Dr. Muhammad Mahtab Hossain Mazed

Dengue is the most talked about topic in the country now. Many people are affected by dengue every dayAccording to the report on Tuesday (September 10), the number of people affected by dengue fever in the last 24 hours has reached 16 thousand 819 in the current year. Meanwhile, five more people have died. As a result, the number of deaths due to mosquito-borne diseases has increased to 102 this year. 534 people were admitted to hospital. Among the victims are 199 people from the two city corporation areas of Dhaka. Besides, 90 patients in Dhaka Division, 113 in Chittagong Division, 59 in Khulna, 17 in Mymensingh and 37 in Barisal have been admitted to hospital.

From January 1 to September 10 this year, a total of 16 thousand 819 people have been admitted to hospital due to dengue infection. Of whom 66.1 percent are men and 33.9 percent are women. From January 1 to September 10, 52 percent of the dead are women and 48 percent are men.

* Symptoms: Fever is the main symptom. Skin rashes (rash), some people get bleeding.

* Fever: Like other viral fever, dengue fever does not last more than seven days. Initially, the fever may go away after six days of continuous high temperature. It may also happen that after two days there is no fever for one day and then there is a fever for two days and then the fever goes away.

* Other symptoms: All fevers, especially viral fevers, cause throbbing pain. Pain is more in dengue. Many people experience so much pain that they compare it to breaking a bone. Apart from this, the patient also feels pain behind the eyes.

* Bleeding: can be in the skin, mouth, esophagus, eyes. But what happens more often is that girls have menstruation once but in the same month they menstruate again.

* Rash (Rash): The typical dengue rash appears on the sixth day of fever. Then there is no fever. You can see it, you don't have to look for it. Apart from this, if you press on the body at the beginning of the fever, you will get fingerprints. It is called three phases.

1. The febrile phase consists of fever and chills.

2. During the afebrile phase, the fever goes away. But it is also called critical phase. The stage of dengue hemorrhagic fever is very complicated. It lasts for two days. Even if there is no fever, you have to be careful at this time.

3. While most recover during the convalescent phase, some are severely debilitated. Suffer from depression.

> Dengue is of two types—

A. Classical dengue fever: No problem if you don't get scared like ten viral fevers.

b. Dengue Hemorrhagic Fever: Classical dengue has everything. There are additional problems due to the leakage of blood vessels. If the platelet count is less than 100,000 with fever and the hematocrit is 20% variation, then it is dengue hemorrhagic fever. There are four grades of dengue hemorrhagic fever.

Grade-1: There is no evidence of hemorrhage except for a positive tunicate test.

Grade-2 : Visibly, bleeding is present.

Grade-3: With 1 or 2, if blood pressure decreases, pulse increases.

Grade-4 : If blood pressure, pulse cannot be recorded with 1 or 2, grade 3 and 4 together are called dengue shock syndrome.

*Laboratory tests: No tests are needed for three days before any fever unless it is very toxic. TC DC Hemoglobin ESR, SGPT : Count does not increase in viral fever. If the count falls, especially if the TC falls below 3000, dengue is certain.

NS1 Antigen: This is the test for the first week of fever. Positive during fever.

* Antibody test: It is not effective as it is positive after seven days. It is not needed if the NS1 antigen is made.

* Platelet count and hematocrit: Not essential unless platelets are critical. Hemorrhagic fever should be done for diagnosis and follow-up. In case of hemorrhagic fever, abdominal ultrasonography and chest X-ray are needed to confirm fluid in the abdomen and lungs.

* Nutrition: During fever, there is loss of appetite, vomiting. Fruit juice is beneficial at this time. Normal food can be eaten. Classical dengue and grade-1 haemorrhage do not require more than this. An additional problem in grade-2 is that if it is not caught first, it can go to grade-3 or grade-4 i.e. shock syndrome if not treated. Moderate water should be given to keep the fever down.

In grade-2, if the abdominal pain is not reducing, vomiting or the blood pressure is not normal, then it should be taken to the hospital. It is more common in children.

* Giving blood (Blood transfusion): In case of bleeding, the rule is to exchange blood. If the systolic blood pressure falls below 100, if the pulse is more than 100. Blood should be given if hemoglobin drops below 10 and hematocrit decreases.

> Prevention: Use indoor sprays to kill mosquitoes. Also use full sleeve clothes and foot socks. Sleep with a mosquito net during the day. Mosquitoes hatch from eggs to larvae. So to prevent the breeding of this pot mosquito, spray it in gutters, construction material water, rain-soaked roads and pot water.

★ Home remedies for dengue fever patient

* Chicken Vegetable Soup
Chicken vegetable soup is a delicacy for dengue patients. Add broccoli, beans, capsicum and beets as vegetables. Vitamin B12, folic acid, iron, zinc, protein and vitamin C are available from soup. Apart from maintaining the balance of fluids in the body, this soup will help in the production of antibodies and will give energy to the body. However, the use of spices in the soup should be reduced.

* Sour yogurt
On the one hand, sour yogurt will maintain the fluid balance in your body, on the other hand, it will work as a probiotic and boost the digestive system. As a result, the absorption of nutrients in the body will increase. The body will have the ability to fight the virus.

* Papaya juice
Papaya juice is a good source of vitamin B12 and folic acid. It plays an important role in the production of molecules. So at least 500 ml of papaya juice should be consumed daily.
* Rice starch
Rice starch is a very useful food as a source of vitamin B. Add some boiled vegetables and a little lemon juice to it to increase its quality. If rice starch is fed to the dengue patient, the nutritional needs of the body will be met and the fluid balance will also be maintained.

* Grapefruit juice
Grapefruit is a good source of vitamin C and potassium. Potassium is excreted in the body plasma. Grapefruit juice is very effective to compensate for its deficiency. Vitamins A, B and C are also available.

* Pomegranate juice
Iron, B vitamins and phosphorus are needed to improve bone marrow function. All the ingredients are present in pomegranate juice. Along with adequate amounts of folate, vitamin A and vitamin K. Pomegranate juice as anti-oxidant and anti-inflammatory
works

* Normal saline
Packed Ursaline should be mixed with half liter of water properly. It will fill the deficiency of electrolytes as well as maintain fluid balance.

* Fresh canned water
Kochi dab water is a good source of sodium, potassium and other electrolytes. It also corrects electrolyte deficits as well as maintains fluid balance.

* No food can be eaten
A patient suffering from dengue fever should not eat extra spicy food and fried food. These foods lead the patient into shock. These foods require a lot of water for digestion. At this time, the body is already deficient in water. Meanwhile, if extra water is needed to digest food, the blood pressure may drop further, which is dangerous for the patient. So these foods cannot be eaten at all.

Finally, I would like to say that dengue is the biggest threat in Bangladesh. Last year, many people died due to dengue. In 2023, 3 lakh 21 thousand 179 people were infected with dengue across the country. According to the directorate, 868 people died of dengue in 23 years from 2000 to 2022. And 1 thousand 705 people died in 2023, which is almost double the total deaths of the last two decades.
Dengue fever is caused by the bite of Aedes mosquito. Rainfall, waterlogging and excessive moisture in the air are helpful in the propagation of mosquitoes. And the mosquito breeding places must be destroyed along with measures to kill flying mosquitoes in hotspots. Otherwise, the risk for dengue remains high.

This mosquito breeds in water collected in abandoned plastic products, car tires, water collection tanks, flower tubs and vases. These mosquitoes are reduced in the dry season because they need water to hatch their eggs. So the house and its surroundings should be kept clean. And as people get rid of excess heat during monsoons, they also have to deal with many types of diseases. However, most diseases can be cured if the disease is properly diagnosed and treated. Again, these diseases can be easily prevented by taking some precautions. It is possible to stay free from most diseases only by providing clean water and food and keeping the surroundings clean.

The writer is a, Founder Chairman, Jatiya Rogi Kallyan Society Columnist and researcher