Prevalence of Clinical Malaria in District Khairpur Mir’s Sindh, Pakistan

Aim: To evaluate the frequency of malarial parasites in different seasons at district Khairpur Mir’s, Sindh, Pakistan. Study Design: A prospective study. Place and study duration: This study was conducted at Post Graduate Diagnostic and Research Laboratory (PGRDL), Institute of Microbiology Shah Abdul Latif University (SALU), Khairpur and Bismillah Medical Center (BMC), Khairpur, from 01-Jan-2021 to 30-June-2021. Methodology: Febrile patient of all ages and both sexes were included, pre-diagnosis of malarial parasites using the Immunochromatographic test (ICT) kits, the blood samples were taken by venepuncture procedure after collecting samples in Ethylene diamine tetra acetic acid (EDTA) tubes for ICT and blood slides for microscopy. All results were entered and analyzed in SPSS 24 version. Continuous variables were presented as mean and SD and qualitative variables were presented as frequency/percentages. Probability value ≤0.05 was considered as significant. Results: In this study overall 7332 febrile patients with means age 37.8±22.54, from which male 3476 (47%) and majority of 3856 (53%) were female patients. Whereas 1908 (26%) patients were suffered from the active state of malaria and majority of 5424 (74%) population suffered from non-malarial diseases having vague symptoms including the chills, fever, body aches, abdominal cramps. The positive cases of Plasmodium vivax 1534 (20.92%) Plasmodium falciparum 316 (4%) whereas mixed cases are 58 (1%). Conclusion: The malarial parasites were observed predominantly with type of P. Vivax followed by P. falciparum and mix cases. Therefore dire need to take preventive measures by controlling the spread of plasmodium species in month of March onward till June. Keywords: Malarial Parasites (MP), Febrile Patients, Immunochromatographic Test (ICT).

A case of Falciparum malaria presenting with features of functional bowel obstruction

Malaria is the most common tropical disease in Sudan, which is caused by an infection with Plasmodium protozoa transmitted by an infective female Anopheles mosquito. Headache, fever, cough, fatigue, malaise, shaking chills, arthralgia and myalgia are the cardinal features of malaria, but occasionally, it has an atypical presentation. Intestinal obstruction as a complication is an extremely rare presentation. Here within, we describe a 28-year-old Sudanese man who has presented with of colicky abdominal pain, absolute constipation for two days and fever. Blood film for malaria was positive for Plasmodium falciparum. Intravenous artesunate injections have resulted in the resolution of symptoms of bowel obstruction. In conclusion, malaria should be suspected in any febrile patient with the features of bowel obstruction especially in an endemic area or if the patient has recently travelled to an endemic area with malaria. Treatment of malaria will result in the resolution of symptoms of functional bowel obstruction.

A Study on Role of Ultrasonography in the Diagnosis of Dengue Fever

Background: Dengue Fever is an acute mosquito transmitted viral infection caused by one of the 4 serotypes of the genus flavivirus which has become a major international public health problem. The diagnosis of DF is often delayed owing to time taken for availability of serology test results. Moreover, this test is expensive and not widely available. Ultrasonography (USG) is a cheap, rapid and widely available non-invasive imaging method. In recent years several studies concluded that Ultrasonography of the chest and abdomen can be an important adjunct to clinical profile in diagnosis of DF and diagnosis can be made early in the course of the disease compared with other modes of diagnosis. The aim of the study is to demonstrate the ultrasound findings of dengue fever and also evaluate the specificity of gall bladder findings in dengue fever. Subjects and Methods: We conducted a prospective study in Govt Medical College& Hospital, Srikakulam and Konaseema Institute of Medical Sciences, Amalapuram, A.P. Study included 50 patients referred to the department of Radio-Diagnosis and Imaging for Ultrasonography with clinical suspicion of dengue fever, during a period of July 2018 to December 2019. USG of the abdomen, pelvis and chest was performed in all cases and findings were noted. Dengue serology was performed later and all the ultrasound findings were correlated with dengue serology. Results: In our study of 50 patients all the patients studied were diagnosed with dengue fever based on dengue serology. In our study, 100% of our patients diagnosed with DF (by dengue serology) showed gall bladder wall thickening, 88% showed splenomegaly, 44% showed ascites. Pleural effusion was present in 30% of which 66.66% of pleural effusion was bilateral and the rest 33.33% was right sided. Isolated left sided pleural effusion was not found in our study. Hepatomegaly was present in 28% of our patients. In our study mortality and complications from dengue fever were not seen. Conclusion: Ultrasound findings in dengue fever are gall bladder wall thickening, splenomegaly, ascites, pleural effusion and hepatomegaly. In an area where DF is an epidemic, when Ultrasonography shows gall bladder wall thickening in a febrile patient with thrombocytopenia DF should be suggested On Ultrasonography, when there is gall bladder wall thickening, splenomegaly, ascites, and pleural effusion in a febrile patient with thrombocytopenia in a DF epidemic area a diagnosis of DF should be considered in a differential diagnosis until proved otherwise.