Recurrent cerebral infarctions in a young patient: combined protein c and s deficiencies

The possible etiologies of cerebral infarcts in young patients often present as diagnostic dilemmas as compared to older patients. Recently, deficiencies of fibrinolytic factors have emerged as an important etiology of stroke in the young population. Thrombophilic factors have been implicated in approximately 4 - 8% of the young strokes worldwide. Combined protein C and S deficiencies is a rare cause of recurrent ischaemic stroke in young population. Only a few sporadic cases have been reported in the literature. We are reporting a case of combined protein C and S deficiencyrelated recurrent ischaemic stroke in an 18 years old girl. Early diagnosis and targeted therapeutic management can help such patients to prevent recurrent thrombotic episodes.

clinicoepidemiological study of snakebite in Multan

Objective: To know the epidemiological characteristics of snakebite in and around Multan and to highlight various patterns of toxicity in sufferers of snake`s envenomation

Design: Descriptive, observational study

Place and duration of study: This study was conducted at Medical Unit-IV, Nishtar Hospital, Multan during the year 2002-2003

Patients and Methods: One hundred victims of snakebite from seven various districts around Multan, who were brought to Nishtar Hospital, Multan, irrespective of age, sex and previous medical therapy were included in this study. All victims of snakebite were examined and investigated to know the various patterns of toxicity

Results: Most of the victims [78%] were found to be sufferers of toxic bite, affected mostly on lower limbs [62%] and during night time [52%] of summer season. Hemotoxic snakes were the most common type of snakes [52%] causing envenomations. 90% patients recovered completely and a death rate of 6% and disability rate of 4% was observed

Conclusion: Morbidity and mortality from snakebite can be reduced by proper health education of the farmers, regarding importance of footwear and potential hazards of snakebite

Computerized tomography; a diagnostic help in hypertensive intracerebral haemorrhage

Hypertensive intracerebral haemorrhage is a serious condition with mortality over 50% while more than three fourths of the survivors are left with moderate to severe disability. OBJECTIVE: To find out the common anatomical sites of cerebral heamorrhage in hypertensives. SETTING: Nishtar Hospital Multan: PERIOD: January 1996 to December 1996. PATIENTS AND METHODS: 2420 C.T. Scans of brain were performed. 104[4.3%] of these patients suffered from spontaneous intracerebral haemorrhage. Hypertension was the etiology in 77[3%] patients. The size of clot, its location shift and intraventricular extension were critically, analyzed. 77 patients suffered from hypertensive intracerebral haemorrhage. 48[62%] were putaminal, 11[14%] thalamic, 6[8%] in caudate nucleus, 3[5%] in pons, 2[3%] in ventricles, 5[7%] in lobes and 2[3%] in cerebellum. Uncontrolled arterial hypertension is an important cause of spontaneous intracerebral haemorrhage. Putamen is the most common site with thalamus, caudate nucleus and pons following in that order. Emergency CT scan should be performed in all such patients