Frequency of asymptomatic spontaneous bacterial peritonitis in chronic liver disease patients with first presentation of ascites

This study is done to assess the frequency of asymptomatic spontaneous bacterial peritonitis in chronic liver disease patients with first presentation of ascites. Design: Case control study. Place and duration of study: This study was carried out on patients attending Medical special ward Services hospital and PTCL medical center Lahore from June 2002 to October 2003. Patients and method: One hundred and fifty chronic liver disease patients with first presentation of ascites were screened for presence of asymptomatic spontaneous bacterial peritonitis. 9.3% of patients in this study had asymptomatic spontaneous bacterial peritonitis. Asymptomatic spontaneous bacterial peritonitis can be present in first presentation of ascites in chronic liver disease patients. It is suggested that this condition should be actively sought in all chronic liver disease patients who develop ascites for the first time. Further studies should be done to assess for prognostic implications of treating such cases

Blind extrathoracic subclavian venipuncture for temporary pacing lead insertion: a 4 year experience in 760 patients

Seven hundred and sixty patients admitted in Cardiology Dept. Mayo Hospital, Lahore from Feb.1994 to Jan 1998 were inserted temporary pacing lead for different indications. Modification of the percutaneous technique for extrathoracic subclavian venipuncture proposed by Magney and colleagues for permanent pacing lead placement was used. Before puncturing bony landmarks were marked on the skin according to Magney's description to identify the needle entry point. Then the venipuncture was accomplished by inserting the needle through a standard infraclavicular land mark. 760 patients were approached with this technique with in a span period of four years. This technique was successful in 684 [90%] cases with first puncture, additional 35 [5%] with second attempt, while additional 14 [2%] patients required multiple attempts or the change of the site. In rest 3% the procedure was completed using other routes. Patients were followed till the removal of temporary pacing wire or implantation with permanent pacing system. In the present study the blind approach to the extrathoracic portion of the subclavian vein proved to be safe and effective for pacing lead insertion. Further observations are required to establish whether this method decreases the complication rate

Experience with permanent pacemaker implantation at Mayo Hospital, Lahore

Permanent pacemaker implantation procedure was started at Mayo Hospital, Lahore in March, 1978. Till December 31st 1998 nine hundred and sixty six permanent pacemakers had been implanted in this institution. 53% patients were males and 47% patients were females. 55% patients were between 50-70 years old. The youngest patient was only six months old while maximum age of the patients implanted with permanent pacemaker was ninety nine years old. 92% patients had fist implant while 6% patient had second implant and 2% patient had third implant. 84% patients had complete heart block, 5.5% patients had sick sinus syndrome, 2.7% patients had symptomatic second degree heart block, 2.6% patients had congenital heart block

Septicemia caused by pseudomonas paucimobilis

This is a retrospective study of Pseudomonas paucimobilis causing septicaemia. The organism was isolated aerobically from blood cultures of nine patients suffering from speticaemia. Antibodies susceptibility results showed that out of nine isolated, three were sensitive to only three of the antibiotics tested. All the patients were treated with antibiotics as guided by susceptibility results, and all of them recovered

Calcium channel blockers and bradyarrhythmias

Two hundred and eleven patients out of 350 patients admitted to Coronary Care Unit at Mayo Hospital, Lahore were put on calcium channel blockers. Conduction defects and haemodynamic effects of calcium channel blockers alone or in combination with beta-blockers were observed. Eight patients on Diltiazem developed bradyarrhythmias In four patients Diltiazem was omitted due to hypo-tension and bradyarrhythythmias. In other four patients dose was reduced from 270 mg per day to 90 mg per day to abolish the bradyarrhythmias. One patient on Verapamil developed bradyarrhythmia which was reverted to sinus rhythm after reducing the dose. None of the patients on Nifidipine developed any conduction defect. Six patients on Diltiazem who had bradyarrhythmias were admitted with unstable angina. We conclude that Diltiazem should be used carefully in patients having unstable angina