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OBJECTIVE: The aim of the study is to assess the impact of hypertensive disorders of pregnancy on stillbirths and other perinatal outcomes among women in Karachi, Pakistan. METHODOLOGY: This was a retrospective cohort study conducted at two tertiary care hospitals, Aga Khan Hospital (AKU) and Liaquat National Hospital (LNH) in Karachi, Pakistan. The primary outcome variable of this study was stillbirth. Other outcomes assessed in this study included preterm birth, low birth weight, and early neonatal death. RESULTS: Data of a total of 840 women were included in this study; 280 (33.33%) women had hypertensive disorders of pregnancy and 560 (66.67%) were normotensive. Among women who had hypertensive disorders of pregnancy, the adjusted odds ratio (AOR) of having a stillbirth was two times more than that for normotensive women (AOR=2.62, 95% CI=1.46-4.40), four times for low birth weight (AOR=4.23, 95% CI=2.88-6.20), five times for early neonatal death (AOR=5.03, 95% CI=2.40-10.50) and six times for pre-term birth (AOR=5.16, 95% CI=3.42-7.79). CONCLUSION: The current study found that incidence of stillbirth, low birth weight, pre-term birth, and neonatal mortality is higher in mothers with hypertensive disorders of pregnancy than normotensive mothers.
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[This retracts the article DOI: 10.7759/cureus.22157.].
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[This retracts the article DOI: 10.7759/cureus.22690.].
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[This retracts the article DOI: 10.7759/cureus.22114.].
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INTRODUCTION: Hypertension is the persistent rise of systemic arterial blood pressure. Among diabetic patients, hypertension is one of the important public health challenges. The frequency of hypertension among diabetic patients is almost twice than that of non-diabetic patients. This study aims to determine the determinants of hypertension among type 2 diabetes patients in Karachi, Pakistan. METHODOLOGY: This was a cross-sectional study conducted in diabetic clinics of a tertiary care hospital from August 2020 to August 2021. The source population included all adult patients with type 2 diabetes at the follow-up clinic of Liaquat National Hospital and Aga Khan Hospital. Data collection was done using a structured interviewer-administered questionnaire. REDCap software (Vanderbilt University, Nashville, TN) was used for the data collection. RESULTS: A total of 610 patients were included in the study. The mean age of participants was 57.37 (±11.32) years. The overall prevalence of hypertension among diabetic patients was 39.84%. Age, physical activity, family history of hypertension, smoking status, BMI, sedentary lifestyle, stress level, and serum creatinine were independent determinants of hypertension among people with type 2 diabetes mellitus. CONCLUSION: In this study, age, physical activity, family history of hypertension, smoking status, BMI, sedentary lifestyle, stress level, and serum creatinine are independent determinants of hypertension among type 2 diabetes patients. The findings of the study call for strategies that can target these predictors, and clinicians need to start educating their patients about hypertension and ways to prevent it.
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INTRODUCTION: Percutaneous nephrolithotomy (PCNL) has almost completely replaced open surgery for kidney stones because of continuous advancements in the method since the first PCNL was performed in 1976. The aim of this study is to compare the characteristics and outcomes of adult patients and pediatric patients who had undergone PCNL. METHODOLOGY: A retrospective study was conducted at the Sindh Institute of Urology and Transplantation (SIUT) Hospital in Karachi, Pakistan. It included the data of patients who underwent PCNL from January 2015 to January 2022 at the SIUT hospital. The primary outcome variable was the stone-free rate (SFR). Secondary outcomes included length of hospital stay, and complications were assessed using modified Clavien classification system Results: There is no significant difference in the SFR at discharge between pediatric and adult patients (86.67% vs 88.69%, p=0.634). There is no significant difference between the two groups in relation to the total length of hospital stay (p=0.446). Moreover, 12.50% and 11.11% of adults and children developed complications, respectively, after the procedure. The percentages are not significantly different between the two groups (p=0.266). CONCLUSION: The current study using standardized and consistent PCNL techniques shows that SFR is similar in both adults and children, and there is no difference in complications between adults and children.
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INTRODUCTION: Sepsis is a life-threatening illness caused by the body's response to uncontrolled infection. Different studies have been conducted to identify risk factors associated with the diagnosis of sepsis and mortality, but there has been considerably less focus on mortality due to sepsis-induced blood pressure. The current study was conducted to determine the incidence of mortality within 30 days among patients with sepsis-induced blood pressure drop and its risk factors. METHODOLOGY: It was a retrospective study conducted at the Pakistan Navy Station (PNS) Shifa Hospital, Karachi, Pakistan. Data of all patients aged 18 years or more who visited PNS Shifa Hospital and were diagnosed with sepsis and blood pressure reduction from November 2019 to October 2021 were extracted from Hospital Management Information System (HMIS) and retrospectively analyzed Results: All variables significantly associated with 30-days mortality in multivariable logistic regression analysis, including disturbance of consciousness, cardiac insufficiency, respiratory failure, diabetes mellitus, creatinine level, and aspartate aminotransferase (AST) level, were risk factors for mortality in patients with the sepsis-induced drop in blood pressure (p-value<0.05). CONCLUSION: Identifying these risk factors is important as it will help clinicians identify patients who are at high risk of mortality at an early stage. Through early identification, interventions can be done to reduce the incidence of in-hospital mortality among sepsis patients.
