Background: Artificial intelligence (AI) is the term used to describe the use of computers and technology to simulate intelligent behavior and critical thinking comparable to a human being. John McCarthy first described the term AI in 1956 as the science and engineering of making intelligent machines. Objective: This descriptive article gives a broad overview of AI in medicine, dealing with the terms and concepts as well as the current and future applications of AI. It aims to develop knowledge and familiarity of AI among primary care physicians. Materials and Methods: PubMed and Google searches were performed using the key words ‘artificial intelligence’. Further references were obtained by cross-referencing the key articles. Results: Recent advances in AI technology and its current applications in the field of medicine have been discussed in detail. Conclusions: AI promises to change the practice of medicine in hitherto unknown ways, but many of its practical applications are still in their infancy and need to be explored and developed better. Medical professionals also need to understand and acclimatize themselves with these advances for better healthcare delivery to the masses.
Background: India is a tropical country with a high burden of febrile zoonotic/infectious illnesses, scrub typhus being such a cause with multiple epidemics reported from different regions of the country. Objective: This study was plotted to document the clinical and diagnostic manifestations, treatment, and outcomes of scrub typhus in the sub-Himalayan region of India and to compare the results with other Indian and Asian studies. Materials and Methods: This was a retrospective observational study involving collection of data for 54 IgM ELISA-confirmed in-patient cases of scrub typhus at a tertiary care institute in Uttarakhand, India, from their case records. Results: The majority of patients were from rural background. Housewives constituted 28 (51.85%) patients. The most common symptoms were due to involvement of gastrointestinal tract in the form of abdominal pain in 39 (72.22%) and vomiting in 29 (53.7%) patients. Central nervous system involvement in the form of altered sensorium in 14 (25.9%) patients and pulmonary involvement as cough in 28 (51.85%) patients was observed. An eschar was found in 7 (12.96%) patients and upper eyelid edema in 40 (74.07%) patients. The most common laboratory abnormality documented was elevation of liver transaminases (aspartate aminotransferase > alanine aminotransferase), 40 (74.07%), and blood urea levels, 47 (87.03%). There was no difference in the clinical presentation, severity, or mortality in pregnant females when compared with nonpregnant females. One (1.45% mortality) died in our study. Conclusion: Scrub typhus is an important cause of acute febrile illness with variable, often nonspecific and multisystem involvement. Early recognition and antibiotic administration are the key to reduce complications and mortality, especially for a primary care physician.
While the relative efficacy of remdesivir as a therapeutic agent in selected patients with COVID-19 has been established, safety concerns have been raised regarding potential nephrotoxicity and hepatotoxicity. Our main objective was to investigate the kidney- and liver-related safety outcomes in patients with COVID-19 treated with remdesivir in a public hospital in New York. A propensity score-matched retrospective study was conducted in hospitalized patients with COVID-19 from 1 June 2020 to 10 March 2021. A total of 927 patients were included in this study (remdesivir: 427, non-remdesivir: 500; women: 51.8%; median age 61 years; median BMI: 28.5 kg/m2). Matching without replacement yielded a cohort of 248 patients (124 in each group). In the matched cohort, the remdesivir group had a significantly lower rate of acute kidney injury (AKI) (12.1% vs. 21.8%, p = 0.042), a lower rate of acute liver injury (ALI) on the verge of statistical significance (7.3% vs. 14.5%, p = 0.067), and non-significantly lower death rate (13.7% vs. 16.1%, p = 0.593) compared to the non-remdesivir group. Multivariable analyses revealed that patients treated with remdesivir were found to be associated with a significantly lower likelihood for AKI (OR: 0.40; 95% CI: 0.24–0.67, p < 0.001), no association was found for ALI (OR: 0.68; 95% CI: 0.35–1.30, p = 0.241), while a trend towards an association of patients treated with remdesivir with a lower likelihood for in-hospital death was observed (OR: 0.57; 95% CI: 0.32–1.01, p = 0.053). In conclusion, no safety concerns with regards to renal and liver outcomes were raised in patients with COVID-19 treated with remdesivir. Instead, there were signals of possible nephroprotection and improved in-hospital mortality.
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