ABSTRACT
Systemic inflammatory response syndrome [SIRS] is a generalized disorder, immune response to infection which results in disturbed microcirculation, visceral perfusion and ultimately visceral failure. Objectives: To determine the frequency of systemic inflammatory response syndrome in patients with liver cirrhosis. Design: Cross sectional descriptive. Period: Six months study. Setting: At Liaquat University Hospital Hyderabad. Patients and methods: All the patients with liver cirrhosis for 06 months duration admitted in the ward were further evaluated for systemic inflammatory response syndrome. The data was analyzed in SPSS 16 and the frequency and percentage was calculated. Results: During six months study period, total 100 cirrhotic subjects were studied for SIRS. The mean +/- SD for age in all [100] cirrhotic patients was 45.74 +/- 7.537. The mean temperatures was 40.42+/-0.32 where as it was 39.72+/-0.43 and 38.92+/-0.11 in male and female population respectively. The mean heart beat was 128.42+/-6.74 where as it was 115.83+/-8.93 and 120.62+/-5.53 in male and female population respectively. The mean respiratory rate was 25.31+/-3.52 where as it was 23.52+/-2.31 and 26.63+/-3.21 in male and female population respectively. The mean white blood cell count was 28.81+/-4.51 where as it was 23.74+/-4.73 and 30.83+/-5.73 respectively. The SIRS was observed in 70% subjects of which 47[67.1%] were males and 23[32.9%] were females [p=0.04]. Majority of SIRS subjects were 30-39 years of age and male population was predominant [p=0.03]. The gender distribution in relation to severity of liver disease was statistically significant [p=0.05] while the SIRS in relation statical analysis. Conclusions: The systemic inflammatory response syndrome occurs in patients with liver cirrhosis
ABSTRACT
Ring enhancing lesions are a common neurological problem seen in either gender and in all age groups. Objectives: To determine the clinical presentations and etiological factors in patients with ring enhancing lesion on CT scan brain. Design: Case series study. Period: One year. Setting: Department of medicine, Liaquat University Hospital, Hyderabad. Patients and methods: Subjects of either sex =12 years of age, presented with seizures, fever, focal neurological signs and deficit, headache, weight loss and vomiting and had single or multiple ring enhancing lesions on computed tomography [contrast CT brain film] were enrolled and entered in the study. CT scan brain was advised to evaluate any identified lesion and then certain specific biochemical tests were also advised to detect the particular existence etiological factor. The data was analyzed in SPSS 16 and the frequency and percentage was calculated. Results: During one year study period, total 50 subjects were detected as ring enhancing lesion on CT scan. The mean age +/-SD of the over all population was 28.87+/-4.84 whereas the mean age +/-SD of male and female population was 27.76+/-6.53 and 30.76+/-5.83 respectively. Ring enhancing lesions were right sided in 30 patients [60%], on the left side in 15 [30%] and bilateral lesions were identified in 6 subjects [10%] on brain imaging. Majority of the ring enhancing lesions were single 45 [90%] and the parietal lobe was observed as the commonest site. The headache, seizures, fever, pyramidal signs and papilledema was identified the common clinical features whereas the common etiological factors responsible for ring enhancing impression on brain CT scan were tuberculoma 17[34%], brain tumor 12[24%], metastasis 05[10%] and brain abscess 04[08%]. Conclusions: The male population was predominant while the seizure was observed as common clinical feature whereas the tuberculoma, brain tumour and metastasis are the common etiological factors responsible for ring enhancing lesion on brain imaging.