• Munazza Mir
  • Rukhshan Khurshid
  • Roohi Aftab


Background: Incidence of dengue increased 30 fold between 1960 and 2010. This increase isbelieved to be due to a combination of urbanisation, population growth, increased internationaltravel, and global warming. We tried to find out the effect of herbal water of Tawa-tawa, alsocalled Euphorbia hirta, on the flu like symptoms and blood parameters especially onthrombocytopenia. Methods: Total 125 patients with confirmed dengue fever admitted in medicalward of Sir Ganga Ram Hospital Lahore were included in this experimental study. Duration ofstudy was 3 months. Patients were divided into 2 groups, i.e., group A (ages between 30 to 55years) and group B (ages between 14 to 25 years). A blood sample was obtained on the day ofenrolment and after 24 hours of using Tawa-tawa. The variables used were platelet count,haematocrit (HCT), WBC count, serum AST, ALT, IgM/IgG. Results: In men, platelet count was<25,000 and in women, it was >50,000. Haematocrit were >40% in men and 30–40% in women.TLC in a range of 4,000–11,000/mm3 was observed in both males and females. IgM‘haemagglutination’ antibody titres (>1:160) was observed in 71.3% females and 50% males.Serum AST was >40 IU/L in 38% females and 36% males. Serum ALT was >40 IU/L in 9.5%females and 12% males. In both group A and B platelet count and TLC were increased nonsignificantly after herbal water of Euphorbia hirta (E. Hirta). Haematocrit value decreased nonsignificantly after using the herbal water. Over 70% of patients showed moderate increase in theirplatelet count. However leucopoenia improved significantly after the use of aqueous extract of E.hirta. A marked recovery in fever and flu like symptoms was observed. Conclusion: In over 70%patients there was improvement in platelet count, TLC, fever, and flue-like symptoms.Keywords: Dengue, Thrombocytopenia, Euphorbia hirta, Management


Chen R, Vasilakis N. Dengue –Quo tu et quo vadis? Viruses


Wilson N, Slaney D, Baker MG, Hales S, Britton E. Climate

change and infectious diseases in New Zealand: a brief review

and tentative research agenda. Rev Environ Health


Whitehorn J, Simmons CP. The pathogenesis of dengue. Vaccine


Mahmood K, Jameel T, Aslam HF, Tahir M. Incidence of

dengue haemorrhagic fever in local population of Lahore,

Pakistan. Biomedica 2009;25:93–6.

Halstead SB. Pathogenesis of dengue: challenges to molecular

biology. Science 2009;239:476–81.

Smith DR. An update on mosquito cell expressed dengue virus

receptor proteins. Insect Mol Biol 2011;Sep 7. [Epub ahead of


Heaton NS, Randall G. Dengue virus and autophagy. Viruses


Potts JA, Gibbons RV, Rothman AL, Srikiatkhachorn A, Thomas

SJ, Supradish PO, et al. Prediction of Dengue Disease Severity

among Pediatric Thai Patients Using Early Clinical Laboratory

Indicators. PLoS Negl Trop Dis 2010;4(8):e769.

de Moura Mendonça LS, de Moura Mendonça ML, Parrode

N, Barbosa M, Cardoso RM, de Araújo-Filho JA. Splenic

rupture in dengue hemorrhagic fever: report of a case and review.

Jpn J Infect Dis 2011; 64(4):330–2.

Trung DT, Thao le TT, Hien TT, Hung NT, Vinh NN, Hien


, et al. Liver involvement associated with dengue infection in

adults in Vietnam. Am J Trop Med Hyg 2010;83(4):774–80.

Severson DW, Behura SK. Mosquito Genomics: Progress and

Challenges. Annu Rev Entomol 2010; Dec 15. [Epub ahead of


Kumar S, Malhotra R and Kumar D. Euphorbia hirta: Its

chemistry, traditional and medicinal uses, and pharmacological

activities. Pharmacognosy Review 2010;4(7):58–61.

Vijaya K, Ananthan S, Nalini R. Antibacterial effect of

theaflavin, polyphenon 60 (Camellia sinensis) and E. hirta on

Shigella spp. –a cell culture study. J Ethanopharmacol


Lopez HS, Luna TAMS, Manalo RE, Natividad JAJ, Ngo CY,

Apostol JG. A study on the platelet increasing activity of the

decoction and ethenolic extract of E. hirta as a treatment for

dengue hemorrhagic fever. J Phil Pharm Assoc 2009;2(1):16–23.

Prajapati ND, Purohit SS, Sharma AK, Kumar T. Handbook of

Medicinal Plants. Jodhpur, India: Agarbios 2003; p.120.

Khan E, Kisat M, Khan N, Nasir A, Ayub S, Hasan R.

Demographic and clinical features of dengue fever in Pakistan

from 2003–2007: a retrospective cross-sectional study. PLoS

One 2010;5(9):e12505.

Wichmann O, Gascon J, Schunk M, Puente S, Siikamaki

H, Gjørup I, et al. European Network on Surveillance of

Imported infectious diseases. Severe dengue virus infection in

travelers: risk factors and laboratory indicators. J Infect Disease


Bottieau E, Clerinx J, Van den Enden E, Van Esbroeck

M, Colebunders R, Van Gompel A, et al. Fever after a stay in

the tropics: diagnostic predictors of the leading tropical

conditions. Medicine (Baltimore) 2007;86(1):18–25.

Chacko B, Subramanian G. Clinical, laboratory and radiological

parameters in children with dengue fever and predictive factors

for dengue shock syndrome. J Trop Pediatr 2008;54(2):137–40.

Quiroz E, Ortega M, Guzmán MG, Vázquez S, Pelegrino

JL, Campos C, et al. Dengue in Panama, 1993. Rev Cubana

Med Trop 1997;49(2):86–93. [Article in Spanish]

Srikiatkhachorn A, Green S. Markers of dengue disease severity

Curr Top Microbiol Immunol 2010;338:67–82.

Guzman MG, Kouri G. Dengue: an update. Lancet Infect Dis


Lanhers MC, Fleurentin J, DorfmanP, Mortier P, Pelt JM.

Analgesic, antipyretic and anti-inflammatory properties of

Euphorbia hirta. Planta Med 1991;57(3):225–31.

Chopra RN, Chopra IC, Handa KL, Kapur LD. Indigenous drugs

of India. Calcutta, India: Academic Publishers;1994.p. 88.

Jae-Ha R, Hanna A, Hwa Jin L, Wen He Q, Yong Nam H,

Byung Hoon H. Inhibitory activity of Chinese Medicinal plants

on Nitric oxide synthesis in Lipopolysaccharide activated

macrophages. J Appl Pharmacol 2007;9:183–7.

Rezaeipoor R, Saeidnia S, Kamalinejad M. Immuno suppressive

activity of Achillea talagonia on humoral immune responses in

experimental animals. J Ethanolpharmacol 1999;65;273–6.

Ramesh KV and Padmavathi K. Assessment of

immunomodulatory activity of Euphorbia hirta L. Indian J of

Pharmaceutical Sciences 2010;72(5)621–5.




Most read articles by the same author(s)