Correlation Of Deviance In Arterial Oxygenation With Severity Of Chronic Liver Disease.

BACKGROUND: Hepatitis B and C related chronic liver diseases have led to development of a serious threat to the people of South Asia. The main aim of this study was to evaluate the correlation of magnitude of arterial deoxygention to the severity of liver disease. METHODS: It was a hospital based cross-sectional descriptive study, carried out in the Medical Department of Khyber Teaching Hospital Peshawar. All in all 115 patients were assessed for the severity of the liver diseases and were correlated with arterial deoxygenation using linear regression models. RESULTS: Male to female ratio was 1.5:1. Males infected with hepatitis B, hepatitis C and both were 9, 60 and 1, while females suffered from hepatitis B, Hepatitis C and both were 2, 42 and 1 respectively. The linear relationship between A-a DO2 with severity of liver disease showed positive correlation while PO2 showed negative correlation with severity of liver disease. CONCLUSIONS: There was a positive correlation between A-a DO2 and severity of liver diseases while PO2 and severity of liver diseases showed negative correlation.

Visceral Adiposity Index: A Simple Tool For Assessing Risk Of Type 2 Diabetes Mellitus.

BACKGROUND: The prevalence of type 2 diabetes mellitus (T2DM) has increased recently in Pakistan. Visceral adiposity index (VAI) appears to be a better predictor for metabolic syndrome associated with insulin resistance. VAI has been shown to be linearly and positively associated with diabetes mellitus (DM) in many populations. It is, however, uncertain whether VAI could be associated with T2DM in the Pakistani adult population.. METHODS: This is a cross-sectional study of 300 outpatients with a newly diagnosed T2DM. Subjects were recruited from Lady Reading Hospital, Pakistan, during the period from April, 2020 to January, 2021. For all study subjects, anthropometric measurements were performed. Blood samples were collected for the assessment of high-density lipoproteins (HDL-C), triglycerides (TGs), glycated hemoglobin (HbA1c), and random blood glucose. RESULTS: Participants with high VAI showed poor glycemic control. The number of patients with poor glycemic control increased across the VAI quartiles. VAI showed significant correlations with TGs (r=0.715, p=<0.001), total cholesterol (TC) (r=0.256, p=<0.001), low density lipoprotein (LDL-C) (r=0.154, p=0.007), uric acid (r=0.205, p=0.019), duration of diabetes (r=0.171, p=0.033), TSH (r=0.163, p=0.007), and random blood glucose (r=0.195, p=0.019). CONCLUSIONS: Our data suggest that VAI is significantly and positively correlated with the risk factors of DM such as random blood glucose, uric acid and TSH. The findings of the study do not imply a significant direct association between VAI and DM among the Pakistani adult population. Prospective-large scale studies can help inform an effectiveness of VAI for the prediction of the risk of T2DM among Pakistani population.

Assessment of Medication Dosage Adjustment in Hospitalized Patients With Chronic Kidney Disease.

Background Inappropriate medication dosing can cause adverse drug reactions or ineffective therapy due to declined renal function in patients with renal insufficiency. This necessitates proper renal dose adjustment. This study was proposed to evaluate medication dosage adjustment in hospitalized chronic kidney disease (CKD) patients. Methods This study included all CKD patients hospitalized between May 1, 2019, and April 25, 2020, at the Institute of Kidney Disease, Peshawar, Pakistan. The estimated glomerular filtration rate was calculated using the Modification of Diet in Renal Disease formula, and dose appropriateness was established by evaluating practice with relevant reference books. Results Of the total 1,537 CKD patients, 231 (15.03%) had evidence of dosing error, which was considered for final analysis. Overall, 1,549 drugs were prescribed; 480 (30.99%) drugs required dose adjustment, of which 196 (40.42%) were adjusted properly and the remaining 286 (59.58%) were unadjusted. The most common unadjusted drugs were meropenem, cefepime, ciprofloxacin, and rosuvastatin, whereas captopril, aspirin, bisoprolol, pregabalin, and levofloxacin had the highest percentage of adjusted drugs. On multivariate logistic regression, the number of drugs requiring dosing adjustments and obstructive nephropathy were found to be statistically significant factors that increased the likelihood of the medication dosing errors: a unit increase in the number of drugs requiring dose adjustment increases 5.241 times the likelihood of dosing error. Similarly, the presence of obstructive nephropathy (OR: 0.383; 95% Cl: 0.153-0.960; p = 0.041) was found to be significantly associated with dosing error after adjustment for potential confounding factors. Conclusion The dosing of more than half of the prescribed drugs that required adjustment in CKD patients was not adjusted, which showed that medication dosing errors were high. This highlights the importance of medication prescription according to guidelines in these patients to improve the outcomes of pharmacotherapy.