clinical account of ICU cases with severe H1N1 [2009 pandemic influenza A] infection

To determine clinical characteristics in adults with confirmed severe 2009 pandemic influenza A [H1N1] infection. A descriptive case series. The study was carried out at the department of Pulmonology and Critical Care, Military Hospital Rawalpindi, from 1st December 2009 to 30th May 2010. Fifteen in-hospital adults with severe H1N1 infection confirmed by reverse transciptase polymerase chain reaction [RT-PCR] were studied. A pre-designed patient data collection form was used to record clinical features, laboratory and radiological investigations and management data. Mean age for severe H1N1 cases was 41.56 +/- 15.08 years and about 75% cases were from 20-40 yrs age group. Seventy five percent of our cases had at least one risk factor for complications with 2009 H1N1 infection; namely obesity - 33.3%, smokers - 26.7%, pregnancy, COAD and diabetes mellitus - 20% each. Fever [100%], cough [100%], and shortness of breath [93.3%] were the commonest symptoms. Radiographic abnormalities were bilateral patchy consolidations [60%], interstitial/ reticular infiltrates [20%], and reticular shadows with areas of consolidation [20%]. PaO[2]/ FiO[2] ratio was less than 200 in 60% cases on presentation. 73.3% cases had 1000-2000 [U/L] lactate dehydrogenase [LDH] levels while creatinine kinase [CK] levels were 400-1000 [U/L] in 66.7% cases. Six [40%] ICU cases with severe H1N1 infection died during hospital stay. Severe H1N1 virus infection cases most commonly presented with fever, cough and shortness of breath. The severe H1N1 cases presenting with abnormal chest radiograph and hypoxemia require ICR care with high mortality

clinical account of hospitalized 2009 pandemic influenza A [H1N1] cases

To determine the clinical characteristics in adults with confirmed pandemic influenza A [H1N1] infection 2009. A case series. The study was carried out at the Department of Pulmonology and Critical Care, Military Hospital, Rawalpindi, from 1st December 2009 to 30th May 2010. Thirty six adults with confirmed 2009 pandemic H1N1 infection by reverse transcriptase polymerase chain reaction [RT-PCR] were included in the study. All patients were followed in-hospital and clinical features, laboratory and radiological investigations and management data was collected on a pre-designed patient data collection form. Mean age was 34.24 +/- 13.92 years with 61.1% females. Seventeen [47.2%] had at least one risk factor for complications with 2009 H1N1 infection; namely obesity in 19.4%, pregnancy in 8.3%, COPD in 5.6%, cardiac failure in 5.6%, chronic liver disease in 5.6%, Diabetes mellitus in 5.6%, immunosuppression in 2.3%, smoking in 25%. Fever [97.2%], cough [97.2%], rhinnorhea [80.6%], and shortness of breath [58.3%] were the commonest symptoms. Radiographic abnormalities were interstial/reticular infiltrates [30.6%], patchy consolidations [11.1%] and reticular shadows with areas of consolidation [25%]. PaO2/FiO2 ratio was less than 200 in 27.8% cases. Thirty six percent cases had creatinine kinase [CK] levels greater than 400 U/L and lactate dehydrogenase [LDH] levels higher than 1000 U/L. Twenty seven percent cases were managed in ICU and 16.7% cases died during hospital stay. The 2009 pandemic H1N1 virus infection had a wide clinical spectrum with a potential to cause high morbidity and mortality. Early empirical antiviral therapy for hospitalized suspected influenza A [H1N1] is vital to prevent the rapid disease progression

Comparison between serological testing and biopsy examination of helicobacter pylori

This study was conducted at the gastroenterology department of the MH Rawalpindi to compare the sensitivity and specificity of serological assay for H .Pylori with the histopathological tests. A total of 50 patients were included. 32 cases were found to have H. Pylori on the histological examination. Out of these 32 patients 28 cases were found to have anti H. Pylori antibodies. 2 cases were found to have false positive anti H. Pylori antibodies in serum. The sensitivity and specificity of tests were 87.5% and 88.8% respectively with negative predictive value of 80% and diagnostic efficacy of 88%