RESUMO
Loop diuretics are often administered to hospitalized patients to augment urinary output. They play an essential role in the treatment of fluid overload in patients of congestive heart failure and chronic renal failure. Torsemide is a new loop diuretic that has revolutionized the therapy of fluid overload disorders. Torsemide has a higher bioavailability, greater potency and longer duration of action than frusemide. Torsemide causes significantly greater diuresis, natriuresis, lesser kaluresis, greater reduction in body weight and improvement in edema and ascites as compared to frusemide.
RESUMO
Aims: To analyze and evaluate ‘ring-enhancing’ appearance as a sign in the differential diagnosis of neurological lesions in the brain and clinically correlate such an appearance with patients’ mode of presentation, etiological factors, outcome and mode of management. Study Design: A cross-sectional study was done in 40 patients in whom ring-enhancing lesions were found on neuroimaging. They were retrospectively analyzed in view of their clinical presentation and investigative profile. Material and Methods: The study was conducted at the Dept. of Medicine, Shri Sayajirao General (SSG) Hospital, Vadodara, Gujarat. The study was conducted over a period of 24 months in 40 patients. Results: We observed that infective pathology was the most common etiology in patients with multiple ring-enhancing lesions of the brain. Tuberculosis (TB) and neurocysticercosis (NCC) were the most common infections. Neoplastic etiology was the commonest noninfective etiology. Conclusion: Our study establishes the role of TB as the leading cause of ring-enhancing lesions in the Indian setup as compared to tumors in the Western world. It might serve a basis for early recognition and intervention in these patients. We suggest that in patients with multiple ring-enhancing lesions of the brain, a CSF examination and imaging of chest should always be performed.