BACKGROUND: Malaria remains one of the major health problems in the tropics with increased morbidity & mortality. Thrombocytopenia is a common finding in malaria, but its correlation with the type of malaria and prognostic implications in context with severity of low platelet count has not been evaluated in large studies. In view of paucity of data from Indian studies, we attempt to correlate the low platelet count with type of malaria and outcome. AIM: Study of platelet count in malaria patients and correlation between the presence and severity of platelet count with type of malaria. MATERIAL & METHODS: A total of 180 patients diagnosed to have Malaria over a period of two years admitted in Guntur Teaching and General Hospital attached to Guntur Medical College, Guntur were studied. All study subjects were identified positive for Malaria parasite on peripheral smear examination with conventional microscopy. Platelet count was done on a fully automated, quantitative analyzer. Daily platelet count was done for all those admitted with malaria. P.falciparum antigen test (PfHrp antigen test-Parascreen) was performed in subjects with P.vivax Malaria on the peripheral smear with a platelet count less than 20,000cells/cmm for more emphatic exclusion of associated P.falciparum infestation. P.falciparum antigen test was also performed in subjects with high index of clinical suspicion or multi organ involvement. RESULTS: a total of 180 patients were found to have malaria, 114(63.3%) were P.vivax, 62(34.4%) were P.falciparum and 4(2.7%) were mixed. 146(81.1%) patients had thrombocytopenia. 34(23.3%) developed complicated malaria. Severe thrombocytopenia was noted in 58.8% of complicated malaria with p<0.001. 20 patients persisted to have thrombocytopenia on 6th day even after adequate therapy. 14(70%) patients out of 20 recovered and 6(30%) died in which 2 was P.falciparum and 4 were mixed infection. CONCLUSION: Thrombocytopenia is a common association of malaria with incidence of 81.1%. Severe thrombocytopenia is commonly seen in P.falciparum. Platelet count <20,000 was seen in P. falciparum and P.vivax. But more commonly in P. falciparum. Out of 36 severe thrombocytopenia 34 developed complicated malaria with significant p value indicating that patients with severe thrombocytopenia at the time of admission are 8.5 times more prone to develop complications when compared to mild and moderate thrombocytopenia. Patients who persisted to have thrombocytopenia even after 6th day of therapy, their mortality increased by 30%.

BACKGROUND:A non-resolving opacity on chest X-ray despite intensive pharmacotherapy poses a diagnostic problem for the clinician. Transthoracic Fine Needle Aspiration Cytology is regarded as the most effective of the cytological methods for diagnosing lung cancer, in particular peripherally-located lesions including lung nodules of infective etiology. In this study we evaluated the role of ultrasound guided percutaneous Fine Needle Aspiration Cytology in various peripheral pulmonary lesions. MATERIALS AND METHODS: Eighty one (81) Patients with peripheral lung lesions who were admitted in the Department of pulmonary medicine, Guntur Medical College/Government Fever Hospital, Guntur from January 2014 to March 2015. RESULTS: Out of 81 patients, diagnostic yield was obtained in 71 patients. In 71 patients, 45patients (55.5%) were with malignant and 26(32%) were with non-malignant lung lesions. Out of 45 malignant patients, Squamous cell carcinoma was seen in 27 patients (60%) followed by Adenocarcinoma in 10 (22.22%), Large cell carcinoma in 07(15.55%) and Metastatic carcinoma in 01 patient (2.22%). Out of 26 non-malignant lung lesions, 18 patients were with Tuberculosis (69.23%) and 08 patients were with pneumonia (30.76%). CONCLUSION: Ultrasound Guided Trans-thoracic FNAC of peripheral pulmonary lesion is, simple, safe, quick, acceptable, easily accessible, accurate and cost-effective procedure without radiation. It lessens the need of other procedures like BAL, FOB and cutting biopsy procedures etc. KEYWORDS: FNAC, Lung Cancer, Peripheral Lung Lesion, Pneumonia, Tuberculosis, Ultrasound. INTRODUCTION:A non-resolving opacity on chest X ray despite intensive pharmacotherapy poses a diagnostic problem for the clinician (1) . Radiographic features such as size, location of the lesion, margins, shape, growth rate and presence of calcification are helpful for the diagnosis, and are not confirmative. Fine Needle Aspiration Cytology (FNAC) is a well-established method of diagnosing both neoplastic and inflammatory conditions of the lung, has resulted in a decrease in the need of other procedures that are more invasive. Transthoracic Fine Needle Aspiration Cytology is regarded as the most effective of the cytological methods for diagnosing lung cancer, in particular peripherallylocated lesions including lung nodules of infective etiology. Trans-bronchial lung biopsy or brushings via Fibre Optic Bronchoscope and Per-cutaneous transthoracic aspiration under fluoroscopic guidance are the other alternatives. Diagnostic methods which are time consuming and not available in all centers. In such cases Ultrasound guided Fine Needle Aspiration Cytology of peripheral pulmonary lung lesions using fine needle is the choice for establishing the diagnosis which is simple and safe. Real time B-mode ultra-sonography which is readily available in most centers is easy to perform and free from radiation, helps in the evaluation of pulmonary lesions and also the needle can be guided under vision and aspirates can be obtained from d...