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A wide range of opportunistic infections have been described in patients with Coronavirus disease 2019 (COVID-19). Aspergillus and Candida have been reported as the main fungal pathogens for co-infection in these patients. Mucormycosis including Rhino-Orbital-Cerebral Mucormycosis (ROCM) has been increasingly described in patients with COVID-19 disease but the risk factors and outcome of such patients are not well described.

This prospective observational study was conducted at a tertiary centre in North India of 50 patients with radiologically and microbiologically proven Mucormycosis.

The included subjects were evaluated for the risk factors, the clinical presentation, and outcomes. Frequency(t=50) Percentage 1 Age Below 40 10 20 40 and above 40 80 2 Sex F 21 42 M 29 58 3 Covid 19 history positive 39 78 negative 4 8 nr 7 14 4 HTN history Present 21 42 absent 29 58 5 Diabetes history present 42 84 absent 8 16 6 Duration of DM <1 month 8 16 >1 month 26 52 NR 16 32 7 Vaccination Status Vaccinagainst Covid-19, and only 42% had a history of Hypertension. Dexamethasone was used in 46% of the patients admitted and 82% were discharged with satisfactory recovery.

Out of the 50 patients under study, 78% had Covid-19 disease. The primary risk factor of Mucor in patients of Covid-19 was Diabetes Mellitus (84%) with known diabetics (52%) having uncontrolled hyperglycemia (54%) and those who required oxygen support (home/ hospital) (32%). Mucor was more common in males (58%) of age 40 years and above (80%). About 96% of these patients were not vaccinated against Covid-19, and only 42% had a history of Hypertension. Dexamethasone was used in 46% of the patients admitted and 82% were discharged with satisfactory recovery.Monoclonal antibodies have gained attention in developing countries owing to its benefits portrayed by few clinical trial. However, no studies until now have been undergone in India.

Aretro - prospective comparative observational study was conducted in symptomatic COVID19 patients to evaluate the impact of Casirivimab and Imdevimab antibody cocktail in the high-risk population. Through an extensive data retrieval for 6 months, 152 samples were documented and sorted into test (Casirivimab and Imdevimab treated patients, n=79) and control (Non- Casirivimab and Imdevimab treated individuals, n=73) subsets. The research had two phases; first, estimation of mechanical ventilation and high flow oxygen requirement and mortality in samples amidst the treatment, and second was the post COVID19 patients' feedback through validated (Cronbach's alpha coefficient= 0.7) questionnaire that evaluated their health and vaccination status, and treatment satisfaction.

We noticed lesser requisite for mechanical ventilation (6.3%; p<0.001), high flow oxygen (5.1%; p<0.001) and no death during Casirivimab and Imdevimab therapy. Meanwhile, non-vaccinated test groups were not on mechanical ventilation and those fully immunized seldom entailed high flow oxygen (test, 6.3%; control, 41.9%, p<0.01). On evaluating the post COVID19 status of each patient in the study, 90.1% of the test samples were healthy and 97.2% were satisfied with the treatment than those in control group.

Casirivimab and Imdevimab regimen was clinically beneficial for high risk COVID19 patients than those treated without the antibody cocktail.

Casirivimab and Imdevimab regimen was clinically beneficial for high risk COVID19 patients than those treated without the antibody cocktail.Navi Mumbai Municipal Corporation, Covid-19 DCHC and ICU, Navi Mumbai COVID- 19 pandemic has become a leading cause of morbidity and mortality worldwide since the emergence of novel coronavirus SARS-CoV-2 in December 2019. The patterns of imaging abnormalities and data from prior coronavirus outbreaks suggest that patients with severe COVID-19pneumonia are at increased risk of progression to interstitial lung disease and chronic pulmonary vascular disease.We have devised an effective,inexpensive approach for Covid-19 recovering patients to reduce the incidence and severity of these pulmonary complications.

This cross sectional study was conducted across two centres-largest government-run DCHC,Vashi, Navi Mumbai and private tertiary care hospital in Airoli, Navi Mumbai from Nov'20 to Feb'21. IEC approval, consent was obtained.472 patients were enrolled. Demographic,clinical,radiological data was collected.Adults >18yrs who tested Covid-19 RTPCR/ Rapid Antigen Positive, HRCTSS of >10, required hoplications and must be advocated.

Covid-19 Rehabilitation Therapy is cost effective,easy and convenient approach to reduce and prevent related pulmonary complications and must be advocated.Mucormycosis (Zygomycosis) is a rare and lethal invasive fungal infection, often acute and extremely severe caused by opportunist and ubiquitous fungi belonging to the class Phygomycetes, subclass Zygomycetes, order Mucorales, family Mucoraceae. India has reported surge in cases of post COVID 19 Mucormycosis over the past few months due to the increasing frequency of risk factors like corticosteroid therapy, uncontrolled diabetes, DKA, neutropenia and iron overload. Patients with a history of COVID-19 infection are at increased risk of developing fungal infections like Mucormycosis. The emergence of COVID-19 associated mucormycosis (CAM) across several nations, particularly India, warrants a detailed study to identify potential contributing factors.

This cross sectional study conducted at Bowring and Lady Curzon Hospital, Bangalore, involving 75 subjects diagnosed with CAM either clinically, radiological or microbiologically. The objective was to study the clinical profile of patients with COVID associated Mrmycosis infection, suggesting dysregulated iron metabolism in its pathogenesis.Mucormycosis is an angioinvasive disease caused by mold fungi of the genus Rhizopus, Mucor. India has reported surge in cases of COVID 19 associated Mucormycosis over the past few months due to the increasing frequency of risk factors like corticosteroid therapy, uncontrolled diabetes, neutropenia and obesity. Studies have shown that eukaryote cell membrane contains cholesterol and fungal cell wall contains ergosterol with lanosterol being precursor for both and ergosterol is essential for mitochondrial DNA maintenance in fungi, as cholesterol is in humans. The current study is based on the hypothesis that fungi can use human cholesterol as a raw material to maintain its cell function and accentuate its own multiplication and this can indirectly be shown by the association between deranged lipid parameters in an individual with severity of Mucormycosis. Thus present study aims to estimate the lipid parameters and correlate the serum lipid parameters with clinical profile, stage of the disease and duration of pid parameters. It also showed statistically significant correlation such that patients with increasing TC,LDL,VLDL,TG levels had shorter COVID 19 onset to mucormycosis onset duration.

The study showed a positive correlation between serum lipid profile and staging of mucormycosis and negative correlation between lipid levels with duration between onset of COVID 19 to onset of mucormycosis. Hence serum lipid profile can be used as an excellent marker to predict the severity and prognosis of COVID 19 associated mucormycosis.

The study showed a positive correlation between serum lipid profile and staging of mucormycosis and negative correlation between lipid levels with duration between onset of COVID 19 to onset of mucormycosis. Hence serum lipid profile can be used as an excellent marker to predict the severity and prognosis of COVID 19 associated mucormycosis.The triaging of COVID 19 patients is of paramount importance to plan further management. There are several clinical and laboratory parameters that help in categorizing the disease severity, triaging, and prognostication. Little is known about the prognostic significance of eosinopenia in predicting the severity of COVID 19 from large hospital data especially from low- and middle-income countries. The objective of this study is to evaluate the level of eosinopenia as an early prognostic marker for assessing the outcomes in COVID 19 patients and to assess the superiority of eosinopenia as a prognostic marker for assessing the outcomes in COVID 19 patients compared to lymphopenia and neutrophil lymphocyte ratio (NLR).

The study was carried out in a tertiary care hospital. A retrospective longitudinal approach was adopted wherein the hospital records of COVID 19 patients were analysed. Two separate groups of patients were included for analysis to describe the association between initial eosinophil counts of the was found in 86 % whereas a high neutrophil lymphocyte ratio >17 was seen in only 25.6% of patients who died. Thus, implying that is eosinopenia is an important marker of disease severity in COVID 19.

Eosinopenia is an important parameter in the evaluation of COVID 19 and the presence of it should alert the clinicians regarding the further progression of the disease. It is not only an important marker but also an early marker for severe disease.

Eosinopenia is an important parameter in the evaluation of COVID 19 and the presence of it should alert the clinicians regarding the further progression of the disease. It is not only an important marker but also an early marker for severe disease.Dengue fever is the world's fastest growing vector borne viral disease. Dengue infection has high morbidity and mortality unless managed promptly and appropriately. Calcium regulates many physiological processes such as neuromuscular transmission, heart contractility, hormonal release, blood coagulation and is essential for cell function. Low calcium level is present in almost 80% of dengue cases and is more associated with severe cases. Hypocalcemia enhances the binding of the dengue virus to monocyte macrophages and cells of T cell and B cell lineages in dengue infection. However, there is scarcity of literature on calcium homeostasis in dengue infection, and current guidelines do not address the necessity to monitor or correct blood calcium levels in dengue patients. In present study, we evaluated serum calcium level in dengue patients and correlated it with disease severity.

The present observational cross-sectional study conducted in the Department of Medicine and Biochemistry, VMMC and Safdarjung Hospiengue infection but further studies are required to support this.Convalescent plasma therapy, a classic adaptive immunotherapy used in the treatment of SARS, MERS, and 2009 H1N1 pandemic with acceptable efficacy and safety in the past. Convalescent plasma therapy was taken into consideration in management of COVID 19 disease during the initial days of pandemic but was withdrawn later due to its doubtful beneficial role. This study aims to explore the beneficial role of convalescent plasma and to determine whether convalescent plasma therapy holds a second chance in treating SARS COV-2.

This cross-sectional observational study includes 82 cases of moderate to severely ill COVID 19 patients who received convalescent plasma therapy and 41 controls who didn't. Regular monitoring of TLC, P/F ratio, N/L ratio inflammatory markers, respiratory rate, oxygen saturation, ABG and radiological imaging was done for comparative analysis.

In case group 39 patients (47.56%) were on oxygen mask, 17 patients (20.73%) on NIV, 9 Patients on NRM (10.97%), 16 patients (19.51%) on room air, 1(1.21%) on HFNC initially. After 7th day of convalescent plasma therapy 49 patients (59.75%) were on room air which suggests significant improvement in mode of ventilation in case group as compared to control group. Y-27632 Mean respiratory rate in case group was 30.46 CPM initially and 24.7 CPM on day 7th of plasma therapy which is statistically significant.

Plasma therapy is effective if given in early stage of disease and convalescent plasma donors having adequate antibody titre.

Plasma therapy is effective if given in early stage of disease and convalescent plasma donors having adequate antibody titre.Since December 2019, an emerging coronavirus called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2) has been spreading worldwide. Older people and those with comorbidities are more likely to develop severe illness. link= Y-27632 Vaccines against coronavirus have been developed recently. In India, the two vaccine currently authorized to use are namely ChAdOx1 nCov, Covishield and Covaxin; both of which require 2 shots few weeks apart for adequate protection. Although COVID antibody test has not been done following vaccination in my subjects, it was observed that those who were vaccinated with one or two doses had less clinical severity compared to non vaccinated patients. In this study, we did a comparative analysis of the laboratory markers of severity in elderly COVID patients who were fully vaccinated, partially vaccinated and non vaccinatednon-vaccinated.

This study is conducted with COVID-19 patients in age group more than 65 years for duration of 6 months. Participants were divided in three group Fully Verence (p>0.05) was observed in terms of procalcitonin and NLR among the groups although the average values were found to increase from fully vaccinated to partially vaccinated to non-vaccinated groups.

Vaccination was associated with less severity when analysed in terms of laborotary parameters in COVID-19 elderly patients.

Vaccination was associated with less severity when analysed in terms of laborotary parameters in COVID-19 elderly patients.Tuberculosis may lead to adrenal insufficiency by direct glandular involvement, by extra glandular infection or as a by-product of Anti tuberculous therapy. Subclinical adrenal insufficiency becomes important in stressful situation which require increased release of ACTH to meet heightened metabolic demands. Our objective was to determine the adrenal reserve in patients with pulmonary tuberculosis and to determine the effect of ATT on adrenal function.

Prospective observational study was performed on 50 pulmonary tuberculosis patients. Blood sample for baseline serum cortisol is drawn between 800 and 830 a.m. with patients fasting overnight. Patients with serum cortisol level < 220 nmol/L will be followed up by ACTH stimulation by injecting 250μg of Cosyntropin intramuscularly and blood samples for serum cortisol is drawn at 30 and 60 minutes. Serum cortisol levels < 220 nmol/L, Post-ACTH <500 nmol/L or post ACTH increment <200 nmol/L are suggestive of adrenal insufficiency. Aftert manifestations of these conditions are however unusual. Incidence of adrenal insufficiency in pulmonary tuberculosis patients was high, and it was confirmed with ACTH stimulation test. This present study helps identifying cases at risk of fatal adrenal crisis and institute timely management, thus improving disease prognosis.COVID-19 is a highly infectious disease with varied presentation as well as outcome. Inflammation plays a major role in the outcome of COVID-19 infection. This study was aimed to evaluate the role of conventional feasible inflammatory markers in predicting the outcome of COVID-19 in hospitalized adult patients.

A total of 100 confirmed COVID-19 patients were included in the study. Clinical and demographic data were collected. Biochemical, hematological, and inflammatory markers were assessed in all the patients. Disease severity and primary outcome as survival and or mortality were recorded.

Hematological indices and inflammatory markers were significantly higher among the non-survivor. N/L (Neutrophil/Lymphocyte) ratio and CRP (C-reactive protein) can differentiate non-survivor from survivors with the sensitivity of 85.7%, 85.7%, and specificity of 96.8 %, 77.4% with a cut-off value of 6.44, 23.02 respectively in the receiver operator curve (ROC). N/L ratio and CRP were significantly increased among the patients with severe COVID-19 infection. Cox regression Survival analysis showed that an elevated N/L ratio and CRP were significantly associated with mortality with the Hazard ratio of 1.331 (P <0.001) and 1.014 (P <0.015) respectively.

The present study implicates that increased N/L ratio and CRP were significantly correlated with severity and mortality in COVID-19 patients. These conventional feasible markers can be useful in predicting the outcome of COVID-19 infection.

The present study implicates that increased N/L ratio and CRP were significantly correlated with severity and mortality in COVID-19 patients. These conventional feasible markers can be useful in predicting the outcome of COVID-19 infection.Drug repurposing is considered as a rapid strategy for COVID-19 drug discovery and many drugs have been tried for treatment of COVID-19. Antivirals like favipiravir and remdesivir have become part of the COVID-19 Management Protocol by Ministry of Health and Family Welfare (MOHFW) as well as Maharashtra State guidelines since beginning, after being approved by Drugs Controller General of India (DCGI). Although these drugs have shown promising results, their efficacy is still not proven completely and needs to be studied in large populations. The purpose of our study was to evaluate the clinical outcomes in hospitalised patients with COVID-19 treated with remdesivir and/or favipiravir.

Retrospective analysis of medical records of 914 adult COVID-19 patients hospitalized in a tertiary care center in Mumbai was conducted. We assessed the following outcomes severity of disease, need for oxygen supplementation, incidence of complications, discharge from hospital or death, oxygen requirement at the time of dischariravir only group, 7.04% in remdesivir plus favipiravir group and 10.47 % patients in control group needed oxygen support after discharge.

Majority of patients in our study got discharged under ICMR guidelines with higher proportion of patients in the treatment groups as compared to the control group. Also, lesser number of patients in the treatment groups required oxygen supplementation post discharge as compared to the control group.

Majority of patients in our study got discharged under ICMR guidelines with higher proportion of patients in the treatment groups as compared to the control group. Also, lesser number of patients in the treatment groups required oxygen supplementation post discharge as compared to the control group.The post-Covid symptoms among patients hospitalised with covid has to be determined for elucidating the spectrum of illness which persists even after the apparent recovery. The understanding of the post-Covid symptoms will help us to better manage aftermath of the pandemic. Our aim is to determine the incidence of post-Covid symptoms in a cohort of inpatients who recovered from COVID-19 from a tertiary care centre in South India.

120 survivors from patients admitted with COVID 19 were prospectively followed up for 6 weeks after their discharge from the hospital. The cohort included 50 patients requiring Intensive care unit (ICU) care and 70 ward patients. The follow-up was conducted on the second and sixth week after discharge with a structured questionnaire. The questionnaire was filled by the patient/ bystanders during their visit to the hospital for follow-up at 2 weeks and through telephone follow up at 6 weeks.

Mean age of the cohort was 55 years and 55% were males. 58.3% had mild covid and 41.7% had t-Covid symptoms at 6 weeks post- discharge from hospital. Female sex and steroid administration during hospital stay were identified as predictors of persistence of post-Covid symptoms at 6weeks.The COVID 19 infection is highly transmissible and spreading globally, including in populations with high vaccination rates. COVID-19 vaccination in India, was started in month of January 2021 with healthcare workers (HCWs) becoming the first to get vaccinated. However, there has been lot debate on the efficacy of the vaccine. This study highlights breakthrough COVID-19 infections among vaccinated HCWs comparing clinical and lab parameter among hospitalized and non hospitalized.

This was a retrospective study conducted using questionnaire assessing COVID-19 like symptoms and confirmed COVID 19 infections among fully vaccinated HCWs (all faculty including nurses, wardboys, professors, post graduate students and interns) of the institute from a period of 4 months from March 2021 to June 2021. The number of infections was also matched with hospital records.

Out of 36 HCWs, all had received both doses of covishield vaccine. Males were 18 and females were 18, mean age was found to ne 32.17. People with co-morbi breakthrough infections among vaccinated HCWs(health care workers) were common. Most breakthrough infections were mild or asymptomatic, although persistent symptoms did occur. The findings suggested that COVID-19 were more severe in hospitalized patients compared to non-hospitalized and even though infections did occur none resulted in any severe form or mortality, it also indicates that vaccination prevents from severe form of the disease. But, preventive measures should be continued even among vaccinated individuals.Upper gastrointestinal bleed (UGIB) is a life threatening condition which presents as hematemesis, coffee-ground vomiting or melena. There are multiple scoring systems which have been developed for the same, which predict different outcomes, are important in the management of UGIB and are essential to determine high and low risk patients.

To compare the sensitivity and specificity for various risk scoring systems for UGIB and to determine the optimum cut-off values of various risk scoring systems in assessment of patients with UGIB.

81 patients presenting with acute UGIB to M. S. Ramaiah hospitals between October 2018 to July 2020 were evaluated and Glasgow Blatchford score (GBS), AIMS65, pre-rockall and full- rockall scores were calculated for risk assessment in predicting clinical outcomes such as need for ICU care, blood transfusion, in-hospital mortality or discharge and endoscopic intervention.

The GBS was the best at predicting mortality with the cut off of >14 (p 0.01, sensitivity 80%, NPV 98.6%) and blood transfusion at a cut-off >6 (sensitivity 97.6%, NPV 94.6%). The GBS and AIMS65 scores of more than 8 (p 0.000) and 1 (p 0.032) respectively were good predictors of need for ICU care. link2 AIMS65 was the best at predicting duration of hospitalisation (p 0.032).

The GBS was superior in predicting clinical outcomes, categorisation into high risk and low risk and need for blood transfusion. GBS and AIMS65 scores help in predicting the need for ICU care; AIMS65 being a simple score will reduce the cost burden of unnecessary ICU admissions.

The GBS was superior in predicting clinical outcomes, categorisation into high risk and low risk and need for blood transfusion. link2 GBS and AIMS65 scores help in predicting the need for ICU care; AIMS65 being a simple score will reduce the cost burden of unnecessary ICU admissions.The Rome IV criterion for a diagnosis of NUD is chronic or recurrent epigastric pain within the last 3 months and an onset of symptoms at least 6 months prior to presentation. The term functional Dyspepsia and idiopathic dyspepsia are often used as well. Symptoms include ulcer-like dyspepsia; gastroparetic-like (nausea, early satiety, and post-prandial pain), and undifferentiated. Pathogenesis of NUD is not completely known yet. Several mechanisms have been proposed to be responsible for these symptoms. Although there is strong evidence of an association between H. pylori infection and NUD, Celiac Disease and NUD. Being a tropical country, the prevalence of infections is parasitic cause. Dyspepsia is likely to be more in India. However, the present data from India as scares in literature. Hence the present study was planned to decipher the clinical profile, prevalence of H. pylori, IgA tTG, spectrum of duodenal biopsy abnormalities in NUD patients.

This Descriptive Observational study was carried out in the tTG. Only 4% of total NUD patients were positive for both biopsy and IgA-tTG antibody labeled as Celiac Disease (CeD). There is a significant association between H. pylori and duodenal eosinophilia.Esophageal variceal bleeding remains the leading cause of acute mortality in patients with cirrhosis. As per guidelines, upper gastrointestinal screening endoscopy is recommended for all patients with cirrhosis to rule out esophageal varices. However, only 50% of newly diagnosed patients with cirrhosis have Esophageal varices. Hence there is a need for non-invasive parameters to predict the presence of esophageal varices to restrict the endoscopic studies to those with a high probability of having varices. In this study, we aimed to identify the effectiveness of Platelet Count/Spleen Length Ratio as a non-invasive predictor of esophageal varices.

An observational cross-sectional study was conducted including 52 patients with liver cirrhosis without a previous history of upper GI bleeding. Relevant clinical parameters were assessed including complete hemogram, upper GI endoscopy, and ultrasonographic measurement of spleen length. Patients were divided into two groups, one with esophageal varices and the otheran be used as a predictor of esophageal varices and also to identify the subset of patients who require endoscopy for the prophylactic management of variceal bleeding. Therefore, to reduce the burden on the endoscopy units, avoiding unnecessary screening endoscopies.Acute Pancreatitis is an acute inflammation of the pancreas.Acute pancreatitis is an acute inflammatory process ranging clinically from mild discomfort with localized inflammation to severe disease involving remote organ systems. There is a continuum from the development of systemic inflammatory response syndrom, to the onset of multiple organ dysfunction (MODS), which is seen in about 24% of patients with acute pancreatitis and carries the highest mortality rate of 36%, and imaging tests showing characteristic findings of acute pancreatitis. Several inflammatory markers are being used routinely in various hospitals in India to assess the prognosis of patients with acute pancreatitis. Among these are the total and differential leukocyte counts, erythrocyte sedimentation rate, and C-reactive protein (CRP), interleukin-6, thioredoxin-1, and polymorphonuclear elastase. serum procalcitonin is one of the components to assess the severity of pancreatitis. Procalcitonin is an acute phase reactant that has been extenatients out of 60, with mean of 1.94±2.4ng /ml. These 23 patients were later on found to have severe acute pancreatitis on the basis Atlanta classification and rest 37 patients who had mild pancreatitis had mean PCT 0.38±0.66ng/ml. A study conducted on 40 patients of acute pancreatitis which was confirmed by Computed tomography was conducted in Poland, where they collected blood samples on admission and 24 hour thereafter, in which they tried to evaluate the role of procalcitonin as an early predictor of course of acute pancreatitis and they found that procalcitonin concentration was significantly higher in patients of acute pancreatitis and cut off was estimated at 0.5ng/ml.79 Similarly, in this study PCT was found to be high in patients of severe acute pancreatitis only.Hepatic encephalopathy (HE) is a frequently encountered complication of chronic liver disease (CLD). The manifestation is thought to be due to alteration in absorption of nutrients with associated altered metabolism with deterioration in synthetic function of liver. Several factors are known to precipitate HE. Recent studies have demonstrated the role of 25 hydroxyvitamin D (25OHD) in development of HE. Although uncertain as a causative factor, studies have shown significant lower levels of 25OHD with worsening HE. This study was therefore undertaken with the aim to access the 25OHD levels in patients of CLD and the relationship with the degree of severity of HE.

A cross-sectional hospital based observational study for a period of one year (1st June 2020 to 31st May 2021) was carried out with a total of 88 subjects of either sex above 12 years of age after application of inclusion criteria and exclusion criteria.

The results showed significant difference in serum albumin levels (p= 0.003) in patient groups of with and without overt HE. The mean levels of serum 25OHD was significantly lower in the overt HE group than the covert HE group (24.11 ± 6.46 ng/ml vs 11.72 ± 4.84 ng/ml, p< 0.001). The study showed the mean levels of serum 25OHD among patients with grade 1 HE is 24.11 ± 6.46 ng/ml, in patients with grade 2 HE is 13.61 ± 4.73 ng/ ml, followed by 8.41 ± 2.84 ng/ml and 8.00 ± 2.66 ng/ml in grade 3 and grade 4 HE respectively, p<0.001. There was a statistically significant negative correlation between serum 25OHD levels and HE (person's correlation coefficient r = -0.731, p <0.001).

Serum 25OHD levels were significantly lower in patients with overt HE. Serum levels of 25OHD showed a negative correlation with the degree of severity of HE.

Serum 25OHD levels were significantly lower in patients with overt HE. Serum levels of 25OHD showed a negative correlation with the degree of severity of HE.The mortality due to acute pancreatitis, one of commonest gastrointestinal disorder for emergency admissions, ranges from 0.5% in mild disease to 20-30% in severe acute pancreatitis. The early assessment of severity is essential but the available multiparameter scoring systems are cumbersome and require multiple measurements. Hence a simple and less cumbersome score is required for easier and quick assessment of severity in acute pancreatitis.

After obtaining detailed history all participants were subjected to investigations like CBC, amylase, lipase, LFT, RFT, Ultrasound abdomen and pelvis. Severity scores like APACHE II, SAPS II, BISAP were calculated on Day 1. NLR, LMR, RDW, PNI were calculated on day 1, 3, 7 & 14 of admission and their diagnostic accuracy were assessed in predicting severity, mortality & morbidity.

A total of 92 patients with acute pancreatitis (39 mild, 7 moderate and 46 severe) were enrolled. A total of 7 patients died during study. The baseline NLR, LMR and PNI on Day 1 were comparable among mild, moderate and severe pancreatitis. In patients with severe acute pancreatitis, non survivors had higher LMR on Day 1 (p<0.05) compared to survivors. Further, in non survivors there was increase in the serial NLRs (day 1-14) and a decrease in serial LMRs (day 1-14) during their hospital course where as the values of NLR and LMR remained relatively unchanged in the survivors.

The baseline inflammation markers (NLR, LMR, RDW, PNI) does not help in early prediction of severity in patients with acute pancreatitis. However, an increase in serial NLRs and decrease in serial LMRs is associated with a poorer prognosis in patients with severe pancreatitis.

The baseline inflammation markers (NLR, LMR, RDW, PNI) does not help in early prediction of severity in patients with acute pancreatitis. However, an increase in serial NLRs and decrease in serial LMRs is associated with a poorer prognosis in patients with severe pancreatitis.Progressive deterioration of liver functions for more than 6 months is considered Chronic liver disease (CLD). Hepatic fibrosis occurs in response to chronic liver injury. The gold standard for assessment of hepatic fibrosis is Liver biopsy, which is an invasive and painful procedure. and rarely can pass on potential life-threatening complications. Thus non-invasive tests that can correctly indicate the severity of liver fibrosis is essential. A number of non-invasive markers have been developed which are useful supplements to assess stages of fibrosis. These are biomarkers (aspartate transaminase (AST) to alanine transaminase (ALT) ratio (AAR), AST to Platelet Ratio Index (APRI), fibrosis index (FI), fibrosis-4 (FIB-4), Age Platelet Index (API), Pohl score, Fibrosis Cirrhosis Index (FCI)) and transient elastography. In our study, we will compare Novel Fibrosis Index (NFI) with other available noninvasive serum indices and transient elastography in predicting Liver Fibrosis Stages. NFI=[(bilirubin×(ALP)2)/ (ph a sensitivity of 100% and specificity of 5.3%.The NFI had maximum area under the curve compared to other indices in predicting F2,F3 and F4 stage.

NFI was the best index in predicting various fibrosis stages in chronic liver disease patients compared to other available serum indices and had maximum accuracy in predicting F4 stage.

NFI was the best index in predicting various fibrosis stages in chronic liver disease patients compared to other available serum indices and had maximum accuracy in predicting F4 stage.The patient's history is inaccurate and unreliable in diagnosis of ALD. None of laboratory test gives an unequivocal indication of Alcohol Abuse. GGT indicates Alcohol Abuse only in background of normal LFT. After the onset of liver disease due to any etiology, GGT rise parallel to ALP. Although, AST/ALT>2 is useful marker for ALD, its valid only in Steatohepatitis. The ratio may be normal in Cirrhosis. Although serum carbohydrate deficit transferrin is most specific biomarker for ALD, its an acute phase reactant, its valid only in Steatohepatitis, not in Cirrhosis. The main metabolite of ethanol is acetaldehyde which accumulates in alcoholics. Acetaldehyde binds exposed proteins which trigger immunoglobulin production.The antibodies directed against acetaldehyde adducts are predominantly IgA type.

All subjects admitted to hospital with ALD with cirrhotic dose consumption were studied. link3 link3 The stage of ALD was decided based on serum albumin, Ultrasound abdomen and Fibroscan. Those seronegative for Viral Hepat;0.5 correlated with onset of Hepatorenal Syndrome.

The present study shows that IgA concentration increases in all stages of ALD, while AST/ ALT ratio increase only in Steatosis/Hepatitis. Although Hypergammaglobulinemia is known to occur in CLD, the fraction of immunoglobulin elevated indicates etiology of Liver Disease. IgA is elevated fraction in ALD. Its level can be used to decide the stage of ALD and prognosis.

The present study shows that IgA concentration increases in all stages of ALD, while AST/ ALT ratio increase only in Steatosis/Hepatitis. Although Hypergammaglobulinemia is known to occur in CLD, the fraction of immunoglobulin elevated indicates etiology of Liver Disease. IgA is elevated fraction in ALD. Its level can be used to decide the stage of ALD and prognosis.Acute upper gastrointestinal bleeding (UGIB) is a common emergency and can be a serious condition that requires hospitalization, rapid evaluation and management. The usual presentation is hematemesis (vomiting of blood or coffee ground-like material) and/or melena (black, tarry stools) 1. UGIB occurs more commonly in men and older subjects. PUD is the most common cause of UGIB in the US accounting for about 50% of the cases, whereas in tropical country like India, esophageal varices attribute to half the cases. Esophago-Gastro-Duodenoscopy [EGD] is a primary diagnostic and therapeutic modality in the setting of UGIB.

Prospective study. Forty patients who have presented with frank blood or coffee ground color vomitus and/or melena were considered for this study. All patients greater than 18 years of age were included. Their clinical presentation, hemogram and endoscopic findings were analyzed. Descriptive statistical analysis has been applied.

In our study, the age distribution was between 23 and 87 years. les, however, the percentage is more in males as compared to females. Varices are an important cause of massive variceal bleed.Among the causes of malabsorption, tropical sprue is one of the leading cause.Several reports indicating that celiac disease, now being recognised more frequently.

94 patients, aged more than 12 years, presenting with Chronic diarrhoea and malabsorption syndrome were analyzed by clinical presentation, endoscopic and histopathological examination.The spectrum of disease in these patients and features differentiating celiac disease and tropical sprue are reported here.

Most common cause was Celiac Disease (65%), followed by Tropical Sprue (21%), common variable immunodeficiency (2%), lymphangiectasia (1%), idiopathic (3%). Patients with celiac disease were younger,having anemia, scalloping of folds,moderate or severe villous atrophy, crypt hyperplasia, diffuse epithelial damage. Patients with tropical sprue were older and more often normal duodenal epithelium.

Malabsorption, a disease which is often missed and not recognised by clinicians. A meticulous search for diagnosis is required.

Malabsorption, a disease which is often missed and not recognised by clinicians. A meticulous search for diagnosis is required.With India being the "Diabetes capital of the world", nonalcoholic fatty liver disease (NAFLD) is becoming the most common cause of liver dysfunction. Varied prevalence of this disease in Type II Diabetics indicate variability in NAFLD risk factors along with the particular diagnostic methods used. Investigations like liver biopsy and ultrasound abdomen have their limitations. Liver biopsy is invasive on the other hand ultrasound has less sensitivity. Several others are in the list, but are cost ineffective. Among the several non-invasive biomarkers, recently developed Novel Fibrosis Index (NFI) is a new addition. Newly developed NFI was developed by observing the various relationships and variations of serum bilirubin, alkaline phosphatase, platelet count and serum albumin in liver fibrosis.

This hospital based observational cross section study was conducted from June 2020 to May 2021in 76 study population of Assam Medical College and Hospital. Type II Diabetes mellitus patients having more than 18 years wee for NFI and APRI were 0.814 and 0.810. Area under the ROC curve for discriminating F0-F3 and above for NFI and APRI were 0.935 and 0.913.

Aggregate measures of performance across all possible classification threshold for NFI is better then APRI.

Aggregate measures of performance across all possible classification threshold for NFI is better then APRI.Acute kidney injury (AKI) is a frequently encountered outcome in critically ill patients, accounting for increased mortality. Neutrophil gelatinase associated lipocalin (NGAL) has been of paramount importance as a novel biomarker of AKI. This study is an attempt to assess the use of NGAL in critically ill patients so that timely interventions can be done to reduce morbidity and mortality in such patients.

A prospective observational study was conducted at SRN Hospital, Prayagraj from August 1st 2020 to March 15th 2021, which included only critically ill patients with SOFA score>1 and requiring ICU admission. Patients of known renal diseases were excluded from the study. Blood as well as urinary samples for NGAL and other laboratory parameters were collected within 8 hours of admission. Patients who developed renal dysfunction were noted as our cases and the others were noted as controls.

The study was done on 125 patients, out of which 67 developed AKI while 58 did not develop AKI. Higher mortality ment of NGAL at the time of admission had good predictive ability for AKI. Higher values of NGAL were associated with staging of AKI and thus, correlated with need of hemodialysis. Furthermore, mortality was found to be associated with development of AKI and raised NGAL. Thus, NGAL maybe used to assess the prognosis of ICU patients so that patients at high risk may be managed aggressively, thus reducing mortality.Sepsis becomes a life threatening condition, which diagnosed clinically with simple q-SOFA score at bedside. In sepsis there is increased oxidative stress due to high oxygen free radicals and low levels of antioxidants causing multi-organs failure, one of which is kidney dysfunction, resulting in inhibition of uric acid (UA) excretion, causing rise in serum UA. Thus UA can be a marker of severity of oxidative stress and poor prognosis in patients with sepsis.

This was a prospective cohort study, conducted from March 2020 to August 2021 at tertiary care centre in the state of Madhya Pradesh, India. Study includes 80 patients with clinical diagnosis of sepsis in age group of ≥16 and ≤60 years of both sexes; who were admitted in Medicine ICU and wards. Clinical diagnosis of sepsis was based on 2016-Sepsis- 3 criteria including q-SOFA score. The patients were divided into two study groups with serum UA level <7 mg/dl and with serum UA level ≥7 mg/dl.

In present study 45(56.30%) cases were males and 35(4ondition serum UA may determine a useful early prognostic marker in sepsis patient at admission. However, further large case control study will be required to establish this hypothesis.

It is concluded that the raised serum UA value in sepsis patients at their admission have positive association with poor outcomes and longer duration of hospital stay. Hence, in favourable condition serum UA may determine a useful early prognostic marker in sepsis patient at admission. However, further large case control study will be required to establish this hypothesis.Sepsis is a life-threatening organ dysfunction with high mortality and morbidity. Various mortality prediction scores are currently in use for prediction of mortality. Although combination of various scores have not been used before. The aim of the study was to compare SOFA, APACHE II, SAPS II, as a predictor of mortality and to assess the usefulness of combination of different scores.

A one-year hospital based prospective study conducted from 1st January 2020 to 31st December 2020 in medical ICU, where 100 patients of sepsis admitted in ICU with evidence of organ dysfunction were included in the study and various scores like SOFA, APACHE II, and SAPS II were calculated at 24 and 48 hours of admission, using laboratory results and clinical examination. and an attempt to access for predictive accuracy of combination of scores was undertaken.

Majority of the patients (37%) were in the age group of 60-79 years with maximum mortality in this age group of (39.22 %). Mortality rate was 51%, with higher mortalityas seen with APACHE II score at 24 and 48 hours and higher specificity was seen with SAPS II at 24 and 48 hours. Combination of scores did show a slightly better predictability with combination of SAPS II and SOFA showing maximum Youden's index at 48 hours. Mortality was comparatively higher among the females and elderly group with most common risk factor being diabetes.

All the three scores showed good mortality prediction rate but among the scores higher sensitivity was seen with APACHE II score at 24 and 48 hours and higher specificity was seen with SAPS II at 24 and 48 hours. Combination of scores did show a slightly better predictability with combination of SAPS II and SOFA showing maximum Youden's index at 48 hours. Mortality was comparatively higher among the females and elderly group with most common risk factor being diabetes.Sepsis continues to be a medical and financial burden for both developed and developing countries, and affects all age groups. The normal value of uric acid varies with age, gender, ethnicity and physiologic status of the population. Uric acid levels in septicemic patients and their correlation with increased global prevalence along with septic shock depends on its severity. The use of uric acid levels for grading the severity and its outcome in these patients is widely advocated despite caveats to its use with septicemia and conditions like shock being cited as a major confounding factor. The value of serum uric acid may be erroneous in those with septicemia and its sequelae, thus mandating its evaluation. The objective of this study was to identify a correlation between severity of sepsis & outcome of patients and the derangement of uric acid levels in an adult population.

The present study was conducted on patients with a diagnosis of sepsis admitted in the Department of General Medicine of KLES Prabhen consumption of alcohol and the outcome of patient, mostly leading to mortrality.

Uric acid levels in patients with septicemia may be affected by variables such as age, sex, chronic illnesses or drugs. We feel it is worthwhile to study these confounding factors with large sample sizes for ascertaining a correlation of uric acid levels with sepsis and the outcome of patients considering these variables.

Uric acid levels in patients with septicemia may be affected by variables such as age, sex, chronic illnesses or drugs. We feel it is worthwhile to study these confounding factors with large sample sizes for ascertaining a correlation of uric acid levels with sepsis and the outcome of patients considering these variables.The ability to predict the fate of critically ill patients admitted to an intensive care unit is very important, as there are only few studies which have focused on this aspect. Our study has focused to determine the relationship between C-Reactive protein/Albumin ratio (CAR) and Lactate/Albumin ratio (LAR) and Intensive care unit stay, the requirement for vasopressor and mechanical ventilator support, recovery and mortality in the patients admitted to critical care unit.

The study group comprised of 100 patients who were admitted to critical care unit. These patients were evaluated using a structured proforma, detailed case history and clinical examination. Blood sample collection was done after obtaining valid consent from the subjects immediately after admission and serum Albumin, Lactate and C- reactive protein levels were estimated in these patients.

The mean age of the patients in our study was 54.05.Out of the total patients admitted 74% of the patients were males. The common diagnosis was COVID broer CAR was found to be a better indicator of mortality than LAR and it was also noted that the patients who required inotropes and mechanical ventilator support were found to have higher CAR.

CAR and LAR are better indicators of mortality and duration of stay in the intensive care unit as the patients with higher values of these ratios were found to have increased risk of mortality. However CAR was found to be a better indicator of mortality than LAR and it was also noted that the patients who required inotropes and mechanical ventilator support were found to have higher CAR.

Volume replacement remains the cornerstone of resuscitation in critically ill patients. This study explored the ability of subclavian vein collapsibility index in predicting fluid responsiveness.

In this prospective observational study conducted in the Department of Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, hypotensive patients presenting to the emergency underwent sonographic evaluation of Inferior Vena Cava and right Subclavian vein at three time points. The study population was divided into two groups Responders and non-responders, based on ≥ 15 % increase in stroke volume following fluid bolus.

Among 45 recruited patients, 33 patients were responders. The area under ROC curve for SCV CI at baseline to predict fluid responsiveness was 0.745 (95% confidence interval 0.549 - 0.941; p = 0.014). An SCV-CI of 46 % predicts fluid responsiveness in a hypotensive patient in terms of change in stroke volume by 15% following fluid bolus with a sensitivity of 87.88 % (95 % confidence interval 71.80% to 96.60%) and specificity of 66.67 % (95 % confidence interval 34.89% to 90.08%). Spearman's correlation coefficient between IVC CI and SCV CI was 0.59 (p < 0.001, n = 135).

The results of the study show that right subclavian vein respiratory variation has the ability to predict fluid responsiveness in a spontaneously breathing patient in circulatory shock and correlates with Inferior Vena Cava collapsibility index. Subclavian vein can be an alternative to Inferior Vena Cava in predicting fluid responsiveness in spontaneously breathing patients.

The results of the study show that right subclavian vein respiratory variation has the ability to predict fluid responsiveness in a spontaneously breathing patient in circulatory shock and correlates with Inferior Vena Cava collapsibility index. Subclavian vein can be an alternative to Inferior Vena Cava in predicting fluid responsiveness in spontaneously breathing patients.The sars -cov 2 causing covid 19 disease. B/l pneumonia, systemic inflammation, coagulation activation, ards , multiorgan failure are key features of covid 19. Patients need icu admission. Proinflammatory cytokines, tnf, il 6, 8, 1 beta, causes cytokine storm in covid 19 disease.

In this single-center, retrospective, cross sectional study, the clinical and laboratory characteristics of 154 patients with severe covid-19 were collected. 38 Patients with severe covid -19 had incidence of thromboembolism with its symptoms, and 116 patients (ie, the controls) did not have incidence of thromboembolism. A severe case was defined as including at least one of the following criteria (1) respiratory rate >30/ min. (2) Oxygen saturation ≤90%. (3) Pao2 /fio2 ≤300mm hg. (4) Patients, either with shock or respiratory failure, requiring mechanical ventilation, or combined with other organ failure, requiring admission to intensive care unit (icu). Also pe cases were those patients with high clinical suspicion [tachycaresponse, and cardiac, hepatic, renal and coagulation impairment. Finally, the kaplan-meier survival curve showed a trend towards poorer survival in patients with severe covid-19 with incidence of thromboembolism than patients without incidence of thromboembolism. The hr was 2.24 [95% Ci 1.17-4.29], P = 0.015). After adjustment for age, sex, hypertension, cardiovascular disease and cerebrovascular disease by cox regression. The median survival durations from hospital admission in patients with severe covid-19 with and without incidence of thromboembolism were 8 days and 15 days, respectively.

The mortality rate in patients with severe covid-19 with incidence of thromboembolism is high. Incidence of thromboembolism may lead to an increase in the risk of death.

The mortality rate in patients with severe covid-19 with incidence of thromboembolism is high. Incidence of thromboembolism may lead to an increase in the risk of death.Hyponatremia is defined as serum sodium concentration less than 135meq/l. More severe symptoms are seen when serum sodium falls below 120 meq/l. Hyponatremia in ICU is a very common scenario. Treatment strategy is decided after thorough history taking and clinical examination. Judicious treatment is necessary as rapid correction and delayed correction both can lead to various neurological sequelae. This study was done on critically ill patients who had hyponatremia on the day of admission and clinical and aetiological profile was studied.

An observational study was conducted between March 2020 to July 2021. With in this period of time 210 patients got admitted in medical ICU with serum sodium value less than 120meq/L on the day of admission. Clinico aetiological profile in terms of age, gender, symptoms, co morbidities, response to standard treatment approach, time taken for correction and complications were studied.

Mean age was 65.5 years. Y-27632 52.3 % of patients were male.

92.3% had generalised weakness. 89.