Background. Dengue viruses (DV) belong to the family Flaviviridae, with four serotypes referred to as DV-1, DV-2, DV-3, and DV-4. A large-scale outbreak of dengue fever occurred in 2012 involving several districts of West Bengal. Objective. To present a comprehensive picture of the dengue fever outbreak in 2012 and to identify the prevailing serotypes. Materials and Methods. Serum samples were collected from suspected dengue fever cases. Samples from fever cases <5 days duration were tested for dengue NS1 antigen employing Pan Bio (Australia) NS1 ELISA kit. Serum samples of ≥5 days fever were tested for dengue-specific IgM by MAC ELISA test kit prepared by the National Institute of Virology Pune, India. Serotyping of dengue samples was done by dengue-specific reverse transcriptase polymerase chain reaction (RT-PCR). Results. The number of dengue cases in 2012 clearly outnumbered the dengue cases in 2010 and 2011. The majority of the cases were in the age group 11-30 years with a male preponderance. Outbreak occurred during the months of Aug.-Nov. indicating increased vector transmission in the monsoon and postmonsoon periods. The prevailing serotypes in this outbreak were Den1, Den3, and Den4.

Out of 230 rotavirus-positive acute diarrhea children, 224 children completed the study, (113 in the drug group and 111 in the placebo group). At recruitment on Day 1, there were no significant differences between the 2 groups in terms of frequency of vomiting, mean loose stool frequency, stool consistency, and mean frequency of oral rehydration salts (ORS) and intravenous fluids administered. On Day 2, a lower mean stool frequency and improved stool consistency was noted in the drug group, which achieved statistical significance. This was also reflected in the lower volume of ORS administration in the drug group. Even on Day 3, mean loose stool frequency and frequency of ORS use and frequency of intravenous fluid use was significantly lower in the drug group. The differences in the frequency of loose stools persisted till 8 hours of Day 4. After this, as the placebo group also showed spontaneous improvement the difference between the 2 groups in terms of the overall stools frequency became comparable. However, the overall ORS requirement continued to be significantly lower in the drug group even on Day 4. The overall recovery rates were significantly better in the drug group compared with placebo. No side effects were noted with the use of the probiotic mixture. Use of probiotic mixture VSL[sharp]3 in acute rotavirus diarrhea resulted in earlier recovery and reduced frequency of ORS administration reflecting decreased stool volume losses during diarrhea.

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The high levels of sFasL and TNF-alpha are associated with ALF. Following the trend of these cytokines can be useful in predicting death and timely referral to a transplant centre.