RESUMEN
About 110 patients were enrolled to study the atypical presentations and the chloroquine sensitivity pattern of Plasmodium vivax malaria. The diagnosis was made from Giemsa stained peripheral blood smear. The co-infection of falciparum malaria was excluded both by smear and ParaSight F-test. After a thorough clinical work up, biochemical investigations were done. The fever clearance and parasite clearance time were determined in all cases. Absence of malarial paroxysm (22.8 per cent), migrainous headache (4.5 per cent), myalgia (6.3 per cent), episodic urticarial rash (1.8 per cent), relative bradycardia (13.6 per cent) and postural hypotension (2.7 per cent) were the atypical manifestations encountered. Besides this, severe forms like jaundice (7.2 per cent), cerebral involvement (0.9 per cent), severe anaemia (7.2 per cent), thrombocytopenia (3.6 per cent) and pancytopenia (0.9 per cent) had been detected. All, except the patient with cerebral involvement were treated with chloroquine patients responded well to the treatment except two (1.8 per cent) patients who had chloroquine resistance. This study showed that vivax malaria can present with atypical and protean manifestations. The changing clinical profile along with development of chloroquine resistance may be considered as a warning signal.
Asunto(s)
Antimaláricos/uso terapéutico , Cloroquina/uso terapéutico , Malaria Vivax/fisiopatología , Adolescente , Adulto , Femenino , Humanos , India , Pruebas de Función Hepática , Malaria Vivax/sangre , Malaria Vivax/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Resultado del TratamientoRESUMEN
To study the extent of serum lipid peroxidation in malaria, 62 patients of falciparum malaria (18 uncomplicated and 44 complicated), 15 patients of vivax malaria and 25 healthy controls were enrolled in this study. The extent of serum lipid peroxidation was evaluated by estimating serum thiobarbituric acid reactive substances (TBARS) colorimetrically. The mean serum TBARS levels were 1.5 +/- 0.29, 1.21 +/- 0.2 and 3.58 +/- 1.35 nmol/ml in controls, vivax malaria and falciparum malaria patients respectively. The TBARS level was significantly more in complicated falciparum malaria patients (4.2 +/- 1.03 nmol/ml) than uncomplicated falciparum malaria patients (2.01 +/- 0.61 nmol/ml). The TBARS level was also more in patients who died (4.82 +/- 0.64 nmol/ml) when compared to the survivors (2.92 +/- 1.05 nmol/ml).
Asunto(s)
Peroxidación de Lípido , Malaria/metabolismo , Tiobarbitúricos/metabolismo , Adolescente , Adulto , Femenino , Radicales Libres , Humanos , Malaria/complicaciones , Masculino , Persona de Mediana EdadRESUMEN
Twenty two patients of subacute hepatic failure (SAHF), diagnosed when jaundice progressed for more than 8 weeks with appearance of ascites, with or without encephalopathy, along with biochemical evidence of hepatocellular damage, were studied. The male and female ratio was 4.5:1 and majority (45.4%) of cases were between the age group of 41-50. The mean biochemical values were: S.bilirubin; 9.2 +/- 3.8 mg/dl SGOT; 94.4 +/- 25.0 I.U./lit., SGPT; 107.8 +/- 32.7 I.U./lit., S.Protein; 5.2 +/- 3.5 secs. Ascitic fluid analysis showed transudate in 16 (72.7%) and exudate in 6 (27.2%) patients. Bacterial peritonitis was found in 5 (22.7%) patients. Liver biopsy showed bridging and submassive necrosis. The complications developed in the hospital were: renal failure (36.3%), infection (27.2%), G.I. bleeding (18.1%) and encephalopathy (13.6%). The mortality was (86.3%). Out of 3 (13.6%) patients who survived, only two recovered completely and one had biochemical evidence of hepatocellular necrosis after 6 months of follow up.
