ABSTRACT
Ileocecal Tuberculosis [TB] is difficult to diagnose clinically as getting histological specimens means resorting to surgery, which is often hazardous and complicated in sick, anemic and emaciated patients with malabsortion syndrome. The present study was undertaken as an attempt to devise clinical criteria for diagnosis of ileocecal TB without resorting to invasive surgery. 52 patients with suspected ileocecal TB were assigned pre-determined criteria based on clinical signs, symptoms and simple laboratory investigations. Criteria for exclusion were also devised; patients were followed up for an average of 1.1 years. Clinical response was assessed by complete resolution of symptoms and signs within 3 months. All 52 patients completed the study and all became symptom free within 3 months of treatment. All patients gained a minimal of 2 kg over 6 weeks and 32 patients gained more than 10% of body weight within 3 months; the difference in mean weights before and after 3 months treatment was highly significant [p<0.001]. In patients with suspected ileocecal tuberculosis, predetermined clinical criteria can be readily applied for early diagnosis, without resorting to surgery and with excellent clinical response
ABSTRACT
The present study was undertaken to determine the uric acid profile in patients with unexplained chronic musculoskeletal complaints, and to establish any possible causal role for altered uric acid profile in such patients. Method: A comparative study of 36 patients and 36 controls of both sexes and ages between 25-60 years was carried out at Shaikh Zayed Hospital, Lahore from November 2001-May 2002. Patient included were those who had at least 4-24 weeks duration of complaints. Uric acid profile for serum uric acid, uric acid excretion, uric acid clearance and total uric acid production was done. Additional tests included renal functions test, liver function test, cardiac enzymes, haematology and serology to exclude other underlying causes of complaints. Mean serum uric acid levels were higher in patients as compared to controls [p=0.05], with 9 [25%] patients showing hyperuricemia. Uric acid clearance [female patients 5.86+0.42 ml/min, female controls 8.06+0.24 ml/min] and daily uric acid excretion [female patients 412.38+28.52 mg/24 hours, female controls 487.79+18.64 mg/24 hours] in female patients was significantly lower than control females [P=0.034 and P<0.001 respectively]. Twenty patients [55.55%, 3 males and 17 females] were classified as under excretors of uric acid, while there were no under excretors in the control group [p<0.001]. We conclude that abnormalities of uric acid profile, particularly under excretor status may be an underlying biochemical abnormality in a significant number of patients. Female patients appear more predisposed to abnormal uric acid profile such as hyperuricemia and under excretor status