Acute blood transfusion reaction in a tertiary care hospital in Southern Punjab, Pakistan

Background: Blood transfusion is a lifesaving process but carries many risks. Majority of these had been reduced with better diagnostic and management strategies. But the risk of non-infectious adverse transfusion reactions though reduced but cannot be eliminated. Hemovigilance is the system to monitor such reactions.Methods: The objective of current study was to know the frequency of adverse transfusion reactions and to compare it with local and international data. Retrospective cross-sectional descriptive study was done in Ibn-e- Sina hospital. Adverse transfusion reactions reported to blood bank was analysed according to hospital protocol.Results: Out of 6050 blood transfusions 23 (0.38%) develop adverse transfusion reactions. Febrile nonhemolytic transfusion reaction was the commonest adverse event and whole blood was the component implicated.Conclusions: Adverse transfusion reactions are non-infectious complications of blood transfusion which in spite of all efforts cannot be avoided. Frequency of adverse transfusion reactions in our study was 0.38% and Febrile nonhemolytic transfusion reaction was commonest reported reaction type. Hemovigilance system is necessary to monitor, investigate and control such activities.

Evaluation of in vitro and in vivo therapeutic efficacy of Ribes alpestre Decne in Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune inflammatory disorder, despite the discovery of numerous drugs there is still need to introduce newer, safer and more effective sources of drugs such as medicinal herbs. Present research work was an attempt to appraise the antiarthritic potential of Ribes alpestre Decne in rheumatoid arthritis. In vitro inhibition of protein (bovine serum albumin and egg albumin) denaturation, Human red blood cell membrane stabilization assays along with formaldehyde induced arthritis in rats were commenced in this study. Findings of present investigation demonstrated significant and dose dependent antiarthritic effect of Ribes alpestre. Aqueous ethanolic extract, butanol and aqueous fraction illustrated 95%, 69.233% and 92.840% protection at 6400 ug/mL against bovine serum albumin denaturation respectively. Similarly, plant extract together with butanol and aqueous fractions showed 3653.47%, 1484.03% and 3563.19% inhibition of pathological alteration of egg albumin in that order. Moreover, hydroethanolic extract with butanol and aqueous fraction exhibited 91.29%, 65.73% and 89.62% stabilization against erythrocyte hemolysis at 6400 ug/mL correspondingly. Furthermore, hydroethanolic extract, butanol and aqueous fraction notably 73.49%, 66.42% and 68.87% decreased paw edema at highest dose (200 mg/kg). Similarly aqueous ethanolic extract, butanol and aqueous fraction illustrated 72.38%, 54.90% and 66.33% decrease in paw thickness at 200 mg/kg. Hence results suggested that Ribes alpestre possess antiarthritic potential thus supporting its use as natural remedy in rheumatic conditions.

Ventricular Fibrillation with Brugada Syndrome: A Case Report.

Brugada syndrome is a potentially lethal and eminently treatable entity that may present with palpitations or syncope. This article presents the case of a young patient with Brugada syndrome and reviews key features in the epidemiology, pathophysiology, diagnosis, treatment and prognosis of this condition.

Hospital waste management tackling trash as a team

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

Diabetes mellitus modifying factors; investigation among the inhabitants of Sargodha city, Pakistan

Diabetes mellitus is wide spread non transmissible disease but its prevalence is increasing everyday so this study was conducted with an aim to investigate the factors that are modifying diabetes mellitus among patients at DHQ [District Head Quarter] Hospital Sargodha. A prospective study was carried out by well-trained pharmacists in DHQ Sargodha, Pakistan to assess the factors modifying diabetes mellitus. Data was collected from 110 patients randomly by using convenience sampling method. A well structured questionnaire was designed to collect information from patients and entire procedure was conducted with the permission of concerned authorities of Hospital management. The factors that are considered in present study are medication, treatment, patient physician interaction and society attitude towards diabetic patients which are helpful in halting the progression of diabetes and prevention of co morbidities. The results of study disclose that 74.5% diabetic patients felt better after treatment whereas 56% diabetic patients were satisfied with the information provided by physician to them but still 70% patients were suffering from co morbidities. The survey indicated that 62.7% patients said that exercise proved to be healthy activity in improving diabetes. However 59% diabetic patients were following a proper diet plan which was helpful in modifying their diabetes. The diabetic patients must be informed about importance of regular follow-up in averting long-standing complications. Patients should be guided about importance of dietary recommendations, exercise and strict metabolic control, that can holdup or avert the series of complications allied with diabetes

Evaluation of outcome of facet joints injections in low back pain

To find out outcome of short- and medium-term therapeutic efficacy of facet joint blocks. This descriptive interventional study was conducted in the Department of orthopaedic Khyber Teaching Hospital Peshawar, over a period of nine months January, 2008 to September, 2008. All patients were more than 20 years and less than 70 years with low back pain who were not responding to oral medications and Physiotherapy were included in the study. The facet joint blocks were performed under fluoroscopic guidance. The initial pain response was assessed prospectively using Mac nab and Prolo pain assessment criteria. Additional data, including short-term effect [> 1 week] and medium-term effect [at 3 months], were collected by a structured review interview. A note was made of the results of various imaging studies done in these patients. Just for exclusion and inclusion purposes and not for assessment of outcome which was exclusively based on clinical assessment. A positive effect was seen in 37 patients [74%] and 28 [56%] patients in immediate [with in one week] and short term [after 6 weeks] period respectively, while lesser effect was found in 16 patients [33%] at medium term [after 3 months]. Facet joint blocks appear to have a beneficial medium-term effect in one third of patients with chronic lower back pain and may therefore be a reasonable adjunct to non-operative treatment. However, outcome appears to depend on clinical, not the morphologic, imaging findings