Dengue fever; an audit of risk factors among patients reporting at a tertiary care hospital in Hyderabad

Background: Dengue fever and its complications have become a nightmare for common people in Asian countries including Pakistan. Besides environmental factors responsible for its transmission, there are many host factors too involved in its rapid spread

Objective: To assess risk factors for dengue fever among patients reporting at Liaquat University Hospital [LUH] Hyderabad. Study Design, Setting and Study duration: Descriptive cross sectional study was conducted at LUH, Hyderabad for six months i.e. from 15[th] May 2013 to 15[th] November 2013

Methods: 481 patients were registered through convenient sampling after informed verbal consent. Patients' demographic features, clinical presentations and laboratory reports were collected on a preformed proforma

Results: The reporting rate for dengue fever was 18.5% and the mean age of presentation was 28.5 +/- 3.5 years. Males were in majority [72.55%] 3 and the average days of admission were 4.5 days; low platelets count [< 50,000/mm[3]] was recorded in 72% of cases; however 11.64% patients presented with hemorrhagic tendency. Age was strongly associated with thrombocytopenia [p=0.04] and with occurrence of hemorrhage [p=0.03] in both genders; this association was more evident among males [p=0.01]. However among uncomplicated cases no association was evident between gender and length of stay in [p=0.35]

Conclusions: The alarmingly higher reporting rate of dengue fever necessitates contextual preventive interventions. As younger age and male gender are the major risk factors for this disease; therefore age-specific and gender-specific preventive strategies against this disease are recommended

18 years follow-up results of mitral balloon valvuloplasty in 531 consecutive patients and predictors of long-term outcome

Long-term echocardiographic follow-up studies of mitral balloon valvuloplasty [MBV] are scarce. The study aim was to assess the long-term results [up to 18 years] of MBV and to identify predictors of restenosis and event-free survival. The immediate and long-term clinical and echocardiographic results for 531 consecutive patients [mean age 31 +/- 11 years] who underwent successful MBV for severe mitral stenosis [MS] and were followed up for a mean of 8.5 +/- 4.8 years [range: 1 .5 to 18 years] after MBV are reported. Immediately after MBV, the mitral valve area [MVA] was increased from 0.92 +/- 0.17 cm[2] to 1.95 +/- 0.29 cm[2] [p< 0.0001]. Restenosis occurred in 165 patients [31%], and was less frequent [19%] in patients with a low mitral echo score [MES 8 [p< 0.001]. Event-free survival [death, redo MBV, mitral valve replacement, NYHA class III or IV] at 10, 15 and 18 years was 88 +/- 1%, 53 +/- 4%, and 21 +/- 5% respectively, and was significantly higher for patients with MES 8 [p< 0.0001] and previous surgery [p= 0.043] as predictors of restenosis, and MES >8 [p< 0.0001] and baseline atrial fibrillation [p=0.03] as predictors of combined events. MBV provides excellent long-term results for selected patients with MS. The long-term outcome of this procedure can be predicted from the baseline clinical and echocardiographic characteristics of the mitral valve

Prevalnce of iron defeciency and thalassaemia trait in children at paediatric department of L.U.H.

Aims and To assess the prevalence of Iron deficiency and thalassaemia trait in children attending Paediatric Department of Liaquat University Hospital. Subject and Setting: 50 children from paediatric ward and 50 from paediatric O.P.D were selected by simple randomization. Both males and females from 9 months to 10 years were included during study period of November 2002 to Jan 2003. Study was conducted in Liaquat University Hospital which is a tertiary care referral hospital. All investigations were carried out in new research pathology laboratory of Liaquat University Hospital. Clinical history and examination was done in all cases and 3 investigations including complete blood count, serum iron levels and haemoglobin electrophoresis were conducted in all cases. Iron deficiency with serum iron < 20mcg /dl was seen in 51% of cases with no significant difference between male and females, but was documented to be lowest in < 5 years old compared to 5-10 years age. 74% children were anaemic with severe anaemia [Hb < 6gm/dl] in 7% moderate anaemia [Hb- 6-9gm/dl] in 28% both more commonly documented in admitted cases. Prevalence of thalassaemia trait was 11%, with 2 more cases diagnosed as thalassaemia intermedia. Raised Hb A2 was considered as a normal variant with normal absolute valves in further 7% cases. Both iron deficiency anaemia and thalassaemia trait are common in our paediatric population. We need health education nutritional counselling and iron supplementation to prevent iron deficiency especially in view of recent association of iron deficiency with delayed growth, development and behaviour problems. Thalassaemia also needs proper screening and prevention as yet no effective or easily available curative treatment is possible