Hepatic dysfunction is frequent in varicella infection

To determine frequency and severity of hepatic dysfunction in adult chickenpox patients admitted in our hospital. This was a hospital based descriptive study conducted from January 2005 to December 2007 at the Infectious Diseases Unit, Rashid hospital Dubai, UAE. The demographics, clinical information, radiological and biochemical changes observed in each patient were entered in a proforma. Full blood count, liver function tests, blood sugar, urea and electrolytes were done for all the patients, whereas, patients with clinical and/or biochemical evidence of hepatic dysfunction were subjected to viral hepatitis serology, coagulation profile, blood culture and ultrasound abdomen. Management was done as per standard guidelines for the management of chickenpox and its complications. A total of 105 patients were entered into the study. Serum alanine transaminases [ALT] levels were above the reference range in 50.9%. Among the 52 patients with raised serum ALT levels, 16 [30.7%] had levels > 3 times, 4 [7.6%] had > 5 times and 5 [9.6%] had > 10 times of normal levels. Serum bilirubin was increased above the normal value in 20% and was greater than 3-folds in 4.9%. High frequency of thrombocytopenia [p < 0.009], pneumonia [p0.004], impaired renal function [p < 0.01] and disturbed coagulation profile [p < 0.01] were observed in patients with hepatic dysfunction. Overall, five [4.9%] patients expired and two [1.9%] of them had acute fulminant hepatic failure. We observed that liver is frequently involved in adult chickenpox patients and the severity of hepatic dysfunction ranges from mild elevation of transaminases levels to acute fulminant hepatic failure

Malaria and hematological changes

The hematological changes associated with acute malaria are well recognized. This study was conducted to assess and compare the incidence and severity of hematological changes in various types of malaria in adult population. This observational study included 133 acute malaria patients admitted in the Infectious Diseases Unit of Rashid Hospital Dubai [JCI accredited] UAE, during January 2005 to December 2007. The diagnosis of malaria was confirmed by thick and thin film stained with Leishman,s staining for malarial parasite. Slides were reviewed by hematologist and FBC were performed using an automated Beckman Coulter machine. Overall 83% of the patient had thrombocytopenia, 64% anemia, 24% lymphopenia and 10% monocytosis. The incidence of thrombocytopenia was slightly more in P. Falciparum [87%] than P. Vivax [81%] cases, p value > 0.05, where as there was no significant difference in the incidence of anemia in two groups [67% vs 63%]-p value > 0.05. However, lymphopenia was observed in 36% in P. Vivax as compared to 15% in P.Falciparum cases, p value < 0.04. Eosinophil and basophil count was normal in both groups. P.Falciparum as well as P.Vivax can cause significant hematological changes with high frequency of thromboctopenia, anemia lymphopenia and monocytosis