Objective: The objective of the study was to determine the demographic factors affecting Quality Of Life (QOL) of hemodialysis (HD) patients. Methods: This observational study was conducted at Shalamar Hospital, Lahore. Patients of End Stage Renal Disease (ESRD) and on maintenance HD for more than three months were included during the period March to June 2012. Patient of ESRD not on dialysis and Acute Renal Failure were excluded. One hundred and twenty five patients who fulfilled the criteria were included. Demographic data containing age, sex, residence, socio economic status, education, mode of traveling for dialysis, total time consumed in dialysis were collected by the investigators. QOL index was measured using 26 items, WHO QOL BREF. Results: There were 89(71.2%) male and 36(28.8%) female patients. Environmental domain score was highest (p=0.000) than all other domains in HD Patients. In overall analysis age, marital status and total time consumed in getting HD effect QOL significantly (p=<0.05). In domain wise analysis, male has better QOL in social relationship domain than female. Age has negative relationship with physical health and psychological health domain. QOL of unmarried and literate patients is significantly better (p=<0.05) in physical health domain. Employed patients have better QOL in physical, psychological and social relationship domain (p=<0.05) than unemployed patients. Patients of residence of rural areas have better QOL in physical and environment domain. Financial status of HD patients affect QOL in social domain. Distance covered to reach hospital effect QOL in psychological domain (p=<0.05). Patients traveling in private transport have better QOL in environmental domain (p=<0.05). Total time consumed in getting HD effect social relation in QOL (p=<0.05). According to linear regression model, marital status is positive predictor and unemployment is negative predictor of QOL in physical health domain. Age is negative predictor of QOL in psychological domain, monthly income is positive predictor of QOL in domain. Unemployment is positive predictor of QOL in social relation domain. Monthly income and place of residence is positive predictor of QOL in environment domain. Conclusion: Gender, age, marital status, unemployment, residence of rural area, economical status, distance covered to reach hospital, mode of transport, total time consumed in getting HD, effect QOL in HD patient. Education level is a positive factor for improving QOL of HD patients.

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BackgroundPeste des petits ruminants (PPR) is an endemic and highly contagious disease in small ruminants of Pakistan. Despite the fact that an effective vaccine is available, outbreaks are regularly occurring in the country. Thus so far, the diagnosis has primarily been made based on clinical outcome or serology. This study was carried out to characterize PPRV from an emerging wave of outbreaks from Punjab, Pakistan.ResultsA total of 32 blood samples from five different flocks were tested with real-time PCR for the presence of PPRV genome. The samples detected positive in real-time PCR (n = 17) were subjected to conventional PCR for the amplification of the nucleoprotein (N) gene. Phylogenetic analysis of the sequenced N genes (n = 8) indicated the grouping of all the sequences in lineage IV along with PPRV strains from Asian and Middle East. However, interestingly sequences were divided into two groups. One group of viruses (n = 7) clustered with previously characterized Pakistani isolates whereas one strain of PPRV was distinct and clustered with Saudi Arabian and Iranian strains of PPRV.ConclusionsResults demonstrated in this study expanded the information on the genetic nature of different PPRV population circulating in small ruminants. Such information is essential to understand genetic nature of PPRV strains throughout the country. Proper understanding of these viruses will help to devise control strategies in PPRV endemic countries such as Pakistan.

Objective:Many factors affect quality of life (QOL) of dialysis patients. This study was conducted to determine the effect of socio-economic factors effecting QOL of hemodialysis patients.Methods:This descriptive multi-centric, follow up study was conducted at Department of Nephrology, Mayo Hospital, Lahore, from February 2015 to August 2017. All patients who were on regular maintenance hemodialysis (MHD) for more than three months and able to read and understand Urdu version of Kidney Disease Quality Of Life (KDQOL) tool were included in the study. Patients were included from hemodialysis units of Mayo Hospital (MH), Shalamar Hospital (SH), and Shaikh Zayed hospital (SZH), Lahore. Patients with less than three-month duration on dialysis, with cognitive impairment, dementia, active psychosis, non-Urdu readers/speakers were excluded. Demographic data and lab data was collected on predesigned pro forma. Patients were divided into different groups on the basis of education, monthly income, source of funding for treatment and employment. Patients were followed up for two years to determine the effect of QOL on mortality.Results:One hundred and thirty-five patients were included in the study. Socio-economic factors like education, employment, income, funding was compared with KDQOL sub scales and were found statistically significant (p-value (<0.05). We found that patients with higher income had better work status (p=0.039) but social (0.04) and sexual function (p=0.029) were relatively better in patients with low income. Employed patients had better work status (p=0.01), ability to do social function (p=0.027) but they had more pain (0.049), symptoms/problems of disease (p=0.05) and effect of kidney disease (p=0.015). Those patients whose dialysis were funded by their family could socially interact (p=0.012) better and deal more efficiently with effect of kidney disease (p=0.007). Higher education was associated with better emotional well being (p=0.045), patient satisfaction (p=0.046) and staff encouragement (p=0.045) then patient with lower level of education. QOL had no effect on mortality.Conclusion:The socio-economic factors consisting of education, employment, income and funding are important parameters affecting QOL of kidney patients. QOL does not affect mortality of the dialysis patients.