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Introduction: Thrombocytopenia has been known to be a manifestation as well as predictor of severe dengue. However, use of additional biomarkers like Aspartate Aminotransferase (AST)/Alanine Aminotransferase (ALT) alone or in conjunction with platelet count may help in early and better predictability of severe dengue cases. Aim: To determine the correlation between transaminase elevation and severity of dengue fever. Materials and Methods: This was a single centre, crosssectional study conducted at a tertiary care centre of Western Maharashtra. Total 110 hospitalised patients with a diagnosis of suspected dengue fever, based on clinical signs and symptoms with a positive NS1 antigen test (non structural protein 1)/ Immunoglobulin M (IgM) test using rapid test kits were taken as study population. The patients were clinically evaluated on daily basis for development of any warning signs and symptoms along with monitoring of haematological and biochemical parameters. For statistical analysis the technique of percentages, mean and Pearson 'r's were employed using IBM Statistical Package for the Social Sciences (SPSS 20.0) version for windows. The p-value of 0.05 was considered as significant value. Results: Out of 110 patients, 83 were males and 27 females. Clinical fluid accumulation was seen in 5 patients (4.5%), bleeding manifestations and fluid accumulation in 4 (3.6%) and bleeding manifestations in 17 (15.5%). Negative correlation was observed between thrombocytopenia with bleeding manifestations (r=-0.17, p=0.04), whereas positive correlation was seen in incidence of bleeding with serositis (r=0.19, p=0.04), AST with serositis (r=0.21, p=0.02) and ALT with Packed Cell Volume (PCV) (r=0.22, p=0.01). Conclusion: Additional biomarkers like AST and ALT alone or in conjunction with platelet count can also help in early prediction of severity of dengue fever

A 59-year-old male patient presented with a history of dyspnea on exertion for the past 10 years, which was gradually progressive in nature. The patient had orthopnea and paroxysmal nocturnal dyspnea for the past few months. On evaluation, he was found to have cardiomegaly and a giant left atrium. Contrast-enhanced computed tomography of the heart showed the left atrium to be enlarged to a dimension of 20.7 cm which, as of the time of writing, is the largest ever reported.

Background: The COVID-19 pandemic, caused by the Severe Acute Respiratory Syndrome Corona Virus 2 (SARS CoV-2) has the potential to affect the mental health of health-care professionals in several adverse ways, owing to a multifactorial, unprecedented volley of evolving factors. It may contribute to the elevated levels of depression, anxiety, and worry among the personnel on the frontline, who are often affected by medical and psychosocial factors, including pre-existing illness, scarcity of resources, uncertainty of outcome, prolonged working hours, lack of consensus, prevalent societal misbeliefs, prevailing stigma, and a constant threat to safety. Aim: The aim of this study was to screen health-care professionals for symptoms of depression, anxiety, and worry during SARS CoV-2 pandemic. Methods: In this cross-sectional study, a questionnaire was designed based on Patient Health Questionnaire-9, generalized anxiety disorder-7. It was disseminated through web-based and mobile-based social networks, thereby keeping in line with the social distancing and lockdown protocols. Results: Two hundred and fifty-seven participants were included in the study. Anxiety and depression were present in 23% (n = 59) and 16.8% (n = 43) of participants, respectively, most cases being mild in intensity. Nearly 56.4% (n = 145) of the participants reported that they were worried about COVID 19 pandemic, major cause of worry being risk of family and friends to be infected by COVID 19. About 40.9% (n = 105) participants reported sleep disturbances. Nearly 33.5% (n = 86) of participants reported increase in their smoking/alcohol consumption during lockdown. Conclusions: A significant proportion of health-care professionals experienced worry, sleep disturbances, anxiety, and depressive symptoms. Having clear guidelines, policies and procedures, training on infection control measures, occasional drills and being able to maintain communication with family members while in quarantine can go a long way in reducing worry and psychological impact of pandemic on health-care professionals.