ABSTRACT
Objective: To determine the frequency of poor sleep quality in chronic kidney disease [CKD] patients on chronic haemodialysis and compare the quality of sleep amongst patients undergoing chronic haemodialysis in morning shift to other shifts [including afternoon, evening and night]
Study Design: Cross-sectional, descriptive study
Place and Duration of Study: Dialysis Unit, Department of Nephrology, Shifa International Hospital Islamabad, Pakistan, from May to November 2016
Methodology: CKD patients who were dialysis dependant for a minimum of three months between ages of 20 years to 70 years were included. Participants were interviewed using a questionnaire measuring age, gender, time on haemodialysis, duration of each session and shift in which they were dialysed. Sleep quality was assessed using the Pittsburgh Sleep Quality Index [PSQI]. Using patient's responses to all questions in the PSQI, sleep quality score for each patient was calculated and they were classified as poor or good sleepers
Results: A total of 113 patients were included. Out of these, 82 patients [72.6%] had poor quality of sleep and 31 [27.4%] patients had good sleep quality. Thirty three out of the 48 morning shift patients had poor sleep quality and 49 out of 65 patients in other shifts had poor sleep quality. This relationship was not statistically significant
Conclusion: The frequency of poor sleep quality amongst CKD patients receiving chronic haemodialysis is high. However, dialysis shift does not seem to have any statistically significant relationship with the occurrence of poor sleep quality in these patients
ABSTRACT
Objective: To share our initial experience of patient undergoing anastomotic Urethroplasty and trial without catheter, without post Urethroplasty pericatheter urethrogram
Methods: Prospectively maintained records of all patients undergoing standard transecting anastomotic Urethroplasty by single surgeon [one of the authors] at The Kidney Centre PGTI Karachi, Pakistan and Lifecare Hospital Abu Dhabi UAE from September 2006 to December 2017 were reviewed. In all except two cases, supra pubic catheter was removed at second weeks and per urethral catheter by 4 to 5 weeks following which patients were assessed for TWOC without pericatheter urethrogram. Patients were further advised to follow up with Uroflowmetry [UFM] at one week, one month, three and 12 months. In our series, Qmax less than 15 ml/s on UFM were considered to have recurrence and these patients were subjected to ascending urethrogram after six weeks of procedure
Results: There were 18 patients who underwent anastomotic Urethroplasty in bulbar urethra. The mean age of study patients was 37.2+11.2 years with p-value of 0.84. The recurrence rate of urethral stricture was 16.6 percent [3/18 patient] with Qmax of 4.6 and 7.2ml/sec with mean follow-up period of 13.82+13.4 months [range 3-53 months] 02 patients developed infection. No patient developed incontinence or impotence
Conclusion: We found pericatheter urethrogram is not mandatory as a routine for all tension free anastomotic Urethroplasty before per urethral catheter removal. However, it may have a role in difficult cases with tension anastomoses or re-do procedure. This will avoid risk of infection, radiation exposure and extra cost