RESUMEN
Objective: To find out the association of Cerebrospinal Fluid [CSF] adenosine deaminase [ADA] Levels with tuberculosis meningitis
Study Design: Case control study
Place and Duration of Study: This study was conducted in the department of Medicine, Pak Emirates Military Hospital, Rawalpindi over a period of six months from May to Oct 2015
Material and Methods: One hundred and ten participants i.e. 55 cases and 55 controls were included in the study. Lumbar puncture were done and 2cc CSF was obtained. CSF for routine examination and ADA levels were sent to a single lab and pathologist verified report. Based on CSF report, patients were classified as tuberculous meningitis [TBM] and Non- tuberculous meningitis and comparative analysis of ADA level were done in both groups
Results: Mean age of the patients was 51.33 +/- 21.60 and 41.76 +/- 18.66 in tuberculosis meningitis and non-tuberculosis meningitis participants. In Tuberculous Meningitis patients, 33 [60.0 percent] were males while in non Tuberculous Meningitis participants, 35 [63.6 percent] were males. Mean ADA level in CSF [13.71 +/- 4.25 vs. 4.76 +/- 3.49, p<0.001], cerebrospinal fluid [CSF] protein level [144.71 +/- 99.15 vs 58.27 +/- 15.62, p<0.001] and mean cell count [185.00 +/- 97.29 vs. 73.71 +/- 111.38, p<0.001] were significantly higher in Tuberculous meningitis patients as compared to non Tuberculous Meningitis participants. However, mean glucose was significantly [p<0.001] lower 29.42 +/- 8.63 in Tuberculous Meningitis patients in comparison to 57.38 +/- 9.13 non-tuberculous meningitis participants
Conclusion: In conclusion, the estimation of CSF-ADA level is a speedy and simple method, which can be confidently used for diagnosis of tuberculous etiology in TBM patients and differentiating it from non- tuberculous etiology
RESUMEN
This study was planned [a] to document the hospital morbidity and mortality of patients undergoing CABG surgery, who had preexisting renal impairment, [b] to document further deterioration in renal dysfunction in these patients.[c] to evaluate the safety profile of coronary artery by pass grafting [CABG] surgery in such patients. A total of 63 patients with documented chronic renal dysfunction underwent CABG. These patients were divided into three groups; [1] Those with serum creatinine level up to 3.5mg%. [2] Those with serum creatinine level more than 3.5mg%, and [3] those patients already on regular haemodialysis. The commonest cause of renal impairment was diabetes mellitus. Most of the patients did very well after surgery. Renal function deteriorated in significant number of patients. All these patients required an extended I. C. U and hospital stay. Low cardiac output, need for prolonged ventilation, fluid overload, thin coronaries and obesity were found to be the major risk factors for deterioration in renal function