BACKGROUND: By March 2020, The World Health Organization (WHO) has declared Coronavirus disease-19 (COVID-19) as a global pandemic. Further investigations found that COVID-19 may lead to acute kidney injury (AKI). Some studies have been done, but the incidence and outcome of AKI in COVID-19 are variable between studies. Moreover, given the high number of COVID-19 cases in our country, we aimed to perform a systematic review and meta-analysis regarding the detailed outcome of AKI in COVID-19 patients as reported in the available literature. METHODS: We performed a comprehensive literature search from several databases, such as Europe PMC, PubMed, ProQuest, Directory of Open Access Journal (DOAJ), and related references between December 1, 2019, and December 5, 2020. The primary outcome was mortality, and the secondary outcomes were the need for Intensive Care Unit (ICU) care, severe and critical COVID-19 infection, and Acute Respiratory Distress Syndrome (ARDS). RESULTS: There were a total of 25,990 patients from 21 studies. Acute kidney injury was associated with increased odds of mortality (OR 13.43 [8.35, 21.60], p < 0.00001; I2 : 82%, p < 0.00001), need for ICU care (OR 14.57 [8.51, 24.94], p < 0.00001; I2: 84%; p < 0.0001), critical COVID-19 (OR 10.41 [3.88, 27.90], p < 0.00001; I2: 67%; p = 0.02), and ARDS (OR 2.84 [1.30, 6.22], p = 0.009; I2: 91%; p = 0.001). CONCLUSION: Acute kidney injury is associated with mortality, need for ICU care, critical COVID-19 patients, and ARDS.
Coronavirus ; COVID-19 ; Coronavirus Infections ; Acute Kidney Injury

Background: The increasingly widespread use of antiretroviral drugs (ARV) to manage human immunodeficiency virus (HIV) infection has significantly reduced mortality. Accordingly, the number of patients with HIV with a life expectancy >50 years is increasing. With advanced age, the risk of non-communicable diseases (NCD) increases.According to a study in Uganda in 2017, the prevalence of at least one NCD in patients with HIV was 20.7%, with 11–30% of deaths due to NCDs, especially cardiovascular disease. This emphasizes that NCDs in patients with HIV are of clinical concern, as are the factors that increase the risk of these diseases. However, most studies on HIV and NCDs focus on African countries, while research in Asia is limited. Differences in genetics, lifestyle, and co-existing health burdens may influenced NCD prevalence and risk factors. This study aimed to determine the prevalence of and risk factors for NCDs in patients with HIV. Materials and Methods: This was an analytical cross-sectional study conducted at the outpatient clinic of the Ngoerah Hospital from June 8, 2023, to July 7, 2023. Descriptive and multivariate analyses were performed. Results: In total, 1,644 patients with HIV were included in this study. The prevalence of NCDs was 1.9% for hypertension, 1.1% for diabetes mellitus, 0.7% for dyslipidemia, 1.0% for kidney disorders, 0.1% for stroke, 0.3% for cancer, 0.3% for cardiovascular disease, and 0.2% for autoimmune diseases. After conducting a multivariate test, we found that age >50 years increased the risk of comorbid NCDs by 7.886 times, while male sex increased the risk by 2.568 times, and an ARV regimen of two nucleoside reverse transcriptase inhibitors (NRTIs) + non-NRTI (NNRTI) decreased the risk by 2.625 times. Conclusion Hypertension was the most common NCD in patients with HIV, followed by diabetes mellitus. Male patients and those aged >50 years were at a greater risk of developing NCDs, whereas a history of using the two NRTIs + NNRTI regimen was associated with a lower risk of NCDs.

Background: The increasingly widespread use of antiretroviral drugs (ARV) to manage human immunodeficiency virus (HIV) infection has significantly reduced mortality. Accordingly, the number of patients with HIV with a life expectancy >50 years is increasing. With advanced age, the risk of non-communicable diseases (NCD) increases.According to a study in Uganda in 2017, the prevalence of at least one NCD in patients with HIV was 20.7%, with 11–30% of deaths due to NCDs, especially cardiovascular disease. This emphasizes that NCDs in patients with HIV are of clinical concern, as are the factors that increase the risk of these diseases. However, most studies on HIV and NCDs focus on African countries, while research in Asia is limited. Differences in genetics, lifestyle, and co-existing health burdens may influenced NCD prevalence and risk factors. This study aimed to determine the prevalence of and risk factors for NCDs in patients with HIV. Materials and Methods: This was an analytical cross-sectional study conducted at the outpatient clinic of the Ngoerah Hospital from June 8, 2023, to July 7, 2023. Descriptive and multivariate analyses were performed. Results: In total, 1,644 patients with HIV were included in this study. The prevalence of NCDs was 1.9% for hypertension, 1.1% for diabetes mellitus, 0.7% for dyslipidemia, 1.0% for kidney disorders, 0.1% for stroke, 0.3% for cancer, 0.3% for cardiovascular disease, and 0.2% for autoimmune diseases. After conducting a multivariate test, we found that age >50 years increased the risk of comorbid NCDs by 7.886 times, while male sex increased the risk by 2.568 times, and an ARV regimen of two nucleoside reverse transcriptase inhibitors (NRTIs) + non-NRTI (NNRTI) decreased the risk by 2.625 times. Conclusion Hypertension was the most common NCD in patients with HIV, followed by diabetes mellitus. Male patients and those aged >50 years were at a greater risk of developing NCDs, whereas a history of using the two NRTIs + NNRTI regimen was associated with a lower risk of NCDs.

Background: The increasingly widespread use of antiretroviral drugs (ARV) to manage human immunodeficiency virus (HIV) infection has significantly reduced mortality. Accordingly, the number of patients with HIV with a life expectancy >50 years is increasing. With advanced age, the risk of non-communicable diseases (NCD) increases.According to a study in Uganda in 2017, the prevalence of at least one NCD in patients with HIV was 20.7%, with 11–30% of deaths due to NCDs, especially cardiovascular disease. This emphasizes that NCDs in patients with HIV are of clinical concern, as are the factors that increase the risk of these diseases. However, most studies on HIV and NCDs focus on African countries, while research in Asia is limited. Differences in genetics, lifestyle, and co-existing health burdens may influenced NCD prevalence and risk factors. This study aimed to determine the prevalence of and risk factors for NCDs in patients with HIV. Materials and Methods: This was an analytical cross-sectional study conducted at the outpatient clinic of the Ngoerah Hospital from June 8, 2023, to July 7, 2023. Descriptive and multivariate analyses were performed. Results: In total, 1,644 patients with HIV were included in this study. The prevalence of NCDs was 1.9% for hypertension, 1.1% for diabetes mellitus, 0.7% for dyslipidemia, 1.0% for kidney disorders, 0.1% for stroke, 0.3% for cancer, 0.3% for cardiovascular disease, and 0.2% for autoimmune diseases. After conducting a multivariate test, we found that age >50 years increased the risk of comorbid NCDs by 7.886 times, while male sex increased the risk by 2.568 times, and an ARV regimen of two nucleoside reverse transcriptase inhibitors (NRTIs) + non-NRTI (NNRTI) decreased the risk by 2.625 times. Conclusion Hypertension was the most common NCD in patients with HIV, followed by diabetes mellitus. Male patients and those aged >50 years were at a greater risk of developing NCDs, whereas a history of using the two NRTIs + NNRTI regimen was associated with a lower risk of NCDs.

Thymomas are rare tumours which generally account for only 0.2 – 1.5% of mediastinal tumours in adults. Around 40% of patients present with systemic symptoms such as motor weakness due to myasthenia gravis (MG), pure red cell aplasia, and hypogammaglobulinemia. Based on recent guidelines, management of advanced thymoma uses a multimodal approach, which is thymectomy followed by radiotherapy, but not all health care centers have radiotherapy facilities. A 52-year-old woman presented with nasal voice and had difficulty swallowing food. Patient was diagnosed with myasthenia gravis (MG). CT scan with contrast of the thorax showed a heterogenous solid mass in anterior mediastinum. Histopathological examination showed thymoma type B2. Thymectomy followed by seven cycles of platinum-based chemotherapy were done on the patient. Evaluation afterward showed complete remission of thymoma. The patient’s motor weakness improved after the chemotherapy. Post-chemotherapy period was uneventful at six months on follow-up visit. The dosage of acetylcholinesterase inhibitor drug is reduced periodically due to improvement in motor weakness. The case emphasizes how to manage an advanced thymoma with MG with limited therapeutic options, and the importance of multidisciplinary management involving oncologists, surgeons, and neurologists.
Thymoma ; Myasthenia Gravis ; Drug Therapy ; Thymectomy