Background. Dengue fever is an emerging public health problem in Pakistan. The aim of this study was to determine the relationship between comorbid conditions in individuals suffering from dengue fever and the development of dengue hemorrhagic fever or dengue shock syndrome. Methods. In this age- and sex-matched case control study, total of 132 cases of dengue hemorrhagic fever/dengue shock syndrome and 249 randomly selected controls were recruited from two major teaching hospitals of Lahore, Pakistan. A semistructured questionnaire was used to collect data through interview and by reviewing clinical records. SPSS version 18 was utilized for statistical analysis including conditional logistic regression. Results. Odds of developing dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) among diabetics are higher than in controls, but this association was not found statistically significant (OR. 1.26; 95% CI. 0.78–2.03; P=0.34). Similarly, no association was observed in individuals suffering from hypertension (OR. 0.93; 95% CI. 0.57–1.49; P=0.76). Odds of developing DHF and DSS were higher for bronchial asthma (adjusted OR. 1.34) and pulmonary tuberculosis (adjusted OR. 1.41); however P values were insignificant. Conclusion. Presence of diabetes mellitus, hypertension, ischemic heart disease and bronchial asthma among patients contracted dengue fever will not increase the risk of dengue hemorrhagic fever and dengue shock syndrome.

Background. Dengue is a mosquito-borne flavivirus infection prevalent in tropical and subtropical regions around the world. Aim of this study was to determine seroprevalence of anti-dengue IgG antibodies in healthy adult population of Lahore and also describe risk factors in relation to dengue seropositivity.Methods. In this cross-sectional study, 274 healthy adult individuals aged 15 years and above were randomly selected using multistage sampling technique. These individuals were interviewed between July–September 2012, using a semistructured questionnaire, followed by drawing 3 mL of their venous blood for dengue IgG test. Nova Tech ELISA kit with sensitivity and specificity of 96.5% and 97.5%, respectively, was used for serology.Results. Out of 274 participants, 184 (67.2%) were found to be positive for dengue IgG antibodies. Seroprevalence was higher among individuals with poor awareness about potential breeding sites for dengue mosquito (63.6%), followed by the subjects who had poor knowledge about dengue signs/symptoms and complications (52.2% and 68.5%, resp.).Conclusion. About two-third of healthy population of Lahore was also seropositive for anti-dengue IgG during July–September 2012, indicating a considerable burden of subclinical dengue infection in the city. Males were predominantly affected than the females. We found no statistical association between dengue IgG seropositivity and socioeconomic status, occupation, and knowledge about the disease.

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Pulmonary embolism in the cases of tuberculosis (TB) infection has incited physicians and researchers to derive a reasonable association in the past few years. However, despite the efforts, pulmonary embolism is often misdiagnosed in the context of active TB. Pulmonary embolism in TB is still considered a rare phenomenon, even though it seems to be a probable risk factor based on the emerging literature. We report a case of a young man who presented with recurrent respiratory symptoms. He had no risk factors except a former history of smoking. We believe that the symptoms he had on the initial visit were misinterpreted in the background of TB infection. We followed the case for two months after he was discharged on anticoagulants and anti-TB medication. In this case report, we would like to emphasize the need to consider this occult phenomenon in order to rule out TB in cases of pulmonary embolism and vice versa. We hope that the management of TB in the future might take into account the chances of concomitant pathology of pulmonary embolism in patients with active TB.

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