Pulmonary renal syndrome in a patient with vasculitis: case report and review of literature

Granulomatosis with polyangiitis [GPA] previously known as Wegner's granulomatosis, is a small vessel vasculitis that preferentially involves capillaries, arterioles and venules, presenting as multisystemic disease classically with alveolar haemorrhage and renal insufficiency. We report a case of GPA diagnosed on history, clinical findings and supported by imaging and very high levels of C-ANCA. Renal biopsy confirmed the typical histopathological findings. We discuss herein the management of the case and review of literature

Restless legs syndrome in end stage renal disease patients on haemodialysis

This study was cross sectional survey conducted to find the prevalence of Restless legs syndrome [RLS] in end stage renal disease [ESRD] patients on haemodialysis [HD]. Data were obtained from 250 patients on chronic maintenance HD. To assess the prevalence of RLS, Clinical diagnostic criteria for RLS was used which is established by the International RLS Study Group. Total 250 patients were included in this study. 153 [61.2%] patients were male and 97 [38.8%] were females. Mean age of the patients was 45.27 years. Mean duration of HD was 26.10 months. Total162 [64.8%] patients were found to be suffering from RLS. Out of 153 males, 87 [56%] were suffering from RLS and among 97 females, 75 [77.3%] were suffering from RLS. In our study, gender was statistically significantly associated with RLS [p-value 0.001]. In age groups 159 [63.6%] patients were below 51 years; among them 102 [64.1%] were suffering from RLS; whereas 91 [36.4%] patients were equal or above 51 years of age and among this group 60 [65.9%] patients were suffering from RLS. There was no statistically significant association between RLS and age groups [p-value 0.776]. RLS is common in patients undergoing regular HD. It is more commonly seen in females

To determine the efficacy of intravenous l-ornithine l-aspartate in combination with current treatment in patients with hepatic encephalopathy

Hepatic encephalopathy [HE] is the syndrome of disordered consciousness and altered neuromuscular activity that is seen in patients with acute or chronic hepatocellular failure or porto systemic shunting

Objective: To determine the efficacy of intravenous L-ornithine L-aspartate [LOLA] in combination with current treatment in patients with hepatic encephalopathy

Study Design: Quasi experimental

Setting: Study was conducted in medical unit I, Services Hospital, Lahore

Duration of Study: The study was carried out over a period of one and a half years

Subjects: Patients of chronic liver disease presenting with hepatic encephalopathy fulfilling inclusion criteria were enrolled in study

Methods: Sixty patients of hepatic encephalopathy were taken. They were divided into two groups of thirty each. Thirty patients labeled as group A were given the conventional treatment of hepatic encephalopathy; second group of thirty patients was labeled as group B and was given intravenous LOLA in addition to conventional treatment

Results: Group B patients showed statistically significant improvement in encephalopathy and reduction in serum ammonia levels after seventy two hours of treatment. However, there was statistically insignificant reduction in duration of hospital stay

Conclusion: Addition of LOLA in conventional treatment improves recovery from hepatic encephalopathy; but it needs further studies to document role of L-ornithine L-aspartate as regular part of treatment of hepatic encephalopathy