Related neurological adverse effects to metronidazole are rarely encountered in clinical practice despite its wide use as an antibacterial or antiparasitic agent. The neurotoxicity is not dose-dependent and is fully reversible with discontinuation of the drug. We describe a young man who was receiving metronidazole for an amoebic liver abscess and developed encephalopathy and seizures. Brain magnetic resonance imaging showed characteristic bilateral symmetrical cerebellar dentate hyperintensities.
Background: Liver plays a central role in glucose homeostasis. Chronic liver disease is associated with an increased incidence of insulin resistance (IR) and Diabetes Mellitus. Diabetes that develops as a complication of cirrhosis of liver is known as 'Hepatogenous diabetes (HD)'. This study was conducted to study the prevalence of insulin resistance in liver cirrhosis. Methods: One Hundered (100) non-diabetic patients of liver cirrhosis considering the inclusion and exclusion criteria and visiting both indoor and outpatient department of medicine, SGRDIMSAR were included in the study. All cirrhotic patients irrespective of etiology were subjected to fasting plasma glucose level and fasting plasma insulin levels and insulin resistance was calculated by HOMA-IR method. Study was statistically analyzed. Results: 79 out of 100 patients were found to have insulin resistance and increase in prevalence with grades of child pugh score were noted. Conclusions: Keeping in view the results of the study, we conclude that FPG and HbA1c are not sufficient in detecting glucose metabolism disorders in cirrhosis. As insulin resistance can be used as an important prognostic marker in patients with cirrhosis of liver, serum insulin levels can be recommended as routine investigation in these patients. Diabetes mellitus increases the risk of HCC in cirrhosis patients. So, by early detection of diabetes mellitus by calculating insulin resistance with HOMA-IR method we can prevent progression of disease to development into HCC.
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