Frequency of complications during hemodialysis in patients of chronic renal failure

To determine the frequency of various complications occurring during hemodialysis in patients of chronic renal failure undergoing maintenance hernodialysis. A descriptive prospective study. The study was conducted at Department of Nephrology, Military hospital Rawalpindi Pakistan, from 21st July 2005 to 21st Jan 2006 One hundred subjects fulfilling inclusion criteria [Patients suffering from chronic renal failure [CRF] who were on maintenance hemodialysis for at least 03 months] during the above-mentioned period were enrolled in this study with non-probability sampling technique after taking informed consent. One hundred patients of end stage renal disease of maintenance hemodialysis were studied The major causes of renal disease were diabetes mellitus [24.0%] and hypertension [22.0%] The most frequent complication was hypotension seen in 12% of dialectic treatment followed by muscular cramps [10%], chest pain [09%], vomiting [08%] and headache 06% of patients. Other complications like membrane hypersensitivity reactions, pruritis and complications of access route disequilibrium syndrome were uncommon. In the patients with chronic renal failure on maintenance hemodialysis, hypotension was the most frequent complication. So assessment of patient for hernodynamic status and general condition is important to reduce the incidence of complications

Accuracy of ultrasonography in detection of severe liver fibrosis/cirrhosis in chronic liver disease

To determine the accuracy of three ultrasonographic [US] signs; liver surface nodularity, caudate lobe hypertrophy and hepatic vein flow pattern on Doppler ultrasound, in detecting severe liver fibrosis in chronic liver disease. Descriptive study. Department of Diagnostic Radiology, PNS Shifa Karachi. Duration of the study was 6 months -SEPTEMBER 2005 TO MARCH 2006. The study included 50 patients of both sexes [20-60 yrs], presenting with chronic liver disease to department of Ultrasound. TOSHIBA [NEMIO- 20] Doppler Ultrasound Machine with Doppler 3.5 and 5.0MHz probes was used to look for liver surface nodularity, caudate lobe hypertrophy and pattern of hepatic vein flow. After performing US, liver biopsy on these patients was performed under US guidance and sent for histopathology findings; taken as gold standard. On US, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were highest for liver surface nodularity in detecting severe liver fibrosis. However, the above-mentioned values were relatively higher when the three ultrasound signs were collectively considered; compared to single US sign. US determination of liver surface nodularity is a significantly accurate method for identifying severe liver fibrosis or cirrhosis. The accuracy of ultrasound further increases when hepatic vein flow pattern and caudate lobe hypertrophy are also taken into account