Background and Aim:Studies on potential biomarkers in experimental models of acute lung injury (ALI) and clinical samples from patients with ALI have provided evidence to the pathophysiology of the mechanisms of lung injury and predictor of clinical outcome. Because of the high mortality and substantial variability in outcomes in patients with acute respiratory distress syndrome (ARDS), identification of biomarkers such as cytokines is important to determine prognosis and guide clinical decision-making.Materials and Methods:In this study, we have included thirty patients admitted to Intensive Care Unit diagnosed with ARDS, and serum samples were collected on day 1 and 7 and were analyzed for serum interleukin-6 (IL-6) and IL-8 by ELISA method, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring was done on day 1.Results:The mortality in the patients observed with ARDS was 34%. APACHE II score was significantly higher in nonsurvivors as compared to survivors. There were no significant differences in gender and biochemical and hematological parameters among the survivors and nonsurvivors. Serum IL-6 and IL-8 levels on day 1 were significantly higher in all the ARDS patients as compared to healthy controls and these levels were returned to near-normal basal levels on day 7. The serum IL-6 and IL-8 levels measured on day 7 were of survivors. As compared to survivors, the IL-6 and IL-8 levels were significantly higher in nonsurvivors measured on day 1. Spearman's rank correlation analysis indicated a significant positive correlation of APACHE II with IL-8. By using APACHE II score, IL-6, and IL-8, the receiver operating characteristic curve was plotted and the provided predictable accuracy of mortality (outcome) was 94%.Conclusion:The present study highlighted the importance of measuring the cytokines such as IL-6 and IL-8 in patients with ARDS in predicting the clinical outcome.
Background: Vesiculobullous lesions are the major contribution of various skin disorders. They are primary morphological representation of various pathological stimuli. Histopathology plays major role in the initial phase of diagnosis helps in further evaluation to identify the underlying etiology. Aim and Objective: To study the prevalence of various morphological types of vesiculobullous skin lesions in different age groups in a rural area. Methodology: A Retrospective study conducted from May 2018 to May 2021, at Katuri Medical College & Hospital, Guntur. A study of vesiculobullous lesions of the skin biopsies of 90 cases was received to the department of pathology, at Katuri Medical College & Hospital, for 3 years. Complete clinical and relevant history was recorded. The specimens were routinely processed and H&E-stained slides were studied. Results: Out of 454 skin biopsies, of which 90 cases (19.8%) were diagnosed as vesiculobullous lesions by histopathologically. Pemphigous vulgaris comprised 38 cases (42.23%) followed by Bullous pemphigoid 24 cases (26.67%), in clinically suspected Autoimmune Bullous Disorders. Conclusion:Clinical examination has greater significance in diagnosis still histopathological examination plays vital role, helps to arrive at a definitive diagnosis in the majority of vesiculobullous disorders. Skin biopsy is inexpensive, carried out as OPD procedure with minimal discomfort to the patient.
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