study of medical management of liver abscess

Liver abscess is a common problem in our country. There are different treatment modalities depending upon site and size of the abscess. This study was conducted on 25 patients. It was a case series study. The patients were evaluated with detailed history, physical examination and investigations. The diagnosis was made ultrasonographically. In amoebic liver abscess metronidazole 800 mg TDS was given whereas in pyogenic liver abscess and in conditions where distinction was not possible, antibiotics used were Cripple therapy consisting of ampicillin [500 mg 8 hourly], Gentamycin [80 mg 8 hourly] and metronidazole [800 mg TDS]. Percutaneous aspiration was attempted in 12 cases and was successful in 10 cases. In 16 patients [64%] abscess was present in left lobe. In 3 patients [12%] abscess was present in both lobes. Thirteen patients [52%] showed good response to medical treatment alone. Aspiration was attempted in 12 patients and it was successful in 10 [83%]. Two cases were referred for surgery. Results of aspiration show that 3 [30%] had pyogenic abscess whereas 7 cases [70%] had amoebic, abscess. Multiple aspirations were done in 2 patients. The clinical features responded quickly within 48 hours to intravenous metronidazole and after 10 days of the same treatment, patients became mostly symptom free e.g. fever, vomiting or pain. The addition of chloroquine worked favourably towards, resolution of abscess without causing any significant side effects. Side effects observed were metallic taste [70%], anorexia, nausea [62%] and vomiting [15%]. It was relieved by symptomatic treatment. It is concluded that small abscesses respond well to drug therapy alone. Large abscesses are managed with percutaneous aspiration under ultrasound guidance alongwith medical treatment. Ultrasound guided drainage of large liver abscess, as a primary procedure is very useful. There is very little morbidity and the hospital stay is reduced

Assessment of renal functions during 1[st] trimester of pregnancy

Design: A Case Control Study. Purpose: 1. To obtain basic information about the serum levels of different metabolic nitrogenous end products during pregnancy. 2. To determine the renal function alterations during 1[st] trimester of normal pregnancy under local conditions. Study Period: Study was done at Quaid-e-Azam Medical College, Bahawalpur during the year 1999-2000

Material and Methods: Subjects in group-B having normal pregnancy of 1st trimester was taken. No restriction on diet, fluid intake, socioeconomic status or physical activity was imposed. Pregnant woman having hypertension, renal disease, diabetes and any other complication like toxemia of pregnancy were excluded from this study. Diagnosis was carried out on the basis of history, physical examination and local examination performed by the gynaecologist and on laboratory investigation. In control group-A age matched subjects without pregnancy were selected from general population. Most of the controls were selected amongst the students and staff member of QAMC, Bahawalpur. In this group 26 subjects were taken. Renal function was assessed from 24 hours urine collection and morning blood serum samples and the values of creatinine clearance were corrected for body surface area in each case. Data was analysed by SPSS processor

Results: In this study total 44 females were included. [group-A [control] 26 Non-pregnant women and group-B [case] 18 pregnant women in their 1[st] trimester] the rise in GFR [endogenous creatinine clearance] and urinary levels of creatinine was high in case as compared to control group. A small difference in urine specific gravity and urine volume was observed in two groups. A statistically significant change was observed. However the endogenous creatinine clearance [ECC] showed a great variability

Biochemical Parameters: Table-III gives the mean value + SD of serum levels of creatinine, urea, uric acid, glucose and albumin in control [Non-pregnant women] and case [pregnant woman in 1[st] trimester]. Serum level of creatinine, uric acid and albumin was found to decrease in pregnant women. Serum glucose level tends to increase in pregnant women group

Effect of amlodpine on lipid profile

Introduction: Now a days Calcium channel blockers and Beta blockers are widely used for the treatment of essential hypertension. Beta blockers have been observed to increase the serum cholesterol, serum triglycerides and serum LDL cholesterol levels, calcium channel blockers have been noted to have a beneficial effect on lipid profile. Setting: In outpatient clinic of Bahawal Victoria Hospital, Bahawalpur Period: From 1[st] Sep 2003 to 31 Mar 2004 [three months]

Material and Methods: Blood pressure, systolic and diastolic, and lipid profile [Serum cholesterol, LDL cholesterol, HDL cholesterol and serum triglycerides] were investigated in patients receiving Amlodipine therapy. This was a 3 months follow-up study, which was carried on 90 patients. The effects of drugs were assessed at various time intervals. Second generation Calcium channel blocker, Amlodipine, which is widely used for treatment of Hypertension was selected to observe its effect on serum lipid profile in various patients

Results: The mean systolic and diastolic blood pressure decreased from 158 mm Hg and 104.4 mm Hg to 122.26 mm Hg and 38.56 mm Hg respectively after 90 days of treatment with Amlodipine. The fall in serum cholesterol level [mg/dl] and LDL-cholesterol [mg/dl] was from 188.13 and 125.40 to 170.76 and 105.7 after respectively after 90 days

Conclusion: Amlodipine significantly reduced blood pressure, decreased the level of serum cholesterol and LDL cholesterol but did not affect significantly the HDL cholesterol and serum triglycerides