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Objective: To determine the external validity of STONE score for predicting the probability of ureteral stone in patients presenting in emergency department with suspicion of ureteral stones. Methods: In this prospective validation study, a total of 134 patients aged above 18 years, and first time arrived in the emergency unit for treatment of flank pain and then referred for the CT scan for suspected ureteral stone in Sandeman Provincial Hospital, Quetta, from 10-June-2018 to 15-Oct-2019 were included. STONE score calculation was done before sending the patient to the CT scan, using the same protocol as defined by Moore et al. Based on STONE score patients classified into the low-risk group (0 to 5), moderaterisk group (5 to 9) and the high-risk group (10 to13). The AUC, sensitivity, specificity and test characteristics were calculated for STONE score. Results: The mean age was 39.2± 11.2 years, there were 86 (64.17%) men and 48 (35.83%) women. there were 26.8% patients having low-risk score, 52.23% moderate-risk and 21.97% high-risk score. On receiver operating curve (ROC) the area under curve (AUC) of the stone score was 0.75 (95% CI, 0.67 to 0.83), the lower band of AUC 0.67 and upper band 0.83. In high risk STONE score the sensitivity of STONE score was 66.7% and specificity was 75.0%. Conclusion: Based on our study results, CT scan and ultrasonography are standard diagnostic tools for suspected ureterolithiasis but in emergency unit, use of STONE score to categorize the patient as low risk, moderate-risk and high-risk of ureteral stone can help the physician (clinician) to take decision either there is a need of further investigation or not. [ABSTRACT FROM AUTHOR]

Objective: Pulmonary hypertension (PH) has been described in hemodialysis (HD) patients and has been associated with increased morbidity and mortality. Our objective was to determine the prevalence of pulmonary hypertension in patients on regular hemodialysis. Methods: This cross sectional study was conducted in Department of Nephrology, Liaquat National Hospital Karachi from April 2013 to March 2014. Eighty patients of end stage renal disease (ESRD), on maintenance hemodialysis (HD); underwent Trans thoracic Echocardiography were selected. Systolic pulmonary arterial pressure (SPAP) was recorded. Pulmonary hypertension was defined as, pulmonary artery pressure (PAP) greater than 30 mm Hg at rest. Pulmonary hypertension was further divided into mild (PAP b/w 30- 45mmHg), moderate (PAP b/w 45-65mmHg) and severe pulmonary hypertension (PAP > 65mmHg). The effect of different vascular accesses, age, gender, dialysis vintage on the development of pulmonary hypertension was observed. Results: Out of 80 patients, 45 patients (56%) had pulmonary hypertension (PH); 25(55.5%) had moderate, 13(29%) had mild, and 7 (15.5%) patients had severe pulmonary hypertension (PH). Pulmonary hypertension was present in 41(60%) patients with AVF, 3(27%) patients with tunnel cuffed catheter and 1 patient had AV bridge graft. Pulmonary hypertension was more common in females; present in 28 females (67%) and 17 males (45%), that was statistically significant (p<0.05). Mean duration of hemodialysis in (months) of patients with PH was 20.93 ± 12 vs. 10.29 ±10 in patients without PH (p<0.05). Age had no relation to development of PH. Conclusion: ESRD patients on HD have strong tendency to develop PH. Our study demonstrated that PH is more common among females. Duration of hemodialysis and AV access has strong relation to the development of PH. [ABSTRACT FROM AUTHOR]