Frequency of asymptomatic spontaneous bacterial peritonitis in outdoor patients with liver cirrhosis

The objective of this study was to the incidence of silent SBP in asymptomatic cirrhotic patients of Military Hospital out patient department. Prospective study. Gastroenterology Department, Military Hospital Rawalpindi from July 2013 to Dec 2013. Prospective exploration for evidence of SBP in asymptomatic cirrhotic patients due to any etiology with ascites. Clinical and laboratory features of consumptive outpatients with cirrhotic ascites undergoing paracentesis were recorded between July 2013 and December 2013 and ascetic fluid analysis was carried out. The frequency of spontaneous bacterial peritonitis in the population of 80 cirrhotic outpatients as determined by neutrocytic ascites [absolute neutrophil count >250 cells/mm] was 10%. Of the 8 patients with neutrocytic ascites, none was culture positive. The patients with absolute neutrophiI count > 250 cells/mm were treated with antibiotics for seven days. Repeat diagnostic paracentesis showed marked improvement in absolute neutrophilic count. None of the patients developed hepatorenal syndrome or hepatic encephalopathy or recurrent SBP during 3 months follow up. Incidence of silent SBP in asymptomatic cirrhotic patients' cases is significantly high. Antibiotic treatment in these patients ensures no further complications. However, a population may be studied to know the exact prevalence of silent SBP in our country

Comparison of efficacy of calcium channel blockers with angiotensin converting enzyme inhibitors in the treatment of essential hypertension in elderly men

To cornpare efficacy of calcium channel blockers [CCBs] with angiotensin converting enzyme inhibitors [ACEIs] in the treatment of elderly men [age more than 55 years] with essential hypertension. Randomized controlled trial. Military Hospital Rawalpindi, one year [From September 2005 to September 2006]. One hundred male patients with stage 2 hypertension, aged more than 55 years, meeting the inclusion and exclusion criteria were randomized in 2 groups by non-probability convenience sampling. One group received calcium channel blockers [CCBs], and the other group received angiotensin converting enzyme inhibitors [ACEIs] daily for duration of 6 months from the day of enrolment during the one year study period. Reductions in blood pressure means were observed in both groups after six months of therapy i.e. 28.52 mm Hg [with CCBs] and 26.4 mm Hg [with ACEIs] for systolic blood pressure and 16.32 mm Hg [with CCBs] and 13.4 mm Hg [with ACEIs] for diastolic blood pressure. The mean drop of systolic blood pressure in group 1 was 2.12 mm Hg more than group 2 and was significant [p value < 0.05]. The mean drop of diastolic blood pressure in group 1 was 2.92 mm Hg more than group 2 and was significant [p value < 0.05]. The study suggests that calcium channel blockers have a superior efficacy in controlling blood pressure; both systolic as well as diastolic, as compared to angiotensin converting enzyme inhibitors for stage 2 hypertension in elderly men