Indian Journal of Trauma and Emergency Pediatrics

Background: Dengue fever is a mosquito born self limiting febrile illness. It may be asymptomatic or can result in a wide spectrum of disease severity ranging from an influenza like illness (Dengue fever) to the life threatening Dengue hemorrhagic fever (DHF)/Dengue shock syndrome (DSS). Dengue fever has currently become a serious public health problem. During 2019‘s Dengue outbreak more than 1 lac Dengue patients were treated in different hospitals of the country which was more than the double of the total number (50,181) in the last 19 years (2000 - 2018). During this outbreak not only the number of the patients increased, the clinical presentation of the patients has also changed. Objectives: This study was designed to document the presenting features of Dengue infection in ICU admitted children during the Dengue outbreak in 2019 in Bangladesh. Materials and Methods: This retrospective observational study was done among the children having Dengue infection and admitted in an ICU of a tertiary care hospital. All patients who were diagnosed as Dengue fever by serological tests (NS1, Dengue IgG and IgM) and admitted to ICU were included in this study. Total 126 (one hundred and twenty-six) patients were enrolled. Data were collected from hospital record files of every patient. Data was analyzed by SPSS version 20. Conclusion: In this study we find out all the clinical features of Dengue patients who were admitted into the ICU. It was observed that Dengue fever had wide spectrum of clinical presentation in children ranging from flue like illness to life threatening hemorrhage and shock. Moreover, the presentation of dengue cases in this year were different from that of the previous ones. Unlike high fever, headache, eye pain or body ache (which were the typical features of Dengue in the previous years), many children had low grade fever associated with loose motion or vomiting and went into shock rapidly. Therefore, for early and proper diagnosis of the spectrum of Dengue fever we should be aware of the newer clinical presentations.

Degloving Injury are major debilitating conditions and its treatment is also challenging. The treatment of post traumatic degloving injury requires a multimodal approach. Adjuvant platelet rich fibrin matrix can be tried for post traumatic wounds as a modality for wound bed preparation. In this study we share our experience regarding the use of stromal vascular fraction as an adjunct in the management of post-traumatic degloving wounds of the lower extremity.

Total parenteral nutrition is a medication used to manage and treat malnourishment. It is in the nutrition class of drugs. Parenteral nutrition (TPN) is when the intravenous administered nutrition can serve as the main source of nutrition and also as a supplementary nutrition if the patient is not having adequate nutrition. This article highlights the composition, initiation, indications, contraindications, complications of total parenteral nutrition as a valuable agent in managing malnourishment.