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Differntial Diagnosis Of Malaria And Dengue Fever On The Basis Of Clinical Findings And Laboratory Investigations

By: Aqeel Ahmad | Prof. Dr. M. Younus Rana.
Contributor(s): Dr. Muti ur Rehman | Prof. Dr. Azhar.
Material type: materialTypeLabelBookPublisher: 2010Subject(s): Department of PathologyDDC classification: 1198,T Dissertation note: I took two hundred (200) patients in total for purpose of my study. I included all cases with pyrexia of unknown origin with chills and rigors with 6-7 days history. These cases were first evaluated for Malaria by making their thin and thick films for malarial parasites. There were thirty patients out of two hundred who were positive for malarial parasites. There complete blood picture was done that is RBC count, Heamogolobin percentage, platelet count, WBC count and ESR. The cases who were negative from malaria were further evaluated for dengue viral infection by doing capture ELISA 1gM. Before doing ELISA 1gM dengue strip method test was done and the cases who were positive on strip (Paper Chromatography) were included in 1gM ELISA study. The cases that were positive for 1gM ELISA were studied for same blood investigation which was mentioned earlier. It was also found that there had been some incidence of dual dengue infection and malaria and the incidence rate was 2%. Now after collecting the data it was analyzed by SPSS. It was inferred afterwards from the data that all the patients +ve for dengue 1gM had been facing with low platelet count increased reticulocyte count, increased hemoglobin, decreased WBC and no significant effect on ESR had been seen. About 83% of dengue 1gM patients were having decrease platelet count. This thrombocytopenia varies from person to person and an inverse relationship has been found between dengue 1gM and platelet of the patients. The intensity of thromobocytopenia was more in old age patients or in patients with poor health status or in those patients in which tire of anti dengue 1gM was very high. This thromobocytopenia can be used as a diagnostic tool in addition to clinical history in patients who live in periphery where the facility of ELISA is not available. The rise in platelet number indicates recovery of the patients and it should be monitored daily till the complete recovery of patients is achieved. The rise in hemoglobin concentration has also been noticed due to hemo concentration about 76% of patients with anti dengue 1gM positive were having elevated level of hemoglobin that is ranging from 17-19 gram/dl. The increase in RBC count has also been noticed in association with increased hemoglobin concentration a mild fall in WBC count has also been noticed i-e upto 4000 in 76% of the patients. In those patients who were +ve for malarial parasites and negative for dengue 1gM, such changes in blood pictures were not appreciated although the vector of both diseases is same but AD's mosquitoes which is the carrier of dengue virus (an ARBO virus) causes more severe form of disease.
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I took two hundred (200) patients in total for purpose of my study. I included all cases with pyrexia of unknown origin with chills and rigors with 6-7 days history. These cases were first evaluated for Malaria by making their thin and thick films for malarial parasites.

There were thirty patients out of two hundred who were positive for malarial parasites. There complete blood picture was done that is RBC count, Heamogolobin percentage, platelet count, WBC count and ESR. The cases who were negative from malaria were further evaluated for dengue viral infection by doing capture ELISA 1gM. Before doing ELISA 1gM dengue strip method test was done and the cases who were positive on strip (Paper Chromatography) were included in 1gM ELISA study. The cases that were positive for 1gM ELISA were studied for same blood investigation which was mentioned earlier. It was also found that there had been some incidence of dual dengue infection and malaria and the incidence rate was 2%.

Now after collecting the data it was analyzed by SPSS. It was inferred afterwards from the data that all the patients +ve for dengue 1gM had been facing with low platelet count increased reticulocyte count, increased hemoglobin, decreased WBC and no significant effect on ESR had been seen. About 83% of dengue 1gM patients were having decrease platelet count. This thrombocytopenia varies from person to person and an inverse relationship has been found between dengue 1gM and platelet of the patients.

The intensity of thromobocytopenia was more in old age patients or in patients with poor health status or in those patients in which tire of anti dengue 1gM was very high. This thromobocytopenia can be used as a diagnostic tool in addition to clinical history in patients who live in periphery where the facility of ELISA is not available. The rise in platelet number indicates recovery of the patients and it should be monitored daily till the complete recovery of patients is achieved.

The rise in hemoglobin concentration has also been noticed due to hemo concentration about 76% of patients with anti dengue 1gM positive were having elevated level of hemoglobin that is ranging from 17-19 gram/dl. The increase in RBC count has also been noticed in association with increased hemoglobin concentration a mild fall in WBC count has also been noticed i-e upto 4000 in 76% of the patients. In those patients who were +ve for malarial parasites and negative for dengue 1gM, such changes in blood pictures were not appreciated although the vector of both diseases is same but AD's mosquitoes which is the carrier of dengue virus (an ARBO virus) causes more severe form of disease.

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