RESUMEN
From January 1996 to January 2000, twenty-five patients were diagnosed to have idiopathic intracranial hypertension at our institution. Twenty-three were females and two were males with age range of 13-43 years. Main presenting features were headache (100%), vomiting (44%), blurred vision (36%), diplopia (28%), neck pain (12%), and transient visual obscuration (12%). Duration of symptoms before diagnosis ranged from one week to 8 months. Nine patients had cranial nerve involvement. Seventeen patients were obese, 3 were using oral contraceptives and one patient had . taken tetracycline for 4 months for acne and other was taking Vit. A 50,000 units twice daily for 9 months. All patients had papilloedema. CT and MRI brain were done in all to exclude intracranial pathology. Patients were followed up every two to three months. At five years follow up, 19 were symptom-free with normal vision and 6 had residual visual deficit. Idiopathic intracranial hypertension once diagnosed necessitates regular follow-up to avoid permanent visual loss.
RESUMEN
Twelve episodes ofsevere metabolic acidosis were observed among 10 maintenance dialysis patients using Bicarbonate Haemodialysis (HDB). Patients were stable at the start of haemodialysis (HO) and became sick during or following the procedure. The main clinical features observed were abdominal pain and vomiting, hypotension or shock, and CNS manifestations. Laboratory investigations revealed severe metabolic acidosis in all and hyperkalemia in 4 patients. On four occasions, dialysate fluid sample analysis revealed purely acidic dialysate being delivered to the patients. Patients were treated by sodium bicarbonate, redia lysis on another machine and vasopressors when severely hypotensive. One patient died and the rest improved. This potentially lethal complication needs to be considered early in all patients who become sick during or following HOB.