Degree of thrombocytopeniaand malaria parasite species

Background: Malaria is a common health issue of our country and has shown variable prevalence in different regions of the world. It has a vast array of clinical presentation including, high grade fever with rigors and chills, headache, dizziness, acute renal failure, hepatopathy, joint pains and congenital malaria. It has various abnormalities on laboratory indices like thrombocytopenia, anemia, and leucopenia

Objective: This study was conducted to find out the degree of thrombocytopenia and types of the parasites among malaria patients from upper Punjab

Patients and Methods: This descriptive case series was conducted in CMH, Kharian, from 1[st] September, 2011 to 30[th] September, 2012. All the suspected malaria patients were included on the basis of history, physical examination and diagnosed on laboratory parameters [thick and thin films]

The data was entered and analyzed in SPSS version 16

Results: Out of the 273 enrolled cases in our study, 190 [69.6%] had malaria. 145 [76.3%] were infected by Plasmodium vivax and 45 [23.7%] had falciparum malaria. Out of these 190 patients 151 [79.5%] had thrombocytopenia, and among these patients having thrombocytopenia, 118 [78.1%] were infected by vivax species and 33 [21.8%] were infected by Falciparum species

Conclusion: It is concluded from our study that majority of the patients in this region of country, are suffering from Vivax and Falciparum malaria and present with varying degree of thrombocytopenia

Efficacy of propofol mixed with lidocaine versus lidocaine followed by propofol to reduce injection pain due to propofol in patients undergoing general anaesthesia

Introduction: Propofol is widely used for induction and maintenance of anaesthesia and possesses many characteristics of an ideal anaesthetic. A disadvantage of propofol is pain on injection, which is sometimes very distressing to patients. Many different methods have been proposed to reduce the incidence and severity of this adverse effect of propofol

Objective: To determine the efficacy of premixed inj lidocaine and propofol versus separately giving them, for reducing propofol injection pain

Study Design: Randomized clinical trial

Place and duration of study: Study was conducted in main operation theatre Combined Military Hospital Peshawar over a period of six months from 1st July 2010 to 31st Dec 2010

Methodology: One hundred and twenty patients in ASA I and II were enrolled by non probability consecutive sampling, who were scheduled for different elective surgical procedures under general anaesthesia. The patients were randomized into two groups [A and B]. Patients of Group A received pretreatment with lidocaine 2% [0.5 mg/kg body weight] followed by inj propofol 1% [2mg/kg body weight].Group B received premixed inj propofol with lidocaine on similar weight base doses

Results: In group-A pain was reported by 19 patients [30.9%] and in group B pain developed in 6 patients [9.7%] [P=0.003]

Conclusion: Premixed Propofol and lidocaine was more effective in reducing propofol induced pain incidence on injection than giving these two injections separately

Effect of suplemental oxygen on the apgar score ofnewborn given to mother undergoing elective caesariansection under spinal anesthesia

Objective: To determine the effect of supplementaloxygen on APGAR score of newborn babies, givento pregnant ladies undergoing elective lowersegment caesarian section under spinal anesthesia

Study Design: Cohort study

Place and durationof study: Combined Military hospital Rawalpindi,from Jun 2010 to Mar 2011

Methodology: Onehundred and twenty full term pregnant ladies wereenrolled by non probability consecutive sampling,who were scheduled for elective caesarian sectionunder spinal anesthesia. The patients wererandomized into two groups [A and B]. In patientsof Group A supplementation of oxygen was given tothe mothers after spinal block, while in Group B,patients were not provided with supplementaloxygen after spinal anesthesia. Cases requiringgeneral anesthesia or supplemental oxygen [in groupB] for some other reasons causing maternal hypoxiawere excluded from the study. APGAR Score at oneminute and five minute was recorded

Results: Intotal of one twenty newborns, 56 [47%] were malesand 64 [53%] females. Mean age of the pregnantladies under study was 35 + 5 in group A and 33 + 7in group B. In group A, the value of APGAR scoreat one minute varied from 6 to 10 and, at fiveminute it was from 8 to 10. While in group B, theresults of APGAR score were same without anysignificant difference [P>0.05]

Conclusion:Supplemental oxygen has no role on the APGARscore of newborns but simple psychologicalsatisfaction to some of the mothers at the cost ofwastage of oxygen while in some patients causinganxiety, so patients should be educated on thisaspect and un-necessary use of supplemental oxygenmust be avoided