Clinical pattern of cirrhotic ascities in the state of Qatar

Ascites is a common important feature of chronic liver disease and to determine the extent, causes, clinical presentation and nature of cirrhotic ascites in Qatar a descriptive, prospective study was made of 48 males and 14 females with cirrhotic ascites and a mean age of 56.2 "12.6 years admitted to the Medical Department, Hamad General Hospital between January 2004 and January 2005. Twenty six were Qatari, the remainder being of various nationalities. The most common cause of cirrhotic ascites was chronic alcoholism, found in 29 [46.8%] patients. Uncomplicated liver cirrhosis was found in 40 [64.5%] patients, complicated liver cirrhosis in 22 [35.5%] patients. At admission, encephalopathy, GI bleeding, and fever were found to be significantly associated with complicated cirrhotic ascites. Results of the study suggest that cirrhotic ascites is common in the State of Qatar with the most common causes being chronic alcoholism followed by chronic viral hepatitis C and B. It is suggested that efforts are needed to prevent and treat these two conditions

Tuberculous tenosynovitis: a rare presentation of miliary TB

We present, as a rare manifestation of miliary TB, a case of tuberculous tenosynovitis, preceding by two weeks onset of tuberculous meningitis. A gradual progressive onset of a painless swelling of the right forearm was followed by high-grade fever, headache and neck pain. A suspected diagnosis of tuberculous meningitis based upon analysis of cerebrospinal fluid [CSF] was confirmed later by positive CSF polymerase chain reaction [PCR] for mycobacterium tuberculosis. Although the patient had a positive Mantoux test of 20 mm, there was no evidence of pulmonary TB and a negative CSF smear for acid fast bacilli but a positive smear from a fine needle aspirate of the swelling of the right forearm. The antituberculous therapy led to a successful outcome

Pravastatin induced myopathy

Lipid-lowering agents such as HMG-CoA reductase inhibitors [also known as statin drugs] are generally well tolerated. But a recognized side effect still can happen, We report a case of 47-year-old Iraqi male patient previously known hypothyroid, was not on replacement therapy, as he did not appear after his thyroid functions was checked came in with severe body pain for 10 months got worse in the last three months, started on lipostat [ten months ago] found to have myopathy as evident by high CPK which improved gradually clinically and biochemical after stopping lipostat

IgA kappa chain myeloma with cast nephropathy in a man with type 2 diabetes mellitus and retinopathy

A 68-year-old gentleman with a long history of type 2 diabetes mellitus and recurrent multidrug resistant urinary tract infection and a recent history of a carbuncle, presented with a one week history of fever and dysuria. Laboratory results included erythrocyte rouleaux formation, ESR 121 mm/h, creatinine 217umol/l, total protein 83 g/l, albumin 32g/l, and Bence- Jones protein in k urine. Skull X-ray showed multiple lytic lesions. Serum frotein electrophoresis showed a monoclonal band of 33g/l of IgA kappa, IgG 665 mg/dl, and IgM 26.9 mg/dl. Bone marrow aspirate showed an infiltration of plasma cells. Renal biopsy showed a mild cast nephropathy with mild diabetic glomerular disease. The patient was assessed as stage IIIB multiple myeloma IgA kappa type and was started on chemotherapy MP protocol [oral Melphalan 5 mg/sq m body surface area plus oral prednisolone 60mg/sq m body surface area for four days every four weeks] after which he became stable