ABSTRACT
Objective: Many factors affect quality of life [QOL] of dialysis patients. This study was conducted to determine the effect of socio-economic factors effecting QOL of hemodialysis patients
Methods: This descriptive multi-centric, follow up study was conducted at Department of Nephrology, Mayo Hospital, Lahore, from February 2015 to August 2017. All patients who were on regular maintenance hemodialysis [MHD] for more than three months and able to read and understand Urdu version of Kidney Disease Quality Of Life [KDQOL] tool were included in the study. Patients were included from hemodialysis units of Mayo Hospital [MH], Shalamar Hospital [SH], and Shaikh Zayed Hospital [SZH], Lahore. Patients with less than three-month duration on dialysis, with cognitive impairment, dementia, active psychosis, non-Urdu readers/speakers were excluded. Demographic data and lab data was collected on predesigned pro forma. Patients were divided into different groups on the basis of education, monthly income, source of funding for treatment and employment. Patients were followed up for two years to determine the effect of QOL on mortality
Results: One hundred and thirty-five patients were included in the study. Socio-economic factors like education, employment, income, funding was compared with KDQOL sub scales and were found statistically significant [p-value [<0.05]. We found that patients with higher income had better work status [p=0.039] but social [0.04] and sexual function [p=0.029] were relatively better in patients with low income. Employed patients had better work status [p=0.01], ability to do social function [p=0.027] but they had more pain [0.049], symptoms/problems of disease [p=0.05] and effect of kidney disease [p=0.015]. Those patients whose dialysis were funded by their family could socially interact [p=0.012] better and deal more efficiently with effect of kidney disease [p=0.007]. Higher education was associated with better emotional well being [p=0.045], patient satisfaction [p=0.046] and staff encouragement [p=0.045] then patient with lower level of education. QOL had no effect on mortality
Conclusion: The socio-economic factors consisting of education, employment, income and funding are important parameters affecting QOL of kidney patients. QOL does not affect mortality of the dialysis patients
ABSTRACT
Objective: to translate, validate and assess the reliability of kidney disease quality of life - short form [KDQOL-SF-36] in Urdu, national language of Pakistan
Study Design: a multicentric descriptive cross-sectional study
Place and Duration of Study: department of Nephrology, Mayo Hospital, Lahore, from February to July 2015
Methodology: patients of end-stage renal disease [ESRD] on maintenance hemodialysis [MHD] for more than three months were included in the study. Patients of ESRD not on dialysis and those with acute renal failure were excluded. The English version of KDQOL-SF-36 was translated in Urdu and then translated back in English; further validation was done by a senior professor of Punjab University, Lahore
Results: one hundred and thirty patients were included in the study. Fifty patients were from Mayo Hospital, 35 from Shalamar Hospital and 50 from Shaikh Zayed Hospital, Lahore. The internal consistency reliability coefficient for overall scale was 0.84. Twelve sub-scales [symptoms, effect of kidney disease, and burden of kidney disease, cognitive function, and quality of social interaction, sexual function, social support, physical functioning, role physical, pain, emotional wellbeing and role emotional] had more than 0.70 internal consistency reliability coefficients. Overall mean score of the domains i.e kidney disease component score [KDCS], physical component score [PCS], and mental component score [MCS] was 60.62 +/-17.61, 43.12 +/-19.54, and 49.27 +/-14.52, respectively. A significant positive relationship was observed between KDCS and MCS domains, KDCS and PCS domains, PCS, and MCS domains
Conclusion: the Urdu version of KDQOL-SF-36 is a reliable and valid version to measure QOL in kidney disease patients on dialysis in Pakistan
ABSTRACT
Background: Trial of labour after caesarean section is a significant issue faced in obstetrics practice
Objective: To determine the frequency of success of trial of labour after previous one caesarean section
Subjects and Methods: This descriptive case series study was conducted at Department of Obstetrics and Gynaecology Unit-1, Sir Ganga Ram Hospital, Lahore, from 1[st] July to 31[st] December 2010. One hundred seventy five patients of trial of labour after previous one caesarean section were included who fulfilled the inclusion and exclusion criteria. The data was entered and analyzed by SPSS version 16
Results: The mean age of patients was 26.73+2.90 years. The age range was from 20 to 30 years. The mean gestational age was 38.15+0.76 weeks. After trial of labour, 72% of patients delivered spontaneous vaginally, 22% has caesarean section, 4% has vacuum delivery while 2% has forceps delivery
Conclusion: It is concluded that the present study showed that trial of labour in patients with previous one caesarean section due to non recurrent cause is safe and has success rate of 78% which is encouraging
ABSTRACT
Background: Chronic kidney disease [CKD] is a permanent condition which requires renal replacement therapy to maintain life. There are multiple modalities for the treatment of CKD including dialysis, non dialysis care and transplantation. Transplantation is not in reach of many patients and dialysis remains the only life saving treatment option for patients. Unfortunately, awareness is lacking in patients, even when they present with end stage renal disease with only immediate choice of hemodialysis
Objective: To assess the perception of renal failure patients regarding dialysis and treatment modalities, secondarily; to assess the status of medical counseling to these patients
Patients and methods: This descriptive study was conducted in medical ward and dialysis unit of Sheikh Zayed Medical College/Hospital from January to June, 2011. A total of 68 patients of chronic renal failure irrespective of sex were included in this study, all the patients with CKD were included in this study, those patients who did not give informed verbal consent were excluded. Data was analyzed in SPSS 15
Results: A total of 68 patients were included in study. The mean age of study subjects was 41 +/- 9.5 years and 65% were male. When the perception of patients regarding their health problem was assessed, 58[85.3%] were knowing that they have end stage renal disease. When asked about the source of information about treatment modalities and dialysis, 53% reported that doctors are the source of information, while 36% reported Paramedics/Hakims as sources of information. When asked about which treatment option would you prefer, 71% of patients answered "Medicines", 23% answered "Dialysis", whereas, only 6% answered "Kidney transplant". When asked about the perceived benefits of dialysis, it was noted that 53% have perception that it has no benefit, 26% reported some symptom improvement. When study subjects were asked about possible side effects of dialysis, 56% has no knowledge of side effects, 21% reported that it damages kidney, 15% reported that it leads to death once started its use as treatment, another 8% has opinion that life is reduced due to stoppage of kidney functioning after the patient is on dialysis
Conclusion: Misconceptions among CKD patients regarding treatment modalities and dialysis are high and status of medical counseling is poor. There should be a standardized, comprehensive patient information system and personalized decision support to facilitate modality selection and to enable patients to make fully informed treatment decisions
ABSTRACT
Background: Pregnancy has marked effect on pulmonary functions and capacities. The knowledge of the expected changes in pulmonary parameters is fundamental to understanding how the disease states affect pregnancy and vice versa
Objectives: this study was designed to determine the changes in pulmonary functions during pregnancy
Patients and Methods: This was prospective study, conducted from 1[st] January 2008 to 30[th] November, 2008, in the Department of Physiology, Sheikh Zayed Medical College, Rahim Yar kha. A total of 80 study subjects were included in this study, divided into 4 groups, with each group having 20 study participants. The groups were as; 1[st] group having non pregnant females in their mid-luteal phase, 2[nd] group having females in their 1[s]t trimester of pregnancy, 3[rd] group having females in 2[nd] trimester of pregnancy, 4[th] group having females in their 3[rd] trimester of pregnancy. A questionnaire in which data regarding name, age, parity, duration of gestation was used
Results: A total of 80 study subjects were included in this study. Overall mean age was 25 +/- 3.5 years. 1[st] group was having age of 21+/- 2 years, 2[nd] group was having mean age of 26 +/- 4 years, 3[rd] group having mean age of 27+/- 4 years, whereas, 4[th] group was having mean age of 24+/-3.2 years. All the females were house wives, except controls, who were students. 71% of the study subjects were uneducated. We found out significant decrease in FEV[1] [P=0.000], FVC [P=0.002], and FEV[1]/FVC[P=0.014] in all three groups of pregnant women as compared to non-pregnant
Conclusion: The respiratory system undergoes anatomical and physiological changes during pregnancy and there is a significant decrease in FEV[1], FVC and FEV[1]/FVC among pregnant women
ABSTRACT
Background: acne vulgaris is the most common skin disease treated by dermatologists. Misconceptions about acne, regarding its causes, treatment options and their possible outcome are widespread
Objectives: the objective ofthis study was; to evaluate the knowledge and perception of acne patients regarding their understanding of acne pathogenesis, treatment options, and expectations
Patients and methods: this descriptive study was conducted in dermatology clinic, outpatient department of Sheikh Zayed Medical College /Hospital, from 1st January to 15th april,2010 and a total of 105 consecutive study subjects, who were diagnosed with acne were included. An informed verbal consent was ensured from every study subject
Results: the mean age of the patients was 18.8 +/- 2.7 years. Majority of the patients [87%] were females and unmarried [83 %]. 74% had education level matric and above. 48.6% belonged to urban areas, 30.4% to rural areas and 21% to urban slums. 67% of the patients of acne in our study reported that they felt frequently worried about their acne. 55 % of the study subjects had duration of acne less than three months, 41 % had duration between 3 to 12 months and 4% had duration more than one year. When asked about causes of acne, 35% related it with poor skin hygienic conditions, 19% to dietary factors, 13% to blocked skin pores, 10.5 % to inheritance factors, 7.6% to stress, 6.7% related to infection by germs. Regarding dietary aggravating factors; 38 % linked to oily food items, 14 % with tea, 13.3% with milk products. 17 % perceived that acne is not a curable disease. 41 % of the patients had no opinion about mode oftreatment. 67% ofthe patients expected the duration ofacne treatment may beup to 3 months
Conclusion: there is a need for accessible, accurate, community-based education on the natural history of acne, its pathogenesis, risk of sequelae, the effectiveness and expected duration of treatment, and the importance of prompt medical attention
ABSTRACT
To observe the rate of biliary tract injury and to prove the effectiveness of mini-cholecystectomy in developing countries. Department of Surgery, Nishtar Hospital, Multan. Descriptive study. One year, starting from October 2002 to October 2003. Material and methods: Total 50 patients were treated with mini-cholecystectomy. Follow up for complication was done for the period of 6 months after procedure. In 50 patients there was no bile duct injury. Biliary peritonitis and strictures were seen in 2[4%] patients. Patients developed biliary leakage in which drain was not put at the time of operation and only drain was put and recovered. Mini-cholecystectomy is relatively economical method for the treatment of gall stone disease which is associated with less patients discomfort and less incidence of postoperative complications, short hospital stay, good cosmetic results, early return to work, so it should always be preferred to conventional cholecystectomy