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Guidelines for Unani Practitioners for Clinical Management of Dengue Fever by  CCRH & AYUSH

 

Dengue fever is known as Hummā Danj in Unani medicine. It is one of the Wabā’ī Amrāz

experienced in the past and treated on the pattern of other Wabā’ī Amrāz. Prevention and

treatment of Wabā’ī Amrāz has been well described in Unani system of medicine.

Hummā Danj (Dengue Fever) is an acute febrile illness caused by a flavivirus

transmitted by the Aedes mosquito and characterized by sudden onset of high fever, severe

muscle and joint pain, headache, rash, sore throat, lymphadenopathy and depression.

 

AETIOLOGY

The causative agent of Dengue Fever is dengue virus which belongs to genus Flavivirus.

There are four serotypes of dengue virus – DEN-1, 2, 3 and 4; all produce a similar clinical

syndrome and all are transmitted by Aedes aegypti mosquitoes which bite in the daytime and

breed in standing water. Infection with one serotype provides life-long immunity to that

serotype but not to the other three serotypes.

Humans are infective during the first 3 days of the illness (the viraemic stage).

Mosquitoes become infective about 2 weeks after feeding on an infected individual, and

remain so for the rest of their lives.

 

CLINICAL FEATURES

The incubation period is 4 to 6 days (range 3 to 14 days) following the mosquito bite.

Asymptomatic or mild infections are common. Two clinical forms are recognized: Classic

Dengue Fever and Dengue Haemorrhagic Fever (DHF).

 

Prodrome

 2 days of malaise and headache

Acute onset

 Fever:

o Continuous or 'saddle-back', with break on 4th or 5th day and then

recrudescence; usually lasts 7-8 days

 Break-bone aching ('break-bone fever'): severe headache, backache, myalgias and

arthralgias

 Retro-orbital pain (pain on eye movement)

 Skin rash:

o Initial flushing faint macular rash in first 1-2 days. Maculopapular, scarlet

morbilliform rash from days 3-5 on trunk, spreading centrifugally and sparing

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palms and soles, onset often with fever defervescence. May desquamate on

resolution or give rise to petechiae on extensor surfaces

 Relative bradycardia

 Anorexia, Nausea, and Vomiting

 Lymphadenopathy

 Haemorrhagic manifestations:

o A positive tourniquet test

o Petechiae, ecchymoses, purpura

o Bleeding per mucosa, GIT, other

o Haematemesis, melaena.

o Thrombocytopenia <100,000/mm³

Convalescence

 Slow

Complications

 Minor bleeding from mucosal sites, hepatitis, cerebral haemorrhage or oedema,

rhabdomyolysis

In the past, the Central Council for Research in Unani Medicine has created

awareness in the community on the preventive approach to control Dengue Fever. Unani

medicines and preventive measures suggested by CCRUM proved fruitful.

 

PREVENTIVE MEASURES FOR DENGUE

Primary prevention of dengue is currently possible only with vector control and personal

protection from the bites of infected mosquitoes.

 Be aware of countries or areas where dengue fever is endemic.

 Mosquitoes may be in more number close to or on spaces with plenty of trees, so keep

away from such spaces.

 Don’t allow any kind of water around your environment.

 Changes to vector habitats: Management of “essential” containers

o Frequently empty and clean the purposely-filled household containers such as

water-storage vessels, flower vases and desert room coolers

o Recycle or properly dispose of the rain-filled habitats – including used tyres

and discarded food and beverage containers

o Shelter stored tyres from rainfall

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o Manage or remove from the vicinity of homes the plants such as ornamental or

wild bromeliads that collect water in the leaf axils

 Actions to reduce human–vector contact

o Install mosquito screening on windows, doors and other entry points

o Use insecticide-treated mosquito nets while sleeping during daytime (e.g.

infants, the bedridden and night-shift workers)

o Wear covered clothes to minimize skin exposure during daylight hours when

mosquitoes are most active

o Apply mosquito repellents containing DEET, IR3535 or Icaridin to exposed

skin or to clothing.

o Use household insecticide aerosol products, mosquito coils or other insecticide

vaporizers to reduce biting activity.

 

TREATMENT AND MANAGEMENT

 Bed rest during the acute phase

 Try to keep temperature below 102°F:

o Use antipyretics to lower the body temperature:

 Habb-e-Ikseer Bukhar: 400 mg thrice a day with lukewarm water

(NFUM-VI, page 15)

 Sharbat-e-Khaksi: 25-50 ml (NFUM-V, page 140)

 Malerian: Adult: 6 ml BD, Children: 3 ml BD with warm water,

contraindicated for pregnant women (NFUM-VI, page 122)

o Use cold sponging

 Try to avoid Dehydration:

o Use Oral rehydration solution (ORS)

o Use fruit juices like pomegranate juice

o Sharbat-e-Anar Shirin: 25-50 ml (NFUM-I, page 221)

 Use the Unani drugs possessing immunomodulatory activity to boost your immunity:

o Khamira Marwareed: 3-5 g (NFUM-I, page 111)

 Use the Unani drugs with hepato-corrective and hepato-protective activity to

normalize the functions of the liver:

o Majun Dabid-ul-Ward: 5 g BD (NFUM-V, page 90)

 Use Jawarishat to relieve the gastrointestinal symptoms including anorexia, nausea,

and vomiting:

o Jawarish Amla Sada: 5 g BD (NFUM-V, page 71)

o Jawarish Anarain: 5 g BD (NFUM-I, page 98)

 

Some Important Prescriptions

Prescription-1

  1. Powder the following ingredients and prepare the tablets of 500 mg.

Gilo Khushk (Tinospora cordifolia Miers) 1 Part

Tabasheer (Bambusa bambos Linn.) 1 Part

Tukhm Khurfa Siyah (Portulaca oleracea Linn.) 1 Part

Two tablets twice daily

  1. Sharbat Khaksi: 25 ml twice daily

Prescription-2

  1. Habb-e-Ikseer Bukhar: 500 mg twice daily
  2. Sharbat Khaksi: 25 ml twice daily

Prescription-3

  1. Sharbat Khaksi: 25 ml twice daily
  2. Majun Dabid-ul-Ward: 5 g twice daily

iii. Khamira Marwareed: 3-5 g twice daily

Prescription-4

The eminent Unani Physicians suggested that the sachet containing the following ingredients

may be distributed for prevention. This may be used in the form of decoction or tea.

Afsanteen Artemisia absinthium Linn. 1 Part

Chiraita Swertia chirayita Karst. 1 Part

Kasni Cichorium intybus Linn. 1 Part

Gaozaban Borago officinalis Linn. 1 Part

Nankhuah Trachyspermum ammi 1 Part

Neem Bark Azadirachta indica A. Juss. 1 Part

Saad Kufi Cyperus scariosus R. Br. 1 Part

 

Always Remember

NOTHING TO PANIC

 

Dengue Fever is a self-limiting disease. Only timely and proper intervention is required to

attain perfect health and to prevent complications and fatal outcome. Use preventive

measures and medicines as mentioned above. The nearest hospital may be approached for

proper treatment.

CLINICAL RESEARCH

Clinical studies on Dengue Fever may be conducted in collaboration with modern medical

centres so that the life of the patients may be saved in emergency conditions. In active cases

of Classic Dengue Fever, supportive Unani treatment for strengthening the Quwwa

(Faculties) may be given as an adjuvant therapy to allopathic treatment in order to shorten the

duration of illness, and to relieve the symptoms following the acute illness like general

weakness and depression. The record of the efficacy of the Unani drugs evaluated may be

maintained.

For more information please contact

CENTRAL COUNCIL FOR RESEARCH IN UNANI MEDICINE

Ministry of AYUSH, Government of India, New Delhi)

61-65, Institutional Area, Opposite “D” Block, Janakpuri, New Delhi-110058

Tel. No.: +91-11-28521981

Fax No.: +91-11-28522965

Website: www.ccrum.net

E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

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