Vitamin E cuts virulence of dengue
Reduces duration of leaking in DHF Anti-oxidants in the vitamin useful in management of DF & DHF Proven through a Clinical Trial at LRH
With the monsoon winds lashing the country bringing about heavy showers and also dry spells on and off, the spectre of dengue rises once again.
Terrified are the people, especially parents with young children, fearful of the disastrous consequences of this mosquito-borne viral disease.
Amidst the gloom and the doom, there is good news.
The use of Vitamin E during a dengue infection, be it Dengue Fever ( DF) or Dengue Haemorrhagic Fever ( DHF) helps to reduce the virulence of the infection, a groundbreaking study has revealed.
Vitamin E ‘ significantly’ reduced the duration of leaking, the major culprit for complications in DHF, the Sunday Times learns.
Reiterating that Vitamin E should be used in the ‘management’ of dengue along with the usual treatment protocols, Honorary Consultant Pa e d i a t r i c i a n , L a dy Ridgeway Hospital (LRH) for Children, Prof. Pujitha Wickramasinghe who is also Professor in Paediatrics at the Faculty of Medicine, University of Colombo was categorical that “it is not a cure by itself ”.
“We have known the usefulness of Vitamin E through clinical experience but now it is scientifically established,” he says, adding that the purpose of the study was to determine whether the anti- oxidant properties of Vitamin E would be helpful in the management of DF and DHF in children.
The ‘significant’ results of this study -- a Clinical Trial (CT) conducted among 127 children in the age-group 5-12 years at the LRH who fulfilled the clinical cri- teria for dengue infection -- have been published in October in the respected indexed Asian Pacific Journal of Tropical Medicine under the title ‘Effects of Vitamin E supplementation on the clinical outcome of DF and DHF in children’.
The objective of this ‘ triple blinded controlled interventional trial’ was the evaluation of the effects of Vitamin E supplementation on the clinical course of DF and DHF. Ethical clearance had been obtained as also approval by the National Medicines Regulatory Authority, with the protocol being registered in the Sri Lanka Clinical Trials Registry. Informed written consent had been obtained from the parents and the participants.
A CT means a carefully and ethically-designed experiment, in which the participants are assigned to different modes of intervention simultaneously at random. They are also supervised in a simultaneous w a y. Meanwhile, ‘ triple blind’ denotes that the participant, the observer-researcher and the statistician who analyses the data do not know who receives what treatment – the Vitamin supplementation or the placebo (a fake treatment which has no adverse effect).
Detailing the study, he conducted along with Dr. P. W. Prasad Chathurangana at the LRH’s Professorial Paediatric Unit, from August 2015 to July 2016, Prof. Wickramasinghe says that children recruited for it fulfilled the clinical criteria for dengue infection.
These criteria were fever and two other clinical symptoms such as headache; retro-orbital pain (pain behind the eyes); myalgia (muscle pain); arthralgia (joint pain), bone pain and haemorrhagic manifestations (bleeding). These children had been admitted to the LRH within the first 84 hours of the onset of fever. Any child with an underlying chronic illness such as cardiac ( heart), renal (kidney) or hepatic (liver) disease or on long-term medications had been excluded from the study.
The patients had then been ‘ randomized’ into ‘ treatment’ and ‘ control’ groups according to two age- categories ( 5– 9 years and 10– 12 years) using a computer generated random number table.
The treatment group in the 5- 9 year age-category had been given 200mg of Vitamin E and those in the 10- 12 year age-category 400mg of Vitamin E. The respective doses were given daily from the day of admission to the LRH up to the 7th day of illness.
The control group, meanwhile, had received a commercially-prepared placebo for the same period.
On admission, a thorough physical examination including the Hess test (to assess the fragility of capillaries or the smallest blood vessels) had been performed and blood samples sent for a full blood count (FBC) to check the haematological and biochemical parameters.
The haematological parameters were WBC (white blood count), platelets and PCV (packed cell volume). The biochemical parameters were AST ( aspartate aminotransferase); alanine aminotransferase (ALT); serum albumin, serum calcium and serum cholesterol.