Introduction: Urinary tract infections (UTIs) are one of the most frequent infections encountered by doctors. It can be a significant source of morbidity for some patients. Microbes are growing resistant to commonly prescribed antimicrobials and UTIs are becoming more difficult to treat day by day. The study aimed to investigate the common uropathogens encountered in our geographical region and to study their antibacterial susceptibility patterns.Material and Methods: It was a retrospective descriptive study carried out in the Armed Forces Institute of Urology, in collaboration with the Armed Forces Institute of Pathology, Rawalpindi, Pakistan, during the year 2019. Positive reports for urine culture and sensitivity performed during the last two years were studied to document various isolates and their antimicrobial sensitivity.Results: A total of 3191 positive urine cultures in the last two years (2017-2019) were studied. Escherichia coli (66%), followed by Klebsiella Pneumonia (12%) were the most frequently encountered organisms. Overall resistance to Ciprofloxacin was 66%, Cotrimoxazole was 62%, Gentamycin was 40%, Fosfomycin (9.5%) followed by Meropenem (28%) and Nitrofurantoin (35%) were the most sensitive antibiotics.Conclusion: Gram-negative bacilli are the predominant organisms responsible for urinary tract infections. These uropathogens show significant resistance to routinely used antibiotics. Fosfomycin and Nitrofurantoin are suitable oral anti-bacterials for patients with UTI, whereas Meropenem is suitable if an injectable therapy is required. Our study may act as a guide for the choice of empiric antibiotics based on local resistant patterns.
Objectives: To assess and compare the glomerular filtration rate (eGFR) estimated through MDRD and CKD-EPI cr equations in early and late stages of chronic kidney disease on biochemical marker creatinine (eGFR cr ), cystatin C (eGFR cys ); and combined (eGFR cr-cys ), using CKD-EPI equation.
Objective: To determine association between iron deficiency anemia and bone profile in cases of chronic kidney disease not undergoing dialysis. Study Design: Comparative cross sectional study. Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology in collaboration with department of Nephrology, Armed Forces Institute of Urology, Rawalpindi, from Sep 2018 to Oct 2019. Methodology: A total of 300 chronic kidney disease patients who were not dependent on any kind of dialysis were included in our study. Chronic kidney disease was confirmed according to National Kidney Foundation/Kidney Disease Outcome Quality Initiative criteria. Hemoglobin, Mean corpuscular volume and ferritin levels were used to diagnose iron deficiency anemia. Association of Calcium, inorganic Phosphorous, Magnesium, Alkaline phosphatase and Parathyroid Hormone (PTH) was determined with iron deficiency anemia. Results: Out of 300 patients studied 201 (67%) were females while 99 (33%) were males. Mean age of participants was 43.51 ± 5.652 years. Mean duration of chronic kidney disease was 4.36 ± 3.712 years. One hundred and forty one (47%) patients had no anemia while 159 (53%) had presence of iron deficiency anemia. After applying binary logistic regression analysis hypocalcemia, hypophosphatemia and hypomagnesemia were noted to have a statistically significant association with iron deficiency anemia in the target sample size. Conclusion: This study revealed a high frequency of iron deficiency anemia in non-dialysis chronic kidney disease patients. Hypocalcemia, hypophosphatemia and hypomagnesemia were found having strong association with presence of iron deficiency anemia in non-dialysis dependent chronic kidney disease patients.
Objective: To determine the frequency of treatment-resistant hypertension in individuals of high BMI and factors associated with resistant hypertension Study Design: Comparative cross-sectional study Place and Duration of Study: Pak Emirates Military hospital , Rawalpindi Pakistan,from Nov 2020 to Oct 2021. Methodology: Patients being managed for essential hypertension at the medical outpatient department were included in the study. Body mass index was calculated at the time of routine evaluation during the outpatient visit, and a detailed evaluation regarding the number of anti-hypertensive medications used was carried out on patients with a body mass index>25.Resistant hypertension was diagnosed if the blood pressure of the patient was not controlled on three or more antihypertensive medications. Results: A total of 600 patients with hypertension and a body mass index of more than 25 were included in the final analysis. Out of 600 patients, 489(81.5%) had essential hypertension, which was not treatment resistant, while 111(18.5%) had resistant hypertension. Statistical analysis showed that type 2 diabetes mellitus and cigarette smoking had a statistically significant relationship (p-value<0.05) with resistant hypertension among patients with high body mass index. Conclusion: Resistant hypertension was a fairly common diagnosis among patients suffering from hypertension and having a body mass index of more than 25. Patients who had comorbid diabetes mellitus or who were cigarette smokers were more at risk of having resistant hypertension in our data set.
Objective: To assess live donor nephrectomy for development of hypertension. Study Design: Retrospective observational study. Place and Duration of Study: The study was conducted at Armed Forces Institute of Urology (AFIU) Rawalpindi, from May 2016 to May 2020. Methodology: All consenting kidney donors for live renal transplant were introduced with the process. Baseline blood pressure at time of workup of donation and annually afterwards after transplant on follow up examinations using retrospective data analysis of donor’s workup and follow up was used. Comparison of 1,2,3 and 4-year occurrence of hypertension among (normotensive) donors with 1,2,3 and 4-year of donation using estimates from Framingham Hypertension Risk Score. Results: A total of 79 donors with a completed annual follow-up rate of up to100 % during a 4-year period. The average age at donation was 33.96 ± 10.23 SD years; 50 donors (63.4%) were women. Overall 27% (22 out of 79) of all live donors developed post donation hypertension who were normotensive at the time of donation. Almost 2/3rd of the patients developing hypertension were females. There was a significant increase in blood pressure measurements each year after donation. Increased BMI of the patient was a risk factor for post donation development of hypertension. The donors who continue being normotensive 1-year post donation yielded an analogous risk to that fit Framingham populace. Conclusion: Live organ kidney givers are at augmented risk of development of hypertension post kidney donation. The study ascertains the potential significance of following donors and handling risk factors aggressively................
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