Cutaneous Leishmaniasis: An emerging childhood infection

Cutaneous Leishmaniasis [CL] has been an endemic parasitic infection in certain areas of Pakistan. New outbreaks have occurred in many areas not identified previously especially in the province of Sindh. The object of this study was to see the prevalence of CL as a childhood disease. It was a cross sectional study in which 400 cases coming to various skin disease clinics were included for confirmation of CL by microscopy, culture and PCR. Out of 400 cases, 185 cases of ages from 1-14 years were diagnosed clinically and confirmed by Lab. Tests for CL. Both dry and wet types of lesions were observed that indicated presence of more than one strain of the parasite. Cutaneous Leishmaniasis was found to be significantly prevalent in children. The strains were found to be L. tropica and L. major as was indicated by the nature of lesions and confirmed by PCR

Age and symptomatology of menopause in Karachi, Pakistan

Menopause depicts end of woman's reproductive life usually occurring between ages 45 and 55. Many studies have been carried out to determine the mean age at menopause in different countries. In Pakistan, the greatest hurdle is ascertainment of correct age of women causing difficulty in determining the correct age at menopause. The objective of this study was to overcome this hurdle and to determine the mean age at menopause and occurrence of different symptoms at menopause in Pakistan. An observational cross sectional study was carried out in which the correct ages of 212 women from different hospitals, workplaces and housewives were estimated using Matriculation Certificates and/or National Identification Cards between February-November 2004. Age at menopause and associated symptoms were recorded. Menopausal age of the subjects' mothers was also documented. Epi Info Version 3.3 was used for data analysis. Mean age at menopause was determined to be 44.5 years [ +/- 0.8 years] ranging from 32-62 years. The predominant symptom experienced was hot flashes [82%]. There was no significant negative impact of menopause on libido in our subjects [p>0.05]. A significant similarity was observed between menopausal ages of 110 women and their mothers [p<0.001]. Mean age at menopause in Karachi, Pakistan is significantly lower than in West, which highlights need for studying social, economic and cultural basis of this difference. However, strong conclusions about menopausal age can only be made by large scale population-based studies. The symptoms experienced are similar as elsewhere in the world, although occurring with varying frequencies. There is a familial pattern to the onset of menopause

Frequency of cryptosporidium in childhood diaarrhoea-importance of modified acid fast technique

One of the important causes of childhood diarrhoea is cryptosporidium, a parasitic pathogen which is usually overlooked. This study was therefore designed to show the importance of modified acid fast stain in the diagnosis of cryptosporidium in childhood diarrhoea. Stool samples from 300 children with prolonged diarrhoea were examined by modified acid fast staining along with wet mounts in saline and iodine. Out of 300 samples five [1.7%] were diagnosed as positive for cryptosporidium. Results indicate that Cryptosporidiosis exists as a cause of diarrhoeal illness in our society. It was also noted that modified acid fast staining of stool samples is an important, non-invasive and useful diagnostic technique in identification of cryptosporidium

Plasma fibrinogen - a coronary risk factor

This study was carried out to measure the levels of fibrinogen in patients of ischaemic heart disease. Fibrinogen levels were determined in 43 patients of ischaemic heart disease and compared with thirty clinically healthy non-smoker controls. Levels of fibrinogen [mean +/- SEM] in patients were 431.51 +/- 7.89 Mg/dl and in controls 241.83 +/- 3.03 Mg/dl [P<0.001]. Patients were also sub-grouped as smokers and non-smokers. Plasma fibrinogen in thirty one non-smokers was 421.51 +/- 9.3 Mg/dl and in twelve smokers fibrinogen was 457.92 +/- 11.59 Mg/dl [P<0.001 when compared to controls] and P<0.05 when smoker patients were compared with non-smoker patients. Fibrinogen can be considered as coronary risk factor. It should be included in the assessment of coronary risk profile alongwith lipid profile and efforts should be made to reduce the elevated levels of fibrinogen. Clinical studies with agents which may reduce fibrinogen levels are needed to reduce the prevalence of coronary artery disease

Haematocrit values in ischemic heart disease

Haemoglobin [g/dl] and haematocrit [%] values were determined in 30 healthy controls and 40 patients with ischaemic heart disease. Both groups were non-smokers. Haemoglobin and haematocrit values [mean +/- SE] in patients were 15.65 +/- 0.18 and 46.45 +/- 0.49 and in controls 14.30 +/- 0.14 and 41.50 +/- 0.23. Significantly higher [P< 0.001] haematocrit value by influencing the blood viscosity may impose extra burden on the ischaemic heart