A Case of Sexual Abuse Presenting as Recurrent Vomiting

History taking in medicine is an important step andintegral part towards reaching diagnosis. Sometimes,it becomes necessary to evaluate history in more detailand essentially, beyond usual steps in diagnosisparticularly, when medico-legal, psychological andbehavioral aspects are concerned, which becomes veryimportant to reach a final decision in diagnosis andhence in further management; this implies particularlyin case of adolescents presenting with recurrentdisorders. Sexual abuse can present as recurrent orchronic headaches, recurrent abdominal pain and sleepdisturbances.

Correlation of thrombocytopenia in urban childern with malaria.

Background: Malaria, is endemic in Surat, (an industrious city of Gujarat), which is categorised under High risk zone. Malaria affects all blood components and is a true haematological disease. Thrombocytopenia and anaemia are the most frequently malaria associated haematological complications of malaria. Aims & Objective: To study the occurrence, severity and correlation of Thrombocytopenia in urban children with malaria. Materials and Methods: A retrospective study was conducted at Surat Municipal Institute Of Medical Education and Research (SMIMER) , Surat Gujarat . The Data of all smear positive and Rapid Diagnostic Test positive malaria cases of age between 1 and 17 year admitted in the Deptt. Of Pediatrics were collected. These patients were further assessed for thrombocytopenia, its severity, its relation with type of malaria and age. Results: Thrombocytopenia was observed in 233 (74%) cases of Malaria of which P. vivax was in 103 (44%) cases, P. falciparum in 130(56%) cases. Severe thrombocytopenia was observed in 22% and 29% cases of Pv and Pf malaria respectively. Sensitivity of thrombocytopenia in Pv and Pf was 71.53% and 76.92% whereas specificity was 66.67 for both respectively. Sensitivity of thrombocytopenia in Pv increased as the platelet count decreased. Conclusion: Thrombocytopenia is a frequent overall manifestation of both falciparum and Vivax malaria Severe Thrombocytopenia should alert one to consider a possibility of malaria in children.