Human cysticercosis is an infection with the larval stage of Taenia solium and is commonly seen in developing countries. It usually involves the central nervous system but other organs like the heart, skeletal muscle and the orbit can also be involved. Rarely, the liver can also be the site of involvement. We report a case of a 25-year-old male with no premorbid illness but with a history of headache and vomiting. His physical and laboratory examinations suggested a diagnosis of tubercular meningitis. However, the high resolution ultrasound imaging of his abdomen showed that there were multiple cysticerci with scolices. IgG of cysticercosis detected by ELISA was also strongly positive, which supported the diagnosis of hepatic cysticercosis. He was managed with albendazole. This kind of cases has only been reported twice before in medical literature. It highlights the need to use high resolution ultrasonography in patients with a high index of suspicion of hepatic cysticercosis because of its occult presentation.

Out-of-hospital cardiac arrest (OHCA) patients require immediate cardiopulmonary resuscitation (CPR). Early initiation of CPR and defibrillation before arrival at Emergency Department (ED) increases the chance of survival from sudden cardiac arrest. The main objective of this study was to identify the factors that influenced the outcome of early cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OHCA) patients managed at the ED of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). The second objective was to determine the incidence of CPR initiated by the public prior to ambulance arrival. The present study was a one-year cross-sectional study. The OHCA patients were identified from the ED resuscitation logbook. Patients’ medical records were used to obtain details of the resuscitation. Factors recorded included: aetiology of arrest, initiation of on-scene CPR, use of automated external defibrillators (AEDs), mode of transportation and the incidence of return of spontaneous circulation (ROSC) in the ED. Categorical data was analysed using chi-square and Fisher exact tests. Nine patients out of 98 had early CPR. Three patients achieved ROSC. Gender was significantly associated with ROSC (p-value=0.015). More patients who received early CPR achieved ROSC compared to those who received late CPR. The provision of early CPR and usage of AEDs by the public is still low. Female gender had a positive influence on ROSC. Efforts are required to increase the awareness and involvement of the public in initiating early CPR prior to the arrival of ambulance service.
Cardiopulmonary Resuscitation