{"paper_id":"2df3c973-b8f3-4803-a2cd-5c827a0c26e1","body_text":"A Retrospective Study on Analysis of Hematological and Biochemical Profiling in Dengue Patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Retrospective Study on Analysis of Hematological and Biochemical Profiling in Dengue Patients Dr Vikas Tiwari, Dr. Jaishree Tiwari This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9121099/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Dengue is a rapidly emerging mosquito-borne viral disease that poses a major public health challenge in tropical and subtropical regions. Hematological and biochemical abnormalities are common in dengue infection and play a crucial role in disease diagnosis, monitoring, and prognosis. This study aimed to evaluate hematological and biochemical alterations in patients diagnosed with dengue infection. Methods: A retrospective observational study was conducted on 125 patients who underwent laboratory testing for suspected dengue infection between June 2025 and December 2025. Dengue infection was confirmed using a dengue combi rapid diagnostic test detecting NS1 antigen, IgM, and IgG antibodies. Hematological parameters were analyzed using an automated hematology analyzer, while biochemical parameters including bilirubin, SGOT, and SGPT were measured using the Cobas 6000 analyzer. Coagulation parameters such as prothrombin time (PT), activated partial thromboplastin time (APTT), and international normalized ratio (INR) were also assessed. Statistical analysis was performed using SPSS software. Results: Among the 125 patients, 119 (95.2%) were dengue positive and 6 (4.8%) were malaria positive. Male patients constituted 60.8% of the study population. The most affected age group was 21–30 years. Thrombocytopenia was observed in a significant proportion of patients, with approximately 30% having platelet counts below 50,000/mm³. Leukopenia (< 4000 cells/mm³) was detected in 28% of cases. Elevated liver enzymes were observed in the majority of patients, with SGOT elevated in 74.4% and SGPT in 67.2% of patients. NS1 antigen positivity was the most common serological finding. Conclusion: Hematological abnormalities such as thrombocytopenia and leukopenia, along with elevated hepatic enzymes, are commonly associated with dengue infection. Early laboratory evaluation plays a crucial role in the diagnosis and management of dengue patients. General Microbiology Virology Parasitology Dengue fever hematological profile biochemical parameters thrombocytopenia NS1 antigen INTRODUCTION Dengue fever is a mosquito-borne viral disease caused by the dengue virus belonging to the Flavivirus genus of the Flaviviridae family. The virus has four distinct serotypes, namely DEN-1, DEN-2, DEN-3, and DEN-4¹. Infection with any serotype can result in clinical manifestations ranging from mild febrile illness to severe dengue hemorrhagic fever and dengue shock syndrome². Dengue is transmitted primarily by Aedes aegypti and Aedes albopictus mosquitoes. Globally, approximately half of the world's population resides in areas at risk for dengue infection³. It is estimated that nearly 400 million dengue infections occur annually , with about 100 million symptomatic cases and thousands of deaths worldwide⁴. Laboratory investigations play a critical role in the diagnosis and management of dengue infection. Hematological abnormalities such as thrombocytopenia, leukopenia, and hemoconcentration are commonly observed in infected patients⁵. Biochemical alterations, particularly elevated liver enzymes, are also frequently reported and reflect hepatic involvement during infection⁶. Understanding the hematological and biochemical changes associated with dengue infection is essential for early diagnosis, monitoring disease progression, and preventing severe complications. Therefore, the present study aimed to evaluate the hematological and biochemical profile of dengue patients presenting to a tertiary care center. MATERIALS AND METHODS Study Design and Setting This retrospective observational study was conducted in the Departments of Laboratory Medicine and Biochemistry at a tertiary care diagnostic facility. The study period extended from June 2025 to December 2025 . Study Population A total of 125 patients who underwent laboratory testing for suspected dengue infection were included in the study. Patients with confirmed dengue infection based on serological testing were considered for analysis. Inclusion Criteria Patients with confirmed dengue infection based on NS1 antigen or antibody positivity Patients with complete hematological and biochemical investigations Exclusion Criteria Patients with incomplete laboratory data Patients with pre-existing hematological disorders Laboratory Investigations Serological Testing Dengue infection was confirmed using a rapid dengue combi diagnostic test detecting: NS1 antigen IgM antibodies IgG antibodies A case was considered positive if any one parameter showed positivity . Hematological Analysis Complete blood count parameters were measured using an automated hematology analyzer (18-parameter system) including: Hemoglobin (Hb) Total leukocyte count (TLC) Differential leukocyte count Platelet count Hematocrit RBC indices Peripheral blood smear examination was performed using Leishman staining for morphological assessment. Biochemical Analysis Biochemical parameters were measured using Cobas 6000 analyzer (Roche Diagnostics) : Serum bilirubin (total, direct, indirect) SGOT (AST) SGPT (ALT) Coagulation Profile Coagulation parameters were analyzed using Human Clot Junior and TCOAG analyzers including: Prothrombin time (PT) Activated partial thromboplastin time (APTT) International normalized ratio (INR) Statistical Analysis Data were entered and analyzed using IBM SPSS Statistics version 25.0 . Descriptive statistics were used to summarize demographic and laboratory data. Continuous variables were expressed as mean ± standard deviation (SD) . Categorical variables were expressed as frequencies and percentages . Associations between laboratory parameters were evaluated using Chi-square tests where appropriate. A p-value < 0.05 was considered statistically significant. RESULTS The present retrospective study was conducted in 2021 to evaluate the hematological and biochemical profile of patients with dengue infection in the Dehradun region. A total of 125 patients presenting with acute febrile illness were included in the study. All patients underwent relevant laboratory investigations for dengue and malaria infection. Among these, 119 (95.2%) patients were confirmed dengue cases , while 6 (4.8%) patients were diagnosed with malaria infection . Additionally, 30 patients presenting with fever tested negative for both dengue and malaria . The analysis presented in this study focuses primarily on confirmed positive cases. All patients included in the study presented with high-grade fever , frequently accompanied by symptoms such as weakness and malaise . Demographic Characteristics Sex Distribution Out of the total 125 patients , 76 (60.8%) were males and 49 (39.2%) were females , indicating a higher prevalence of dengue infection among males. The detailed distribution is presented in Table 1 . Table 1 Distribution of Patients According to Sex Sex Frequency (n) Percentage (%) Male 76 60.8 Female 49 39.2 Total 125 100 Age Distribution Age-wise distribution showed that dengue infection affected a wide range of age groups. The highest number of cases (21.6%) occurred in the 21–30 years age group , followed by 51–60 years (18.4%) and 41–50 years (16.8%) . Pediatric cases (1–10 years) were relatively fewer and mostly admitted to pediatric wards rather than medical wards. The detailed age distribution is shown in Table 2 . Table 2 Age Distribution of Patients Age Group (years) Frequency Percentage (%) 1–10 4 3.2 11–20 13 10.4 21–30 27 21.6 31–40 13 10.4 41–50 21 16.8 51–60 23 18.4 61–70 10 8.0 71–80 9 7.2 The findings indicate that young adults were the most affected population , which is consistent with epidemiological patterns reported in other dengue studies. Hematological Findings Hematological analysis revealed significant variations in total leukocyte counts among the study population. Leukopenia (TLC < 4000 cells/mm³) was observed in 35 patients (28%) , whereas 11 patients (8.8%) exhibited leukocytosis (> 11,000 cells/mm³) . The majority of patients ( 79 cases; 63.2% ) had leukocyte counts within the normal range. These findings are summarized in Table 3 . Table 3 Hematological Findings Parameter Frequency Percentage (%) Leukopenia (< 4000/mm³) 35 28 Normal TLC 79 63.2 Leukocytosis (> 11000/mm³) 11 8.8 In addition, thrombocytopenia was a common finding in dengue patients , with platelet counts frequently dropping below 150,000/mm³ . Approximately 30% of patients had platelet counts below 50,000/mm³ , a level commonly associated with dengue hemorrhagic fever and bleeding manifestations. Serological Findings Serological testing using dengue rapid diagnostic tests revealed varying patterns of antigen and antibody positivity. NS1 antigen positivity was the most common finding , detected in 88 patients (64.8%) , suggesting early-stage infection in a significant proportion of cases. IgM antibodies were detected in 36 patients (28.8%) , whereas IgG antibodies were detected in 30 patients (24%) . These findings are presented in Table 4 . Table 4 Serological Test Results Test Positive Cases Percentage (%) NS1 Antigen 88 64.8 IgM Antibody 36 28.8 IgG Antibody 30 24 The higher prevalence of NS1 antigen positivity indicates that many patients presented during the early acute phase of infection . Coagulation Profile Coagulation studies were performed in 40 patients. Among these, 26 patients exhibited prolonged prothrombin time (PT) while 14 patients had normal PT values. Additionally, 15 patients showed prolonged INR values, whereas 25 patients had normal INR levels. Activated partial thromboplastin time (APTT) was prolonged in 14 patients, indicating coagulation abnormalities in some dengue cases. Liver Function Abnormalities Biochemical analysis revealed significant hepatic involvement among dengue patients. Elevated liver enzymes were frequently observed, with SGOT elevated in 93 patients (74.4%) and SGPT elevated in 84 patients (67.2%). Increased bilirubin levels were observed in 30 patients (24%). These findings are summarized in Table 5 . Table 5 Liver Function Abnormalities Parameter Abnormal Cases Percentage (%) Elevated SGOT 93 74.4 Elevated SGPT 84 67.2 Elevated Bilirubin 30 24 The higher frequency of SGOT elevation compared to SGPT suggests hepatic involvement associated with dengue infection. Malaria Co-infection Although both dengue and malaria infections were detected among febrile patients in this study, no cases of dengue–malaria co-infection were identified . Six patients were positive for malaria infection, while 119 patients were positive for dengue infection. Bleeding Manifestations Bleeding manifestations were relatively uncommon in the present study. Only 4% of patients developed bleeding complications , with cutaneous petechial hemorrhage being the most common clinical presentation . DISCUSSION The present study evaluated hematological and biochemical alterations among patients with dengue infection. Male predominance observed in this study is consistent with findings reported by Laul et al.⁷ and Gupta et al.⁸. Thrombocytopenia was a major hematological abnormality observed in dengue patients. Previous studies have reported that platelet destruction and bone marrow suppression contribute to thrombocytopenia during dengue infection⁹. Leukopenia observed in several patients is likely due to viral suppression of bone marrow activity¹⁰. Elevated liver enzymes were also frequently observed in this study. SGOT elevation was more common than SGPT elevation, which is consistent with earlier reports indicating that dengue infection can cause hepatic injury and muscle involvement¹¹. Serological testing demonstrated that NS1 antigen positivity was the most common finding. Early detection of NS1 antigen is particularly useful during the initial phase of infection before antibody formation¹². Similar laboratory abnormalities have been reported in studies conducted in various regions of India and Southeast Asia¹³ −15 . Limitations Retrospective study design Limited sample size Lack of long-term clinical follow-up CONCLUSION Dengue infection is associated with significant hematological and biochemical abnormalities including thrombocytopenia, leukopenia, and elevated liver enzymes. Laboratory evaluation plays a critical role in early diagnosis and monitoring of dengue patients. Regular monitoring of hematological parameters can assist clinicians in preventing severe complications. References Guzman MG, Harris E, Dengue (2015) Lancet 385:453–465 Simmons CP, Farrar JJ, Nguyen VV, Wills B, Dengue (2012) N Engl J Med 366:1423–1432 Bhatt S et al (2013) Global distribution and burden of dengue. Nature 496:504–507 World Health Organization (2023) Dengue and severe dengue. WHO Azeredo EL et al (2015) Thrombocytopenia in dengue. Mediators Inflamm 2015:313842 Samanta J, Sharma V (2015) Dengue and its effects on liver. World J Clin Cases 3:125–131 Laul A et al (2016) Clinical profile of dengue infection in northern India. J Trop Med 2016:5917934 Gupta N et al (2012) Dengue in India. Indian J Med Res 136:373–390 Martina BE, Koraka P, Osterhaus AD (2009) Dengue virus pathogenesis. Clin Microbiol Rev 22:564–581 Srikiatkhachorn A (2009) Plasma leakage in dengue hemorrhagic fever. Thromb Haemost 102:1042–1049 Trung DT et al (2010) Liver involvement in dengue infection. Clin Infect Dis 50:84–91 Peeling RW et al (2010) Evaluation of diagnostic tests for dengue. Nat Rev Microbiol 8:S30–S38 Wiwanitkit V (2010) Dengue fever: diagnosis and treatment. Expert Rev Anti Infect Ther 8:841–845 Wilder-Smith A et al (2019) Dengue Lancet 393:350–363 Tiwari V1;, Afzal M2;, Sharma (2024) Abhishek2; Tiwari, Jaishree1. Dengue dynamics: Prognostic and disease monitoring through molecular and serological profiling of clinical isolates. Journal of Vector Borne Diseases 61(3):p 420–425, Jul–Sep | 10.4103/JVBD.JVBD_202_23 Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-9121099\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":606019517,\"identity\":\"236bd4a4-e1ff-4979-aa7d-ec1d65397cdd\",\"order_by\":0,\"name\":\"Dr Vikas Tiwari\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABGklEQVRIiWNgGAWjYDACZjYwxQMiDoCZ7A1AwsCCkBYDuBYJBh4QZSCBxxqIFjhXgkEiAULjAgbH2RI//mD4I2Nw/OzDA4xtdnXyM59f3fCjQIKBv707AauWw2yHpXmADjM4k24A1JIsYXA7p+xmD9BhEmfObsCmRbKZvUEa5BezA2lAv5xhljCQzkm7wQPUYiCRi0tL888fIC3nn4G01EvIzzyTdvMPHi38zGzHJEAOM7sBsqXisATDDfZjt/HZAtSSZs1jYMxjfwNoS0LFcckNZ3LYbssYSPDg8gsb/zHjmz8q5Owl+9OYP3wwqOaXbz/+7OabPzZy/O29WLVAww1KJ4BJHjCXB7dyTMD+gBTVo2AUjIJRMPwBAFOYWQcDdM+YAAAAAElFTkSuQmCC\",\"orcid\":\"\",\"institution\":\"AIPH University\",\"correspondingAuthor\":true,\"prefix\":\"Dr\",\"firstName\":\"Vikas\",\"middleName\":\"\",\"lastName\":\"Tiwari\",\"suffix\":\"\"},{\"id\":606019518,\"identity\":\"e85781bb-5e76-42ce-9724-6556d4904483\",\"order_by\":1,\"name\":\"Dr. Jaishree Tiwari\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"AIPH University\",\"correspondingAuthor\":false,\"prefix\":\"Dr.\",\"firstName\":\"Jaishree\",\"middleName\":\"\",\"lastName\":\"Tiwari\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2026-03-14 09:02:32\",\"currentVersionCode\":1,\"declarations\":{\"humanSubjects\":true,\"vertebrateSubjects\":true,\"conflictsOfInterestStatement\":false,\"humanSubjectEthicalGuidelines\":true,\"humanSubjectConsent\":true,\"humanSubjectClinicalTrial\":false,\"humanSubjectCaseReport\":false,\"vertebrateSubjectEthicalGuidelines\":true},\"doi\":\"10.21203/rs.3.rs-9121099/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-9121099/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":104976266,\"identity\":\"3d2e1c14-7031-43da-a77f-d24c470bce4e\",\"added_by\":\"auto\",\"created_at\":\"2026-03-19 12:12:43\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":1321810,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9121099/v1/c320ff0d-71f6-4280-9f78-36fe05fbeb9a.pdf\"}],\"financialInterests\":\"The authors declare no competing interests.\",\"formattedTitle\":\"\\u003cp\\u003e\\u003cstrong\\u003eA Retrospective Study on Analysis of Hematological and Biochemical Profiling in Dengue Patients\\u003c/strong\\u003e\\u003c/p\\u003e\",\"fulltext\":[{\"header\":\"INTRODUCTION\",\"content\":\"\\u003cp\\u003eDengue fever is a mosquito-borne viral disease caused by the dengue virus belonging to the \\u003cem\\u003eFlavivirus\\u003c/em\\u003e genus of the \\u003cem\\u003eFlaviviridae\\u003c/em\\u003e family. The virus has four distinct serotypes, namely DEN-1, DEN-2, DEN-3, and DEN-4\\u0026sup1;. Infection with any serotype can result in clinical manifestations ranging from mild febrile illness to severe dengue hemorrhagic fever and dengue shock syndrome\\u0026sup2;.\\u003c/p\\u003e \\u003cp\\u003eDengue is transmitted primarily by \\u003cem\\u003eAedes aegypti\\u003c/em\\u003e and \\u003cem\\u003eAedes albopictus\\u003c/em\\u003e mosquitoes. Globally, approximately half of the world's population resides in areas at risk for dengue infection\\u0026sup3;. It is estimated that nearly \\u003cb\\u003e400\\u0026nbsp;million dengue infections occur annually\\u003c/b\\u003e, with about \\u003cb\\u003e100\\u0026nbsp;million symptomatic cases\\u003c/b\\u003e and thousands of deaths worldwide⁴.\\u003c/p\\u003e \\u003cp\\u003eLaboratory investigations play a critical role in the diagnosis and management of dengue infection. Hematological abnormalities such as thrombocytopenia, leukopenia, and hemoconcentration are commonly observed in infected patients⁵. Biochemical alterations, particularly elevated liver enzymes, are also frequently reported and reflect hepatic involvement during infection⁶.\\u003c/p\\u003e \\u003cp\\u003eUnderstanding the hematological and biochemical changes associated with dengue infection is essential for early diagnosis, monitoring disease progression, and preventing severe complications. Therefore, the present study aimed to evaluate the hematological and biochemical profile of dengue patients presenting to a tertiary care center.\\u003c/p\\u003e\"},{\"header\":\"MATERIALS AND METHODS\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\"\\u003e\\n \\u003ch2\\u003eStudy Design and Setting\\u003c/h2\\u003e\\n \\u003cp\\u003eThis retrospective observational study was conducted in the Departments of Laboratory Medicine and Biochemistry at a tertiary care diagnostic facility. The study period extended from \\u003cstrong\\u003eJune 2025 to December 2025\\u003c/strong\\u003e.\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003ch3\\u003eStudy Population\\u003c/h3\\u003e\\n\\u003cp\\u003eA total of \\u003cstrong\\u003e125 patients\\u003c/strong\\u003e who underwent laboratory testing for suspected dengue infection were included in the study. Patients with confirmed dengue infection based on serological testing were considered for analysis.\\u003c/p\\u003e\\n\\u003ch3\\u003eInclusion Criteria\\u003c/h3\\u003e\\n\\u003cul\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003ePatients with confirmed dengue infection based on NS1 antigen or antibody positivity\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003ePatients with complete hematological and biochemical investigations\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n\\u003c/ul\\u003e\\n\\u003ch3\\u003eExclusion Criteria\\u003c/h3\\u003e\\n\\u003cul\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003ePatients with incomplete laboratory data\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003ePatients with pre-existing hematological disorders\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n\\u003c/ul\\u003e\\n\\u003ch3\\u003eLaboratory Investigations\\u003c/h3\\u003e\\n\\u003cdiv id=\\\"Sec8\\\"\\u003e\\n \\u003ch2\\u003eSerological Testing\\u003c/h2\\u003e\\n \\u003cp\\u003eDengue infection was confirmed using a \\u003cstrong\\u003erapid dengue combi diagnostic test\\u003c/strong\\u003e detecting:\\u003c/p\\u003e\\n \\u003cul\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eNS1 antigen\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eIgM antibodies\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eIgG antibodies\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003c/ul\\u003e\\n \\u003cp\\u003eA case was considered positive if \\u003cstrong\\u003eany one parameter showed positivity\\u003c/strong\\u003e.\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003ch3\\u003eHematological Analysis\\u003c/h3\\u003e\\n\\u003cp\\u003eComplete blood count parameters were measured using an \\u003cstrong\\u003eautomated hematology analyzer (18-parameter system)\\u003c/strong\\u003e including:\\u003c/p\\u003e\\n\\u003cul\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eHemoglobin (Hb)\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eTotal leukocyte count (TLC)\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eDifferential leukocyte count\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003ePlatelet count\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eHematocrit\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eRBC indices\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n\\u003c/ul\\u003e\\n\\u003cp\\u003ePeripheral blood smear examination was performed using \\u003cstrong\\u003eLeishman staining\\u003c/strong\\u003e for morphological assessment.\\u003c/p\\u003e\\n\\u003ch3\\u003eBiochemical Analysis\\u003c/h3\\u003e\\n\\u003cp\\u003eBiochemical parameters were measured using \\u003cstrong\\u003eCobas 6000 analyzer (Roche Diagnostics)\\u003c/strong\\u003e:\\u003c/p\\u003e\\n\\u003cul\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eSerum bilirubin (total, direct, indirect)\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eSGOT (AST)\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eSGPT (ALT)\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n\\u003c/ul\\u003e\\n\\u003cdiv id=\\\"Sec11\\\"\\u003e\\n \\u003cdiv id=\\\"Sec12\\\"\\u003e\\n \\u003cdiv id=\\\"Sec13\\\"\\u003e\\n \\u003ch2\\u003eCoagulation Profile\\u003c/h2\\u003e\\n \\u003cp\\u003eCoagulation parameters were analyzed using \\u003cstrong\\u003eHuman Clot Junior and TCOAG analyzers\\u003c/strong\\u003e including:\\u003c/p\\u003e\\n \\u003cul\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eProthrombin time (PT)\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eActivated partial thromboplastin time (APTT)\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eInternational normalized ratio (INR)\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003c/ul\\u003e\\n \\u003c/div\\u003e\\n \\u003c/div\\u003e\\n\\u003c/div\\u003e\\n\\u003cdiv id=\\\"Sec14\\\"\\u003e\\n \\u003ch2\\u003eStatistical Analysis\\u003c/h2\\u003e\\n \\u003cp\\u003eData were entered and analyzed using \\u003cstrong\\u003eIBM SPSS Statistics version 25.0\\u003c/strong\\u003e.\\u003c/p\\u003e\\n \\u003cul\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eDescriptive statistics were used to summarize demographic and laboratory data.\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eContinuous variables were expressed as \\u003cstrong\\u003emean\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;standard deviation (SD)\\u003c/strong\\u003e.\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eCategorical variables were expressed as \\u003cstrong\\u003efrequencies and percentages\\u003c/strong\\u003e.\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eAssociations between laboratory parameters were evaluated using \\u003cstrong\\u003eChi-square tests\\u003c/strong\\u003e where appropriate.\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003cli\\u003e\\n \\u003cp\\u003eA \\u003cstrong\\u003ep-value\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05\\u003c/strong\\u003e was considered statistically significant.\\u003c/p\\u003e\\n \\u003c/li\\u003e\\n \\u003c/ul\\u003e\\n\\u003c/div\\u003e\"},{\"header\":\"RESULTS\",\"content\":\" \\u003cdiv id=\\\"Sec15\\\" class=\\\"Section2\\\"\\u003e \\u003cp\\u003eThe present retrospective study was conducted in 2021 to evaluate the hematological and biochemical profile of patients with dengue infection in the Dehradun region. A total of \\u003cb\\u003e125 patients presenting with acute febrile illness\\u003c/b\\u003e were included in the study. All patients underwent relevant laboratory investigations for dengue and malaria infection. Among these, \\u003cb\\u003e119 (95.2%) patients were confirmed dengue cases\\u003c/b\\u003e, while \\u003cb\\u003e6 (4.8%) patients were diagnosed with malaria infection\\u003c/b\\u003e. Additionally, \\u003cb\\u003e30 patients presenting with fever tested negative for both dengue and malaria\\u003c/b\\u003e. The analysis presented in this study focuses primarily on confirmed positive cases.\\u003c/p\\u003e \\u003cp\\u003eAll patients included in the study presented with \\u003cb\\u003ehigh-grade fever\\u003c/b\\u003e, frequently accompanied by symptoms such as \\u003cb\\u003eweakness and malaise\\u003c/b\\u003e.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec16\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eDemographic Characteristics\\u003c/h2\\u003e \\u003cdiv id=\\\"Sec17\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003eSex Distribution\\u003c/h2\\u003e \\u003cp\\u003eOut of the total \\u003cb\\u003e125 patients\\u003c/b\\u003e, \\u003cb\\u003e76 (60.8%) were males\\u003c/b\\u003e and \\u003cb\\u003e49 (39.2%) were females\\u003c/b\\u003e, indicating a higher prevalence of dengue infection among males. The detailed distribution is presented in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eDistribution of Patients According to Sex\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"3\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSex\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFrequency (n)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003ePercentage (%)\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e76\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e60.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e49\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e39.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eTotal\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e125\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e100\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec18\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eAge Distribution\\u003c/h2\\u003e \\u003cp\\u003eAge-wise distribution showed that dengue infection affected a wide range of age groups. The \\u003cb\\u003ehighest number of cases (21.6%) occurred in the 21\\u0026ndash;30 years age group\\u003c/b\\u003e, followed by \\u003cb\\u003e51\\u0026ndash;60 years (18.4%)\\u003c/b\\u003e and \\u003cb\\u003e41\\u0026ndash;50 years (16.8%)\\u003c/b\\u003e. Pediatric cases (1\\u0026ndash;10 years) were relatively fewer and mostly admitted to pediatric wards rather than medical wards. The detailed age distribution is shown in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eAge Distribution of Patients\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"3\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eAge Group (years)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFrequency\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003ePercentage (%)\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e1\\u0026ndash;10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e11\\u0026ndash;20\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e13\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e10.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e21\\u0026ndash;30\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e27\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e21.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e31\\u0026ndash;40\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e13\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e10.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e41\\u0026ndash;50\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e21\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e16.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e51\\u0026ndash;60\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e23\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e18.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e61\\u0026ndash;70\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e8.0\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e71\\u0026ndash;80\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e7.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eThe findings indicate that \\u003cb\\u003eyoung adults were the most affected population\\u003c/b\\u003e, which is consistent with epidemiological patterns reported in other dengue studies.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec19\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eHematological Findings\\u003c/h2\\u003e \\u003cp\\u003eHematological analysis revealed significant variations in total leukocyte counts among the study population. \\u003cb\\u003eLeukopenia (TLC\\u0026thinsp;\\u0026lt;\\u0026thinsp;4000 cells/mm\\u0026sup3;)\\u003c/b\\u003e was observed in \\u003cb\\u003e35 patients (28%)\\u003c/b\\u003e, whereas \\u003cb\\u003e11 patients (8.8%) exhibited leukocytosis (\\u0026gt;\\u0026thinsp;11,000 cells/mm\\u0026sup3;)\\u003c/b\\u003e. The majority of patients (\\u003cb\\u003e79 cases; 63.2%\\u003c/b\\u003e) had leukocyte counts within the normal range. These findings are summarized in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab3\\\" class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab3\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 3\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eHematological Findings\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"3\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eParameter\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFrequency\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003ePercentage (%)\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eLeukopenia (\\u0026lt;\\u0026thinsp;4000/mm\\u0026sup3;)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e35\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e28\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNormal TLC\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e79\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e63.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eLeukocytosis (\\u0026gt;\\u0026thinsp;11000/mm\\u0026sup3;)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e11\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e8.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eIn addition, \\u003cb\\u003ethrombocytopenia was a common finding in dengue patients\\u003c/b\\u003e, with platelet counts frequently dropping below \\u003cb\\u003e150,000/mm\\u0026sup3;\\u003c/b\\u003e. Approximately \\u003cb\\u003e30% of patients had platelet counts below 50,000/mm\\u0026sup3;\\u003c/b\\u003e, a level commonly associated with dengue hemorrhagic fever and bleeding manifestations.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec20\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eSerological Findings\\u003c/h2\\u003e \\u003cp\\u003eSerological testing using dengue rapid diagnostic tests revealed varying patterns of antigen and antibody positivity. \\u003cb\\u003eNS1 antigen positivity was the most common finding\\u003c/b\\u003e, detected in \\u003cb\\u003e88 patients (64.8%)\\u003c/b\\u003e, suggesting early-stage infection in a significant proportion of cases. \\u003cb\\u003eIgM antibodies were detected in 36 patients (28.8%)\\u003c/b\\u003e, whereas \\u003cb\\u003eIgG antibodies were detected in 30 patients (24%)\\u003c/b\\u003e. These findings are presented in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab4\\\" class=\\\"InternalRef\\\"\\u003e4\\u003c/span\\u003e.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab4\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 4\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eSerological Test Results\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"3\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eTest\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ePositive Cases\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003ePercentage (%)\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNS1 Antigen\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e88\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e64.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eIgM Antibody\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e36\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e28.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eIgG Antibody\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e30\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e24\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eThe higher prevalence of \\u003cb\\u003eNS1 antigen positivity\\u003c/b\\u003e indicates that many patients presented during the \\u003cb\\u003eearly acute phase of infection\\u003c/b\\u003e.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec21\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eCoagulation Profile\\u003c/h2\\u003e \\u003cp\\u003eCoagulation studies were performed in 40 patients. Among these, 26 patients exhibited prolonged prothrombin time (PT) while 14 patients had normal PT values. Additionally, 15 patients showed prolonged INR values, whereas 25 patients had normal INR levels. Activated partial thromboplastin time (APTT) was prolonged in 14 patients, indicating coagulation abnormalities in some dengue cases.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec22\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eLiver Function Abnormalities\\u003c/h2\\u003e \\u003cp\\u003eBiochemical analysis revealed significant hepatic involvement among dengue patients. Elevated liver enzymes were frequently observed, with SGOT elevated in 93 patients (74.4%) and SGPT elevated in 84 patients (67.2%). Increased bilirubin levels were observed in 30 patients (24%). These findings are summarized in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab5\\\" class=\\\"InternalRef\\\"\\u003e5\\u003c/span\\u003e.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab5\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 5\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eLiver Function Abnormalities\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"3\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eParameter\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eAbnormal Cases\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003ePercentage (%)\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eElevated SGOT\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e93\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e74.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eElevated SGPT\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e84\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e67.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eElevated Bilirubin\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e30\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e24\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eThe higher frequency of \\u003cb\\u003eSGOT elevation compared to SGPT\\u003c/b\\u003e suggests hepatic involvement associated with dengue infection.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec23\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003eMalaria Co-infection\\u003c/h2\\u003e \\u003cp\\u003eAlthough both dengue and malaria infections were detected among febrile patients in this study, \\u003cb\\u003eno cases of dengue\\u0026ndash;malaria co-infection were identified\\u003c/b\\u003e. Six patients were positive for malaria infection, while 119 patients were positive for dengue infection.\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec24\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eBleeding Manifestations\\u003c/h2\\u003e \\u003cp\\u003eBleeding manifestations were relatively uncommon in the present study. \\u003cb\\u003eOnly 4% of patients developed bleeding complications\\u003c/b\\u003e, with \\u003cb\\u003ecutaneous petechial hemorrhage being the most common clinical presentation\\u003c/b\\u003e.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"DISCUSSION\",\"content\":\"\\u003cp\\u003eThe present study evaluated hematological and biochemical alterations among patients with dengue infection. Male predominance observed in this study is consistent with findings reported by Laul et al.⁷ and Gupta et al.⁸.\\u003c/p\\u003e \\u003cp\\u003eThrombocytopenia was a major hematological abnormality observed in dengue patients. Previous studies have reported that platelet destruction and bone marrow suppression contribute to thrombocytopenia during dengue infection⁹. Leukopenia observed in several patients is likely due to viral suppression of bone marrow activity\\u0026sup1;⁰.\\u003c/p\\u003e \\u003cp\\u003eElevated liver enzymes were also frequently observed in this study. SGOT elevation was more common than SGPT elevation, which is consistent with earlier reports indicating that dengue infection can cause hepatic injury and muscle involvement\\u0026sup1;\\u0026sup1;.\\u003c/p\\u003e \\u003cp\\u003eSerological testing demonstrated that NS1 antigen positivity was the most common finding. Early detection of NS1 antigen is particularly useful during the initial phase of infection before antibody formation\\u0026sup1;\\u0026sup2;.\\u003c/p\\u003e \\u003cp\\u003eSimilar laboratory abnormalities have been reported in studies conducted in various regions of India and Southeast Asia\\u0026sup1;\\u0026sup3;\\u003csup\\u003e\\u0026minus;15\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec26\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eLimitations\\u003c/h2\\u003e \\u003cp\\u003e \\u003cul\\u003e \\u003cli\\u003e \\u003cp\\u003eRetrospective study design\\u003c/p\\u003e \\u003c/li\\u003e \\u003cli\\u003e \\u003cp\\u003eLimited sample size\\u003c/p\\u003e \\u003c/li\\u003e \\u003cli\\u003e \\u003cp\\u003eLack of long-term clinical follow-up\\u003c/p\\u003e \\u003c/li\\u003e \\u003c/ul\\u003e \\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"CONCLUSION\",\"content\":\"\\u003cp\\u003eDengue infection is associated with significant hematological and biochemical abnormalities including thrombocytopenia, leukopenia, and elevated liver enzymes. Laboratory evaluation plays a critical role in early diagnosis and monitoring of dengue patients. Regular monitoring of hematological parameters can assist clinicians in preventing severe complications.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eGuzman MG, Harris E, Dengue (2015) Lancet 385:453\\u0026ndash;465\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSimmons CP, Farrar JJ, Nguyen VV, Wills B, Dengue (2012) N Engl J Med 366:1423\\u0026ndash;1432\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBhatt S et al (2013) Global distribution and burden of dengue. Nature 496:504\\u0026ndash;507\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWorld Health Organization (2023) Dengue and severe dengue. WHO\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAzeredo EL et al (2015) Thrombocytopenia in dengue. Mediators Inflamm 2015:313842\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSamanta J, Sharma V (2015) Dengue and its effects on liver. World J Clin Cases 3:125\\u0026ndash;131\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eLaul A et al (2016) Clinical profile of dengue infection in northern India. J Trop Med 2016:5917934\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eGupta N et al (2012) Dengue in India. Indian J Med Res 136:373\\u0026ndash;390\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMartina BE, Koraka P, Osterhaus AD (2009) Dengue virus pathogenesis. Clin Microbiol Rev 22:564\\u0026ndash;581\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSrikiatkhachorn A (2009) Plasma leakage in dengue hemorrhagic fever. Thromb Haemost 102:1042\\u0026ndash;1049\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTrung DT et al (2010) Liver involvement in dengue infection. Clin Infect Dis 50:84\\u0026ndash;91\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePeeling RW et al (2010) Evaluation of diagnostic tests for dengue. Nat Rev Microbiol 8:S30\\u0026ndash;S38\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWiwanitkit V (2010) Dengue fever: diagnosis and treatment. Expert Rev Anti Infect Ther 8:841\\u0026ndash;845\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWilder-Smith A et al (2019) Dengue Lancet 393:350\\u0026ndash;363\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTiwari V1;, Afzal M2;, Sharma (2024) Abhishek2; Tiwari, Jaishree1. Dengue dynamics: Prognostic and disease monitoring through molecular and serological profiling of clinical isolates. Journal of Vector Borne Diseases 61(3):p 420\\u0026ndash;425, Jul\\u0026ndash;Sep | \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.4103/JVBD.JVBD_202_23\\u003c/span\\u003e\\u003cspan address=\\\"10.4103/JVBD.JVBD_202_23\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":true,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"AIPH University\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Dengue fever, hematological profile, biochemical parameters, thrombocytopenia, NS1 antigen\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-9121099/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-9121099/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003ch2\\u003eBackground:\\u003c/h2\\u003e \\u003cp\\u003eDengue is a rapidly emerging mosquito-borne viral disease that poses a major public health challenge in tropical and subtropical regions. Hematological and biochemical abnormalities are common in dengue infection and play a crucial role in disease diagnosis, monitoring, and prognosis. This study aimed to evaluate hematological and biochemical alterations in patients diagnosed with dengue infection.\\u003c/p\\u003e\\u003ch2\\u003eMethods:\\u003c/h2\\u003e \\u003cp\\u003eA retrospective observational study was conducted on 125 patients who underwent laboratory testing for suspected dengue infection between June 2025 and December 2025. Dengue infection was confirmed using a dengue combi rapid diagnostic test detecting NS1 antigen, IgM, and IgG antibodies. Hematological parameters were analyzed using an automated hematology analyzer, while biochemical parameters including bilirubin, SGOT, and SGPT were measured using the Cobas 6000 analyzer. Coagulation parameters such as prothrombin time (PT), activated partial thromboplastin time (APTT), and international normalized ratio (INR) were also assessed. Statistical analysis was performed using SPSS software.\\u003c/p\\u003e\\u003ch2\\u003eResults:\\u003c/h2\\u003e \\u003cp\\u003eAmong the 125 patients, 119 (95.2%) were dengue positive and 6 (4.8%) were malaria positive. Male patients constituted 60.8% of the study population. The most affected age group was 21\\u0026ndash;30 years. Thrombocytopenia was observed in a significant proportion of patients, with approximately 30% having platelet counts below 50,000/mm\\u0026sup3;. Leukopenia (\\u0026lt;\\u0026thinsp;4000 cells/mm\\u0026sup3;) was detected in 28% of cases. Elevated liver enzymes were observed in the majority of patients, with SGOT elevated in 74.4% and SGPT in 67.2% of patients. NS1 antigen positivity was the most common serological finding.\\u003c/p\\u003e\\u003ch2\\u003eConclusion:\\u003c/h2\\u003e \\u003cp\\u003eHematological abnormalities such as thrombocytopenia and leukopenia, along with elevated hepatic enzymes, are commonly associated with dengue infection. Early laboratory evaluation plays a crucial role in the diagnosis and management of dengue patients.\\u003c/p\\u003e\",\"manuscriptTitle\":\"A Retrospective Study on Analysis of Hematological and Biochemical Profiling in Dengue Patients\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2026-03-19 12:11:58\",\"doi\":\"10.21203/rs.3.rs-9121099/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"3fb73cb4-5e99-4c47-940f-1cba1eac8ec9\",\"owner\":[],\"postedDate\":\"March 19th, 2026\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[{\"id\":64495502,\"name\":\"General Microbiology\"},{\"id\":64495503,\"name\":\"Virology\"},{\"id\":64495504,\"name\":\"Parasitology\"}],\"tags\":[],\"updatedAt\":\"2026-03-19T12:11:58+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2026-03-19 12:11:58\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-9121099\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-9121099\",\"identity\":\"rs-9121099\",\"version\":[\"v1\"]},\"buildId\":\"XKTyCvWXoU3ODBz1xrDgd\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}