RESUMO
Background@#The World Health Organization guidelines did not make a recommendation on use of remdesivir based on disease severity. Little is known regarding effectiveness of remdesivir in critically ill coronavirus disease 2019 (COVID-19) patients. This has led to a state of dilemma for doctors leaving them skeptical of whether they should continue to recommend the drug or not. @*Materials and Methods@#A systematic search adhering to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines was conducted from inception until February 20, 2020. Electronic bibliographic databases (PubMed, Cochrane database, Scopus, Embase) were included. Using dichotomous data for select values, the unadjusted odds ratios (ORs) were calculated applying Mantel Haenszel (M-H) using random-effects model. The primary outcome of interest was all-cause mortality in ventilated and nonventilated patients. @*Results@#The Remdesivir arm was associated with similar rates of 28-day all-cause mortality (OR: 0.93, 95% confidence interval [CI]: 0.80 - 1.08; P = 0.33). Remdesivir was not found to be favorable for ventilated patients. Non ventilated COVID-19 patients showed a significant lower in-hospital mortality rate as compared with patients requiring mechanical ventilatory support (OR: 6.86, 95% CI: 5.39 - 268.74;P<0.0001). @*Conclusion@#Non-ventilated patients were associated with significant lower all-cause mortality rates. Prudent use of remdesivir is recommended in critically ill COVID-19 patients.
RESUMO
Background@#The World Health Organization guidelines did not make a recommendation on use of remdesivir based on disease severity. Little is known regarding effectiveness of remdesivir in critically ill coronavirus disease 2019 (COVID-19) patients. This has led to a state of dilemma for doctors leaving them skeptical of whether they should continue to recommend the drug or not. @*Materials and Methods@#A systematic search adhering to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines was conducted from inception until February 20, 2020. Electronic bibliographic databases (PubMed, Cochrane database, Scopus, Embase) were included. Using dichotomous data for select values, the unadjusted odds ratios (ORs) were calculated applying Mantel Haenszel (M-H) using random-effects model. The primary outcome of interest was all-cause mortality in ventilated and nonventilated patients. @*Results@#The Remdesivir arm was associated with similar rates of 28-day all-cause mortality (OR: 0.93, 95% confidence interval [CI]: 0.80 - 1.08; P = 0.33). Remdesivir was not found to be favorable for ventilated patients. Non ventilated COVID-19 patients showed a significant lower in-hospital mortality rate as compared with patients requiring mechanical ventilatory support (OR: 6.86, 95% CI: 5.39 - 268.74;P<0.0001). @*Conclusion@#Non-ventilated patients were associated with significant lower all-cause mortality rates. Prudent use of remdesivir is recommended in critically ill COVID-19 patients.
RESUMO
Background alcohol poisoning is a serious issue in both the developed and developing countries. Illicit alcohol is commonly called as moonshine or bootleg whereas in Pakistan it is ordinarily known as tharra, kuppi, desi sharab, or daroo. This alcohol is mainly prepared by fermenting the mash of sugar cane pulp in a clay pot up to near 100% alcohol; however, it may contain impurities and many toxic materials. The awareness and basic knowledge of methanol poisoning is quite scarce in our society due to the cultural aspects. The goal of our study is to identify the clinical factors associated with the alcohol poisoning along with the frequency of mortality
Methodology a cross sectional has been conducted on the patients who were admitted in the National Poison Control Centre, Jinnah Postgraduate Medical Centre, and Karachi. The patients who presented in a critical condition afterwards the alcohol consumption were included in the study from the year 2011 to 2015
Result the inclusion criteria conscripted a total of 188 patients in the study amongst which majority was observed during a single outbreak in the month of September 2011. The results of the study recorded mortality in 38.83% of the study group while 35.64% indicated survival with sequelae. On the other hand, 25.53% of the patients were discharged with recovery
Conclusion morbidity in the cases of methanol poisoning tends to be crucial and high along with an eminent rate of mortality. Sequelae from methanol poisoning predominantly involves the visual disturbances including the blindness