Arrangements and use of blood in elective surgical procedures

To evaluate Blood Ordering and Transfusion ratios for elective surgical procedures. This was a prospective study carried out at Muhammad Medical College Hospital Mirpurkhas from January 2007 to December 2007. A total of 1032 patients were included, both male and female. All patients who underwent elective surgical procedures in Surgical Unit, Muhammad Medical College hospital, Mirpurkhas from January 2007 to December 2007 were included in this study. Blood units cross matched and units transfused intra-operatively and post-operatively were recorded apart from patient demography and hepatitis profile. A total of 1032 patients underwent elective surgical procedures during the study period. Total 1500 blood units arranged, among these only 74 units of blood were transfused. This means only 4.9% of blood was utilized while 95.1% of blood was not utilized. Cross-match to transfusion ratio [C/T] = 20.27, Transfusion probability [Tp] = 7.1 and Transfusion index [Ti] = 0.07. For elective surgical procedures, there is no need for routine cross matching of blood. However, one must confirm the availability of blood for Hepatitis B and Hepatitis C reactive patients, and for cases, where the bleeding is inevitable like transvesical / transurethral removal of prostate

Proton pump inhibitors - over-prescribed in a rural community?

There are specific licensed indications for the use of Proton Pump Inhibitors [PPIs]. However it is over-prescribed globally. We performed a study to find out the uses and misuses of this expensive drug in our rural and financially poor population. Prospective survey of patients successively admitted in medical and surgical wards of a teaching hospital in rural setting. Two hundred fifty successively admitted patients over a month were interviewed. Of them 144 [58%] were females. Mean age was 42 years [range = 10-100 years]. Ninety [36%] were using PPIs for which there was a licensed clinical indication in 44 [49%], whereas 46 [51%] had no definite indications. Fifty three patients [59%] who were taking PPIs were either self prescribing or were prescribed by an unqualified medical practitioner. Of these, 34 [64%] did not appear to have a valid indication. Of the remaining, 15 patients were prescribed PPI by a specialist, and 22 by a qualified general practitioner. Over half of patients [51%] in our setting are using PPIs with no definite indication. Over 2/3 [64%] of those were prescribed either by unqualified practitioner or bought over-the-counter, had no licensed indication