C-reactive protien and lactate dehydrogenase in serum and cerebrospinal fluid in rapid and early diagnosis of childhood meningitis

Bacterial meningitis is still a life threatening epidemiological problem especially in many developing countries; considering its dire consequences, its prompt and accurate diagnosis has become a priority for clinicians. Because of the various limitations of conventionally used laboratory techniques, we evaluated and compared the diagnostic utility of C-reactive protein and lactate dehydrogenase in serum and cerebrospinal fluid in the diagnosis of bacterial meningitis and its effectivity in distinguishing it from aseptic meningitis. A total of 125 pediatric cases, aged between 1 month and 12 years, including patients with bacterial meningitis [n=45], aseptic meningitis [n=42] and a control group [n=38], were retrospectively analyzed on the basis of data from the initial clinical examinations. Cultures, smears and other common serum and CSF indices were compared with serum and CSF CRP levels and LDH activity. Compared with each of the other variables, there were significant differences in the mean values of serum-CRP, CSF-glucose, CSF-LDH and CSF/serum LDH ratio between the bacterial and aseptic meningitis groups [p<0.001]. Of all the tests applied, the highest sensitivity [95%] and negative predictive value [95%] belonged to CSF-LDH activity and the most specific [100%] test with the highest positive predictive value [100%] was CSF-CRP titration as well as smear and culture. Combination of CSF-CRP serum-CRP, and CSF-LDH yielded the highest sensitivity [100%] and negative predictive value but the combined application of CSF-LDH and CSF-CRP proved to be the most specific and efficient. In the presence of a normal CRP titration and low glucose level in CSF, bacterial meningitis is excluded, whereas elevated level of CSF-LDH activity is a valid confirmatory predictor of BM. In addition, combination of these three tests with serum CRP is far more effective than the separate determination of any of these parameters

[Dyslipidemia and it's relation with smoking in Tehran]

Dyslipidemia and smoking are among the most important medical problems in human society. Their share in the mortality of coronary heart disease [CHD] has led to multiple investigations about them. This study was done to determine the prevalence of dyslipidemia and the effect of cigarette usage on it. This epidemiological cross-sectional study was carried out on 9632 persons selected randomly in Tehran urban with a minimum age of 20 years and over. We measured fasting blood sugar, blood sugar 2 hours after 75 grams oral glucose, triglyceride, total cholesterol, LDL cholesterol, HDL cholesterol. Degree of physical activity was registered according to Lipid Research Clinics classification. Anthropometrics data, social condition, family history and smoking exactly delineated. Our patients were divided into: those having normal lipid profile and primary dyslipidemia [without any risk factor for dyslipidemia] and secondary dyslipidemia [having one or more risk factors such as diabetes mellitus]. ANOVA, t.test, and logistic were used to analyze the level of significance. Our population sample consisted of 5619 female and 4013 male. 68.5% of our cases had dyslipidemia. 65.8% of females and 72.3% of males had at least one type of dyslipidemia. There were 1085 smokers [11.4%] that 73.2% of them were dyslipidemic. With comparing smokers to nonsmokers shows that in smokers HDL.cholesterol, LDL.cholesterol and total cholesterol had decreased and triglyceride increased [p<0.05]. Tehran population suffers from dyslipidemia. Large number of secondary dyslipidemia and smoking highlighted the importance of education to overcome to these preventable and modifiable factors