Evaluation of malaria cases in individuals after traveling to endemic regions of the world.

AIM: This study evaluates types of malaria and treatment success in a series of identified cases among individuals who were presumed to have travelled to regions where malaria is endemic. MATERIALS AND METHODS: In Sema Hospital, 25 cases of malaria (5 in women, 20 in men) were diagnosed during the 6-year period between 2006 and 2012. The mean age of the patients was 34.5 years. Diagnoses were established with thick and thin peripheral blood smears that were parasite-positive. These tests were then compared to the rapid diagnostic test based on Plasmodium falciparum histidine-rich protein 2. RESULTS: All cases demonstrated fever beginning with chills. Three patients had prophylaxis with doxycycline, but all stopped the prophylaxis early of their own volition. P. falciparum was the parasitic agent in all cases. A regimen of artemisinin and lumefantrine was administered in 18 of the 25 cases; quinine plus doxycycline was given in 3, and chloroquine was administered in the remaining 4. Usage of these regimens cured all cases of malaria without complications. CONCLUSION: The importance of prophylaxis of malaria was demonstrated. Malaria should also be included in the differential diagnosis of patients with fever that have a history of travel to endemic regions.

The Type of Anesthesia Used during Cesarean Section Is Related to the Transient Tachypnea of the Newborn.

Aim. To demonstrate whether transient tachypnea of the newborn (TTN) is found more frequently in women undergoing general or combined epidural-spinal (CES) anesthesia during Cesarean section. Methods. This study was done retrospectively. A total of 1447 Cesarean sections (C/S) were performed in our clinic between January 2008 and December 2011. General anesthesia was performed in 1078 (74.5%) of the Cesarean cases. CES anesthesia was performed in 369 cases (25.5%). The International Classification of Diseases,Tenth Revision code of P22.1, was used to identify the infants with TTN. Stratified multivariate analysis was undertaken on subgroups to assess the effect modification by factors known to influence the incidence of TTN: maternal age, maternal systolic-diastolic artery pressure, heart rate, Apgar score at 1 and 5 minutes, sex, time interval from spinal block to skin incision, and time interval from skin incision to umbilical cord clamping. Results. The rate of TTN diagnosis was found to be higher in parturients who had a cesarean section with combined epidural-spinal anesthesia, but no statistical differences were found. (P < 0.05) (odds ratio = 1.471 and 95%CI: 0.92-2.35). Conclusions. The incidence of TTN was found related to C/S but independent from the type of anesthesia. However, studies with a wider spectrum of patients and a lower quantitative difference between the groups are needed in order to draw firm this conclusions.