Thrombocytopenia in malaria

To determine the frequency of thrombocytopenia in Malarial Parasite [MP] positive patients. A cross-sectional study. Medical Unit-III, Ward-7, JPMC, Karachi, from June to October 2006. One hundred twenty four MP positive cases were included in the study. Infections with both Plasmodium falciparum and Plasmodium vivax species were included. Complete blood picture with platelet count was obtained in all patients. Thrombocytopenia was defined as platelets count of < 150.000/cmm. Among 124 patients of MP positive, 100 [80.6%] were found to have thrombocytopenia. Over all 64 patients had Plasmodium falciparum, while 60 patients were having Plasmodium vivax infection. The frequency of thrombocytopenia was 71.87% [n=46] in falciparum and 93.33% [n=56] in vivax infection. Thrombocytopenia was a common haematological finding in patients with Plasmodium infection particularly marked in vivax species infection

Hematological and biochemical indicators for the early diagnosis of dengue viral infection

To determine the haematological and biochemical indicators for the early diagnosis of dengue viral infection. A case series. At Medical Unit-III, Ward 7, Jinnah Postgraduate Medical Centre and referred cases from Faiz-e-Rehman Hospital, Metroville, Karachi from September to November 2007. Patients presenting with a fever of less than 2 weeks duration, generalized morbiliform rash and bleeding manifestations were included. Clinical history was recorded and patients were placed on fluid and haematological support. Diagnosis was established by Polymerase Chain Reaction [PCR] for dengue virus or detection of dengue virus specific IgM and IgG. Results: One hundred and four patients met the inclusion criteria during the study period. Sixty six patients had clinical and haematological features suggestive of grade I Dengue Hemorrhagic Fever [DHF]; 34 patients had grade II DHF and 4 had grade III DHF out of whom 3 progressed to grade IV DHF. All the patients presented with fever followed by generalized morbiliform rash [81.73%], vomiting [79.8%], abdominal pain [65.38%], backache [62.5%], depression [60.6%] and mucosal bleeding manifestations [34.6%]. Clinically, conjunctival infection was present in 93 patients [89.4%], hepatomegaly 59 [56.7%], lymphadenopathy in 17 [16.3%], splenomegaly in 13 [12.5%], pleural effusion in 11 [10.5%] and ascites in 8 [7.6%]. Common laboratory findings were thrombocytopenia in 100% patients, leucopenia in 55 [52.8%], raised hematocrit in 52 [50%], and elevated aminotransferases, gamma GT in 100 [96%] patients. The overall mortality was 2.88%. In this series clinical history and examination supported by the triad of thrombocytopenia, raised hematocrit and elevated liver enzymes was sufficient for the early diagnosis of dengue hemorrhagic fever without waiting for dengue serology

study of 76 cases of heat stroke at J.P.M.C, Karachi

Heat stroke is the most severe among heat illnesses. People at risk are military personnel, sportsmen, labourers, alcoholics and patients on major tranqailizers. In June 1996, 76 patients were admitted in Medical Unit-III, Jinnah Postgraduate Medical Centre, Karachi with the clinical diagnosis of heat stroke. Of 76 patients 56 recovered, while 20 expired. Mortality rate was 26.31 percent. Clinical presentation like stroke, grade-IV coma and DIC were associated with high mortality. Old age, hypertension, diabetes mellitus and IHD were major risk factors of heat stroke mortality. Quick medical help and treatment of associated diseases decreased mortality

Microalbuminuria: its relation with glycaemic control and duration of diabetes

Diabetic nephropathy is one of the most dreadful complications of diabetes mellitus. It is a progressive disorder culminating in end stage renal disease. Microalbuminuric stage of diabetic nephropathy is reversible with therapeutic intervention and good metabolic control. Hundred patients were studies for microalbuminuria duration of diabetics and its control in this study which showed its prevalence of 37% in both IDDM and NIDDM. [45% in IDDM and 35.1% in NIDDM]. Microalbuminuria had a linear relationship with duration of diabetes. Its prevalence was 87% in diabetics with diabetic duration of more than 20 years, while it was only 5.88% in patients with diabetes of less than 5 years [P < 0.001]. Impaired glycaemic control was directly asscoicated with development of microalbuminuria. Regular fasting and post-prandial sugar levels along with HbA

c estimation were used to assess glycaemic status. Micral test was used to detect microalbuminuria. With the high prevalence of diabetes mellitus and soaring cost of management of nephropathy, an early detection for prevention of mortality and morbidity related to nephropathy cannot be overemphised