European Journal of Cardiovascular Medicine

Background: A stroke or Cerebrovascular accident is defined as an abrupt onset of neurologic deficit that is attributable to a focal vascular cause. Infections and inflammation play a vital role in the pathophysiology of atherosclerosis. Objective: To estimate and correlate levels of high-sensitivity C-reactive protein in acute ischemic stroke. Methods: This Observational Case-Control Study was conducted in the Government Medical College, Nagpur in Central India. The duration of the study was 2years. 51 patients who were diagnosed with the First ischemic stroke were included in the study. Results: The mean HsCRP of the cases was 4.2±1.4 years and the mean HsCRP of the controls was 1.6±1.2 years. There was statistically significant difference. The patients who survived had NIHSS score 16±3.0 on admission and 12±3.0 on discharge. The patients who did not survive had NIHSS score 30±1.5 on admission.The size of the infarct was found to be increasing with the increase in hsCRP levels. Te size of the infarct was like, 1.92 cm² in hsCRP<3; 18.55 cm² in hsCRP 3-8; 24.60 cm² in hsCRP 9-14; 36.54 cm² in hsCRP 15-20 and 51.25 cm² in hsCRP>20. Conclusions: HsCRP levels are independent risk factor in Acute Ischaemic Stroke patients without infection, as well as for in-hospital mortality. Also, higher level of serum HsCRP is associated with increased neurological deficit assessed by NIHSS and poor outcome.

Background: Psoriasis vulgaris (PV) is a chronic recurrent inflammatory skin disease that occurs in genetically predisposed individuals, influenced by various endogenous and exogenous transducing factors. Objectives: The present study was aimed to assess the relationship between cardiovascular risk factors such as, the pattern of dyslipidaemia and body fat deposition with insulin resistance in Psoriatic patients. Methods: Body mass index (BMI) and waist circumference (WC) were measured in 40 psoriaitic patients against matched controls. Fasting Blood Glucose (FBG), Triglyceride (TG), Cholesterol(CHOL), Low density lipoprotein(LDL), Very low density lipoprotein(VLDL), High density lipoprotein(HDL), hsCRP were measured by spectrophotometry. Homocysteine was measured by immune fluroscene technology. Insulin resistance was assessed by measuring the HOMA-IR values. Results: FBG, HDL and WC between this two groups were statistically not significant (p value=0.271, 0.21 and 0.72 respectively). On the other hand, BMI, HOMA-IR, TG, CHOL, LDL, VLDL, hsCRP and Homocysteine levels were significantly higher in the case group (p<0.05). Bivariate correlation analysis showed HOMA-IR to be significantly associated with FBG, BMI, WC, Total CHOL and LDL (but not with VLDL, TG and HDL, hsCRP and Homocysteine values). Conclusions: Mainly an increased insulin resistance that is directly related to significantly elevated levels of abdominal obesity and LDL cholesterol levels reflects metabolic derangements in psoriatic patients in this region. We suggest regular monitoring of psoriatic patients for these parameters to avoid the impending cardiovascular risks in them.

Traditionally, the diagnosis of appendicitis used to make solely based on clinical signs and symptoms. Later diagnosis included results of inflammatory laboratory investigations such as leukocyte counts, neutrophil counts and CRP. This practice in diagnostics led to a false positive diagnosis (negative appendectomy) rates many times in the range of 15-30%. So, it requires more data & correlation of investigations to diagnose acute appendicitis in time. Out of the total 100 patients, who were diagnosed clinically as to have acute appendicitis, 86% of them were found to be having elevated HsCRP level and 58% presented with acute suppurative appendicitis. HsCRP test sensitivity against histopathological findings was computed to be 97.67%, specificity 85.71%, positive predictive value 97.67%, negative predictive value 85.71% and diagnostic accuracy to be 96.0%. Appendix wall thickness and HsCRP both test sensitivity was 81.40%, specificity was 42.86%, positive predictive value was 89.74%, negative predictive value was 27.27% and diagnostic accuracy was 76.0% so both HsCRP and appendix wall thickness were found to be very useful test to detect acute appendicitis. 14.0% negative appendectomies were done. Therefore, HsCRP and appendix wall thickness can be considered as a reliable diagnosis of acute appendicitis. A normal serum HsCRP level after 12 hours of onset of symptoms should be used as a basis for the decision to defer surgery to reduce the rate of negative appendicectomies, and also to reduce burden on patient as well as on health system.