Abstraction
The most common arthropod-borne viral disease in the world is dengue, a virus spread by mosquitoes. Because of the severity of the muscular spasms and joint pain, it is often referred to as “breakbone fever,” “dandy fever,” or “seven-day fever” due to the typical duration of symptoms. The majority of cases have no symptoms, however fatalities and serious sickness can happen.
The virus is spread by Aedes mosquitoes, which are widespread in tropical and subtropical regions of the world. Over the past few decades, there has been a significant increase in dengue incidence. In several regions of the world, the virus is currently prevalent.
A small number of individuals who had previously contracted one subspecies of dengue virus go on to develop severe bleeding and capillary permeability when they contract another subspecies of the virus. This illness is known as dengue hemorrhagic fever .[1][2][3]
ETIOLOGY:
Dengue fever is caused by any of four distinct serotypes (DENV 1-4) of single-stranded RNA viruses of the genus Flavivirus. Infection by one serotype results in lifelong immunity to that serotype but not to others.[4][5][6]
PATHO- PHYSIOLOGY :
The dengue virus, which belongs to the Flavivirus family, is a 50 nm virion that contains a 10.7 kb capped positive-sense single strand of ribonucleic acid, three structural and seven nonstructural proteins, and a lipid envelope. Of infected persons, up to 75% have no symptoms at all. There may be a range of illnesses, from bleeding and shock to self-limiting dengue fever. A small percentage of infections—between 0.5 and 5%—develop into severe dengue. Inadequate care can result in mortality rates as high as 20%. These mostly affect young people. The illness typically takes 4 to 7 days to incubate, but it can take up to 10 days. If symptoms appear more than two weeks after exposure, dengue fever is not likely to be the cause.
It’s unclear how a mosquito bite might inject the dengue virus into the skin. Dendritic cells and skin macrophages seem to be the primary targets. It is believed that the contaminated cells subsequently travel to the lymph nodes and disperse to other organs via the lymphatic system. Before symptoms appear, viremia may be present for 24 to 48 hours. Then, a complicated interplay between virus and host variables decides whether the infection will be mild, normal, or severe. A second dengue virus serotype and the patient’s immune system are assumed to be the cause of severe dengue fever with enhanced microvascular permeability and shock syndrome. On the other hand, severe dengue cases do happen when only only one serotype. As virus titers decline, worsening microvascular permeability frequently occurs.
SYMPTOMS:
Dengue typically progresses through three phases: febrile, critical, and recovery.
The febrile phase kicks off with a sudden high fever around 40 degrees Celsius lasting two to seven days. In some severe cases, about 6% of patients experience a “saddleback” fever pattern, where the fever pauses for a day before returning for another day. Symptoms during this phase include facial flushing, muscle and joint pains, headaches, sore throat, nausea, vomiting, and a blanchable rash that appears early in the fever or within 24 hours as a different kind of rash.
The critical phase begins with a decrease in fever (37.5-38 degrees Celsius) on days three to seven. This phase is marked by increased capillary permeability and typically lasts one to two days. It’s signaled by a rapid drop in platelet count, a rise in hematocrit, and the emergence of warning signs. Without proper management, this phase can progress to shock, organ dysfunction, or bleeding disorders.
The recovery phase involves the gradual reabsorption of fluids over two to three days, and during this time, patients might experience a slower heart rate.
Dengue can also lead to expanded syndromes affecting various organs like the nervous system, liver, kidneys, and more. Unusual manifestations may arise due to severe shock, such as seizures, meningitis, or bleeding in the brain. Other complications can affect the gastrointestinal system, heart, lungs, kidneys, and blood.
Evaluating dengue involves common lab findings such as low platelet and white blood cell counts, along with elevated aspartate aminotransferase levels. The disease is categorized as either dengue or severe dengue.
Criteria for Dengue Diagnosis Include:
Probable Dengue: Fever plus two symptoms among nausea, vomiting, rash, muscle or joint pains, positive tourniquet test, or low white blood cell count, in someone from or who has traveled to a dengue-prone area.
Warning Signs: Indicators like abdominal pain, persistent vomiting, fluid accumulation, bleeding, lethargy, enlarged liver, increased hematocrit, and low platelet count.
Severe Dengue: Dengue with severe plasma leakage, bleeding, organ dysfunction, high liver enzymes, impaired consciousness, heart or lung issues.
Clinical warnings for Dengue Shock Syndrome include a rapid rise in hematocrit, severe abdominal pain, ongoing vomiting, and low blood pressure.
Diagnosis involves detecting the virus antigen using ELISA, PCR, or viral isolation from bodily fluids. Serology shows a significant increase in antibodies. A confirmed diagnosis requires culture, antigen detection, PCR, or serologic testing.Special attention should be given to pregnant patients as dengue symptoms can resemble those of preeclampsia.
HOMOEOPATHIC MANAGEMENT:{11}
1. Eupatorium Perfoliatum –
This is considered to be one of the best homeopathic medicines for dengue by most homeopathic physicians. It is mostly used as the first medicine for dengue cases. This medicine is prescribed when the patient complains of extreme muscle, bone, and joint pains along with a high fever. This medicine is known for being effective in bone and joint pains caused by fever. This homeopathic medicine is also effective if the patient has extreme pain in the eyes due to dengue fever. It is also beneficial for headaches, nausea, and vomiting. Symptoms get better upon sweating.
2. Bryonia Alba –
This is one of the common homeopathic remedies for dengue fever. It gives relief from muscle and joint pains due to dengue fever. This medicine is prescribed to patients who have fever with chills. The symptoms include feeling heat in the head even when there are chills in the body. This medicine is specifically suitable for those who are experiencing excruciating pain with even a slight movement in the body. Another symptom is feeling extreme thirst while having a dry mouth. Bryonia Alba is a very effective homeopathic medicine for dengue fever with these symptoms.
3. Rhus Tox –
Rhus Tox is one of the best homeopathic remedies for dengue fever. This medicine is mainly used to alleviate body pain that is caused by dengue fever. Unlike the symptoms for which Bryonia Alba is prescribed, Rhus Tox is prescribed when muscles, bones, and joint pains increase with rest and are reduced with movement. Other symptoms are having fever with both heating and chilling stages, one after another. This medicine is given when the body is first experiencing burning heat followed by chills and shivering.
4. Belladonna –
Belladonna is considered to be one of the top homeopathic medicines for dengue fever. This medicine is given when there is unbearable and throbbing pain around the temples (sides) of the head. This is the best homeopathic remedy to manage violent and throbbing headaches. Sometimes, there is a lot of pain behind the eyes. Other symptoms include lack of thirst and raised heat in the body with a red face and a flushed look. In cases needing belladonna, the patient is experiencing throbbing pain. To get some relief, they may be advised to bind the head tightly.
5. Arsenic Album –
Arsenic Album is one of the top homeopathic remedies for dengue fever when it comes to managing weakness. This medicine is required when the patient feels fatigued even due to standing and walking. The symptoms include tiredness to such an extent that the patient feels a need to lie down all the time. Even though the body may feel hot to touch from the outside, the patient may be feeling chills inside the body. Before this medicine is prescribed, the patient has complaints of having a fever at night which comes with anxiety and restlessness.The patient feels thirsty very regularly but needs very little water at once. Apart from alleviating these symptoms, Arsenic Album is also useful for managing vomiting and nausea. The patient feels repulsed by the sight and smell of food.
Homeopathic remedies for Dengue Hemorrhagic Fever
Hamamelis is one of the top homeopathic medicines that is used to manage bleeding from any body part. Other symptoms include exhaustion.
China is also one of the commonly recommended homeopathic medicines to manage bleeding. It is used to control bleeding and exhaustion.
REFRENCES:
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Authors
Dr. Ashok Yadav (Head Of Department, Department Of Practice Of Medicine), Dr Virendra Chauhan (ASS.PROF. PRACTICE OF MEDICINE) Dr. Mansi Mishra Md(Pgr) Department Of Practice Of Medicine, Dr. Anandita Debonath Md(Pgr) Deprtment Of Practice Of Medicine
