ABSTRACT
Background: Chronic kidney disease [CKD] is now a public health problem with a high prevalence in Pakistan. However, there has been very little research on the profile of chronic kidney disease-related bone mineral disorders [CKD-MBD] in Pakistan. We thus aimed to assess the bone-mineral metabolism parameters in patients with CKD who are being followed at the Ziauddin University Hospital [a tertiary care hospital] in the southern city of Karachi, Pakistan
Methods: A hospital based cross-sectional study was conducted on 101 patients. The following clinical and biochemical data was collected: age, gender, serum creatinine and stage of CKD, serum PTH, calcium, albumin, phosphorus and Vitamin D levels- all at the same point in time
Results: The percentages of patients with serum levels within the recommended KDOQI guidelines for stages 3, 4 and 5 were as follows: serum PTH: 11.1, 31.8, 25.8, serum corrected calcium: 88.8,31.8, 42.9, phosphate 66.6, 50.0, 57.1, respectively. A significant number of patients were found to have secondary hyperparathyroidism as per the KDOQI criteria. 25-OH Vitamin D deficiency was also noted, as was hypocalcemia especially in CKD stage 5. However, our study demonstrated optimal control of serum phosphate levels for the majority of patients
Conclusion: This study highlights the difficulty of achieving KDOQI recommended serum PTH levels, and the need for raising awareness for more aggressive management of bone mineral metabolism parameters in order to decrease the morbidity and mortality associated with this disorder
Methods: A hospital based cross-sectional study was conducted on 101 patients. The following clinical and biochemical data was collected: age, gender, serum creatinine and stage of CKD, serum PTH, calcium, albumin, phosphorus and Vitamin D levels- all at the same point in time
Results: The percentages of patients with serum levels within the recommended KDOQI guidelines for stages 3, 4 and 5 were as follows: serum PTH: 11.1, 31.8, 25.8, serum corrected calcium: 88.8,31.8, 42.9, phosphate 66.6, 50.0, 57.1, respectively. A significant number of patients were found to have secondary hyperparathyroidism as per the KDOQI criteria. 25-OH Vitamin D deficiency was also noted, as was hypocalcemia especially in CKD stage 5. However, our study demonstrated optimal control of serum phosphate levels for the majority of patients
Conclusion: This study highlights the difficulty of achieving KDOQI recommended serum PTH levels, and the need for raising awareness for more aggressive management of bone mineral metabolism parameters in order to decrease the morbidity and mortality associated with this disorder
ABSTRACT
Clinical waste is a major source of infection amongst patients, hospital workers and the community. The Hospital Waste Management committee established in Dr. Ziauddin Hospital has active involvement of Nursing, Housekeeping and Infection Control departments. This multifaceted approach has brought about changes in the form of educational campaigns, involving training sessions and informational posters to improve awareness among hospital workers. This not only decreases the number of injuries and accidents occurring in relation to clinical waste disposal, but proper disposal of hazardous waste is beneficial for the community and the environment we live in. The first step is to target the areas which need the most attention and then to develop a tailor-made plan focusing on the major problems. Effective communication and teamwork help control the issue from all different angles and provide a pro-active approach to improve the waste management facilities of the hospital and serve the community as a whole
ABSTRACT
Background: Sensorineural hearing loss in adults is commonly associated with aging, trauma or autoimmune disease. In children, however, sensorineural hearing loss can also be due to genetic causes, leading to malformation of internal ear structures, like the vestibular aqueduct. In this article we present a rare anatomic malformation which causes progressive hearing loss in children
Methods: Our patient is a 12 year old boy who presented with deafness and tinnitus after mild trauma to the side of the head. Steroids and carbogen were administered but showed no improvement
Results: Audiological evaluation demonstrated profound bilateral sensorineural hearing loss. Radiological investigations including CT scan and MRI of the temporal bone showed bilateral enlargement of the vestibular aqueduct
Conclusion: The patient was diagnosed with Large Vestibular Aqueduct Syndrome and recommended cochlear implantation which has a high success rate and improves the quality of life for the patient
Methods: Our patient is a 12 year old boy who presented with deafness and tinnitus after mild trauma to the side of the head. Steroids and carbogen were administered but showed no improvement
Results: Audiological evaluation demonstrated profound bilateral sensorineural hearing loss. Radiological investigations including CT scan and MRI of the temporal bone showed bilateral enlargement of the vestibular aqueduct
Conclusion: The patient was diagnosed with Large Vestibular Aqueduct Syndrome and recommended cochlear implantation which has a high success rate and improves the quality of life for the patient
ABSTRACT
According to regulatory guidelines, Fresh Frozen Plasma expires within 24 hours of thawing. Therefore, if transfusions are delayed or cancelled, FFPs are often wasted. The coagulation factor activity of thawed plasma was extensively researched and it was determined that most of the factor activity maintained its efficacy for four days after thawing making it usable with equivalent clinical results. Although derived from FFP, the composition of this product differs slightly and so, the AABB introduced this product as a separate entity called Thawed Plasma. In the US, many blood banks have been using Thawed Plasma interchangeably with FFPs. This not only increases the inventory of plasma products but also eliminates thawing time, providing faster patient care. There are still some concerns regarding transfusing neonates and liver failure patients, but for the majority of surgical patients or those with elevated INRs, Thawed Plasma is an acceptable alternate to FFP. This manuscript reviews attributes and benefits of thawed plasma and its approval by various recognized authorities
ABSTRACT
Background: The ABO Blood group system has been evaluated many a times for increased risk of vascular accidents and heart diseases. This study aims to prove that the reason behind the decreased risk of thrombosis in O blood group population could be the decreased levels of clotting factors in its plasma compared to other blood groups
Objective: To assess the levels of clotting factors VII, VIII, IX and X in all blood groups to determine whether blood group O has the lowest levels of all clotting factors in its plasma
Methods: This is a Descriptive Cross sectional study, conducted at Dr. Ziauddin Hospital Karachi and Dow University of Health Sciences over a period of six months. The study involves 16 plasma units divided into four of each blood group. On the day of testing plasma was thawed and assays of factor VII, VIII, IX and X were performed on all blood groups and results noted
Results: Levels of Factor VIII, IX and X were found to be highest in blood group AB and lowest in blood group O. Factor VII levels varied from others
Conclusion: Our results showed that factor VII levels vary in different blood groups, may be due to its short half-life. Thus we could not establish a link between ABO blood groups and clotting factor levels