Tuberculous and cryptococcal meningitis in a setting with high TB and low HIV prevalence

To compare the differences in presentation and outcome of patients with tuberculous meningitis [TBM] and cryptococcal meningitis [CCM]. Case series. The Aga Khan University Hospital, Karachi, from December 1995 to December 2005. Patients with a confirmed diagnosis of TBM or CCM were included in this study. The signs and symptoms, laboratory findings and other variables of patients were entered and analyzed by Statistical Package for Social Sciences [SPSS] Software version 14. We compared 16 patients of TBM with 11 of CCM. None of the patients with TBM were Human Immunodeficiency Virus [HIV] positive while 4 patients with CCM had HIV. The common initial signs and symptoms in patients with TBM were fever, altered mental status and headache; and in patients with CCM were fever, headache and cough. The mean CSF glucose level decreased according to the Medical Research Council [MRC] stage in TBM. The mean CSF RBCs, WBCs, glucose and protein in TBM were 2010/mm[3], 228/mm[3], 52.32 mg/dL and 289.48mg/dl respectively and in CCM were 178.54 mm[3], 529.54/mm[3], 32.63 mg/dL and 432.18 mg/dL respectively. TBM and CCM should be suspected in all cases that present with symptoms of chronic meningitis. Patients with TBM are more likely to have altered mental status and higher CSF RBCs; those with CCM are more likely to have headache, cough and higher CSF WBCs

Latest approaches to the diagnosis and management of food allergies in children

Adverse food reactions are a challenge for physicians. As the prevalence of this condition rises, it is important that paediatricians and other health care professionals adeptly diagnose this condition. We begin by discussing the relevant points in history and physical examination, then we discuss the recent effective diagnostic tests and techniques available for doctors and patients, along with several management options. Over the last decade, there have been major advancements in this field and novel mechanisms have been proposed which efficiently modulate immune mechanisms involved. Although results are only preliminary, they do however, indicate a promising future for patients with food allergies