BACKGROUND Meningitis often presents as a medical emergency which requires rapid and prompt diagnosis with aggressive management to select appropriate therapy to prevent mortality and long-term morbidity. Sometimes clinical signs and symptoms, results of routine CSF analysis and radiological findings are inadequate in making a definitive diagnosis of meningitis. On the other hand, tests like ELISA, Gram's and AFB stain of CSF are although rapid techniques for detection of organism, have disadvantages of cost, availability and sensitivity respectively. With GeneXpert, diagnosis of Mycobacterium tuberculosis and RIF resistance is now available in less than 2 hours but again has disadvantage of cost and availability. In such circumstances, the determination of CSF CRP appears to provide a new dimension to the additional supportive diagnosis of the type of meningitis. METHODS The study was carried out on 90 patients admitted in the

Background: Various risk factors for development of hypertension, both modifiable and non modifiable ,have been identified to aid in its prevention and management. In recent years, various studies have shown serum uric acid (UA) levels to be an independent predictor for developing hypertension. This study determined the uric acid level in hypertensive patients and established a relation between hypertension and uric acid level. Materials and methods: It was a case control study done from 1 st March 2018 to 31 st August 2018,which included a total of 80 newly diagnosed hypertensive cases and 80 normotensive controls matched for age and sex admitted in the Department of Medicine GMCH. The cases were classified into the various stages of hypertension as per the JNC-7 classification criteria.One way ANOVA analysis was performed to compare the differences in mean serum uric acid levels in the various categories. Results: The mean serum uric acid level among the controls was 5.09±1.33 mg/ dl while among the cases was 5.72±1.35 mg/dl. Among the cases, mean serum uric acid in stage 1 and stage 2 HTN were 5.15±0.97 and 6.35±1.45 mg/dl respectively. There was statistically significant differences among the 3 groups, i.e between stage 1 and stage 2 HTN, between control group and stage 1 HTN and between control group and stage 2 HTN, with a p value <.05. Conclusion: There was statistically significant differences between mean serum uric acid levels of newly diagnosed hypertensive cases and age and sex matched normotensive healthy controls and it tends to rise with the severity of hypertension.

Introduction: Bacterial infections represents one of the most important precipitating event for acute decompensation and mortality in a case of cirrhosis of liver. Patients with cirrhosis are highly susceptible for bacterial infections and their severe courses. Infections occur more often in advanced stage of liver disease, impair hepatic function, trigger the onset of complications, and are significant factors of mortality as well. Gastrointestinal hemorrhage confers a higher risk for infections and infections play important role in provoking of variceal bleeding episodes and can also be associated with the failure to control bleeding. The incidence and severity of infection in cirrhosis is greater than in the population without cirrhosis. Infection with multi resistant organisms is common in cirrhosis and its occurrence is associated with higher mortality rates than in patients without cirrhosis. The endorgan damaging effect of bacterial infection is greater in patients with cirrhosis due to altered sensitivity, which often culminates in acute-on-chronic liver failure. Delays in the diagnosis and start of treatment results in higher mortality particularly in hypotensive patients with cirrhosis. Materials and methods: This was a hospital based observational, descriptive study to find data on bacterial infection in 123 cirrhotic patients. Results: Bacterial infection was present in 41(33.33%) patients of study population. SBP was the most common (39.02%) bacterial infection documented. In hospital mortality was highest with Child Pugh Class C (50%). Conclusion: With increase in Child Pugh Class, bacterial infections and in hospital mortality increases.