Unconventional treatments in dengue fever

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Unconventional treatments in dengue fever

1. Simple dengue fever requires only observation and fever reduction using paracetamol or non-aspirin group drugs

2. Severe dengue is characterised by capillary leakage which presents with a rise in haematocrit and rapid fall in platelets count. The condition can be fatal if intravascular dehydration is allowed to persist. Capillary leakage happens due to endothelial dysfunction. Treatment of dengue therefore is to treat the endothelial dysfunction.

3. Death is due to dehydration and organ failure and not fall in platelets. Rising haematocrit can be treated by any fluid replacement. Fall in platelets is self-limiting and required no replacement unless associated with active bleeding.

4. Giving platelet transfusions or increasing platelets counts without taking care of dehydration will cause no good

5. There is no scientific study in modern medicine that goat milk heals endothelial dysfunction. If it helps it may help being a fluid and not goat milk. Raw goat milk can carry harmful bacteria (Salmonella, E. coli, and Listeria) and other germs that can make one very sick. Raw milk is milk that has not been pasteurized to kill harmful bacteria. This raw, unpasteurized milk can carry dangerous bacteria such as, which are responsible for causing numerous foodborne illnesses. As per US CDC, between 1993 and 2006 more than 1500 people in US became sick from drinking raw milk or eating cheese made from raw milk. Unpasteurized milk is 150 times more likely to cause foodborne illness and results in 13 times more hospitalizations than illnesses involving pasteurized dairy products. The bacteria in raw milk can be especially dangerous to people with weakened immune systems, older adults, pregnant women, and children. CDC analysis found that foodborne illness from raw milk especially affected children and teenagers.

6. Brucellosis: Drinking raw Goat milk can also cause brucellosis. It presents with fever, night sweats, malaise, anorexia, arthralgias, fatigue, weight loss, and depression. The onset of symptoms may be abrupt or insidious, developing over several days to weeks. The musculoskeletal and genitourinary systems are the most common sites of involvement. Neurobrucellosis, endocarditis, and hepatic abscess occur in 1 to 2 percent of cases. The diagnosis should be considered in an individual with otherwise unexplained fever and nonspecific complaints who has a possible source of exposure (eg, contact with animal tissues, ingestion of unpasteurized goat milk or cheese). It can be confirmed using ELIESA test.

7. There are many pubmed search and medline results on the use of papaya leaves in the treatment of dengue fever. (1) Fresh C. papaya leaf extract significantly increased the platelet and RBC counts in the test group as compared to controls. [Asian Pac J Trop Biomed. 2013 Sep; 3(9):720-4]; (2) Carica papaya leaf extract can mediate a Th1 type shift in human immune system. [J Ethnopharmacol. 2010 Feb 17; 127(3):760-7]; (3) Plant extracts of Quercus lusitanica have maximum activity against DENV-2 Replication of Dengue virus[Dengue Bull. 2006;30:260–269]; (4) C. papaya contains two important biologically active compounds vis: chymopapain and papain[Biochem Biophys Res Commun. 2006 Mar 10; 341(2):620-6.]; (5) A recent in vitro study demonstrated the possible effectiveness of cocktail extracts prepared from four species of phyllanthus against the DENV. [BMC Complement Altern Med.2013; 13:192]; (6) CPLJ does significantly increase the platelet count in patients with DF and DHF. [Evid Based Complement Alternat Med. 2013; 2013:616737]; (7) Thrombocyte count had increased from 28000/micro liter to 138000/micro liter at the end of five days. [J Pak Med Assoc. 2014 Mar; 64(3):364-6.]; (8) the study establishes the anti-inflammatory activity of Carica papaya leaves. [Inflammopharmacology. 2008 Aug;16(4):168-73.]; (9) C. papaya leaf extract at a dose up to fourteen times the levels employed in practical use in traditional medicine in Malaysia could be considered safe as a medicinal agent. [Molecules. 2012 Apr 10; 17(4):4326-42.]; (10) In vitro upregulated synthesis of IL -6 and SCF both in PBL and SHED reveals the potential mechanism of unripe papaya to induce thrombopoietic cytokines synthesis in cells of hematopoietic and mesenchymal origin.[ BMC Complement Altern Med. 2015 Jul 8;15:215.]; (11) the incubation with Fermented papaya preparation may have a protective effect on platelets from patients with DM 2, by preventing the progression of oxidative damage associated with diabetes and its complications. [Nutr Metab Cardiovasc Dis. 2015 Feb;25(2):224-9]; (12) Fresh C. papaya leaf extract significantly increased the platelet and RBC counts in the test group as compared to controls [Asian Pac J Trop Biomed. 2013 Sep;3(9):720-4.}; (13) Thrombocyte counts in mice after the administration of papaya leaf suspension [Wien Klin Wochenschr. 2009 Oct;121 Suppl 3:19-22. doi: 10.1007/s00508-009-1229-0]; (14) FPP Fermentedpapaya preparation , as a potent antioxidant, might alleviate symptoms associated with oxidative stress in severe forms of thalassemia.[ Phytother Res. 2008 Jun;22(6):820-8]

8. The above studies confirms some rile of papaya leaves in dengue. Those systems of medicine who practice them should continue doing so as long as they also advise management of timely intra vascular dehydration

9. Guduchi or Giloy, – Tinospora cordifolia, is a famous Ayurvedic herb, used extensively in treatment for fever. Many studies in pubmed relate to it (1) anti-inflammatory activity of Guduchi Ghana.[ Ayu. 2014 Jan;35(1):108-10.]; (2) It has analgesic activity (J Clin Diagn Res. 2014 Aug;8(8)); (3) The Methanolic extract of T.cardifolia has considerable antimicrobial activity against S. mutans, E. faecalis and S. aureus.[ Eur J Dent. 2014 Apr;8(2):172-7]; (4) The stem contains alkaloidal constituents, including berberine and bitter principals, including columbin, chasmanthin, palmarin, tinosporon, tinosporic acid and tinosporol. The drug is reported to possess one fifth of the analgesic effect of sodium salicylate. [Himalaya website]

10. Dengue nosode is homeopathic way of treating dengue and may be of sue if useid in serotype specific dengue

All pathy experts must agree on adequate fluid replacement in dengue, oral or intravenous) and timely identify danger signals and transfer for ICU care where indicated.

Formula 1: Simple dengue fever: 500 ml fluid at diagnosis and then 100 ml per hour and pass urine every 4 hours

Formula 2: severe dengue fever: drink 1.5 liter of fluid at diagnosis and then drink 150 ml per hour and pass urine every four hours

Formula of 20: All should remember the formula of 20 for identifying high risk patients.

1. Rise in pulse by more than 20.

2. Fall in upper BP by more than 20.

3. Difference between lower and upper BP of less than 20.

4. Rapid fall of platelet count to less than 20 thousand and simultaneous rise in haematocrit by 20%

5. Presence of more than 20 hemorrhagic spots on the arm after tourniquet test.

6. Treat such patients with 20 ml/kg body weight in twenty minutes ( or till he passes urine) and then follow with 150 ml fluid per hour to let pass urine every four hours

We must respect al pathies. They must practice their own systems.

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