10 days with two or more of retro orbital pain, headache, arthralgia, myalgia, rash, hemorrhagic manifestations (as evidenced by HESS test
)14, thrombocytopenia (<100,000/mm3) and leukopenia (<4000/mm3) and further serologically confirmed (either by IgM or NS-1) by enzyme-linked immunosorbent assay (ELISA), of both genders aged more than 13 years were included in this study that consented to use of their clinical data for research purposes on admission (Definite cases of dengue fever).
Hess test was performed in all the subjects and the result noted.
Abnormal Hess test was also not seen in any of the subjects.
The only study till date seeking a true association between CCBs and purpura and bleeding included 19 patients on CCBs of whom 16 had had either abnormal Hess results or marked acral purpura after a Hess test which led the authors to suggest that the high frequency of purpura shown in their study was a pharmacological class effect rather than idiosyncratic reaction.
We undertook the study to verify the findings of the study by Cox et al.11 which suggest that CCBs are related to bleeding, purpura and abnormal Hess test. We selected patients only on CCB therapy to avoid confounding effects of other drugs to avoid the drawback of the study by Cox et al.11 which included patients on multiple drugs.
This study aimed to estimate the frequency of purpura and bleeding in patients on calcium channel blockers and to look for an association between calcium channel blocker therapy and petechiae due to capillary fragility induced by Hess test.
In SD group presence of fever, myalgia, vomiting, pain in abdomen, rash, positive Hess test, pallor, hepatomegaly was seen in all the cases (P value <0.001.).
In the Stepwise Multivariate Logistict Regression analysis model, the features entered as independent factors were prolonged PT, APTT, hypoalbuminemia (<2.5g/dl), positive Hess test, Positive IgM and increased GBWT>3 mm.
Fever 100 52 100.00 40 Vomiting 42 0 0.00 34 Pain Abdomen 42 1 1.92 33 Myalgia 69 31 59.62 30 Rash 13 0 0.00 5 Bleeding Manifest'n 7 0 0 1 Positive Hess Test 8 0 0.00 0 Respiratory Distress 5 0 0.00 0 Altered Sensorium 4 0 0.00 0 Pallor 21 7 13.46 6 Lymphadenopathy 7 2 3.85 1 Flushing 7 2 3.85 1 Cold Extremities 7 1 1.92 0 Hepatomegaly 39 20 38.46 11 Symptoms/Signs Dengue Classification 'p' Value With warning Severe (n=8) signs (n=40) % No.
was done to investigate the vascular defects.
The Hess test or tourniquet test is a simple clinically test procedure that reflects capillary fragility and has been reported that to be positive in nearly all of the DHF cases .
In the present study Hess test was found 15.2% in DF and 34.2% in DHF but was observed high in DHF and only 33.3% present in DSS.