Protein calorie malnutrition is common in chronic kidney disease patients especially on maintenance hemodialysis (MHD). Multiple factors including mainly frequency and adequacy of dialysis and dietary habits may result in malnutrition besides other comorbidities. Different tools have been designed to analyze the nutritional status of dialysis patients including subjective global assessment, malnutrition inflammation score, Mini Nutritional Assessment– Short Form (MNA-SF) and several others. We assessed the nutritional status of our MHD patients using Mini Nutritional Assessment–Short Form (MNASF) Methods Total of 44 patients aged between 13 to 64 years, undergoing MHD for at least 6 months were included in the study. Results Out of 44 patients 63% patients were malnourished, 34% were at risk of malnutrition and 3% were having normal nutritional status according to MNA-SF. The mean of mid-arm circumference was low even in the presence of mean albumin and BMI within the normal range. Conclusion Nutrition is a neglected aspect of the dialysis patients. Multiple factors including poor socioeconomic status, lack of knowledge and poor dietary compliance lead to significant malnutrition among MHD patients.

Objective: To record the incidence of AKI following acute gastroenteritis and to poor prognostic factors in patients having AKI following gastroenteritis. Methodology: We enrolled 92 cases with above 14 years of age diagnosed to have acute kidnay injury due to gastroenteritis. Detailed history, clinical examination and laboratory investigations were done at admission. Serum creatinine, urea, potassium were done daily. Other investigations done were liver function tests, urine complete examination, serum sodium levels, ultrasound abdomen and renal failure and its associated factors were recorded. Results: We studied 92 patients admitted to our hospital with acute gastroenteritis. Among those 48(54%) patients had AKI whereas 44(46%) patients didn’t developed AKI following acute gastroenteritis. AKI was more common in males(72%) as compared to females(28%). The most common manifestation was oliguria and anuria in( 66%)of the cases, (43%) of the patients having AKI had hypertension and (29%) had DM.(94%) patients were managed conservatively and (6%) required hemodialysis. Conclusion: We concluded that AKI is highly prevalent in patients with gastroenteritis whereas diarrhea is a major risk factor of AKI. Keywords: Gastroenteritis, Acute renal failure(AKI), risk factor

Introduction: Urinary stones, also known as calculi, are a common urological problem affecting millions of people worldwide. Medical expulsion therapy (MET) is a commonly used treatment for lower ureteral calculi. Objectives: The main objective of the study is to find the role of silodosin as a superior substitute for tamsulosin in medical expulsion therapy for patients with lower ureteral calculi. Material and methods: The study design for this research article would be a randomized controlled trial comparing the efficacy and safety of silodosin and tamsulosin in medical expulsion therapy (MET) for patients with lower ureteral calculi. Patients with lower ureteral calculi who meet the inclusion criteria will be recruited for the study. Inclusion criteria may include age over 18 years, presence of lower ureteral calculus confirmed by imaging, and willingness to participate in the study. Exclusion criteria may include previous history of ureteral surgery, contraindication to alpha-blockers, and pregnancy. Results: A total of 100 participants were randomized to receive either silodosin (n=50) or tamsulosin (n=50) for medical expulsion therapy of lower ureteral calculi. The mean age of the participants was 45 years, and 60% were male. The stone expulsion rate at 4 weeks was 80% in the silodosin group and 75% in the tamsulosin group. There was no statistically significant difference between the two groups (p=0.54). Conclusion: In conclusion, the results of this study indicate that silodosin may not be a superior substitute for tamsulosin in medical expulsion therapy for patients with lower ureteral calculi. Both drugs demonstrated similar rates of stone expulsion and time to stone passage, as well as comparable safety profiles and patient satisfaction rates. Keywords: Silodosin, Tamsulosin, Lower Ureteral Calculi

Catheter related blood stream infections (CRBSI) in patients undergoinghemodialysis frequently results in significant morbidity and mortality. Attempts at prevention ofCRBSI by catheter lock antibiotics, antibiotic combinations or solutions including Taurolidinehave emerged over years. Objectives: To determine the role of taurolidine lock in presentationof Catheter related infection in hemodialysis. Design: Multicentre un-builded, randomizedcontrolled, non-inferiority trail. Period: Jul 2012 to Dec 2013. Setting: Department of Nephrology,Fatima Memorial Hospital UHS Lahore. Methods: It was a multicentre, un-blinded, randomizedcontrolled, non-inferiority trial. Results: Out of 95 patients, total of 38 patients were randomizedinto two groups. In group A catheters were locked with Taurolidine 2% and Heparin (5000IU/ml) equal to the catheter volume according to the protocol. In group B (control) catheters werelocked with Heparin alone. 36 patients completed the study protocol. For primary end pointanalysis (30 days) the mean duration of catheter days was 27.25 + 5.5 days (median 30 days).During this period of follow up only one patient from Group B had CRBSI resulting in a pointincidence of CRBSI of 2.7%. Conclusions: Catheter lock with Taurolidine 2% in combinationwith heparin compared to heparin alone had no additional benefit in prevention of CRBSI. Thishowever needs to be evaluated in a larger study using non cuffed temporary vascular access(TVA).

Progressive loss of kidney function in chronic kidney disease (CKD) leads to reduced production of 1-α-(OH)2-D3 (1,25-dihydroxyvitamin D; calcitriol) and abnormal mineral homeostasis leading to bone mineral disorders. The disorder starts with stage 2 CKD but manifests itself as the disease progresses until stage 3 CKD. Material and methods This study was carried out on 61 patients with end-stage renal disease on regular HD at our Centre. After obtaining informed consent, complete blood count, blood urea level, serum creatinine level, albumin level, uric acid level, Ca level, phosphate level, alkaline phosphatase level, and PTH level were done. Results Out of 60 patients 41 (68.33%) were high bone turnover,10 (16.6%) were normal bone turnover whereas 9(15%) were low bone turnover. Conclusion The prevalence of CKD-MBD among dialysis patients is 83.33% at our center and needs proper monitoring by routine investigations including serum phosphate, calcium, vitamin D levels and most importantly i-PTH levels according to guidelines.