Seasonal variation and identification of plasmodium species in blood samples of patients referred to labs of Karachi for suspected malaria from 2009 to 2011

To identify the seasonal effect on the frequency of malaria and its species in blood samples of patients referred to private and public Labs of Karachi for suspected Malaria and to observe if there has been any change in the frequency of the malaria species from May 2009 to Feb 2011. A cross sectional retrospective review of the laboratory data of the positive blood samples of malarial parasites over a period of 22 months from May 2009 till Feb 2011 via convenient sampling from a private and a public sector laboratory. Blood samples of patients of all ages and gender who were referred from various doctors with suspected diagnosis of malaria were checked for the presence of malarial parasite [MP] using the slide method and/ or Immunochromatographic Technique. The samples found positive for the MP were then analyzed for species identification. The seasonal variation in the frequencies of these species assessed and the number of positive MP results observed from May 2009 to Feb 2011 were described. Plasmodium vivax was found to be the most frequently identified plasmodium species present in 78.6% of the cases followed by Plasmodium falciparum. Adult males predominated over female and children. Frequency of Malaria was highest in the months of September with an overall surge of cases in the months of Aug to Dec. It is also observed that the number of cases in the year 2010 is much higher than in 2009. The study concludes that P.vivax is the most frequently isolated species causing malaria in Karachi. The frequency of P.vivax causing malaria seems to have increased from 2009 to 2010. Malaria was more frequent in the months of August to December in Karachi affecting adult males more frequently as compared to females and children

Intestinal amoebiasis in children and its effect on nutritional status

To determine the frequency and clinical presentation of amoebic diarrhea in children and its effect on the nutritional status of the affected children. Descriptive. Department of Diarrhea Treatment Unit [DTU], Dow Medical College and Civil Hospital, Karachi, from November 1998 to April 2001. Paediatric patients between the ages of > 1 month to 15 years were included, who visited the DTU of the department with diarrhea. Stool samples of all these patients were checked under microscope for the vegetative forms of Entamoeba histolytica [E.h.]. Patients who were positive for E.h. were evaluated for the symtomatology including the type of diarrhea [acute watery diarrhea [AWD] or dysentery], abdominal pain, tenesmus and nausea/vomiting. Examination carried out was assessed for state of hydration, fever and anaemia and nutritional status of those less than 5 years of age. The patients were divided into three age groups to assess the association of the age with severity and type of clinical presentation. Chi- square test was applied to calculate the p-values. P-values of 0.05 or less were considered statistically significant. The stool samples of 3870 patients with diarrhea were examined under microscope. Three hundred and twenty eight [8.47%] of these samples were positive for E.h. The difference between the number of patients presenting with acute watery diarrhea n=157, 47.86% and with dysentery n=171, 52.13% was found to be statistically non-significant [p=0.364]. Two hundred and seventy seven [84.45%] patients had tenesmus, while abdominal pain was present in 287 [87.5%]. Fever and malnutrition were present in 169 [51.52%] patients each. Malnutrition was significantly most frequent in 1-5 years of age groups [n=98, 57.98%, p=0.026]. The nutritional evaluation of the 272 under-5 children with amoebic diarrhea showed a significantly normal status in 123 [45.55%, p-value <0.001]. All the signs and symptoms followed a similar trend with 1 -5 years age group being the most affected group. However, the frequency of blood in stools increased in direct proportion to the increasing age. Although dysentery was the more common presenting complaint, almost half of the patients presented with watery diarrhea. Most of the patients with dysentery were under the age of 5 years. Fever was present in a high number of patients. The age group most affected by amoebiasis and malnutrition was 1-5 years

experience of oral acyclovir in treating children with varicella infection

To study the morbidity and complications of varicella infection in patients treated with acyclovir. It is a descriptive observational study conducted at Paediatric out patient department of Civil Hospital Karachi during September 1997 to March 1998. Alt children between the ages of 2-15 years presenting with clinical features of varicella but healthy otherwise and of average weight, and presenting within 72 hours of the onset of rash were treated with oral acyclovir in a dose of 80 mg/ kg/ day for five days. At the end of five days the patients were evaluated for the duration of illness, severity of rash and itch and development of complications. The patients were also assessed for the side effects of the drug. Cost of the treatment was also calculated. A total of 31 children, 15 mate and 16 females were studied. After the treatment the fever remained for 1- 8 days [mean 3.12 days]. Eighteen [58%] patients had a moderate rash. Six [19.3%] had a severe rash while in seven [22%] the rash was of mild nature. Twenty [64.5%] of the patients had a moderate itch while five patients each [16.1%] had mild and severe itch. New rash continued to appear for three to nine days [mean 3.3 days]. Complications were noted in three [6.9%] patients' only and included otitis media, pneumonia and secondary bacterial infection of vesicular lesions in one patient each. None of the patients developed any side effects to the drug. The average cost of treatment was Rs.3269/=. Use of oral acyclovir in varicella infection [chicken pox] seems to limit new rash formation and total duration of illness to an average of

association of Plasmodium vivax malaria with thrombocytopenia in febrile children

Plasmodium vivax infection has always been considered much less severe than Plasmodium falciparum and usually not associated with complications. Recently it was observed that many patients with malaria due to Plasmodium vivax also develop thrombocytopenia and other complications, once considered to be the exclusively due to Plasmodium falciparum. We carried out this study in order to find out the association of Plasmodium vivax with thrombocytopenia and to determine the presence of malaria in admitted cases of thrombocytopenia with febrile illness. This study was carried out at the pediatric ward of the Dow University of Health Sciences and Civil Hospital Karachi from Aug 2006 to Dec 2006. All patients in the age group of 1 month - 15 years and admitted in the pediatric ward with febrile illness were checked for thrombocytopenia. All study cases were also screened for the presence of malarial parasites in the thick and thin blood films and by immunochromatography [ICT]. Patients with malarial parasitemia and thrombocytopenia were included in the study. The data was then analyzed and conclusions drawn. 18/36 study cases [50%] were found to have malarial parasites in blood. 13/18 cases [72%] of malaria had thrombocytopenia and were infected with P.vivax while 2/18 cases [11%] were infected with Pl. falciparum. Six patients with malarial parasitemia showed normal platelet counts, 4 cases were due to Pl. falciparum. Platelet count was

experiment of renal replacement therapy in children

To determine the prevalence of renal failure in children requiring renal replacement therapy [RRT], the types of RRT being performed, problems encountered during the procedure and the outcome of the RRT in pediatric age group. Design: It was a retrospective study on pediatric patients with renal failure undergoing RRT. Place and Duration of Study: The study was carried out at National Institute of Child Health [N.I.C.H] covering a period of four years. Subjects and The study included all pediatric patients of acute renal failure, chronic renal failure and end stage renal disease who underwent RRT at N.I.C.H. 17% of the patients with renal disease came in renal failure. A total of 65.04% patients received RRT. Out of these, 84.7% underwent peritoneal dialysis [PD] while 15.3% required hemodialysis and 2 were successfully transplanted. High cost of the RRT was the most commonly encountered problem during the procedure. Peritonitis was the commonest complication faced during the peritoneal dialysis while hypotention and complications related to vascular access were commonest during hemodialysis. About 50% of the patients undergoing peritoneal dialysis were left with persistent renal impairment while hemodialysis revealed a mortality of 37%. The two transplanted patients were doing well. The study showed that renal failure was a fairly common problem in pediatric age group and the prospects of successful RRT in Pakistan were quite high with a little effort on the part of medical professionals along with some financial assistance from the affluents of the country