OSCE- pre final practical examination

Pre final examination

Date:01 Dec 2023

I have  presented a case of 25 yr old female housewife by occupation resident of nalgonda came to general medicine OPD with 

Chief complaints:-

Body pains since 6 days

Fever since 3 days

petechial rash on left fore arm on the day of admission after applying Bp cuff 

i.e hess test is positive 

Direct NS 1 antigen test- positive

Diagnosis:

Dengue hemorrhagic fever.

OSCE question & answers:

Link:

https://shwethamummadi87.blogspot.com/2023/11/25-yrs-old-female-with-dengue-fever.html

1)What are the newer treatment options for dengue other than supportive care?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10111087/table/Tab1/?report=objectonly

• Monoclonal antibodies

VIS513: Pan-serotype anti - DENV monoclonal antibody Diminished circulating infectious DENV

Other drugs under studies include

•AT-752: Guanosine nucleotide analog replication Reduced viremia on certain days and improved survival in immunocompromised mice models infected with DENV [63] Phase 1 (NCT05366439) and phase 2 (NCT05466240) clinical trials are in progress

Zanamivir

Neuraminidase inhibitor to block desialylation on platelet membrane

Reduction in DENV2 NS1-induced endothelial hyperpermeability and vascular leakage in vitro [73]

Clinical trial to test efficacy against vascular leakage (NCT04597437) is currently on-going

Montelukast

Cysteinyl leukotriene receptor antagonist

Reduced vascular leakage in mouse models of DENV infection [18]

One randomized open-label clinical trial (n = 200) reported reduced incidence and relative risk of DSS (narrow pulse pressure < 20 mmHg and hypotension for age) [95]. A randomized, double-blind, placebo controlled, superiority trial (NCT04673422) to test efficacy of montelukast is currently on-going

Carica papaya leaf extract

Anti-inflammatory agent, augments megakaryocyte development and platelet formation

Reduced production of proinflammatory cytokines [118] and increased platelet count in vivo [119]

Three randomized controlled trials showed an improvement in platelet counts [106–108]