Pulmonary Embolism.

First case (UTO) was a 42 year old Myanmar male who was admitted to Asia Royal Hospital on 31st December 2014 for shortness of breath and tightness of chest for duration of two days. He had a fainting attack on 30th December 2014 that lasted about one minute and recovered spontaneously. He had both long bone fractures in his right leg and POP was applied from foot to below knee. CT pulmonary angiogram (CTPA) revealed pulmonary embolism (PE) in both main pulmonary arteries and fi rst order branches. Color Doppler Vascular Ultrasound was done after removal of the POP cast in the right lower limb which revealed deep vein thrombosis. Low molecular weight (LMW) heparin (Enoxaprin) was given sub-cutaneously BID followed by oral anticoagulant, warfarin. He was discharged from hospital on 6th January 2015 with full recovery. The second case (Mr SFSW), was a 64 year old gentleman from New Zealand, residing in Yangon for over 20 years who was admitted to Asia Royal Hospital on 6th April 2015 for breathlessness and dyspnoea on exertion for three days. He had a past history of hypertension and type 2 diabetes mellitus for 15 years. He is grossly obese with a BMI of 50.99. Color Doppler ultra-sonography revealed deep vein thrombosis in the right lower limb. CT Pulmonary Angiogram (CTPA) revealed pulmonary embolism in the main pulmonary arteries on both sides extending into upper and lower lobe pulmonary arteries. He was treated with LMW heparin (Enoxaprin) sub-cutaneously BID followed by warfarin. He was also discharged on 17th April 2015 with full recovery.

The Response of Children with Falciparum Malaria to Quinine

10 children with falciparum malaria (highly parasitised) who had not had previous antimalarial therapy were chosen for the study-Quinine dihydrochloride 10 mg/kg body weight diluted in 150-200ml of normal saline was administered as infusion over 4-5 hours as the first dose. Subsequent doses were given orally as quinine sulphate 10 mg/kg body weight 8 hourly. The total duration of treatment was 7 days. The serum quinine levels, the parasite count, and the clinicalprogress were determined at different intervals of treat,emt/ 9 pit pf 10 cjo;drem jad serim quinine levels above Burmese MIC level of 4.3 mg per litre and no signs and symptoms of quinine toxicity was observed even in patients with high serum quinine levels. (ie.> 10 u gm/ml.)