ABSTRACT
Objective: To assess the magnitude of flood related rise in the frequency of malaria, diagnosed at a secondary care hospital, during 2007-2011
Study Design: Cross sectional descriptive study
Place and Duration of Study: Pakistan Air Force hospital Mianwali, from 1[st] Jan 2007 to 31[st] Dec 2011
Patients and Methods: Monthly records of hospital laboratory patients with peripheral blood smears, positive for malarial parasites, were counted from 1[st] Jan 2007 to 31[st] Dec 2011. Frequencies of vivax and falciparum malarial cases diagnosed each year during 2007-2009 were compared with the corresponding frequencies during the year of floods i.e. 2010, and the following year i.e. 2011
Results: When compared with the mean of the annual frequencies during 2007-2009, there was a rise in the total number of malaria cases by 1.3 times in 2010; while next year, i.e. during 2011, the rise was 3.0 times. During the period 2007-2011, vivax malaria cases always peaked during the months of September each year while falciparum malaria cases had a spike in the months of November
Conclusion: Massive floods resulted in a rise in the frequency of malaria cases during flood season and as an after math during the next malarial season. Planning for prevention and control should be done accordingly. Spread of falciparum malaria following the floods demands more efforts towards halting its possible rise in Mianwali district
ABSTRACT
To determine the frequency of hepatotoxicity with standard ATT. Descriptive. Department of Medicine, Combined Military Hospital Lahore. Feb 2007 to April 2008. 250 patients aged 18 years or greater having pulmonary TB were selected through non-probability convenience sampling technique. All patients were given four drugs for two months indoors, followed by two drugs for four months in outdoor. Symptoms suggestive of hepatotoxicity were enquired from the patients regularly. Serum bilirubin and ALT were measured on monthly basis and finally on completion of therapy. Hepatotoxicity was defined as a five fold rise in serum ALT. In patients developing hepatotoxicity, treatment was modified accordingly. This study was done on 189 male and 61 female patients [total: 250]. Hepatotoxicity developed in 13 [5.2%] patients, mostly during the initial phase of treatment [84.6% incidence during the first month]. Risk factors included: age [4 out of 156 young patients and 9 out of 94 older patients; p: 0.016] and nutritional status [8 malnourished patients and 5 well nourished patients; p: 0.031]. Hepatotoxicity was not related to the gender [9 males and 4 females; p: 0.585] or the results of baseline sputum smears [7 out of 102 smear positive cases and six out of 148 smear negative cases; p: 0.064]. Hepatotoxicity with ATT is fairly common, especially in the elderly, malnourished patients and during the initial phase of treatment