05 October 2010
Lucknow, India
More Dengue Cases In City
Cross Check Platelet Count As Extra Transfusion Can Lead To Complications: Health Dept
"For last three days, there has been a mad rush for platelets, particularly of the attendants of the patients admitted in private hospitals," said incharge of blood bank Dr Tulika Chandra. "As per medical guidelines, transfusion of platelets is required only when the count is below 20,000, whereas doctors in the private hospitals are recommending transfusion even if the count is 50,000 or one lakh," she added.
People, she said, should cross check the platelet count before rushing for purchase because extra and unnecessary transfusion can lead to complications and at the same time cause scarcity for patients who actually need platelets. The CSMMU blood bank produces around 200 platelet units everyday and all is sold out by the end of the day. The bank also needs more voluntary blood donation from people for the production of platelets to meet the increasing demand.
While the health officials claimed that so far only 200 dengue cases have been reported in the state and no death has taken places, sources said more than 500 cases have been admitted in the government and private hospitals in the city in last 15 days alone. It is said that while three dengue deaths occurred in the city, about 10 people have died in the state.
The figure includes patients from other districts getting treatment in Lucknow. The reason why official figures of dengue patients and deaths are low is that the health department does not keep track of private hospitals and does not recognise confirmation test other than prescribed by it.
On Monday, 10 dengue patients were undergoing treatment in SGPGI, over 30 in Chhatrapati Shahuji Maharaj University, 10 in Ram Manohar Lohia hospital, 17 in Balrampur hospital and nine in Shyama Prasad Mukherjee hospital. While private practitioners and nursing homes said that dengue patients are pouring in on a regular basis, the health department accepts a case to be dengue positive only when the test is done through the polymerase chain reaction test using an elisa reader. Very few pathologies in private sector in the city have elisa facility.
Director general medical health Dr SP Ram said people should not panic as dengue can be treated through proper management. Chief medical officer Dr AK Shukla said there are many cases of viral fever these days which people mistake as dengue. Dengue, he added, is a self limiting virus which lasts for only few days.
President of pathologists’ association Dr PK Gupta said the patients should get the tests done only from the labs having qualified pathologists.
He added that people should insist on manual reading of platelet count because automated reading has been found to be giving wrong results. "Patients should go to certified doctors and trust them for treatment rather than insisting on platelet transfusion if diagnosed with dengue," he said.
Know About Platelets Diagnosis
No self medication. Go to doctor for expert advise.
Test should be done by a qualified pathologist. Inquire about the pathology and the experts before giving sample for test.
Two tests for confirmation of dengue virus are – elisa test and rapid chromotographic test. Elisa test and Rapid Chromotographic test cost between Rs 600–800 in private establishment. Free in government hospitals. But only few private pathology labs in the city have the facilities. In government sector, the two tests are available in CSMMU and SGPGI.
Expert recommend platelet count test at a regular interval, if dengue like symptoms such as fever or rashes, to keep a track on platelet strength. The test cost Rs 100–200 in private pathologies. If platelet count decreasing rapidly, only then go for confirmatory test.
What Is A Platelet?
Platelet is a component of blood. It prevents bleeding and helps in formation of clot. Normal platelet count in Human body up to 4 lakh. In dengue patients, its drops to between 50,000 to 1 lakh. Regular monitoring required, if platelet count goes below 50,000. Platelet transfusion required only when platelet count goes below 20,000.
Dengue is a self limiting virus which goes away in few days. Only proper management required for treatment.
Excess and unnecessary platelet transfusion might lead to development of antibodies in the blood which might cause complications.
A unit of platelet is made from five units of blood through a component separator. The shelf life of the platelet is five days. Only CSMMU and SGPGIMS have facility in the government sector to produce platelets. Only 2–3 private hospitals are producing platelets.
Platelet transfusion required if count going down accompanied by internal bleeding. The cost of platelet in CSMMU for in–house general ward patient is Rs 50 and for an outsider Rs 400 as fixed by the government. At private hospital, a unit is available for Rs 8000 at present due to crisis. Normally, at private hospital the cost is between Rs 2500–4500.
Panic buying leads to escalation of cost and scarcity of platelets for those who actually need it.
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