Frequency and Predictors of Acute Kidney Injury in Patients With Acute Coronary Syndrome in a Tertiary Care Hospital: A Retrospective Study.

Introduction Acute kidney injury (AKI) is a complex condition marked by rapid deterioration of renal function (within hours or days), with clinical symptoms ranging from a minor rise in serum creatinine to anuric renal failure needing renal replacement therapy. AKI is one of the complications of acute coronary syndrome (ACS). This study aims to determine the frequency of AKI among patients with ACS and identify its predictors. Method This study is a retrospective observational study conducted at the Dow University of Health Sciences, a tertiary care hospital located in Karachi, Pakistan. This study was conducted from January 2020 to June 2021. All patients aged 18-75 years admitted with ACS and admitted for more than 48 hours were included in the study. A pre-set questionnaire was used to collect data from the hospital management information system (HMIS). Results The frequency of AKI among patients with ACS was 24.18%. The factors associated with AKI among patients with ACS on multivariable logistic regression included the age of patients (odds ratio (OR) = 1.04, p-value = 0.018), having diabetes mellitus (OR = 2.33, p-value = 0.031), admission Killip ≥ II (OR = 2.12, p-value = 0.041), previous history of myocardial infarction (MI) (OR = 3.64, p-value = 0.001), baseline glomerular filtration rate (GFR) (OR = 0.94, p-value = 0.001), in-hospital ejection fraction (EF) (OR = 0.93, p-value = 0.001), and serum creatinine at admission (OR = 1.02, p-value = 0.001). Conclusion Age, comorbidities including diabetes mellitus and previous history of MI, admission Killip ≥ II, baseline GFR, in-hospital EF, and serum creatinine level at admission are significant independent predictors of AKI in patients with ACS.

Retraction: Comparison of the Performance of Various Scores in Predicting Mortality Among Patients Hospitalized With COVID-19.

[This retracts the article DOI: 10.7759/cureus.20751.].

Retraction: Evaluating the Clinical Outcomes of Remdesivir Among Patients Admitted With COVID-19 in a Tertiary Care Hospital.

[This retracts the article DOI: 10.7759/cureus.19487.].

Retraction: Frequency and Predictors of Acute Kidney Injury in Patients With Acute Coronary Syndrome in a Tertiary Care Hospital: A Retrospective Study.

[This retracts the article DOI: 10.7759/cureus.21869.].

Evaluating the Clinical Outcomes of Remdesivir Among Patients Admitted With COVID-19 in a Tertiary Care Hospital.

INTRODUCTION: This study was conducted to determine whether remdesivir administration for treatment of coronavirus disease 2019 (COVID-19) is associated with reducing deaths among COVID-19 hospitalized patients. METHODOLOGY: It was a retrospective study, and the data was acquired at Ziauddin Hospital in Karachi, Pakistan. All patients admitted between February and May 2021 with severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection confirmed by polymerase chain reaction testing from nasopharyngeal samples were included in the study, including those who received at least five-day treatment of remdesivir and who did not receive even a single dose of remdesivir. RESULTS: Data of overall 174 patients were used, out of which 71 (40.80%) received remdesivir. After propensity score matching, 71 patients in the remdesivir group were successfully matched with the non-remdesivir patients on the basis of age, gender, and disease severity. Results of multivariable logistic regression showed that there is no significant difference in deaths between patients who received remdesivir and patients who did not receive remdesivir (p-value=0.122). However, the length of hospital stay was significantly lower in the remdesivir group than in the control group (p-value=0.001). CONCLUSION: Results of this study can provide evidence that remdesivir can be efficient in reducing the duration of COVID-19 illness, and a five-day course of treatment is sufficient for patients to get clinical benefits.

Evaluating the Clinical Risk Factors Associated With Miscarriages in Women in Karachi, Pakistan.

Introduction Spontaneous pregnancy loss is unquestionably common worldwide, with roughly 5% of pregnancies ending in this way. Miscarriage can lead to serious psychological issues for women as well as their mothers. Although, it is irreversible but can be prevented through proper risk assessment of women. The goal of this study is to find clinical predictors of miscarriages in Karachi, Pakistani women. Methodology The study is a retrospective chart review that used data of women having livebirth and miscarriages at the Liaquat National Hospital Karachi Pakistan. Data of a total of 517 women were included in the study, out of which 453 have had a live birth, and 64 had miscarriages. To determine the factors associated with miscarriages, multivariable logistic regression was used.  Results The mean age of women was 31.08 (±5.10) years. Age of mother over 40 years (adjusted odds ratio [AOR]=10.28; p-value=0.001), overweight and obesity (AOR=3.01; p-value=0.001) and history of miscarriage (AOR=2.91; p-value=0.003) are variables significantly associated with miscarriages. Conclusion Findings of the current study shown that risk factors of miscarriages included age of mother, increased BMI and previous history of miscarriages. All these factors need to be considered while providing antenatal care to mothers to mitigate the risk of miscarriages.

Comparison of the Performance of Various Scores in Predicting Mortality Among Patients Hospitalized With COVID-19.

Introduction Coronavirus disease 2019 (COVID-19) is a major social and economic challenge, devastating the health care system in several countries around the world. Mortality scores are important as they can help health care professionals to plan treatment as per the patients' condition for proper resource allocation. When it comes to patients, it provides invaluable information for implementing advance directives. The aim of the study is to validate mortality scores for predicting in-hospital mortality in patients with COVID-19. Methodology This was a retrospective cohort study that included data from three tertiary care hospitals in Karachi, Pakistan. Data of patients diagnosed with confirmed COVID-19 infection and hospitalized in Ziauddin Hospital, Aga Khan Hospital, and Liaquat National Hospital were enrolled in the study from November 1, 2020, to April 30, 2021. Data was extracted from the hospital management information system (HMIS) using a structured questionnaire. Results Overall, 835 patients were included in the final analysis. The mean age of patients was 53.29 (SD ± 15.17) years, and 675 patients (80.72%) were males. The sensitivity of the CALL score is highest among all four scores, i.e., 77.25%, and the quick Sequential Organ Failure Assessment (qSOFA) score has the lowest sensitivity (59.79%). However, CALL has the lowest specificity (58.04%), while qSOFA has the highest specificity (73.91%). However, MulBSTA and CRB-65 have a sensitivity of 70.11% and 64.96%, respectively. Conclusion The current study showed that the CALL score had better sensitivity as compared to other mortality scores.