Etiology and epidemiology of patients presenting with liver disease during pregnancy

We conducted this study to elaborate the etiology and epidemiology of liver diseases presenting during pregnancy. It was a prospective, observational study. This study was conducted in the Department of Gastroenterology, Fatima Memorial Hospital in collaboration with the Department of Obstetrics and Gynaecology from June 2011 -May 2013. 73 patients were evaluated. Data was evaluated for quantitative and qualitative variables. Outcome of mother, pregnancy and neonates was also recorded were available. During the study period 73 pregnant patients were evaluated for the presence of liver disease giving an incidence of 3.6%. The mean age of the patients was 26.3 +/- 3.8 [median: 26, range: 16 - 45] years. The patients presented at a mean gestational age of 5.8 +/- 2.4 [median: 6, range: 1- 9] months. The mean STB and ALT levelswere 11.5 +/- 8.5 [median: 9.3, range: 1.4 - 48] mg/dL and 943.5 +/- 887.4 [median: 765, range: 13 - 4810] IU/Lrespectively. The mean duration of jaundice and mean hospital stay were 6.82 +/- 5.32 [median: 5, range: 2 - 30] days and 5.6 +/- 2.7 [median: 5, range: 1-18] days. Fulminant hepatic failure was seen in 6.8% of the patients. Acute Hepatitis E was the most frequent diagnosis in our population. Maternal deaths were seen in 8.2%, foetal deaths were seen in 12.3% and neonatal deaths in 6.5%. Liver diseases during pregnancy can have multiple causes and may predict poor outcomes for the patients and neonates

Thrombocytopenia and platelets transfusion in Dengue fever

This study was done to see how much prevalent is thrombocytopenia and need and indications of platelets transfusion in patients with dengue fever in our community hospitals, This study was done from I[th], September 2010 to 15[th], November 2010 in three different hospitals, two were urban and one was rural and all three were tertiary care hospitals, Our study was based on 200 patients who were serologically confirmed cases for Dengue fever [IgM +ive] and had symptoms and signs of dengue fever for more than four to seven days at the time of admission. Clinical data reports of hematological investigations, platelets requirements, and data obtained from daily follow up, were analyzed. There were 200 serologically confirmed Dengue fever patients, among them 176 were males, 24 females, 183 patients were urban and 17 were rural patients. Thrombocytopenia was found in 174 [87%] on the day of admission. Among them 48 [24%] patients had platelets count in between 20, 000 to 40, 000/cumm, 46 [23%] had platelets count <20, 000/cumm, and 4 [2%] had platelets count <10, 000/cumm. Patients having platelets count <20, 000/cumm all have hemorrhage manifestations. Out of 48 [24%] patients having platelets count in between 20, 000 to 40, 000/cumm, 21[43%] had hemorrhagic manifestations. 98[49%] patients were given platelets transfusion. None of these patients got platelets transfusion with platelets count above 40, 000/cumm. 27 patients received platelets therapy inappropriately [platelets count < 40, 000/cumm with no hemorrhagic manifestations. There was only 2 mortality in these patients. Our study suggests that bleeding occurs more often in patients with severe thrombocytopenia [platelets count <20, 000/cumm] and these patients need urgent platelets transfusion. Patients having platelets count in between 20, 000-40, 000/cumm are at moderate risk and these patients require platelets transfUsion if they have hemorrhagic manifestation. Platelets count above 40, 000/cumm are at low risk and no need of platelets transfusion in these patients, only these patients need careful monitoring

Renal outcome in patients with pre-eclampsia and eclampsia at presentation, three and six months postpartum

To assess the natural history of Renal Disease in patients with Pre-eclampsia or Eclampsia. It was an observational study. This study was conducted simultaneously at two tertiary care hospitals: Fatima Memorial Hospital, l.ahore and Bhatti International leaching Hospital, Kasur from March 2009 to January 2011 women presented with pre-eclampsia or/ and eclampsia were consectively selected for the study fulfilling the inclusion criteria. A total number of 220 patients were eniolled in this study. All parameters required f'or the study were done carefully as blood pressure, proteinurla, renal function tests, urinary creatinine, weight, primary or multiparous, any previous history of pre-eclampsia. These parameters are checked at three and then six months post delivery. Among 220 patients, 140 [63.6%] were primigravida and 80 [36.4%] were multigravida. Blood pressure was from 140/90 to 210/110mmHg average blood pressure was 175100. 195 [8863%] patients had deranged renal function tests and 215 [97%] patients had protelnuria >2+. At Three months post-delivery 151[68.6%] patients achieved normal blood pressure and 190[86.3%] had normal serum creatinine i-e < 1.4. At six months 161 [73.8%] got adequate control of blood pressure, 59 [26.81%] had blood pressure > 140/90. Serum creatinine became in normal range in 195 [88.63%]. Acute renal failure was observed in 6 patents who weie put on renal replacement therapy