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1.
Cureus ; 14(2): e21869, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35273843

RESUMO

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.

6.
Cureus ; 13(11): e19354, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34909315

RESUMO

Introduction Double J stents (DJS) are commonly used in urological practice, but they do have a risk of complications, such as infection and hematuria. This study explored the association between ureteral double J stent colonization and lower urinary tract symptom (LUTS) severity. Methodology This cross-sectional study was conducted from January 2021 to June 2021 in patients admitted to a tertiary care hospital in Karachi, Pakistan, who required double J stent (DJS) insertion. Patients who came to the site for stent removal were invited to participate in the study and enrolled using a consecutive sampling technique between January 15, 2021, and March 15, 2021. Results The study enrolled 176 patients, of whom 73.33% had colonization and the remaining had no colonization. The factors significantly associated with symptom severity included colonization of the DJS (P-value = 0.001) and the patients' ages (P-value = 0.046). The two groups have significantly different symptoms, which included incontinence (P-value = 0.001), polyuria (P-value = 0.001), and nocturia (P-value = 0.001). Conclusion Our study found more severe symptoms in DJS patients with colonization than in those without colonization. Irritative voiding symptoms, including nocturia and dysuria, are more common in DJS patients with colonization.

7.
Cureus ; 13(10): e18803, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34796076

RESUMO

Introduction Multimorbidity is defined as the coexistence of more than one chronic condition in one individual. It is related to enhanced rates of disability and mortality, enhanced disease burden, decreased function levels, and it can affect the wellbeing and daily activities of people, including loss of autonomy and independence. The aim of the current study is to determine the predictors of quality of life among patients with multimorbidity in Karachi, Pakistan. Methodology It was a cross-sectional study conducted in 12 health care facilities of six districts in Karachi, Pakistan. Two health care facilities were selected from each district using a convenient sampling technique. The total sample size of this study was 690, equally distributed among 12 health care facilities. Results The majority of participants (33.47%) belonged to the age group of 40 to 49 years, while 29.85% of participants had an age between 30 to 39 years. More than half of the participants were females (50.87%). Overall, the multivariate analysis showed being male, married, younger, high educational status and employed were positively associated with quality of life. While having lower family income is negatively associated with quality of life. Conclusion The findings of this study had important implications for identifying distinct multimorbidity individuals who were at risk of a lower quality of life, and they emphasized the need for disease detection and treatment at an early stage. The study can also give important evidence for decision-makers when it comes to allocating health resources more efficiently, and health administrative departments can improve chronic disease management.

8.
Cureus ; 13(12): e20751, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35111439

RESUMO

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.

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