This story is from October 5, 2016

Dengue alert! Painkillers may do more harm

<arttitle><p>Dengue alert! Painkillers may do more harm</p></arttitle>
PUNE: Got fever with body ache? Think twice before reaching for painkillers as they could do more harm than good.
Experts have warned that popping painkillers like Brufen, Combiflam and others falling in the non-steroidal anti-inflammatory drug (NSAID) category may lead to complications like gastrointestinal bleeding in case of dengue fever.
In view of the rampant self-medication by people suffering from fever and body ache, state government's technical committee has directed local self-government bodies to sensitize people against the use of over-the-counter painkillers.

"Since dengue presents as a fever with body ache in the beginning, most people mistake it for a viral fever. They end up taking drugs like Combiflam, Brufen and others. However, taking these pills may complicate things. We have directed municipal corporations to sensitize people against taking these pills," Kanchan Jagtap, joint director (vector-borne diseases), told TOI on Tuesday.
Senior physician D B Kadam, who is also one of the members of the state government's technical committee, said, "As the count of platelet goes down in dengue, taking these NSAID drugs may cause gastrointestinal bleeding in patients with dengue. Instead, patients can take paracetamol or Crocin. Although these medicines should only be taken after consulting a physician."
The infecting organism in dengue affects the platelets which are responsible for clotting (stopping bleeding) increasing the tendency of the person to bleed. The NSAID drugs also have similar action. Both of them could cause the person to bleed excessively, pushing the patient into what is called the 'Dengue Shock Syndrome'. And once in this stage, medical treatment is needed on an emergency basis and hospitalization becomes necessary.

"All doctors should suspect dengue whenever a patient with fever comes for treatment and refrain from prescribing the NSAIDs. The fever may be managed with paracetamol and sponging with tepid water," said internal medicine expert Abhijit Joshi.
The NSAIDs will have systemic and local impact. The systemic effect would include impaired platelet aggregation (clumping together to cause clotting) and an impact on the coagulatory system. The local effect would be tiny gastric erosions, experts said.
"We have already started sensitizing people about following right treatment regimen and do not indulge in self-medication in case of dengue," said S T Pardeshi, chief of the health department at Pune Municipal Corporation.
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