(1) Background: Immune compromised hemodialysis patients are more likely to develop COVID-19 infections, which increase the risk of mortality. The benefits of Remdesivir, despite less literature support on its effectiveness in dialysis patients due to renal toxicity, can outweigh the risks if prescribed early. The aim of this study was to evaluate the efficacy of Remdesivir on the 30-day in-hospital clinical outcome of hemodialysis population with COVID-19 infection and safety endpoints of adverse events. (2) Study design: A prospective quasi-experimental study design was used in the study. (3) Methods: The sample population consisted of 83 dialysis patients with COVID-19 who were administered Remdesivir at a dose of 100 mg before hemodialysis, as per hospital protocol. After the treatment with Remdesivir, we assessed the outcomes across two endpoints, namely primary (surviving vs. dying) as well as clinical and biochemical changes (ferritin, liver function test, C-reactive protein, oxygen requirements, and lactate dehydrogenase levels) and secondary (adverse effects, such as diarrhea, rise in ALT). In Kaplan–Meier analysis, the survival probabilities were compared between patients who received Remdesivir within 48 h of diagnosis and those who received it after 48 h. Cox regression analysis was employed to determine the predictors of outcome. (4) Results: Of the 83 patients, 91.5% survived and 8.4% died. Remdesivir administration did not reduce the death rate overall. Hospital stays were shorter (p = 0.03) and a nasopharyngeal swab for COVID-19 was negative earlier (p = 0.001) in survivors who had received Remdesivir within 48 h of diagnosis compared to those who had received Remdesivir after 48 h. The only variables linked to the 30-day mortality were serum CRP (p = 0.028) and TLC (p = 0.013). No major adverse consequences were observed with Remdesivir. (5) Conclusions: Remdesivir has the potential to shorten the recovery time for dialysis patients if taken within 48 h of onset of symptoms, without any adverse effects.

Objective: To ascertain the efficacy of Sevelamer Carbonate as a better phosphate binder for controlling mineral bone disease biochemical parameters in dialysis patients of a tertiary care centre compared to calcium acetate. Study Design: Prospective Quasi-experimental study. Place and duration of the study: Dialysis unit of Pakistan Emirates Military Hospital Rawalpindi Pakistan from Aug to Dec 2020. Methodology: The sample population comprised 91 patients undergoing maintenance thrice weekly haemodialysis patients treated with Sevelamer Carbonate or Calcium Acetate. CKD-MBD was assessed by serum calcium, phosphorus, ALP, albumin and PTH at the start of the study and then at the end of three months after being treated with phosphate binders. Results: Both Groups had reduced serum phosphorus significantly from baseline to 12 weeks but Sevelamer slightly more than calcium acetate. (Group-1 from 6.90±1.35 to 5.10±1.21, while Group-2 from 7.00±1.31 to 5.90±1.48). The mean Calcium × Phosphorus product was also significantly reduced (p<0.005), decreases after 12 weeks, with 50.0 ± 16.0 in the Sevelamer Hydrochloride Group and insignificantly reduced (52.20±5.20mg2/dl) in the calcium acetate Group. The mean serum calcium increased significantly in the calcium acetate Group from 9.55±0.47 to 10.50±0.90) p=0.003 but was unchanged in the Sevelamerhydrochloride Group (9.56±0.60 to 9.57±0.67; p=0.94). Conclusions: CKD-MBD and its sequelae need special medication, and early detection of biochemical abnormalities and timely intervention with phosphate lowering therapy can abridge the disease burden, thus revamping the quality of life and ultimately abatement of cardiovascular morbidity and mortality.

Objective: The purpose of this research was to compare gastrointestinal (GI) symptoms in ESRD patients receiving PD and HD to see whether there were any significant changes. Methods: After the ethical approval from the institute review board, this crossectional study was conducted at shahida Islam medical complex ,lodhran. From 01/01/22 to 30/06/22. A modified 15-item gastrointestinal symptom rating scale (GSRS) questionnaire was used to assess GI symptoms; this questionnaire included questions on eating dysfunction. Age, a etiology of ESRD, and most recent adequacy evaluation of dialysis were collected through the follow-up database, patient interviews, and chart reviews. Results: Total seventy patients were included in the present study, N=35 was on hemodialysis and N=35 on peritoneal dialysis. HD and PD patients were similar with respect to age, sex, the occurrence of diabetes mellitus, and average dialysis duration. In ESRD patients’ overall prevalence of GI symptoms (GSRS >1) was 68.5% (48/70 patients). Patients with a GSRS > 1 were more common among those with HD group (28/35; 80%) than those with PD (57%; 20/35) (P 0.058*). In the HD group, more patients suffered from abdominal pain, constipation, and diarrhea (74%, 60% and 68.5%, respectively), compared with those in the PD group (34%, 28.5% and 32%, respectively; P value is 0.003, 0.001, and 0.008 respectively) Conclusion: Gastrointestinal (GI) symptoms vary in frequency, intensity, and variety across HD and PD individuals. Keywords: Gastrointestinal symptom, Hemodialysis, Peritoneal dialysis, End-stage renal disease

Background: Neuroendocrine neoplasms most commonly arise from the gastroenteropancreatic (GEP) system. The WHO classification of digestive system tumors describes four main types: Neuroendocrine tumor (NET) grades 1-3 and neuroendocrine carcinoma (NEC). NECs have an aggressive biology and are often diagnosed in an advanced stage associated with poor prognosis. First-line palliative chemotherapy is commonly carboplatin or cisplatin in combination with etoposide, while in secondline capecitabine-temozolomide, FOLFIRI or FOLFOX regimens are used. Few prospective studies have been done and data on efficacy is scarce. We conducted a retrospective study of patients with GEP-NEC treated with FOLFIRINOX, evaluating response to treatment and survival. abstracts Annals of OncologyVolume 32 -Issue S5 -2021 S915

Objective: To determine the prevalence of patterns of CKD-MBD in dialysis patients at a tertiary care hospital and analyze its relationship with various socio demographic factors. Study Design: Analytical cross sectional study. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Jul 2017 to Dec 2017. Methodology: The sample population comprised of 100 patients undergoing hemodialysis and blood samples of calcium, phosphate, alkaline phosphatase and intact PTH were obtained from these patients. CKD-MBD was classified on the basis of biochemical abnormalities and their relationship with age, gender, marital status, smoking history, dialysis count per week, dialysis duration was assessed.Results: Out of 82 patients consisting of 62 males and 20 females, the mean age was 49.8 ± 16 years, 68% of dialysis patients had biochemical abnormalities of which 73% showing high turn over bone disease and 26.8% showing low turnover bone disease (adynamic and osteomalacia). After applying the logistic regression we found that age, gender, dialysis vintage and other socio-demograhic factors had no significant association with the CKD-MBD subtypes. Conclusion: Biochemical abnormalities although common in dialysis patients but the sturdy interconnection between them is still shrouded in disputation. Special consideration should be remunerated to the dialysis population with different spectrum of CKD-MBD as propitious management can procrastinate the progression of CKD and eventually paring down the cardiovascular morbidity and mortality.