Diagnostic value of automated haematology analyzer in the diagnosis of malaria

To evaluate the diagnostic utility of a haematology analyzer in malaria cases in which the analyzer failed to give a differential leukocyte count. It was an observational study carried out at Pathology Department, Rehman Medical Institute Peshawar, from August 2006 to Jan 2009. During this period a total of 96,865 blood counts were done using Sysmex XT 2000i, haematology analyzer, In 310 consecutive cases, in which the instrument failed to give any differential, 225/310 [73%] were suspected as having blasts or nucleated red cells by the analyzer. In 80/310 [26%] cases in which the instrument did not suspect any blasts or nucleated red cells, some type of malaria was detected on slide examination. Out of the 80 malaria cases, Plasmodium vivax trophozoites were seen in 99% cases with or without ring forms. It included 5% cases of mixed malaria. Using this analyzer, if there is no White Blood Cells differential and no flagging or suspicion, there is a strong possibility of finding trophozoite forms of Plasmodium vivax malaria in peripheral blood

Primary prophylaxis in preventing 1st bleed in oesophageal varicies

To study the efficacy of oesophageal band ligation versus use of beta -blockers for primary prophylaxis of 1st variceal bleed in portal hypertension Randomized controlled trial Place and duration of study: At department of Medicine and Gastroenterology, Combined Military hospital Rawalpindi, during June 2006 to June 2007 Sixty eight patients with portal hypertension were included in the study after screening endoscopy. All the patients were divided in two groups, A and B. Group A patients underwent oesophageal band ligation and patients in group B were given beta -blockers for primary prophylaxis. Each group contained equal number of 34 patients to start with but in the very first week, 6 patients in group B could not tolerate beta blockers. They were switched to group A treatment. These patients were followed up for next one year Group A patients who underwent band ligation had significantly reduced incidence of 1st variceal bleed[p value=0.020] as compared to group B who received beta -blockers. As far as mortality is concerned there was no significant difference [p=0.067] was noted between the two groups. The oesophageal band ligation is superior to beta -blockers in preventing 1st oesophageal variceal bleed but no difference in mortality was noted whichever prophylaxis was used in this study