ABSTRACT
Objectives: To assess the blood transfusion support requirements in mass disaster and trauma situations
Study Design: Cross-sectional observational study
Place and Duration of Study: This study was conducted at Combined Military Hospital Quetta from, Jan 2013 to Dec 2015
Material and Methods: Nature of injuries, triage details, details of surgical procedures and duration of hospital stay were noted. Data was analyzed with respect to cross match to transfusion ratio and the number of units of each component transfused. Patients requiring massive transfusion and any associated complications were also studied
Results: A total of 2228 casualties were received during the study period, of these, males were 18 [75 percent] and 6 [25 percent] were females. Mean age was29.7 years. 1636 [73.4 percent] casualties had sustained major injuries. Mean hospital stay was 6.31 days. Only 199 [12.2 percent] patients required blood transfusion with a mean of 2.9 units of RCC, 8.7 bags of FFP and 4.6 bags of platelets. Fifteen [7.5 percent] patients received massive transfusion. Following massive transfusion, one case of metabolic acidosis and two cases of coagulopathy were reported
Conclusion: Mass disasters and trauma casualties pose a serious challenge to any healthcare facility in general and the blood transfusion services in particular. Only a well-organized blood transfusion center and blood transfusion emergency preparedness can result in better patient care and outcome. Not all patients need transfusion and a delicate balance between demand and supply has to be maintained
ABSTRACT
To compare antihypertensive effect of fixed dose combination Hydrochlorothiazide-Amiloride and Amlodipine in patients of mild essential hypertension. Randomized controlled trial [RTC]. Department of Medicine Combined Military Hospital Multan Cantt from 29 January 2007 to 29 June 2007. After fulfilling the inclusion criteria of mild essential hypertension, defined as per recommendations of Seventh Joint National Committee [JNC 7] for treatment of Hypertension as stage 1 hypertension, systolic blood pressure [SBP] >/= 140-159-mmHg and Diastolic blood pressure[DBP] >/= 90-99-mmHg, 100 patients were randomized into two study groups using a table of random numbers. Group 1 received tab amlodipine [5 mg] and Group 2 received tab hydrochlorothiazide-amiloride [25 mg-2.5mg]. Informed written consent was taken. The patients were followed on subsequent visits [6 in total] for five months and systolic and diastolic blood pressure was recorded carefully. All the data thus obtained were processed and analyzed using SPSS version 10.0. Mean and standard deviation [SD] were calculated for age, diastolic and systolic blood pressure. In group 1 the drop in mean SBP between first and last visit was 15.42 mm Hg. In group 2 the drop in mean SBP between first and last visit was 18.34 mm Hg. In group 1, the drop in mean DBP between first and last visit was 10.08 mm Hg. In group 2 the drop in mean DBP between first and last visit was 14.65 mmHg. Mean drop in SBP of both the groups were compared with each other and found to be significantly different [P=0.003]. Similarly mean drop in DBP of both the groups were compared with each other and found to be significant statistically [P=0.001]. Hydrochlorothiazide-Amiloride had significantly better antihypertensive effect than Amlodipine in patients of mild essential hypertension at the end of five months therapy