Cognutuve and neurological complications of bacterial meningitis in adult patients: a hospital based study

Bacterial meningitis is associated with disabling sequelae in a significant proportion of patients. It is associated with high mortality, risk of neuropsychological sequelae and risk of cognitive impairment the purpose of this study is to assess cognitive and neurological complications in adult patients with bacterial meningitis. A total of 45 patients with bacterial meningitis and 16 patients with tuberculous meningitis were enrolled. They were subjected to full medical history taking and clinical examination, full neurological examination on admission and discharge. Mini mental state examination [MMSE] and Wechsler memory scale [WMS] were used to assess cognitive function. The results showed that the ischemic brain insult [87.88%] followed by cranial nerves affection [32.42%] were the commonest neurological complication detected on discharge. Cognitive impairment was detected in 53.66% of patients using MMSE.WMS showed that orientation, information and logical memory were the most common affected. Cognitive and neurological complications were not statistically related to age or etiology [P>0.05]. Longer duration until diagnosis [Beta = -.18, p <0.001], presence of intracranial complications [Beta = -.12, p <0.005], need for mechanical ventilation [Beta = -.79, p <0.001] and drug abuse [Beta = -0.11, p < 0.05] were significant predictors of worse outcome assessed by Glasgow outcome score

Pathological changes in mice vaccinated with swap, challenged and treated with praziquantel

Not only SWAP vaccinated mice and challenged with Schistosoma mansoni cercaria [100 +/- 20 / mouse] showed a significantly decrease in worm burden of perfused vaccinated mice compared with control non vaccinated infected mice, but also minimized the size and number of granuloma in different tissues [intestine, spleen and liver] compared with infected control. Praziquantel therapy showed a significant decrease in egg granuloma size and number in the intestine but the liver showed less significant decrease in egg granuloma size and number. This observation may aggravate hepatic fibrosis, especially if some worms are still viable and shift to the liver due to partial drug resistance and/or incomplete therapy. These data may guide and recommend follow up and repeat therapeutic dose to surely kill and prevent worms from shift to the liver. There is a synergism between drug therapy and vaccination, which showed marked decrease in egg granuloma size and number in the liver, while the intestine was nearly cured. Finally SWAP vaccinated mice showed a partial protection due to acquired immunity but the mice are still susceptible to infection with Schistosoma

Tumour necrosis factor and in cerebrospinal fluid as a prognostic factor in patients with bacterial meningitis

This study included 125 cases with meningococcal infection which have been admitted in King Faisal Hospital Makkah from March 1993 to April 1996. The majority of cases were due to group A meningococci [88.8%]. High incidence of the disease developed in the age group 24 -60 years and the males were affected more than females. Fever, headache vomiting, disturbed level of consciousness and neck stiffness were the predominant symptoms and signs. The C.S.F TNF-alpha was highly significantly increased in patients with meningitis in comparison to the control group. We found positive correlation between C.S.F TNF-alpha level and the development of complication. Our conclusion is that C.S.F TNF-alpha level is a good prognostic parameter for the outcome in meningococcal meningitis

Role of cystic duct in gall stone disease clinico pathological correlation

Fifty cases with gall stone were included in this study 35 females and 15 males with mean age 46 years. The presence of gall stones was proved by ultrasonography and or cholecystography. All patients were investigated for liver functions, blood picture, blood sugar and serum creatinine before the operation. Exploration of common bile duct was done in 4 cases, cholesterol stone was found in 6 cases, pigment stones in 14 and remaining [30] with mixed [infected] stones. The cystic duct and gall bladder were examined grossly and histologically. The cystic duct was narrowed in 68% of cases and shared more or less the same inflammatory changes and its sequele as in the gall bladder associated with gall stones. Also, it is recommended to examine the cystic duct in any gall bladder specimen. The cystic duct plays an active role in the flow of bile into and out of the gall bladder.So its pathological changes may share in the pathogenosis of gall stones even in absence of inflammatory process in the gall bladder

Studies on adriamycin side effects on the renal function and morphology in rats

Adriamycin [ADR] is an antitumor antibiotic, which is widly used in cancer chemotherapy Previous studies revealed cases of heavy proteinuria following single injection of 5 mg/kg ADR. Marked alteration in sodium and potassium contents were seen in cases of cardiomyopathy induced by chronic intoxication with ADR. We are interested to study the relationship between renal sodium and potassium content and proteinuria, in adriamycin treated rats [1mg/kg b.w. twice a week for 4 and 8 weeks], and the renal function and morphology The results showed impaired renal function as revealed by the significant increase in plasma creatinine and decreased urinary creatinine and creatinie clearance in ADR treated rats. ADR treatment also produced significant decrease in plasma proteins and proteinuria. Sodium content of the kidney was not significantly changed while potassium content was significantly decreased in ADR treated rats. These finding are consistant with the pathological examination which show glomerular sclerosis, cloudy swelling of the proximal convoluted tubules, dilated collecting tubules with protein casts and inflammation of the interstitial tissue. These changes are more marked in 8 weeks ADR treated rats. The study advise interrupted courses of ADR in the long treatment periods, with investigation for the kidney function

Primary splenic lymphoma in bilharzial splenomegaly [clinico-pathological study]

Primary splenic lymphoma is an uncommon disease, diagnosed pathologically during examination of the spleens removed in the course of treatment of hepatosplenic bilharziasis. 5cases were reported [2.5%]. All of them were non Hodgkin's lymphoma. 4 cases were in the form of well differentiated lymphocytic follicular lymphoma and one case was well differentiated lymphocytic lymphoma of the diffuse variety

Stimulation of tissue repair by ultrasound effect on venous leg ulceration

Twenty eight patients with chronic venous ulcers of the leg were divided into two matching groups. Ulcers in [Group "A"] were irradiated with ultrasound three times/week for 16 weeks, while ulcers in [Group "B"] were mock-insonated using a disconnected transducer for the same period and acted as controls. The ulcer area were measured every 2 weeks. Insonated ulcers [Group "A"] showed continuous decrease in their surface area. Furthermore, 50% of then healed completely before the 14th week while 71% healed before the. 16th week of treatment, The mock-insonated ulcers [Group "B"] showed minimal decrease in their surface and none of them healed at the 16th week of treatment. In conclusion, ultrasound have a remarkable therapeutic value in stimulating tissue repaire in venous ulcerations of the leg