Objective: To determine the diagnostic accuracy of elevated C reactive protein (CRP) and ferritin in predicting severe Covid-19 infection using the World Health Organization’s (WHO) Covid-19 severity classification as gold standard. Study Design: Descriptive study. Place and Duration of Study: This study was conducted at the Pak Emirates Military Hospital, Rawalpindi, from January 1st 2021 till April 30th 2021. Ethical review committee’s (ERC) approval was taken and good clinical practice guidelines were followed. Material and Methods: Baseline blood samples were sent to the hospital laboratory for the measurement of C reactive protein and ferritin levels. PCR was taken as gold standard for the diagnosis of Corona virus disease. Patients were classified into severe and non-severe categories using WHO classification of severity. Sensitivity, specificity, diagnostic accuracy, negative predictive value and positive predictive value were calculated for elevated CRP and ferritin. Results: There were 65 (57.5%) patients who had severe Covid-19 disease and 48 (42.5%) patients who had non-severe Covid-19 disease. Among the patients with severe Covid-19, 57 (87.7%) had elevated CRP levels, and 50 (76.9%) patients had elevated ferritin levels. Testing ferritin levels, against the severity of Covid-19 patients, there was a sensitivity of 76.9%, specificity of 79.2%, positive predictive value (PPV) of 83.3%, negative predictive value (NPV) of 71.7% and diagnostic accuracy of 77.8%. Testing CRP levels, there was a sensitivity of 87.7%, specificity of 85.4%, PPV of 89.1%, NPV of 83.6% and diagnostic accuracy of 86.7%. Conclusion: The results from our study show that CRP has a slightly improved diagnostic accuracy as compared to ferritin. However, both these markers have value in the prediction of severity of Covid-19 infection. Keywords: Covid-19, elevated C reactive protein and ferritin.

Objective: To assess the smoking abstinence rate after a twenty-minutes structured counselling session. Study Design: Prospective Cohort Study. Place and Duration of Study: Respiratory Clinic, Pak Emirates Military Hospital, Rawalpindi Pakistan from Jun to Dec 2020. Methodology: A total of 400 active smokers visiting respiratory clinics were inducted into counselling sessions of twenty-minute duration for a structured smoking cessation counselling advice during which additional information regarding age, motivation status, duration of smoking, previous cessation attempts etc., was also recorded. All candidates were followed by telephone for six months for subject-reported abstinence status. Results: All the study participants were males between 39 to 64 years of age (mean age: 52.27 ± 4.78 years), of which 23 lost to follow-up, 102 (25.5%) remained quitters successfully, while the remaining 305 candidates relapsed at the end of 6 months. The highest relapse was observed at the end of 3 months, while the lowest relapse rate was observed in the fifth and sixth months since the quit date. Younger age had more odds of successful cessation rate than others (OR=6.13 CI 95%, p<0.001). Those with a motivation score of 8 or more had more probability of abstaining (OR=5.38, CI 95%, p-value=0.001) Conclusions: The smoking abstinence rate in these counselling sessions was as significant as in other smoking cessation programs. The probability of quitting was more in younger adults and highly motivated ones.

The analgesic efficacy of the gabapentin-tramadol combination was compared with meloxicam-tramadol and tramadol perioperative analgesic regimens in cats brought to the clinic for ovariohysterectomy. Thirty adult cats belonging to comparable demographics (age, body weight), were enrolled into a randomized, blinded study after due consent from their owners into four treatment groups. A Gabapentin-Tramadol group (GT-group, n = 10), Meloxicam-Tramadol group (MT-group, n = 10), and a Tramadol group (T-group, n = 10) were formed. Gabapentin capsules at 50 mg were administered orally 2 hours before surgery while the rest received a placebo dose. Tramadol (2 mg/kg, IM) and meloxicam at (0.2 mg/kg, SC) were injected immediately prior to anesthetic premedication. Anesthetic protocol involved premedication with ketamine and xylazine, while anesthesia was induced using propofol. Inhalant isoflurane anesthesia was used to maintain a surgical plane. GT group scored lower on IVAS as well as CPS than MT group, and T group for up to 8 hours after surgery. The mechanical nociceptive threshold remained higher (98±0) for up to 12 hours postoperatively a nd serum cortisol concentrations remained significantly lower during the 24hr period. The addition of gabapentin to the tramadol regimen significantly improved analgesia and mechanical nociceptive threshold than when used on its own.