Dengue Virus Causes dengue and dengue hemorrhagic fever Is by frb17196

VIEWS: 272 PAGES: 68

									 Homoeopathy & Dengue
            By

           Dr.A.Shanthakumar
Member            :   Sri Lanka Homoeopathic Medical Council
Chairman          :   The National Homoeopathic research Institute,
National Organizer:    Lanka Homoeopathic Foundation.
Founder           :   Association for protection, propagation Research of
                      Classical Homoeopathy (APPROCH)
Member           :    Society of Homoeopaths U.K
                      British Homoeopathic Association U.K

Ex: co Member     :   All India Homoeopathic awareness and welfare
                      association.

Advisor           :   International Homoeopathic Foundation (Kolkota)

                  www.ask-homoeopathy.com
                 Email:drshanthahom@live.com
                  drshantha@ask-homoeopathy.com




                                                             www.similima.com   1
Our Vision and Mission
                          “strive to generate
                           Homoeopaths of
                           High standard”

                          Extend the best of
                           the science of
                           Homoeopathy for
                           the humanity


        www.similima.com                        2
                 What is dengue?
   Dengue is a mosquito-borne infection that causes a
    severe flu-like illness, and sometimes a potentially lethal
    complication called dengue hemorrhagic fever.
   Global incidence of dengue has grown dramatically in
    recent decades.
   About two fifths of the world's population are now at
    risk.
   Dengue is found in tropical and sub-tropical climates
    worldwide, mostly in urban and semi-urban areas.
   Dengue hemorrhagic fever is a leading cause of serious
    illness and death among children in some Asian
    countries.
                            www.similima.com                      3
                Allopathic view
   There is no specific treatment for dengue, but
    appropriate medical care frequently saves the
    lives of patients with the more serious dengue
    hemorrhagic fever.


   The only way to prevent dengue virus
    transmission is to combat the disease-carrying
    mosquitoes. (Allopathic and present social
    structural view)

                       www.similima.com              4
           Homoeopathic view
   Dengue can be cured based on
    individualized treatment.

   Treat the diseased individual not the
     effect of the disease

    Understand the historical development of
    disease.
                     www.similima.com           5
                 Dengue Virus

Causes dengue and dengue hemorrhagic fever Is an
arbovirus Transmitted by mosquitoes
Composed of single-stranded RNA Has 4 serotypes
(DEN-1, 2, 3, 4)
The dengue virus causes dengue and dengue
hemorrhagic fever.
It is an arbovirus, and within this group it is a flavivirus,
in the same family as the viruses that cause yellow
fever, St. Louis encephalitis, West Nile fever, and
Japanese encephalitis.
All these viruses are transmitted by mosquitoes.
The dengue virus is composed of single-stranded RNA,
and it has four serotypes, known as DEN-1, 2, 3, and 4. 6
                         www.similima.com
           Dengue Viruses

Each serotype provides specific lifetime immunity, and
short-term cross-immunity
All serotypes can cause severe and fatal disease
Genetic variation within serotypes
Some genetic variants within each serotype appear to be
more virulent or have greater epidemic potential




                      www.similima.com                    7
Transmission of Dengue Virus by Aedes aegypti




                   www.similima.com             8
         Replication and Transmission of Dengue Virus
                            (Part 1)


 
1   Virus transmitted to human in mosquito
        saliva
         




                                                                 
2   Virus replicates in target organs
         



3   Virus infects white blood cells and
        lymphatic tissues
                                                                                                             

4   Virus released and circulates in blood
                                                                              


                                             www.similima.com                                     9
       Replication and Transmission of Dengue Virus
                          (Part 2)


   5. Second mosquito ingests
                                                  
    virus with blood

   6. Virus replicates in mosquito
    midgut and other organs,
    infects salivary glands

   7. Virus replicates in salivary
    glands 




                                      www.similima.com   10
Aedes aegypti Mosquito




         www.similima.com   11
           Aedes aegypti


Dengue transmitted by infected female mosquito
           Primarily a daytime feeder
        Lives around human habitation
 Lays eggs and produces larvae preferentially in
              artificial containers



                     www.similima.com              12
Dengue Clinical Syndromes

     Undifferentiated fever
     Classic dengue fever
     Dengue hemorrhagic
      fever
     Dengue shock syndrome




             www.similima.com   13
              Undifferentiated Fever
 May be the most common manifestation of
  dengue
 Prospective study found that 87% of
  students infected were either
  asymptomatic or only mildly symptomatic
 Other prospective studies including all
  age-groups also demonstrate silent
  transmission
Source: DS Burke, et al. A prospective study of dengue infections in Bangkok. Am J Trop Med Hyg 1988; 38:172-80.


                                                 www.similima.com                                                  14
    Clinical Characteristics of
          Dengue Fever
 Fever
 Headache
 Muscle and joint pain
 Nausea/vomiting
 Rash
 Hemorrhagic manifestations



                  www.similima.com   15
    Signs and Symptoms of Encephalitis /Encephalopathy
    Associated with Acute Dengue Infection


 Decreased level of consciousness:
  lethargy, confusion, coma
 Seizures
 Nuchal rigidity
 Paresis




                         www.similima.com                16
Hemorrhagic Manifestations of Dengue

 Skin hemorrhages:
  petechiae, purpura, ecchymoses
 Gingival bleeding
 Nasal bleeding
 Gastrointestinal bleeding:
  hematemesis, melena, hematochezia
 Hematuria
 Increased menstrual flow
                 www.similima.com     17
      Clinical Case Definition for
      Dengue Hemorrhagic Fever
4 Necessary Criteria:
 Fever, or recent history of acute fever
 Hemorrhagic manifestations
 Low platelet count (100,000/mm3 or
   less)
 Objective evidence of “leaky capillaries:”
      elevated hematocrit (20% or more over
       baseline)
      low albumin
      pleural or other effusions

                      www.similima.com         18
      Clinical Case Definition for
       Dengue Shock Syndrome
 4 criteria for DHF
 Evidence of circulatory failure manifested
  indirectly by all of the following:
     Rapid  and weak pulse
     Narrow pulse pressure (< 20 mm Hg) OR
      hypotension for age
     Cold, clammy skin and altered mental status
   Frank shock is direct evidence of
    circulatory failure
                      www.similima.com              19
             Four Grades of DHF
   Grade 1
       Fever and nonspecific constitutional symptoms
       Positive tourniquet test is only hemorrhagic
        manifestation
   Grade 2
       Grade 1 manifestations + spontaneous bleeding
   Grade 3
       Signs of circulatory failure (rapid/weak pulse, narrow
        pulse pressure, hypotension, cold/clammy skin)
   Grade 4
       Profound shock (undetectable pulse and BP)



                             www.similima.com                    20
                 Danger Signs in Dengue
                   Hemorrhagic Fever

   Abdominal pain - intense and sustained
   Persistent vomiting
   Abrupt change from fever to hypothermia, with
    sweating and prostration
   Restlessness or somnolence



   Source: Martínez Torres E. Salud Pública Mex 37 (supl):29-44, 1995.


                                                          www.similima.com   21
Warning Signs for Dengue Shock




            www.similima.com   22
Signs and Symptoms in Cases of DHF

         SIGNS AND SYMPTOMS 

           Fever
           Rash
           Hepatomegaly
           Effusions
           Frank shock
           Coma
           Any hemorrhage**  




              www.similima.com       23
Hemorrhagic Signs and Symptoms


      SIGNS AND SYMPTOMS  
        
     Microscopic hematuria
     Petechiae
     Epistaxis

     Gingival hemorrhage
     Blood in stools
     Positive tourniquet test
            www.similima.com     24
Hemorrhagic Signs and Symptoms in Cases of DHF,


        Signs and Symptoms

        Bloodinvomitus
        Bleeding at venipuncture
        Hemoptysis
        Vaginal hemorrhage
        Gross hematuria
        Other hemorrhage**
                    www.similima.com          25
Clinical Laboratory Analyses in Cases of DHF

Test with Abnormal Result
Thrombocytopenia
Platelet count
Increased Capillary Permeability  
Hemoconcentration > 0.20  
Low serum protein  
Low serum albumin



                       www.similima.com    26
Unusual Presentations of Severe
        Dengue Fever

     Encephalopathy
     Hepatic damage
     Cardiomyopathy
     Severe gastrointestinal
      hemorrhage



                www.similima.com   27
    Risk Factors Reported for DHF
 Virus strain
 Pre-existing anti-dengue antibody
     previousinfection
     maternal antibodies in infants

 Host genetics
 Age



                       www.similima.com   28
    Risk Factors for DHF (cont)
 Higher risk in secondary infections
 Higher risk in locations with two or more
  serotypes circulating simultaneously at
  high levels (hyperendemic transmission




                   www.similima.com           29
Increased Probability of DHF




           www.similima.com    30
     Hypothesis on Pathogenesis of DHF (Part 1)


   Persons who have experienced a dengue
    infection develop serum antibodies that
    can neutralize the dengue virus of that
    same (homologous) serotype




                      www.similima.com            31
Homologous Antibodies Form Non-Infectious
               Complexes




                 www.similima.com           32
     Hypothesis on Pathogenesis of DHF (Part 2)


   In a subsequent infection, the pre-existing
    heterologous antibodies form complexes
    with the new infecting virus serotype, but
    do not neutralize the new virus




                      www.similima.com            33
Heterologous Antibodies Form Infectious
              Complexes




                www.similima.com          34
     Hypothesis on Pathogenesis of DHF (Part 3)


   Antibody-dependent enhancement is the
    process in which certain strains of dengue
    virus, complexed with non-neutralizing
    antibodies, can enter a greater proportion
    of cells of the mononuclear lineage, thus
    increasing virus production



                      www.similima.com            35
Heterologous Complexes Enter More Monocytes,
           Where Virus Replicates




                  www.similima.com             36
     Hypothesis on Pathogenesis of DHF (Part 4)


   Infected monocytes release vasoactive
    mediators, resulting in increased vascular
    permeability and hemorrhagic
    manifestations that characterize DHF and
    DSS




                      www.similima.com            37
       Viral Risk Factors for DHF
              Pathogenesis

   Virus strain (genotype)
     Epidemic   potential: viremia level, infectivity
   Virus serotype
     DHF risk is greatest for DEN-2, followed by
      DEN-3, DEN-4 and DEN-1



                         www.similima.com                38
Differential Diagnosis of Dengue

   Influenza
   Measles
   Rubella
   Malaria
   Typhoid fever
   Leptospirosis
   Meningococcemia
   Rickettsial infections
   Bacterial sepsis
   Other viral hemorrhagic fevers
                          www.similima.com   39
     Clinical Evaluation in Dengue Fever


 Blood pressure
 Evidence of bleeding in skin or other sites
 Hydration status
 Evidence of increased vascular
  permeability—pleural effusions, ascites
 Tourniquet test



                    www.similima.com            40
Petechiae




  www.similima.com   41
Pleural Effusion Index




         www.similima.com   42
                        Tourniquet Test

 Inflate blood pressure cuff to a point
  midway between systolic and diastolic
  pressure for 5 minutes
 Positive test: 20 or more petechiae per 1
  inch² (6.25 cm²)

   Source: Pan American Health Organization: Dengue and Dengue Hemorrhagic Fever: Guidelines
    for Prevention and Control. PAHO: Washington, D.C., 1994: 12.




                                        www.similima.com                                    43
Positive Tourniquet Test




          www.similima.com   44
     Laboratory Tests in Dengue Fever


   Clinical laboratory tests
     CBC—WBC,     platelets, hematocrit
     Albumin
     Liverfunction tests
     Urine—check for microscopic hematuria
   Dengue-specific tests
     Virus isolation
     Serology

                        www.similima.com      45
    Laboratory Methods for Dengue Diagnosis



 Virus isolation to determine serotype of
  the infecting virus
 IgM ELISA test for serologic diagnosis




                    www.similima.com          46
Virus Isolation: Cell Culture




            www.similima.com    47
Virus Isolation: Cell Culture




            www.similima.com    48
Virus Isolation: Mosquito Inoculation




               www.similima.com         49
Virus Isolation: Fluorescent Antibody Test




                 www.similima.com            50
ELISA Test for Serologic Diagnosis




              www.similima.com       51
ELISA Plate




   www.similima.com   52
Collection and Processing of Samples for Laboratory
                     Diagnosis

Type of Specimen           Time of Collection      Type of
                                                   Analysis

Acute-phase blood          When patient            Virus isolation
(0-5 days after onset)     presents;               and/or serology
                           collect second sample
                           during convalescence
                            
Convalescent-phase blood   Between days 6 and      Serology
(>6 days after onset)      21                       
                           after onset




                            www.similima.com                         53
    Procedures for Diagnosing a Suspected Dengue Fatality



 Inform the laboratory processing the
  samples that the case was fatal
 Obtain a blood sample to attempt virus
  isolation and serology
 Obtain tissue samples for separate tests of
  virus isolation and immunohistochemistry



                          www.similima.com                  54
Temperature, Virus Positivity, and Anti-Dengue IgM, by
                     Fever Day




                       www.similima.com            55
        Homoeopathic View
Treat the Diseased Individual
not the disease in a individual




                 www.similima.com   56
How dose Homoeopathy remove the
            cause?


    Weight is give to who is suffering , rather
    than what he is suffering.


   Homoeopathic Science at the very
    inception, has been devised to treat the
    indivudal in diseases
                      www.similima.com         57
      Homoeopathic treatment
 Eradicating the cause is the basis of
  homoeopathic treatment. Treat the cause
  and the effect will disappear.
 This means making the tissue healthy so
  that the immunity in the tissue increases
  and the tissue dose not invite any
  bacteria or viruses or provide any
  nouurishement to them.

                   www.similima.com           58
    According to the body responses most of the
    individual Following rubrics can be selected
                                 .

1.Extremities Pain fever during
2.Fever chilliness with
3.Head pain heat during
4.Stomach vomiting heat during
5.Generals Weakness fever during
6.Fever: Exanthemic




                          www.similima.com         59
Homoeopathic Medicines

   Ars Alb       11/5
   Puls          11/5
   Acon          10/4
   Bell          10/4
   Bry            9/4
   Eup-per        9/4

          www.similima.com   60
   Following Medicines
Also can be considered based on individualization



            Gelsemeium
            Lachesis
            Millefolium
            Rhus Tox
            Hamemelis
            Leadum pal
            Baptisia
            Pyrogenum

                   www.similima.com                 61
Dr.Prafull Vijayakar’s
 Theory of Acutes

  Activity
  Thirst
  Thermal




        www.similima.com   62
  “ Similimum conceived
Homoeopathy, Singlimum
and minimum developed it
 to its normal stature and
 the vital principle put life
           into it”

            www.similima.com    63
Cardinal principles of
   Homoeopathy




        www.similima.com   64
    Physical Generals
(Homoeopathic parameters)


   Desire to work
   Stamina to work
   Desire to eat and drink
   Sleep
   Excretions: stool, urine and
      perspiration


                     www.similima.com   65
Homoeopathic remedy acts on
   the body to enhance the
     nutritive gradients by
    adjusting the electrical
 potentials, which should be
higher in the more important
   tissues like brain, heart,
            lungs ect

             www.similima.com   66
Vital force itself which is curing
    the disease and not our
  Homoeopathic Medicine.

   The work of the Homoeopathic
Single dose administered was only to
              stimulate
 the immune reaction that proceeds
            towards cure.

               www.similima.com    67
Thank you




  www.similima.com   68

								
To top