Background: Kidneys have a prominent role in the metabolism, degradation and excretion of thyroid hormones. There is an increased prevalence of hypothyroidism in chronic kidney disease (CKD) patients as the glomerular ltration rate falls. T Objectives: o study the thyroid function in chronic kidney disease patients and to study the correlation of thyroid dysfunction with respect to staging of CKD. A Materials and Methods: prospective Cross-sectional study was done on 100 patients with Chronic kidney disease who were not on dialysis and fullled all the inclusion criteria at Dr PSIMS & RF. Total and Free T3, T4 and TSH levels were estimated for those patients. Majority of subjects included in our Results: study were in the age group of 60-69 years with male predominance. Out of 100 patients included in our study, 50 patients(50%) were found to have low T3 syndrome; 6 patients (6%) were having hypothyroidism; 44 patients (44%) were having normal thyroid gland function. Most of the patients (n=58) were in stage 5 of Chronic kidney disease. In the present study, as creatinine clearance reduced with each CKD stage, the levels of total T3 and free T4 were also reduced. There is a positive correlation between the Conclusion: severity of CKD and thyroid dysfunction. Hence by studying the incidence of thyroid dysfunction in CKD patients and their subsequent treatment, it may help in slowing the progression of CKD.

Background- Acute pancreatitis is a potentially lethal acute inammatory process with a highly variable clinical course. Extreme form of the disease can develop in 25% of patients and with an estimated mortality of 40%.Methods- This study aimed to evaluate the effectiveness of RDW & NLR in suspecting the outcome in patients with acute pancreatitis. It was carried out among 50 patients who had acute pancreatitis and were diagnosed based on diagnostic criteria for acute pancreatitis. RDW, WBC count, platelet count, RBC count, haemoglobin level, MCV, Serum Amylase, lipase, serum creatinine, total protein, albumin, total bilirubin, calcium, glucose, LDH, SGOT and SGPT levels and Ultrasound abdomen were done. NLR & RDW were done on days 0 & 2, and is correlated with the severity Out of 50 study subjects ,78% of the subjects were Resultsclassied as mild acute pancreatitis group and 22% as severe acute pancreatitis group. There is signicant change in RDW in severe acute pancreatitis group. NLR showed signicant change in mild and severe acute pancreatitis. The change in value is more signicant in 0 & 48 hrs in severe acute pancreatitis group. Also, NLR has more signicant rise during admission than at 48 hours. RDW & NLR values along Conclusionwith various scoring systems will be helpful for accurately predicting the severity of acute pancreatitis

A 20-year-old female patient with chronic kidney disease was brought to our emergency medical department with symptoms of pain in chest and abdomen, vomitings. Laboratory testing revealed serum potassium 7.7 mEq/L, serum creatinine 9.1 mg/dL. Electrocardiogram (ECG) showed left bundle branch block (LBBB) pattern with left axis deviation, tall T waves and ST elevation. Among ECG alterations in hyperkalemia, LBBB is rare and is being reported in our case.

Coronavirus disease 2019 (COVID-19) was announced in early December 2019. By genome sequencing, the virus was recognised. From Wuhan City, the virus spread globally. The pandemic situation was declared by the World Health Organization.The first case of COVID-19 in Indiawas reported in Kerala on January 27, 2020.The clinical features varied with disease severity. Most COVID-19 patients have non-severe manifestations and show a good prognosis. However, patients with severe disease may progress to pulmonary dysfunction, multiple organ dysfunction, and death. COVID-19 related to a considerable mortality rate in older patients and cases had other morbidities. Studies suggested that the inflammatory storm is a common finding in other coronaviruses.Similarly, increases in the inflammatory markers like C-reactive protein (CRP),ferritin,interleukin-6 (IL-6) and were described in COVID-19 (1). Albumin levels decreased in the inflammatory conditions reduced levels were confirmed in severe COVID-19 patients. Hypoalbuminemia and high CRP/albumin ratio were previously linked to the mortality of various clinical conditions as critically ill patients.To avoid the unnecessary or inappropriate utilisation of the healthcare resources, early prediction of the severity of COVID-19 will be helpful. Severity prediction will also improve the prognosis by reducing the mortality rate.Thus, this study aimed to evaluate the role of inflammatory markers in estimating the severity and predicting the prognosis of COVID-19. This study hypothesised that elevated values of CRP/ albumin ratio and the neutrophil-lymphocyte ratio at the time of COVID-19 diagnosis are associated with COVID-19 severity and mortality.