ABSTRACT
Background: Severe acute respiratory illness due to SARS-CoV-2 represents great global public health concern. The spectrum of disease ranges from mild to life-threatening. Surveillance of hospitalized patients with severe acute respiratory infections (SARI) is an important public health tool used to identify etiologies to understand the disease, track changes in circulating viruses and as an alert mechanism for potential pandemic viruses. We aim to find out the rate of SARS-CoV-2 positivity in SARI cases and further study the epidemiological and clinical characteristics of patients.Material & Methods:A Prospective study was conducted on 200 Severe Acute Respiratory Illness patients admitted at tertiary care hospital. The clinical, demographic, epidemiological, risk factors / co-morbidities of all the patients were recorded. Oropharyngeal and nasopharyngeal samples were collected and tested for SARS-CoV-2 by real time reverse transcriptase (RT-PCR) test.Results:Out of 200 SARI patients, 51 (25.5%) were tested positive for SARS-CoV-2. Maximum cases (54.90%) were in the age group of 41-60 years; males were infected predominantly (52.94%). The most common symptoms of presentation were fever (100%), cough (86.27%), dyspnoea (82.35%) and sore throat (56.86%). Comorbidities associated with COVID-19 were Hypertension (56.86%), Diabetes Mellitus (33.33%), Chronic Obstructive Pulmonary Disease (13.72%) and Coronary Artery disease (9.8%). More than 30% of the patients were admitted in ICU and 9.80% received mechanical ventilation.Conclusions:Evaluation of clinical and epidemiological profiles of SARI patients can help in understanding and managing the outbreak more efficiently. Close monitoring and quarantine will be required to prevent extensive transmission within the community.
ABSTRACT
Background: Pleural effusion is the abnormal and excess accumulation of serous fluid in the pleural space. A number of biochemical tests are required to differentiate transudative from exudative pleural effusion. Pleural fluid to serum protein ratio, pleural fluid to serum lactate dehydrogenase ratio and pleural fluid to serum bilirubin ratio and serum cholesterol are commonly done to differentiate transudative from exudative pleural effusion. Methods: In this study on 25 patients with pleural effusion, by predefined criteria, these patients were divided into three groups as transudative, tubercular and non tubercular exudative group. All patients were investigated to differentiate transudative from exudative pleural effusion. Apart from routine investigations, biochemical tests of pleural fluid as well as blood were performed. Pleural fluid to serum protein ratio and pleural fluid to serum bilirubin were done in all patients. Results: Pleural fluid to serum protein ratio to differentiate exudative pleural effusion showed sensitivity, specificity, positive predictive value and negative predictive value of 86.66%, 100%,100% and 83.33% respectively. Pleural fluid to serum protein ratio to differentiate transudative pleural effusion showed sensitivity, specificity, positive predictive value and negative predictive value of 100%, 86.66%, 83.33% and 100%. Pleural fluid to serum bilirubin ratio to differentiate exudative pleural effusion showed sensitivity, specificity, positive predictive value and negative predictive value of 100%,85.71%,84.62% and 100% respectively. Pleural fluid to serum bilirubin ratio to differentiate transudative pleural effusion showed sensitivity, specificity, positive predictive value and negative predictive value of 85.71%,100%,84.62% and 84.62% respectively. Conclusion: It is concluded that pleural fluid bilirubin to serum bilirubin is a simple, easy, cost effective and highly useful parameter to distinguish transudative from exudative pleural effusion but it does not tell the etiology of pleural effusion.