Plasmodium falciparum malaria with bleeding diathesis-an experience in NWFP

Falciparum Malaria is a syndrome and a disease of protean clinical manifestations including DIG. This descriptive study was conducted in Medical department of Khyber teaching hospital Peshawar from January 2004 to August 2005. Fifty patients between the ages of 15 to 70 years, who presented with fever and bleeding manifestations, having positive trophozoites of plasmodium falciparum in blood smear, were included. Out of 50 patients 27 [54%] were males, while 23 [46%] were females. Male to female ratio was 1.17:1. The age of the study group ranged form 15 to 70 years. Maximum number of patients were in the age group 15-29 years [44%]. Fever was noticed in 48 [96%], anemia in 32 [64%] and splenomegaly in 33 [66%]. Bleeding diathesis was noticed in 3 [6%] patients with prolonged PT, APTT, thrombocytopenia and raised FDPs, Four patients had thrombocytopenia and positive FDPs in low titre, with 03 patients having prolonged PT and APTT but no clinical evidence of bleeding. We conclude that any patient with history of fever and bleeding diathesis, falciparum malaria should be considered in the differential diagnosis

clinical and etiological profile of urinary tract infection

To study clinical profile of urinary tract infection [UTI] and to document the common microorganisms causing UTI in admitted patients and to test their sensitivity pattern. We did a hospital based descriptive study in the department of Medicine Khyber Teaching Hospital, Peshawar from December, 2005 to July, 2006. The data of total 50 patients above 13 years of age with signs and symptoms suggestive of UTI was collected on a structured proforma. The clinical presentation, the common causative organisms and their sensitivity pattern was documented. The results were compared with other national and international studies. In this study 47/50 [94%] cases were culture positive with a colony count >105/ml. Overall male to female ratio was 1:2 table. 1. Among the culture positive cases, the commonest pathogens found were E. coli in 25 cases [53.1%] followed by citrobacter in 8 cases [17.02%]. The commonest organisms E.coli and citrobacter showed maximum sensitivity to Amikacin, ofloxacin, ciprofloxacin and ceftriaxones, in decreasing order of frequency. The most common symptom found in all age groups was fever while the commonest sign was anaemia. UTI should be considered in any patient with fever without focus beyond three days. E Coli is the commonest organisms and amikacin is the drug of choice