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Introduction: The purpose of the study is to study the potential role of neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and mean platelet volume (MPV)–platelet ratio as diagnostic and prognostic markers in patients with hepatocellular carcinoma (HCC), prostate cancer, stomach cancer, and aplastic anemia. Materials and Methods: We have conducted the present study by screening 208,486 patients who have got admitted during January 2013–June 2017 as in patients in our hospital. The data collected were analyzed for NLR, PLR, and MPV–platelet ratio. Inclusion Criteria: Patients admitted with a diagnosis of HCC, prostate cancer, stomach cancer, and aplastic anemia irrespective of the age and gender. Exclusion Criteria: Patients with multiple malignancies, the presence of secondary infection, and any source of sepsis. SPSS tool was used for statistical analysis. Results: Cost-effective predictive and prognostic biomarkers identified in the study are – NLR for liver cancer, prostate cancer, and stomach cancer; PLR for prostate and stomach cancer; MPV/plate ratio can be used in addition to NLR for liver cancer. These ratios were not significant in aplastic anemia. Conclusion: From our study, we conclude that NLR and PLR are better cost-effective predictor and prognostic markers of HCC, prostate cancer, and stomach cancer. These ratios can be used at the primary health-care level as it can be derived from a simple complete blood count/peripheral smear. Early identification of carcinoma is possible using these potential markers along with the respective clinical presentations and symptoms. These ratios will reduce the financial burden on the patients from rural and low socioeconomic background and will aid in better management of the disease process.

Aims and Objectives: To look for mortality predictors of Leptospirosis, with specific importance given to oliguric renal failure and hypotension as possible predictors. Materials and Methods: A Prospective Cohort study conducted over two years which enrolled patients with clinically and serologically confirmed Leptospirosis. Of these, 30 patients were included who had hypotension and 30 patients who had oliguric renal failure, as per statistical requirements. Epidemiological, clinical, and laboratory data was collected at admission and the patients were followed up to look for outcome (discharge/death). Results: A total of 83 patients were included in this study. Of these 8 patients died (Mortality of 9.6%). Data analysis with Chi Square Test showed that oliguric renal failure was significantly associated with mortality in Leptospirosis (p<0.05). Other factors were also found which were associated with mortality including elevated bilirubin and AST levels, anemia, Type 2 Diabetes Mellitus, Alcohol Dependence Syndrome, and Chronic Liver Disease. However, hypotension was found to not be significantly associated with mortality. Conclusion: In patients with Leptospirosis, significant mortality predictors included oliguric renal failure, elevated bilirubin and AST levels, anemia, Type

BackgroundSLE is a disease which is easily missed in regular clinical practice. In developing countries due to lack of investigation modalities and rheumatologist, early identification of the diseases process is delayed. By the time the patient reaches a higher medical care centre there is a significant time loss and advancement of the disease. NLR, PLR, RDW and MPV can be calculated from a complete blood count which will be available at any grass route heath centre.ObjectivesTo identify Cost effective biomarkers in predicting SLE in developing countries. Focussing on markers - Neutrophil Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), MPV.MethodsThis is a retrospective hospital based observational study conducted screening patients admitted from January 2016- November 2018 in with a diagnosis of SLE. We identified 150 patients with SLE and their NLR, PLR, and MPV data were collected and were correlated with equal control group without SLEResultsWe found that NLR, PLR, and MPV were highly significant with a p-value of 0.001 to be used as bio marker and also when further analysis was done using ROC curve with an area under curve of 76%, 81% and 78% respectively when compared with the control group.ConclusionWe conclude that NLR,PLR,and MPV is cost-effective bio marker which costs (< 1 Euro) in predicting SLE and also play a great in monitoring following up referring patient to higher centre for biopsy at a golden period which will aid in early management which will limit the mortality and morbidity associated with the diseaseReferences[1] Qin B, Ma N, Tang Q, Wei T, Yang M, Fu H, Hu Z, Ling Y, Yang Z, Zhong R Neutrophil, to Lymphocyte ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. ModRhematol.2016;26(3):372-6. doi: 10.3109/14397595.2015.1091136. Epub 2016 Mar 4.[2] Wu Y1, Chen Y1, Yang X2, Chen L1, Yang Y3 Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with disease activity in patients with systemic lupus erythematosus.Int Immunopharmacol. 2016 Jul;36:94-99. doi: 10.1016/j.intimp.2016.04.006. Epub 2016 Apr 22.[3] Soliman WM1, Sherif NM1, Ghanima IM1, El-Badawy MA2. Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios in Systemic Lupus Erythematosus: Relation With Disease Activity and Lupus Nephritis. [4] Reumatol Clin. 2018 Aug 27. pii: S1699-258X(18)30167-0. doi: 10.1016/j.reuma.2018.07.008. [Epub ahead of print]Disclosure of InterestsNone declared

Background: Non-Alcoholic Steatohepatitis (NASH) is an aggressive form of Non-Alcoholic Fatty Liver disease (NAFLD), with liver inflammation and scarring. Due to a lack of clinical biomarkers and asymptomatic nature, NASH is often under-diagnosed. It is the most common cause of chronic liver disease in the USA. Liver biopsy is the gold standard to diagnose NASH, but it is invasive and life-threatening and histologic evaluation of a liver biopsy sample is imperfect as a reference because of sampling variability due to the irregular distribution of fibrosis. Aim: Validating AST/ALT ratio as a stand-alone scoring system in NASH is scarce and so this study aims to establish a correlation between FibroScan values and AST/ALT ratio. Methodology: All NASH patients, who underwent FibroScan were included. Their demographics, FibroScan, AST, ALT values were recorded in M S Excel and Pearson correlation between FibroScan values and AST/ALT ratios of 150 NASH patients was calculated using SPSS. Results: Out of 150 NASH patients, 72% were males and 57.33% belonged to 40-50 years age group. FibroScan values and AST/ALT ratio showed positive Pearson correlation of 0.245, (p value=0.003). FibroScan values and splenic size also showed a positive Pearson correlation of 0.289 (p value<0.001). Conclusion: Males of 40-50 years age group had higher distribution of NASH, so middle aged males should be screened routinely as they are at a higher risk. FibroScan value with AST/ALT ratio and splenic size showed a positive correlation, thus showing that AST/ALT ratio and splenic size increases with increase in liver stiffness.