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The association of hematological parameters especially platelet parameters with disease severity in malaria is poorly understood. We aimed to characterize the platelet parameters across Plasmodium falciparum and Plasmodium vivax malaria stratified by severity and to elucidate the potential role of platelet parameters to predict disease severity. Individuals > 18 years, of either gender with microscopically proven symptomatic malaria were prospectively enrolled between October 2014 and August 2016 in a tertiary center in Manipal, India. Severity of malaria was defined as per the WHO definition. Among 159 patients, 32 (20.1%) had severe malaria. 116 (73%) had infection with P. vivax, 37 (23%) P. falciparum and 6 mixed infection. Thrombocytopenia was seen in 32 (86.4%) of P. falciparum and 105 (90.5%) of P. vivax malaria cases. Patients with renal failure (p=0.02), shock (p=0.04) and liver dysfunction (p<0.001) had significantly lower platelet count compared to those who did not. Admission platelet count of 50,000 cell/mm 3 had a sensitivity and specificity of 65.6% and 70.6% respectively, to discriminate severe malaria. A plateletcrit of 0.05% had a sensitivity and specificity of 65.6 % and of 70.6% respectively. Thrombocytopenia was seen in 89.3% of malaria cases due to both P. vivax and P. falciparum. Platelet count and plateletcrit could be used as markers of disease severity. P. vivax malaria which has been traditionally regarded as 'benign' can be as sinister and menacing as P. falciparum malaria and hence warrants equal attention. Unnecessary transfusion of platelets should be avoided.

. Srivastava, R. N., Gupta, P. C., Mayekar, G. and Roy, S. (Departments of Paediatrics, Neurology and Pathology, All India Institute of Medical Science, New Delhi, India). Cockayne's Syndrome in two sisters. Acta Paediatr Scand, 63 461, 1974.–Clinical and laboratory data in two sisters with Cockayne's syndrome are presented. Both had severe dwarfiim and mental retardation and the elder girl (11 years) had senile facies, optic atrophy and intracranial calcification. The serum cholesterol values were elevated. Peripheral neuropathy was found in both cases, evidenced by slow nerve conduction velocities. Examination of sural nerve biopsies showed focal demyelination with preservation of axis cylinders. These observations support the concept of Cockayne's syndrome being a leucodystrophy.

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