Frequency of asymptomatic spontaneous bacterial peritonitis in patients of liver cirrhosis with ascites

To determine the frequency of asymptomatic spontaneous bacterial peritonitis in patients of liver cirrhosis with ascites. Descriptive study. The study was conducted at indoor and outpatient departments of Medicine, Military Hospital, Rawalpindi, Pakistan from 29[th] February 2008 to 28th August 2008. One hundred and ninety five patients of liver cirrhosis with ascites were selected. To standardize the study; patients of both genders over 18 years of age, diagnosed with liver cirrhosis and ascites were included in the study after obtaining their informed consent. Patients with abdominal tenderness and fever, hepatic encephalopathy, intra-abdominal surgically treatable cause, with any co-morbid disease [hypertension and diabetes mellitus] or refusing to give consent were excluded from the study. Strict inclusion/exclusion criteria were observed to control the confounding variables. Diagnosis of spontaneous bacterial peritonitis was based on increased ascitic fluid absolute polymorphonuclear leukocyte [PMN] count [> 250 cells / mm[3]] and/or positive bacterial culture. Out of 195 patients, 10 patients [5%] had neutrocytic ascites [absolute neutrophil count > 250 cell/mm[3]]. Out of these 195 patients, three patients [1.5%] were found to have positive ascitic fluid culture. In our study the frequency of asymptomatic spontaneous bacterial peritonitis in patients of liver cirrhosis with ascites turned out to be 5% which is low. Therefore, analysis of ascitic fluid through diagnostic paracentesis should be reserved for inpatient or outpatient with clinically apparent new onset ascities or in cirrhotic patients with ascities whose general condition deteriorates

Types of anemia in patients with hemoglobin less than 10g/dl

To find out different types of anemia in patients with hemoglobin less than 10 g/dl in relation to age and sex in Rawalpindi region. A descriptive study. This study was carried at Military Hospital Rawalpindi and Armed Forces Institute of Pathology Rawalpindi from February 1997 to March 1998. Patients above 12 years of age from both sexes with hemoglobin less than 10g/dl were randomly selected for the study. Patients suffering from other hematological diseases such as leukemia, myeloproliferative/lymphoproliferative disorders were excluded. Total 208 anemic patients were included in the study. History and physical findings were recorded. Laboratory investigations such as blood complete counts, red blood cells morphology, bone marrow examination and other relevant investigations where indicated for diagnosis were carried out. Iron deficiency anemia was found to be the most common type [n=68, 32.69%] of anemia. In 12-45 years age group, iron deficiency anemia was found in 54 [35.29%] cases, followed by megaloblastic anemia in 23 [15.03%] cases. In age group 46 years and above, megaloblastic anemia was found in 16 [29.09%] cases followed by iron deficiency anemia in 14 [25.45%] cases. Nutritional anemias are the most common types of anemia in our population. Iron deficiency is the commonest type present in females of reproductive age. Megaloblastic anemia was the commonest types of anemia in individuals of either sex over 46 years of age

Anemia and intestinal parasitic infestations in school children in Skardu

Anemia and intestinal parasitic infestations are major medical and public health problems in Pakistan. This study was carried out to determine the frequency of anemia, intestinal parasitic infestations and possible correlation between two in Skardu district of Northern Areas. This study included 978 school children in the villages of Alchori, Kharmang, Hamzigound and Dassu of district Skardu under school health care program 2004. Stool smears were prepared with normal saline and each sample was studied under light microscope using 10x and 40x objectives. Free flowing 20 ul capillary bloods by prick method was taken from each student and hemoglobin estimation was done by Cyanmethemoglobin method. Out of 978 specimens, 537 [54.91%] revealed the presence of either cysts or ova of the intestinal parasites. Out of 543 parasites isolated, the most common parasite isolated was Ascaris lumbricoides 193 [35.54%] followed by Giardia lamblia 168 [30.94%], Entamoeba histolytica 59 [10.87%], Trichuris trichura 46 [8.47%], Ankylostoma duodenale 32 [5.89%], Hymenolepsis nana 31 [5.71%], Entrobius vermicularis 11 [2.02%] and Taenia species 3 [0.55%]. Three hundred and sixty two students [37.01%] had anaemia out of 978 students. Out of the 362 children with anemia, 283 [78.18%] were positive for intestinal parasites. Out of these 978, 623 [63.70%] were males and 355 [36.30%] were females. They were further subdivided on the basis of age into two groups. Six hundred and thirty three [64.72%] students were in 5-10 years age group and 345 [35.28%] in 11-15 years age group. The present study revealed the high percentage of intestinal parasitic infestation associated with anemia in school children of district Skardu