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Background:*Soluble urokinase-type plasminogen activator receptor (suPAR) is a new biomarker, which is increased in conditions associated with inflammatory immune cell activation. In low resource, densely populated countries, there is a need for a quick test for triage and prognosticating in the emergency department.Materials and Methods:*A pilot, observational study was conducted wherein all consenting adult patients (>18 years) presented to casualty with acute medical illnesses were included. Detailed clinical history, examination, and suPAR quick tests were done and patients were categorized into five groups based on the emergency severity index (ESI) triage algorithm. Patients with suPAR level more than 5.5 ng/mL were advised hospitalization and those below were advised follow-up. All patients were followed-up after 3 days.Results:Total 190 patients (20–80 years), 80 males and 110 females participated. ESI triage 1, 2, and 3 had suPAR levels > 5.5 ng/mL and ESI triage 4 and 5 had suPAR level of <5.5 ng/mL. In ESI-1, 29 patients were admitted in ICU and 16 left against medical advice (LAMA) and on follow-up mortality was 96% (P = <0.05). In ESI-2, all patients were admitted in high dependency units and on follow-up they still needed hospitalization. In ESI-3, 22 patients admitted in ward and 24 went LAMA, on follow-up all improved except LAMA patients who required hospitalization (P – <0.05). Patients in ESI-4 and 5 did not require admission (P = <0.001).Conclusion:*suPAR can reliably be used in the emergency department to prognosticate and triage.

Methanol poisoning is rare but carries high risk of morbidity and mortality. Most of the cases witnessed in emergency are due to consumption of adulterated alcohol. Here we are reporting a very rare case of methanol poisoning through inhalational exposure leading to putamen necrosis and decreased visual acuity. He had dyselectrolytemia and metabolic acidosis which was successfully managed with early intervention. Its importance lies in the fact that inhalational methanol poisoning is an entity which if picked up early can prevent long-term neurological sequelae.

We report a patient with COVID-19 infection presenting with acute pancreatitis. The diagnosis of pancreatitis was based on laboratory as well as radiological evidence, and all the usual etiologies were ruled out. The temporal association with COVID-19 is strongly suggestive of novel coronavirus induced pancreatic injury.

Available online xxxKeywords: H1N1 Economic Social Morbidity Expenditure a b s t r a c t Background & aim: : Recent outbreak of H1N1 influenza leads to increased morbidity and mortality. High infection rate and virulence created panic among masses and huge health care burden. Socio-economic impact of H1N1 influenza has been underestimated. We describe socio-economic impact of H1N1 by taking hospitalization expenditure model. Method: In a prospective observational study at tertiary care centre in Northern India hospitalization costs were collected from 1st January 2015 to 31st March 2015. Real time reverse transcriptase polymerase chain reaction (RT-PCR) testing on nasopharyngeal swabs was used to confirm diagnosis. Result: Data of 209 patients were analyzed. Age of the patients ranged from 3 months to 85 years. The mean and median age of the patients was 41.5 and 45 years respectively. Female patients constituted 46% of all patients admitted. Hospital stay duration ranged from 1 day to 41 days. Minimum and maximum expenditure was 164 USD and 32548 USD respectively.Mean expenditure was 3326 USD. Mean room rent was 940 USD, investigation cost À457 USD, medicines cost e 808 USD, doctors' consultation-468USD and miscellaneous cost of 653 USD. Mean expenditure in H1N1 ward was 17 times(1983 USD), whereas in isolated single room it was 22 times(2554 USD) and in ICU mean expenditure was 62 times(7172 USD) the monthly per capita income. Expenditure increased with increasing age (P ¼ 0.004) with highest expenditure was seen in age group more than 60 years and lowest among age group less than 20 years. Apart from these direct effects, H1N1 influenza had huge indirect impact on the socio-economic framework in terms of absenteeism, decreased manpower causing economic slowdown, low tourism increased workload and anxiety among healthcare workers. Conclusion: H1N1 influenza outbreak severely affected the socio-economic framework of the country. Isolation wards seem to be cost effective and expenditure has got direct linear association with age. ScienceDirect jo urnal homepage: www .e lsev ie r. co m/ lo cate/ cmrp c u r r e n t m e d i c i n e r e s e a r c h a n d p r a c t i c e x x x ( 2 0 1 5 ) 1 e5 http://dx.Please cite this article in press as: Kumar P, et al., Socioeconomic impact of the recent outbreak of H1N1, Current Medicine Research and Practice (2015), http://dx.