Objective: To establish correlation between serum albumin during early days of ICU admission and risk of death in COVID-19 pneumonia. Methods: In this retrospective study, we included 76 patients hospitalized in ICU, who stayed for at least four days with COVID-19 pneumonia, from May 1, 2020 to June 30, 2020 in Lahore Health Care Hospital and Al-Shafi Hospital. Patients were labelled as COVID-19 pneumonia on radiological basis as bilateral ‘ground-glass opacity’ in lower zones and RT-PCR positive result in nasopharyngeal swab. All patients were oxygen dependent, either on high flow oxygen via non rebreathing mask or invasive positive pressure ventilation support. Serum albumin levels were measured daily from first day to fourth day of ICU admission. The data was analyzed using SPSS version 26 and Microsoft excel 2016. Results: Out of 76 patients of COVID-19 pneumonia admitted in ICU who stayed for more than four days, 38 patients expired. The mean age of all the patients was 58.9±12.56 years, 38(50%) of the patients were ≥60 years and 49 (62%) of them were male. On day four of ICU admission, mean serum albumin of discharged patients was 3.83±0.22 g/dl while mean serum albumin level of expired patients was 2.96±0.46 g/dl. Strong negative correlation (r = -767) was found between decrease in serum albumin level and increase number of deaths from COVID-19 pneumonia. Weak correlation was observed between increase in serum CRP and increase number of deaths in the same patients. Conclusion: Daily monitoring of serum albumin level of COVID-19 pneumonia patients can be used as a biological marker for monitoring of cytokine storm and risk of death in COVID-19 pneumonia. doi: https://doi.org/10.12669/pjms.38.3.4154 How to cite this:Baig MA, Raza MM, Baig M, Baig MU. Serum albumin levels monitoring in ICU in early days and mortality risk association in patients with moderate to severe COVID-19 pneumonia. Pak J Med Sci. 2022;38(3):---------.  doi: https://doi.org/10.12669/pjms.38.3.4154 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective: To explore the disappearance of neutralizing antibodies from patients, their myths, and facts. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital Multan Pakistan, from Jul 2021 to Aug 2021. Methodology: A total of 100 blood samples were collected from 100 COVID-19 patients. These 100 patients were followed up for a period of 3 months. Antibodies were determined with the modified neutralization assay method and enzyme-linked immuno-sorbent assay (ELISA). Results: The antibody level by NA and ELISA peaked on days 30-35 then decreased slightly. In multivariate analysis, patients aged 25-35, 36-56, and 57-84 years had a higher neutralizing antibody level than those aged 10-21 years. The patient with the worst clinical manifestation had a higher neutralizing antibody titer. In serum samples, IgG was undetectable at 18.3% and 11% and the geographical mean reciprocal titers dropped from 244 at 3-month period and neutralizing antibodies, the geographical mean reciprocal titers dropped from 874 at 3 months. Conclusion: All COVID-19 patients were seropositive and significantly neutralizing antibody response. Neutralizing antibody levels depend on the time after the onset of symptoms, age, and severity of the disease.

Objective: To compare efficacy of endoscopic turbinoplasty versus conventional inferior turbinectomy for hypertrophy of inferior turbinate. Study Design: Comparative prospective study. Place and Duration of Study: Ear, Nose and Throat (ENT) Department Combined Military Hospital (CMH) Multan, from Jun 2019 to May 2020. Methodology: This study comprised of 50 patients of various age groups and both genders. Patients were grouped into two groups A and B, each group having 25 patients through random sampling. Patients in group A had endoscopic turbinoplasty whereas patients in group B had partial turbinectomy through conventional surgical method. Patients were followed regularly in both groups and were inspected postoperatively at 2 weeks, after 1 month and after 3 months. Results: Patients who underwent Endoscopic turbinoplasty experienced less pain (p˂0.05) postoperatively at 2 weeks compared to conventional surgical turbinectomy. In addition, these patients showed statistically significant healing and reduced crusting at 1 month postoperatively. At 3 months post operatively all patients had healed completely as opposed to only 72% with surgical turbinectomy. Conclusion: Endoscopic turbinoplasty is more effective than conventional surgical technique for inferior turbinate hypertrophy as it leads to less post-operative pain, reduced nasal crusting and earlier healing.