faiza saeed - Academia.edu (original) (raw)

Papers by faiza saeed

Blood Purification, 2009

Background: The objective was to investigate the status of vascular calcification, and to explore... more Background: The objective was to investigate the status of vascular calcification, and to explore factors influencing vascular calcification in maintenance hemodialysis patients. Methods: Vascular calcification was quantitatively evaluated using radiographic films of the abdomen, pelvis and hands. Plasma fetuin-A and other parameters related to calcification were examined. Results: 33/50 cases of vascular calcification were identified by radiographic film. Calcifications of the abdominal aorta and peripheral muscular arteries were seen in 90.9 and 36.4%. Patients with moderate to severe calcification were older, more likely to be male, had lower diastolic blood pressure and fetuin-A levels, and a higher incidence of diabetes than those with mild calcification. Logistic regression analysis showed that diabetes and plasma fetuin-A were independent risk factors for vascular calcification. Conclusions: Vascular calcification was present in a large proportion of maintenance hemodialysis ...

European Journal of Clinical Medicine

Introduction: There is continuous experience that AKI is very common in COVID-19 patients and tha... more Introduction: There is continuous experience that AKI is very common in COVID-19 patients and that SARS-CoV-2 specifically invades the kidneys with poor outcome. In-hospital AKI is associated with multiple risk factors including DM, CCF, drugs etc. Also, there is difference in the mortality rate all over the world for various reasons. To date no data has been found from Pakistan on outcome of AKI with COVID-19 infection. Therefore, this study was conducted to help determine the outcome and associated risk factors in this part of the world. Material and Method: This is a prospective cohort of COVID-19 adult patients with AKI admitted in Indus Hospital COVID ICU from March 2020 to September 2020. History, clinical examination, laboratory investigations, and ultrasound imaging of the kidneys was acquired from the Health Management Information System (HMIS) record of the patients. The data was analyzed in SPSS version 21. Association between outcomes of AKI with different variables was ...

European Journal of Clinical Medicine, 2022

Background: The normal axis of calcium, phosphorus, vitamin D, and intact parathyroid hormone (iP... more Background: The normal axis of calcium, phosphorus, vitamin D, and intact parathyroid hormone (iPTH) come under stress when chronic kidney disease (CKD) progresses beyond stage 3(GFR<30 ml/kg/1.732). This results in increased secretion of iPTH which is known as secondary hyperparathyroidism. This exacerbates further if simultaneous deficiency of nutritional vitamin D (Cholecalciferol) is also found. Secondary hyperparathyroidism results in vascular calcification and increases cardiac mortality. Early intervention in form of dietary modification (low phosphorus, low potassium), correcting vitamin D deficiency along with the addition of active vitamin D (calcitriol) would help in alleviating patients’ suffering and saving costs as well. Material and method: This study was conducted from Jan 2017 to Jan 2018 at The Indus Hospital, Karachi with the age group ≥14 years of either gender who were suffering from chronic kidney disease (CKD). Patients on dialysis, chronic liver disease, a...

European Journal of Clinical Medicine, 2021

Introduction: The patients with end stage renal disease requires 12 hours of hemodialysis per wee... more Introduction: The patients with end stage renal disease requires 12 hours of hemodialysis per week divided in three equal sessions (4 hours/day for 3 days/week). Some studies show that adequacy of hemodialysis can be maintained by increasing the surface area of the dialyzer membrane and decreasing the frequency of treatment which can help the poor socioeconomic status patients in getting effective hemodialysis at a low cost. Objectives: To observe whether by increasing the surface area of dialyzer the dose of dialysis can be reduced against the standard hemodialysis prescription. Study design: Randomized Control Trial. Study Duration: Six months from March 2017 to August 2017. Settings: Department of Nephrology, The Indus Hospital Karachi. Subjects: ESRD patients undergoing Hemodialysis for at least 6 months at The Indus Hospital Karachi. Methods: In this prospective randomized control study, a total of 60 patients of end stage renal disease receiving hemodialysis for more than six ...

Objective: To assess the association of Diabetic Retinopathy (DR) with type and duration of Diabe... more Objective: To assess the association of Diabetic Retinopathy (DR) with type and duration of Diabetes Mellitus, mode of treatment and glycaemic control. Methods: An observational study was carried out. Patients with the diagnosis of either Type1, insulin dependent diabetes mellitus (IDDM) or Type 2, non-insulin dependent diabetes mellitus (NIDDM) were enrolled into the study through non-probability, convenient sampling method from Jinnah Medical College Hospital Karachi from July 2012 to March 2013. Thorough history and physical examination was done on each patient. Glycaemic control was assessed by glycosylated Hb level (HbAIc). All information so collected was entered into a proforma. Data was analyzed using SPSS version 20. Results: A total of 108 patients were examined. Out of these, 33 (30.6%) had Type 1 and 75 (69.4%) had Type 2 diabetes. In Type 1 group, 18 (54.5%) were female while in Type 2 group, 37 p atients (49.3%) were female. In Type 1 group, 60.6% (n=20) had DR comp ar...

Background.Imbalance of serum sodium in the form of hypo and hypernatremia has bad prognostic imp... more Background.Imbalance of serum sodium in the form of hypo and hypernatremia has bad prognostic impact, and linked with increase morbidity and mortality. Covid 19 is a deadly viral infection can be complicated with either of the two state. This increases the complications associated with the covid 19 infection.Material and method.This is the observational cohort study, conducted at The Indus Hospital Karachi, from March 2020 to September 2020. All patients were divided in to three groups on the basis of their serum sodium level, and distribution of variables was observed in all these three groups. To observe the effect of dysnatremias on outcome, binary logistic regression was run and odds ratios with 95% confidence interval were obtained.Results.We included 655 patients, in which 70.7% were male, while 29.3% were female. Mean age was 54 ± 15.5 with minimum of 1 year and maximum of 95 year. Hyponatremia was more common 154(23.5%) than hypernatremia 79(12.1%) patients. Dysnatremia were...

COVID-19 pandemic has affected the whole world in last 1 year with catastrophic effects. This vir... more COVID-19 pandemic has affected the whole world in last 1 year with catastrophic effects. This virus has been commonly associated with thromboembolic tendency, resulting in pulmonary embolism, Cerebrovascular accidents, Myocardial infarctions and Acral Cyanosis. Acute kidney injury is also very common amongst patients with COVID-19 infection, mostly due to pre-renal AKI, Acute tubular necrosis or collapsing glomerulopathy. Renal injury due to thrombotic microangiopathy and cortical necrosis is not a common finding in COVID-19 infections. Here we are reporting a case of young female with Critical COVID Pneumonitis and Cytokine release syndrome, who developed AKI due severe TMA and cortical necrosis.

European Journal of Clinical Medicine, 2021

Background: Corona virus disease (Covid -19) is the most contagious form of the disease of presen... more Background: Corona virus disease (Covid -19) is the most contagious form of the disease of present time. Therefore, the risk factors which proliferate the spread and hinders the better outcome should be identified. There is gross difference in the spread and outcome of covid 19 in different region of the world. There is need to identify these factors in different communities of the globe. Material and method: This is a retrospective observational cohort study of Covid -19 patients admitted during the study period. Institutional and ethical review board permission was taken prior to the study. Univariate and multivariate binary logistic regression was run and odds ratio with 95% confidence intervals were obtained. P value of ≤ 0.05 was considered significant. Outcome variables were recovery and death. Results: There were 840 patients admitted between the study duration, while 704 (83.8%) were included in our study. There were 491(69.7%) males and 213(30.3%) females. The mean age of t...

European Journal of Clinical Medicine, 2021

Background: Cytopathic effects of virus and cytokine release syndrome complicate acute respirator... more Background: Cytopathic effects of virus and cytokine release syndrome complicate acute respiratory distress syndrome and ultimately leads to multi-organ failure which can eventually culminate to mortality in COVID-19 patients. Many therapeutic agents have been tried from different aspects in desperation to control the unrestricted spread of virus, although the evidence of benefit was sparse. Material and method: It is a retrospective cohort study of the treatment given to the patients admitted at Indus hospital Karachi from March 2020 to September 2020. In this study, we aim to evaluate therapeutic response of the treatment recommended in COVID-19 patients which included Methylprednisolone, Remdesivir, Tocilizumab and Hydroxychloroquine. We categorized the patients according to the CALL score (Comorbid, Age, Lymphocyte count, LDH) in to mild, moderate and at severe risk of progression of disease. Results: Overall, out of 704 patients, 238(33.8%) patients died while 466(66.2%) surviv...

International Journal of Nephrology and Renovascular Disease

Background: In an ESRD subset of patients, COVID-19 infection is associated with increased diseas... more Background: In an ESRD subset of patients, COVID-19 infection is associated with increased disease burden and higher mortality rates. Methods: We conducted a retrospective single-center cohort study in which 43 ESRD patients had a diagnosis of COVID-19. Association of risk factors with mortality was assessed by chi-square test and logistic regression analysis. Data were collected on a structured performa which included variables like age, gender, comorbid conditions, drug history, clinical presentation, hemodynamic status and laboratory parameters. Outcome variables were recovery and death. All patients received standard treatment for COVID-19 according to hospital protocols, along with hemodialysis and continuous renal replacement therapy (CRRT) when needed. Results: Those most affected were found to be male, 25 (58.1%), while the number of females affected was 18 (41.9%). The most frequent comorbid condition was hypertension (HTN), seen in 35 (81.4%) patients; however, thromboembolic complications were very few in these patients. The mortality rate in our study was 25.6%, and the population most susceptible to poor outcomes in the ESRD subgroup was elderly people (45.5%), while younger patients recovered the most from COVID-19 (53.1%). Hypoalbuminemia, leukocytosis, lymphopenia and raised LDH were also found to be associated with death in ESRD patients suffering from COVID-19 (81.8, 72.7, 100 and 100%, respectively). In multivariate logistic regression analysis, we found that the odds ratio of dying from COVID-19 was 19.5 times higher in patients aged >65 years as compared to patients aged 18-50 years (p=0.039). Similarly, patients with a high TLC were 24.1 times more likely to die than patients with a normal TLC (p=0.008). Conclusion: In our center, the mortality rate of ESRD patients affected with COVID-19 disease was 25.6%, and older age, leukocytosis, lymphopenia, hypoalbuminemia and high LDH were significantly associated with mortality.

Blood Purification, 2009

Background: The objective was to investigate the status of vascular calcification, and to explore... more Background: The objective was to investigate the status of vascular calcification, and to explore factors influencing vascular calcification in maintenance hemodialysis patients. Methods: Vascular calcification was quantitatively evaluated using radiographic films of the abdomen, pelvis and hands. Plasma fetuin-A and other parameters related to calcification were examined. Results: 33/50 cases of vascular calcification were identified by radiographic film. Calcifications of the abdominal aorta and peripheral muscular arteries were seen in 90.9 and 36.4%. Patients with moderate to severe calcification were older, more likely to be male, had lower diastolic blood pressure and fetuin-A levels, and a higher incidence of diabetes than those with mild calcification. Logistic regression analysis showed that diabetes and plasma fetuin-A were independent risk factors for vascular calcification. Conclusions: Vascular calcification was present in a large proportion of maintenance hemodialysis ...

European Journal of Clinical Medicine

Introduction: There is continuous experience that AKI is very common in COVID-19 patients and tha... more Introduction: There is continuous experience that AKI is very common in COVID-19 patients and that SARS-CoV-2 specifically invades the kidneys with poor outcome. In-hospital AKI is associated with multiple risk factors including DM, CCF, drugs etc. Also, there is difference in the mortality rate all over the world for various reasons. To date no data has been found from Pakistan on outcome of AKI with COVID-19 infection. Therefore, this study was conducted to help determine the outcome and associated risk factors in this part of the world. Material and Method: This is a prospective cohort of COVID-19 adult patients with AKI admitted in Indus Hospital COVID ICU from March 2020 to September 2020. History, clinical examination, laboratory investigations, and ultrasound imaging of the kidneys was acquired from the Health Management Information System (HMIS) record of the patients. The data was analyzed in SPSS version 21. Association between outcomes of AKI with different variables was ...

European Journal of Clinical Medicine, 2022

Background: The normal axis of calcium, phosphorus, vitamin D, and intact parathyroid hormone (iP... more Background: The normal axis of calcium, phosphorus, vitamin D, and intact parathyroid hormone (iPTH) come under stress when chronic kidney disease (CKD) progresses beyond stage 3(GFR<30 ml/kg/1.732). This results in increased secretion of iPTH which is known as secondary hyperparathyroidism. This exacerbates further if simultaneous deficiency of nutritional vitamin D (Cholecalciferol) is also found. Secondary hyperparathyroidism results in vascular calcification and increases cardiac mortality. Early intervention in form of dietary modification (low phosphorus, low potassium), correcting vitamin D deficiency along with the addition of active vitamin D (calcitriol) would help in alleviating patients’ suffering and saving costs as well. Material and method: This study was conducted from Jan 2017 to Jan 2018 at The Indus Hospital, Karachi with the age group ≥14 years of either gender who were suffering from chronic kidney disease (CKD). Patients on dialysis, chronic liver disease, a...

European Journal of Clinical Medicine, 2021

Introduction: The patients with end stage renal disease requires 12 hours of hemodialysis per wee... more Introduction: The patients with end stage renal disease requires 12 hours of hemodialysis per week divided in three equal sessions (4 hours/day for 3 days/week). Some studies show that adequacy of hemodialysis can be maintained by increasing the surface area of the dialyzer membrane and decreasing the frequency of treatment which can help the poor socioeconomic status patients in getting effective hemodialysis at a low cost. Objectives: To observe whether by increasing the surface area of dialyzer the dose of dialysis can be reduced against the standard hemodialysis prescription. Study design: Randomized Control Trial. Study Duration: Six months from March 2017 to August 2017. Settings: Department of Nephrology, The Indus Hospital Karachi. Subjects: ESRD patients undergoing Hemodialysis for at least 6 months at The Indus Hospital Karachi. Methods: In this prospective randomized control study, a total of 60 patients of end stage renal disease receiving hemodialysis for more than six ...

Objective: To assess the association of Diabetic Retinopathy (DR) with type and duration of Diabe... more Objective: To assess the association of Diabetic Retinopathy (DR) with type and duration of Diabetes Mellitus, mode of treatment and glycaemic control. Methods: An observational study was carried out. Patients with the diagnosis of either Type1, insulin dependent diabetes mellitus (IDDM) or Type 2, non-insulin dependent diabetes mellitus (NIDDM) were enrolled into the study through non-probability, convenient sampling method from Jinnah Medical College Hospital Karachi from July 2012 to March 2013. Thorough history and physical examination was done on each patient. Glycaemic control was assessed by glycosylated Hb level (HbAIc). All information so collected was entered into a proforma. Data was analyzed using SPSS version 20. Results: A total of 108 patients were examined. Out of these, 33 (30.6%) had Type 1 and 75 (69.4%) had Type 2 diabetes. In Type 1 group, 18 (54.5%) were female while in Type 2 group, 37 p atients (49.3%) were female. In Type 1 group, 60.6% (n=20) had DR comp ar...

Background.Imbalance of serum sodium in the form of hypo and hypernatremia has bad prognostic imp... more Background.Imbalance of serum sodium in the form of hypo and hypernatremia has bad prognostic impact, and linked with increase morbidity and mortality. Covid 19 is a deadly viral infection can be complicated with either of the two state. This increases the complications associated with the covid 19 infection.Material and method.This is the observational cohort study, conducted at The Indus Hospital Karachi, from March 2020 to September 2020. All patients were divided in to three groups on the basis of their serum sodium level, and distribution of variables was observed in all these three groups. To observe the effect of dysnatremias on outcome, binary logistic regression was run and odds ratios with 95% confidence interval were obtained.Results.We included 655 patients, in which 70.7% were male, while 29.3% were female. Mean age was 54 ± 15.5 with minimum of 1 year and maximum of 95 year. Hyponatremia was more common 154(23.5%) than hypernatremia 79(12.1%) patients. Dysnatremia were...

COVID-19 pandemic has affected the whole world in last 1 year with catastrophic effects. This vir... more COVID-19 pandemic has affected the whole world in last 1 year with catastrophic effects. This virus has been commonly associated with thromboembolic tendency, resulting in pulmonary embolism, Cerebrovascular accidents, Myocardial infarctions and Acral Cyanosis. Acute kidney injury is also very common amongst patients with COVID-19 infection, mostly due to pre-renal AKI, Acute tubular necrosis or collapsing glomerulopathy. Renal injury due to thrombotic microangiopathy and cortical necrosis is not a common finding in COVID-19 infections. Here we are reporting a case of young female with Critical COVID Pneumonitis and Cytokine release syndrome, who developed AKI due severe TMA and cortical necrosis.

European Journal of Clinical Medicine, 2021

Background: Corona virus disease (Covid -19) is the most contagious form of the disease of presen... more Background: Corona virus disease (Covid -19) is the most contagious form of the disease of present time. Therefore, the risk factors which proliferate the spread and hinders the better outcome should be identified. There is gross difference in the spread and outcome of covid 19 in different region of the world. There is need to identify these factors in different communities of the globe. Material and method: This is a retrospective observational cohort study of Covid -19 patients admitted during the study period. Institutional and ethical review board permission was taken prior to the study. Univariate and multivariate binary logistic regression was run and odds ratio with 95% confidence intervals were obtained. P value of ≤ 0.05 was considered significant. Outcome variables were recovery and death. Results: There were 840 patients admitted between the study duration, while 704 (83.8%) were included in our study. There were 491(69.7%) males and 213(30.3%) females. The mean age of t...

European Journal of Clinical Medicine, 2021

Background: Cytopathic effects of virus and cytokine release syndrome complicate acute respirator... more Background: Cytopathic effects of virus and cytokine release syndrome complicate acute respiratory distress syndrome and ultimately leads to multi-organ failure which can eventually culminate to mortality in COVID-19 patients. Many therapeutic agents have been tried from different aspects in desperation to control the unrestricted spread of virus, although the evidence of benefit was sparse. Material and method: It is a retrospective cohort study of the treatment given to the patients admitted at Indus hospital Karachi from March 2020 to September 2020. In this study, we aim to evaluate therapeutic response of the treatment recommended in COVID-19 patients which included Methylprednisolone, Remdesivir, Tocilizumab and Hydroxychloroquine. We categorized the patients according to the CALL score (Comorbid, Age, Lymphocyte count, LDH) in to mild, moderate and at severe risk of progression of disease. Results: Overall, out of 704 patients, 238(33.8%) patients died while 466(66.2%) surviv...

International Journal of Nephrology and Renovascular Disease

Background: In an ESRD subset of patients, COVID-19 infection is associated with increased diseas... more Background: In an ESRD subset of patients, COVID-19 infection is associated with increased disease burden and higher mortality rates. Methods: We conducted a retrospective single-center cohort study in which 43 ESRD patients had a diagnosis of COVID-19. Association of risk factors with mortality was assessed by chi-square test and logistic regression analysis. Data were collected on a structured performa which included variables like age, gender, comorbid conditions, drug history, clinical presentation, hemodynamic status and laboratory parameters. Outcome variables were recovery and death. All patients received standard treatment for COVID-19 according to hospital protocols, along with hemodialysis and continuous renal replacement therapy (CRRT) when needed. Results: Those most affected were found to be male, 25 (58.1%), while the number of females affected was 18 (41.9%). The most frequent comorbid condition was hypertension (HTN), seen in 35 (81.4%) patients; however, thromboembolic complications were very few in these patients. The mortality rate in our study was 25.6%, and the population most susceptible to poor outcomes in the ESRD subgroup was elderly people (45.5%), while younger patients recovered the most from COVID-19 (53.1%). Hypoalbuminemia, leukocytosis, lymphopenia and raised LDH were also found to be associated with death in ESRD patients suffering from COVID-19 (81.8, 72.7, 100 and 100%, respectively). In multivariate logistic regression analysis, we found that the odds ratio of dying from COVID-19 was 19.5 times higher in patients aged >65 years as compared to patients aged 18-50 years (p=0.039). Similarly, patients with a high TLC were 24.1 times more likely to die than patients with a normal TLC (p=0.008). Conclusion: In our center, the mortality rate of ESRD patients affected with COVID-19 disease was 25.6%, and older age, leukocytosis, lymphopenia, hypoalbuminemia and high LDH were significantly associated with mortality.