Idiopathic thrombocytopenic purpura [ITP]; frequency of clinical features in children

To find the frequency of common clinical features of Idiopathic Thrombocytopenic Purpura [ITP] in children and to see whether bone marrow aspiration needed in every child with typical presentation of ITP. Cross-sectional study. Hematology/Oncology Department, the Children Hospital and the Institute of Child Health Lahore Pakistan. April 2008 to March 2009 [One year]. A total of 30 children presenting with bleeding through any orifice with diagnostic evidence of ITP were evaluated by a cross sectional study. Common clinical features were recorded along with the related hematological parameters. After taking detailed history and thorough examination, relevant investigations like peripheral smear, bleeding time and coagulation screen were carried out in all cases. Bone marrow examination was done only in selected cases. The cases were then managed according to standardized management criteria. Male: Female ratio was 3:2, age ranging from 18 months to 14 years [mean +/- SD of 5.2 +/- years] with median age of 5.2 years. 26.6% [n=08] patients were having preceded history of upper respiratory tract infection. The positive clinical findings were bruises in 30% [n=09] cases; petechiae in 23.3% [n=07] cases; epistaxis in 23.3% [n=07] cases; gum bleeding in 13.3%[n=04] cases and hematuria only in 10% [n=03] cases. Anemia [<9gm%] was noted in 40% [n=12] patients. On peripheral smear examination this was microctic hypochromic in nature. Bleeding time was prolonged in all patients in line with documented thrombocytopenia i.e platelet count < 150,000. PT/APTT was normal in all 30 patients. Bruises, Petechiae and epistaxis are the commonest clinical findings of ITP. Bone marrow aspiration revealed inconclusive results in such cases

Scabies; safety of permethrin and ivermectin

Scabies is a common health problem worldwide. Most treatment modalities available are topical. Among them 5% Permethrin is the most effective scabicide with few side effects. Limiting factors are its high cost, cumbersome application and emerging resistance. Ivermectin is the only oral scabicide available. It is effective, inexpensive and easy to use drug with no known drug interactions and limited side effects. To compare the safety of topical Permethrin and oral Ivermectin in treatment of scabies. Quasiexperimental study. Setting: Department of dermatology Jinnah Hospital, Lahore. Subjects: 120 patients were enrolled and were randomly divided in 2 groups of 60 each.-12-02-07 to 31-01-08. Non funded study [As ivermectin was not available in Pakistan during the study period, it was imported from India as tablet Ivecop 12 mg]. Topical Permethrin and oral Ivermectin were used in groups A and B respectively. Patients were examined and certain investigations were carried out before dug administration, and at day 7 and day 14 to evaluate the safety of both drugs on the basis of appearing of side effects and change in baseline investigations. In both groups, equal number of patients experienced side effects [n=15]. In group A, side effects observed were burning [n=8], contact dermatitis [n=4] and stinging [n=3]. In group B, we observed muscular pain [n=5], nausea [n=5], headache [n=2] and others [n=3]. Significant rise of hepatic enzymes was noticed in only 1 patient of group B which improved on next follow up. We found no statistically significant difference regarding safety of use between permethrin and ivermectin

comparison of efficacy of single topical permethrin and oral ivermectin in the treatment of scabies

Scabies is a common health problem worldwide. Among available topical treatment modalities, 5% permethrin is the most effective scabicide with few side effects. Ivermectin is the only oral scabicide available. It is effective, inexpensive and easy to administer with no known drug interactions and limited side effects. To compare the efficacy of topical permethrin and oral ivermectin in treatment of scabies. In this quasi-experimental study, a total of 120 patients of scabies were enrolled and randomly divided in 2 groups of 60 each. Topical 5% permethrin whole body application for 10-12 hours and oral ivermectin as 200 micro g/kg were used in groups A and B, respectively. In both groups, history, examination and microscopy were carried out at day 0, 7 and day 14. Response to treatment was judged on following parameters: decrease in severity of pruritus, nonappearance of new lesions and absence of burrows. Each parameter was scored and sum total of individual scores was used to determine the efficacy. Mean age in group A [permethrin] was 29.45 +/- 9.72 years and in group B [ivermectin] was 31.45 +/- 12.78 years. In both groups, 66.7% patients showed complete cure. There is no significant difference regarding efficacy of topical permethrin and oral ivermectin when used in treatment of scabies