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Objectives: This study was aimed to find out the frequency of iron deficiency anemia (IDA) among children with febrile seizures (FS). Study Design: Descriptive, Cross- Sectional study. Setting: Department of Pediatric Medicine, The Children's Hospital and The Institute of Child Health Multan. Period: from 31st July to 31st December 2017. Material & Methods: A total of 57children, age 6 months to 6 years of either gender presenting with FS were enrolled in the study. Demographic data included age, gender, residential area, maternal literacy and socio-economic status. Work-up for iron deficiency anemia included hemoglobin (Hb) level with serum ferritin levels. Mean and standard deviation were reported for age, disease duration, Hband ferritin levels whereas frequency and percentages are reported for categorical data. Results: A total of 57 children that included 66.7% females (n=38) were enrolled. Mean Hb (g/dl) and ferritin (µg/L) level was 8.87±6.01 and 9.12±7.36 respectively. IDA was observed in 28.1% (n=16) of the patients. IDA was significantly higher in children 6 months to 3 years age (p-value 0.038), from rural origin (p-vale 0.005), with low income status (p-value 0.025) and children of illiterate mothers (p-value 0.004). Conclusion: IDA is not uncommon in children with FS. Children younger than 3 years, from rural origin, with low income status, and having illiterate mothers were more prone to IDA. [ABSTRACT FROM AUTHOR]

Objectives: To determine the factors those may predict hyperkalemia in cirrhotic patients receiving spironolactone. Study Design: Cross sectional descriptive study. Setting: Medicine Department Shalamar Hospital, Lahore. Period: 15 days from 1st September to 15th September 2017. Materials & Methods: 150 patients with documented liver cirrhosis, receiving spironolactone and fulfilling the inclusion criteria were made part of the study. Five mL blood was drawn in two different vials; 2 mL in EDTA vial to check the prothrombin time (PT) and 3 mL in clotted vial to measure serum potassium, sodium, creatinine, urea, albumin, and bilirubin in serum after centrifugation. Potassium level was measured at baseline (Day-0) and two weeks later after receiving spironolactone. Results: Patients with raised serum creatinine (>1.3 mg/dL) and hyperbilirubinemia (>2.8 mg/dL) were found to have serum potassium more than 5 mmol/L. Increased potassium levels were found in patients receiving high dosage of spironolactone (>100mg/day). These patients had decompensated liver cirrhosis as evident from their child-class C and significant hypoalbuminemia. Conclusion: Decompensated cirrhotic patients with raised serum creatinine, hyperbilirubinemia, hypoalbuminemia and receiving high dosage of spironolactone remain at higher risk of developing hyperkalemia. [ABSTRACT FROM AUTHOR]

Cirrhosis with subsequent portal hypertension is a major health problem worldwide. Among various etiologies, HCV is the leading cause of chronic hepatocellular injury. Cirrhosis being the commonest cause of portal hypertension results in a spectrum of complications. Approximately 5-15% of cirrhotic develop varices. Gastric varices although present less frequently as compared to esophageal varices but are associated with greater mortality and morbidity. Objectives: To determine prevalence of Gastric varices in patients with decompensated cirrhosis. Study Design: Cross sectional study. Place & Duration: Carried out at two centers, Pakistan Ordinance Factories Hospital Wah Cantt and Shalimar Hospital Lahore from Jan 2014 to Jan 2015. Subjects: A total of 421subjects of decompensate cirrhosis were included in the study. Methods: Patients with decompensate cirrhosis of any etiology who were visiting the two hospitals as inpatient or outpatient were included in the study. Upper GI endoscopy was done in all these subjects for determination of gastric varices. Results: Among 421 patients of decompensate cirrhosis, frequency of gastric varices was 10.9%, GOV1 as the most common variant. Gastric varices contributed to 5.4% of all variceal bleeds. Conclusion: Gastric varices are found in significant number of patients of decompensate cirrhosis. Since gastric varices are associated with increased mortality and poor outcomes, these should be carefully looked during upper GI endoscopy. Successful management of gastric variceal hemorrhage necessitates availability of expertise and newer diagnostic modalities. [ABSTRACT FROM AUTHOR]

Perioperative shivering is a common problem during spinal anaesthesia. It causes tremendous deleterious effects on metabolism of body. Despite of re-warming and raising the ambient temperature, several drugs are under research to evaluate their preventive role in shivering during anaesthesia like tramadol, butorphanol, midazolam, ketamine and ondansetron. The present study was conducted to evaluate the effect of prophylactic low dose ketamine and ondansetron for prevention of shivering during spinal anaesthesia. Objective: To compare prophylactic low dose ketamine with ondansetron for prevention of shivering during spinal anaesthesia in patients undergoing lower abdominal surgeries. Study Design: Randomized controlled trial. Setting: Department of Anaesthesia, Nishtar Hospital Multan. Period: November 2012 to May 2013. Material and methods: A total of 256 patients were included in the study divided into two equal groups. Results: In this study basic demographics like age, gender, mean weight and height and type of surgery patients underwent were similar, having no significant difference in both groups, while on comparison in both groups, the frequency of shivering revealed 4.69%(n=6) in K Group and 11.72%(n=15) in O Group while remaining 95.31%(n=122) in K and 88.28%(n=113) in O Group had no findings of the morbidity, p value was calculated as 0.03, which showed significant difference. Conclusion: The result of the study concluded that prophylactic intravenous administration of low dose ketamine (0.25mg/kg) is significantly more effective than ondansteron (4 mg) for prevention of shivering during spinal anesthesia in patients undergoing lower abdominal surgeries. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) has infected about 200 million individuals across the world and is known as the major cause of liver disease . Objectives: Viral load measurement at early stages of the therapy in Hepatitis C patients is believed to be a more effective tool to predict the sustained virological response (SVR). The primary aim of the present study was to evaluate whether the decline in viral load of HCV at early stages of the therapy may predict the treatment response. Another objective was to see the benefits of therapy extension in non-responders. Study Design: Descriptive, analytical study. Setting: Shalamar Hospital Lahore. Period: November 2010 to October 2013. Methods: Four hundred and thirty patients, chronically infected with different genotypes of Hepatitis C virus were treated with Interferon alpha 2b plus Ribavirin (IFNα-2b + RBV). Viral load was assessed at day zero, week four, in the mid time of therapy and at the end of therapy. The treatment duration was extended 12-24 weeks (according to HCV genotypes) in non-responders. Results: The patients with <2 MIU/ mL viral load at day zero, able to drop ⩾2 log viral load at week-4 or showed no virus at the time of half therapy completion, exhibited better response. The extension of therapy was more beneficial for those non-responder who had <0.05 MIU/mL viral load at the end point of therapy than those who had ⩾0.05 MIU/mL at that stage. Conclusions: The viral load detection at early stages of the therapy will be useful in clinical practice. Moreover, the patients with <0.05 MIU/ mL viral load at the end of therapy are suitable candidates for the therapy extension. [ABSTRACT FROM AUTHOR]