Introduction: Pneumonia Severity Index (PSI) and CURB-65 rule for community acquired pneumonia (CAP) have been developed to stratify patients based on mortality. Lack of a risk stratifying score like PSI or CURB-65 can lead to significant delay in starting treatment. This study was conducted to find out the ability of CURB-65 score and PSI to predict clinically relevant outcomes. Methods: 78 patients diagnosed as CAP admitted to a tertiary care hospital were enrolled into the study. Detailed clinical history was noted and CURB-65 and PSI scores were given with the help of a structured questionnaire in <24 hours of admission. The patients were revisited at day 3 and at discharge and data collected. Results:Out of 78 patients included in the study, 60 were males and 18 were females. Of the 78 patients, 14 died accounting for aninhospital mortality of 17.94%. Mortality in the mild, moderate and severe groups of CURB-65 were 0%, 16.7% and 47.8% respectively. Mortality in the mild, moderate and severe groups of PSI were 1.8%, 50% and 80% respectively. Area under the curve (AUC) for CURB-65 and PSI in terms of in hospital mortality were 0.935 and 0.920 respectively. Conclusion: The CURB-65 and PSI scores correlated well with mortality and other severity indicators. The CURB-65 has a better discriminatory power than PSI inour study. Because of its simplicity in addition to its better discriminatory power than PSI, CURB-65 may be better suited as a severity scoring system in CAP.

Background: The factors essential to define the severity and the prognosis of subjects with NCFB have not been sufficiently assessed. A prospective observational study was conducted to assess the serum parameters, their correlation with BSI (bronchiectasis severity index) and FACED (FEV1% predicted, age, chronic colonization by pseudomonas aeruginosa, extension by radiological assessment and dyspnoea) score in assessing disease severity and respiratory hospitalizations in patients with NCFB.Methods: About 76 clinically stable patients diagnosed as NCFB were included. Data extraction was done using structured proforma. The BSI and FACED scores were calculated. The serum parameters albumin, CRP (C-reactive protein), ANC (Absolute neutrophil count) and Hb (hemoglobin) levels were estimated. The number of exacerbations and hospitalizations during the 6 months follow up period were recorded.Results: The mean value of the serum parameters albumin, CRP, absolute neutrophil count (ANC) and Hb were 3.86 (95% CI 3.77- 3.95), 19.61 (95% CI 15.53 -23.68), 8632.95 (95% CI 7258.5-10068) and 12.3 (95% CI 11.84- 12.74) respectively. There was strong negative correlation between serum albumin and the BSI and FACED score. The mean exacerbations and hospitalizations during the 6 months follow up period were 3.3 (95% CI 2.93-3.65) and 1.14 (95% CI 0.85-1.44) respectively.Conclusions: The serum albumin level exhibited strong correlation and was identified as a variable associated with the BSI and FACED scores. Further studies in this direction are needed for use of serum parameters in severity assessment.

Aim : To Determine the seroprevalence of Human immunodeficiency virus infection among Pulmonary Tuberculosis patients in a tertiary care teaching institution, in Ernakulam district of Kerala state in India. Methods : Study was conducted in Respiratory medicine department and integrated counselling and testing centre (ICTC) of Government Medical College, Ernakulam With approval of IEC after getting written informed consent , a cross sectional study was conducted among 384 pulmonary TB patients who were registered under the National TB elimination Programme (RNTCP). Result :The prevalence of HIV among study population was 1.3 %. There was no gender difference while the highest age group less than 30 followed by 30-60. The major respiratory pathology among study subjects was consolidation (42.7%) followed by fibrosis(25.3%).Consolidation was a predominant presenting pathology seen in female pulmonary TB patients.The sensitivity of sputum smear against CBNAAT was 60.4% and specificity was 83%. Conclusion : The prevalence is low compared with the national average of 3 to 3.4 % HIV co infection among Tuberculosis patients during the study period.