Gaurav Kumar

BackgroundDengue is one of the most common vector-borne diseases in India, and it is transmitted by Aedes family mosquitoes. Hepatic injury is known to occur from dengue infection. Direct hepatotoxicity and deranged host immune responses to the virus are responsible for this hepatic dysfunction. Hence, the study was undertaken to understand the deranged hepatic enzymes using liver function tests (LFTs) and the severity and outcome of dengue fever in children.MethodsThis study is an observational-descriptive study conducted between June 2022 and May 2024. The study population includes children between the ages of one month and 16 years who have been diagnosed with dengue fever and admitted to pediatric wards and pediatric intensive care units (PICUs), with a sample size of 151. Informed consent from guardians and institutional ethical clearance were obtained.ResultsA total of 4.8% (N = 7) mortality was seen in this study with dengue patients. Hepatomegaly was seen in 34% (N = 49) of cases. There is a clear statistical significance that is seen among the non-survived and survived dengue patients with a 10-fold increase in serum glutamic-oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) levels, respectively, along with total bilirubin, activated partial thromboplastin time (APTT), and prothrombin time (PT).ConclusionsThe current study shows that deranged LFTs are associated with more severe disease with more PICU admissions and mortality of the disease. The evidence clearly indicates the inclusion of LFTs as a routine investigation to understand the severity of the disease and the prognosis of the outcome.

Dyggve-Melchior-Clausen (DMC) disease, also known as DMC syndrome, is a rare, progressive genetic disorder that is characterized by skeletal and intellectual abnormalities. The case report involves a four-year-old male child presenting with marked short stature, intellectual disability, coarse facies, and microcephaly. Initial investigations, including blood tests and radiological evaluations, prompted further genetic testing via whole-exome sequencing. This identified a homozygous mutation in the Dymeclin (DYM) gene, implicating DMC disease. The condition usually poses diagnostic challenges due to overlapping clinical features with Morquio syndrome. This case highlights the importance of a comprehensive diagnostic approach and genetic testing in elucidating the underlying genetic etiology of complex presentations in pediatric patients.

Gaurav Kumar is the founder and CEO of Beyond Codes, Inc. and the author of the book Sales Lessons From Golf. getty

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