Setting. The study was undertaken at the Department of Pulmonology at a public, tertiary care centre in Karachi, Pakistan. Objectives. To evaluate factors concerned with in-hospital deaths in patients admitted with pulmonary tuberculosis (TB). Design. A retrospective case-control audit was performed for 120 patients hospitalised with pulmonary TB. Sixty of those discharged after treatment were compared to sixty who did not survive. Radiological findings, clinical indicators, and laboratory values were compared between the two groups to identify factors related to poor prognosis. Results. Factors concerned with in-hospital mortality listed late presentation of disease (P < 0.01), noncompliance to antituberculosis therapy (P < 0.01), smoking (P < 0.01), longer duration of illness prior to treatment (P < 0.01), and low body weight (P < 0.01). Most deaths occurred during the first week of admission (P < 0.01) indicating late referrals as significant. Immunocompromised status and multi-drug resistance were not implicated in higher mortality. Conclusions. Poor prognosis was associated with noncompliance to therapy resulting in longer duration of illness, late patient referrals to care centres, and development of complications. Early diagnosis, timely referrals, and monitored compliance may help reduce mortality. Adherence to a more radically effective treatment regimen is required to eliminate TB early during disease onset.

This is an analysis of the records of 29 children with Kawasaki disease (KD) admitted to Sulaimania Children's Hospital (SCH) in Riyadh in the period between January 1989 and December 1996. The aim was to review our experience with KD in Riyadh and the ability of our paediatricians to recognize the disease. The number of cases admitted from 1993 to 1996 (23) was significantly higher than the number of cases (six) admitted from 1989 to 1892. Of the 29 children who finally met the diagnosis of Kawasaki disease, 19 (66%) were diagnosed on admission.

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Introduction: Chronic obstructive pulmonary disease in non-smokers has been an importantconcern in past decade. We studied the risk factors responsible for more severe Chronic obstructivepulmonary disease. Identifying them would help to work against progression to more severe diseaseas well as prevention.Methods: A prospective cross sectional study was done in outpatient clinic of Jinnah postgraduatemedical center from December 2010 to December 2011. All patients fulfilling the criteria for Chronicobstructive pulmonary disease were taken in study. Patients with less than five pack years smokingwith other risk factors for Chronic obstructive pulmonary disease were evaluated.Results: Out of total 90 patients, 74 (82.2%) had mild chronic obstructive pulmonary disease and 16(17.7%) had moderate to severe chronic obstructive pulmonary disease. Patients with single biomassexposure were found to have mild chronic obstructive pulmonary disease except those havingmosquito coil exposure. Patients with mosquito coil and wood smoke exposure were observed tohave moderate to severe chronic obstructive pulmonary disease (p-value 0.009).Conclusions: Wood smokewith mosquito coil smoke exposure is responsible for more severe chronicobstructive pulmonary disease._______________________________________________________________________________________Keywords: biomass; chronic obstructive pulmonary disease; non-smoker; tuberculosis.

Introduction: Lung abscess is a commonly encountered entity in South-East Asia but not much data regarding its outcome is available. The objective of this study was to identify the factors associated with increased mortality in patients diagnosed with lung abscess in a tertiary care center of Karachi, Pakistan. Methods: A retrospective case analysis was performed via hospital records, on patients admitted with lung abscess between January 2009 and January 2011 at the largest state-owned tertiary care centre in Karachi, Pakistan. Out of the 41 patients hospitalized, 17 could not survive and were evaluated for clinical, radiological and microbiological factors to determine association with heightened mortality. Results: Mortality due to lung abscess stood at 41.4% (17 of 41 cases). Adult male patients were found to have higher mortality with 13 out of 17 (43%) dead patients being male. A majority (21/41, 51.2%) of the cases belonged to the 41-60 year old age group. Highest mortality was seen in patients <20 years of age (3/4, 75%). Patients with blood sugar levels of >200 mg/dL (56%) succumb to disease. Patients with a positive history of smoking, diabetes mellitus, and alcohol intake expressed mortality rates of 44%, 56%, and 50% respectively; while 29.4% of the mortalities were positive for Pseudomonas aeruginosa on sputum culture. A significant association was found with elevated mortality and low haemoglobin levels at time of admission; mortality was 58% ( p=0.005) in patients with Hb less than or equal to 10 mg/dL. Conclusions: The risk factors involved with heightened mortality included male gender and history of smoking, diabetes and alcohol intake. High blood sugar levels and detection of Pseudomonas aeruginosa on sputum cultures were also implicated. Anemia (Hb level less than or equal to 10mg/dl) was statistically significant predictive factor for increased mortality. Keywords: lung abscess; mortality; risk factors.