Objectives: To see the difference in mortality among hospitalized COVID-19 patients given Remdesivir (RDV) with those who were not given RDV. Methods: A prospective cohort study was conducted on patients who were admitted to the COVID-19 isolation unit at The Indus Hospital, Korangi Campus Karachi between March and June 2020. Results: Groups were similar in age and gender distribution. RDV group was more hypoxic, had severe ARDS and needed higher Oxygen support compared to non-RDV group (p=0.000). Median SOFA score was 2 in RDV vs 5 in non-RDV (p=0.000). More than moderate COVID pneumonia was found in 92% of the RDV group while 89% of non-RDV group (p value=0.001). Median day of illness to administer Remdesivir was 10. There was no difference in mortality (45.5% in RDV vs 40.4% in non-RDV; p=0.4) between the two groups. Median length of hospital stay was 12 days (IQR=7.5-14.5) in RDV group compared to 10 days (IQR=6-14) in non-RDV group (p=0.009). Conclusion: RDV did not show any difference in in-hospital mortality in our patients. More patients had severe ARDS in the RDV group while patients in the non-RDV group had higher SOFA score and multi-organ failure. Length of stay was longer in patients receiving Remdesivir. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5779 How to cite this:Shaikh Q, Sarfaraz S, Rahim A, Hussain M, Shah R, Soomro S. Effect of Remdesivir on mortality and length of stay in hospitalized COVID-19 patients: A single center study. Pak J Med Sci. 2022;38(2):405-410.  doi: https://doi.org/10.12669/pjms.38.ICON-2022.5779 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Mucormycosis is a fungal infection that can be very destructive and often fatal. People most prone to this infection include those who are immunocompromised. Early diagnosis and treatment, along with addressing the risk factors, play a pivotal role in the management. Here, the authors are reporting three cases of immunocompromised patients. Among them, two had uncontrolled diabetes, and the third had a history of renal transplant and COVID-19 infection. All three cases are distinct anatomically; one is pulmonary, one is rhino-orbital-cerebral, and the last one is rhino-maxillary.

Objectives: To assess the clinical, environmental, and socio-demographic characteristics leading to gender disparity in tuberculosis in Pakistan. Study Design: Prospective Comparative study. Study Setting and Duration: The Indus Hospital, Karachi Pakistan, from Jul 2020 to Dec 2020. Methodology: A sample of 200 patients with diagnosed tuberculosis (detected on an acid-fast bacillus (AFB) smear with radiographic abnormalities) irrespective of gender, sensitivity, or site of tuberculosis, were included in the study. Data of gender, personal history, substance abuse history, and dietary habits was documented. Results: Pulmonary tuberculosis was significantly more common in female patients than in males (p<0.001). The mean age of male patients was 30.16 ± 9.47 years. Male patients were significantly older than their female counterparts (p=0.003). The diabetes mellitus in male patients was significantly higher than in female patients with TB (p=0.01). Similarly, substance abuse history was more frequently positive in male patients as compared to female patients, 28 (40.60%) vs 9 (6.70%); p-value <0.001. There was no significant difference in the occurrence of drug-resistance tuberculosis between the two genders. However, pulmonary tuberculosis was significantly more common in female patients than in males (p<0.001). Conclusion: We reported some distinctive differences between male and female tuberculosis patients. Young females had more predilections toward tuberculosis as compared to men. Diabetes mellitus and substance abuse history were more common in male tuberculosis patients than in females.

Background: Hospital acquired Blood Stream Infections is one of the major type of nosocomial infection. As compared to 1.3-2.1 per 1000 central line days in high income nations, CLABSI occurs more frequently in middle- and low-income countries, with rates ranging from 7.4 to 12.2 per 1000 central line days. The incidence of both type of BSI is also reported to be different in different regions. Staphylococcus aureus, E. coli, enterococcus species, and candida species are some examples of common causative organisms. Objective: The primary objective: • To study the incidence of CLABSI per 1000 line days among patients with inserted central line during hospital stay • To study the incidence of PLABSI per 1000 line days among patients with inserted peripheral line during hospital stay The secondary objective: • Frequent pathogens isolated from patients • Additional length of stay in patients with blood stream infection (CLABSI and PLABSI) • Excess cost incurred from excess investigations and medications Material and Methods: Total 250 patients of age ≥15 years and acquired CLABSI or PLABSI during hospital stay after 48 hours of admission were included. Sensitivities of the cultured organism were recorded. Antibiotics and other drugs for management of blood stream infection were recorded with dosage, duration and excess cost. Excess length of hospital stay due to blood stream infection along with total length of in hospital stay was checked. Finally outcome of every patient was analyzed. Descriptive statistics were calculated. Independent T test / Man Whitney U test was applied to compare the length of hospital stay and cost among patients with and without BSI (CLABSI/PLABSI). P value of less than or equal to 0.05 was considered significant. Results: There were 44% male and 56% female patients. Mean hospital stay was 11.30±7.24 days. Mortality rate was 17.2% while 8.8% patients were found with infection. Most common isolated organisms were pseudomonas (31.8%), staphylococcus aureus (18.2%), klebsiella (9.1%), acenatobacter (9.1%) and candida tropicalis (9.1%). Sixteen patients have excess hospital stay from infection acquisition day with average of 9.31±4.97 days. Majority (40.9%) of patients spends more than 35,000 PKR (7,062 PKR to 70,988 PKR) as excess cost in terms of treatment. Mortality rate among infected patients was 50%. Conclusion: Patients had to bear a heavy burden as a result of infections contracted when using central venous catheters, which lengthened hospital stays and raised treatment costs. Keywords: Central line, Peripheral, Blood Stream Infections, pathogens, length of stay, excess cost

Objective: The study compared the demographics, clinical characteristics and site of infection leading to community acquired and hospital acquired sepsis. Secondly, the study further compared the distribution of the isolated organisms and complications caused by community and hospital acquired sepsis. Methods: A prospective cohort study was undertaken at the intensive care unit, high dependency unit, and critical care unit at the Indus Hospital, Karachi, Pakistan between 14-April-2021 to 15th-April-2022. All the individuals diagnosed with sepsis, admitted through the Emergency Department or transferred from a ward were included in the study. Age < 15 years or who were shifted from another hospital were removed from the study. The data on demographics, vital signs, SOFA score, site of infection, laboratory parameters, radiological investigations, culture results, and complications, if any, were filled on a pre- designed Performa. Results: Age of the participants was 42.1 ± 17.4 years with a predominance towards female gender. Urinary tract was the most common site from which the organisms were isolated with a frequency of 35 (28.9%). Table 3 revealed that gender was significantly associated with gender (p=0.008). It was found that the majority of the community acquired sepsis were reported in males while the majority of the hospital acquired sepsis was reported in females. Furthermore, marital status (p=0.019) and site of infection were significantly correlated with the hospital acquired sepsis. It was further found that mean creatinine was significantly lower in community acquired sepsis than those with hospital acquired sepsis [(7.83 ± 4.85) vs (15.4 ± 10.4); p<0.001]. Conclusion: The study revealed both hospital acquired and community acquired sepsis are life threatening conditions that may add significant burden on the healthcare facility while at the same time placing significant financial burden upon the patients. Keywords: Sepsis; Community-acquired infections; Nosocomial; Mortality