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Dengue Fever

Sunday, August 9, 2015

/ Published by VIRTHLI
Dr. Janet Thiek Stephens,M.D, Specialist,Medicine Dept, SDNH,Delhi

Tulai Delhi khawpui le hmun dangdanga hai thokang se leia natna-DENGUE le MALARIA khuosik leia na an um Å£an tah a. India Hmar Sak mi ngei khawm tukum Delhi le Bangalore ah Dengue leia hringna chân ei um hiel an tah, a pawi khawp el. Hieng natna hai hi mani invêngá¹­hat chun ei him thei anih. Dengue a na hi India Hmar Sak –Guwahati, Imphal, etc, tieng khawm hmu ding an um ve á¹­an tah anih. Ei sung le kuo vêng tienga um hai khawm hi natna hi inlâu el lo a, á¹­ha taka inenkawlchun dam thei ani zie le Dengue leia damnaw nazawng Thisen/platelet pek an ngainaw zie inhrilhriet a á¹­ha. 
      
Dengue’ hi virus hrik lei a nih a. Hi virus hi chi 4 a um. Hi hrik hi thokang chikhat ‘Aedes’ in a pâi a, mihriem hi natna lo invawi lai a sê hnungin, mihriem dang a sê nawk pha leh, natna a hung siem hlak  a nih. Hi thokang hi, ‘Tiger mosquito’ ti khawm a nih , a san chu, a pum le a kê hai a Å£iel leiin. Thokang hi an intuia inthawka an puitling chen sûng hi ni 7 vel a nih. Tui faiah an intui nuom a. In sung, mihriem chengna hmun, thimtham lai an cheng nuom a,tui tlâwmte intlinga hai an intui thei a nih. Chuleichun, in kawlvela tui intling- cooler, bêl, flower pot, plastic no/ bag, motor tyre, hmunhnawk intling, inchunga tank, inbawlna hmun, etc a hai hin an tam a. Ruosur zo hin an pung nasa hlak. Sun lai mihriem an sê nuom hlak bawk a nih, abiktakin zingkhawvar iná¹­an le zantieng khuo inthim tâwmin.
      
Natna inlang dân tlângpui chu hienghai hi annih-
1. Khuosik ni 2 a inthawka ni 7 vel chen .
2. Lu nâ , mitmu nâ, pangkham,ru le chang nâ.
3. Pang a hai chi te te a sen (rashes) hung um.
4. Hnar, bau, zun, pang a inthawka hai thisen a suok thei a,rîl a thisen pût leiin êk khawm a dum thei a nih. Nuhmei hai chu an thi pût a tam thei bawk a nih.
5. Phing na /mar (hihi tam takin an nei tlangpui), luoksuok,thuokinsam, (Hieng hai hi khuosik a inthawka ni nga na vela inthawkin a um hlak).
6. Luhai, khuomuol hrelo, Blood Pressure in hnuoi, so them mumal theilo, thlan suok rakrak, etc
      
Mihriemin a vawikhatnaa a nat hin Viral Fever pangngai angin a na a, thisen suok, BP in hnuoi, ti hai a nei ngai rak nawh.Virus chikhat  an vawi ta chun,hi virus vek a inthawk hin hmatieng peia dingin a him thung anih.Nisienlakhawm, Virus dang an vawi nâwk pha hin , a taksâah a hmaa, antibody lo um ta sâ le tuta virus lut thar hin reaction an nei a. Hileihin Platelet , ei taksâa thi suk chât tu , a suk tlâwm a, nuoi khat nekin a hung tlâwm hlak a nih. Platelet hi dân naranin khuosik a inthawka ni 3, 4 hnungah, a tlâwm á¹­an hlak chau a nih. Amiruokchu , Platelet hi darkar 6 danah an siem thar nâwk pei a, chuleichun mi tlâwmtea chau Platelet hi an hnuoi vieuin ,miá¹­hen tlâwmteah thisen a pût/suok hlak chau a nih.  Hi baka hin,  thisen zâm a inthawkin Thisen tui(Plasma) a pût a, Thin , Mît (gall bladder), Chuop, etc hai an vûng hlak bawk a nih. Hi lei hin thisen zâmah thisen tak a tam ta lem a, Thisen tak(Haematocrit) level a hung in sâng a nih. Thisen zâma hin tui (Plasma) a tlâwm tâk leiin, BP a hung in hnuoi a, so (Pulse)  khawm them mumal thei loin a um hlak anih.Ei hriet dinga pawimaw  pakhat chu Dengue a Lo Na ta sâ hai khawm kha ,Virus Chi li an um leiin,an na nâwk thei anih.Dengue ahin Platelet hai sinthâw(function) -thisen suk chât sin khawm hi a sukbuoi leiin, Platelet inhnuoi rak naw sien khawm , taksâ a inthawkin thisen a pût thei tho anih.

Khuosik ni 2 vel a re hma le a re hnung ni 3 vel chen hin, thisen zâma inthawkin plasma hi a pût dawk nuom a, platelet count khawm a tla hnuoi hlak bawk leiin khuosik a re hnung ni 3 vel chen, Platelet count le Haematocrit nitina en a ṭha.Dân naranin nat sûng hun hi ni 2 a inthawka ni 7 vel chen ani tlângpui. Hi natna a inthawka damsuok zo hnungin kârkhat vel chenin mihriem a suk châu/zawi em2 thei anih.

A.    INENKAWLDAN-
Dengue fever sukchieng na hi MacEliza test a nih a. Hi test hi khuosik iná¹­ana inthawka ni 5 hnunga thaw ding a nih. Rapid Antigen Test khawma khuosik iná¹­antir a inthawka ni 5 chen thaw ve thei a nih, anachu, hi test hi virus dang leia natna a khawm a positive thei tho a nih(false positive).
Dengue virus thatna dingin tu chen hin damdawi le vaccine hmu suok ala ni nawh.Thingfanghma hnâ/ kêl nenetui,etc mitamtakin anin hril hmû chu Dengue ahin a á¹­angkâina scientifically research a  proved ala ninaw bawk anih. Platelet count 20,000 /cumm chen a ni khawmin, BP a pângngai a, thisen a suok/pût naw chun, iengkhawm inlâu ding a um nawh.Amiruokchu, platelet 1 lakh vel a inthawka 50,000 vêla a hung tla hnuoi dâwr , annnawleh thisen taksâ a inthawk a pût/suok  le BP an hnuoi chun á¹­hataka monitor( enkawl) a ngaia, hospital pan vat a á¹­ha.
1. Um hâdam a pawimaw.
2. Pang suk deina dingin –Paracetamol (500mg) puitlingah le naupangah 10mg/kg body weight darkar 6 dana pêk thei a nih. Puon deia pang po2 lu chau niloin dep ding. Aspirin, combiflam, etc fâk lo ding.
3. Oral Rehydration Solution (ORS), tui, thei tui, etc thei ang anga dâwn ding.

Hienghai hi a um chun Hospital pan vat ding:
Khuosik insâng taluo, khuosik lai zing / khuosik re hnunga Phingna dam thei lo, inluok nasat leia châu, taksâa inthawka thisen suok/pût, pang chite tea hung sen(rashes), khawmuol hrelo, inthlan nasa, zun a tlâwm, lu inhai, thuok insam, khawsik nihnih, nithum vel a re hnunga khawsik hung um ṭan nawk, kei(seizures)etc. Abiktakin, naupang Dengue ana hai hin an natna an hril fie thiem ngâi naw leiin, chîktaka nu le pa le puitling haiin enkawl le ngâiven a ṭha.School khawm an khuosik a re hnung kârkhat vêl bêk inchâwl hâdam tir a ṭha.

 Dengue leia complication hai- Platelet tlâwm leia Thisen pût le Thisen zâm leak nuom leia inthawka-BP inhnuoi le thin,mît,chuop invûng leia phingna êm2 / luoksuok êm2, thuok insam ,hai hi Khuosik a re hma ni2 a inthawk le a re hnung ni3 vel sung hin dân naranin a um hlak leiin khuosik a re tah ti lei ela ngaisam ding ani nawh.
 Viral fever pângngai angin a tam lem chu kâr khat hnungah an hung dam el hlak anih. Mi tlâwmte a chau complications hai hi a um hlak anih.

B. INVENG DAN-
1. Tui intling, hmunhnawk reng reng pei ding kâr khat ah vawikhat bek.Cooler, bêl, no, bottle, par bêl, tyre,etc a haihi enkai ngun a ṭha tui intling a um le um naw. Cooler hmang lo a ni chun, in ruok ding.
2. Tui intling pei thei lo chu thau (oil) eg. kerosene, petrol, hair oil, cooking oil- thirhâihaw hnih kârtin vawikhat sung ding. Annaw khawma, Temephos granules thirhâihaw khat kârkhatah vawi khat thlâk ding.
3. Thokang sê laka in vêng fimkhur- Thosilen hmang ding sûn le zanah, cream(odomos)pang inlangna(exposed parts) ahai nâl ding  , coil, electric liquidator(all out, etc) hmang ding, zakuo ban tluon hak, kekawr tluon bun,etc.
4. Thokang insûnga an lût nâwna dinga kawtkhâr, tukvera hai lên(net) zar ding.
5. Thokang thatna dingin Spray (Hit, odomos,etc) hmang ding.
6.Mosquito racquet or mosquito zapper(China suok) khawm hi thokang thatna ding chun a á¹­angkai ve khawp el.
7.Tuisiekhâwlna(Water tanks/Overhead ) tanks hai det deua sîn ding.
8. Damnaw enkawltu/kan tu, hospital a sinthaw Doctors, Nurses, etc hai invêng ṭhat le fimkhur a ṭha. Asanchu,Hospital tam lema a hai hin Aedes Thokang hmu ding an um el bâkah, damnaw haiin Dengue hrik/ virus an pâi bawk leiin.

Malaria leia khuosik khawm hi thokang chikhat Anopheles se a inthawk bawk anih.A hrik hi protozoa chi 4 a um a-chuong hai chu P(Plasmodium) vivax(PV),P .Falciparum(PF),P,Malariae le P.Ovale annih.Delhi le a sê vêl ahin chu PV a tam tak a, a dawtah PF anih. Tukum khawm hin Delhi ahin PV le PF a khuosik an um nuol tah. Northeast tieng ruok chu PF le PV a um ve2.Malaria hrik thatna ding in damdawi a um leiin ,in enkawl vat a á¹­ha.      
Hi natna inlang dân tlângpui chu – taksa in dei a hung ti phawt a(cold stage), chun sikinhning(chills) in a hung um a, chun ,pang a hung sa á¹­an nâwk a(hot stage),chu zo phât leh thlantui in a buok hlak anih.Khuosik hi dân naranin PV Malaria a chu hunbi neiin an lang hlak. PF Malaria a hin chu khuosik hin hunbi a nei chuong ngai lêm nawh. Hieng baka hin, lu nâ, um inhawi lo,pangkham, luoksuok, lâ(spleen) le thin(liver) a hung sâwt chun a hung lien hlak.PF Malaria lem hi chu a thawk hrât a,inenkawl vat naw chun, thluok,kal,etc a tawk thei leiin ngaitha lo a Å£ha,thîna khawm an tlun vat thei anih.
         
Mihriem thisen zâma ahin Red Blood Corpuscles(RBC )a um a. RBC sunga hin Haemoglobin a um nawk a.Hihi, ei taksa bung hranghranga Oxygen petu anih,hi lei a mihriem ei hring/dam anih.Malaria hrik ,abikin PF hin , RBC hai hi a suk kawi a, Haemoglobin khawm hi a suk kawi bawk anih.Hieng lei hin, Haemoglobin a hung tlâwm a, Malaria invawi hai hi enin  an da a,a á¹­hen lem chu thisen pek khawm an ngâi hiel hlak anih. Haemoglobin kawidar leiin Mîtliem (jaundice) a um thei a.Thin a tawk lei khawmin Mîtliem (jaundice) a um thei bawk anih. Mi tamtakin MALARIA LE JAUNDICE hi natna dangdang sawnin, Malaria damdawi fa loin , Jaundice hi an enkawl hmasa lem hlaka. Hileihin, tamtakin hringna an chân pha tah anih. Thluok a tawk leiin khuomuol hrelo, kei(seizures), á¹­awng invâi,etc a um thei bawk a.Kal khawm a suksiet thei bawk leiin, zun hai a hung tlâwm a, taksa a toxin(taksâ le thisena hnawksak/bal) hai zunah a suksuok  thei tak naw leiin, thuokinsam,pang invûng,khuomuol hrelo,etc hai a um thei anih. Hieng hai hi a um chun Hospital hnâi tak pan vat a Å£ha.
      
PV hrik hi Delhi le a sê vêl ahin chu Chloroquine in a la that theia, course kima fak ngei ding anih. Hi baka hin, a hrik a bo fel vawng na dingin Primaquine ni 14 sung fak ngeingei ding anih.PF a ruok hin chu Chloroquine hi a thawk ṭhatnaw leiin, damdawi chihni vel bek fak kawp a ngai hlak.India Hmar Sak a ruok hin chu Chloroquine hi PV ah a thawk ṭha nawh.
    
Hieng natna a tawizawnga ei ziek lang hai hi ei chêngna insûng,tuol,office,school,mani  sinthâwna ,etc, hmuna hai Thokâng pungding ei khap á¹­ha phawt chun hi natna hai laka inthawk ei him thei anih. Mitin fimkhur seng ei tiu.
       


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