Vital sign variations with complications during dialysis among end-stage renal disease patients

Objective: To analyse the association of vital sign variations with complications during dialysis among end-stage renal disease patients

Study Design: Cross-sectional study

Place and Duration of Study: Dialysis Centre, Memon Medical Institute Hospital, Karachi, Pakistan, from December 2016 to February 2017

Methodology: Patients on regular hemodialysis with permanent vascular access were selected. Analysis was done during their regular hemodialysis session. Vital signs were measured before and after dialysis, and ultrafiltration [in litre] was recorded post-dialysis. Complications and the variations in vital sign during dialysis were documented as 'yes' or 'no' on the proforma. The association of vital sign on complications during dialysis was analysed by using Pearson Chi-square or Fisher Exact test. A p-value <0.05 was considered statistically significant

Results: Among the study participants, 250 [65.78%] were males and 130 [34.21] were females. Overall mean age and ultrafiltration rate were 51.89 +/-15.83 years and 2.11 +/-0.99, respectively. Most of the patients suffered with complications of cramps during dialysis, i.e. 151 [39.73%] followed by complication of hypotension 143 [37.63%]. Significant association was observed only in variation in systolic blood pressure with complication of hypotension [p<0.001], followed by variation in body weight with complication of cramps [p=0.016] and hypotension [p=0.037]

Conclusion: Vital signs variations, i.e. variation in systolic blood pressure and variation in body weight, are associated with intradialytic complications, i.e. hypotension and hypotension with cramps, respectively

Seroprevalence of HBV, HCV and HIV infection among voluntary non renumerated and replacement donors in northern Pakistan

To compare the prevalence of Hepatitis B, hepatitis C and human immunodeficiency virus [HIV] in voluntary non-remunerated and replacement donors in Shifa International Blood Transfusion Services, over a period of 14 months from January 2002 to February 2003. Setting: Blood transfusion service of a tertiary care center in northern Pakistan Method: A total of 3430 donors were bled. Out of these, 3187 [92.9%] pints were from replacement donors and 243 [7.1%] pints were from voluntary non- remunerated donors. Screening of both groups for hepatitis B surface antigen [HBsAg], hepatitis C virus [HCV] antibody and HIV1/2 antibody were performed by using fully automated random access AXSYM [Abbott] which utilizes MEIA technology. The prevalence of HBsAg, HCV antibody and HIV 1/2 antibody in 3187 replacement donors was 2.51%, 5.14% and 0.25% respectively. The prevalence of same in 243 voluntary non-remunerated blood donors was 0.82%, 2.46% and zero% respectively. Prevalence of HBsAg, HCV antibody and HIV antibody was much lower in voluntary non-remunerated blood donors as compared to replacement donors. In Pakistan where main source of blood is from replacement donors, the source of blood ought to be changed to voluntary nonremunerated blood donors. This is the only way to achieve the safest blood in Pakistan under current circumstances

Hepatits C virus serotypes in chronic liver disease

To determine the HCV sero-types in patients with chronic liver disease, secondary to chronic hepatitis C in Northern Pakistan. Patients with clinical features of chronic liver disease, elevated ALT, positive anti-HCV, and HCV RNA positive by PCR underwent HCV sero-type determination. Out of 148 patients there are 95 [64.1%] patients who had HCV sero-type III. The second and third most common categories were untypable and HCV sero-type I. Females out numbered males. Patients with chronic liver disease due to HCV infection in this part of Pakistan had predominantly HCV sero-type III