Pleural fluid cholesterol level is an important parameter in differentiating exudative from transudative pleural effusions

Background: The first important step is to decide whether the pleural effusion is transudate or exudates by Light’s criteria. Light’s criteria can misclassify 25% of pleural transudates as exudates. Pleural fluid cholesterol level can differentiate transudates from exudates as a single parameter instead of multiple parameters used in Light’s criteria. Measurement of pleural fluid cholesterol levels to differentiate transudative effusions from exudative effusions.Methods: Consecutive 60 cases of pleural effusion were taken in the study. Pleural fluid analysis was done for parameters of Light’s criteria along with pleural fluid cholesterol levels. First exudative and transudative effusion was classified by Light’s criteria. Other clinical and relevant biochemical tests were done to arrive in the final etiological diagnosis and data were collected and analysed .Pleural fluid cholesterol levels was correlated to Light’s criteria.Results: Total 60 cases of pleural effusion were there in the study. There were 43 exudative and 17 transudative effusions. Mean cholesterol level was 64.2± 7.5mg/dl in exudative effusions and 26.05±8.01 mg/dl in transudates. Pleural fluid cholesterol was ≥55mg /dl in 43 cases of exudates and <55mg/dl in 17 cases of transudates.Conclusions: Pleural fluid cholesterol level of ≥ 55mg/dl had similar sensitivity and specificity to Light’s criteria and as a single important parameter to differentiate exudative from transudative pleural effusion

Prophylaxis oral aspartame improves anaemia and decreases frequency and severity of vaso-occlusive painful crisis among sickle cell disease patients and noninferior to hydroxyurea

Background: Sickle cell disease (HbSS) causes much of the morbidity and mortality due to its chronic anaemia and vaso-occlusive painful crisis. Hydroxyurea is now using to treat HbSS. Aspartame appears to have antisickling properties. The objective of this study was to asses the effects of prophylaxis oral Aspartame among HbSS patients on anaemia and vaso-occlusive painful crisis.Methods: 208 cases of HbSS patients with history of vaso-occlusive crisis (VOC) and/or anaemia were selected for the study and divided into study group (n = 104) and control group (n = 104). 31 and 38 patients were on Hydroxyurea in study group and control group respectively. Baseline hemoglobin was estimated in all cases and oral Aspartame was given in a dose of 4 mg/kg/day in three divided doses. Monthly hemoglobin levels were measured in all cases for six months. Data were collected and compared with control data by using SPSS software version 25.Results: Mean baseline hemoglobin was 6.99 gm% and increased to 8.43 gm% (P <0.05) after receiving Aspartame prophylaxis. Aspartame add on to Hydroxyurea also had increased in haemoglobin levels. Incidence of VOC was 7.26% in control group. In Hydroxyurea group 3.58% had VOC. In study group 1.2% and in add on to Hydroxyurea group had 1.125 of milder degree of VOC (P <0.05).Conclusions: Aspartame appears to have antisickling properties and improves anaemia and decreases frequency and severity of VOC among HbSS patients and is non-inferior to Hydroxyurea.