Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients

(1) Background: Severe coronavirus disease can be complicated by a hypercoagulable state in conjunction with sepsis, increasing the risk of venous thromboembolism. This study aimed to observe the effect of anticoagulants on 30-day high-dependency unit (HDU) outcomes of moderate to severe coronavirus disease 2019 (COVID-19) patients of a tertiary care hospital at Rawalpindi, Pakistan. (2) Methods: A retrospective propensity-based case–control study was carried out to examine COVID-19 patients admitted to the HDU. Patient groups who did and did not receive anticoagulants were labeled as “anticoagulant” and “non-anticoagulant”, respectively. Case–control matching (1:1) was performed via propensity scores (calculated by a regression model). Kaplan–Meier and logrank analyses were used to study survival probability. Single predictors of outcomes were determined by Cox regression analysis. (3) Results: The anticoagulant group had elevated D-dimers, advanced age, more comorbidities and a higher frequency of severe disease compared to the non-anticoagulant group (p < 0.05). Therefore, 47 cases and 47 matched controls were selected based on their propensity scores. The primary endpoint was outcome (survived vs. died). The 30-day in-HDU mortality was 25.5% for cases and 61.7% for controls (p = 0.0004). The median time from admission to death was 16 days for the case group and 7 days for the control group (p < 0.0001). The 30-day mortality was 19.1% for the enoxaparin group and 16.4% for the heparin group (p > 0.05). Enoxaparin (therapeutic and prophylactic doses) and heparin (prophylactic dose) were found to be independent factors affecting the outcomes of these patients (p < 0.001). (4) Conclusions: Anticoagulants play a beneficial role in reducing mortality among COVID-19 patients. Both anticoagulant formulations, enoxaparin (therapeutic and prophylactic doses) and heparin (prophylactic dose), were associated with improving survival among these patients.

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A prospective case control study of the effects of oligohydramnios on fetomaternal outcome in mothers with term pregnancy in a rural medical college

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184534 ◽

2018 ◽

Vol 7 (11) ◽

pp. 4706

Author(s):

Dipak Mandi ◽

Sayantan Sen ◽

Vasundhara Goswami

Keyword(s):

Demographic Data ◽

Tertiary Care ◽

Birth Asphyxia ◽

Case Control ◽

Control Group ◽

Case Group ◽

Perinatal Complications ◽

Medical College ◽

Increased Risk ◽

Nicu Admission

Background: The aim of the current study was to assess the fetomaternal effects of oligohydramnios on term pregnancies in a rural tertiary care setup.Methods: A perspective case control hospital-based trial was conducted at Burdwan Medical College and Hospital for a period of one year. Pregnancies at term (37-42 weeks) were included in the study. 103 patients with sonographically diagnosed oligohydramnios were included in the case group. The control group comprised of 103 mothers at term with normal liquor volume. Demographic data and fetomaternal outcome parameters were assessed and compared.Results: There was increased incidence of fetal and perinatal complications including low birth weight, birth asphyxia and NICU admission. There were more perinatal deaths in the case group compared to the control group. Induction of labour, operative delivery, meconium stained liquor and incidence of preeclampsia were also increased in mothers with low AFI.Conclusions: Oligohydramnios is associated with an increased risk of labour and perinatal complications. Adequate antenatal surveillance and intranatal monitoring coupled with correction of underly-ing factors is the mainstay of management.

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Diabetes and hypertension in patients with psoriasis: a cross sectional and case control study in a tertiary care hospital of Bangladesh

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20213063 ◽

2021 ◽

Vol 9 (8) ◽

pp. 2217

Author(s):

Samira Jamal ◽

Sheikh Anwarul Karim ◽

Sheikh Mahee Ridwan Raihan ◽

Rajat Biswas ◽

Mansurul Alam

Keyword(s):

Case Control Study ◽

Skin Diseases ◽

Tertiary Care ◽

Case Control ◽

Control Group ◽

Care Hospital ◽

College Hospital ◽

Cross Sectional ◽

Increased Risk ◽

Control Study

Background: In this study our main goal was to evaluate the association of psoriasis as a risk predictor for the occurrence of diabetes mellitus (DM) and hypertension (HTN).Methods: This case control study was carried out in the department of dermatology and venereology, Chittagong medical college hospital (CMCH), Chittagong, Bangladesh from 15 June 2011 to 14 May 2012. Where 60 patients with psoriasis and 60 patients with skin diseases other than psoriasis were included according to availability within the study period.Results: During study, among the psoriatic patients, most of the patients with DM and HTN had body mass index (BMI) within normal limit. During analysis of different clinical findings in psoriatic patients scaling was present in all the cases followed by Auspitz sign, koebnerization, itching, scalp involvement and nail changes. Patients with psoriasis were found to have higher incidence of DM and HTN in comparison to their non-psoriatic control group. It was also observed that psoriatic patients having DM and HTN had longer duration of diseases (p<0.05).Conclusions: In conclusion, our study indicates that patients with psoriasis have an increased risk of DM and HTN, confirming the findings from previous several case control and cross sectional studies. These data illustrate the importance of considering psoriasis as a systemic disorder rather than simply a skin disease. Awareness of concurrent diseases will provide the clinician an opportunity of screening .for others systemic diseases.

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Infection and Predictors of Outcome of Cirrhotic Patients after Emergency Care Hospital Admission

Annals of Hepatology ◽

10.5604/01.3001.0012.2230 ◽

2018 ◽

Vol 17 (5) ◽

pp. 0-10

Author(s):

Wajima Safi ◽

Mayada Elnegouly ◽

Raphael Schellnegger ◽

Katrin Umgelter ◽

Fabian Geisler ◽

...

Keyword(s):

Cox Regression ◽

Care Center ◽

Tertiary Care ◽

Multivariable Analysis ◽

Scoring Systems ◽

First Episode ◽

Care Hospital ◽

Cox Regression Analysis ◽

Cirrhotic Patients ◽

The Impact

Introduction and aims: We aimed to explore the impact of infection diagnosed upon admission and of other clinical baseline parameters on mortality of cirrhotic patients with emergency admissions. Material and Methods: We performed a prospective observational monocentric study in a tertiary care center. The association of clinical parameters and established scoring systems with short-term mortality up to 90 days was assessed by univariate and multivariable Cox regression analysis. Akaike’s Information Criterion (AIC) was used for automated variable selection. Statistical interaction effects with infection were also taken into account. Results: 218 patients were included. 71.2% were male, mean age was 61.1 ± 10.5 years. Mean MELD score was 16.2 ± 6.5, CLIF-consortium Acute on Chronic Liver Failure-score was 34 ± 11. At 28, 90 and 365 days, 9.6%, 26,0% and 40.6% of patients had died, respectively. In multivariable analysis, respiratory organ failure (Hazard Ratio (HR) = 0.15), albumin substitution (HR = 2.48), non-HCC-malignancy (HR = 4.93), CLIF-C-ACLF (HR = 1.10), HCC (HR = 3.70) and first episode of ascites (HR = 0.11) were significantly associated with 90-day mortality. Patients with infection had a significantly higher 90-day mortality (36.3% vs 20.1%, p = 0.007). Cultures were positive in 32 patients with resistance to cephalosporins or quinolones in 10, to ampicillin/sulbactam in 14 and carbapenems in 6 patients. Conclusion: Infection is common in cirrhotic ED admissions and increases mortality. The proportion of resistant microorganisms is high. The predictive capacity of established scoring systems in this setting was low to moderate.

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Clinical outcomes of patients with advanced solid tumors of cutaneous capillary hyperplasia following treatment with camrelizumab: A retrospective case-control study

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1255 ◽

2021 ◽

Vol 2 (4) ◽

Author(s):

Xiaolei Wang ◽

◽

Qihe Long ◽

Qian He ◽

Jingjing Li ◽

...

Keyword(s):

Solid Tumors ◽

Clinical Outcomes ◽

Case Control Study ◽

Cox Regression ◽

Objective Response ◽

Case Control ◽

Control Group ◽

Advanced Solid Tumors ◽

Cox Regression Analysis ◽

Control Study

Objective: To investigate the difference of clinical outcomes between patients with and without Reactive Cutaneous Capillary Endothelial Proliferation (RCCEP) after camrelizumab treatment. Methods: A retrospective, matched case-control study was designed. A total of 92 patients with advanced solid tumors treated with camrelizumab at xx hospital between July 2019 and October 2020 were included, of whom 16 patients developed RCCEP (RCCEP group) and the remaining 76 served as the control group. The primary endpoint is Progression-Free Survival (PFS), and the secondary endpoint is Objective Response Rate (ORR) and Overall Survival (OS). Multivariate Cox regression analysis is used to assess the relevant indicators of PFS. Results: Compared with the control group, significantly increased ORR was observed in patients with RCCEP (56.3% vs 19.7%) (P < 0.05). The PFS was 13 months (5-15 months) in the RCCEP group and 6 months (2-11 months) in the control group. Compared with the control group, the PFS was significantly higher in the RCCEP group (HR = 0.555, 95% CI: 0.278-0.985, P < 0.05). In multivariate Cox regression, RCCEP remained statistically significant after excluding potential confounders (HR=0.312, 95% CI: 0.095-0.637, P < 0.01) and was associated with PFS in patients. Conclusion: In camrelizumab treatment, the occurrence of RCCEP may be a marker of strong immune response and improved tumor treatment outcomes, and has potential predictive value in patient efficacy and prognosis.

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Evaluation of upper gastro intestinal endoscopy among HIV positive and negative patients at a tertiary care hospital: a comparative study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20183896 ◽

2018 ◽

Vol 5 (5) ◽

pp. 1213

Author(s):

Ramapriya Rengaswamy ◽

Thayumanavan L.

Keyword(s):

Helicobacter Pylori ◽

Comparative Study ◽

Tertiary Care ◽

General Medicine ◽

Hiv Positive ◽

Control Group ◽

Case Group ◽

Care Hospital ◽

Endoscopic Findings ◽

Hiv Negative

Background: Endoscopy is the diagnostic test of choice for most HIV-associated GI diseases, as endoscopic and histopathologic evaluation can render diagnoses in patients with non-specific symptoms. The objective of the present research was to study the gastrointestinal endoscopic findings among HIV positive patients and compare them with HIV negative patients.Methods: A comparative study was carried out in the department of General Medicine to study the gastrointestinal endoscopic findings among HIV positive patients and compare them with HIV negative patients for a period of two years. 101 cases who were HIV positive were compared with equal number of HIV negative subjects. The subjects in the case group as well as control group were chosen randomly.Results: There was a significant lower incidence of Helicobacter pylori positivity (38.6%) among HIV positive patients when compared to controls (73.6%). There were overall 63 patients with abnormal biopsy findings in HIV group and 75 patients with abnormal biopsy findings in the control group. Among HIV positive patients who were also RUT positive approximately 80% had abnormal histopathological findings. Similarly, among the RUT positive control 81% of the patients had abnormal biopsy findings. Incidence of normal biopsy findings was more in the control group (57.1%) compared to the study group (48.4%). But this difference was not found to be statistically significant.Conclusions: The histology of gastric mucosa was no different in Helicobacter pylori positive or negative subjects with HIV. But Helicobacter pylori incidence was significantly less in HIV positive persons compared to HIV negative.

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periodontitis: A Risk Factor for Preterm Labour

Esculapio ◽

10.51273/esc20.2516313 ◽

2020 ◽

Vol 16 (03, july 2020-Septmber 2020) ◽

Author(s):

Shamila Ijaz Munir ◽

Falak Naseer ◽

Amna Ahsan ◽

Mahnaz Gondal, ◽

Nazia Khalil ◽

...

Keyword(s):

Risk Factor ◽

Tertiary Care Hospital ◽

Preterm Labour ◽

Tertiary Care ◽

Mean Value ◽

Control Group ◽

Case Group ◽

Care Hospital ◽

Probing Depth ◽

The Mean

Objective: To determine the relationship between periodontitis and preterm labour in pregnant women presenting to a tertiary care hospital in Lahore. Methods: This case control study was conducted at Obstetrics & Gynecology Unit 4 of Sir Ganga Ram Hospital, Lahore for six months. The delivering women, who consented to participate, were divided into two case and control groups. For each case one control was enrolled who met the inclusion criteria, so total sample size was 380 women. Women delivered before 37 weeks of gestation were case group and those delivered after 37 weeks were control group. A patient was considered having periodontitis if she had probing pocket depth of ≥3mm in at least 3 sites. Data was collected and analyzed on SPSS version 21. Results: In this study the mean age of the case group patients was 28.52±6.45 years while of the control group was 28.67±6.35 years. The mean value of probing depth pocket in the case group was 3.872±1.37 while the mean value probing depth pocket of the control group was 3.58±1.52. Out of 380 patients the periodontitis was found in 275 patients. The odds of having periodontitis in case group was 1.85 times higher than control group i.e. OR=1.85[1.17-2.92]. Conclusion: Periodontitis is a preventable risk factor of preterm labour in women presenting at a tertiary care hospital. Keywords: Preterm Labour, Periodontitis, dental hygiene, preterm delivery

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Impact of frailty on 30-day and 1-year mortality in hospitalised elderly patients with community-acquired pneumonia: a prospective observational study

BMJ Open ◽

10.1136/bmjopen-2020-038370 ◽

2020 ◽

Vol 10 (10) ◽

pp. e038370

Author(s):

Jia Luo ◽

Wen Tang ◽

Ying Sun ◽

Chunyan Jiang

Keyword(s):

Elderly Patients ◽

Mortality Risk ◽

Cox Regression ◽

Tertiary Care ◽

Community Acquired Pneumonia ◽

Care Hospital ◽

Frailty Phenotype ◽

Cox Regression Analysis ◽

Frail Patients ◽

The Impact

ObjectivesThis study evaluates the impact of frailty, which is a state of increased vulnerability to stressors, on 30-day and 1-year mortality among elderly patients with community-acquired pneumonia (CAP). The main hypothesis is that frailty is an independent predictor of prognosis in elderly CAP patients.DesignProspective, observational, follow-up cohort study.SettingA 2000-bed tertiary care hospital in Beijing, China.ParticipantsConsecutive CAP patients aged ≥65 years admitted to the geriatric department of our hospital between September 2017 and February 2019.Main outcome measuresThe primary outcomes were all-cause mortality at 30 days and 1 year after hospital admission. The impact of frailty (defined by frailty phenotype) on 30-day and 1-year mortality of elderly patients with CAP was assessed by Cox regression analysis.ResultsThe cohort included 256 patients. The median (IQR) age was 86 (81–90) years, and 180 (70.3%) participants were men. A total of 171/256 (66.8%) patients were frail. The prevalence of frailty was significantly associated with older age, female gender, lower body mass index, comorbidities, limitations in activities of daily living (ADLs) and poor nutritional status. Frail participants were significantly more likely to have severe CAP (SCAP) than non-frail counterparts (28.65% vs 9.41%, p<0.001). The 1-year mortality risk was approximately threefold higher in frail patients (adjusted HR, 2.70; 95% CI, 1.69 to 4.39) than non-frail patients. Subgroup analysis of patients with SCAP showed that the 1-year mortality risk was approximately threefold higher in the frail group (adjusted HR, 2.87; 95% CI, 1.58 to 4.96) than in the non-frail group. The association between frailty and 30-day mortality was not significant.ConclusionsThese findings suggest that frailty is strongly associated with SCAP and higher 1-year mortality in elderly patients with CAP, and frailty should be detected early to improve the management of these patients.

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Mastalgia and associated factors: A case control study

Medpusle International Journal of Surgery ◽

10.26611/1061923 ◽

2021 ◽

Vol 19 (2) ◽

pp. 45-47

Author(s):

Y Satish Reddy ◽

Keyword(s):

Pain Score ◽

Case Control Study ◽

Tertiary Care ◽

Case Control ◽

Control Group ◽

Care Hospital ◽

Breast Pain ◽

The Mean ◽

Cyclical Mastalgia ◽

Control Study

Background: patients with breast pain are often referred to surgery department. The present study was conducted to determine the factors associated with Mastalgia among women attending a tertiary care hospital Methods: This case control study was conducted on 120 women between the age 18 to 65 in the department of General surgery. The study included case subjects (n = 50) with Mastalgia and the control subjects (n = 50) without Mastalgia. The severity of breast pain was calculated with visual analog scale. questionnaire was given to all the participants and data is collected. Data was analysed by SPSS version 16 and P value of < 0.05 was considered statistically significant value. Results: Among those who had experienced mastalgia, 76% (46) had cyclical mastalgia and 24% (14) had non-cyclical mastalgia. The mean of pain score was 4.72 ± 2.28 and most of the women(18%) had pain score of “6” which is moderate pain The mean age and Body mass index were higher in the case group than control group (p<0.005). Stressful lifestyle, caffeine consumption, smoking, higher BMI and higher breast-fed infants were significantly associated with mastalgia (p < 0.001). postmenopausal women have decreased frequency of mastalgia which is significantly associated with mastalgia (p < 0.001). Conclusion: age, BMI, Stress, caffeine, smoking, lactation frequency, menopause state were found to be related with mastalgia.

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A study of maternal outcome in term premature rupture of membranes in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20202739 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2953

Author(s):

Aayushi Jain ◽

Mohini Paul

Keyword(s):

Hospital Stay ◽

Maternal Morbidity ◽

Tertiary Care ◽

Morbidity Rate ◽

Control Group ◽

Case Group ◽

Care Hospital ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Ascending Infection

Background: Premature rupture of membranes (PROM) remains a subject of great clinical relevance. The present study was conducted to study maternal morbidity and its relationship with PROM-delivery interval in patients with term PROM as compared to patients without PROM.Methods: A prospective case control study was conducted in the department of obstetrics and gynecology, Kasturba Hospital, New Delhi. 100 pregnant patients presenting to the labor room with features of PROM at term (POG>37 weeks) were taken as cases and 100 term pregnant women (age and parity matched) with intact membranes were taken as controls and compared in terms of maternal outcome.Results: This study reported maternal morbidity rate of 21% in term PROM cases which was significantly higher than in control group (5%). The major cause was febrile morbidity which occurred in 16% of cases indicating ascending infection. Other complications were abdominal and episiotomy wound infection (4%), chorioamnionitis (2%), postpartum hemorrhage (2%) and puerperal sepsis (1%). There was an increased rate of operative delivery in the case group (33%) as compared to 18% in patients without PROM. Duration of PROM-delivery interval had a significant direct proportional impact on the maternal morbidity. The duration of combined hospital stay of mother and neonate was also increased.Conclusions: Patients with term PROM have significant maternal morbidity which was mainly due to infection. The duration of the hospital stay was also significantly increased.

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Clinical Outcomes of Patients with Advanced Solid Tumors of Cutaneous Capillary Hyperplasia Following Treatment with Camrelizumab: A Retrospective Case-Control Study

Journal of Disease Markers ◽

10.26420/jdismarkers.2021.1044 ◽

2021 ◽

Vol 6 (2) ◽

Author(s):

Wang X ◽

◽

Long Q ◽

He Q ◽

Li J ◽

...

Keyword(s):

Solid Tumors ◽

Clinical Outcomes ◽

Case Control Study ◽

Cox Regression ◽

Objective Response ◽

Case Control ◽

Control Group ◽

Advanced Solid Tumors ◽

Cox Regression Analysis ◽

Control Study

Objective: To investigate the difference of clinical outcomes between patients with and without Reactive Cutaneous Capillary Endothelial Proliferation (RCCEP) after camrelizumab treatment. Methods: A retrospective, matched case-control study was designed. A total of 92 patients with advanced solid tumors treated with camrelizumab at xx hospital between July 2019 and October 2020 were included, of whom 16 patients developed RCCEP (RCCEP group) and the remaining 76 served as the control group. The primary endpoint is Progression-Free Survival (PFS), and the secondary endpoint is Objective Response Rate (ORR) and Overall Survival (OS). Multivariate Cox regression analysis is used to assess the relevant indicators of PFS. Results: Compared with the control group, significantly increased ORR was observed in patients with RCCEP (56.3% vs 19.7%) (P<0.05). The PFS was 13 months (5-15 months) in the RCCEP group and 6 months (2-11 months) in the control group. Compared with the control group, the PFS was significantly higher in the RCCEP group (HR=0.555, 95% CI: 0.278-0.985, P<0.05). In multivariate Cox regression, RCCEP remained statistically significant after excluding potential confounders (HR=0.312, 95% CI: 0.095-0.637, P<0.01) and was associated with PFS in patients. Conclusion: In camrelizumab treatment, the occurrence of RCCEP may be a marker of strong immune response and improved tumor treatment outcomes, and has potential predictive value in patient efficacy and prognosis.

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