European Journal of Molecular & Clinical Medicine

Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. In patients with Type 2 diabetes, low grade inflammation is reflected by increased plasma levels of several biomarkers  such as C-reactive protein (CRP).Alkaline phosphatase (ALP) is a generally accepted clinical marker of hepatic or bone disease.It had been showed that elevated ALP acted as a prognostic indicator of decreased survival in diabetic patients with acute myocardial infarction (MI), possibly in association with decreased renal function in these patients

Limited data is available about C Reactive protein (CRP) and its significance in mortality and morbidity in Acute Myocardial infarction (AMI) in diabetic patients. The aim of current study is to examine whether CRP levels are associated with for long-term all-cause, cardiovascular, and cardiac mortality in AMI patients with diabetes and those without separately.
Methods: This is a cohort study on 100 patients with Acute Myocardial Infarction out of which 50% are diabetics and 50% are non-diabetics.
Results: The CRP level cut off was taken as 7 mg/L in our study. The patients were divided into two groups, Diabetics and Non Diabetics. In diabetic patients with AMI, 96% of patients have crp levels more than 7 mg/L. In non-diabetic patients with AMI, 88% of patients have crp level more than 7mg/L. The mean CRP in diabetic group was 51.80 mg/l as compared to 15.78mg/l in non-diabetic group which was statistically significant (p<0.001). Diabetic patients who died in hospital presented with higher plasma levels of CRP on admission as compared to non-diabetic patients.
Thus, this study reveals that CRP can be used as a prognostic marker in diabetic patients with AMI.
Conclusion: In diabetic patients with AMI CRP levels are higher on admission, CRP value is an independent predictor of long term, all cause, cardiovascular and cardiac mortality after AMI.

Aim: To study the diagnostic role of rise in bilirubin in Acute appendicitis.
Materials and method: Prospective analytical study of Pre-operative Role of Rise in Bilirubin in acute appendicitis was carried out in December 2019 – April 2021. All cases coming with uncomplicated acute appendicitis admitted during study period in Sharda Hospital, Gr. Noida, UP. were included in study. Patients withPre-operative diagnosed case of acute appendicitis with age above 18 years were included. The patients with Complicated appendicitis, Negative proved specimen on Histopathalogy Examination, Patients suffering from Positive HBs Ag, Previous history of Jaundice, Chronic Alcoholism (daily intake of >40 ml for male &>20 ml for female),Patients suffering from Hemolytic Disease, Congenital biliary disease, Hepato-biliary malignancy, Recent history of liver trauma, Cholelithiasis, Females with history of oral contraceptive pill, Patients with history of Statins, Pregnancy were excluded from the study. A detailed history, complete physical examination and routine & appropriate investigations were done for all patients.
Results: The mean age of the study population was 29.46±9.81 (18-70) years with majority of the study population belonging to 18-30 years (62.7%) followed by 31-40 years (22.7%) and above 39 years (14.5%). The study population consisted of 78 (70.9%) males and 32 (29.1%) females. The mean Total Sr. Bilirubin (mg/dL), Direct (mg/dL) and Indirect (mg/dL) among study population was 0.98±0.37 (0.29-2.11), 0.77±0.33 (0.28-1.72) and 0.20±0.21 (0.00-1.73). The mean Alvarado Score of the study population was 7.40±0.59 (7-9). The mean Total Sr. Bilirubin (mg/dL) was significantly more among subjects with Alvarado score≥ 7 compared to subjects with Alvarado score7. Frequency Percent Paracaecal 18 16.4% Pelvic 1 0.9% Retrocaecal 89 80.9% Subcaecal 2 1.8% Total 110 100.0% The Pre-operative findings showed that appendicitis was Paracaecal, among 18 (16.4%), Pelvic, among 1 (0.9%), Retrocaecal, among 89 (80.9%) and Subcaecal, among 2 (1.8%) subjects. There was no significant difference in mean TLC (/mm3) between subjects with Abnormal and Normal Bilirubin level. The mean C-Reactive Protein (mg/dL) was significantly more among subjects with Abnormal Bilirubin level compared to Normal Bilirubin level.

Knee osteoarthritis is a common cause of severe pain and functional limitation. Total knee arthroplasty is an effective procedure to relieve pain, restore knee function, and improve quality of life for patients with end stage knee arthritis. The aim of this study was to investigate the inflammatory process in patients with primary knee osteoarthritis before surgery and in subsequent periods following total knee arthroplasty. A prospective study of 14 patients undergoing primary total knee replacements was conducted from October 2014 to May 2015 in our institution. The patients were evaluated by monitoring serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), knee skin temperature and clinical status. Measurements were carried out preoperatively and postoperatively on day 2 and 2nd week, 6th week, 14th week and 24th week during follow-up review. The CRP was elevated on the 2nd postoperative day but fell to preoperative values at two weeks postoperatively. CRP returned to within the normal range by six weeks postoperatively. In addition, the postoperative ESR showed a slow rise with a maximum level at two weeks after surgery and returned to within normal range at 14 weeks postoperatively. The difference in skin temperature between operated and contralateral knee had a mean value of 3.9C at two weeks. The mean value decreased to 3.4C at six weeks, 2.3C at 14 weeks, and 1.0C at 24 weeks. The difference in skin temperature decreased gradually and eventually there was no statistically significant difference at 24 weeks after surgery. A sustained elevation in serum CRP, ESR, and skin temperature must raise the concern of early complication and may suggest the development of postoperative complication such as haematoma and or infection.

Background: CRP measurement is quick, non-invasive, and risk-free that can be a
useful diagnostic test for evaluating and categorizing the risk levels and also
anticipating the morbidity of both mother and fetus.
Aims: To identify the association between the level of C-Reactive protein (CRP) with
preterm deliveries.
Materials and methods: It is Hospital based Prospective Observational study done for a
period of 2 Years in 95 pregnant women with gestational age between 24 weeks to 36
weeks+6days, who present to emergency /labor room with regular uterine contractions,
at least four in 20 minutes or eight in 60 minutes in presence or absence of cervical
changes.Patients were then followed up till 7 days for preterm delivery. Further
categorization of subjects was done into 2 groups:Group 1: Those who delivered
preterm within 7 days of admission.Group 2: Those who did not deliver within 7 days of
admission.
Results: 95 patients with premature uterine contractions were analysed for CRP levels
and were followed up to find out if they underwent preterm delivery within 7 days of
admission. The mean value of CRP was calculated in the 2 groups and was found to be
higher in those who delivered within 7 days with a statistically significant p value 0.001.
The curve generated cut off for CRP was ≥3.55 mg/l (AUC 0.809, SE 0.046, P <0.001),
indicating a positive association for preterm delivery. With the derived cut off, the
sensitivity, specificity, positive predictive value, negative predictive value of CRP for
predicting preterm delivery was found to be 80.4 %, 75.5%, 80.7% and 75.2%
respectively, with diagnostic accuracy of78.3%.
Conclusions: Prediction of preterm delivery by a simple biomarker like CRP could help
in early intervention and subsequentprevention of preterm birth and its sequelae.

Background: Even though appendicectomy is the most regularly performed emergency surgery, its diagnosis remains uncertain, with a high probability of negative investigations. The study's goal was to investigate the relevance of CRP measurement accuracy in the diagnosis of acute appendicitis and to reduce morbidity by avoiding negative exploration.
Materials and Methods: The present investigation included 30 patients who were clinically diagnosed by surgeons as having acute appendicitis and were sent for an emergency appendectomy at the General Surgery Department, JSS Hospital Mysuru, between the 1st of December 2020 and the 1st of May 2021. Preoperative blood was sent for CRP estimation; postoperative, all specimens were sent for histopathological evaluation; CRP values were correlated with HPE reports to evaluate their function in the diagnosis of acute appendicitis.
Results: In the current study, CRP had the highest sensitivity and specificity of 90% and 80%, respectively, with a positive predictive value of 90%. As a result, it was demonstrated that CRP levels can be used to rule out negative appendicitis, allowing surgery to be postponed in these patients and lowering the rate of negative appendicectomies.
Conclusion: We continue to highlight the importance of a professional surgeon's history and clinical examination in detecting acute appendicitis. CRP, on the other hand, significantly reduces the rate of negative appendicectomy and, as such, should always be included in the diagnostic workup of acute appendicitis

Background: Sepsis is a life-threatening condition in ICU with high morbidity and
mortality. Biomarkers which can act as a predictor for diagnosis, prognosis, and patient
outcome in sepsis are needed.
Aim:Aim of the study is to compare the significance of hs-C-reactive Protein (CRP),
Procalcitonin, White blood cell count, and blood culture in patients with bloodstream
infections and compare their prognostic significance with blood cultures in sepsis.
Materials and Methods: This hospital based prospective observational study was conducted
between July 2018 to July 2019 forone year with 216 cases of sepsis. Serial determination
of Procalcitonin and CRP at admission and Day 6 was done. Data was analyzed check to
compare the prognostic significance of the PCT, CRP, and WBC count.
Results:A blood culture positivity rate of 50.9% was reported with male preponderance.
WBC count has significantly reduced after 72hrs of admission (p= 0.007). CRP levels have
significantly reduced on day 6 (p = 0.043) in comparison to at the time of admission (p=
0.032). The serial determination of PCT levels at admission and on day 6 (p= 0.032) was
found to be a better prognostic indicator in patients with sepsis than at the time of
admission. The significant patient outcome in terms of mortality and reduction in length of
hospital stay has been found (p= 0.018, p=0.002). The positive correlation of PCT and CRP
and SOFA score has been reported.
Conclusion: Prognostic significance was found for the biomarkers PCT, CRP, and WBC
count with significant patient outcomes in terms of mortality and hospital stay reduction

Introduction: COVID-19 is the current global coronavirus pandemic caused by the SARS-CoV-2 coronavirus. The first reports of the disease outbreaks appeared in China on December 31, 2019 and the first clinical manifestations occurred earlier on December 8, 2019. On January 30, 2020, the World Health Organization declared the outbreak as a public health emergency of international concern. On March 11 it was declared a pandemic. Common symptoms include fever, cough, fatigue, shortness of breath, and anosmia (loss of smell).Complications can cause acute respiratory distress syndrome (ARDS) and pneumonia. The incubation period is usually around five days, but can range from two to fourteen days.
Aim of the research isto study of clinical and diagnostic criteria for neurological disorders and changes of laboratory parameters in patients with COVID-19.
Material and methods: We examined 31 patients who had undergone COVID-19 and were hospitalized at the private clinic "Neuromed-Service" named after academician N.M. Madjidov. There were 19 males and 14 females. The age of the patients varied from 18 to 75 years (the mean age made up 41 years).
Results: Patients with inflammatory diseases of the peripheral nervous system (neuropathy, facial nerve, trigeminal neuralgia), considering an increase of C-reactive protein were performed anti-inflammatory therapy with NSAIDs and steroids (Dexamethasone intramuscularly). In patients with convulsive syndrome EEG was monitored using the "Neuron - range 2" (Russia). Diffusechangesinthebioelectricalactivityofthecerebralcortexwererevealedinthestudiedpatients.Epiactivityinthefronto-parietalregionofthebrain (against the background of taking anticonvulsants)was also recorded. The dose of anticonvulsants was increased for these patients and decongestants were prescribed. An increase in fibrinogen was also noted in the blood of these patients. Conclusion: Thereby, in patients after suffering COVID-19, the blood tests showed an increase of fibrinogen by more than 2 times and an increase of C-reactive protein. All this testifies the fact that in these patients after treatment, at the alleged improvement of their condition, the blood continued the process of thrombosis strengthening and inflammation persisted in tissues and organs. In patients who prematurely stopped taking antiplatelet agents and anti-inflammatory drugs after illness, neurological and other complications were developed

Among kidney failure patients, especially those on dialysis, malnutrition is associated with poor outcomes. Malnutrition is a multifactorial process, including inflammation, which can be measured by C-reactive protein (CRP). The objective is to evaluate the dynamics of CRP associated with nutritional status changes in kidney failure patients at initiation and after 3 months of dialysis. A prospective cohort study using a consecutive sampling method consisting of 40 kidney failure patients who received initial dialysis at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia from January-March 2020. Nutritional status was evaluated with Subjective Global Assessment (SGA), and CRP was measured at the initial dialysis and after 3 months. All subjects received nutritional education at the beginning. Nutritional status was defined as well-nourished (WN, SGA A) and malnourished (MN, SGA B and C), then classified into 4 groups denoting nutritional changes: Group 1 (WN to WN), Group 2 (MN to WN), Group 3 (WN to MN), and Group 4 (MN to MN). ANOVA, paired t-test, and chi-square test (significance p<0.05) were used for statistical analyses. Subject’s mean age was 50.5±14.8 years old; 52.5% were male. Diabetes and obstructive nephropathy were the most frequent underlying diseases, both had a prevalence of 35%. At initiation, the prevalence of malnutrition was 77.5%; after 3 months, it was 70%. The highest proportion of Group 4 were female (62.5%) and those with diabetes (45.9%). Among all subjects, mean CRP decreased (9.4±32.3 mg/dL) after 3 months. While mean CRP based on nutritional changes, Group 2 had the highest reduction (18.8±26.8 mg/dL), and Group 3, CRP increased (17.5±17.0 mg/dL). C-reactive protein is negatively associated with nutritional status changes in kidney failure patients after 3 months of dialysis. Malnutrition was higher in female subjects and those with diabetes.