Comparing The Efficacy And Safety Of Pregabalin Vs Gabapentin In Uremic Pruritus In Patients Of Chronic Kidney Injury Undergoing Haemodialysis.

BACKGROUND: World has been facing an epidemic of non-communicable diseases including heart, metabolic and renal diseases. Renal diseases have been commonly diagnosed and managed in low- and middle-income countries. Objective was to compare efficacy and safety of Pregabalin and Gabapentin in uremic pruritus among patients of chronic kidney injury undergoing haemodialysis. It was a comparative cross-sectional study, conducted at the Department of nephrology Abbottabad International Medical Institute. February 2021 to January 2022. METHODS: Total of 90 cases were included in the study, which were diagnosed as chronic kidney disease stage 5 undergoing haemodialysis and presented with pruritus. Pruritus was gauged on numeric rating scale and patients score of more than 6 were included. Patients were randomly divided into two groups via lottery method. Group A received Pregabalin while group B received Gabapentin. Efficacy and safety were assessed in both groups at the end of six months. RESULTS: Out of 90 dialysis dependent chronic kidney disease patients with significant pruritus included in the study, 61 (52.7%) patients were males and 29 (46.3%) were females. At the end of 6 weeks, we found out that 35 (38.9%) had no pruritus, 25 (27.8%) had mild, 19 (21.1%) had moderate while 11 (12.2%) had severe pruritus. After applying the chi-square test we found that Pregablin was statistically significantly more efficacious then Gabapentin (p-value-0.026). Sedation, nausea and blurred vision were found more in patients who took Pregabalin (p-value<0.001). CONCLUSIONS: Pregablin emerged out to be more efficacious with regards to reducing pruritus of the two medications compared in our study population while patients who took Gabapentin experience significantly a smaller number of side effects as compared to patients who were given Pregabalin.

Frequency Of Hyperuricemia In Subjects With Unstable Angina/Myocardial Infarction And Their Prognosis.

BACKGROUND: Inhibition of nitric oxide synthesis and stimulation of smooth muscle proliferation by increased serum levels of uric acid play an important role in accelerated atherogenesis in the vessels of patients with hyperuricemia. The objective of the study was to determine the frequency of hyperuricemia in patients with acute coronary syndrome and their in-hospital outcomes. METHODS: This cross-sectional study was conducted in the cardiology department of Ayub Teaching Hospital, Abbottabad from 1st September, 2018 to 28th February, 2019. A total of 199 patients diagnosed with acute coronary syndrome (ACS) were enrolled in this study using non-probability consecutive sampling. Diagnosis of ACS was made on history, electrocardiogram (ECG) findings and on the presence of elevated cardiac biomarkers. Serum uric acid was checked within 24 hours of presentation and patients were grouped into hyperuricemic and normouricemic groups according to uric acid levels. Next in-hospital outcomes were compared between the two groups by comparing the presence or absence of complications. The data was collected on a structured proforma and was analyzed statistically by using SPSS version 16. RESULTS: Out of 199 patients, 146 (73.37%) were male and 53 (26.63%) were female. The mean age of the study participants was 57.99 ± 6.07 years with a range of 48-68 years. Hyperuricemia was diagnosed in 50 (25.13%) study participants. Among complications, 15 patients (7.94%) had cardiogenic shock, 27 (13.57%) had heart failure, 10 (5.03%) had cardiac arrhythmias, 16 (8.04%) had conduction defects and hyperuricemia was diagnosed in 50 (25.13%) patients. Cardiogenic shock was more common in patients with hyperuricemia (p < 0.05). CONCLUSIONS: Hyperuricemia is associated with a number of significant adverse outcomes for patients with an acute coronary event. Regular screening / monitoring of serum uric acid level in general population can prevent the direct and indirect morbidity associated with hyperuricemia.

Frequency Of Elevated Troponin T In Patients Of Hronic Renal Failure Without Clinically Suspected Acute Myocardial Infarction.

BACKGROUND: Cardiac Troponins are established markers of myocardial injury; however, they may be elevated in chronic renal failure (CRF) patients even in absence of acute myocardial infarction. The objective of the study was to determine the frequency of elevated Troponin T in patients of chronic renal failure without clinically suspected acute myocardial infarction. METHODS: This cross-sectional study was conducted at Medical B Unit of Ayub Teaching Hospital, Abbottabad from 16th December 2013 to 16th June 2014. A sample of 117 patients of chronic renal failure was included in the study without any gender discrimination. The patients were defined as known chronic renal failure when renal failure was reported in their past medical history and by estimation of glomerular filtration rate (GFR). Those patients who had raised Troponin T due to any other reason like acute myocardial ischemia (chest pain, electrocardiographic changes and greater than 20% elevation in Troponin T from baseline), sepsis, heart failure and those who were receiving cardiotoxic chemotherapy were excluded. The subjects were enrolled by non-probability consecutive sampling. Results were analysed by SPSS 16.0. RESULTS: Out of 117 participants, 72 (61.5%) were males and 45 (38.5%) were females. The mean age of the study participants was 52.08±14.21 years. Elevated Troponin T was found in 45 (38.5%) of the patients. There is statistically significant association between the stage of CRF and elevated levels of Troponin T. Statistically significant negative correlation (r=-0.213,p=0.021) was found between the Glomerular Filtration Rate and serum levels of Troponin T. CONCLUSIONS: A high proportion of CRF patients have elevated Troponin T and the rise is significantly associated with the stage of chronic renal failure.