Evaluation of Trifarotene 50 ?g/g Cream in the Treatment of Facial and Truncal Acne Vulgaris: A Single Centre Study

Background: Acne vulgaris is a frequent skin condition of the face and trunk that negatively influences the quality of life. It frequently impacts the face, shoulders, chest, and back, however, the cure for nonfacial acne has no longer been fastidiously studied. Trifarotene is a new first-in-class fourth-generation topical retinoid that has been uniquely studied in the treatment of each facial and truncal acne. Through selective agonism of the retinoic acid receptor (RAR)-?, the most predominant RAR-? isotype in the epidermis, trifarotene exerts extra targeted, skin-specific outcomes than earlier-generation retinoids. The aim of the study to assess the safety and efficacy of trifarotene 50 ?g/g cream, a novel topical retinoid, in moderate facial and truncal acne.Material & Methods:Clinical samples were analyzed between 36 weeks in Shahid Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh. The patient informations and sources were retrospectively collected. 120 patients were detected in the department of Skin & venereal disease, at Shahid Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh. This cross-sectional study was done among patients to the evaluation of trifarotene 50 ?g/g cream in the treatment of facial and truncal acne vulgaris.Results:Out of 120 patients, the study population of patients according to age, where 46(38.33%) were 12 to 20 years and 74(61.67%) were 21 to 30 years. And according to sex, where 60% were female and 40% were male. Most of the patients belong to the female.Conclusion:We focus on efficacy, safety, and tolerability records and highlight exceptional life outcomes and patient-reported satisfaction. Future medical trials and the clinical applicability of this novel medication in the treatment of acne are additionally discussed.

Cell cannibalism: a diagnostic and prognostic marker of breast cancer

Background: Cell cannibalism (cytophagocytosis) is defined as a tumor cell within a tumor cell, such that smaller tumor cells are found in the cytoplasm of larger tumor cells with crescent shaped nuclei. Aims and Objectives were to study the cytomorphological characters of cell cannibalism in primary and metastatic breast cancer, to correlate the histologic type and grade of tumors with positive rate of cannibalism and to study the role of Cannibalism as an independent prognostic factor in breast cancer.Methods: The study was conducted during the period of July 2003 to June 2005 in the Department of Surgery and Pathology, JNMCH, Aligarh. A total of 42 cases were included in the study. A minimum of 3 FNAC smears per case were assessed for cytophagocytosis. Presence of metastasis was also noted to establish the cytological grade and aggressiveness of the tumor.Results: Out of 42 cases, significant cannibalistic activity was noted in 30 (71.42%) cases. All grade III (33.4%) breast tumors were found positive for cytophagocytosis (4.28/smear), while the rate was much lower (2.33/smear) in grade II and (1.63/smear) in grade I tumors. LN metastasis was confirmed by histopathological examination in all high grade tumors showing significant cannibalistic activity.Conclusions: Cannibalism in breast carcinoma is an indicator of both the anaplastic grade and invasiveness. The rate of cytophagocytosis may have a prognostic significance.

Transfusion, mortality and hemoglobin level: associations among emergency department patients in Kigali, Rwanda

Background: Studies from high-income countries (HIC) support restrictive blood transfusion thresholds in medical patients. In low- and middle-income countries (LMIC), the etiologies of anemia and baseline health states differ greatly; optimal transfusion thresholds are unknown. This study evaluated the association of packed red blood cell (PRBC) transfusion with mortality outcomes across hemoglobin levels amongst emergency center (EC) patients presenting with medical pathology in Kigali, Rwanda. Methods: This retrospective cohort study was performed using a random sample of patients presenting to the EC at the University Teaching Hospital of Kigali. Patients ≥15 years of age, treated for medical emergencies during 2013­16, with EC hemoglobin measurements were included. The relationship between EC PRBC transfusion and patient mortality was evaluated using logistic regression, with stratified analyses performed at hemoglobin levels of 7 mg/dL and 5 mg/dL. Results: Of 3609 cases sampled, 1116 met inclusion. The median age was 42 years (IQR 29, 60) and 45.2% were female. Transfusion occurred in 12.1% of patients. Hematologic (24.4%) and gastrointestinal pathologies (20.7%) were the primary diagnoses of those transfused. Proportional mortality was higher amongst those receiving transfusions, although not statistically significant (23.7% vs 17.0%, p=0.06). No significant difference in adjusted odds of overall mortality by PRBC transfusion was found. In stratified analysis, patients receiving EC transfusions with a hemoglobin >5.0 mg/dL, had 2.21 times the odds of mortality (95% CI 1.51­3.21) as compared to those ≤5.0 mg/dL. Conclusions: No association between PRBC transfusion and odds of mortality was observed amongst EC patients in this LMIC setting. An increased mortality association was found for patients receiving PRBC transfusions with an initial hemoglobin >5 mg/dL. Results suggest benefits from PRBC transfusion are limited as compared to HIC. Further research evaluating emergent transfusion thresholds for medical pathologies should be performed in LMICs to guide practice

Impact of Chronic Kidney Disease on Outcomes in Transcatheter Aortic Valve Implantation

INTRODUCTION@#Chronic kidney disease (CKD) is a significant comorbidity in aortic stenosis (AS) patients. We examined the impact of baseline CKD, postoperative acute kidney injury (AKI) and CKD progression on clinical outcomes in patients who underwent transcatheter aortic valve implantation (TAVI).@*MATERIALS AND METHODS@#Consecutive patients with severe AS who underwent TAVI were classified into CKD stages 1-2 (≥60 mL/min/1.72m), 3 (30-59 mL/min/1.73m) and 4-5 (<30 mL/min/1.73m or dialysis) based on estimated glomerular filtration rate (eGFR). Primary outcome was mortality and secondary outcomes included 1-year echocardiographic data on aortic valve area (AVA), mean pressure gradient (MPG) and aortic regurgitation (AR).@*RESULTS@#A total of 216 patients were included. Higher eGFR was associated with lower overall mortality (adjusted hazards ratio [AHR] 0.981, 95% confidence interval [CI] 0.968-0.993, = 0.002). CKD 4-5 were associated with significantly higher mortality from non-cardiovascular causes ( <0.05). Patients with CKD 3-5 had higher incidence of moderate AR than those with CKD 1-2 ( = 0.010); no difference in AVA and MPG was seen. AKI patients had higher mortality ( = 0.008), but the effect was attenuated on multivariate analysis (AHR 1.823, 95% CI 0.977-3.403, = 0.059). Patients with CKD progression also had significantly higher mortality (AHR 2.969, 95% CI 1.373-6.420, = 0.006).@*CONCLUSION@#CKD in severe AS patients undergoing TAVI portends significantly higher mortality and morbidity. Renal disease progression impacts negatively on outcomes and identifies a challenging subgroup of patients for optimal management.

Noncommunicable Disease Risk Factors Among Adolescent Boys and Girls in Bangladesh: Evidence From a National Survey

Objectives@#To assess the prevalence of noncommunicable disease (NCD) risk factors and the factors associated with the coexistence of multiple risk factors (≥ 2 risk factors) among adolescent boys and girls in Bangladesh. @*Methods@#Data on selected NCD risk factors collected from face to face interviews of 4,907 boys and 4,865 girls in the national Nutrition Surveillance round 2018-2019, was used. Descriptive analysis and multivariable logistic regression were performed. @*Results@#The prevalence of insufficient fruit and vegetable intake, inadequate physical activity, tobacco use, and being overweight/obese was 90.72%, 29.03%, 4.57%, and 6.04%, respectively among boys; and 94.32%, 50.33%, 0.43%, and 8.03%, respectively among girls. Multiple risk factors were present among 34.87% of boys and 51.74% of girls. Younger age (p < 0.001), non-slum urban (p < 0.001) and slum residence (p < 0.001), higher paternal education (p = 0.001), and depression (p < 0.001) were associated with the coexistence of multiple risk factors in both boys and girls. Additionally, higher maternal education (p < 0.001) and richest wealth quintile (p = 0.023) were associated with the coexistence of multiple risk factors in girls. @*Conclusion@#The government should integrate specific services into the existing health and non-health programs which are aimed at reducing the burden of NCD risk factors.

Noncommunicable Disease Risk Factors Among Adolescent Boys and Girls in Bangladesh: Evidence From a National Survey

Objectives@#To assess the prevalence of noncommunicable disease (NCD) risk factors and the factors associated with the coexistence of multiple risk factors (≥ 2 risk factors) among adolescent boys and girls in Bangladesh. @*Methods@#Data on selected NCD risk factors collected from face to face interviews of 4,907 boys and 4,865 girls in the national Nutrition Surveillance round 2018-2019, was used. Descriptive analysis and multivariable logistic regression were performed. @*Results@#The prevalence of insufficient fruit and vegetable intake, inadequate physical activity, tobacco use, and being overweight/obese was 90.72%, 29.03%, 4.57%, and 6.04%, respectively among boys; and 94.32%, 50.33%, 0.43%, and 8.03%, respectively among girls. Multiple risk factors were present among 34.87% of boys and 51.74% of girls. Younger age (p < 0.001), non-slum urban (p < 0.001) and slum residence (p < 0.001), higher paternal education (p = 0.001), and depression (p < 0.001) were associated with the coexistence of multiple risk factors in both boys and girls. Additionally, higher maternal education (p < 0.001) and richest wealth quintile (p = 0.023) were associated with the coexistence of multiple risk factors in girls. @*Conclusion@#The government should integrate specific services into the existing health and non-health programs which are aimed at reducing the burden of NCD risk factors.

Liver abscess: demographic, clinical, biochemical, imaging and microbial spectrum

Background: Liver abscesses are localized suppurative destruction of liver tissue due to infections of either bacterial (Pyogenic) or protozoa (Amoebic). Historically; pyogenic liver abscess has been described since the time of hippocrates (400 BC). Despite the more aggressive approach to treatment, the mortality rate remained at 60-80%.Methods: This Cross-sectional analytical study carried out at Department of Medicine, Al-Tibri Medical College Hospital, Karachi, from June 2017 to December 2018. All participants of either gender with diagnosis of liver abscess were included in this prospective study. Patients with co morbidities like malignancy, autoimmune disease or on immunosuppressive treatment for any reason were excluded from the study. Following confirmation of the diagnosis; different characteristics of either type of liver abscess like demographic, clinical features, biochemical and imaging findings were evaluated.Results: Data of 73 subjects, 65(89.0%) males and 08(11.0%) females were analyzed with mean age was 45.42±14.518 years. Fifty-four (73.97%) patients had pyogenic liver abscess while amoebic liver abscess was found in 19(26.03%) subjects. Clinically, the most common symptom was abdominal pain, found in 66(90.4%) subjects, followed by fever in 61(83.6%), hepatomegaly in 47(64.4%), jaundice in 18(24.7%) and vomiting in 10(13.7%) cases. Demographics and clinical features are shown in (Table 1).Conclusions: Local trends have been changing and majority of liver abscess were of pyogenic liver abscesses. Clinically, clear differentiation between two types of abscesses is not possible always but few manifestations like typical symptoms, raised alkaline phosphatase and leucocytosis may be helpful.

Technical varieties of Ross procedure: a case series

Replacement of aortic valve with the pulmonary autograft is carried out through the Ross procedure due to its potential for growth, durability in pediatric population, and absence of anticoagulation. This case series reports the postoperative outcome of two technical variations of Ross procedure in eight patients who underwent surgery from January 2007 to December 2016. The dominant valvular hemodynamic indication was aortic regurgitation. The techniques employed for Ross procedure included free standing root replacement in six patients and modified root replacement with autograft stabilisation using Dacron interposition graft in two patients. Right ventricular outflow tract [RVOT] conduit reconstruction was achieved by utilisation of Contegra bio prosthesis in four patients; and use of manually constructed valved conduit comprising of PTFE [polytetrafluoroethelene] membrane and bovine pericardial tube in remaining four patients. There was no mortality and no re-intervention. The technical varieties of Ross procedure offer freedom from need of anti-coagulation, mortality, and RVOT conduit failure in younger adults

Comparison between intravenous boluses versus infusion of tranexamic acid [TXA] to reduce bleeding in paediatric cyanotic congenital heart disease [CHD] surgeries

Objective: To compare the intravenous boluses and intravenous continuous infusion of tranexamic acid [TXA] to reduce postoperative bleeding in cyanotic congenital heart disease surgeries

Study Design: Single-blinded randomised clinical trial

Place and Duration of Study: Anaesthesia Department, The Aga Khan University Hospital, Karachi, from July 2016 to April 2017

Methodology: Sixty patients of cyanotic congenital heart disease, undergoing either palliative or corrective surgery involving cardiopulmonary bypass [CPB], were recruited. These 60 patients were divided randomly into two groups. The infusion group received intravenous infusion of TXA at 5 mg/kg/hour while the bolus group received three intravenous boluses of 10 mg/kg after induction, after going to bypass and after protamine reversal. Data was collected through predesigned proforma. There were two primary outcomes: postoperative bleeding in the first 24 hours, and chest closure time

Results: Postoperative bleeding was 13.94 [10.27-20.18] ml/kg in the first 24 hours in infusion group and 15.05 [9.04-23.50] ml/kg in the bolus group. Chest closure time was 38.5 [25-45] in infusion group and 30 [20-46.25] minutes in the bolus group. There was no statistically significant and clinical difference between both groups regarding postoperative bleeding in the first 24 hours and chest closure time

Conclusion: These infusion and bolus groups had comparable postoperative bleeding and chest closure time

Accuracy of echocardiography in diagnosing total anomalous pulmonary venous return

Objective: Total anomalous pulmonary venous return is an uncommon cyanotic congenital heart defect. Echocardiography is the initial diagnostic tool. Complimentary non-invasive modalities like cardiac computerized tomographic angiography and cardiac magnetic resonance imaging have replaced the need for cardiac catheterization in difficult cases. This study aimed to determine the accuracy of echocardiography in diagnosing total anomalous pulmonary venous return, and to determine the factors that may decrease its sensitivity

Methods: This was a cross-sectional study conducted at the Aga Khan University Hospital Karachi, Pakistan from January 2010 to August 2016. All patients who were diagnosed with Total anomalous pulmonary venous return on echocardiography and had subsequent confirmation either on cardiac CT angiography or surgery were included. The diagnostic accuracy of echocardiography was expressed as sensitivity. Previously described taxonomy was used to define diagnostic error. Univariate and multivariate analysis were done by logistic regression OR [95 percent CI] were reported to identify factors causing the diagnostic error

Results: High diagnostic sensitivity [81 percent] was found in isolated total anomalous pulmonary venous return and low [27 percent] in heterotaxy and mixed [20 percent] varieties. Poor acoustic windows and right isomerism were found to be significant factors responsible for the diagnostic error on multivariate analysis

Conclusion: Echocardiography can diagnose isolated total anomalous pulmonary venous return with high accuracy. Use of additional modalities may be required for a complete diagnosis in cases with mixed variety, heterotaxy and poor acoustic windows

Barriers to exclusive breastfeeding in children under 6 months of age in district kasur

Objectives: The objectives of my study were to identify major factors which prevent mothers to breastfeed their infants in the first six months and to analyze the behavioral constraints to develop a suitable strategy for strengthening the practices of exclusive breastfeeding

Study Design: Descriptive Study

Methodology: The study was conducted on 37 subjects, who were mothers with young children under six months of age and were not breastfeeding their children due to any reason. The study was based on direct interview taken at DHQ Hospital Kasur and BHU Rao Khan Wala in the district Kasur. The interviews lasted for about half an hour with each subject. Subjects who were breastfeeding regularly or who were HIV, Hepatitis and other diseases positive were not included. The interviews were conducted in a separate room with least disturbance. Quantitative data like age was presented by mean and standard deviation while qualitative data education, profession were presented by frequency and percentages. SPSS [version 20] software was used for data analysis

Results: The mean age of infants of group [62.1%] was of 2.2 months ± 0.7 and other group of infants [37.9%] was of mean age 5.2 months +/- 0.6. The mean weight [kg] and standard deviation of the index children at birth was 3.1 [kg] +/- 0.2. Among index infants 37.8% were male infants and 62.2% were female infants. By place of birth of children, 75.6% births took place in a health facility. 32.4% mothers were illiterate. 13.5% mothers were on job. Only 83.7% females had fed colostrum to their infants. 62.1% mothers were those who never fed their infants. 27.0% were those who initially fed their infants for short period of time and then stopped feeding who fed irregularly was 10.8%. Important factor identified was insufficient milk production [65.2%] with significance of p-value = <0.05 and Sickness of mothers and consequently advised by doctor to avoid breastfeeding to their infants, was contributing [52.1%] with significance value p= <0.05 among mothers who never breastfed their infants under six months of age

Conclusion: Inadequate milk production and mothers' sickness were most commonly stated factors

Early detection of chronic obstructive pulmonary disease in apparently healthy attendants of tertiary care hospital and assessment of its severity

Objective: Early detection of Chronic Obstructive Pulmonary Disease in apparently healthy attendants of tertiary care hospital and assessment of its severity

Study Design: Cross-sectional, observational study

Place and Duration of Study: Study was conducted from January 2015 to July 2015 at Dow University Hospital, Ojha campus

Methodology: A screening method was designed for apparently healthy individuals including attendants of patients, hospital staff, faculty and students, belonging to age group 18-60 years after excluding severe obesity and already diagnosed respiratory and cardiovascular diseases by means of history. Each participant performed pulmonary function tests via spirometer after filling a questionnaire based on various risk factors and symptoms of chronic obstructive pulmonary disease [COPD]. Data was entered and analysed by SPSS-20

Results: Out of the 517 participants, 122 [23.6%] were found to have COPD diagnosed by means of spirometry. Out of these, 23 [4.4%] had COPD stage I, 42 [8.1%] had COPD II, 34 [6.6%] had COPD III, and 23 [4.4%] had COPD IV. Exposure to smoking, wooden stoves, pesticides, biomass fuel, aerosol sprays, gas grill and vehicle exhaust were found to be statistically significant factors in relation to development of COPD

Conclusion: Apparently healthy individuals may have underlying COPD and active screening by means of spirometry plays vital role in early detection of COPD. Smoking and exposure to certain hazardous environmental pollutants are responsible for the development and progression of COPD

Frequency of hepatic hydrothorax and its association with child pugh class in liver cirrhosis patients

Objective: To determine the frequency of hepatic hydrothorax and its association with Child Pugh Class in patients with liver cirrhosis

Study Design: Descriptive, analytical study

Place and Duration of Study: Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-Ill, [Ward- 7], from June 2012 to May 2013

Methodology: All patients with established diagnosis of decompensated chronic liver disease were included. Detailed history, thorough physical examination, routine laboratory investigations, chest X-ray and abdominal ultrasound were carried out in all patients to find out the presence of pleural effusion and ascites, respectively. Fifty milliliters of pleural fluid was aspirated in all patients with pleural effusion using the transthoracic approach, taking ultrasound guidance, wherever required. Fluid was sent for microscopic, biochemical, and microbial analysis. SBEM defined if pleural fluid with polymorphonuclear [PMN] cell count > 500 cells/mm[3] or positive culture with PMN cell count > 250 cells/mm[3] with exclusion of a parapneumonic effusion

Results: Two hundred and six patients met the inclusion criteria, with mean age of 41.25 +/- 13.59 years. Among them, 149 [72.3%] were males and 57 [27.7%] females. Twenty-three [11.2%] had hydrothorax; right sided involvement was in 18 [78.3%] subjects, 3 [13%] had left sided while bilateral pleural effusion was found in 2 [8.7%] cases. SBEM was found in 07 [30.43%] cases. Mean serum albumin 3.125 +/- 0.71 gram/dl. There was association between serum albumin levels and hydrothorax. A significant association of hydrothorax with Child Pugh scoring system [p=0.018], but not with serum albumin [p=0.15]

Conclusion: The frequency of hepatic hydrothorax has a significant association with hepatic function as assessed by Child Pugh scoring system, but not with serum albumin

Fixation of intertrochanteric intertrochanteric femoral fractures femoral fractures by dynamic hip screw

Objective: Aim of the study was to evaluate the results of DHS fixation union rate, complications and functional outcome

Study Design: Experimental / clinical trial study

Place and Duration of Study: This study was carried out at Bolan Medical Complex Hospital Quetta from January 2014 to December 2015

Materials and Methods: 45 patients were surgically treated with use of dynamic hip screw [DHS] to stabilize the intertrochanteric fractures. Out of total 45 patients 35 [74%] were males and 10[14%] females. Age ranged between 25 -71 years average 63.9 years. Most common mode of injury was mixed in 28 patients. All the cases were classified according to Jensen's classification. All the cases were performed under image use of 135' angle plate with hip screw

Results: Out of 45 patients 03 patients died, two in the hospital and I at home. It was observed that patients from rural areas arrived late [19.8 days] after their injuries and these from urban areas reached within two days and thus affected the reduction and operation time

Time lapse between the injury and operation was 11.7 days. Overall union time was 20.02 weeks

No nonunion was seen

Complications were seen in 12 patients

Conclusion: Excellent to good results were achieved in 96% of cases which concludes that DHS is bio-mechanically stronger and better implant for fixation of intertrochanteric fractures

Management of developmental dysplasia of hip in older children by triple procedure

Objective: To review the presentation and evaluate the radiographic and functional outcome of developmental dysplasia of hip [DDH] in older children treated by triple procedure surgery, consisted of open reduction, Salter Innominate Osteotomy [SIO], femoral shortening and derotation Osteotomy

Study Design: Observational / descriptive study

Place and Duration of Study: This study was conducted at the BMC Hospital Quetta from January 2013 to December 2015

Materials and Methods: We assess the efficacy and safety of underwent triple procedure treatment of DDH in older children. The study series comprising 22 patients [25 hips].Patients were classified pre-operatively according to the Tonnis Classification, and post-operative functional evaluation was performed using modified Mackay's scoring system, while radiographic assessment considered Severin scoring method

Results: The average age at presentation was 5.60 years and the male to female ratio was 2:46 months. While the average follow-up were 16.4 months. The final outcome was successful in 19 hips [76%] in 16 patients. Patients younger than 5-6 years of age had a better radiological and clinical outcome as compared to older children. Although in the outcome of clinical and radiological assessment there were no significant different between group-I and group-II

Conclusions: Late presentation of DDH is still common in Quetta, Balochistan, which necessitates Triple procedure operative management given frequent occurrences of best result in younger children. Early diagnosis and surgical interventions is therefore imperative in the successful treatment of patients suffering from DDH

Giant ethmoidal sinus osteoma with intraorbital extension: a case report.

Osteoma is the most frequent benign tumor of paranasal sinuses. Usually osteomas are asymptomatic and discovered incidentally during radiological imaging for other reasons. A giant osteoma with intraorbital extension is rare. Plain radiograph may be useful; however CT scan is the best modality of investigation for diagnosing and treatment planning. In asymptomatic osteomas, serial follow-up can be done. Surgery is performed in the presence of symptoms and signs. We report a case of 60 years old woman with a large osteoma of right ethmoid sinus extending into the ipsilateral orbital cavity.

Assessment of OPD patient's satisfaction with health care services at Al-Nafees medical hospital

Objective: To determine socio-demographic profile among the OPD patients and the overall satisfaction level of the patients utilizing the OPD

Study Design: A descriptive cross sectional study

Place and Duration: Conducted in OPD of Al-Nafees Hospital Islamabad from 12th January -12th March 2015

Methodology: Through convenient sampling a closed ended structured questionnaire was employed to collect the quantitative data. OPD patients aged 18-64 who showed willingness to participate were included in the study. Indoor patients, patients below 18 and above 64 and those who were not willing were excluded

Results: The study was conducted on 209 patients. Overall satisfaction level of patients with the OPD health services was 86.2%. Satisfaction level was found to be more in females than males. 42.6% had a family income of >15000 Rupees but satisfaction level with OPD services was same among respondents falling in different categories of family income. Patients with primary level of education were more satisfied. 41.1% waited 15-30 minutes for the examination by the doctor. 89% of the patients were satisfied from the registration staff. 73.3% were satisfied with doctor's service. The satisfaction level from the nurses was 64.6%. 63.3% were satisfied from the services provided by the pharmacy. 63.2% said that the medical expenses were affordable. 88% of the patients agreed upon the cleanliness of the building of the hospital and 77% stated that that signs and boards were easy to follow

Conclusion: In the current study it was found that majority of respondents were highly satisfied with the OPD services offered at Al-Nafees Hospital. Patients were satisfied with the behavior of registration staff, Physicians' communication skills, waiting time for examination, nursing care, pharmacy services and logistic arrangements

Study is about the prevalence of the HCV disease and survival of HCV patients with associated factors in the population of district Multan

To find out the significant factors associated with HCV disease and evaluate the impact of these factors on the survival patternof HCV patients in district Multan. The study was conducted in Nishter Hospital of Multan district from 1[st] January 2011 to l[st]October 2012. To see a significant difference between the survival rates of patients with associated factors, non-parametric Cox- proportional hazard model with their graphical results were used. All the patients above 11 years old of both sexes were included in the study. All those who were surviving with HCV diseasewere studied with their associated factors such as age, family history [FH] barber/parlor services, blood group [BG] types weight loss [WL], Gender and drug use were collected from Nishter Hospital Multan. Results indicated that age, blood group types and gender are the most significant factors in the patients who are surviving with HCV disease. It was also observed that survival rate of female patients is high as compare to male patients

Temporary hemodialysis; taurolidine lock to prevent catheter-related blood stream infections

Catheter related blood stream infections [CRBSI] in patients undergoing hemodialysis frequently results in significant morbidity and mortality. Attempts at prevention of CRBSI by catheter lock antibiotics, antibiotic combinations or solutions including Taurolidine have emerged over years. Objectives: To determine the role of taurolidine lock in presentation of Catheter related infection in hemodialysis. Design: Multicentre un-builded, r and omized controlled, non-inferiority trail. Period: Jul 2012 to Dec 2013. Setting: Department of Nephrology, Fatima Memorial Hospital UHS Lahore. Methods: It was a multicentre, un-blinded, r and omized controlled, non-inferiority trial. Results: Out of 95 patients, total of 38 patients were r and omized into two groups. In group A catheters were locked with Taurolidine 2% and Heparin [5000IU/ml] equal to the catheter volume according to the protocol. In group B [control] catheters were locked with Heparin alone. 36 patients completed the study protocol. For primary end point analysis [30 days] the mean duration of catheter days was 27.25 + 5.5 days [median 30 days]. During this period of follow up only one patient from Group B had CRBSI resulting in a point incidence of CRBSI of 2.7%. Conclusions: Catheter lock with Taurolidine 2% in combination with heparin compared to heparin alone had no additional benefit in prevention of CRBSI. This however needs to be evaluated in a larger study using non cuffed temporary vascular access [TVA]

HCV; prevalence in the population of district Multan Pakistan

To find out the risk factors associated with HCV disease and evaluate the association of risk factors of HCV disease patient's in the population of Multan District. Experimental study. Nishter Hospital of Multan District. 1[st] January 2011 to 1[st] April 2012. 540 patients with ages 11 to 90 years old of both sexes were included in this study. All those who were surviving with HCV disease were studied with their associated risk factors such as age, family history; barber/parlor services, blood group types, drug use and weight loss were collected. For the data analysis, descriptive and Chi-square analysis are used to determine the association between risk factors and HCV. Results shows that out of 540 patients surviving with HCV, out of which 48% are female and 52% are males. The mean age for male and female was 37 +/- 12.62 and 34 +/- 11.22 respectively. Results showing that blood groups types and age of the patients were significantly related to the HCV survival status at 5% level of significance. The study shows that HCV patients with blood group "O' patients are maximum as compared to other groups. HCV is more common in males as compare to female. Persons who are above 30 years old were more affected with HCV disease. Age and blood group types are the most significant factors in the patients who are surviving with HCV disease