scholarly journals Role of total leukocyte count and C-reactive protein in diagnosis of acute appendicitis

2018 ◽  
Vol 5 (3) ◽  
pp. 883
Author(s):  
Anuradha Dnyanmote ◽  
Sagar Ramesh Ambre ◽  
Foram Doshi ◽  
Snehal Ambre
Keyword(s):  
Acute Appendicitis ◽  
Sensitivity And Specificity ◽  
Leukocyte Count ◽  
Total Leukocyte Count ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Surgical Emergencies ◽  
Group A ◽  
Negative Appendicectomy ◽  
Group B

Background: Acute appendicitis is still one of the most common surgical emergencies. This study was conducted to check the sensitivity and specificity of Total leukocyte count (TLC) and C Reactive Protein (CRP) of acute appendicitis. Aim and objectives were to check the sensitivity and specificity of total leukocyte count in diagnosis of acute appendicitis and to check the sensitivity and specificity of CRP in diagnosis of acute appendicitis. To determine TLC and CRP efficacy in diagnosis of acute appendicitis.Methods: TLC and CRP were calculated in all patients who were planned to undergo appendectomy. Appendectomies were performed independent of results of TLC and CRP levels. For statistical purpose the patients were assigned into 2 groups- Group-A Patients with inflamed/perforated/gangrenous appendix, Group-B patients with Normal appendix. The normal TLC and CRP values, raised TLC, raised CRP, and raised both TLC and CRP values calculated in each of these groups. Sensitivity and Specificity were calculated. The cut off value for TLC was 11x106/L. This value was selected arbitrarily as it corresponds to the elevated TLC. The CRP levels were calculated and cut off value was taken as 1.7mg/dl.Results: Out of 75 cases, 55 were male and 20 were female. Age ranged from 13 to 58 years. CRP was raised in 82.14% of inflamed appendix cases TLC was raised in 76.79% of inflamed appendix cases and both was raised in 92.5% of inflamed appendix cases.Conclusions: TLC and CRP are useful in diagnosis of acute appendicitis. Negative appendicectomy rate can be decreased.

scholarly journals Effectiveness of Dual Antibacterial Therapy and Effectiveness of Recommendation Criteria as a Diagnostic Tool in Children with Uncomplicated Acute Appendicitis

2020 ◽  
Vol 18 (1) ◽  
pp. 31-35
Author(s):  
Liene Taurina ◽  
Zane Liepina ◽  
Astra Zviedre ◽  
Arnis Engelis ◽  
Aigars Petersons
Keyword(s):  
Emergency Department ◽  
Acute Appendicitis ◽  
Antibacterial Therapy ◽  
Moderate Correlation ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Group A ◽  
Group B ◽  
Uncomplicated Acute Appendicitis ◽  
Suspected Acute Appendicitis

SummaryIntroductionAcute appendicitis (AA) – acute inflammation and infection of the appendix – is one of the most common cause for abdominal surgery in pediatrics. Appendectomy has been the gold standard since 1735, but in recent years there have been several studies that investigate antibacterial therapy for uncomplicated acute appendicitis. In 2016 new recommendations for suspected AA were implemented in emergency department setting of Children's Clinical University Hospital (CCUH).Aim of the StudyTo evaluate whether diagnostic criteria for patients with a suspected acute appendicitis is effective as a diagnostic tool and to evaluate whether dual antibacterial therapy is safe and effective as first line treatment for children with diagnosis of uncomplicated acute appendicitis in CCUH.Material and methodsA retrospective study was made in CCUH from January 2017 to December 2017. Patients aged 7 to 18 with suspected uncomplicated acute appendicitis were identified and data were collected from an internal hospital management system and patients’ medical records. Patients were divided into two groups – A and B. In group A were patients who met the criteria of uncomplicated AA, and in group B – patients who met the criteria of complicated AA. Both groups received ampicillin and metronidazole. For statistical analysis IBM SPSS Statistics 22 program was used.ResultsFrom 98 patients majority were boys (51% (n=50)) with mean age 12.6 years. As a result of antibacterial therapy clinical condition improved in 93% (n=89) of patients who were discharged without surgery. 7 patients did not improve and underwent surgery within 48 hours after admission, another 2 had elective appendectomy. There was a significant positive moderate correlation between C–reactive protein (CRP), white blood cell count (WBC), basophil granulocytes (BASO) and appendix diameter at admisson and after 48 hours of dual antibacterial therapy (r=0.31, p=0.003 vs. r=0.37, p<0.001 vs. r=0.41, p=0.017 vs. r=0.51, p=0.013). In group A (68% (n=67)) there was a significant positive moderate correlation between CRP, WBC and appendix diameter at admission and after 48 hours of dual antibacterial therapy (r=0.31, p=0.003 vs. r=0.37, p<0.001 vs. r=0.51, p=0.013). In group B (30% (n=31)) 7 patients underwent appendectomy and 2 patients received a broad spectrum antibacterial therapy prior to elective appendectomy. There is evidence of significant association between ALVARADO score (p=0.004), rebound tenderness (p<0.001), WBC (p=0.004), CRP (p<0.001) and stage in which appendicitis has progressed to.ConclusionsAntibiotic-alone treatment may be a safe and effective initial management choice in children with uncomplicated acute appendicitis. However, to fully evaluate effectiveness of antibacterial therapy and diagnostic criteria, further follow–up research is needed.A normal C–reactive protein value does not rule out uncomplicated acute appendicitis, therefore it can not act as a single marker to diagnose AA or to differentiate between complicated and uncomplicated AA.Recommendations of treatment of UCAA are acceptable for use in emergency department as they act as a unified tool that allows pediatricians and pediatric surgeons to quickly assess suspected acute appendicitis.

Utility of Blood Markers in Early Prediction of Bacteraemia in Acute Febrile Paediatric Patients – An Observational Cohort Study in a Tertiary Care Hospital of North India

2021 ◽  
Vol 8 (28) ◽  
pp. 2526-2531
Author(s):  
Rabindra Bhunia ◽  
Bindu T. Nair ◽  
Vandana Negi
Keyword(s):  
Tertiary Care Hospital ◽  
Leukocyte Count ◽  
Tertiary Care ◽  
North India ◽  
Total Leukocyte Count ◽  
Care Hospital ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Neutrophil Percentage ◽  
Observational Cohort

BACKGROUND Bacteraemia is a common cause of children presenting to the paediatric emergency with acute febrile illness. Blood cultures remain the gold standard for detection of bacteraemia but the positivity is low and also takes time to show positive results. A rapid and reliable biomarker like procalcitonin (PCT), C-reactive protein (CRP), total leucocyte count (TLC), and neutrophil-lymphocyte count ratio (NLCR) can be used to identify febrile children with greater risk for bacteraemia or serious bacterial infections. This would be very helpful to start early treatment of bacteraemia with antibiotics. METHODS The study was an observational cohort study conducted in the Department of Paediatrics of a tertiary care hospital in North India in children between age group 6 months to 12 years presenting with fever of > 100.4° F for 2 - 7 days. Blood samples were sent for PCT, CRP, TLC, NLCR and blood cultures. RESULTS The most sensitive biomarker was total leukocyte count (47.36 %) followed by the neutrophil percentage (26.32 %), C-reactive protein (21.05 %), and procalcitonin (15.79 %). The most specific biomarker was procalcitonin (75.14 %) followed by C-reactive protein (58.56 %), neutrophil percentage (22.65 %) and total leukocyte count (11.05 %). The only biomarker that was statistically significant between the bacteraemia and non-bacteraemia group in the present study was total leukocyte count (P – value < 0.05). CONCLUSIONS The sensitivity and specificity of each single biomarker is low and hence these cannot be used singly to predict bacteraemia. There should be a combination of biomarkers with adequate sensitivity and specificity that can be used to create an algorithm to aid in diagnosis and prognostication. KEYWORDS Procalcitonin, C-Reactive Protein, Blood Culture, Acute Febrile Patient

scholarly journals Efficacy of Telmisartan in Pristane Induced Arthritis Rat Model

2021 ◽  
Vol 35 (3) ◽  
pp. 6-11
Author(s):  
Quratulain Mehdi
Keyword(s):  
Rheumatoid Arthritis ◽  
Rat Model ◽  
Leukocyte Count ◽  
Female Rats ◽  
Total Leukocyte Count ◽  
Standard Diet ◽  
Entire Study ◽  
Intergroup Comparison ◽  
Group A ◽  
Group B

Introduction: Rheumatoid arthritis is one of the most common systemic inflammatory diseases characterized by progressive damage to the joints. There is rising evidence that Renin Angiotensin Aldosterone System signaling is also involved in the inflammatory response in rheumatoid arthritis and its blockers possess anti-arthritic properties. Telmisartan is an angiotensin receptor blocker and PPAR-? agonist and its anti-arthritic effects were evaluated. Aims & Objectives: This experimental study was designed to evaluate the anti-arthritic efficacy of telmisartan in pristane induced rat model of arthritis in adult female rats. Place and duration of study: The study was conducted in the Department of Pharmacology, Army Medical College, Rawalpindi, in collaboration with National Institute of Health and Armed Forces Institute of Pathology from July 2020 to August 2020. Material & Methods: Twenty four (24) adult non-pregnant female Sprague Dawley rats were divided in three groups (n=8) designated as Group A (normal control), Group B (arthritic control) and Group C (telmisartan group) & maintained on standard diet and water adlibitum. Rheumatoid arthritis was induced in each rat of Groups B &C by a single intradermal injection of 0.5ml pristane at the base of its tail on day 0 and the disease developed in two weeks. All 3 groups were given distilled water 2.5 ml/kg from 2-4 weeks and Group C was additionally given dissolved telmisartan orally at 2 mg/kg/day. Anti-arthritic efficacy was determined by assessing arthrogram score and total leukocyte count on day 0, 14 and 28 along with histological examination done at the end of the study. Data analysis was done using SPSS version 25. Results: Healthy rats in group A maintained a unremarkable arthogram & histogram score & TLC count of 6675±350/?l during the entire study period. Telmisartan administration in Group C for two weeks after pristane induction resulted in significant reduction in arthrogram score (AS) 9.5±3.66, total leukocyte count (TLC) 7350±550/?l and histological score (HS) to 6.88±1.24 as compared to (AS) 14.50±2.07, WBC 10150±350/?L & (HS) 10.75±2.05 in Group B, left untreated with pristane alone. The intergroup comparison showed significant p value < 0.05 respectively. Conclusion: Anti-arthritic effect was shown by telmisartan as it was able to ameliorate the changes induced by pristane.

Evaluation of β-Tricalcium Phosphate Biomaterial in Femur Fracture Repair in Dogs

2021 ◽  
Author(s):  
D.K. Dwivedi ◽  
R.B. Kushwaha ◽  
M.S. Bhadwal ◽  
A.K. Gupta ◽  
J.S. Soodan ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Tricalcium Phosphate ◽  
Femur Fracture ◽  
Leukocyte Count ◽  
Weight Bearing ◽  
Fracture Repair ◽  
Total Leukocyte Count ◽  
Intramedullary Pinning ◽  
Group A ◽  
Group B

Background: Fracture repair is one of most common procedure carried out by veterinary clinicians. Fracture healing most of the time associated with delayed union, non-union and mal-uinon. Therefore, the objective of this study was to evaluate the clinical, haemato-biochemical and radiological outcome in patients after implantation of β-tricalcium phosphate as a bone graft substitute to promote the fracture healing.Methods: Eight clinical cases brought to the clinics with femur fracture were divided into two groups viz. A and B, with four animals in each group. Femur fractures were stabilized with intramedullary pinning and β-TCP biomaterial and intramedullary pinning and β-TCP plus autologous bone marrow aspirate (BMA) composite in group A and B respectively. The efficacy of fixation was studied on the basis of clinical evaluation, haemato-biochemical and radiographical parameters on day 0 and on 7th, 15th, 30th, 45th and 60th post-operative day. Result: Excellent weight bearing was noticed in group B. The overall functional outcome in group B was better in comparison to group A animals. Haematological parameters viz. haemoglobin, packed cell volume, total leukocyte count and differential leukocyte count did not differ significantly within and between the groups. The biochemical parameters viz. serum calcium increased significantly (P less than 0.05) on 7th and 15th post-operative day. A significant reduction in serum alkaline phosphatase level observed on successive post-operative days in both groups. Radiographs of fractures treated in both the groups showed good reduction and fracture fixation, early signs of fracture healing in group B than group A animals. The size of callus formation was more in group A than group B. No any graft related complications observed during the study period. The β-tricalcium phosphate facilitated fracture healing and early ambulation of affected limb.

scholarly journals C-Reactive Protein Predicts Progression of Peripheral Arterial Disease in Patients with Type 2 Diabetes: A 5-Year Follow-Up Study

2014 ◽  
Vol 33 (4) ◽  
pp. 347-355
Author(s):  
Ljiljana Popović ◽  
Katarina Lalić ◽  
Olga Vasović ◽  
Danijela Drašković Radojković ◽  
Nataša Rajković ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Group A ◽  
Hs Crp ◽  
Group B ◽  
Peripheral Arterial

Summary Background: Previous studies have indicated that high sensitivity C-reactive protein (hs-CRP) is a risk factor for the peripheral arterial disease (PAD) in diabetes. This study aimed to evaluate the possible predictive significance of hs-CRP for the development and progression of PAD in patients with type 2 diabetes (T2D). Methods: The study included 80 patients previously diagnosed with T2D, aged 45–70 years, divided into group A (T2D patients with PAD; n=38) and group B (T2D patients without PAD; n=42). After five years, all the patients were re-examined and divided into subgroups depending on de novo development of PAD or progression of previously diagnosed PAD. Ankle-Brachial Index (ABI) measurement was used for PAD diagnosis and hs-CRP was determined by nephelometry. Results: We found significantly higher hs-CRP levels in group A compared to group B, but only at baseline. Among the patients in group A, those with later progression of PAD (subgroup A1) had the highest levels of hs-CRP at baseline, although not significantly different from those in subgroup A2 (non-progressors). In contrast, hs-CRP level was significantly higher in subgroup B1 (progressors) in comparison to subgroup B2 (non-progressors) at both the first and second exam. Of all the investigated metabolic parameters, hs-CRP was the only independent predictor of PAD progression (OR=0.456, 95% CI=0.267–0.7815, p=0.004). The cut-off point for hs-CRP was 2.5 mg/L (specificity 75% and sensitivity 73.3%) with the relative risk for PAD of 2.93 (95% CI=1.351–6.3629). Conclusions: Our study implies that hs-CRP can be used as a reliable predictor for the progression of PAD in patients with T2D.

scholarly journals Study of High sensitive C - reactive protein and Gamma-glutamyl transferase in Type 2 Diabetes Mellitus with Hypertension

2020 ◽  
Vol 11 (3) ◽  
pp. 3478-3483
Author(s):  
Ramya S ◽  
Sureka Varalakshmi V ◽  
Uma Maheswari K ◽  
Chandan Bala R
Keyword(s):  
Diabetes Mellitus ◽  
Gamma Glutamyl Transferase ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Difference ◽  
Group A ◽  
Hs Crp ◽  
Group B ◽  
Glutamyl Transferase

C-reactive protein (CRP), produced by the hepatocytes is a primary inflammatory marker of T2DM. Higher levels of gamma-glutamyl transferase enzyme (GGT) and Hs CRP (High sensitive CRP)are associated with the complication of poor glycemic control.This study was aimed to find the association of Hs CRP and GGT for cardiovascular risk factors in Type 2 diabetes mellitus (T2DM)and Hypertension in the suburbs of Chennai. This study includes 57 subjects with T2DM and Hypertension (Group A) and 62 subjects with T2DM (GroupB) within the age group of 40-60 years. FBS, HbA1C, Hs CRP, GGT and blood pressure were determined. Statistical analysis was performed using Statistical Package for the SPSS 17 version. Mean values of FBS, blood HbA1C, Hs CRP and GGT were significantly higher among participants of Group A than Group B. Significant difference of FBS, HbA1C were found between the two groups. In contrast, no significant difference of GGT was found between the groups. Differences were considered statistically significant at two-sided P < 0.05. Within the group, Hs CRP shows the significance and positive correlation with FBS, SBP and DBP. Still, GGT does not show any significance in Group A. In contrast, in Group B, both Hs CRP and GGT shows the importance and positive correlation with FBS and HbA1C.It is concluded that high levels of HsCRP are associated with T2DM and Hypertension, indicating increased cardiovascular risk, and it should be included in regular monitoring of type-2 diabetic patients.

scholarly journals Serum resistin: A possible link between inflammation, hypertension and coronary artery disease

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Sobia Niaz ◽  
Javaria Latif ◽  
Shaista Hussain
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Angina Pectoris ◽  
Leukocyte Count ◽  
Total Leukocyte Count ◽  
C Reactive Protein ◽  
Hypertensive Patients ◽  
Reactive Protein ◽  
Artery Disease

Background & Objectives: Inflammation is considered as the main triggering factor in evolution of atherosclerotic pathology of heart and blood vessels. Resistin, an inflammatory cytokine is proved to be a main mediator of initiation and progression of mechanisms leading to atherosclerosis, hypertension and ultimately to coronary artery disease. Our objective was to compare the levels of serum resistin, C-reactive protein and total leucocyte count in subjects of hypertension and coronary artery disease; and to observe the correlation of serum resistin with CRP and TLC in the study participants. Methods: Eighty selected participants were divided into four equal groups including normal healthy participants, newly diagnosed cases of hypertension, stable angina pectoris and myocardial infarction, both with hypertension. The study was conducted in the physiology department of Post Graduate Medical Institute Lahore, during 2013. After consent, history and examination, fasting blood samples of the participants were collected. Serum resistin and C-reactive protein were determined by using standard techniques of enzyme linked immunosorbent assay, while total leukocyte count by automated hematology analyzer. Results: The values of serum resistin, C- reactive protein and total leukocyte count were found significantly raised in patients of hypertension, angina pectoris and myocardial infarction with hypertension as compared to normal participants (p<0.001 for all). Significantly positive correlation of resistin was observed with TLC only in hypertensive patients of myocardial infarction (r = 0.459, n = 20, p = 0.042) while in other study groups correlation between resistin and TLC as well as CRP was non-significant. Conclusion: Serum resistin levels along with CRP and TLC are significantly raised in patients of hypertension and coronary artery disease while resistin levels revealed significantly positive correlation with TLC in hypertensive patients of myocardial infarction. doi: https://doi.org/10.12669/pjms.35.3.274 How to cite this:Niaz S, Latif J, Hussain S. Serum resistin: A possible link between inflammation, hypertension and coronary artery disease. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.274 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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