Notes

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03, p < 0.001). The overall 30-day mortality was 46%. Blood urea nitrogen, procalsitonin, C-reactive protein and creatinine levels were higher in the nonsurvivor group (p < 0.001). However, albumin (p < 0.001), BMI (p=0.03) and longer hospital stay (p < 0.001) were higher in the survivor group. Adezmapimod Inotropic support, APACHE-II score and CCI were independently related to increased mortality risk, whereas albumin was associated with decreased mortality risk.

High APACHE II score, low CCI, low albumin levels and the requirement for inotropic support were found to be independently risk factors of 30-day mortality in the geriatric patients with respiratory failure in ICU.
High APACHE II score, low CCI, low albumin levels and the requirement for inotropic support were found to be independently risk factors of 30-day mortality in the geriatric patients with respiratory failure in ICU.
To discuss common indications and findings on upper gastrointestinal endoscopy as well as to correlate these findings with alarm symptoms in the rural population of Gadap town, Sindh.

This was a retrospective study on 1288 patients conducted in the medical ward of Fatima Hospital, Baqai Medical University. Patients' demographics and other data related to the procedure were recovered from patients' records. Adezmapimod SPSS version 20 was used for statistical analysis.

Ratio of male and female patients was approximately 11. Majority of the patients were young, and most procedures were done as outpatients without the requirement of conscious sedation. Epigastric pain was the primary indication for upper GI endoscopy (62.6%). One third of the procedures performed did not report any pathological finding. Probability of a positive finding was more likely if a patient presented with dysphagia, heart-burn, hematemesis, vomiting, or for screening endoscopy (for varices). Patients who were diagnosed with esophageal candidiasis, esophageal varices or esophageal growth/ ulcer had reported one or more alarm symptoms in their history.

Upper gastrointestinal endoscopy is a useful test to diagnose disorders of the esophagus, stomach and duodenum. However, it is an expensive procedure and therefore referring physicians should keep appropriate clinical indication and ethical considerations in mind before recommending such an investigation to their patients.
Upper gastrointestinal endoscopy is a useful test to diagnose disorders of the esophagus, stomach and duodenum. However, it is an expensive procedure and therefore referring physicians should keep appropriate clinical indication and ethical considerations in mind before recommending such an investigation to their patients.
To determine the association between ABO/Rh-D blood types and susceptibility to SARS-CoV-2 infection in Pakistan.

In this cross-sectional study, 1935 confirmed cases of COVID-19 were included using consecutive sampling. Age and gender-matched sample of 1935 blood donors was used as a comparison group. Chi-square test and binary logistic regression were used for inferential statistics.

Significantly higher proportion of blood type-B was observed in COVID-19 group (35.9% vs 31.9%, p=0.009). Blood type-AB was found more frequently (14.2% vs 11.8%, p=0.03) in the comparison group. The Rh-D Positive blood types were 93.3% in COVID-19 group and 94.9% in comparison group (p=0.03). The odds of blood type-B, AB and Rh-D positive to test positive for SARS-CoV-2 were 1.195 (95% CI 1.04 - 1.36, p=0.009), 0.80 (95% CI 0.66 - 0.97, p=0.03) and 0.75 (95% CI 0.57- 0.98, p = 0.03), respectively. Blood types A and O did not have significant association with SARS-CoV-2 PCR result (p = 0.22 and 0.88, respectively).

There is significant association between blood types B & AB and susceptibility to COVID-19. There is no association between blood types A and O with COVID-19. Rh- D positive blood types are less susceptible to COVID-19.
There is significant association between blood types B & AB and susceptibility to COVID-19. There is no association between blood types A and O with COVID-19. Adezmapimod Rh- D positive blood types are less susceptible to COVID-19.A Romanian 5-month-old girl was referred to our hospital after being diagnosed with congenital corneal opacities. She was sent in order to undergo penetrating keratoplasty (PKP) surgery on her left eye. link2 The patient presented a natural tendency to esotropia. We took into account two different surgical techniques PKP and lamellar keratoplasty. The latter was technically impossible to carry out because of the full-thickness corneal opacity. We conducted several tests to accurately obtain the patient's preoperative parameters and specifically decide the details of the surgical technique to be applied. For each step of the surgical procedure we carefully compared the individual results in the literature in order to ensure a stable and lasting result. In addition to this, we used an innovative suture technique nylon thread, interrupted suture, alternating 11-0/10-0 threads. Six months after the operation, the functional result obtained was 4-5/10, with recovery of the fixation. Pediatric PKP, therefore, cannot follow a surgical standard, but requires careful case-by-case evaluation from the pre- to the postoperative phase, with the aim of maximizing stable visual acuity.We present the case of a 43-year-old woman with unilateral loss of vision who had a history of cervical cancer, staged as FIGO IIIB, and who had undergone previous chemotherapy and radiotherapy, but was not a surgical candidate. An examination revealed serous retinal detachment with an underlying choroidal mass in the left eye. link2 We reviewed all available published case reports of uterine cervix metastases to the eye and adnexa and compiled all information into a table to present clinical and epidemiological findings. Unilateral choroidal metastasis arising from cervical cancer is extremely rare. In most cases, a history of cervical carcinoma is confirmed in the advanced stage of the disease. Ocular metastasis may be the presenting feature of primary cervical malignancy; therefore, to rule out malignancy in every woman who develops these clinical features, a cervical examination should be included in the workup.There is a wide spectrum of cilial anomalies; however, ectopic cilia are the rarest of the cilial anomalies. We report, to the best of our knowledge, the third worldwide case of this eyelid anomaly in the inferior palpebral conjunctiva and the first with a long-term follow-up of 18 months without recurrence following excision. The 41-year-old Saudi male presented with posterior ectopic cilia in the palpebral conjunctiva of the left lower eyelid. This rare anomaly was not associated with other findings. Eighteen months after complete excision of the cilia (along with the adjacent conjunctiva and tarsal plate), there was no recurrence of the ectopic cilia. This case highlights the importance of considering ectopic cilia when patients present with focal punctate keratopathy and the importance of excision of the cilia along with the adjacent conjunctiva and tarsal plate to prevent recurrence.We report a 12-year-old female patient with acute macular neuroretinopathy assessed with multimodal retinal exams. Initial fluorescein angiogram and optical coherence tomography angiography (OCT-A) were both normal, and after 4 months OCT-A showed abnormal vascular flow with normal flow in superficial retina layers, choroid, and choriocapillaris.Optic disc coloboma (ODC) is a rare congenital anomaly of the optic nerve. Optical coherence tomography (OCT) helps to monitor the complications when there is associated retinoschisis, retinal detachment, or peripapillary neovascularization, while being minimally invasive. OCT angiography could help to better understand this entity from a vascular perspective. We report multimodal imaging of 3 children with large ODC associated with cat eye syndrome, CHARGE syndrome (coloboma, heart defects, atresia choanae, growth retardation, genital abnormalities, and ear abnormalities), and branchio-oculo-facial syndrome.Immune checkpoint inhibitors are increasingly being used for the treatment of several malignancies. In rare cases, patients develop disabling ophthalmic side effects such as dry eyes, episcleritis, keratitis, uveitis, inflammatory orbitopathy, myasthenia gravis, macular edema, and serous retinal detachment. We present a case of acute bilateral anterior uveitis, prolonged hypotony, and cataracts following the use of dual therapy ipilimumab and nivolumab. Physicians should be aware of these immune-mediated ocular adverse events and should have a management plan to deal with these side effects that range from mild to vision threatening.We report the clinical and microbiological features of contact lens-related mixed infectious keratitis caused by a spore-forming filamentous fungus and a rare gram-negative bacterial infection. A 66-year-old Caucasian female presented with right eye (OD) pain after sleeping in her 2-weekly contact lenses for 3 days. On presentation, corrected distance visual acuity was 0.46 LogMAR OD and 0.20 in the left eye. link2 Slit lamp biomicroscopy revealed a 1.9 mm by 1.9 mm area of dense stromal infiltrate with epithelial defect. Corneal scrapes grew Aspergillus fumigatus and Pseudomonas koreensis, and culture-directed microbial therapy with oral and topical voriconazole and topical fortified gentamicin along with regular debridement resulted in slow resolution of the infection, leaving a dense stromal scar in the visual axis requiring penetrating keratoplasty. Mixed infectious keratitis caused by filamentous fungi and gram-negative bacteria is rare. Pseudomonas koreensis infection has not been previously reported as a cause of infectious keratitis in humans. In our experience, these mixed infections require prolonged systemic and topical therapy and the secondary scarring may require surgical intervention for vision rehabilitation.A patient presented with complaints of a sudden decrease in vision, ocular redness, and pain in the right eye. The patient had a history of clear lens extraction with intraocular lens (IOL) implantation for myopia 2 years previously. He had been prescribed topical steroids for episodes of inflammation that occurred repeatedly every 1-2 months. With a presumptive diagnosis of chronic endophthalmitis, a 23-G transconjunctival sutureless pars plana vitrectomy (PPV) with delivery of intravitreal antibiotics was performed the next day. link3 Culture sensitivity testing of the vitreous sample indicated Pseudomonas stutzeri that was sensitive to ceftazidime and gentamicin. Two weeks later, the patient presented with sudden loss of vision and all the signs of recurrent endophthalmitis. 23-G transconjunctival sutureless PPV was performed along with removal of the posterior chamber IOL through a corneal incision. Complete resolution was only achieved after removal of the IOL, resulting in excellent visual recovery. link3 link3 Due to its chronic and fulminating nature, P. stutzeri can induce endophthalmitis and should be considered in the differential diagnosis. Aseptic measures are the best prevention.Neurofibromatosis type 1 (NF1) is a phacomatosis known to be associated with several developmental abnormalities in multiple organ systems including the eyes. NF1 can present with varying ophthalmic manifestations, including Lisch nodules, retinal astrocytic hamartomas, capillary hemangiomas, plexiform neurofibromas, and choroidal nodules. We present 2 cases of NF1 with presentations that may represent underreported retinal abnormalities occurring in NF1. Case 1 presents a patient who developed spontaneous peripheral retinal dialysis with subsequent retinal detachment; case 2 discusses a patient with multiple pigmented choroidal lesions bilaterally.
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