Oral candida in subjects who sucked dummies was almost double that of controls. Although the carriage of Candida albicans on silicone dummies was significantly reduced compared with latex dummies, oral colonisation was unaffected, suggesting that dummy carriage is not the cause of the observed increase.

No abstract

Malaria caused by Plasmodium species is a disease with high morbidity and mortality, especially in children. The changing clinical and blood manifestations of P.falciparum, emerging trends of complications with P.vivax are some of the important issues that merit attention at present in India. The prospective crosssectional study conducted on 170 patients of malaria in Mumbai aimed at studying the clinico-haematological alterations in the disease. Fever and splenomegaly were critical findings in majority of patients so that they may be used for clinical diagnosis of malaria and early institution of therapy. P.vivax was the predominant species with severe thrombocytopenia however anemia was common in P.falciparum infection.Older children were affected more severely than infants with hematological complications, namely anemia and thrombocytopenia. Anemia and thrombocytopenia were common observations while leucocyte count was normal in most patients. After 48 hours of antimalarial treatment, platelet count improved with restoration to normal in majority of patients while anemia worsened in most cases. There was a negative correlation between platelet count and hyperparasitemia. Despite availability of extensive literature on various manifestations of malaria, the evolving nature of the disease mandates continuous revision of existing data.

Malaria and dengue fever are endemic in the South-East Asian region including India. Both the illnesses share similar symptomatology, but differ in certain respects such as different- causative organisms and mosquito vector with diverse habitat. Hence, concurrent malaria and dengue fever in the same patient is said to be unusual. There have been cases of concurrent malaria and dengue, but they are scarce from highly endemic region like ours. Here, we describe three unusual cases of Plasmodium vivax and dengue co-infection diagnosed by use of rapid diagnostic tests. Early diagnosis and timely intervention is crucial in managing such patients.

A 5-year-old immunocompetent girl presented with fever, jaundice, hepatosplenomegaly and pancytopenia. The peripheral blood smear demonstrated mixed malaria infection (Plasmodium vivax and Plasmodium falciparum). Fever was persistent despite antimalarials in the absence of any coexisting bacterial or viral infection. Laboratory findings included cytopaenia, hyperbilirubinaemia, hyperferritinaemia, hypertriglyceridaemia, hyponatraemia, deranged partial thromboplastin time, decreasing ESR and megaloblastic changes on bone marrow aspiration. A final diagnosis of haemophagocytic lymphohistiocytosis (HLH) with megaloblastic anaemia associated with severe mixed malaria was made. There was a dramatic response to corticosteroid treatment with improvement in her clinical condition. This report endorses the use of corticosteroids in malaria-associated HLH whenever there is no clinical improvement with antimalarials alone.