Background and aims The spectrum of Coronavirus disease-2019 (COVID-19) has been clinically defined from asymptomatic carriers to critical illness. Different inflammatory markers have been used to account for the severity and outcomes of this disease in different settings. Our study aims to investigate the role of these inflammatory markers in defining COVID-19 severity. Methods This cross-sectional study included 200 confirmed cases of COVID-19. Inflammatory markers including lymphocyte count, D-Dimers, Ferritin, CRP, LDH were noted at admission. The moderate-to-critical disease was defined according to the WHO criteria. Descriptive statistics were applied. Mann–Whitney U-test was applied to compare the difference of markers between moderate-severe and critical patients. ROC was plotted to determine the cut-off values of these markers. Binary logistics regression analysis was used to assess which markers significantly predict the severity of COVID-19. Results A D-dimer value of >775 ng/ml and LDH >495 U/L had a sensitivity of 72.9% and 79.2% and specificity of 57.9% and 53.6% respectively for critical COVID-19 illness. CRP levels of >100.5 mg/dl has a sensitivity of 66.7%. All inflammatory markers were significantly higher in a critical group of patients (p < 0.05) except for lymphopenia. Binary logistics regression analysis shows that LDH levels and D-dimers were only significant predictors of severity in COVID-19 patients. Conclusion Inflammatory markers at admission are very useful in defining the severity of COVID-19 in addition to the clinical criteria. This is also useful in predicting adverse outcomes.

Background and Aim: Nutrient absorption, dietary pattern, and food ingestion might be affected by a common gastrointestinal disorder known as irritable bowel syndrome (IBS). Metabolic syndrome is significantly associated with nutrition-related parameters, inferring irritable bowel syndrome which increases the potential risk for metabolic syndrome (MS). The present study aimed to assess the incidence of irritable bowel syndrome and metabolic syndrome among young adults. Methodology: This cross-sectional study was conducted on 428 adults between 16 and 60 years at the Department of Medicine and Gastroenterology, Isra University Hospital, Halaroad Hyderabad from January 2019 to December 2021. Anthropometry and biochemistry were used in screening out the individual health check-up. The presence and absence of metabolic syndrome were identified based on the results. Individuals with a history of metabolic syndrome or already on medication for dyslipidemia or diabetic Mellitus or hypertension were excluded. Results: Of the total patients, the incidence of irritable bowel syndrome and metabolic syndrome was 18 (4.2%) and 132 (30.8%) respectively. The proportion of irritable bowel syndrome was insignificant in patients with or without metabolic syndrome (1.9% versus 4.1% respectively; p=0.5). Individuals with irritable bowel syndrome had a significantly higher mean weight 74.5 kg versus 66.8 kg; p=0.007). The mean value of body mass index, waist circumference, and fasting glucose was 27.6 versus 23.8 kg; p=0.001, 87.6 versus 84.3 cm, and 97 versus 88 mg/dl; p<0.000) respectively. Conclusion: In our study, we discovered an insignificant association between irritable bowel syndrome and the presence or absence of metabolic syndrome in young adults. Furthermore, the study findings suggested that irritable bowel syndrome treatment could be used to prevent metabolic syndrome as a potentially beneficial factor. Keywords: Irritable bowel syndrome, Metabolic syndrome, Prevalence, Young adults.

Objective: To determine the diagnostic accuracy of serum albumin for the detection of esophageal varices (EV) in cases presented with chronic liver disease taking Esophagogastroduodenoscopy (EGDs) as the gold standard. Methodology: This cross-sectional study was conducted at the Department of Medicine, Sir Ganga Ram Hospital, Lahore in collaboration of Department of Gastroenterology, Services Hospital, Lahore, during a period of six months. After receiving informed consent, each patient's blood was drawn using a 5cc disposable syringe and sent to the hospital's laboratory for analysis of serum albumin levels. Esophageal varices were suspected as positive on albumin level <3.5mg. Then, patients were referred to and underwent EGD. All EGDs were done on every patient by a consultant gastroenterologist having a minimum experience of 5 years. Self-made study proforma was used for the data collection and SPSS version 26 was used for the data analysis. Results: The patient’s average age was 55.44+12.51 years. Males were found in majority 70.53%. Esophageal varices were noted positive among 41.1% of the cases out of a total 95 study subjects. The sensitivity and specificity of the serum albumin in the diagnosis of esophageal varices were found to be 80.55 percent and 83.05 percent, respectively, followed by a positive predictive value 74.35 percent, negative predictive value 87.5 percent, and the diagnostic accuracy was 82.10 percent by taking EGD as the gold standard. Conclusion: Decreased serum albumin level was observed to be the non-invasive, useful predictor and as a good first-line diagnostic tool of esophageal varices among cases having chronic liver disease in clinical practice. Keywords: Serum Albumin, Esophageal Varices, CLD, EGD

Background and Aim: The risk of colorectal cancer is significantly associated with excessive body mass index, the relationship between body fatness at a young age and the risk of colorectal cancer has proven equivocal. The aim of the present study was to assess the association of early-onset colorectal cancer with body mass index at different ages. Methodology: This population-based control case study was conducted on 450 colorectal cancer patients and 410 controls in the department of Gastroenterology, Isra University Hospital, Hyderabad, Pakistan from March 2020 to February 2022. Standardized questionnaire was used for gathering patient’s information such as medical history, sociodemographic, and lifestyle history with interviewers who collected information and data. All the patients with age less than 35 years and had histopathological evidence of colorectal cancer were included in this study. Prior to study conduction, ethical approval was taken from the respective hospital. Multiple regression model was used for estimating colorectal cancer. SPSS version 23 was used for data analysis. Results: The risk of colorectal cancer at early-onset was compared in patients with body mass index of <25 kg/m2 and >30 kg/m2 at age between 20 and 30 years. The diagnosis of interviewers had early-onset CRC fold risk 2.6- (95% confidence interval, 1.19–5.32), 2.1- (confidence interval, 1.3–3.32), and 1.9- (95% confidence interval, 1.29–2.67). The link between BMI and early-onset CRC risk was most significant among, and virtually limited to, the majority of people who had never had a colonoscopy. Conclusion: The present study found that being overweight or obese in early adulthood is closely connected with an increased chance of developing CRC. As a result, data strongly supports the notion that topical increases in the incidence of obesity among younger population may be a contributing cause to the rise in the prevalence of early-onset CRC. Our findings show that interventions to reduce the obesity pandemic in future generations will be important in preventing CRC. Keywords: Early-onset colorectal cancer, Body Mass index, Different Ages

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