Introduction to Cancer Biology

The Cancer Biology portion of the site contains  in-depth information about the structure and function of normal cells and cancer cells.  The changes that make normal cells turn into cancer cells are described.  Topics covered include:

Biological Building Blocks - Information on the molecules that are found in living things.  Includes proteins, carbohydrates, lipids and nucleic acids.

Cell Structure - Discusses the functional parts of cells called organelles.  Organelles covered include the nucleus, ribosomes, mitochondria and the cytoskeleton

Cell Division - Covers the control of normal cell division and the problems found in cancer cells.

Gene Function - Discusses the way genetic information is  used in cells.

Mutation -  Describes the types and causes of changes to genes (mutations) that can result in cancer.

Cancer Genes - Describes the types of genes (oncogenes and tumor suppressors) that are altered in cancer.  Some key examples are given for each type of gene

Cancer Formation - Includes details about the causes of cancer, including chemicals, radiation and viruses

Angiogenesis - Animations and text describe how tumors develop a blood supply.  Includes discussions of drugs that fight cancer by blocking the process.

Metastasis - The majority of cancer deaths are caused by spread of the disease from its orginal location. This section covers the 'how' and 'why' of cancer spread.  Also covered are attempts to interefere with the process in cancer patients.

Tumor-Host Interactions - There are many interactions between different cells in a tumor.  This section covers some of the key cell types and the ways that they influence the growth of a tumor.

The Immune System - The immune system is involved in guarding our bodies from internal and external threats, including cancer.  Because of the important role of immune cells in preventing and possibly contributing to cancer, as well as the use of immune cells and products in treating cancer, the subject is treated here in detail.

Cancer in Animals - Animals other than humans get cancer and this section examines a few types of cancer in domesticated and wild animals.

The cancer Genes - the DNA type

Cells can experience uncontrolled growth if there are damages or mutations to DNA, and therefore, damage to the genes involved in cell division. Four key types of gene are responsible for the cell division process: oncogenes tell cells when to divide, tumor suppressor genes tell cells when not to divide, suicide genes control apoptosis and tell the cell to kill itself if something goes wrong, and DNA-repair genes instruct a cell to repair damaged DNA.
Cancer occurs when a cell's gene mutations make the cell unable to correct DNA damage and unable to commit suicide. Similarly, cancer is a result of mutations that inhibit oncogene and tumor suppressor gene function, leading to uncontrollable cell growth

Carcinogens

Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Tobacco, asbestos, arsenic, radiation such as gamma and x-rays, the sun, and compounds in car exhaust fumes are all examples of carcinogens. When our bodies are exposed to carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. Theses free radicals damage cells and affect their ability to function normally.

Genes - the family type

Cancer can be the result of a genetic predisposition that is inherited from family members. It is possible to be born with certain genetic mutations or a fault in a gene that makes one statistically more likely to develop cancer later in life.

Other medical factors

As we age, there is an increase in the number of possible cancer-causing mutations in our DNA. This makes age an important risk factor for cancer. Several viruses have also been linked to cancer such as: human papillomavirus (a cause of cervical cancer), hepatitis B and C (causes of liver cancer), and Epstein-Barr virus (a cause of some childhood cancers). Human immunodeficiency virus (HIV) - and anything else that suppresses or weakens the immune system - inhibits the body's ability to fight infections and increases the chance of developing cancer.

 

What is Cancer? What Causes Cancer?

Cancer is a class of diseases characterized by out-of-control cell growth. There are over 100 different types of cancer, and each is classified by the type of cell that is initially affected.
Cancer harms the body when damaged cells divide uncontrollably to form lumps or masses of tissue called tumors (except in the case of leukemia where cancer prohibits normal blood function by abnormal cell division in the blood stream). Tumors can grow and interfere with the digestive, nervous, and circulatory systems, and they can release hormones that alter body function. Tumors that stay in one spot and demonstrate limited growth are generally considered to be benign.
More dangerous, or malignant, tumors form when two things occur:

1. a cancerous cell manages to move throughout the body using the blood or lymph systems, destroying healthy tissue in a process called invasion
2. that cell manages to divide and grow, making new blood vessels to feed itself in a process called angiogenesis.

When a tumor successfully spreads to other parts of the body and grows, invading and destroying other healthy tissues, it is said to have metastasized. This process itself is called metastasis, and the result is a serious condition that is very difficult to treat.
In 2007, cancer claimed the lives of about 7.6 million people in the world. Physicians and researchers who specialize in the study, diagnosis, treatment, and prevention of cancer are called oncologists.

What causes cancer?

Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, cancer begins to form. Unlike regular cells, cancer cells do not experience programmatic death and instead continue to grow and divide. This leads to a mass of abnormal cells that grows out of control.

Dengue continues to take toll, 6 more die in Lahore

Dengue has not yet shown any decrease in its spread and has claimed six more lives in Lahore Monday, Geo News reported. The toll now stands at 182 in Lahore while 201 in Punjab.
According to health department, six patients lost their lives in Mayo Hospital today. The number of patients affected from Dengue in Lahore is 13,250 while in Punjab it has reached 15,310.
The health department said that fumigation is being done while awareness campaigns are also being organized.
Medical experts from Indonesia are training the doctors and paramedical staff regarding the treatment and control of the epidemic.

Dengue fever and your eyes

Currently, the Dengue Fever which is an endemic affliction of the tropical areas is very much rampant in various parts of the country, causing a great concern to our people. The disease can cause eye complications with symptoms of mild to serious threatening of vision in 10% of the sero-positive patients during hospitalization. Dengue fever is caused by ARBOVIRUS, which has predilection for small blood vessels in the body and Central Nervous System. It is an immune-mediated disorder rather than a direct viral infection. During hospitalization patient may complain of gross visual disturbances in one or both eyes. He may suffer permanent loss of vision if not treated well in time.

A detailed study has been reported by two main hospitals from Singapore and accordingly the usual complications of Dengue Fever are Optic Neuritis and Dengue Neuropathy mainly involving the Optic Nerve and Macula – the most sensitive part of the retina ( the visual membrane) with maximum vision. The treating physicians are strongly advised if they find the signs of the above-said afflictions should be treated with a course of IV Methylprednisolone (starting with 1G daily for 3 days), to be repeated if necessary after consulting the senior Eye Specialist of the hospital. Though the complications are uncommon yet very serious as these have far reaching economic consequences for the society. Therefore, the patient in general and the treating physician in particular must keep in mind the possible complication while evaluating the patient. In fact, a routine examination should be carried out if the patient complains of slightest visual disturbance.

Dengue goes out, may revisit in 2012

THE deadly dengue virus, which created scare among the masses in Punjab in general and Lahore in particular appears to be subsiding and with winter season approaching, it would die its natural death. According to reports, Sunday was the happier day for the people of Lahore when no patient lost his/her life against the deadly virus but it is natural that there may still be some deaths as thousands of people are still admitted in hospitals.

Dengue fever, also known as break bone fever, is an infectious tropical disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains and a characteristic skin rash that is similar to measles. In a small proportion of cases the disease develops into the life threatening dengue hemorrhagic fever resulting in bleeding, low levels of blood platelets and blood plasma leakage where dangerously low blood pressure occurs. Though according to medical experts, it is a curable disease, yet it led to sounding of alarm bells in Lahore where it affected about 500 people daily and claimed nine to ten lives in a day. What was more worrisome that thousands of people, suffering from normal fever, lined up at hospitals for tests and that put additional burden on the doctors and paramedical staff. Realizing the gravity of the situation, Chief Minister Shahbaz Sharif took personal interest by visiting hospitals and holding daily meetings to control the disease. Awareness campaign was also launched and the latest law “Punjab prevention and control of Dengue Regulations, 2011” is a welcome step. Though mosquitoes die during winter and one expects that the virus would be over next month, yet we should not forget that the Dengue has gone but may revisit in 2012 and to prevent that we may prepare a strategy in advance. Since there is no vaccine, the only method of controlling or preventing dengue virus transmission is to combat the vector mosquitoes.

Dengue returns with vengeance in lahore

After a lean day on Sunday, the ruthless dengue virus took lives of seven more persons on Monday. The new victims included four women. 

The deadly virus has forced hundreds of more in the City to rush to public sector and private hospitals for preliminary tests. As many as 237 new persons were also confirmed to have been suffering from dengue. The overall tally of the affected persons stands at 25,444. 

Muhammad Nasir (40), a resident of Narowal, Zarina Bibi (50) of Farooq Gunj, Amina Rasheed (30) of Band Road, Husan Pari (70) of Kot Khawaja Saeed and Shahnaz (50) of Band Road breathed their last at Mayo Hospital. Rafiq Akbar (60) and Khushi Muhammad (80) of Baghbanpura lost their lives at Jinnah Hospital. 

Out of the 237 new cases, 48 people were tested positive at Sir Ganga Ram Hospital, 32 at Shaikh Zayed Hospital, 31 at Jinnah Hospital, 28 at Mayo Hospital, 21 at Lahore General Hospital, 19 at Children’s Hospital, 14 each at Services Hospital and Institute of Public Health while remaining cases were reported from other public sector hospitals and private healthcare centres in the City. 

According to the Punjab Health Department, as many as 198 new cases have been reported from across the province and out of these 150 were from Lahore. As such number of affected people has reached to 15433 of which 13297 relate to Lahore. So far 15226 patients have been recovered and discharged from the various hospitals of Punjab including 13142 from Lahore. Now 1500 patients are under treatment at various hospitals of Punjab including 1207 in Lahore. Seven patients die on Monday and as such death toll has risen to 202, of which 181 from Lahore.

Briefing to the newsmen regarding dengue situation at King Edward Medical University on Monday, Secretary Agriculture Punjab Arif Nadeem said that it has been noticed through the analysis for the last three weeks that dengue virus has started decreasing gradually and 24 percent decrease has been recorded in the province. Vice Chancellor KEMU Prof Asad Aslam Khan, Director Health Information Management System Dr Anwar Janjua and other officers were present in the meeting. 

Secretary Agriculture said that the production of larva has decreased considerably in the city. After continuous larviciding at 400 breeding sites, little quality of larva was found at 17 places. He said that the experts of agriculture and health departments were continuously monitoring the insects and strict vigilance of tyre shops, nurseries and other hot spots was being made. He said that the implementation of unanimous guideline formulated by senior consultants of health department for treatment of dengue patients in the light of the recommendations of Sri Lankan and Indonesian medical experts was being ensured that has shown good results. 

He said that letters containing unanimous guideline prepared by Prof Faisal Masood for dengue patients have also been sent to all divisional commissioners so that this virus could also be controlled in other districts. 

No vaccine exists for dengue fever

Principal Post Graduate Medical Institute Prof Tariq Salahuddin has said that the vaccine for dengue virus has not been invented in the world and preventive measures should be adopted for safety from this disease.

Briefing the newsmen on Sunday about the healthcare facilities provided at the Lahore General Hospital, he said that despite the fact that dengue was new disease the doctors, nurses, social organisations, media and all the departments have done excellent work and all the stakeholders deserve praise over their role in fighting against dengue.

Tariq Salahuddin said 262,950 people visited the LGH from September 1 to 8 and 168,686 out of them suspected dengue patients. He said that free CBC of 188,725 patients was conducted and out of them 5,325 were admitted and treated, adding that 5,024 patients were discharged after recovery and only 263 are under treatment at present. He said to confirm the dengue virus, elisa tests of 1,800 patients were conducted. Due to the extraordinary care of patients by the doctors and nurses, only 0.76 per cent death rate was found, he added. He said that with the consultation of Sri Lankan and Indonesian experts and senior faculty members of the hospital, the administration prepared a strategy for the next year to deal with dengue. He said that Sri Lankan and Indonesian teams termed the facilities for the treatment of dengue fever high standard especially the high dependency ICU for the patients of dengue. He said that more than 400 beds were specified for the dengue patients and classes of nurses and dispensers were suspended and they were deputed on the duty to take care the dengue patients. He said all the resources had been utilised for the 
treatment of dengue patients and steps of the Punjab health department caused decrease in the rush of the patients that would further reduce in coming days when the temperature come down. 

Meanwhile, Gulberg Town Emergency Response Committee Acting Chairman MPA Mian Mohsin Latif has said that vast areas of Pakistan Railways are breeding places of dengue mosquito which can only be eliminated through a comprehensive programme for which 100 percent cooperation of people is required. These views were expressed by him while inspecting the breeding places of mosquito at Pakistan Railway Diesel Shed and Achantgarh Mughalpura in connection with dengue awareness campaign here on Sunday. 

MPA Nighat Sheikh, Member Chief Minister’s Inspection Team Tahir Yousaf, former councilor Malik Imran and officers and staff of WASA, Solid Waste Management and Gulberg Town administration accompanied him.

Latif said that manhole, sewerage lines, water in open vessels, garbage and debris are breeding places of mosquito. He said that awareness should be created among the people regarding elimination of mosquitoes from these places. Otherwise, in case of negligence from this menace, the entire nation will have to fight against dengue virus for many years. He said that government was making efforts round the clock for the eradication of dengue and in order to get rid of this menace, people will have to take effective measures in this regard. He said that Gulberg Town administration besides distributing pamphlets for awareness against dengue among public is also removing filth and drying the stagnant water. 

Meanwhile, Nishter Town Dengue Control Committee Chairman MNA Naseer Bhutta has said that on the directions of Chief Minister, elected representative have created awareness about dengue virus among the masses and we will overcome this fatal disease soon. 

However, he said that every member of the society has to play its due role to eliminate dengue virus as the Punjab government is utilising its all resources for this purpose. He said that Chief Minister’s Qadam Barho, Dengue Mukao campaign was achieving success with the cooperation of students, youth, party workers and common citizens and the campaign was continued. He asked the people to use full sleeve shirts and change their life style to avoid dengue fever.

Treating the Patient With Severe Dengue Infection

Dengue has been called the most important mosquito-transmitted viral disease in terms of morbidity and mortality. Dengue fever is a benign, acute febrile syndrome occurring in tropical regions. In a small proportion of cases, the virus causes increased vascular permeability that leads to a bleeding diathesis or disseminated intravascular coagulation (DIC) known as dengue hemorrhagic fever (DHF). Secondary infection by a different dengue virus serotype has been confirmed as an important risk factor for the development of DHF.

In 20-30% of DHF cases, the patient develops shock, known as the dengue shock syndrome (DSS).

Worldwide, children younger than 15 years make up 90% of DHF cases.^[1] In the Americas, however, DHF occurs in adults and children.

Dengue fever is not contagious through person-to-person contact.

Complications

Complications are rare but may include the following:

• Brain damage from prolonged shock or intracranial hemorrhage
• Myocarditis
• Encephalopathy
• Liver failure

Go to Dengue Infection, Pediatric Dengue, and Dermatologic Manifestations of Dengue for complete information on these topics.

Next Section: Prehospital Care

Pediatric Dengue

Dengue, a Spanish alteration of the Swahili word Ki-dinga, is the most common mosquito-borne viral illness in humans. The earliest known documentation of denguelike symptoms was recorded in the Chinese Encyclopedia of Symptoms during the Chin Dynasty (AD 265-420). The illness was called "the water poison" and was associated with flying insects near water. Today, dengue is known to be caused by a single-stranded RNA virus (approximately 11 kilobases long) with an icosahedral nucleocapsid and covered by a lipid envelope. The virus is in the family Flaviviridae (of the genus Flavivirus), and the type-specific virus is yellow fever.

The dengue virus has 4 closely related but distinct serotypes, DEN1-DEN4.^[1]It maintains an infection cycle that uses mosquitoes, mostly the Aedes aegypti mosquito^[2] and rarely the Asian tiger mosquito (Aedes albopictus), as vectors to human hosts, who also serve as sources of viral amplification. A aegypti is a small, highly domesticated, black-and-white tropical insect that prefers to feed on humans (favoring ankles and the back of the neck). See the images below.

The insect typically lays its eggs in artificial containers that contain water, and, as a consequence, dengue is frequently an urban-acquired disease.

Worldwide distribution of dengue in 2003. Picture from the Centers for Disease Control and Prevention (CDC) Web site.

In 1779-1780, the first reported outbreak of dengue fever (DF) occurred almost simultaneously in Asia, North America, and Africa. This indicates that the virus and its vector have a worldwide distribution in the tropical regions of the world (see the images below).

Worldwide distribution of dengue in 2000. Picture from the Centers for Disease Control and Prevention (CDC) Web site.

Worldwide distribution of dengue in 2005. Picture from the Centers for Disease Control and Prevention (CDC) Web site

The clinical presentation of dengue infection involves a wide spectrum of findings, from asymptomatic or mild self-limiting infection of dengue fever to potentially fatal hemorrhage and shock (dengue hemorrhagic fever [DHF], dengue shock syndrome [DSS]).

Next Section: Pathophysiology

Can Sri Lankan experts on dengue save the day?

 On the invitation of the Punjab chief minister, a 12-member team of dengue experts from Sri Lanka held a detailed session of discussion and briefing with the high-ups of Punjab Health Department at the Institute of Public Health 

Punjab Health Secretary Jahanzeb Khan and Health Services DG Dr Aslam Chaudhry briefed the meeting dengue statistics. They said that the first dengue case surfaced in Punjab in 2003 and now this number had risen up to 4,989. Maximum number of dengue patients had been detected in Lahore, where residents of Gulberg Town were worst hit with 19 percent patients infected with this virus. Similarly, 75 percent patients belonged to 15 to 50 years of age while male to female ratio was 70 to 30. They informed the meeting that the Punjab chief minister had taken up the issue on war-footings and had involved elected representatives and the civil society to meet this challenge. Punjab Health Department had been given more resources and now thermal spray would start from September 16 (today), they concluded. Head of Sri Lankan Team Dr Hasitha Tissera said that on the Punjab CM’s request, Sri Lankan president took a quick action. He said that they had been facing this problem from the last 30 years and now they were here to share their expertise. He said that now it was possible to control dengue and the CM’s spirit could help overcome this problem. IPH Dean Dr Yaqub Qazi, Dr Faisal Masood and Dr Javed Akram also addressed the sessions and gave a number of proposals to counter dengue virus on a permanent basis

Dengue - Guidelines for diagnosis, Treatment, prevention and control

Since the second edition of Dengue haemorrhagic fever: diagnosis, treatment, prevention and control was published by the World Health Organization (WHO) in 1997, the magnitude of the dengue problem has increased dramatically and has extended geographically to many previously unaffected areas. It was then, and remains today, the most important arthropod-borne viral disease of humans.

This new edition has been produced to make widely available to health practitioners, laboratory personnel, those involved in vector control and other public health officials, a concise source of information of worldwide relevance on dengue. The guidelines provide updated practical information on the clinical management and delivery of clinical services; vector management and delivery of vector control services; laboratory diagnosis and diagnostic tests; and surveillance, emergency preparedness and response. Looking ahead, some indications of new and promising avenues of research are also

described. Additional and more detailed specific guidance on the various specialist areas related to dengue are available from other sources in WHO and elsewhere, some of which are cited in the references.

New WHO/TDR dengue guidelines can save lives and bolster research

The new edition of "Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control" received an especially favorable review in this year's BMA Medical Book Competition. Since the last edition of the book over a decade ago, the magnitude of the dengue problem has increased significantly and has spread in many previously unaffected regions of the world.

Dengue is a viral infection, transmitted by mosquitoes, which can cause shock, bleeding, organ impairment and ultimately death. The new edition of the guidelines encompasses a decade of research, and provides health practitioners and officials with the latest information on clinical management and delivery, vector control, laboratory diagnosis, and surveillance and response. A revised Dengue disease classification system was introduced with the guidelines, in order to distinguish between different types and levels of severity of the disease. Many endemic countries now use the new disease classification in their reporting to public health authorities.

What is the treatment for dengue fever?

Because dengue fever is caused by a virus, there is no specific medicine or antibiotic to treat it. For typical dengue, the treatment is purely concerned with relief of the symptoms. Rest and fluid intake for adequate hydration is important. Aspirin and nonsteroidal anti-inflammatory drugs should only be taken under a doctor's supervision because of the possibility of worsening bleeding complications. Acetaminophen (Tylenol) andcodeine may be given for severe headache and for joint and muscle pain (myalgia).

What is the prognosis for typical dengue fever?

Typical dengue is fatal in less than 1% of cases. The acute phase of the illness with fever and myalgias lasts about one to two weeks. Convalescence is accompanied by a feeling of weakness (asthenia), and full recovery often takes several weeks.

What is dengue hemorrhagic fever?

Dengue hemorrhagic fever (DHF) is a specific syndrome that tends to affect children under 10 years of age. It causes abdominal pain, hemorrhage(bleeding), and circulatory collapse (shock). DHF is also called Philippine, Thai, or Southeast Asian hemorrhagic fever and dengue shock syndrome.

DHF starts abruptly with high continuous fever and headache. There are respiratory and intestinal symptoms with sore throat, cough, nausea,vomiting, and abdominal pain. Shock occurs two to six days after the start of symptoms with sudden collapse, cool, clammy extremities (the trunk is often warm), weak pulse, and blueness around the mouth (circumoral cyanosis).

In DHF, there is bleeding with easy bruising, blood spots in the skin (petechiae), spitting up blood (hematemesis), blood in the stool (melena), bleeding gums, and nosebleeds (epistaxis). Pneumonia is common, and inflammation of the heart (myocarditis) may be present.

Patients with DHF must be monitored closely for the first few days since shock may occur or recur precipitously (dengue shock syndrome). Cyanotic(bluish) patients are given oxygen. Vascular collapse (shock) requires immediate fluid replacement. Blood transfusions may be needed to control bleeding.

The mortality (death) rate with DHF is significant. With proper treatment, the World Health Organization estimates a 2.5% mortality rate. However, without proper treatment, the mortality rate rises to 20%. Most deaths occur in children. Infants under a year of age are especially at risk of dying from DHF.

Dengue Ward to be Opened in SCB Medical, Death Toll Touches 17 in Orissa

Orissa government has sprung into action to grapple with the recent dengue outbreak, even as two more cases of death due to the infectious disease has been reported.
With this, the death toll due to dengue has touched 17 in Orissa. According to reports, nearly 407 patients are undergoing treatment in the state.

Alarmingly, nearly 21 out of the 30 districts in Orissa have reported cases of dengue. Angul district has the maximum number of dengue cases with 192 people testing positive.

The Orissa High Court has asked the State Government to ensure the opening of a separate dengue ward at SCB Medical College and Hospital in Cuttack.

Blood sampling will also begin in 21 dengue affected districts.  

The wrong approach to wiping out the mosquitoes that cause dengue infections could lead to worse epidemics in the future, according to a study released Tuesday.
Targeting only mosquito larvae, and not adults, with insecticides may work in the short run, but could result in higher resistance in the insects and less disease immunity among humans, especially in urban settings, the study found.

Dengue is a mosquito-borne infection that causes severe, flu-like symptoms in some 50 million people every year, mainly in developing countries.

Global incidence of the disease, which is rarely fatal but often debilitating, has risen dramatically in recent decades, linked to both rapid urbanisation and the impact of global warming. Some 2.5 billion people are at risk.

There is no treatment, cure or vaccine -- the only way to control the disease is to kill the mosquitoes that carry it, especially one species: Aedes aegypti.

But which insecticides work best, how frequently they should be applied and whether it is more effective to target mosquitoes in their larval or adult stage are still debated among experts.

Researchers led by Paula Luz of the Oswaldo Cruz Foundation in Rio de Janeiro used mathematics and computer models to simulate the impact over five years of dozens of different strategies for reducing the vectors in which the blood-seeking insects breed and live.

The cost of different approaches was also taken into account, using World Health Organisation (WHO) guidelines as to "cost-effectiveness," that is, the trade off between results and the price tag. 

More Than 12,000 Infected By Dengue in Pakistan

Pakistan, already plagued by floods and suicide bombings, now faces a new menace from an unprecedented outbreak of deadly tropical disease dengue fever.In less than a month, 126 people have died and more than 12,000 have been diagnosed with the virus, which has spread rapidly among both rich and poor in Pakistan's cultural capital Lahore.

Dengue affects between 50 and 100 million people in the tropics and subtropics each year, resulting in fever, muscle and joint ache.

But it can also be fatal, developing into haemorrhagic fever and shock syndrome, which is characterised by bleeding and a loss of blood pressure.

Caused by four strains of virus spread by the mosquito Aedes aegypti, there is no vaccine -- which is why prevention methods focus on mosquito control.

Pakistani authorities in Lahore have blamed the crisis on prolonged monsoon rains and unusually high seasonal temperatures.

But furious locals say the outbreak is yet another example of government inefficiency, citing a failure to take preventive measures to kill off the mosquitos and lengthy power cuts.

Saad Azeem, 45, is a police officer who should be out spraying the streets with insecticide, but he is laid up at home suffering from the fever and mourning the death of his elderly father.



Read more: More Than 12,000 Infected By Dengue in Pakistan | MedIndia http://www.medindia.net/news/More-Than-12000-Infected-By-Dengue-in-Pakistan-91320-1.htm#ixzz1Zzl0cLDS

Treating the Patient With Severe Dengue virus Infection

Dengue has been called the most important mosquito-transmitted viral disease in terms of morbidity and mortality. Dengue fever is a benign, acute febrile syndrome occurring in tropical regions. In a small proportion of cases, the virus causes increased vascular permeability that leads to a bleeding diathesis or disseminated intravascular coagulation (DIC) known as e

 hemorrhagic fever (DHF). Secondary infection by a different dengue virus serotype has been confirmed as an important risk factor for the development of DHF.

In 20-30% of DHF cases, the patient develops shock, known as the dengue shock syndrome (DSS).

Worldwide, children younger than 15 years make up 90% of DHF cases

 In the Americas, however, DHF occurs in adults and children.

Dengue fever is not contagious through person-to-person contact.

Complications

 

• Brain damage from prolonged shock or intracranial hemorrhage
• Myocarditis
• Encephalopathy
• Liver failure

Go to Dengue Infection, Pediatric Dengue, and Dermatologic Manifestations of Dengue for complete information on these topics.

Dengue medicines to be imported from India for dengue patients

 A special team of the Punjab Health Department is set to leave for India within the next few days to finalise matters with the neighbouring country’s authorities for importing medicines and chemicals to counter the dengue virus, 

On the instructions of Punjab Chief Minister Shahbaz Sharif, the health secretary contacted the Indian high commissioner and worked out a plan to go to India to ensure that the medicines are in accordance with the standards of the World Health Organization.

Machines which separate platelets from blood are also being imported from Germany, an official told The Express Tribune.

However, a member of the Special Emergency Committee, set up for eradication of dengue, said that there were no specific medicines for treating dengue virus, adding that anti-mosquito sprays and chemicals were being imported from India.

“Mosquitoes that carry the virus have become resistant to certain sprays. A spray of specific composition is effective against them which we are importing from India,” the member, who is also a doctor, said on condition of anonymity.

Additionally, an 11-member team of Sri Lankan experts, comprising epidemiologists and public health experts, will reach Lahore today to provide technical assistance to the Punjab government.

CM Shahbaz Sharif, while presiding over a meeting to review measures against dengue on Tuesday, said that a special committee comprising assembly members should negotiate for providing diagnostic facilities to dengue patients in private laboratories at reasonable charges. Sharif added that stern action will be taken against those involved in taking advantage of the outbreak through price hikes of mosquito repellants.