Prevalence of diarrhoea and use of oral rehydration salt in children of rural and urban areas of Peshawar

To find out the prevalence of diarrhoea and use of oral rehydration salt [ORS] for the management of diarrhoea in rural and urban areas of Peshawar. Two areas from Peshawar districts, one rural [Palosi] and one urban [academy-town] were selected. Hundred parents from each area were interviewed based on a specially designed questionnaire. The data regarding prevalence of diarrhoea and type and mode of delivery of ORS was collected in addition to educational and socioeconomic background. Prevalence of diarrhoea was found to be more in rural area [27%] as compared to urban area [16%]. Use of ORS was more in urban area [99%] as compared to rural area [40%]. Similarly awareness regarding use of ORS was found to be more in urban area [93%] than rural are [32%]. Diarrhoea was more common in the rural area while the use of ORS and the awareness regarding use of ORS was more in the urban area

Renal biopsy: an effective and safe diagnostic procedure

This study was conducted to know the frequency of various complications of percutaneous renal biopsy [PRB] and to find out its diagnostic yield in terms of enough material for diagnosis. We conducted this study at the department of Nephrology; Khyber Teaching Hospital Peshawar, from 1st January 2003 to 31st December 2004. PRB were performed on native kidneys with ultrasound guidance. All the patients were observed for 24 hours after the biopsy for any complications. Once the report of the biopsy was available, we recorded further information regarding diagnosis and adequacy of biopsy. We analyzed 200 percutaneous renal biopsy procedures. There were no complications in 90% of biopsies [n=180]. Only 8% [n=16/200] of the cases had minor complications and 2% [n=4/200] had major complications including gross haematuria requiring blood transfusion and catheterization for clot retention. Definitive diagnosis was made in 96% [n=192] of biopsies. Two percent [n=4] had inadequate biopsy or medullary sample. No patient sustained major complications like infections, nephrectomy and death. We conclude that PRB with automatic biopsy needle and ultrasound guidance is a very effective and safe procedure for the definitive diagnosis of renal diseases

role of branch chain amino acids [aminoleban] in the management of hepatic encephalopathy

To find out the efficacy of branch chain amino acids [Aminoleban] in the reversal / improvement of hepatic encephalopathy due to chronic liver disease [CLD] presenting with grade 3 and 4 hepatic coma. This descriptive study was carried out at the Department of Medicine, Saidu Teaching Hospital, Swat from 1st July 2005 to 31st December 2005. Patients meeting the criteria were enrolled by nonprobability convenient sampling method. Aminoleban was administered, transfusing two consecutive infusions [500 ml each] daily for 3 consecutive days only. The changes in the mental state were evaluated on day 1, 2 and 3 following Aminoleban therapy. A total of 50 patients [30 males and 20 females] with mean age of 51.3 years were recruited. The duration of CLD was 1-2 years in 25 patients [50%], 2-5 years in 15 patients [30%] and >5 years in 10 patients [20%]. Forty patients [80%] had first episode of hepatic encephalopathy. Complete reversal of hepatic encephalopathy was observed in 25 patients [50%] at end of 3rd day and there was no change in the grade of the coma in 15 patients [30%]. Grade of coma aggravated in 10 [20%] patients. Majority of non-responders [n=10] were having >5 years of duration of CLD. The parentral use of branch chain amino acids [Aminoleban] is reasonably effective treatment modality in the reversal of first episode of hepatic encephalopathy especially with shorter duration of CLD

Arteriovenous fistula construction in chronic haemodialysis patients: comparison of end-to-side and side-to-side techniques

To compare the techniques of end-to-side and side-to-side anastomosis in arteriovenous fistulae construction in terms of success rate and immediate postoperative complications. Design: Comparative study. Place and Duration of Study: Ayub Hospital Complex, Abbottabad, from October 1999 to December 2002 and Khyber Teaching Hospital, Peshawar, from January 2003 to December 2003. Patients and One hundred and ninety patients with end stage renal disease [ESRD] were included in the study. Arteriovenous fistula was constructed in these patients by two techniques i.e. end-to-side and side-to-side anastomosis. The two methods were compared in terms of duration of surgery, immediate success rate and short-term complications. Among 190 patients, 118 [62%] were males and 72 [38%] females. The age ranged between 24 to 66 years with average age of 54 years. Side-to-side anastomosis was done in 120 [63%] patients while end-to-side in 70 [37%] patients. The average duration of surgery in side-to-side group was 50 minutes and in end-to-side group it was 75 minutes. Bleeding occurred in 4[5.7%] cases in end-to-side group and 2[1.7%] patients in side-to-side group requiring reexploration. The immediate failure rate of the procedure was 2.5% in side-to-side group and 7.5% in end-to-side group. Wound infection occurred in 1[1.4%] case in end-to-side group and 2[1.7%] cases in side-to-side group. In patients with end stage renal disease [ESRD] arteriovenous fistula construction by side-to-side anastomosis is less time-consuming and has less complications as compared to end-to-side technique