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Background: Hemodialysis in end-stage renal disease patients causes disability in different domains of patient's lives, leading to impaired (quality of life [QOL]). Studies measuring the QOL in patients on renal replacement therapy are limited in the Indian scenario. Aims: To evaluate the QOL in adult patients on maintenance hemodialysis by applying the World Health Organization QOL (WHOQOL)-BREF scale. Material and Methods and Study Design: Health-related QOL was evaluated in 100 adult patients on maintenance haemodialysis for 3 months or more in Dayanand Medical College and Hospital, Ludhiana. The WHOQOL-BREF was applied in these patients and the physical, psychological, social, and environmental health domains were assessed. Results: Most common age group was 31–60 years (56%) with a mean age of 54.44 years, male: 74%. Patients with age more than 60 years had better QOL scores in the social domain which was statistically significant (P = 0.005). Male patients had better scores in all four domains and was significant in the social domain (P = 0.025). Married patients had better QOL scores in social domain. Duration of dialysis had a reverse correlation with QOL scores in physical domain with better scores in dialysis duration of 60 years had better QOL scores in the social domain. Female gender, low serum proteins, HD duration of more than 1 year, and low monthly income were found to be associated with impaired QOL domains in patients undergoing maintenance hemodialysis.

OBJECTIVE: A rapid AKI risk assessment score would allow for improving management and outcomes. STARZ (Sethi, Tibrewal, Agrawal, Raina, waZir) score was developed for acute kidney injury (AKI) risk stratification of critically ill neonates. This is the first independent validation for the novel score outside the original enrolled centres. STUDY DESIGN: 750 neonates were included in the study. The STARZ score was calculated after 12 hours of admission. Neonates admitted in NICU and receiving IV fluids for at least 48 hours were included. RESULTS: A total of 8.8% neonates had AKI in the first 7 days post admission. The duration of hospital stay was significantly higher among neonates with AKI [10.5 (7–19) vs. 7 (5–10) days; p

Aims: The etiological spectrum and clinical profile of admitted patients presenting with pancytopenia were studied. Study Design: This was a prospective study conducted on 200 patients presenting to the Department of Medicine, Department of Oncology and the Allied Specialities of Medicine, Dayan and Medical College and Hospital, Ludhiana and were found to have pancytopenia during hospital stay. Results: Mean age of the patients was 45.69 ± 17.05 years with maximum number of patients (23%) in the age group of 51-60 years and 119 patients were males and 81 patients were females. Most common physical finding was pallor (95%), followed by splenomegaly (22%) and hepatomegaly (17%). Total of 107 patients were vegetarians (53.5%) and 93 patients (46.5%) were non-vegetarians. Mean hemoglobin was 7.16 ± 2.04 g/dl, mean total leucocyte count was 2.51 ± 1.02 x 103/cu. mm, mean platelet count was 54885.37 x 103/ul ± 40320.96 and mean the absolute neutrophil count was 1.59 x 103 /cu.mm ± 0.84. Ten patients of pancytopenia were because of tropical fever which included 4 cases of dengue, 3 cases of malaria, 2 cases of enteric fever and 1case of mixed infection (malaria + scrub typhus). Viral markers were positive in 14 out of the 63 patients tested. Out of these 14 patients, 4 were HBsAg reactive, 7 were HCV +ve and 3 were HIV +ve. Most common red blood cell picture on peripheral blood film was normocytic normochromic (34.5%), followed by mixed morphology (33.5%). Macrocytic and microcytic morphology was seen in 19.5% and 12.5% of the patients respectively. Hypercellular marrow was seen in 82 patients (42.9%), normocellular marrow was seen in 58 patients (30.3%) and hypocellular marrow was seen in 51 patients (26.7%). The most common cause of pancytopenia in this study was megaloblastic anemia in 59 patients (29.5%), the 2nd common cause was leukemias in 28 patients (14%) and the 3rd cause was aplastic anemia in 22 patients (11%). Drug induced pancytopenia was seen in 21 patients (10.5%) and hypersplenism in 9 cases (4.5%). Conclusion: This study has helped us in knowing the various etiologies of pancytopeniain this hospital. Megaloblastic anemia was the most common etiology in this study followed by leukemiasand aplastic anemia. The study helped us in understanding of the age and gender distribution, the hematological parameters, the peripheral blood film in pancytopenia and the bone marrow picture in these patients.

Oral cyclophosphamide (CYP) is an important therapeutic agent in treatment of steroid-sensitive nephrotic syndrome having a steroid-dependent (SD) or frequent relapsing (FR) course. This retrospective observational study aimed to determine response to oral CYP and factors associated with positive response in these patients.We studied 100 children (male; 75) with FR (19%) and SD (81%) NS treated with CYP in the Pediatric Nephrology clinic. Responders were defined as children in whom steroids were stopped for at least 6 months following CYP and factors affecting response were analysed. Relapse-free survival was estimated by Kaplan-Meier method.Median age at onset of NS was 3 years (IQR 2-5.2). Median age at CYP was 5.7 years (IQR 3.7-7.9). Fifty percent of patients were in the responder group at 6 months of CYP. Relapse-free survival post CYP therapy was 31% at 1 year, 11% at 2 years. Factors predicting good response were age at onset of NS3 years with 61.2% response at 6 months (p = 0.028) and older age at CYP initiation (5 years) with 61% response (p = 0.008). Multivariate regression analysis showed age at start of CYP5 years was an independent factor for good response (p = 0.044, OR = 2.903, CI -1.03 to 8.18).Judicious selection of patients, especially with age of onset of NS more than 3 years and initiation of CYP after age of 5 years, can predict better response in this group of patents.

Background: The physiological changes associated with menopause are responsible for increase in cardiovascular disease after menopause. BMI, physical inactivity, metabolic syndrome, hypertension and diabetes mellitus increase in post-menopausal women which are all powerful predictors of cardiovascular events. The risk factor profile between pre-menopausal and post-menopausal women presenting with acute coronary syndrome was thus studied.Methods: This study was a prospective cross-sectional hospital based study and was conducted in the Department of Medicine and Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana wherein 50 pre-menopausal women and 50 post- menopausal women who presented with acute coronary syndrome were enrolled. The risk factor profile and angiography findings amongst the 2 groups were compared.Results: There was no difference in the incidence of Diabetes Mellitus and Hypertension among the pre & post-menopausal groups. The prevalence of family history of cardiovascular disease was higher in the pre-menopausal group. The post-menopausal women showed a significant decrease in physical activity due to sedentary lifestyle. Both the groups had high BMI and increased waist circumference. Lipid parameters did not show any significant difference between the two groups. However, pre-menopausal women had higher LDL-C and triglyceride levels and lower HDL-C levels. On analysis of the angiographic findings in diabetics and non-diabetics, of both the groups diabetes mellitus was much higher in subjects presenting with triple vessel disease suggesting extensive atherosclerosis.Conclusions: study showed physical inactivity as an important cardiovascular risk factor in post-menopausal women. Obesity is an important risk factor for coronary artery disease in both pre- and post-menopausal women.