Analysis of identifiable risk factors precipitating acute encephalopathy in chronic liver disease, at PNS Shifa Karachi

Background: Hepatic encephalopathy is one of the most debilitating manifestations and frequent complication in patients suffering from chronic liver disease

Objective: To determine the frequency of identifiable risk factors precipitating hepatic encephalopathy in patients with chronic liver disease, at PNS Shifa Karachi and their correlation with grades of hepatic encephalopathy, length of hospital stay and mortality. Study Design: It was a cross sectional study Period: 24 Oct 2014 to 31 Aug 2015

Methods: during which 96 patients of clinically diagnosed hepatic encephalopathy associated with CLD were enrolled. Hepatic encephalopathy was graded and precipitating factors identified based on history, clinical examination and relevant laboratory investigations. Management was carried out according to the latest guidelines. Patients were followed up till discharge/death from the hospital and duration of hospital stay. Mortality was recorded

Results: Majority of patients [57.3%] had one precipitating factor; more than one factor was found in 43.5%. Gastrointestinal bleed was the most common precipitating factor identified in 42 [44%] patients followed by Infection in 36 patients [38%], diuretic therapy in 10 patients associated with electrolyte imbalance [11%], constipation in 8 [9%] patients, use of high protein diet in 7[6.72%], sedative /tranquilizers in 4[3.84 %] and large volume paracentesis in 4 [3.84%] were least common factors, Mean hospital stay was 11 +/- 1.8 days. Mortality was 15 % with 14 patients expiring during the hospital stay. There was no statistically significant correlation between the various precipitating factors and grade of hepatic encephalopathy, length of hospital stay and mortality [p >0.05]

Conclusion: Commonest precipitating factors of hepatic encephalopathy in patients of liver cirrhosis are, gastrointestinal bleed, infection, electrolyte imbalance and constipation. There is no correlation between the various precipitating factors and grade of hepatic encephalopathy, length of hospital stay and mortality. There is a need to improve the awareness of patients and attendants about the precipitating factors and their avoidance. This also includes effective control measures against rising cases of hepatitis C and hepatitis B as it is the leading cause of liver cirrhosis in Pakistan

Eye donation: awareness in urban population of Pakistan: an analysis

Objectives: To evaluate the awareness and willingness of an eye donation among urban population of Pakistan

Methodology: A cross sectional study was conducted among urban population of Pakistan to access the awareness and concern about eye donation. For this a convenient sampling technique was used and a self-administrative questionnaire was administered. Participants were selected from 3 provinces and 5 major cities of Pakistan. A total of 1520 responded, 52.6% were males and 47.4% were females

Results: 530[66.2%] out of 800 male and 463[64.3%] out of 720 female participants were aware about eye donation. Willingness to donate eyes after death was only seen in about 54/800 [6.7%] males and 58/720 [8%] females. Mass media, television, radio were the most common source of information for both male 342/800 [42.7%] and female 316/720 [43.8%] regarding eye donation. At the end nobility was treated the most common influencing factor for both male 102/800 [12.7%] and female 145/720 [20%] participants

Conclusion: Awareness of eye donation among urban population was not found to be adequate and the willingness for eye donation is too much low. This may be because of lack of high literacy rate in Pakistan, no government eye banks, very few NGO's eye bank and lack of eye donation awareness campaigns

Risk factors for hypertension in serving uniform personnel of Pakistan navy

Objective: to highlight the risk factors relevant to hypertension in Naval set up and to submit recommendations for a better control of these risk factors

Study Design: a retrospective study

Place and Period of study: the study was conducted over a three years period at PNS SHIFA and PNS RAHAT hospitals, Karachi, Pakistan, from Feb 2012 to Feb 2015

Subjects and Methods: medical record of 118 diagnosed cases of Essential hypertension was retrieved from Pakistan Navy Medical Record Section [PNMRS] and was scrutinized. Interviews were arranged when and where found necessary/possible. Based upon detailed history, physical examination and investigations the risk factors responsible for their hypertension were identified and recorded

Results: out of 118 patients studied, 45% were found to be sailors followed by officers [32%] and chief petty officers [23%]. Age group most affected was 31-40 years [36%]. Smoking, sedentary lifestyle, stress of service conditions and high caloric diet were found to be the most common factors contributing to high blood pressure

Conclusion: general awareness of healthy life style, avoidance of smoking, alleviation of unnecessary stresses, and dietary modifications along with ample opportunities for recreation could control the emergence of hypertension in serving personnel of Pakistan Navy

Appraisal of Hepatitis-B and Hepatitis-C prevalence

Objective: to asses prevalence of HBV and HCV among healthy blood donors

Study Setting: Blood Transfusion Services Center DHQ Hospital Faisalabad. [Blood donation record of blood donors]

Study Design: retrospective review of blood donation record of blood donors, who attended this center from 1[st] Jan 2014 to 31[st] Dec 2014

Materials and Methods: the blood donation record of 32028 persons was reviewed who visited BTSC DHQ Hospital Faisalabad for donation of blood. The donors were selected according to International donor selection criteria. All the blood donors were screened for HBV and HCV by "Rapid Method."

Results: review and analysis of blood donation record of 32028 screened blood donors showed that 11.16% blood donors were female [ n= 3574 ] and 88.84% were male [n=28454].Among total, 609 blood donors were HBV positive i.e.1.90% and 2724 were HCV positive i.e. 8.50%

Conclusion: this study concluded that the prevalence of HBV and HCV among healthy blood donors of this area, HBV to be in low endemic group [<2 %] while HCV in high endemic group [>8%]. Female donors are proportionately less than male donors

Personality traits of the adjusted and maladjusted medical students in punjab medical college, Faisalabad, Pakistan

Objective: The study was designed to examine the association between the personality traits and adjustment level of medical students

Method: 190 medical students from Punjab Medical College, Faisalabad participated in this study through purposive convenient sampling technique. Personality traits were measured through Gordon Personal Inventory [GPI] and Gordon Personal Profile [GPP], while adjustment and mal adjustment was assessed through Rotter's Incomplete Sentences Blanks [RISB]. The results were obtained through chi square statistics on SPSS version 17

Results: Results showed that out of 190 medical students 173 students [91%] were well adjusted. While 17 students [9%] obtained RISB scores above the cutoff point hence they were labeled as mal adjusted. Hypothesis testing with Chi square test has shown statistically significant differences in the scores on the trait of responsibility, cautiousness, personal relationship and vigor among adjusted and mal adjusted medical students. Mal adjusted students were seen associated with below average scores on all previously mentioned traits

Conclusion: The traits of responsibility, cautiousness, personal relationship and vigor are crucial for the adjustment in the society. So the parents and teachers should play their part in improving the fabric of the society by the means of building and emphasizing upon the sense of responsibility, cautious behavior, balance in personal relationships, and vigor in daily tasks among their children and students so that they may become well-adjusted in the society