Epidemic of cutaneous leishmaniasis: 109 cases in a population of 500

In February 2004, 4 patients aged 10-15 years presented at the Pakistan Institute of Medical Sciences with non-healing multiple ulcers on exposed parts. On the basis of history, clinical assessment and fine needle aspiration cytology, they were diagnosed as having cutaneous leishmaniasis. We were informed that several similar cases were present in their village. A team of doctors and technicians visited the area. A survey was conducted and another 105 cases with various morphological presentations were identified. The area was visited several times to find the vector, reservoirs and source of infection and to advise on controlling the epidemic

Iron deficiency in Sudanese children with sickle cell anaemia

Iron status was studied in 100 patients with homozygous sickle cell disease between 4 months and 16 years of age. All patients were prescribed folic acid for at least 1 month prior to the study but none was taking any other medication or had received a blood transfusion during the previous 3 months. Basic haematologic data [Hb, PCV, reticulocyte and red cell counts, MCV, MCH, MCHC and peripheral blood picture], serum iron, total iron binding capacity [TIBC] and transferrin saturation were obtained in all 100 patients. Bone marrow aspiration and staining for iron was performed in 82 patients [over 2 years of age] and these were divided into three groups according to the results of marrow iron. There were 68 [83%] patients with absent marrow iron in group 1, five [6%] with reduced iron in group 2 and nine [11%] with sufficient marrow iron in group 3. In 18 patients [under 2 years of age] bone marrow aspiration Was not performed and these patients are referred to as group 4.Patients in group 1 had the lowest mean Hb and their basic haematologic data, serum iron, TIBC and transferrin saturation were compatible with the diagnosis of iron deficiency anaemia. Patients in group 2 showed evidence of early iron deficiency as indicated by reduction in marrow iron but there was no evidence of iron deficiency in other results. Group 3 patients showed no evidence of iron deficiency. Group 4 patients had basic haematologic data, serum iron, TIBC and transferring saturation similar to those in group 1. Although marrow iron content was not known for patients in group 4 available data were suggestive of iron deficiency anaemia in this group. Combining the results of groups 1 and 4, made the diagnosis of iron deficiency anaemia as high 35 86% in this study