Abdominal tuberculosis diagnosed on Gallium scintigraphy in a child with pyrexia of unknown origin

We report a case of an eleven year old girl with pyrexia of unknown origin whose illness remained undiagnosed after extensive investigations. We were able to localize the disease to abdomen with a Gallium Whole Body Scan. In the background of a history of tuberculosis in a family member in an endemic area, empirical anti-tuberculosis treatment was given with clinical success that was also demonstrated on a repeat Gallium scan four months later

Characteristics of diabetic patients and pattern of diabetic complications

The objective of our study was to elucidate and establish the basic characteristics of diabetic patients in Pakistani population and to determine the prevalence of micro and macrovascular complications in them. This was an observational study conducted in the diabetic clinic of Mayo Hospital, affiliated with King Edward Medical College Lahore. Six hundred and seventy patients attending diabetic clinic in the year 1996-97 were studied. We determined the basic characteristics of patients and diabetic complication on history, physical examination and investigations. A total of 670 patients [174 males and 496 females] were studied. Most of the patient's ages at the onset of diabetes ranged from 36-55 years, with the mean value of 41.1 t 13.5 years. Female to male ratio was 2.5:1. Fifty-four% of patients were overweight [BMI >25 kg/m2] and history of diabetes in first degree relatives was obtained in 46.7% of patients. Ninety one% had NIDDM and 9% IDDM. Out of the total, 22.3% had retinopathy, 14.6% had nephropathy while sensory and motor neuropathy was present in 40.6% and 29.1% respectively. History of angina pectoris was present in 16.4%, myocardial infarction in 5.5%, cerebrovascular accident in 5.8%, and 3.7% had peripheral vascular disease. Approximately 53% of the patients were hypertensive [systolic > 140 or diastolic >90]. Out of 112 patients with an early onset of disease [< 40 years] 8 had experienced ketoacidosis compared to 9 out of 503 [1.8"/0] who had late onset diabetes. Two hundred eighty nine [42.9%] patients required hospitalization, either for the control of diabetes or for the management of its complications. Seventy five% of the patients had at least one complication attributable to diabetes mellitus. We conclude that NIDDM is highly prevalent in our society with seventy five% of patients presenting with one or more complications. Needless to say that more attention given to good metabolic control can reduce the prevalence of diabetic Complications