BackgroundCoronavirus disease 2019 (COVID-19) is a global health crisis. The literature suggests that cancer patients are more prone to be affected by COVID-19 because cancer suppresses the immune system and such patients usually present poor results. The objective of this study is to present all clinical, laboratory, and demographic characteristics of COVID-19 patients with solid tumors. MethodologyThis study was conducted at the Dow University of Health Sciences for a period of six months from April 2020 to September 2020. In this study, we included a total of 1,519 confirmed patients diagnosed with solid tumors via polymerase chain reaction. The mortality timeline within 30 days of contracting the virus was considered, and the median age of the included individuals was 61 years, with a range of 20-95 years. Of the patients included in the study, 49.4% (750) were men; moreover, 3.15% of our study population had prostate cancer, 10.20% had colorectal cancer, 2.76% had breast cancer, and 10.46% had lung cancer. Of the patients, 25.93% presented with at least one comorbidity. For 73% of the patients, at least one direct therapy for COVID-19 was included in the treatment; 56.6% of the patients were hospitalized, and 11.32% were admitted to the intensive care unit. ResultsThe mortality rate was 4.74% in the first 30 days after diagnosis, where 72 patients died. The findings of the first multi-variation model showed that males at older ages who were diabetic and going through cytotoxic therapy were prone to die within the first 30 days. However, the 30-day mortality rate was lower in patients diagnosed with prostate and breast cancer. The second set incorporated laboratory factors, where we found that higher values of leukocytosis, thrombocytopenia, and lymphocytopenia were correlated with higher rates of mortality within 30 days. ConclusionsWe conclude that there is a higher mortality rate of COVID-19 in patients with solid tumors than in the general population. However, it was found to be lower in the Pakistani population compared with the Chinese and Western populations. Intensive care can decrease mortality rates in COVID-19 and cancer patients.
Out of 210 patients, 146 were found to have degenerative scoliosis at the level of the lumbar and thoracolumbar spine. Fifty-two patients had a right convex curve, and 94 had a left convex curve. Sixty-nine patients had GERD. According to the analysis of the multivariate logistic regression, the Cobb angle was highly related to GERD (p-value <0.05 and odds ratio of 1.031). The participants were grouped according to the Cobb angle of curve at the lumbar spine (less than 30 degrees with a large right-sided convex curve, 30 and more with a small curve, and more than 30+ degrees with a large left-sided convex curve). The study revealed that a large left-sided convex curve was highly related to GERD, with a p-value <0.05 and odds ratio of 10.935. ConclusionsThe left-sided large convex curve at the thoracolumbar or lumbar spine, especially when the Cobb angle was more than 30 degrees, was highly associated with GERD. Therefore, the symptoms of GERD should be monitored in the elderly population with degenerative scoliosis.
Introduction: Diabetes is considered a coronary artery disease equivalent. With its ever-increasing prevalence, early detection and management are imperative. Glycosylated Hemoglobin (HbA1c) has become the recognized marker for screening and diagnosis of diabetes. Objective: To screen and diagnose patients for prediabetes and Diabetes Mellitus (DM), among patients admitted to the hospital with the principal diagnosis of low or intermediate risk chest pain to Rule Out Myocardial Infarction (ROMI). The study was done to emphasize the importance of diabetes screening in these patients and to include this test as part of a chest pain admission order set in our hospital. Methods: After randomized retrospective review of 400 patients, 175 subjects with no prior diagnosis of diabetes were included. Data variables included patient demographics, Body Mass Index (BMI), TIMI® score and HbA1c results when available. BMI and HbA1c were also analyzed to previously established categories. BMI (kg/m2) was categorized as 18 to 24.9, 25 to 29.9 and 30 and above as healthy (0), overweight (1) and obese (2), respectively. HbA1c was categorized as 6.1% (normal), 6.2 to 6.4% (Impaired Glycemic Control) and 6.5% and above as DM as per our hospital criterion. Data were then summarized using descriptive statistics; chi-square and analysis of variance were performed to determine relationships between the variables. Results: Of the 175 subjects, 18 had HbA1c greater than 6.5% (10%), 19 subjects (11%) had HbA1c greater than 6.2% (prediabetes) and 138 (79%) had HbA1c less than 6.1%. An analysis of variance comparing mean age, BMI and TIMI score by HbA1c categories revealed p-values of 0.894, 0.054 and 0.320, respectively. Conclusion: Patients who are admitted to the hospital for low/intermediate chest pain to rule out myocardial infarction should be screened for DM using HbA1c, as we identified 18 subjects (10%) with HbA1c greater than 6.5% and 19 subjects (11%) with prediabetes as a subset of the population. We suggest that the admission order set for "Chest Pain" include HbA1c to regularly screen patients for diabetes and prediabetes and recommend close follow-up of the patients who have prediabetes with repeat HbA1c. Strong consideration should be made in screening patients with elevated BMI >30 for DM if they are admitted not just for chest pain but also for other medical ailments.
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