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Objective: To determine the frequency of protein energy wasting among end stage renal disease patients on maintenance hemodialysis. Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Nephrology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from May 2019 to Mar 2020. Methodology: Two hundered patients diagnosed with end-stage renal disease on maintenance hemodialysis were included in the study. Protein-energy wasting was assessed using the Malnutrition inflammatory score comprising four x components: medical history, physical examination, laboratory parameters and body mass index. Malnutrition inflammatory score was used to categorize protein-energy wasting. Results: Out of 200 patients with ESRD on maintenance hemodialysis, 73(36.5%) patients had mild, 120(60.0 %) patients had moderate, and 7(3.5%) patients had severe protein-energy wasting. The advanced age group, multiple comorbid (diabetes mellitus, hypertension, ischemic heart disease), and duration of hemodialysis (> 2 years) had a statistically significant association with the protein energy wasting (p-value < 0.05). Protein-energy wasting was also more prevalent in patients with low monthly income (p-value 0.04). Conclusion: Protein-energy wasting is common among patients with end stage renal disease on maintenance hemodialysis. Old age group, multiple comorbid, and duration of hemodialysis are important risk factors. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of Amlodipine with Captopril in the management of patients presenting to the emergency department with uncontrolled blood pressure. Study Design: Comparative prospective study. Place and Duration of Study: Emergency Department, Combined Military Hospital, Malir Pakistan, from Jul to Dec 2021. Methodology: A total of 127 individuals presenting to the Emergency Department with two readings of uncontrolled blood pressure (Systolic blood pressure > 160mmHg and Diastolic blood pressure >90mmHg) were included. They were administered a tablet of Captopril 12.5mg per oral and a tablet of Amlodipine 10mg per oral on the turn by turn basis. Patients were observed for 3 hours and monitored for the reduction in blood. The efficacy of medication was judged based on the ability to achieve target blood pressure reduction, which was at least a 20-30% reduction in systolic blood pressure. Results: Out of 127 individuals, 65(51.2%) patients were given a tablet of Captopril 12.5mg orally, and 62(48.8%) were given a tablet of Amlodipine 10mg orally. The mean reduction in systolic blood pressure was 20.73±5.17 in all patients. In addition, target blood pressure reduction was achieved in 35(53.8%) individuals of the Captopril-Group and 33(53.2%) of the Amlodipine-Group, with a total of 68(53.5%) individuals achieving target blood pressure within 3 hours after medication. Conclusion: Both medications were efficient in achieving target blood pressure levels. However, no drug was superior to another in reducing blood pressure in an emergency. [ABSTRACT FROM AUTHOR]