Positive CT brain during early postoperative period in head injury patients: impact on clinical course and outcome

Objectives: To assess the impact of positive postoperative CT head during the initial 72 hours on overall clinical course and outcome

Methodology: 157 patients of head trauma who underwent cranial surgery were prospectively included. All patients underwent a repeat head CT during the initial 72 hours or as was indicated by neurological status of the patient. Data was collected about patient demographics, initial CT diagnosis, repeat CT findings, re-operation if performed, GCS at discharge, mortality and outcome in terms of GOS. Data was analysed for impact of positive finding in postoperative CT head and its impact on clinical course and outcome

Results: The overall mean age was 34.25 +/-11.59 years with a mean arrival GCS of 9.2 +/-2.32. The mean time to first postoperative CT was 21.45 +/-9.83 hours. The postoperative CT scan was positive in 29 [18.5%] patients in which 16 [10.2%] cases required re-intervention. Overall mortality was 19 [12.1%], of which 9 [44.1%] had a positive post-operative CT scan and 4 [21.1%] of them underwent a repeat intervention. 2.3% of patients with negative CT were re-operated while 44.8% were re-operated in the positive CT [p <0.0001]. Similarly, mortality was 7.8% in the negative CT group while it was 31.0% in the positive CT group [p <0.0001]

Conclusions: Positive follow-up CT scan during early post-operative period can affect significantly the clinical course and neurological outcome of patients

Antimicrobial and toxicological studies of Ochthochloa compressa plant

The present study demonstrates the biological activity of Ochthochloa compressa, since extensive literature survey has shown no documented biological activity of this plant. Ethanolic extract of whole plant was prepared and evaporated under reduced pressure by rota vapor

The crude extract was further fractionated into n- hexane, dichloromethane, ethyl acetate and n-butanol soluble fractions

These fractions were screened for antifungal, phytotoxic, cytotoxic and antibacterial activities

Dichloromethane soluble fraction showed significant phytotoxicity whereas n-hexane, ethyl acetate, and n-butanol soluble fractions showed non-significant phytotoxicity

Similarly, ethyl acetate soluble fraction was the only fraction, which showed significant cytotoxic activity

There was no antibacterial but moderate antifungal activity was shown by these fractions against selected strains of bacteria and fungi. This is the first report on the biological activity of O. compressa

Platelet count / splenic size ratio: a parameter to predict the presence of oesophageal varices in cirrhotics

350 million people are infected with Hepatitis B virus [HBV] and 60 million people with Hepatitis C virus [HCV]. Chronic infection by these viruses leads to cirrhosis of liver and hepato-cellular carcinoma [HCC]. Esophageal varices develop in cirrhotic patients which can be demonstrated by invasive methods or predicted by non-invasive methods. An observational, Cross sectional study was conducted in Medical Unit-IV, Liver Center of District Head Quarters Hospital and Medical units of Allied Hospital, Faisalabad for 6 months from 23 May 2007 to 22 November 2007. The study was conducted on 100 patients diagnosed as post viral cirrhosis of liver of either sex between 25 -70 years of age. The ratio between platelet count and spleen size was calculated .The mean ratio for those with esophageal varices was found to be 650 [100 -1614] and for those without esophageal varices, the mean value of the ratio was calculated to be 2453 [1600-3483], which was significantly different [p<0.05]. Non-invasive markers have been used to predict varices in cirrhotic patients. Cirrhotics with esophageal varices have a significantly lower platelet count and a significantly greater ultrasonographic spleen size as compared to those patients of liver cirrhosis without esophageal varices [13,14] a fact also consistant with our study [p < 0.05]