Seasonal variations of vivax and falciparum malaria: an observation at a tertiary care hospital

Malaria is a major public health problem in the malaria endemic zones of the world. Various factors influence the prevalence of malaria. This study was conducted to determine the variation in frequency of Plasmodium vivax and Plasmodium falciparum malaria in different seasons of the year in Khyber Teaching Hospital, Peshawar. A total of 411 patients were included in the study. All these febrile patients were reported to have trophozoites of either Plasmodium vivax or Plasmodium falciparum malaria on Giemsa stained thick and thin smears. The frequency of vivax and falciparum malaria was worked out and statistically analysed for different season of the year. The study was carried out from 2[nd] Jan 2004 till 31[st] December 2008. Out of total 411 diagnosed malaria cases, total 134 [32.60%] presented in the autumn season [vivax=33.58%, and falciparum=66.42%], 37 [9%] in winter season [vivax=32.4%, and falciparum=67.6%], 76 [18.49%] in spring season [vivax=93.4% and falciparum 6.6%] and 164 [39.90%] in summer season [vivax=89.6, and falciparum=10.4%]. The malaria showed a highly significant pattern in different seasons of the year [p=0.00] in a way that Plasmodium falciparum malaria reached its highest frequency in autumn and winter seasons while Plasmodium vivax malaria reached its peak frequency in spring and summer seasons. There was highly significant seasonal variation of vivax and falciparum malaria. There is arrival of Plasmodium falciparum in autumn which peaks in winter followed by arrival of Plasmodium vivax in spring till the end of summer.

Diurnal variations in the levels of progesterone during late pregnancy

Progesterone is a C-21 steroid hormone, plays a major role in the occurrence, maintenance and termination of pregnancy. To study the diurnal variations in the levels of progesterone at the start and end of the day during late pregnancy in women having different life set ups. Experimental and Observational Study. This study was conducted at the Department of Gynae and Obs., Khyber Medical College, Peshawar. Blood samples of 50 women between 26-40 weeks of gestation were collected at two different intervals with a gap of 12 hours. Progesterone level was estimated by Serozyme EIA method. The concentration of progesterone was found low in the early morning and high in the late evening in our population. Besides, the magnitude of fluctuations in the samples of two different intervals declined with progress of age and weeks of gestation. Our findings support the recommendation of restricting progesterone measurements to morning hours at all ages particularly during late pregnancy which is important information for clinicians at the time of interpretation of results

Malignant pleural mesothelioma in northern Pakistan and its response to treatment

Malignant pleural mesothelioma [MPM] is a rare but extremely aggressive malignancy related to exposure to asbestos in over 80% cases. Despite surgery, radiation or chemotherapy, survival is extremely poor. To study the cases of MPM and evaluate their response to chemotherapy Retrospective study at an oncology unit of a major hospital where records were checked over 2 years From January 2001 to December 2002, twelve patients [08 male and 04 female] with histologically proven diffuse MPM were treated with combination of Gemcitabine [1000 mg/m2, IV, day 1 and 8] and Carboplatin [AUC-6, IV, day 1] repeated every 21 days. Age of patients ranged from 50-65 years.All except one patient belonged to the areas adjoining Mardan in NWFP [mesothelioma belt]. Complete responses was seen in none while 4 patients showed partial response and 4 showed stable disease with disappearance of pleural effusion and appreciable improvement in quality life was seen in 8 [66%] patients. Median survival was II months [03 months to 17 months]. Overall, chemotherapy was well tolerated. Gemcitabine and Carboplatin/ Cisplatin offer a chance of palliation with improvement in quality of life and symotoms

Study of skin lesions in 221 patients of meningococcal disease

During a meningococcal outbreak, 221 patients were studied. A skin rash was present in 78 [35.3%] patients. Twentyone [11.3%] patients had a frankly purpuric rash, involving mainly the extremities and the remaining had a generalised macular or petechial lesions. Extensive purpuric lesions, involving mainly the extremities were associated with disseminated intravascular coagulation [DIC], shock and a fatal outcome. This peripherally distributed rash may be used as a clinical substitute for the laboratory tests that confirm DIC