ABSTRACT
Acute meningitis in children is predominantly aseptic and does not require specific treatment. However, meningitis has a bacterial origin in about 5% of patients and carries a risk of fatal outcome or severe neurological sequelae, especially when diagnosis and antibiotic administration are delayed. The objective of the present study was to evaluate the value of determining procalcitonin levels to discriminate between bacterial and non-bacterial meningitis in young children or infants and describe the variation in serum PCT levels over time during the treatment of meningitis. A total of 50 children with meningitis admitted to a University Hospital were followed in this prospective study. Cerebrospinal fluid [CSF] and serum levels of procalcitonin were measured. The diagnosis of meningitis was based on clinical findings, gram staining, culture, and chemical analysis of CSF. Twenty-five children were diagnosed as bacterial meningitis and the other 25 children as non-bacterial Meningitis.The mean procalcitonin level on admission in patients with acute bacterial meningitis was 18.3 ng/mL, and the lower level was 4.6 ng/mL, while the higher level in patients with non-bacterial meningitis was 0.62 ng/mL [mean level, 0.38 ng/mL]. It is clear from the range of serum procalcitonin level that, there are no overlapping values seen for serum procalcitonin in both groups.serum PCT levels can be used in the early diagnosis of acute bacterial meningitis and is more valuable than the other predictive marker. Similarly, they may be useful adjuncts in differential diagnosis of bacterial and non-bacterial meningitis and diminishing the value of 2nd lumbar puncture performed 48-72 hours after admission to assess treatment efficacy
ABSTRACT
Kidney transplantation is the most common transplantation in the world. Annually, a large number of patients that have chronic renal failure are undergoing renal transplantation and the major subject about these patients is the rejection of graft that should be controlled by immunosuppressive agents. The aim of this study is investigation of the effect of Cyclosporin against Tacrolimus in patients with kidney transplantation. This study was performing between 2010 and 2012 on all patients who had kidney transplantation and refer to Imam Reza hospital from Kermanshah University of Medical Sciences. 100 patients, aged 18-60 years, with end-stage renal disease were administered either Tacrolimus [n=49] or Cyclosporine [n=51]. In both groups, Cellept could be discontinued from day 92 onwards. Corticosteroid treatment comprised methylprednisolone boluses followed by a rapid prednisone taper from 20 mg [day 2] to 5 mg [day 43 and thereafter]. Patients followed up 12 months. In the Tacrolimus treatment group, 7 grafts [14%] were lost and 8 [16%] grafts were lost in the Cyclosporine treatment group between months 0 and 12 and there is no significant different between these groups [P= 0.845]. No cases were diagnosed with biopsy-proven chronic rejection at months 0 and 12. Mean serum creatinine concentrations were 1.8 +/- 1.5 mg/dl in the Tacrolimus group and 2.3 +/-2.9 in the Cyclosporine group by month 12 [P= 0.348]. these data are consistent with previously published observations and confirm that Tacrolim us is a highly efficacious baseline immunosuppressant for patients undergoing kidney transplantation. Tacrolimus-based immunosuppression may promote long-term benefits with regard to graft functio n and graft survival