To determine correlation between biochemical parameters of nutritional status with disease severity in HCV related liver cirrhosis

Objective: To identify correlation between biochemical parameters of nutritional status with disease severity in HCV related liver cirrhosis in patients attending tertiary care hospital

Methods: Total 259 HCV related liver cirrhosis patients who attended the outpatient department of KRL Hospital, Islamabad from June 2016 to January 2018 were included in this crosssectional study. HCV status was confirmed with PCR. Cirrhosis was preestablished by ultrasound, while cirrhosis severity was gauged by CTP score. Biochemical parameters for nutrition status included serum albumin, creatinine, cholesterol, LDL, HDL, triglycerides, hemoglobin, ferritin, sodium, potassium, magnesium and calcium. Other demographic and clinical data were also recorded

Results: The mean age of patients was 58.73 +/- 6.04 years with 57.1% being males. The average BMI was 22.72 +/- 1.69 kg/m[2]. Majority patients i.e. 123 [47.5%] belonged to CTP-A, 67 [25.9%] were in CTP-B and 69 [26.6%] in CTP-C groups. Significant negative correlations of cirrhosis severity were established with BMI, albumin, creatinine, cholesterol, LDL, TG, HDL, hemoglobin, sodium and magnesium indicative of malnutrition. Analysis of biochemical parameters amongst individual cirrhosis groups revealed significant negative correlation across the same factors in group CTP-C, while CTP-A correlated positively with these parameters. The only significant correlation found in CTP-B was with albumin, HDL, hemoglobin, sodium and magnesium

Conclusion: Considering limitations of standard ways alone to assess malnutrition in liver cirrhosis, biochemical parameters are valid to aid in diagnosing malnutrition

Frequency and risk factors of frequent exacerbations of asthma in patients in a tertiary care hospital: a hospital-based comparative study

Objective: To determine the frequency of recurrent exacerbations in asthma patients and compare the risk factors for frequent and non-frequent exacerbations. Study Design: Cross-sectional study. Place and Duration of Study: KRL Hospital Islamabad from Jun to Dec 2016

Patients and Methods: Non-probability technique was used to sample two hundred and eighty one patients. Asthma exacerbations were defined by GINA guidelines. Frequent exacerbations were defined as two or more in the previous year. Data regarding demographics and risk factors were collected. Inhaler technique was checked. BMI and blood eosinophil levels were measured. SPSS 22 was used for data analysis

Results: Out of total 281 patients, frequent asthma exacerbations were observed in 143 [50.9%] patients. Female gender [p=0.00] and lower education [p=0.02] led to frequent exacerbations. Patients education about disease or treatment [p=0.03], URTI [p=0.00], allergen exposure [p=0.00], drug history [p=0.04], treatment step-II [p=0.00], medication non-compliance [p=0.00], incorrect inhaler technique [p=0.01], anxiety [p=0.01], previous ICU admission [p=0.02] and blood eosinophilia [p=0.00] were significantly associated with frequent exacerbations. Of these, independent predictors were patient education [p=0.02], URTI [p=0.00], allergen exposure [p=0.00], drug history [p=0.00], treatment step-II [p=0.03], medication non-compliance [p=0.02], anxiety [p=0.01] and eosinophilia [p=0.00]

Conclusion: Majority of our patients underwent frequent exacerbations. Risk factors found to be associated with frequent exacerbations were female gender, lower education, patient unawareness, URTI, allergen and drug exposure, treatment step-II, medication non-compliance, anxiety and blood eosinophilia

Tuberculosis; the spectrum in admitted children at Bahawal Victoria hospital

The purpose of study is to know the admission rate and spectrum of the tuberculosis in children admitted in the pediatric unit of a high endemic country. This retrospective study was conducted at the Pediatric unit-I, Bahawal Victoria Hospital Bahawalpur. The records of children older than one month but below 15 years of age diagnosed as tuberculosis [TB] during the years 2007-2011 were reviewed and were included for the study. The data [age, sex, history of contact, BCG vaccination, tuberculin test, diagnosis] were entered on a proforma. Data were entered into SPPS version 13 [Statistical Package for Social Sciences] package were presented as rates and proportions. There were 72765 children [excluding children below the age of one month] admitted during the period of five years [2007-2011], out of which 847[1.16%] were diagnosed as tuberculosis. There was no consistent fall in admission rate over the years due to TB cases. There were 61% male cases. The maximum cases were reported under the age of 4 years [46%]. Out of total 847 TB cases BCG scar was present in only 410 [48.4%] cases. The history of contact with adult TB case was found in 243 [28.7%]. Tuberculin skin test was positive [>/= 10mm] in 309 [36.5%] cases. The most common forms of TB were tuberculous meningitis and pulmonary tuberculosis each accounting for 37.5% cases. Other forms of tuberculosis included TB pleural effusion 12.5%, TB abdomen 7.1%, miliary TB 3.1% and TB arthritis 2.2%. The most common form of TB is meningitis and pulmonary each accounting for 37.5% cases and the maximum cases were reported under the age of 4 years