Introduction
Dengue is a mosquito-borne infection that in recent decennaries has become a major international public wellness concern. Dengue is found in tropical and sub-tropical parts around the universe, preponderantly in urban and semi-urban countries.
Dengue haemorrhagic febrility ( DHF ) , a potentially deadly complication, was first recognized in the 1950s during dandy fever epidemics in the Philippines and Thailand. Today DHF affects most Asiatic states and has become a prima cause of hospitalization and decease among kids in the part.
There are four distinguishable, but closely related, viruses that cause dandy fever. Recovery from infection by one provides womb-to-tomb unsusceptibility against that virus but confers merely partial and transeunt protection against subsequent infection by the other three viruses. There is good grounds that consecutive infection increases the hazard of developing DHF.
The incidence of dandy fever has grown dramatically around the universe in recent decennaries. Some 2.5 billion people – two fifths of the universe ‘s population – are now at hazard from dandy fever. WHO presently estimates there may be 50 million dandy fever infections worldwide every twelvemonth.
The disease is now endemic in more than 100 states in Africa, the Americas, the Eastern Mediterranean, South-east Asia and the Western Pacific. South-east Asia and the Western Pacific are the most earnestly affected. Before 1970 merely nine states had experienced DHF epidemics, a figure that had increased more than four-fold by 1995. Not merely is the figure of instances increasing as the disease is distributing to new countries, but explosive eruptions are happening.
Harmonizing to authorities figures 15,061 instances of the disease in the Philippines were reported in the first six months of the twelvemonth. The addition in the figure of dengue instances may be attributed to the invariably altering clime brought by planetary heating every bit good as congestion in urban countries. The biggest addition in the state was seen in Metro Manila, where there was an about 200 percent addition.
Harmonizing to the Department of Health, Southern Mindanao, there is an expected addition in dengue instances in the part because of the oncoming of the rainy season. About six-percent addition in dengue instances was recorded during the first one-fourth of the twelvemonth compared to the same period last twelvemonth. Davao City still has the highest dandy fever incidence, with 371 instances recorded in the first one-fourth. During the same period last twelvemonth, there were 352 instances recorded in the metropolis.
The durion is the fruit of several tree species belonging to the genus Durio and the Malvaceae household. Widely known and revered in Southeast Asia as the “ male monarch of fruits ” , the durion is typical for its big size, alone smell, and formidable thorn-covered chaff. The fruit can turn every bit big as 30A centimeters ( 12A in ) long and 15A centimeters ( 6A in ) in diameter, and it typically weighs one to threeA kgs ( 2 to 7A pound ) . Its form ranges from oblong to round, the coloring material of its chaff viridity to brown, and its flesh picket yellow to red, depending on the species.
There are 30 recognized Durio species, at least nine of which produce comestible fruit. Durio zibethinus is the lone species available in the international market ; other species are sold in their local part.
Surveies have shown different utilizations of durian such as: A.Lipid Lowering Consequence: Lipid entrapment belongings of polyose gel ( PG ) extracted from fruit-hulls of durian ( Durio zibethinus Murr. Cv. Mon-Thong ) . Result suggest that PG from fruit-hulls of durion may be a possible dietetic fiber/ medicative addendum for a blood lipid / cholesterin take downing consequence. B.Hyperthermic Effect / Paracetamol Interaction: Believed to hold body-warming belongingss with concerns on ingestion with paracetamol. Rat survey showed no important organic structure temperature lift. Rats having a durian-paracetamol combination showed a important bead in organic structure temperature. No mechanism for toxicity was identified. C.Antibacterial / Wound Healing Consequence: ( 1 ) Polysaccharide gel extracted from fruit-hulls of durian seems to hold a good consequence on lesion healing in a hog survey. ( 2 ) Bactericidal consequence of polyose gel was clearly demonstrated against S. aureus and E. coli. Study showed accelerated wound mending. D.Phenolic Content / Antioxidant Effect: Survey showed the durian cultivars ‘ high bioactivity and entire polyphenols were the chief subscribers to the overall antioxidant capacity and provides a beginning of nutritionary addendum.
Today, Dengue Fever and Dengue Hemorrhagic Fever affect most Asiatic states and has become a prima cause of hospitalization in kids ( about 500,00 instances each twelvemonth ) and decease. Until now, there is no specific intervention on dandy fever febrility. Due to this, a important figure of households of patients use different option medical specialties which do non hold grounds for remedy in the hope of increasing the thrombocyte count of the patient. One of these is the usage of D. zibethinus Murr, but its efficaciousness is still unkown therefore the intent of the survey.
DEFINITION OF TERMS
Dengue Fever – a benign syndrome caused by several arthropod-borne viruses, is characterized by biphasic febrility, myodynia or arthralgia, roseola, leucopenia, and lymphadenopathy
Dengue Hemorrhagic Fever – a terrible, frequently fatal, feverish disease caused by dandy fever viruses. It is characterized by capillary permeableness, abnormalcies of haemostasis, and, in terrible instances, a protein-losing daze syndrome ( dengue daze syndrome )
Dengue Hemorrhagic Fever Grade I – presence of febrility, non-specific constitutional symptoms, such as anorexia, purging, abdominal hurting ; and positive compression bandage trial
Dengue Hemorrhagic Fever Grade II – symptoms and marks of Grade I plus self-generated hemorrhage: mucocutaneous, GI
Dengue Hemorrhagic Fever Grade III – symptoms and marks of Grade II with more terrible shed blooding plus groundss of circulative failure: violaceous, cold, dank tegument, restlessness, weak to compressible pulsations, contracting of pulse force per unit area to 20mmHg or less, or hypotension
Dengue Hemorrhagic Fever Grade IV or Dengue Shock Syndrome – symptoms and marks of Grade III but daze is normally stubborn or irreversible and associated with monolithic hemorrhage
Aim
General Objective:
This survey aims to find the consequence of Durio zibethinus Murr ( durian ) on the thrombocyte count of paediatric patients with Dengue Fever and Dengue Hemorrhagic Fever Grades I and II.
Specific Aims:
To place the specific constituent of durian that is capable of increasing the thrombocyte count of dandy fever patients.
To find the mechanism of action of the active constituent of durion.
To place important relationship between the addition of thrombocyte count and consumption of durion.
Methodology
Study Design
Randomized controlled, double-blinded survey
Study Puting
Private Tertiary Hospital
Study Subjects
Inclusion Standards
Children ages 6 months old to 18 old ages old diagnosed with dandy fever febrility and dandy fever hemorrhagic febrility classs I and II.
Parents/guardians of the topics who signed the informed consent.
Exclusion Standards
Children ages 6 months old to 18 old ages old diagnosed with dandy fever hemorrhagic febrility III and dandy fever daze syndrome.
Dengue patients who had undergone blood transfusion.
Dengue patients who do non eat durian or unable to digest the odor of durion.
Respondents who developed indecent GI side effects during the class of the survey, such as sickness, purging, diarrhoea and indigestion.
Parents/guardians who did non subscribe the informed consent.
Description of Interventions
Patients included in the survey will be started with endovenous fluids utilizing Isotonic solutions ( D5 LR, D5 NSS/D5 0.9 % NaCl ) at 3 – 5 cc/kgBW/hr. Patients were so indiscriminately selected to have durian decoction ( experimental group ) and evaporated milk ( command group ) . Decoction will be given three times a twenty-four hours from twenty-four hours of diagnosing to day2 afebrile.
Result steps
Patient ‘s informations were collected and recorded. Consecutive thrombocyte monitoring was done every 6 hours, others were every 8 hours and some on a one time a twenty-four hours footing during their infirmary stay. Patients are besides monitored for possible side effects.
Data Collection
An informed consent has been signed by parents or defenders of the topics who were included in the survey. Socio – demographic informations were noted ( e.g. age and sex ) . Clinical informations every bit good as the initial research lab consequences were noted. Persons are indiscriminately selected into two groups, one with the Durian decoction, and the other with evaporated milk. Patient ‘s diagnosed with Dengue febrility, Dengue Hemorrhagic Fever Grades I and II will be selected and observed for the continuance of infirmary stay.
The initial and wining thrombocyte count were noted during the debut of the decoction. Once a twenty-four hours platelet monitoring of all topics is adequate to roll up informations, provided that it is all taken at the same clip. The side effects related to the consumption of decoction were all be noted.
Preparation of Decoction:
Scrapings of durian fruit will be obtained therefore taking the fruit ‘s seed. __gram of scrapings will be obtained, diluted with __ml of H2O. __ml of sugar is added to savor. All ingredients is placed in a liquidizer and assorted good to obtain a syrup solution.
Administration of the decoction:
The decoction will be given to patients with thrombocyte count & lt ; 150,000 cells/ mm3 during the feverish phase and will be discontinued on the 3rd afebrile phase.
Dose: 3mg/kg/day
