Background: Physicians lack a robust and validated method of measuring severity or predicting poor outcome in patients with acute exacerbation of COPD (AECOPD). To study the prognosis in COPD patients with acute exacerbation using CAUDA 70 score. Materials and Methods: 104 patients of age more than 40 years with acute exacerbation of COPD admitted department of respiratory medicine, narayana medical college and hospital, Nellore. CAUDA 70: C: Confusion, Acidosis (pH <7.35), Urea >7mmol/L, MRC Dyspnoea score >4, Albumin <35g/L, Age >70 years. One point was assigned to each variable present, giving a six point scoring system. The patients were followed up upto discharge and the outcome of the patients was correlated with the score to analyse prognosis. Results: 29(27.8%) patients obtained score upto 2. In these patients, 24 (82.75%) recovered without ventilation, 5 (17.24%) required NIV and no patients required invasive ventilation and there were no deaths in patients with this score. 75(72.2%) patients obtained scores of 3 to 6. In these, 48(64%) patients required NIV, 15(20%) patients required invasive ventilation, 4 (5.3%) patients died and only 8 (10.66%) patients recovered without any ventilation. Conclusions: CAUDA 70 score proved to be an effective scoring system in predicting the prognosis in Acute Exacerbation of COPD patients.

Micronutrients deficiency is supposed to impair the overall immune function and causes increased resistance to infection. Such a relationship exists even in tuberculosis. A major threat is multidrug resistant tuberculosis (MDR-TB). In India, few studies are available to discuss about risk factors and serum zinc and selenium status in MDR-TB. Material and Methods: A case control study of 25 diagnosed MDR-TB patients from Damian foundation and 25 healthy controls from Narayan Medical College were recruited after laboratory tests, chest X-ray and clinical history. 5 ml of blood collected and serum zinc and selenium levels were assessed for both groups and correlated with demographic factors, duration of treatment, and BMI. Results:The results indicate that the MDR-TB patients have altered profile of the serum zinc and serum selenium in their sera and this could be more due to the active disease, causing oxidative stress which depletes the micronutrients. In this study, the mean serum zinc levels were 79.08 ± 14.2 μg/dL and 91.1 ± 15.2μg/dL in case and control groups respectively. Serum selenium levels were 56.2 ± 11.1 μg/dL and 65.2 ± 4.2 μg/dL in case and control groups respectively. In both the groups micronutrient levels showed statistical significant. Conclusions:The risk factors in our study, such as lower level of serum zinc was one of the concern for the development of MDR-TB and an attempt to minimize them might contribute to control the upward slope of MDR-TB.