, they are more effective. The most important thing here is that this antigen can be tested at any point during the infection, unlike in malaria where the test yields proper results only while the patient is having fever. Of course, the tests give better results at the peak of the disease.
What complications can dengue fever lead to?
Patients may suffer from very low blood pressure and very low platelet count. The patient?s also likely to bleed from various orifices like the nose and mouth and they might even notice blood in their urine. When it gets worse, the patient is likely to suffer from dengue haemorrhagic fever and dengue shock syndrome.
I am 27 year old male and I am a pharmacist. I am suffering from ringworm infection from last 2 years on my right hip (since december 2012), I got this infection from my younger brother (his got relief from it with in 2-5monts, now he is ok). I have taken lots of medicine since 2 years, my doctor prescribed me ketoconazole cream + beclomethasone, neomycin, clotrimazole cream + 1tab fluconazole + some antihistamine drug. Some doctor prescribed me terbinafin also. When I take fluconazole tablet with appling cream also I got relief from it for 10 to 15 days, but with continue application of creams, it again occurs, some one suggest me to use clotimazole dusting powder, it give me relief but not give cure and thi again occurs. When I use combination of 3 creams (ketoconazole cream + beclomethasone, neomycin, clotrimazole cream + clobetasol, nomycin, miconazole cream) I got relief when I apply this combination. But during application of this combination it not appear & when I stop it again occurs. Please suggest me for resistant ringworm infection, which is initially half ring and now it is dotted in a small area which also looks like ring type with itching. Thanks
My 5 years old son is suffering from Nephrotic Syndrome. Is there any other medication other than Steroid?
Nephropathy is also known as renal disease. It is any type of damage or disease relating to the kidneys. Though not everyone with diabetes has nephropathy, however, diabetic nephropathy can cause kidney failure.
How does diabetes affect the kidney?
Kidneys are responsible for taking waste out from your blood. They have a lot of tiny blood vessels to do this. High blood sugar may kill such blood vessels. Once these blood vessels are destroyed, the kidneys may not function as well or it may even lead to kidney failure.
What increases your risk of getting diabetic nephropathy?
There are several factors which increase your risk of getting diabetic nephropathy including: 1.High blood pressure
4.Being Native American, African American or of Hispanic origin, for whom risk factors have proved to be magnified
5. If you have family history of diabetic nephropathy
Symptoms and diagnosis:
There are very few noticeable symptoms, which appear when you have diabetic nephropathy, except swelling in your arms and legs. The diagnosis is done by checking for a type of protein in your urine known as albumin, which is not supposed to be there. Getting the diagnosis done early is crucial.
You can prevent kidney damage by doing the following:
1. Keeping your blood sugar levels under control - keep HbA1C < 6-7%
2. Keeping your blood pressure under control in the range of 130/80
3. Eating healthy food
4. Exercising regularly
5. Not eating too much protein
6. Not eating too much salt
7. Reducing smoke or excessive tobacco usage
Medicines for treatment
If you do get diabetic nephropathy, here are some medicines, which can help cure it
1.ACE inhibitors which are also called angiotensin-converting enzyme inhibitors
2.Angiotensin II Receptor - blockers (ARBs)
1.Blood pressure may rise
2.Triglyceride levels and cholesterol levels may rise.