Frequency of spontaneous bacterial peritonitis in hospitalized patients with cirrhosis and hypoalbuminemia

Background: Spontaneous bacterial peritonitis [SBP] is one of the complications in patients of cirrhosis. These patients when exposed to infection are likely to develop SBP. Various studies refer its frequency to around 30%, yet no study has estimated its frequency in hospitalized cirrhotic patients with serum albumin <3.5 g/dl

Objectives: To find out the frequency of SBP in hospitalized patients with cirrhosis and hypoalbuminemia

Methodology: This cross sectional study was conducted in Medical wards of Mayo hospital, Lahore from August 2010 to January 2011. A total of 110 cirrhotic patients recently hospitalized and having serum albumin < 3.5 g/dl in their initial investigations were investigated. Relevant history, examination and investigations were carried out and recorded in the proforma

Results: Of 110 patients under study, 60 were males[54.5%] and 50 were females[45.5%]. Total 54 patients [49.1%] had SBP. Patients having SBP were older [52.6 +/- 12.8 years] compared to others [45.4 +/- 10.2 years]. Among those having SBP, 38[70%] patients were > 40 years of age. The mean ascitic fluid white cell count in SBP patients was 884 +/- 260 cells/uL versus 236 +/- 108 cells/uL. The mean neutrophil count in ascitic fluid was 643 +/- 181 cells/uL versus 137 +/- 65 cells/uL. HCV was the commonest etiology of cirrhosis 59 [54%], HBV in 29 [26%], combined HBV and HCV in 10 [9%], and non-viral in 12 [11%]

Conclusion: SBP is a common complication of cirrhosis and its frequency is higher in those cirrhotic patients who also have hypoalbuminemia [<3.5gm/dl]

Evaluation of performance of basic life support and clinical skills among interns in mayo and allied hospitals of king Edward medical university, Lahore

Training of medical students on basic life support and clinical skills is an important part of under graduate medical education. Teaching hospitals can provide these skills efficiently. To compare the performance of basic life support and clinical skills among trained and non-trained medical graduates, working as interns in Mayo and Allied Hospitals of King Edward Medical University. Study type settings and duration: Cross sectional study conducted in the Department of Medical Education, King Edward Medical University, Lahore from May 2010 to April 2011. A total of 227 medical graduates [academic year of 2010] were trained for basic life support of child and adult, neonatal resuscitation, airway opening maneuvers, endotracheal tube insertion and aseptic techniques. They were divided into two groups; group A consisted of 125 King Edward Medical University graduates who, as students were trained in above mentioned skills and now as interns, were working in emergency and intensive care units of Paediatrics, Neonatology, Medicine, Surgery and Gynecology and Obstetrics of Mayo and Allied Hospitals of King Edward Medical University. Group B consisted of 125 interns who graduated from other medical schools, and had not learnt above mentioned skills as undergraduate students. Interns of both the groups were interviewed using a structured questionnaire for importance of learning the skills at undergraduate level and performance of above mentioned skills as an intern. Study group A was also interviewed about grading the skills that they learnt as undergraduate students. Data was entered in SPSS 17. Chi square test was applied to compare the performance of the skills while, logistic regression analysis was done to calculate odds ratio and 95% confidence interval. In group A, 74[59%] interns performed basic life support for child and adult well. Almost 79[63%] performed neonatal resuscitation, 63[50%] airway opening maneuvers, 37[30%] endotracheal tube insertion and 91[73%] aseptic techniques well. In group B, 98[78%], 120[96%], 104[83%], 117[94%], and 81[65%] interns were unable to perform above mentioned skills respectively. The difference between the groups was statistically significant for all the skills. Training of basic life support and clinical skills' courses at undergraduate level can result in better performance of these skills in their practical life