Background and Objectives: Patients of end-stage renal disease are prone to have a very low quality of life (QoL). Variety of factors influence the QoL among sufferers of chronic kidney disease comprising of type of dialysis, sufficiency/adequacy of dialysis, and associated burden of disease. We conducted this study amidst the pandemic to determine the associated factors for poor QoL in hemodialysis patients during the ongoing pandemic.Patients and Methods: This cross-sectional study was conducted in a hemodialysis unit of a tertiary care hospital. A total of 118 participants responded to the validated questionnaire of Quality of Life Index-dialysis version-III (QLI). Higher scores signify good QoL, total scores are further categorized into subgroups desirable, relatively desirable and undesirable.Results: The mean age of the participants was 57.36 ± 10.03 years and mean body mass index of 26.73 ± 5.54 kg/m 2 . The mean total QoL of the study population was found quite low (12.99 ± 5.89). Majority of respondents fell in undesirable category of QoL (49.2%). Total QoL (P = 0.004) and subscale health/functioning (P = 0.003) were significantly lower in females. All the subscales along with total QoL scores were found lower in twice-weekly dialyzed patients (P < 0.001). Marital status (P = 0.049) and twice-weekly dialysis (P < 0.001) were found significant with undesirable QoL. On multivariate analysis, significant determinants of undesirable QoL were twice-weekly dialysis (P = 0.001), catheter access (P = 0.034), phosphate (P = 0.005) and uric acid (P = 0.006).Conclusion: Inadequate dialysis due to lesser frequency per week leading to poorly cleared toxic substances were most significant contributors of poor QoL in our study.
Aim: To investigate effectiveness and safety of mirabegron in a patient’s symptoms associated with prostatitis in routine practice. Study Design: Prospective, pilot study Place and Duration of Study: Department of Urology, Liaquat University Hospital Jamshoro between 1st October 2020 and 30th November 2021 Methodology: Fifteen male subjects in two groups (control and treatment group with Mirabegron), 18 to 50 years old, with acute and chronic prostatitis according to the operational definition were recruited. The overactive bladder started with mirabegron at daily doses of 25mg, 50mg, and 100 mg respectively. Results: The mean ages were 47.7±2.1 years and 33.8±7.0 years respectively in the control and mirabegron groups. The significant efficacy in treating OAB symptoms such as frequent urination, urge incontinence, and urgency. For mirabegron 50 and 100 mg, the mean volume of urine passed per micturition was observed as early as the first assessment after 4-week’s duration and remained stable throughout treatment for up to 12 months. In terms of dry rates, our analyses revealed a considerable improvement with mirabegron 50mg and 100 mg. Patients considered their treatment with mirabegron to be worthwhile, according to an analysis of patient’s satisfaction treatment criteria. Mirabegron observed to be safe in OAB clinical trials with prostatitis that lasted up to 12 months. Conclusion: When contrasted with existing antimuscarinics that restricted due to associated adverse effects and insufficient effectiveness, mirabegron found improved compliance with balance between effectiveness and safety in Pakistani patients with associated symptoms in prostatitis. Key words: Prostatitis, Mirabegron, Effectiveness
INTRODUCTION:Chronic kidney disease (CKD) is a progressive health care issue that is increasing cost burden on patients and health care system. In different researches it was concluded that relatives of patients suffering from CKD are at more risk of development of kidney problems and diagnosed with CKD. OBJECTIVE: To evaluate the early diagnosis of CKD in at risk population by screening the close family relatives of CKD patients. PATIENTS AND METHODS: A cross-sectional screening study of family members of CKD patients performed in Nephrology department of Jinnah Postgraduate Medical Centre (JPMC), Karachi from September 2015 to January 2017. Total 200 relatives (58% male and 42% female) of CKD patients close relatives were enrolled and screened for medical history, physical examination (weight, height and BMI) and clinical investigations such as urine analysis, serum Creatinine and Glomerular filtration rate (GFR) calculated by Cock GraftGault equation for assessment of renal functions.RESULTS: we observed53 abnormalities in relatives of CKD patients. Family history for Diabetes was present in 58(29%) relatives, Hypertension in 42(21%) relatives, 26 (13%) relatives with Glomerulonephritis (GN), and 74 patients (37%) with Tuberculosis (TB), Kidney damage and Stone diseases. Albuminuria was high in 33% relatives of CKD patients, mostly affecting first degree relatives 20.5% as compared to second degree relatives 2.5%. Relatives of CKD patients were diagnosed with high albuminuria in DM (36.2%) as compare to HTN (35.8%) and GN (27.0%). For final diagnosis, albuminuria and CrCl were monitored, that were found abnormalin 26.5% relatives of CKD patients.CONCLUSION:The screened relatives of CKD patients are at higher risk of kidney problems in the future, especially patients suffering from DM, HTN and GN.
Objectives: Erectile dysfunction (ED) is a very common and distressing healthproblem in chronic maintenance hemodialysis patients. There is no such data available fromSind province of Pakistan on this issue; we want to highlight the factors and prevalence oferectile dysfunction among hemodialysis patients in this part of our country. Study Design:This hospital based observational, cross-sectional study Setting: It was conducted at 04hemodialysis centers of Hyderabad city Perod: In 2014 Methods: The Study was conductedby using International Index of Erectile Dysfunction (IIEF-5) for determination of prevalence& severity of ED among these patients. Comparative analysis for frequency of ED was alsodone between urban & rural patients. Adapted Urdu version of IIEF-5 was used for those whocannot understand English pro forma. Results: There were total 62 male patients; all of themwere on maintenance hemodialysis for more than 6 months. Their ages were between 20 to59 years with mean 36±11. In this series of patients 80% (n=50) were < 50 years of age whilethe diabetic patients were 58% (n=36). The overall prevalence of ED observed in patients was88.7% (n=55) in our study. Severe ED was seen in 30 (48.4%) patients. The prevalence &severity of ED was significantly higher in diabetes mellitus and over 50 years of age. There washigher incidence of ED 94% observed in patients who are living in rural areas as compared tourban areas patients 82%. Conclusions: It has been concluded in this study that majority ofmale hemodialysis patients were suffering from ED problem. Diabetes mellitus and & > 50 yearsof age has the highest prevalence of ED. Erectile dysfunction is very common and distressinghealth related issue among hemodialysis patients and this should be addressed with routine
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