Background: Acute Respiratory Distress Syndrome (ARDS) is a life-threatening cause of acute hypoxemic respiratory failure associated with high mortality in intensive care units. Early identification of prognostic factors may improve patient management and outcomes. Objectives: To evaluate the clinical profile, etiological factors, severity, and outcomes of adult patients with ARDS admitted to the intensive care unit. Methods: This prospective observational study included 180 adult patients diagnosed with ARDS according to the Berlin Definition. Demographic characteristics, etiology, severity of ARDS, laboratory findings, ventilatory parameters, APACHE II score, SOFA score, complications, and clinical outcomes were recorded. Patients were followed until ICU discharge or death. Results: Of the 180 patients, 68 (37.8%) died during ICU stay. Pneumonia (41.1%) was the most common cause of ARDS, followed by sepsis (28.9%). Severe ARDS was significantly associated with increased mortality (p<0.001). Non-survivors had significantly higher APACHE II and SOFA scores, lower PaO₂/FiO₂ ratios, longer duration of mechanical ventilation, and higher incidences of acute kidney injury and multiorgan dysfunction syndrome (p<0.001). Multivariate analysis identified severe ARDS, SOFA score ≥10, APACHE II score ≥20, acute kidney injury, multiorgan dysfunction syndrome, and age >60 years as independent predictors of mortality. Conclusion: ARDS remains associated with considerable ICU mortality. Disease severity, organ dysfunction, and higher illness severity scores are major predictors of adverse outcomes. Early recognition, lung-protective ventilation, and comprehensive management of associated organ dysfunction are essential to improve survival in adult patients with ARDS.

Background: Early prediction of disease severity and mortality is essential in the management of critically ill patients. The lactate/albumin ratio (LAR) has emerged as a novel prognostic biomarker that combines indicators of tissue hypoperfusion and nutritional-inflammatory status. Objective: To evaluate the correlation between the lactate/albumin ratio, illness severity, and mortality in critically ill patients admitted to the intensive care unit. Methods: This prospective observational study included 150 critically ill adult patients admitted to the ICU of a tertiary care hospital. Serum lactate and albumin levels were measured within 24 hours of admission, and the lactate/albumin ratio was calculated. Disease severity was assessed using APACHE II and SOFA scores. The primary outcomes were correlation of LAR with illness severity and hospital mortality, while secondary outcomes included mechanical ventilation, vasopressor requirement, and ICU length of stay. Results: The mean age of the study population was 56.8 ± 16.4 years, and overall hospital mortality was 31.3%. Non-survivors had significantly higher lactate/albumin ratios than survivors (2.18 ± 0.71 vs. 0.82 ± 0.34; p < 0.001). The lactate/albumin ratio showed strong positive correlations with APACHE II (r = 0.71) and SOFA (r = 0.76) scores. Elevated LAR was significantly associated with increased need for mechanical ventilation, vasopressor support, prolonged ICU stay, and nearly six-fold higher odds of hospital mortality. Receiver operating characteristic analysis demonstrated excellent predictive performance for mortality with an AUC of 0.89. Conclusion: The lactate/albumin ratio is a reliable and cost-effective prognostic biomarker that correlates closely with disease severity and mortality in critically ill patients. Its routine use at ICU admission may improve early risk stratification and support timely clinical decision-making.

Background: Community-acquired pneumonia (CAP) remains an important cause of hospitalization and mortality worldwide. Early identification of patients at risk for severe disease is essential for improving clinical outcomes. Serum albumin has emerged as a potential biomarker reflecting both nutritional status and systemic inflammation. Objectives: To evaluate the correlation between serum albumin levels, disease severity, and clinical outcomes in patients with community-acquired pneumonia. Methods: This prospective observational study included 160 adult patients admitted with community-acquired pneumonia. Serum albumin levels were measured within 24 hours of admission. Disease severity was assessed using CURB-65 and Pneumonia Severity Index (PSI) scores. Patients were followed until discharge or death. Clinical outcomes including ICU admission, mechanical ventilation, duration of hospitalization, and in-hospital mortality were analyzed. Results: The mean serum albumin level was significantly lower among non-survivors than survivors (2.71 ± 0.39 vs. 3.48 ± 0.42 g/dL; p<0.001). Serum albumin showed a significant negative correlation with CURB-65 (r = −0.64) and PSI scores (r = −0.69) (p<0.001). Patients with hypoalbuminemia experienced significantly higher rates of ICU admission, mechanical ventilation, sepsis, prolonged hospital stay, and mortality. Multivariate logistic regression identified serum albumin <3.0 g/dL as an independent predictor of in-hospital mortality (OR 4.32; 95% CI 1.89–9.91; p<0.001). Conclusion: Hypoalbuminemia is strongly associated with increased disease severity and adverse clinical outcomes in community-acquired pneumonia. Serum albumin is an easily available and cost-effective prognostic marker that complements established severity scoring systems and may assist in early risk stratification and management.

Background: Acute meningitis is a life-threatening neurological emergency associated with high morbidity and mortality, particularly among patients requiring intensive care unit (ICU) admission. Early diagnosis and prompt management are essential to improve survival and reduce neurological complications. Objectives: To evaluate the clinical profile, etiological pattern, management, and outcomes of patients with acute meningitis admitted to the intensive care unit and to identify factors associated with mortality. Materials and Methods: This prospective observational study included 120 consecutive patients with acute meningitis admitted to the ICU of a tertiary care hospital over an 18-month period. Demographic characteristics, clinical presentation, laboratory and cerebrospinal fluid findings, neuroimaging, treatment modalities, complications, and clinical outcomes were recorded. Patients were categorized into survivors and non-survivors for comparative analysis. Statistical analysis was performed using SPSS version 26.0, and a p-value <0.05 was considered statistically significant. Results: The mean age of the patients was 42.8 ± 16.4 years, with males comprising 66.7% of the study population. Acute bacterial meningitis was the commonest etiology (60.0%), followed by tuberculous (23.3%), viral (13.3%), and fungal meningitis (3.4%). Fever (93.3%), headache (86.7%), neck stiffness (75.0%), and altered sensorium (68.3%) were the predominant presenting features. Mechanical ventilation was required in 28.3% of patients, while raised intracranial pressure (23.3%) and septic shock (16.7%) were the most common complications. The overall in-hospital mortality was 24.2%. Older age, Glasgow Coma Scale score ≤8, septic shock, raised intracranial pressure, requirement for mechanical ventilation, and prolonged ICU stay were significantly associated with mortality (p<0.05). Conclusion: Acute bacterial meningitis remains the predominant cause of ICU admission among patients with acute meningitis and is associated with considerable mortality. Poor neurological status at admission and severe systemic complications significantly influence clinical outcomes. Early recognition, prompt antimicrobial therapy, and comprehensive intensive care management are crucial for improving survival and reducing neurological sequelae.

Background:  It is well documented that surgical patients struggle with anxiety prior to surgery, and may be influenced by pain perception after surgery, patient recovery and their experience of surgery. Type of anaesthesia could effect on anxiety and peri-operative outcomes. The present study analyzed the differences between the peri-operative situation of two groups of patients – under general anaesthesia (GA) and under regional anaesthesia (RA) – in terms of their level of preoperative anxiety. Objectives: To see how much anxiety there is in GA patients compared to RA patients, difference in pain after anaesthesia, need of analgesics, PONV, recovery time, hospital stay, recovery satisfaction and anaesthetic complications. Materials and Methods: Comparative study of 120 surgical cases have been performed between the two January 2024 and December 2024 in Datta Meghe Medical College, Wanadongri, Nagpur. In all 60 patients were given GA and 60 were given RA. A pre-standardized anxiety questionnaire was used to evaluate pre-operative anxiety. Data pertaining to perioperative outcomes were recorded and compared between the two groups. A P value <0.05 was considered statistically significant. Results: The admissions anxiety score was significantly higher in GA group compared to RA group. Patients had moderate-severe anxiety in 36.7% and 20.0%, respectively (P = 0.048). Postoperative pain at 6 hours was higher with GA (4.1 ± 1.3 vs. 2.8 ± 1.1; P < 0.001), with greater rescue analgesic use (61.7% vs. 35.0%; P = 0.004). The rates of postoperative nausea and vomiting (PONV) were 25.0% versus 10.0% (P = 0.032). Recovery time was longer with GA (42.6 ± 10.8 vs. 31.4 ± 8.7 minutes; P < 0.001). Hospital stay was comparable (3.8 ± 1.2 vs. 3.4 ± 1.0 days; P = 0.061), while satisfaction was higher with RA (88.3% vs. 73.3%; P = 0.034). Conclusions: Regional anesthesia was associated with lower levels of anxiety prior to surgery, less postoperative pain or need for pain medications, fewer episodes of PNV, quicker recovery and more patient satisfaction than general anesthesia. In conclusion, the present results are suggestive of anesthetic technique as a relevant factor to be taken into account towards optimizing peri-operative outcomes.