Amoebic liver abscess and gender differences

The study was undertaken to elucidate the clinical profile and to find out the of results of Ultrasound guided aspiration of liver abscess in the Department of General Surgery, Baqai Medical University Hospital Nazimabad Karachi, from April 2007 to April 2012. 60 cases were included in the study, which were diagnosed to have amoebic liver abscess with 96.5% male and 3.5% female patients. The diagnosis was based on persistent fever, pain in right upper abdomen with pointing tenderness over liver, serodiagnosis, ultrasound evidence of liver abscess and CT scan in selected cases. Those having abscess larger than 5 cm subjected to percutaneous transhepatic ultrasound guided aspiration of liver abscess and the abscess size and resolution was monitored. Parental antibiotic cover for 4 to 6 weeks was provided to all patients. Fever was the most frequent symptom as diagnosed in 57 [94%] patients, followed by pain in right upper abdomen in 54 [90%] patients and diarrhea in 6 [10%] patients, anorexia and weight loss in 18 [30%] patients. 11 [18.3%] patients had hepatomegaly, 8 [13.5%] showed deranged LFTs and 9 [15%] patients had right sided pleural effusion. Out of total cases, 54 [90%] patients had right lobe abscess, 2 [3.3%] patients had left lobe abscess and three [5%] patients had multiloculated right lobe abscess. One [1.6%] patient had multiple abscess in both lobes of liver. Serology test for Entamoeba histolytica was positive in all patients Ultrasound guided needle aspiration employed in 38 [63.5%] patients and 22 [36.5%] patients were managed conservatively. In 8 [13.3%] patient's second attempt of aspiration employed. In one [1.5%] patient right chest drain was passed. Patient with amoebic liver abscess with fever and pain in right upper abdomen were noted. Our study showed amoebic liver abscess had seven times higher incidence in male than in female

Assessment of antibody titre in patients with meningococcal meningitis group A versus post vaccination in high risk groups

This study have been carried out from March 1992 to April 1994. During this period 125 cases were admitted with meningococcal meningitis. 111 cases [88.8%] were due to Neisseria Meningitides group [A], 11 cases [8.8%] due to N. Meningitides group [W135] and 3 cases [2.4%] due to N. Meningitides group [C]. 20 cases were studied for the antibody titer to N. Meningitides group A during convalescent and 6 months later. 70 individuals of high risk group were studied for the antibody titer 1 month, 6 months and 1 year post-vaccination. There was significant difference in the antibody titer between the sample of patients 6 months post-infection and vaccines 6 months post- vaccination. So, it was concluded that higher antibody titers are produced with systemic infection than following vaccination

Clinical aspect and factors affecting outcome of meningococcal infection in Makkah

This study included 125 cases with meningococcal infection The majority of cases were due to group A meningococci [88.8%], most of them admitted in Ramaddan time of Umra in Makka. 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 mortality rate was relatively high [20.8%]. A significant relationship was found between the death and extensive rashes, leucopenia, normal WBCs count, shock and disturbed level of consciousness grade II, IV, but no significant relationship between the death and C. S. F pleocytosis, petechiae, peripheral leucocytosis and stage I and disturbed level of consciousness