Clinical Features of Autosomal Dominant Polycystic Kidney Disease (ADPKD) Among Bangladeshi Patients in a Tertiary Care Center

To observe the clinical nature of ADPKD in Bangladeshipatients we studied 40 cases, among them 16 (40%) weremale and 24 (60%) female. A higher proportion of younger thanolder patients were affected (40% Vs 10%, P<0.05).Hypertension and loin pain was present in 30 (75%) and 22(55%) cases respectively. Renal function at presentation wasnormal in 20 (50%) cases, with mild to moderate and severerenal failure was present in 16 (40%) and 4 (10%) casesrespectively. Bilateral enlarged kidneys found in 30 (70%)cases. Size of kidneys varies from 12.1cm to 25.6cm. Multiplecysts in both kidneys were present in 36 (90%) patients, withhepatic and pancreatic cyst was present in 15 (37.5%) and 3(7.5%) cases respectively. Much younger patients arediagnosed as ADPKD in our population, so every effort shouldbe made for early diagnosis in suspected cases so that needfor dialysis may be reduced by retarding rate of progression byconservative measures.

Acute Postpartum Pulmonary Edema in a 32-Year-Old Woman Five Days after Cesarean Delivery.

Acute dyspnea after pregnancy is a rare presentation, and a number of important conditions may accompany it. Pulmonary embolism, amniotic fluid embolism, pneumonia, aspiration and pulmonary edema are some of the potential causes that must be considered. The percentage of pregnancies that are complicated by acute pulmonary edema has been estimated 0.08%. The most common contributing factors include the administration of tocolytic agents, underlying cardiac disease, iatrogenic fluid overload and preeclampsia. Here we report a case of 32- year-old woman of 5th postpartum day following lower uterine cesarean section with acute dyspnea from her first pregnancy who was admitted in coronary care unit with history of one episode of raised blood pressure 160/90 mm Hg and cough on 1st postoperative day. Clinical examination and relevant investigations explored that it was a case of bilateral pulmonary edema. Patient was kept in ventilator and was treated with nitroglycerine (GTN), frusemide and ACE inhibitor. After diuresis, considerable improvement was observed in her respiratory status. From the 4th day, the patient became hemodynamically stable and was weaned off the ventilator. After five days, all the biochemical parameters became normal and she had no dyspnea.

Diabetic foot infections and their management in a tertiary care hospital

Diabetic foot is a common complication of diabetes world over. We conducted this study to determine common microbiological pathogens in Diabetic Foot Infections [DFI] at a tertiary care hospital and their management. In this observational study deep wound swabs of all admitted diabetic patients were taken, pathogens isolated, antibiotic used and its response depending on complete resolution of symptoms and biochemical markers were recorded. Data were analysed on SPSS-11. A total of 114 cases were recorded. Sixty-eight [59%] cases had ulcers on forefoot, 28 [25%] mid-foot and 18 [16%] hind-foot. One hundred and four pathogens were isolated from wound swabs after debridement. Commonest pathogen isolated was Staphylococcus aureus [52, 46%] followed by E. coli [11, 10%], MRSA was found in 10 [9%] cases, streptococcus in 6 [5%] and pseudomonas in 5 [4%] cases. Polymicrobial infection was also seen in a few cases. Surgical intervention included superficial debridement in 88 [77%] cases, toe amputation/forefoot amputation in 19 [17%] cases, and below/above knee [major] amputation in 7 [6%] cases. Commonest antibiotic used was Cefoperazone/Sulbactam in 43 [38%] cases, alone or in combination, followed by Ceftraixone 36 [33%] cases. Linezolid was used for MRSA. Ninety-four [82%] patients responded to treatment and were recorded as 'cured'. Diabetic Foot ulcers often present with serious foot infections. Commonest pathogens are Staph. aureus, E. coli, Pseudomonas spp. and MRSA. Treatment was effective with Cefoperazone/Sulbactam and Ceftraixone. MRSA was treated successfully with Linezolid

Prevalence of hepatitis-C antibodies amongst nursing staff working in a tertiary care hospital

To determine the prevalence of HCV infection amongst nursing staff working in a tertiary care hospital. Simple descriptive study of prevalence. Nursing staff of Nishtar Hospital Multan. 152 senior nursing staff working in all wards of Nishtar Hospital Multan. Diagnosis of HCV infection was made by detection of antibodies to HCV in serum [ACON Hepatitis C Virus Rapid Test Strip, Serum]. Those nurses whose test was positive by the above technique, underwent second generation Elisa testing for Hepatitis C to confirm the diagnosis [Cobas Core Anti-HCV EIA]. Study was conducted upon 152 nursing staffs working in different wards of Nishtar Hospital Multan, which is a tertiary care hospital. These 152 staff nurses were checked for anti-HCV and only 3 cases were positive [1.97%] and 149 negative [98.03%]. Study shows that the prevalence of HCV infection among nursing staff is 1.097%, which is low as compared to other studies but higher in comparison to the general population of Multan [0.27%]. It is recommended that both private and public health care systems to increase the awareness. The health care workers should strictly follow appropriate preventive measures