European Journal of Molecular & Clinical Medicine

Bacterial and Viral infections are often hard to be distinguished in daily clinical practice. Biological markers obtained from a routine examination play an important role to minimize time in providing diagnose and giving therapy. Recently, the use of Neutrophil-lymphocyte ratio (NLR)and platelet-lymphocyte ratio (PLR) is greatly considered to differentiate types of infection found in the patients presenting with fever.
Material and Method: This study uses prospective cohort study design and involves patients presenting with fever who are admitted in the hospital. The initial NLRand PLR is examined and categorized into types of infection foundi.e. grade I DHF and grade II DHF. The ANOVA test and t-test are performed to find out the difference among study groups.
Result: In the present study, a total of 104 patients were clinically suspected on the admission as dengue fever, 80 of these were serologically confirmed dengue positive. A 44 of these were grade IDHF infections. The average age was 42.1 years, the range being 23-65 years. Based on 2009 WHO clinical criteria, 34 were identified as Dengue with warning Sign, 27 as Dengue Without warning Signs while 19 were identified as Severe Dengue. Some of the frequently observed clinical features were fever, headache, thrombocytopenia, leukopenia and rashBoth NLR and PLR correlated severity of DHF.NLR and PLR had significantly higher values in grade II DHF patients.
Conclusion: Neutrophil-lymphocyte ratioand PLR have benefit to predict diagnosis for the patients presenting with a fever. Bacterial infection is associated with the high value of NLRand PLR generally has a lower value in viral infection cases.

Introduction: Dengue viral infection is an arboviral disease which is transmitted by Aedes aegypti and Aedes albopictus. Dengue cases are now increasing a global burden especially in tropical and subtropical countries.¹ The patients with dengue fever have high levels of nonstructural protein-1 (NS1) protein in their serum after onset till <5 days.   The present study aims to establish most sensitive and reliable method for the early diagnosis of dengue infection.
Materials & Methods: Total 110 patients were screening who were having <5 days of history of dengue like fever at NIMS Medical College, NIMS University, Jaipur from June 2020 to Oct 2022.  For Dengue NS1 ICT & ELISA J. Mitra Pvt Ltd. Kits were used. Dengue RTPCR was done by TRU PCR 3B Black Bio kits as per standard protocol.⁵
Results: Out of 110, total 72 (65.45%) cases were positive (either by ICT, ELISA & RTPCR).  Among 72 dengue positive cases 48 (66.6%) were male while 24 (33.4%) were females. Male: female ratio was 2:1 observed.  55 patients were positive by Dengue NS1 ICT, 59 were positive by NS1 ELISA while 72 cases were positive by RTPCR.
Conclusion: Early detection and diagnosis are very important in the case of dengue infection as if it is not treated it may lead to many complications. RTPCR is the most sensitive and specific method for the early diagnosis of dengue. After this covid pandemic most hospitals have RTPCR lab facilities which can be utilized for dengue detection by RTPCR.

The present study aimed to compare the haematological and biochemical indices between Dengue patients, and assess the relationship of these indices inprognosis and severity of Dengue fever.
Materials and Methods: A total number of 40 children with confirmed diagnosis of Dengue fever who visited and some of them were admitted Sri SathyaSai Medical College and Research Institute in Chennai were selected in this case-control study. Haematological, biochemical and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and outcome of the disease were assessed in this study.
Results: The number of children confirmed diagnosed with Dengue fever were 40, they were further divided into three different group based on severity of the disease. Haematological and biochemical variables were statistically significant in these three different groups. Neutrophil count, platelet count, lymphocyte count, and haemoglobin concentration were also higher in the dengue fever with warning signs patient group (P=0.001). NLR and PLR were significantly higher in severedengue patients compared to the mild patients (P=0.01). NLR had a significant relationship with the severity of the disease. Multivariable analysis for diagnostic values of NLR and PLR showed that the NLR and PLR were significant at 2.336 (95% CI: 1.636–3.336) and 1.4 (95% CI: 0.28-0.29), respectively.
Conclusion:Platelet-to-Lymphocyte Ratio (PLR) and Neutrophil-To-Lymphocyte Ratio (NLR) can be used as a prognostic marker for Dengue disease given the significant difference of PLR and NLR between mild Dengue patients and severe Dengue patients.

Dengue viral infection is a major public health problem in developing tropic countries. Thrombocytopenia and bleeding manifestations are commonly  associated with dengue patients. The need for platelet transfusion in dengue patients is not clearly defined in them. This study aims at evaluating the effects of prophylactic blood transfusion in dengue patients.
Materials and methods :
About 267 seropositive dengue patients with platelet counts < 20,000/cumm were randomized into two groups. Group A had 135 patients who received prophylactic blood transfusion and group B which had 132 patients who did not receive prophylactic blood transfusion. The outcomes were studied and compared  for statistical significance.
Results :
The patients who received prophylactic blood transfusion did not had a statistically significant reduction in major and minor bleeding  manifestations , transfer to Intensive Care Unit or recovery from thrombocytopenia.
Conclusion :
Prophylactic blood transfusion have no role in treatment of thrombocytopenia in adult dengue patients.

Background: Dengue is the most common arthropod borne viral illness in humans, transmitted by mosquitoes of the genus Aedes. The present study was conducted to evaluate role of clinicohaematological profile in diagnosis of dengue at a tertiary care hospital.
Materials & Methods: The present study was conducted at Department of Pathology, Autonomous State Medical College, Shahjahanpur, Uttar Pradesh (India) over a period of 06 months. Clinical examinations were performed by a physician on each study participant. The diagnosis of dengue was made. All the routine investigations such as hematological determination was determined. Data were entered and analyzed using the SPSS 20.0 statistical software. Data were presented by using tables and figure.
Results: In the present study total participants were 450 in which 55.55% were males and 44.44% were females. Maximum patients suffering from dengue were of age group 18-30 yrs (40%). Clinical features show that fever was present in maximum patients (96%) followed by body ache (95.11%) and Retro-orbital pain (72.44%). Dehydration was absent in 46.66% patients. 1.77% of patients had severe dehydration and 1.55% patients were in shock. Mortality occurs in 3 cases. The most common hematological finding observed was thrombocytopenia (platelet count < 140,000/cumm) in 57.77%, followed by anemia (hemoglobin level < 11.5 g/dl) in 46.66% and leucopenia (total leukocyte count < 4,000/cumm) in 26.66% the cases. Hematocrit > 44% were noted in 11.11% of the cases. Neutrophil < 1500 in 13.33% and lymphocyte > 2900 in 4.44% of the cases. Autopsy findings of 3 cases shows serous effusions, pulmonary oedema, mucosal congestion of GIT, visceral congestion, hepatomegaly, cerebral oedema.
Conclusion: The study concluded that fever was present in most patients. Dehydration was absent in 46.66% patients. 1.77% patients had severe dehydration and 1.55% patients were in shock. The most common hematological finding observed was thrombocytopenia followed by anemia and leucopenia.

Introduction: Dengue is arboviral diseases spread by the bite of infected Aedes mosquito carrying these viruses. Every year, thousands of individuals are affected and contribute to the burden of health care. However, there was little information on serotypes of dengue virus circulating in this part of the country. This study was carried out molecular characterization of Dengue virus isolated from patients in our area and study correlation of prevalent serotype with severity of disease along with the hematological parameters.
Materials& Methods: 1192 dengue like illness patient samples were collected from 2018 -2020 at JNUIMSRC, Jaipur. RNA extraction was done by Qiagen viral RNA mini kit & followed byRTPCR by using type specific primers & probes were used for Dengue RT PCR.
Results: A total of 1192 dengue like illness cases who had less than <14 days of fever, blood samples were collected from various departments of JNUIMSRC, Jaipur.  Out to 1192 cases 585 (49.07%) where Dengue was found. In Dengue Majority of the patients 161 males (27.52%) & 73(12.47%) females belonged to the 21-30 yrs of age group. Out of 585 cases total 108 (18.46%) were DEN I, 163 (27.86%) DEN II, 218 (37.26%) DEN III and 74 (12.64%) DEN IV and along with this 24-mix serotype infection was found.
Conclusion: Dengue remains to be an important health problem in India and across the globe.  There is neither any specific treatment nor any effective vaccine for dengue so far available in India. So, the proper diagnosis is the first requirement for the management of the disease. DHF &DSS are life threatening. Molecular method is much needed as it hardly takes 4 hrs. To produce accurate result

Background: Dengue virus is the most common Arbovirus in India. It is transmitted by female mosquito -Aedes aegypti. It is a major public health problem world-wide, especially in tropical and sub-tropical areas. Approximately 100-400 million dengue cases occur every year according to World Health Organization (WHO). Hence early diagnosis of dengue is essential to prevent complications and mortality.
Material and Methods: A total of 94 cases with clinically suspicious of dengue fever were included. Blood samples from the OP/IP patients with <9 days fever were collected under aseptic conditions. Serum was separated by centrifugation and subjected to detection of dengue NS1 antigen and IgM antibodies by ELISA.
Results: Out of 94 samples, 23 were positive for dengue infection.  Out of 23, NS1 antigen was present in 7(30.4%) samples, IgM antibody was present in 4 (17.4%) samples, and both NS1 & IgM antibody were present in 12 (52.2%) samples. The sensitivity and specificity of NS1 antigen - 87.5%&82.5%, for IgM - 80%&79.7%, for NS1 antigen + IgM antibody - 92.3% and 87.6% respectively.
Conclusion: NS1 ELISA test method is an effective method for early detection of dengue fever. Early detection will help in treatment at appropriate time to prevent complications.  However, the combination of NS1 Ag test and IgM Ab test by ELISA detected high sensitivity and specificity which provides strong evidence for detection of clinically suspected dengue infection.

Background and Objective: Recently, complex and unusual dengue virus infections have become a significant public health concern. Dengue may cause hepatomegaly, increased liver enzymes, and fulminant hepatic failure. To research childhood dengue hepatic dysfunction. To investigate intensity, clinical features, laboratory data, morbidity, and death.
Methods: 110 patients admitted to the Department of Paediatrics, Kamineni Institute of Medical Sciences, Narketpally, Telangana, India, due to a Dengue illness were the subjects of a prospective cohort study from March 2021 to April 2022. Patients who tested positive for the Dengue virus were chosen for further evaluation, including a complete blood count, liver function tests, abdominal ultrasound, PT, APTT, HBsAg, HCV, and Widal testing.
Result: 110 patients with dengue infection were hospitalised; 46 were diagnosed as having probable dengue, 51 as having warning signs, and 13 as having severe dengue. 42% of patients showed signs of hepatomegaly. Comparing the two groups, 88% of patients exhibited warning signals, while 100% had severe dengue. 70% of patients with probable dengue, 94% with warning signs, and 100% with severe dengue experienced thrombocytopenia. In our study, three severe dengue cases passed away. The enzyme levels were extremely high in these two cases

Background: Dengue infection is a systemic and dynamic disease. It has a wide clinical spectrum that includes both severe and non-severe clinical manifestations. Often accompanied by typical changes in blood and biochemical profile.
Objectives: To see hematological and biochemical profile of dengue patients attending Pravara Rural Hospital
Material and Methods: This prospective study was conducted in the Department of Medicine, Pravara Rural Hospital, Loni from 2013 to 2015 for a period of 2 years on 128 dengue cases. All the necessary baseline investigations like complete blood count, platelet count, haematocrit, liver function test, kidney function test, coagulation profile like prothrombin time, activated partial thromboplastin time, bleeding time, clotting time, X-ray chest, ultrasound abdomen were done at admission. Data analyzed using Microsoft excel.
Results: Majority of the patients in the study were less than 35 years of age (74.22%). Maximum numbers of patients were in less than 25 years of age group. 1.56% patients has<10000 platelet count. 48.44% patients were having total leukocyte count less than 4000. AST was raised in 35.16% patients whereas ALT was raised in 28.91% patients. Haematocrit was raised in 35.94% patients.It was evident from the above table that NS1Ag was positive in 98.44% patients. IgG was positive in only one patient whereas None was IgM positive.
Conclusions: blood and biochemical profile help us in deciding treatment protocol and assessment of recovery by the patients

Background: Dengue is a febrile illness caused by infection with 1 of 4 dengue viruses transmitted by the Aedes mosquito. The present study was conducted to assess ECG manifestation of dengue fever.
Materials & Methods: 82 dengue fever patients were enrolled in study. Clinical features and ECG changes such as sinus bradycardia, sinus tachycardia, non- specific ST changes and RBBB were recorded.
Results: Out of 82 patients, males were 50 and females were 32. We observed that common clinical features were fever in 75, myalgia in 23, headache in 41, abdominal pain in 32, rashes in 15, arthritis in 17, palpitations in 20 and diarrhoea in 5 cases. We found that common ECG changes were sinus tachycardia in 6, sinus bradycardia in 30, non- specific ST changes in 12 and RBBB in 4 cases. The difference was significant (P< 0.05).
Conclusion: Common ECG abnormality in patients with dengue fever was sinus bradycardia.

Introduction: Dengue virus infection has emerged as a notable public health problem in recent decades . Laboratory evaluation of  dengue  Serological markers and  platelet count help in early diagnosis and can be used as predictor to reduce the morbidity and mortality of dengue disease.
Aim: Aim of  this  study is  to evaluate  Dengue  serological  markers for early diagnosis of cases  and to study  the correlation between  serological markers  and  platelet count  in dengue positive cases .
Materials and Methods: This was a cross-sectional prospective study  conducted  in  the Tertiary  health care centre , Hyderabad..  All clinically suspected cases of dengue, reported  to various outpatient departments, emergency services and admitted patients in the Hospital were included for this study,  from  July to   September   2018 . The Chi-Square test and statistical software Epi info and MS excel was used to find out the statistical significance of the estimate.
Results:   Among  700 blood  samples were  received from clinically suspected case of dengue , 125 (17.85%)  cases  were detected dengue positive  out of which  65 (52%) cases showed platelet count less than 1 lakh. . In confirmed dengue cases, thrombocytopenia is more consistently found in  dengue  positive cases  with only IgM  and only NS1 positive cases compared to other serological groups.
Conclusion: Detection of  dengue specific serological markers along with platelet count  in the diagnosis of dengue, increases the early diagnosis so as to avoid complications significantly and can be used as prognostic marker to reduce the morbidity and moratlity of dengue disease.

Introduction: Endothelial activation and dysfunction is a central process in the pathogenesis of tropical diseases and von-Willebrand Factor levels have been linked with damage to the endothelium. The purpose of the study is to evaluate von Willebrand Factor in tropical diseases-Scrub typhus, Dengue, Chikungunya, Malaria and its association with clinical outcome. vWF can be used as a novel prognostic marker of clinical outcome.
Methodology: Hospital-based prospective observational analytic study on36 subjects of each disease. Inclusion Criteria: Confirmed cases of Scrub typhus (IgM positive), Dengue (NS1/IgM positive), Chikungunya (IgM positive) and Malaria (slide positive/rapid antigen detection/severe malaria). Exclusion criteria: Patients with von-Willebrand disease, Thrombotic Thrombocytopenic Purpura, and other conditions characterized by vascular damage, including nephritis, myocardial infarction, sepsis, diabetic angiopathy, peripheral vascular disease. Complete history with the examination was done. Investigations including CBC, PBF, RBS, RFT, LFT, vWF activity were done.
Observation and Results: In our study, we observed that vWF levels were elevated in91% patients of malaria, 89% patients of dengue, 75% patients of chikungunya, 88% patients of scrub typhus. We also found that 6, 3, and 3 out of 36 patients died in Malaria, Dengue, and Scrub typhus respectively with mean vWF was 414.67 IU/dl, 420 IU/dl, and 420 IU/dl respectively against alive cases where mean vWF was 259.97 IU/dl, 272.97 IU/dl, and 233.94 IU/dl. There is a statistically significant difference in vWF among alive and dead cases.
Conclusion: Raised vWF shows the association of von- Willebrand Factor activity and its association with the complications in these tropical diseases. von- Willebrand Factor level can be used as a novel prognostic marker of clinical outcome.

Introduction: Nowadays, platelet counting is employed as a routine method owing to the emergence of dengue fever from the past few decades. Manual methods yield varying outcomes while sometimes automated methods produce inappropriate outcomes. Hence, the goal of this study is to evaluate the diagnostic accuracy of manual modality of platelet count with respect to automated analyzers. Additionally, this study was also analyzed the correlation between manual and automated analyzer.
Materials and Methods: The current study was carried out in the Department of Pathology, Employee’s State Insurance corporation (ESIC) Hospital, Sarojini Nagar, Lucknow (U.P.) on a group of 600 patients (375 female and 225 male) including both indoor and outdoor settings  from 1^st November to 30^th November, 2021 in a one month duration. The blood samples were collected in tubes containing K3-EDTA (tri-potassium ethylenediamine-tetra-acetic acid). Manual method of platelet counting was performed by slide method with Leishman stain while automated counting was carried out by using Mindray BC-6200, 5 part auto-hematology analyzer.
Results: A total of 600 patients have studied with the mean platelet count in automated analyzer was 1.16±0.99 ×10³ /µL and by manual method with Leishman stain was 1.23±1.03 lacs /mm³. A positive correlation was observed between automated analyzer and manual platelet count (r=0.837, p=0.00).     
Conclusion: When the platelet counts are very low, manual method of platelet counting should be done carefully to exclude clumping or irregular distribution of platelets. 

Background: Dengue infections vary in severity, ranging from influenza like self-limiting illness to life threatening dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Present study was aimed to study dengue fever in 1-12 years age group at a tertiary hospital.

Wolbachia is the most common bacterial endosymbiont of arthropods, such as the medically important Aedes albopictus. Recent reports also detected in Aedes aegypti. This study collected 12 adults Ae. albopictus and 359 Ae. aegypti from 183 households in a dengue-prone area, Manila, Philippines, between June and September 2017. Aedes larvae (n = 509) were also collected from 17 water containers from 11 households. The DNA of the Aedes larvae and adults were screened for the presence of Wolbachia using the wsp and 16S markers, following optimized polymerase chain reaction (PCR) conditions, and sequenced. Our results showed that 12 out of 12 (100%) adult Ae. albopictus and3 out of 359 (0.84%) adult Ae. aegypti were Wolbachia positive, whereas all larvae tested negative for Wolbachia (0/509; 0%). The wsp marker revealed six Wolbachia-positive Ae. albopictus belonging to supergroups A (n = 2) and B (n = 4). The 16S marker showed Wolbachia in ten Ae. albopictus and 3 Ae. albipictus,most sequences were in supergroup A (n = 11) and two in supergroup B. Our results revealed Wolbachia supergroups in field-collected Ae. albopictus and Ae. aegypti with implications for a successful Wolbachia mass release programs.

Background: Acute febrile illness (AFI)is specified as sudden onset of fever of unknown
origin lasting for 1-14 days. AFI may be caused by pathogens like bacteria, viruses,
parasites, and fungi leading to infectious diseases. Dengue is a vector-borne viral disease
that is transmitted by Aedes aegypti mosquitoes. Dengue NS1 Ag is released into the
blood during viral replication in infected patients and is detectable from the first day
after fever. As NS1 Ag can be identified promptly, it acts as a beneficial biomarker for
the early detection of dengue, allowing rapid management of dengue fever.
Materials and Methods: A retrospective study was carried out on blood samples of
patients presenting with acute febrile illness in OPD/IPD of a tertiary care hospital from
September 2019- December 2019. Out of 694 samples, the samples which were 2 mL in
quantity, non-hemolytic, non-lipemic, maintained in cold chain along with complete
demographic data were selected for the present study i.e. n=270.
Results: Blood samples of 270 patients who presented with acute febrile illness and met
with our inclusion criteria were tested for dengue NS1 antigen/IgM antibodies based on
their fever history. Out of 270, 120 patients tested positive for dengue.
Conclusion: To conclude, patients in tropical countries presenting in the post-monsoon
season with acute febrile illness not responding to appropriate and adequate therapy
aimed for a suspected tropical infection such as dengue should be evaluated for
concurrent infections with other microorganisms.

Background:Dengue is the most prevalent mosquito-borne viral disease affecting humans.
The present study was conducted to assess maternal and fetal complications of dengue
fever in pregnancy.
Materials & Methods: 96 antenatal patients diagnosed with dengue fever clinically and
serologically were included. Parameters such as parity, gestational age, symptoms at the
time of diagnosis, platelet count and haematocrit at the time of diagnosis were recorded.
Details regarding ICU admission need for transfusion and medical examination was
recorded. Maternal and fetal complications were also recorded.
Results: Gestational age at diagnosis (weeks) <12 was seen among 5, 12-20 in 8, 20-28 in
14, 28-34 in 16, 34-37 in 20 and >37 in 33. Trimester I was seen in 7, II in 23 and III in
66. Platelet count <20000 was seen in 10, 21000-50000 in 22, 51000- 100000 in 20, 1
lakh- 1.5 lakh in 32 and >1.5 lakh in 12. Fetal complications were IUGR in 3, fetal
malformation in 2, meconium- stained amniotic fluid in 8 and fetal distress in 5. Neonatal
outcome was prematurity in 11, low birth weight in 34, ICU admission in 5 and vertical
transmission in 6. The difference was significant (P< 0.05).
Conclusion: There were significant maternal and fetal outcome in pregnant women
suffering from dengue fever. Hence, there is need to have close monitoring of
complications.

Background: Dengue fever is a major public health problem with morbidity and mortality and the recent epidemic showed variable clinical presentations with unpredictable clinical progression and outcome. Increasing work is being done to identify a biomarker that may predict the various clinical phenotype or complications.
Materials and Methods: This was a prospective study conducted in the department of Pediatrics in a tertiary care hospital. Patients with clinically suspected dengue fever underwent dengue serology tests. Patients were followed till 48 hours post defervescence of fever or settling of any other ongoing concern. Data analysis was done using Windows SPSS software version 20 and P value less than 0.05 was considered statistically significant.
Results: A total of 200 patients were enrolled in the study. Maximum number of cases (48%) was in the age group of 11 to 15 years. Commonest symptom was fever in 100% cases. NS1 antigen was positive in 96% cases. Severe dengue patients were significantly more in age group of 6 to 10 years (58.2%) Children with dengue with warning signs had significantly raised levels of SGOT, SGPT and CPK.
Conclusion: Biochemical markers may help to identify and appropriately manage the high risk children of dengue fever with warning signs thus reducing morbidity and mortality due to dengue fever.

Introduction: Dengue fever, a mosquito-borne disease that occurs in tropical and subtropical
areas of the world, is considered to be a significant threat for the mankind in both developing
and developed countries.It causes a wide spectrum of illness from mild asymptomatic illness to
severe fatal dengue hemorrhagic fever/dengue shock syndrome. Its impact today is thirty times
>50 years ago. Global incidence of dengue has drastically upped in the last few years.
Materials and Methods: The study was carried out in the department of microbiology at
Government general hospital,siddipet fpr a period of one year , that is from January 2019 to
December 20219. Blood was collected from each patient suspected to be suffering from
dengue, at least 3 days after onset of fever. Serum was tested for the presence of dengue NS1
antigen and antihuman IgM antibodies using Panbio Dengue Early enzyme-linked
immunosorbent assay (ELISA) kit and National Institute of Virology. Results: A total of
samples
2251 were tested over a period of one years i.e. from January 2019 to December 2019. Out of
which 592 (26.29%) were sero-positive for dengue with symptoms of classical dengue fever.
IgM in 349(58.9%) NS1- 243 (41.04%). Conclusion: As vaccines or antiviral drugs are not
available for dengue viruses, the only effective way to prevent dengue is to control the
mosquito vector, Aedes aegypti and prevent its bite.

In the tropical and subtropical area, dengue virus is mostly found. To the determination of the occur-rence of dengue viral infection and hematological profile of dengue infected peoples in the Dhaka city. A sum of 255 samples of blood from both sex and different age groups were collected in this research. Dengue nonstructural protein 1 (NS1) and complete blood count (CBC) test were performed for the study. During this study period, total 255 samples were tested. Among these, 67samples were diagnosed as positive. Seroprevalence of dengue was 26.30%. Out of 67 positive dengue patients, 41 (61.2 %) were male and 26 (38.8 %) were female. Dengue infection was observed more in 21 to 30years age group followed by above 40years and 16 to 20years but observed less in of 1st day to 5years followed by 11 -15years, then 6 -10years and 31 - 40years. It was seen that the >40years of age group had the maximum unit of cases having low platelet count followed by 21-30years and it was also seen that 21-30years of age group had the maximum range of cases having low WBC count followed by above 40years of age group. In our research, we showed thrombocytopenia (100000 - 150,000/μl) with leucopenia (White Blood Cells, WBC <5000/μl) in 8(26.6%) cases and thrombocytopenia (100000-150,000/μl) without leucopenia in 9 (24.3%) cases but thrombocytopenia (<100000/μl) with leucopenia (White Blood Cells (WBC) < 5000/μl) in 5(16.7%) cases and thrombocytopenia (<100000/μl) without leucopenia in 6 (16.2%) cases. Among 67 positive cases, we found that (26.6%) had DF and (16.7%) had DHF according to WHO classification. For validating more reliability, this research needs further work.

Establishing the correct diagnosis of the clinical stage and the severity of dengue patients is very important to determine the prognosis. Examination of platelets, hematocrit and leukocytes for each clinical stage of dengue can help group and manage patients based on their clinical degree. This study aimed to determine the relationship between platelet, hematocrit and leukocyte examination results with the clinical degree of dengue based on WHO. This study used a cross-sectional study design with a sampling technique using consecutive sampling from July-November 2020 in 5 hospitals at Bengkulu City with total sample of 35 patients. The results found a strong relationship between hematocrit levels and the degree of severity of dengue (p = 0.001; r = 0.637). However, there was no significant relationship between the number of platelets (p = 0.826; r = -0.039) and leukocytes (p = 0.554; r = -0.103) with the severity of dengue. Laboratory tests are crucial to establish the clinical degree of dengue and disease’s prognosis.

Infections frequently cause the disease known as febrile thrombocytopenia. The goal of the current study is to understand the underlying causes of fever and thrombocytopenia as well as its varied manifestations and its hepatic dysfunctions in children admitted with fever and thrombocytopenia in our tertiary care hospital in south India.
Methods: A Pre structured proforma was used to obtain information from the parents. Clinical features consisting of respiratory distress (tachypnoea, retractions), abdominal distension, tender hepatomegaly, and Jaundice are recorded at the time of admission. Laboratory investigations included CBP, Platelet count, Coagulation profile including INR, PCV, Serum proteins, serum Albumin, Total bilirubin, Aspartate aminotransferase (AST) Alanine aminotransferase (ALT).
Results: The analysis of different liver enzymes and bilirubin levels was studied in the current study. The high AST levels were found in 10% of cases out of which 50% were in group II. The ANOVA analysis between the groups and AST values found p-values were significant. The ALT levels in the study were between the groups and >132 ALT values were found in n=9 cases out of which 77.78% were in group II the p-values were found to be significant. The serum alkaline phosphatase ALP was found in n=2 cases and they were in group II. Similarly, high levels of serum bilirubin were found in n=3 cases and all these cases belonged to group II and p-values were significant.
Conclusion:  In this study, we found 28% of the study sample had Dengue without warning signs 26% had dengue with warning signs 30% had Fever with Thrombocytopenia without warning signs and 16% had Fever with Thrombocytopenia with warning signs. It was found in this study that children with high AST values and high ALP values tend to have a poor prognosis and prolonged admission time as compared to those with lesser elevated values. In addition cases with high PT and aPTT, PCV >40 and platelet counts tend to have a severe form of the disease.