ABSTRACT
Background: Acute kidney injury (AKI) has been associated with an increased mortality rate among hospitalized patients with Coronavirus disease 2019 (COVID-19). However, AKI among hospitalized patients with COVID-19 is not well described.Methods: In this retrospective cohort study, we enrolled adult patients who were referred to Al -Hussein Teaching Hospital in Thi-Qar Governorate, Iraq, from 15 February to 15 May 2020, diagnosed with Corona Varus by Real-Time polymerase chain reaction (PCR) A test with a diagnosis of COVID.-19. AKI was determined according to the outcome criteria for creatinine determination and Introduced by the KDIGO in 2012. Patients were stratified based on recovery, dialysis, and hospital mortality. We also assessed risk indicators associated with AKI during hospitalization along with in-hospital outcomes, recovery rate, and death at the time of discharge. And after three months of going out for both sexes.Results: We evaluated 2044 patients, whose ages ranged from 18 to more than 65 years, for both males and females, and the percentage of males 54.7% and females 45.3% were admitted with a diagnosis of COVID-19. AKI occurred in 194(8.02%) patients;55(35.5%) of the patients with AKI required dialysis. It was observed that 43.1% of males recovered to 43.8% of the females who were cured inside the hospital, and there was a percentage of patients Those who needed dialysis, and there was a percentage of deaths among males and females. Patients with AKI showed a significantly higher mortality rate. The patients' condition was followed up after their discharge from the hospital, and the percentage of those who were cured and the patients who needed dialysis was determined, and the rate and mortality.conclusion: We found that male sex, patients' ages, history of chronic kidney disease, and disease severity were independent risk factors associated with AKI in COVID-19 patients. Whereas, acute renal insufficiency was associated with an increased risk of death, increased dialysis patients, and in -hospital complications. Our results indicate the need for more careful care and monitoring of AKI during hospitalization in patients with COVID-19, and non-recovery of acute renal impairment on hospital discharge is a common complication in these patients.
ABSTRACT
Background: Acute kidney injury (AKI) has been associated with an increased mortality rate among hospitalized patients with Coronavirus disease 2019 (COVID-19). However, AKI among hospitalized patients with COVID-19 is not well described. Method(s): In this retrospective cohort study, we enrolled adult patients who were referred to Al-Hussein Teaching Hospital in Thi-Qar Governorate, Iraq, from 15 February to 15 May 2020, diagnosed with Corona Varus by Real-Time polymerase chain reaction (PCR) A test with a diagnosis of COVID.-19. AKI was determined according to the outcome criteria for creatinine determination and Introduced by the KDIGO in 2012. Patients were stratified based on recovery, dialysis, and hospital mortality. We also assessed risk indicators associated with AKI during hospitalization along with in-hospital outcomes, recovery rate, and death at the time of discharge. And after three months of going out for both sexes. Result(s): We evaluated 2044 patients, whose ages ranged from 18 to more than 65 years, for both males and females, and the percentage of males 54.7% and females 45.3% were admitted with a diagnosis of COVID-19. AKI occurred in 194(8.02%) patients;55(35.5%) of the patients with AKI required dialysis. It was observed that 43.1% of males recovered to 43.8% of the females who were cured inside the hospital, and there was a percentage of patients Those who needed dialysis, and there was a percentage of deaths among males and females. Patients with AKI showed a significantly higher mortality rate. The patients' condition was followed up after their discharge from the hospital, and the percentage of those who were cured and the patients who needed dialysis was determined, and the rate and mortality. conclusion: We found that male sex, patients' ages, history of chronic kidney disease, and disease severity were independent risk factors associated with AKI in COVID-19 patients. Whereas, acute renal insufficiency was associated with an increased risk of death, increased dialysis patients, and inhospital complications. Our results indicate the need for more careful care and monitoring of AKI during hospitalization in patients with COVID-19, and non-recovery of acute renal impairment on hospital discharge is a common complication in these patients.Copyright © 2022 Mohan R, et al.
ABSTRACT
Background: Interest in organ preservation (OP) strategies for rectal cancer (RC) patients persists. The efficacy of long course chemoradiation (LCRT) vs. short course radiation therapy (SCRT) relative to OP is unknown. We compared OP rates between SCRT and LCRT total neoadjuvant therapy (TNT) strategies. Method(s): During the COVID-19 pandemic we established an institutional SCRT mandate with no exceptions. For comparison, we identified RC patients treated with LCRT immediately before and after the mandate period. After completion of TNT, patients were restaged by clinical exam, endoscopy, and MRI. A watch and wait (WW) approach was recommended for patients with a clinical complete response (cCR), defined by the MSK regression schema. Total mesorectal excision (TME) was recommended for non-cCR patients. OP was defined as alive, TME-free, and with no evidence of disease in the pelvis. We performed survival analysis for: local regrowth rate, OP, disease-free survival (DFS), and overall survival (OS). Result(s): We identified 563 consecutive patients with RC treated with TNT, of whom 231 were excluded due to either metastatic disease, synchronous/metachronous malignancies, or non-adenocarcinoma histology (Jan. 2018-Jan. 2021). Patient and tumor characteristics were similar in the LCRT (n = 256) and SCRT (n = 76) cohorts. No significant differences in high-risk features were noted. Most patients had clinical stage III disease (82% in LCRT vs. 83% in SCRT). Induction chemotherapy followed by consolidative radiation was the most common treatment order (78% (LCRT) vs. 70% (SCRT)). The median interval from end of TNT to clinical restaging was 8 weeks (LCRT) and 9 weeks (SCRT). The cCR rate was 46% in both cohorts. The cCR rate was numerically higher in patients treated with radiation first, as compared to chemotherapy first (53% vs. 44% (LCRT) and 52% vs. 43% (SCRT)). Among patients with a cCR, the likelihood of WW management was similar (98% (LCRT) vs. 94% (SCRT)). From start of TNT, the median follow-up was 32 and 28 months respectively for LCRT and SCRT. The 2-year OS (95% vs. 92%), DFS (78% vs 70%), and distant recurrence (20% vs. 21%) rates were similar. Among all patients, the 2-year OP rate was 40% (95% CI 35-47%) for LCRT and 29% (95% CI 20-42%) with SCRT. In those patients managed by WW, the 2-year local regrowth rate was 20% (95% CI 12-27%) with LCRT vs. 36% (95% CI 16-52%) with SCRT. Conclusion(s): In this nonrandomized comparison, while cCR rates were similar, we observed a numerically higher OP rate with LCRT-TNT than with SCRT-TNT. The ongoing ACO/ARO/AIO-18.1 trial, hypothesizing that LCRT-TNT will increase OP rates relative to SCRT-TNT, should definitively answer this question.
ABSTRACT
Background: Covid-19 is an acute infection caused by novel corona virus called SARS-Cov2 and is consider a major global health disaster causing millions of infected and dead people all over the world The age, gender and smoking habit is well recognized risk factors for many diseases including respiratory disease Their relation to COVID -10 infection is still controversy a though there is a lot of studies that try to clarify theses relatinship Aim of Study: Study of correlation of smoking habit with COVID-19 infection in Thi-Qar province in the south of Iraq and evaluate sex and age in studied group Patients and Methods: Retrospective analytic study of smoking habit in of 325 patients with COVID -19 in thi-Qar province in different centers of isolation prove by PCR testing and or CT findings consist with diagnosis of COVID-19. The control group include 329 healthy persons with PCR negative Result and Discussion: In our study two third of patients with COVID-19 are men [66.5%] this difference can explain by small number of size and social factors that limited the movement of female in community. In our study two third of severe COVID-19 are men [81:41] this go with most of studies that showed that the outcomes of illness were worse for men than women. In our study the mean age of COVID-19 patients in 46 which little pit less than mean age reported at early months COVID pandemic but later the mean start to dropping reaching in USA 34 In our study mean age of patients with severe COVID-19 is 53.2439 while for moderate one is 49.0256 and for mild COVID-19 patients is 36.8871 with highly significant P value 0.000. Active smoking seen in 81 [24,6] of control group while seen only in 43 [13.2%] in patients with covid-19 with highly significant value P value 0.0001 In this study most of cases of severe COVID are non smokers 84 and 26 are x-smoker while only 13 are active smoking with highly significant difference P value 0.000.A lot of studies revealed an unexpected low number of current smokers among subjects tested for SARS-CoV-2 infections. The prevalence of current smokers suffering from symptomatic COVID-19 was frequently significantly lower than in the general population. Current smokers were at reduced risk of being tested positive compared to former smokers and never smokers, which might have been caused by different testing frequencies, but were at higher risk for severe symptomatic COVID-19. This low prevalence of current smokers among COVID-19 patients led to the hypothesis that smoking/nicotine uptake might have a preventive effect.
ABSTRACT
The World Health Organization (WHO) acknowledged that, as health services divert their attention to the COVID-19 pandemic, the delivery of essential nutrition services may be compromised. This impact may be more pronounced in the context of humanitarian crises, such as the one currently unfolding in Yemen. In line with Pillar 9 of the WHO's COVID-19 Strategic Preparedness and Response Plan, this paper reports on the nutrition program adaptations in Yemen to maintain the delivery of essential nutrition services to under-five children. The process of adaptation focused on the services provided within the nutrition surveillance system (NSS), therapeutic feeding centers (TFC), and isolation units (IU). It was conducted in five steps: (1) situation analysis;(2) development of guidance documents;(3) consultation process;(4) capacity-building programs;and (5) incorporation of programmatic adaptation within nutrition services. As of September 2020, NSS, TFC, and IUs services have shifted their standard operating procedures in line with the context-specific adaptations. The process described in this paper may serve as a case-study for other countries that intend to undertake similar adaptations in their nutrition program to contribute to the implementation of the WHO response plan and maintain the delivery of essential nutrition services to children.