European Journal of Cardiovascular Medicine

Objective: The introduction and use of antiretroviral therapies (ART) has revolutionized the management and treatment of Human Immunodeficiency Virus (HIV)/acquired immunodeficiency syndrome (AIDS). HIV/ AIDS globally resulting in increased life expectancy. Current treatment guidelines by WHO recommend the use of a combination of at least 3 ARV drugs which include: 2 Nucleoside Reverse Transcriptase Inhibitors (NRTIs) combined with 1 medication from either of the 2 remaining classes; the Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) or the Protease Inhibitors (PIs). Micronutrients and electrolytes deficiencies are prevalent among HIV-infected populations. The use of Highly Active Antiretroviral Therapy (HAART) on the other hand has been shown to increase the life expectancy of HIV infected individuals. The present study was designed to determine the effects of HAART on serum micronutrients and electrolytes concentrations in HIV positive patients. Materials and Methods: A prospective randomized controlled clinical study was conducted in the with 231 HIV+ adults with low plasma zinc levels (<0.75 μg/ml), randomly assigned into zinc (12 mg of elemental zinc for women and 15 mg for men) or placebo, for 18 months. The primary endpoint was immunological failure. HIV-viral load and CD4+ cell count were determined every 6 months. Questionnaires, pill-counts, plasma zinc and C-reactive protein (hsCRP) were used to monitor adherence with study supplements and ART. Intent-to-treat analysis utilized multiple-event analysis, treating CD4+ cell count <200 cells/mm3 as recurrent immunological failure event. Cox proportional-hazard models and the general-linear model were used to analyze morbidity and mortality data. Results: Severe, moderate and mild malnutrition were detected in 15%, 38% and 24% of human immunodeficiency virus infected individuals respectively. Compared with the healthy control group, serum level of zinc and selenium in the human immunodeficiency virus infected subjects were significantly lower (P = 0.01 and P = 0.02 respectively). Discussion: In our study we found, there is significant increase in weight, BSA, BMI, where as significant decrease in DBP of diabetic group compared to Non-Diabetics & there is significant increase in FBS, HbA1C levels of Diabetic group significant decrease in LH levels of Diabetics compared to Non-Diabetics. However T3 levels of Diabetic and Non-Diabetic group were almost same, where as T4, Oestradiol and progesterone levels of diabetic group non-significantly increased and FSH and TSH levels non-significantly decreased in Diabetics. There is frequent co-existence of thyroid dysfunction and diabetes mellitus among post menopausal diabetic women. Conclusion: ART treatment did not complement zinc status in HIV infection while improving CD4+ T-cell count, hence the need to consider supplementation

Introduction: Type 2 diabetes (T2D), a frequent comorbidity in AMI, has been associated to an increased risk of long-term in-hospital mortality and upcoming cardiovascular events. "Inflammation underlies both the complicated diseases diabetes mellitus and atherosclerosis. Acute myocardial infarction is really a risk factor for type 2 diabetes, which is assessed in a state of low-grade inflammation. Aims: To identify the “CRP level at the time of admission as a reliable indicator of hospital mortality and morbidity in both patients with and without diabetes mellitus who experienced an acute myocardial infarction Materials and Methods: The material for the present study was collected from patients who are admitted in Katihar Medical College and Hospital over a period of one and a half year from December 2020 to May 2022.100 Patients were included in this study. Result: This study found that diabetes patients with acute myocardial infarction had statistically significant higher admission CRP levels than non-diabetic patients . Patients with diabetes who had higher CRP levels had a greater incidence of death and morbidity when compared to non-diabetic patients. Conclusion: According to the results of this investigation, CRP is a potent predictor of hospital morbidity and mortality in both diabetes and nondiabetic individuals with acute myocardial infarction.

Background and Objectives: Bacterial meningitis (BM) poses a considerable global public health concern. C-reactive protein (CRP) has emerged as a viable diagnostic marker, particularly in differentiating bacterial and aseptic meningitis, especially in cases where bacterial culture results are negative in both blood and cerebrospinal fluid (CSF) samples. The present study was done with the primary objective of estimating the serum CRP levels in pediatric meningitis cases caused by bacterial pathogens. Materials and Methods: A hospital-based descriptive cross-sectional study was undertaken at a renowned tertiary care hospital in India, involving the evaluation of 222 samples. Cerebrospinal fluid samples were collected following standard guidelines, and bacterial identification and antimicrobial susceptibility testing were carried out using an automated system. Quantitative estimation of CRP levels was performed using a solid-phase, sandwich-format immunometric assay employing a gold antibody conjugate. Results: The study cohort consisted of pediatric meningitis cases with a median age of 3.9 years, ranging from 1 to 4.6 years. Among the bacterial isolates, Escherichia coli was identified as the most prevalent pathogen, followed by Klebsiella pneumoniae. Notably, 31.32% of the participants exhibited elevated serum CRP levels. Moreover, a statistically significant association was observed between elevated serum CRP levels and cases with Gram-negative bacterial etiology. Conclusion: Elevated serum CRP can serve as a valuable diagnostic marker for identifying pediatric bacterial meningitis cases with a Gram-negative etiology. The utilization of CRP as a diagnostic adjunct can aid in timely and accurate differentiation between bacterial and aseptic meningitis, facilitating appropriate clinical management and improved patient outcomes.

I

Introduction: Prevalence of Diabetes Mellitus is rapidly increasing in India. So are its complications, of which nephropathy is very common. Identifying these complications at early stage becomes crucial. One such proposed hypothesis is based on inflammatory markers. Their association with cardiac complications is proven. The current study is planned with this background. Objectives: To assess the serum high sensitivity C reactive protein levels in patients with type 2 diabetes mellitus with diabetic nephropathy and to estimate the levels of serum high sensitivity C reactive protein in different stages of diabetic nephropathy. Methodology: Cross sectional study design was adopted to conduct the study in a government tertiary care setting i.e. K.R. Hospital. Study population included all patients, aged more than 18 years with DM type 2 who visited the study setting (OP /IP). Patients having Congestive cardiac failure, Liver disease, Infections, Autoimmune diseases, organ damage or Cancer or habit-forming drug intake were excluded from the study. Sample size was calculated to be 60. Data was collected using pre-tested, semistructured questionnaire which included detailed history, clinical examination and investigation findings; entered in Excel and analyzed using SPSS. Results: Mean age was 60.23 years. Males constituted 70%. Mean duration of DM was 13.02 years. 40% patients were in DN stage 3. 43% patients had microalbuminuria and 30% had macroalbuminuria. S. Creatinine was elevated in one-third patients. Overall, mean hs-CRP was 9.5 (3.3) mg/L; and mean hs-CRP among patients with DN stage -1, 2, 3 and 4 respectively, were 5.1, 9.0, 12.4 and 13.1 mg/L respectively. The difference between the means was statistically significant. Conclusion: There was a significant correlation between mean Hs CRP levels and clinical stages of the diabetic nephropathy. Also, hs-CRP significantly correlates with elevated PPBS, HbA1C, S. Creatinine, and eGFR levels. Hence hs-CRP may be used as a
marker to assess development and severity of the diabetic complications like diabetic nephropathy.

Introduction: In addition to established risk factors such as smoking, diabetes mellitus, hypertension, homocysteine, C-reactive protein (CRP), fibrinogen, and albumin, coronary artery disease (CAD) is characterised by a chronic inflammatory state. Inflammation plays a significant role in the initiation and progression of atherosclerotic plaque rupture, thrombus formation, and endothelial dysfunction. Two indicators, the fibrinogen to albumin ratio, are altered, and this results in vascular endothelial dysfunction through a variety of mechanisms, including platelet aggregation, thromboxane affinity, and plaque erosion. As a result, FAR has been identified as a new inflammatory marker that is correlated with the severity of coronary artery disease. Materials And Methods: The study included 108 patients who had acute coronary syndrome (ACS) and were admitted to the IPD division of the ICCU at KIMS Hospital. The patients underwent coronary angiography (CAG) while taking into account inclusion and exclusion criteria. Serum fibrinogen and serum albumin were measured at the time of admission, and the fibrinogen to albumin ratio was computed. Written informed consent was obtained from each subject or relative in every case. A detailed clinical history, including complaints, past history, and family history, was also obtained. The angiographic severity of coronary artery disease was assessed using the Gensini risk scoring system. The Chi-square test was employed to evaluate the association between FAR and other risk variables, and the Pearson correlation coefficient was utilised to determine the linear link between Gensini score (GS) and FAR. Results:  108 patients participated in the research; 70 (64.8%) were men and 38 (35.2%) were women. The mean age was 57 years, and the patients' ages varied from 29 to 83 years. Of the 108 patients who had acute coronary syndrome, 51 (47.2%) had diabetes, 65 (60.2%) had hypertension, 7 (6.5%) had a family history of coronary artery disease, and 52 (48.2%) had smoked. 38 (35.2%) patients with coronary angiography (CAG) had single vessel disease (SVD), 63 (58.3%) with double vessel disease (DVD), and 7 (6.5%) with triple vessel disease. The 108 patients who were enrolled in the study were split into three FAR tertiles: low FAR (n = 36; <9), middle FAR (n = 36; <11.8), and high FAR (n = 36; >11.8). Of the 108 patients, ANOVA in one manner, the mean Gensini score for the low FAR group was 34.6, the mean Gensini score for the intermediate FAR group was 38.8 13.8, and the mean Gensini score for the high FAR group was 48.6 16.2 with a statistically significant p <0.001. The pearson correlation coefficient between FAR and Gensini for the 108 patients is 0.446, indicating statistical significance with a p-value of less than 0.001. Conclusion High FAR levels are strongly correlated with angiographic severity of coronary artery disease, as determined by the Gensini risk score method, in individuals with acute coronary syndrome.

Aim and objective: Is to conduct a comparative analysis of Cord Blood and Whole Blood transfusions on clinical parameters and evaluate their effects on morbidity and mortality outcomes in neonatal sepsis, utilizing the Neonatal Sequential Organ Failure Assessment (N-SOFA) score as a clinical evaluation tool. Methodology: This prospective, comparative study was conducted at Gandhi Memorial Hospital, Rewa, from September 2022 to June 2024, involving 184 neonates with confirmed sepsis and hemoglobin < 7 g/dL requiring transfusion. Neonates were randomly assigned to two groups: Group 1 received umbilical cord blood transfusions, and Group 2 received adult human blood transfusions. The Neonatal Sequential Organ Failure Assessment (N-SOFA) score was utilized to evaluate organ dysfunction pre- and post-transfusion at 12 and 24 hours. Clinical assessments included blood indices and the need for inotropic support, with statistical analyses determining changes in N-SOFA scores and their significance. Results: The study included 184 neonates, equally divided into two groups: 92 receiving cord blood transfusions and 92 receiving whole blood transfusions. The demographic analysis showed no significant differences between groups in sex distribution (p = 0.880), mode of delivery (p = 0.673), or gestational age (p = 0.657). Notably, cord blood transfusions resulted in a significant reduction in the N-SOFA score > 4 from 67.3% pre-transfusion to 53.2% post-transfusion (p = 0.05), indicating an improvement in organ function. Additionally, cord blood transfusions significantly reduced the need for inotropic support (from 34.8% to 12.0%, p < 0.001), increased culture negativity (from 29.3% to 10.9%, p = 0.002), decreased procalcitonin levels (from 21.7% to 5.4%, p = 0.001), and reduced C-reactive protein levels (from 27.2% to 10.9%, p = 0.005). In contrast, the whole blood group did not demonstrate significant improvements in these parameters. Conclusion: This study demonstrates that cord blood transfusions significantly improve outcomes in neonatal sepsis compared to whole blood transfusions. Key findings include reduced N-SOFA scores, decreased inotropic support needs, and lower inflammatory markers in the cord blood group, indicating enhanced organ function and immune modulation. These results support the use of cord blood transfusions as a promising therapeutic option for critically ill neonates, warranting further exploration and clinical implementation. 

Background: Subacute thyroiditis, also known as De-Quervain’s thyroiditis (DT), is a rare condition with an incidence of 4.9 cases per 100,000/ year. The usual work-up includes history-taking, neck examination, thyroid function test, ultrasonography (USG) of the thyroid gland, and a fine-needle aspiration cytology (FNAC). They often show nodules on examination which may appear neoplastic, thus warranting an intensive surgical treatment. This is a self-limiting condition, often with a preceding history of fever or infection.  Case Details A total of 656 cases of thyroid lesions were observed over a period of 24 months among which 14 cases of DT were diagnosed on FNAC. Females outnumbered the males with a ratio of 3.6:1. All the patients complained of painful thyromegaly. On USG, 10 cases (71.4%) showed hypoechoic nodules with ill-defined margins and 4 cases (28.6%) showed diffuse geographical areas. Six patients showed increased vascularity peripherally. Eleven patients were hyperthyroid, 2 patients were hypothyroid and 1 patient was euthyroid. Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) were elevated in 6 cases (42.8%). FNAC in all showed granulomatous inflammation along with multinucleated giant cells engulfing colloid. Ten patients were followed up over 6 months among which 8 patients had disappearance of pain and nodules while another 2 were hypothyroid after 6 months. Conclusion DT may appear dangerously neoplastic at presentation but resolves spontaneously or with anti-inflammatory medication. FNAC helps in precise diagnosis and prevent surgical intervention.  

Objective: To assess the relationship between levels of CRP, IL-6, and fibrinogen with the incidence of cardiovascular events with known cardiovascular risk factors. Methodology:  This prospective cohort study aimed to investigate the predictive role of inflammatory biomarkers (C-reactive protein [CRP], interleukin-6 [IL-6], and fibrinogen) in forecasting cardiovascular events. The study included 500 participants aged 40 to 75 years with at least one cardiovascular risk factor, such as hypertension, diabetes, hyperlipidaemia, or smoking history. Baseline blood samples were collected to measure CRP, IL-6, and fibrinogen levels, and participants were followed for 5 years. Cardiovascular events, including myocardial infarction, stroke, and sudden cardiac death, were recorded during the follow-up period. Results: The study found that elevated levels of CRP, IL-6, and fibrinogen were significantly associated with an increased incidence of cardiovascular events. Participants in the highest quartiles of these biomarkers had notably higher event rates compared to those in the lowest quartiles (p = 0.03 for CRP, p = 0.04 for IL-6, and p = 0.02 for fibrinogen). Cox proportional hazards regression analysis revealed that each unit increase in CRP, IL-6, and fibrinogen corresponded to a 45%, 23%, and 31% higher hazard of experiencing a cardiovascular event, respectively (p ≤ 0.05 for all biomarkers). Conclusion: This study highlights the significant role of inflammatory biomarkers in predicting cardiovascular events, especially in individuals with established cardiovascular risk factors. Elevated levels of CRP, IL-6, and fibrinogen were found to be strong predictors of adverse cardiovascular outcomes, suggesting that these biomarkers may improve cardiovascular risk stratification and help identify high-risk individuals for early intervention. Further research is needed to explore their potential integration into clinical practice for more effective prevention strategies

Objective: To evaluate the antioxidant capacity, anti-inflammatory effects, and potential side effects of synthetic and natural antioxidants in controlling oxidative stress in inflammatory conditions. Methodology: This study aimed to compare the efficacy of synthetic and natural antioxidants in reducing oxidative stress and inflammation in 100 individuals with inflammatory diseases. A randomized controlled trial was conducted with participants assigned to either a synthetic antioxidant group or a natural antioxidant group, with assessments at baseline, 3 months, and 6 months. Key outcomes measured included reactive oxygen species (ROS), inflammatory markers (C-reactive protein [CRP] and tumor necrosis factor-alpha [TNF-α]), and Disease Activity Score (DAS28). Statistical analyses, including t-tests, ANOVA, and multivariate regression, were employed to compare the changes in these markers between the two groups over time. Result: The results revealed that both antioxidant groups experienced significant reductions in ROS, CRP, and TNF-α, with the natural antioxidant group showing a more pronounced improvement. At 6 months, the natural antioxidant group exhibited a 53.5% reduction in ROS levels, compared to a 40% reduction in the synthetic antioxidant group. Similarly, the natural antioxidant group showed greater reductions in CRP and TNF-α, and a significantly lower DAS28 score (2.7) compared to the synthetic antioxidant group (3.5). Statistical significance was observed at both the 3-month (p = 0.04) and 6-month (p = 0.02) time points for disease activity. Conclusion: Natural antioxidants demonstrated superior efficacy in reducing oxidative stress, inflammation, and disease activity compared to synthetic antioxidants. These findings suggest that natural antioxidants may offer a more effective and comprehensive therapeutic approach for managing inflammatory diseases, potentially leading to better long-term clinical outcomes. Further research is warranted to explore the underlying mechanisms and the broader applicability of natural antioxidants in clinical practice.

Background: The laboratory hematological and inflammatory biochemical markers may help to predict COVID-19 prognosis. Many studies were pinpointed various prognostic markers, including D-dimer, C-reactive protein (CRP), lactate dehydrogenase (LDH), and high-sensitivity cardiac troponin, in serum of COVID-19 patients with poor outcomes. Deep analysis of abnormal levels of such factors and the interface between their functions in the organs of the body and mechanisms of viral infection can provide the basis for first-line diagnosis as an efficient screening tool to predict the severity of the disease. Thus our study was planned to evaluate the hematological and inflammatory biochemical parameters to rule out the severity of the SARS Covid-19 among the affected patients in our set up. Research Question: Is  there any difference of Hematological, biochemical and radiological abnormalities between survived and non survived patients affected with SARS - COVID 2 Pneumonia?  The setting of the study was at Department of General Medicine, Mahatma Gandhi Medical College and Research Institute, Pondicherry.  A six months observational study was conducted during the period from January, 2021 to June, 2021 on about 240 SARS Covid-19 patients admitted during the above period in the department of General Medicine by studying their socio-demographic profiles, CBP, LFT, RFT, Serum electrolytes, Serum albumin, RBS & HbA1C, D-dimer and CT- Severity score etc; .Results: Majority (74%) of the study subjects were belong to 50 years and above age group with the mean age 58.5 years      and males (64%) were more when compared to females (36%) in this study. And also it was noticed that, the ratio of male & female was same among both the survivers and non survivors groups. Significantly (P<0.05) about 52.5% of study subjects of Non survivors group fall under severe ARDS when compared to survivors group (15.3%) basing on the NLR report. Also it was observed that significantly (P>0.05) about 70.8%% of study subjects of Non survivors group fall under severe ARDS when compared to survivors group (12.1%) basing on the PF ratio. Furthur with reference to Hematological and Biochemical inflammatory parameters significant results of differences were observed among Total count, Platelet count, Ferritin, LDH, D-dimer, Serum creatinine, Liver function tests of ALP,ALT & AST and Serum electrolytes (Sodium & Potassium) etc; between both the groups of Non survivors and Survivors.

Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. Inflammation plays a central role in the initiation and progression of atherosclerosis, which leads to CAD. Inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL-6), and fibrinogen have been implicated in CAD severity, but their precise role in predicting CAD outcomes remains an area of active research. This study aims to evaluate the association between inflammatory markers and CAD severity, focusing on CRP, IL-6, and fibrinogen, in patients categorized into high and low inflammation groups. Methodology: A cross-sectional observational study was conducted at a tertiary care hospital over a period of 2 years, enrolling 128 patients diagnosed with CAD. Patients were categorized into two groups based on serum levels of CRP, IL-6, and fibrinogen: high inflammation (n=64) and low inflammation (n=64). Demographic and clinical data were collected, and the severity of CAD was assessed using coronary artery stenosis and the Gensini score. Spearman's rank correlation was used to evaluate the relationship between inflammatory markers and CAD severity. Results: The high inflammation group had significantly higher levels of CRP (15.2 ± 5.3 mg/L), IL-6 (11.4 ± 4.5 pg/mL), and fibrinogen (4.8 ± 0.9 g/L) compared to the low inflammation group (p < 0.001 for all markers). However, no significant difference in CAD severity, based on coronary artery stenosis or the Gensini score, was observed between the two groups. The correlation analysis revealed a significant positive relationship between all three inflammatory markers and CAD severity (p < 0.001 for CRP and IL-6, p = 0.003 for fibrinogen). Conclusion:This study highlights the significant elevation of inflammatory markers in CAD patients with high inflammation. While CRP, IL-6, and fibrinogen were correlated with CAD severity, no significant differences in stenosis or Gensini scores were observed between high and low inflammation groups. These findings suggest that inflammation may contribute to CAD progression but further studies are needed to clarify its role in determining disease severity. Inflammatory markers could serve as potential biomarkers for assessing CAD risk and severity in clinical practice

Background: The COVID-19 pandemic has posed significant challenges, particularly for individuals with underlying health conditions such as Type 2 Diabetes Mellitus (T2DM). Understanding the interplay between T2DM and COVID-19 severity is crucial, given the contradictory findings regarding diabetes as a comorbidity affecting COVID-19 outcomes. This study aims to investigate the clinical relationship between T2DM and COVID-19 to fill the knowledge gap and inform better treatment strategies. Objective: To compare the clinical outcomes, laboratory parameters, and complications of COVID-19 between patients with and without T2DM.Methods: This retrospective cohort study was conducted at SCB Medical College and Hospital, Cuttack, including 180 COVID-19 patients (90 with T2DM and 90 non- diabetic) admitted between September 2020 and September 2021. Data on demographics, clinical presentations, laboratory findings, and outcomes were collected. Statistical analyses included the Chi-Square Test for categorical data and Spearman’s Correlation Coefficient for continuous data, using SPSS software version 26. Results: The mean age was slightly higher in diabetic patients (52.2 years) compared to non-diabetic patients (49.67 years), with a male predominance in both groups. Diabetic patients exhibited more severe disease (78.9%) compared to non-diabetics (64.4%) with a significant association between diabetes and COVID-19 severity (Χ² = 7.2053, p = 0.0273). Laboratory analysis showed higher Random Blood Sugar (RBS) and C-Reactive Protein (CRP) levels in diabetics. Significant differences were observed in SGPT and inflammatory markers (LDH, D-dimer, ferritin, and procalcitonin), indicating heightened inflammatory response in diabetics. Complications such as acute kidney injury (AKI), sepsis, and multiple organ dysfunction syndrome (MODS) were more prevalent in diabetic patients, with higher mortality rates (OR=2.55, 95% CI=1.27-5.09, p=0.007). Conclusion: T2DM significantly exacerbates the severity and complications of COVID-19, highlighting the need for tailored clinical management for diabetic patients during the pandemic. Further research is required to explore underlying mechanisms and improve therapeutic strategies for this high-risk group.

Background: Polycystic Ovary Syndrome (PCOS) affects up to 20% of women of reproductive age globally, with chronic inflammation implicated in infertility and adverse pregnancy outcomes. Objective: To investigate the role of inflammatory pathways in PCOS-related infertility and pregnancy complications, highlighting their contribution to altered reproductive and metabolic health. Methods: A one-year observational study was conducted at Akash Institute of Medical Sciences and Research Center, Bangalore, involving 150 women diagnosed with PCOS. Participants underwent clinical assessments, hormonal profiling, and inflammatory marker evaluation, including C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). Statistical analysis involved correlation coefficients and multivariate regression to explore associations between inflammatory markers and clinical outcomes. Results: Elevated levels of CRP (mean: 6.2 ± 1.3 mg/L), IL-6 (mean: 3.8 ± 0.9 pg/mL), and TNF-α (mean: 12.4 ± 2.1 pg/mL) were observed in 78% of participants. Among infertile women (56%), inflammatory markers were significantly higher (CRP: +18%; IL-6: +22%; TNF-α: +25%) compared to fertile counterparts (p < 0.01). Pregnancy complications, including gestational diabetes (34%) and preeclampsia (18%), showed positive associations with inflammatory marker levels (p < 0.05). Multivariate analysis revealed CRP as the strongest predictor of adverse outcomes (β = 0.42, p < 0.001). Conclusions: This study underscores the pivotal role of inflammatory pathways in PCOS-related infertility and pregnancy complications, advocating for targeted anti-inflammatory interventions to improve clinical outcomes.

An accumulating body of evidence has established that one of the clinical implications of vitamin D deficiency in diabetes mellitus (DM) is the contribution of cardiovascular disease (CVD) among different groups. Objectives: This study aims to investigate the correlation of Vitamin D levels with cardiovascular risk and their association in diabetic patients compared to healthy controls, along with the correlation with significant biomarkers. Materials and Methods: This cross-sectional study was conducted on 240 participants (120 diabetic patients and 120 control group). Standardized approaches were used to evaluate Serum Vitamin D concentrations, lipid profiles, glycaemic parameters, pro-oxidant biomarkers, and inflammatory biomarkers. T-tests and correlation analyses were performed to conduct statistical analyses of significant associations. Results: The diabetic group had significantly lower vitamin D status (13±5 ng/mL) compared to healthy subjects (28.2±8 ng/mL, p<0.001). Vitamin D was found to have strong inverse correlations with low-density lipoprotein (LDL) (r = -0.65, p < 0.001), high-sensitivity C-reactive protein (hs-CRP) (r = -0.58, p < 0.001), and systolic blood pressure (r = -0.52, p < 0.001). Based on sex, it was found that the prevalence of vitamin D deficiency was 65 % among women as compared to 45 % among men (p < 0.05).

Introduction: In the developing world, peripheral arterial disease (PAD) is a major health issue that is becoming more prevalent as a result of rising risk factors. Minor impairments to limb loss are among its complications. The primary cause of PAD is atherosclerosis. Lower extremities artery disease affects more than 200 million people globally, with symptoms ranging from mild to severe. Materials And Methods: The study was a comparative study done on 40 patients with signs and symptoms of peripheral arterial occlusive disease referred for evaluation by imaging by colour doppler ultrasonography and MDCT angiography to the department of Radiodiagnosis at MNR Medical College Hospital were included in the study. Results

In comparison of colour doppler ultrasound versus MDCT, there is statistically extremely significant difference in the detection of the extent of segment involvement in ATA. Conclusion: MDCT is better than Doppler in detecting the length of stenosis in the arterial system.MDCT is better than Doppler in detecting the presence of thrombosis especially in the infra-popliteal segment.Even though MDCT is not statistically significant than Doppler in detecting the number of collateral segments , as the arterial tree is better delineated in MDCT , this modality is needed to be performed before any vascular intervention is planned.Doppler is also an effective tool which can detect the lesions to a comparable extent when no intervention is planned and only medical therapy is considered

Asymptomatic bacteriuria (ASB) is a prevalent condition in Type-2 Diabetes Mellitus (T2DM) patients, often exacerbated by the chronic inflammatory milieu associated with diabetes. This study aims to evaluate and compare the levels of key inflammatory biomarkers—Interleukin-6 (IL-6), Tumor Necrosis Factor-alpha (TNF-α), C-reactive protein (CRP), and Hemoglobin A1c (HbA1c)—in T2DM patients with and without ASB in Northern Andhra Pradesh. IL-6 and TNF-α are pivotal pro-inflammatory cytokines that contribute to both the pathogenesis of insulin resistance and the inflammatory response during bacterial infections. Elevated IL-6 and TNF-α levels are associated with poor glycemic control and increased susceptibility to infections, including urinary tract infections. CRP, an acute-phase reactant, is commonly elevated in systemic inflammation and serves as a reliable marker for infection and inflammation, which is critical in assessing the risk of ASB in diabetic patients. HbA1c, reflecting long-term blood glucose control, is also implicated in chronic inflammation, with poorly controlled diabetes being linked to higher inflammation and infection rates. By assessing these biomarkers, this study aims to elucidate the relationship between systemic inflammation, glycemic control, and the incidence of ASB in T2DM.

Background: India has reported a recent surge in Mucormycosis cases. Mucormycosis is a rare, life-threatening fungal infection having an increased incidence during this COVID-19 pandemic, especially in the second wave in India. Number of rhino-orbito-cerebral mucormycosis cases Post COVID-19 infection increased in Ahmednagar.  Aims and Objectives: To study the early contact of mucormycosis infection after covid positive test. To study the relation of D-Dimer, C-Reactive protein, Sr. Ferritin, blood group and HbA1c to mucormycosis infection. To study the incidence of death rate in mucormycosis patient. Materials and Methods: This retrospective clinical analysis includes data collection of 30 patients from tertiary care hospital located in Ahmednagar district of Maharashtra, India from 1st May, 2021 to 31st August, 2021. All these were post COVID-19 patients presented after varying number of days postinfection and had undergone indoor treatment at various hospitals. Results: We had majority of the patients with blood group O+ 13 cases (43.33%), followed by A+ 9 cases (30%) and B+ 6 cases (20%). KOH mount showed Zygomycetes fungus in all specimens. Debridement was done in 22 patients (73.33%). There were 10 deaths in our study participants (33.33%). We observed a significant difference in Serum ferritin levels (p = 0.048) and HbA1c levels (p = 0.017) in patients who had died of Mucormycosis as compared to those who survived. Conclusion: Close correlation was observed between rhino-orbito-cerebral mucormycosis, diabetes mellitus and Serum Ferritin level in COVID-19 positive patients. Possible follow up and larger sample size will be needed to justify these results more.

Background: Acute Myocardial infarction (AMI) causes reduction in cardiac function and is one of major cause of death world-wide. The degree of myocardial damage following myocardial infarction is the key predictor of immediate as well as long term reduction in cardiac function and other complications. The serum CK- MB (Creatine Kinase-MB) levels are useful for assessing prognosis after AMI, the validity of the test goes down after 36 hours due to sudden fall in levels.Serum C-Reactive Protein (CRP), an acute phase protein, also increases during myocardial infarction in proportion to the degree of inflammation. The inflammatory process following myocardial infarction is a key role in determining the real damage to the myocardium following infarction. In this study, we made an attempt to find the correlation between serum CRP levels with CK-MB and left ventricular ejection fraction (LVEF) to assess if serum CRP levels could be used as a proxy to CK-MB levels for the prediction of inflammation and infarct extent, thereby having a reliable prognostication marker after 48 hours. Methods: 55 Patients diagnosed with acute myocardial infarction in a tertiary care centre were enrolled in the study. Serum CRP levels were measured and its correlation with Serum CK-MB levels and left ventricular ejection fraction were studied. Results: The Serum CRP levels were showing significant positive correlation with serum CK-MB levels and significant negative correlation with Left ventricular ejection fraction. Conclusions: The magnitude of elevation of CRP, the marker of inflammation in circulation correlates with the extent of myocardial injury following infarction showed significant positive correlation with CK-MB levels and a significant negative correlation with LVEF. So it could be used to predict the functional status of myocardium following acute MI. So the serum CRP can be used as an independent and more comprehensiveprognostic marker, like CK-MB and LVEF

Background: Metabolic Syndrome (MetS) is a cluster of conditions including obesity, hypertension, dyslipidemia, and insulin resistance, which significantly increase the risk of cardiovascular diseases (CVD). Emerging evidence suggests that gut microbiota plays a pivotal role in regulating metabolic homeostasis and inflammatory responses. This study aimed to evaluate the impact of gut microbiota modulation through dietary interventions and probiotics on inflammatory markers and cardiovascular risk in patients with MetS. Materials and Methods: A total of 120 adult patients diagnosed with MetS, aged between 30 and 65 years, were randomly divided into three groups: Group A (Dietary intervention), Group B (Probiotic supplementation), and Group C (Control - standard care). Interventions were administered over a 12-week period. Serum inflammatory markers including C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were measured pre- and post-intervention. Cardiovascular risk was assessed using lipid profiles and arterial stiffness indices. Statistical analysis was performed using ANOVA and paired t-tests, with a significance level set at p < 0.05. Results: Following the intervention, Group A exhibited a significant reduction in CRP (from 4.8 ± 0.6 mg/L to 3.2 ± 0.5 mg/L, p < 0.01), IL-6 (from 12.5 ± 1.2 pg/mL to 9.3 ± 1.1 pg/mL, p < 0.01), and TNF-α (from 18.6 ± 2.1 pg/mL to 14.8 ± 1.8 pg/mL, p < 0.01). Similar trends were observed in Group B with reductions in CRP (from 4.7 ± 0.7 mg/L to 3.4 ± 0.6 mg/L, p < 0.05), IL-6 (from 12.4 ± 1.3 pg/mL to 10.1 ± 1.0 pg/mL, p < 0.05), and TNF-α (from 18.4 ± 2.0 pg/mL to 15.0 ± 1.7 pg/mL, p < 0.05). However, Group C showed no significant changes. Lipid profiles improved significantly in Groups A and B compared to the Control group. Conclusion: The modulation of gut microbiota through dietary interventions and probiotic supplementation significantly reduces inflammatory markers and improves cardiovascular risk profiles in patients with MetS. These findings highlight the potential of gut microbiota-targeted therapies as an adjunctive approach for managing MetS and reducing CVD risk.

Background:  Post-surgical inflammatory responses significantly influence wound healing and overall surgical outcomes. Understanding the pathological mechanisms underlying these inflammatory processes is crucial for optimizing patient recovery and minimizing complications. This study aims to assess the intensity and characteristics of post-surgical inflammatory responses and their implications for wound healing and surgical outcomes. Materials and Methods: A prospective study was conducted involving 60 patients undergoing elective surgeries across various surgical specialties. Blood samples and tissue biopsies were collected at baseline (pre-surgery), 24 hours, 72 hours, and 7 days post-surgery. Histopathological analysis, inflammatory biomarker assays (C-reactive protein, IL-6, TNF-α), and wound healing assessments were performed. Inflammatory response scores were calculated based on cellular infiltration, edema, and tissue necrosis. Statistical analysis was conducted using ANOVA and Pearson's correlation to determine associations between inflammatory markers and wound healing efficiency. Results: Patients exhibited a significant elevation in inflammatory biomarkers post-surgery, with peak levels recorded at 24 hours (CRP: 35.2 ± 6.1 mg/L, IL-6: 90.4 ± 12.5 pg/mL, TNF-α: 65.7 ± 8.9 pg/mL). Histopathological analysis revealed substantial neutrophil infiltration and tissue edema within the first 72 hours, gradually transitioning to macrophage-dominant infiltration by day 7. Patients exhibiting lower inflammatory marker levels (CRP < 25 mg/L, IL-6 < 70 pg/mL, TNF-α < 50 pg/mL) demonstrated superior wound healing scores (P < 0.05) compared to those with higher levels. A positive correlation was observed between elevated inflammatory markers and delayed wound healing. Conclusion: The intensity of post-surgical inflammatory responses plays a pivotal role in determining wound healing efficiency and surgical outcomes. Elevated levels of inflammatory biomarkers are associated with delayed healing and increased complication rates. Targeted interventions to modulate inflammation may improve surgical recovery and patient outcomes.

Background:  Chronic inflammation plays a crucial role in tumor initiation, progression, and metastasis. In breast carcinoma, inflammatory markers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and neutrophil-to-lymphocyte ratio (NLR) have shown potential as prognostic indicators. This study aimed to evaluate the correlation between selected inflammatory markers and histopathological tumor grades in patients with breast carcinoma. Materials and Methods: A cross-sectional observational study was conducted over a period of 12 months in the Department of Pathology, involving 100 histologically confirmed breast carcinoma patients. Blood samples were collected prior to treatment initiation to assess levels of CRP, ESR, and NLR. Tumor grading was performed according to the Nottingham histologic score system. Statistical analysis was carried out using Pearson’s correlation and ANOVA, with p-value <0.05 considered significant. Results: Among the 100 patients, 30% had Grade I tumors, 45% had Grade II, and 25% had Grade III tumors. Mean CRP levels were significantly higher in Grade III (11.2 ± 2.5 mg/L) compared to Grade I (4.3 ± 1.1 mg/L) (p<0.01). Similarly, ESR and NLR showed a positive correlation with tumor grade (r=0.62 and r=0.58 respectively, p<0.01). A statistically significant association was found between higher inflammatory marker levels and increased tumor grade. Conclusion: The study demonstrates a positive correlation between inflammatory markers and tumor grade in breast carcinoma. Elevated CRP, ESR, and NLR levels may serve as accessible and cost-effective indicators for tumor aggressiveness, aiding in prognostic evaluation and treatment planning.

Background: Acute Myocardial Infarction (AMI) remains a major global health burden, with early risk stratification playing a critical role in optimizing patient outcomes. Admission hyperglycemia in non-diabetic individuals has emerged as a potential prognostic marker, though its clinical implications remain unclear. Objectives: This study aims to evaluate the prognostic significance of admission hyperglycemia in non-diabetic patients with AMI, assessing its impact on in-hospital mortality and major adverse cardiac events (MACE). Methods: An observational study was conducted at a tertiary care hospital over 24 months, enrolling 260 non-diabetic patients with AMI. Admission blood glucose levels were measured, with hyperglycemia defined as ≥140 mg/dL. Patients were categorized into normoglycemia and hyperglycemia groups. Baseline characteristics, inflammatory markers, cardiac function, and clinical outcomes were analyzed. Statistical comparisons were performed using t-tests, chi-square tests, and logistic regression analysis. Results: The hyperglycemia group had significantly higher levels of inflammatory markers (C-reactive protein and white blood cell count) and greater myocardial injury (elevated troponin I and CK-MB) compared to the normoglycemia group (p < 0.05). Left ventricular ejection fraction was significantly lower in hyperglycemic patients (45.8% vs. 51.4%, p < 0.001). In-hospital mortality was notably higher in the hyperglycemia group (16.9% vs. 6.2%, p = 0.009), along with an increased incidence of heart failure, arrhythmias, cardiogenic shock, and reinfarction (p < 0.05 for all). Patients with hyperglycemia also had a longer hospital stay (7.3 ± 3.2 days vs. 5.7 ± 2.1 days, p = 0.004). Conclusion: Admission hyperglycemia in non-diabetic AMI patients is associated with increased myocardial injury, a heightened inflammatory response, and poorer clinical outcomes, including higher in-hospital mortality and MACE. These findings highlight the need for early recognition and potential interventions targeting stress hyperglycemia in this patient population.

Background: Chronic Obstructive Pulmonary Disease (COPD) is associated with chronic systemic inflammation, and C-reactive protein (CRP) is a key biomarker. This study evaluates CRP levels in stable COPD patients compared to healthy controls. Methods: A case-control study included 40 stable COPD patients (GOLD stages 1–4) and 40 age- and sex-matched healthy controls. Serum CRP was measured using high-sensitivity CRP (hs-CRP) assay. Spirometry confirmed COPD severity. Statistical analysis was performed using SPSS v26. Results: Mean CRP was significantly higher in COPD patients (5.2 ± 2.1 mg/L) vs. controls (1.8 ± 0.9 mg/L) (p < 0.001). CRP increased with GOLD stages (Stage 1: 3.1 ± 1.2 mg/L, Stage 4: 7.5 ± 2.4 mg/L; p < 0.01). No significant difference was found between current and ex-smokers (p = 0.45). Conclusion: Elevated CRP in stable COPD suggests persistent systemic inflammation, correlating with disease severity. CRP may aid in monitoring disease progression and guiding therapy.

Background: The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a major healthcare problem around the world, with significantly higher morbidity and mortality in patients with coexisting conditions such as diabetes mellitus and hypertension (1). As zinc deficiency results in altered numbers and dysfunction of all immune cells, subjects with suboptimal zinc state have an increased risk for infectious diseases, autoimmune disorders, and cancer (5-8).    Aim & Objectives: To estimate the serum levels of zinc and CRP (C-reactive protein) in COVID-19 positive patients and to correlate serum zinc levels with CRP in COVID- 19 positive patients. Materials and Methods: Total of 86 patients who were COVID-19 positive by RTPCR (reverse transcription polymerase chain reaction) were included in the study. 5 ml of venous blood is collected, serum separated and utilized for the estimation of serum zinc and CRP by fully automated analyser according to the instructions provided in the kit by the manufacturer. Results: The mean value of serum zinc (97.53 mcg/dl) in male patients is more when compared to the mean value (87.11 mcg/dl) in female patients and the difference is not statistically significant (p =0.26). The mean value of CRP in male patients(2.14 mg/dl )  is lower than the mean value in female patients (3.15mg/dl) and the difference is not statistically significant (p=0.168).The mean value of serum in zinc in patients with age >50 years (100.22 mcg/dl) is more when compared to the mean value of patients with age group <50 years (85.68 mcg/dl)  and the difference is  not statistically significant (p=0.121).The mean value of CRP in patients with age >50 years (2.91 mg/dl) is slightly more when compared to the mean value of patients with age <50 years (2.39 mg/dl) and the difference is not statistically  significant (p=0.480). Conclusion: The present study showed that the mean value of serum zinc is high and CRP is low in male patients compared to the female patients, the mean value of zinc is high in patients with age >50 years than in patients with age <50 years. Further research is required considering a large sample size and other comorbidities.

Background: The most frequent reason for emergency surgery worldwide is appendicitis.  It cannot be diagnosed with a single laboratory or radiological test.  Numerous standard and new blood markers have been discovered, however none have turned out to be definitive.  This study was done to understand the correlation between blood markers like CRP to acute appendicitis Methodology: This study was a retrospective and descriptive observational study done in a tertiary medical college in central India from 1st October 2023 to September 2024 on a total of 241 patients of acute appendicitis undergoing appendectomies in the dept. of General surgery. We reviewed all of the admission bloods for the patients - including their white blood cell (WBC) count, their neutrophil count, and their C-Reactive protein (CRP) value. We also reviewed all of the histology to identify the inflamed appendices, and analyzed all of this information together. Observation And Results: In our study we observed that the neutrophil count is the most sensitive of the three blood markers with a score of 82%. It has a specificity of 63%. The CRP value is the most specific of the three blood markers with a value of 67% and a sensitivity of 76%. WBC has a sensitivity of 75% and a specificity of 63%. Combining all of the blood values (i.e. elevated white blood cell count or elevated neutrophil count or elevated CRP) demonstrates a sensitivity of 96% and a specificity of 45%. Conclusions: In cases of abdominal pain, combining routine admission blood markers (WBC, neutrophil count, and CRP) can assist in diagnosing appendicitis.

Background: PPROM, occurring in 2–4.5% of pregnancies, is a major contributor to preterm births and perinatal mortality, with microbial invasion increasing maternal and neonatal risks. CRP, an inflammatory biomarker, may help predict adverse outcomes in PPROM cases. Methodology: A prospective observational study of 78 PPROM cases analyzed CRP levels and their association with maternal and neonatal outcomes, categorizing participants into CRP-positive and CRP-negative groups. Results: Elevated CRP levels correlated with higher maternal complications (sepsis, UTI, atonic PPH), increased neonatal morbidity (lower APGAR scores, perinatal depression), and longer NICU stays, with more C-sections and labor inductions in the CRP-positive group. Conclusion: While CRP is a useful inflammatory marker, its predictive value for chorioamnionitis remains uncertain, and routine serial monitoring may not significantly alter clinical management. Further research is required to refine its role in PPROM care.

Background: First-episode psychosis (FEP) is often associated with alterations in the hypothalamic-pituitary-adrenal (HPA) axis and immune system dysfunction. Cortisol, a key stress hormone, along with inflammatory biomarkers such as interleukin-6 (IL-6) and C-reactive protein (CRP), have been implicated in the pathophysiology of psychotic disorders. Understanding these alterations may aid in early identification and intervention strategies for psychosis. Materials and Methods: This cross-sectional study involved 60 participants, comprising 30 patients diagnosed with first-episode psychosis and 30 age- and sex-matched healthy controls. Blood samples were collected between 8:00 and 9:00 AM to measure serum cortisol, IL-6, and CRP levels. All participants underwent clinical evaluation using the Positive and Negative Syndrome Scale (PANSS). Data were analyzed using independent t-tests and Pearson correlation coefficients. Results: The FEP group showed significantly elevated mean cortisol levels (21.8 ± 6.2 µg/dL) compared to controls (14.5 ± 4.3 µg/dL, p < 0.001). Similarly, IL-6 (5.6 ± 1.8 pg/mL vs. 2.9 ± 1.2 pg/mL, p = 0.002) and CRP levels (4.1 ± 1.5 mg/L vs. 1.7 ± 0.9 mg/L, p = 0.003) were higher in FEP patients. Positive correlations were observed between cortisol and PANSS total score (r = 0.42, p = 0.01), and between IL-6 and CRP (r = 0.53, p < 0.001). Conclusion: Patients with first-episode psychosis exhibit significant dysregulation in both cortisol secretion and inflammatory responses. These findings support the hypothesis of HPA axis hyperactivity and immune activation in early psychosis, highlighting the potential role of these biomarkers in the pathophysiological assessment and management of psychotic disorders.

Introduction Patients with end-stage kidney disease (ESKD), especially those on dialysis have high inflammatory load leading to endothelial dysfunction which results in high cardiovascular morbidity and mortality. There are very few studies comparing inflammatory markers in children on peritoneal dialysis (PD) and haemodialysis (HD). The primary objectives of this study were to measure inflammatory marker levels in children with ESKD on maintenance dialysis and compare the levels in those undergoing HD and PD.  Methods This was a cross-sectional hospital-based study involving children aged 1-18 years on maintenance HD or PD for at least 3 months. The inflammatory marker levels (Fibroblast Growth Factor 23 (FGF23), high sensitivity C-Reactive Protein (hsCRP) and Interleukin-6 (IL-6)) were measured in all children on maintenance dialysis and compared between the two groups as well as correlated with clinical and laboratory parameters.  Results A total of 16 children were included in the study (10 on PD and 6 on HD). The mean hsCRP was 3.20±0.69 mg/L in all dialysis patients, 3.14±0.59 mg/L in HD group and 3.28±0.87 mg/L (p=0.515) in PD group. The mean IL-6 was 1.69±0.46 pg/ml in all dialysis patients, 1.81±0.37 pg/ml in HD group and 1.50±0.56 pg/ml in PD group (p=0.913). The mean FGF 23 was 811.54±128.6 ng/ml in all dialysis patients, 821.7±137.9ng/ml in HD group and 794.6±121.6 ng/ml in PD group (p=0.233). IL-6 showed positive correlation with dialysis vintage (R=0.509, p=0.044) and FGF23 levels (R=0.547, p=0.028). Conclusion hsCRP and FGF23 were increased in children on dialysis. There was no difference in inflammatory markers in children on HD versus PD. IL-6 levels positively correlated with dialysis vintage and FGF23 levels.

Background: The COVID-19 pandemic, caused by SARS-CoV-2, has been associated with a wide range of clinical presentations, ranging from asymptomatic cases to severe respiratory failure. Inflammatory biomarkers such as C-reactive protein (CRP), D-dimer, and Ferritin have been recognized as important indicators of disease severity and prognosis. This study is aimed to evaluate the levels of these biomarkers in COVID-19-positive patients and correlate them with demographic parameters and clinical outcomes. Methods: A Retrospective Observational Study was conducted in the Department of Pathology, Central Laboratory, RGSSH, OPEC, RIMS, Raichur, from June 2021 to May  2022. A total of 400 COVID-19-positive patients were included. Data on CRP, D-Dimer, and Ferritin levels were collected and analyzed concerning gender, age group, and clinical outcome (ICU vs. ward admission). Results: Of the 400 patients, 58.3% were male and 41.7% were female. The majority belonged to the age group of 41–60 years. Statistically significantly higher levels of CRP (p = 0.02) and D-dimer (p < 0.001) were observed in ICU patients compared to ward patients, while the difference in ferritin levels was not statistically significant (p=0.142). There was no significant association of biomarker levels with gender. However, D-dimer levels showed a significant correlation with age (p = 0.004), with the highest levels in patients above 80 years. Conclusion: Elevated CRP and D-dimer levels are significantly associated with severe COVID-19 infection and ICU admission. These biomarkers may serve as valuable tools for the early identification of high-risk patients, aiding in timely clinical decision-making. Regular monitoring of these markers is recommended to improve patient outcomes.

Background: Inflammation and metabolic dysregulation have been implicated in the pathophysiology of Major Depressive Disorder (MDD). C-reactive protein (CRP) and lactate dehydrogenase (LDH) are peripheral biomarkers with emerging relevance in mood disorders, yet their diagnostic and prognostic utility remains underexplored. Methods: We conducted a retrospective case–control study at Vilasrao Deshmukh Government Medical College, Latur, analyzing 145 participants (72 MDD patients, 73 age- and sex-matched healthy controls) from March 2022 to March 2024. Serum CRP and LDH levels were measured using turbidimetric immunoassay and NADH oxidation method, respectively. Group comparisons were performed using independent samples t-tests, while correlations with Hamilton Depression Rating Scale (HDRS) scores and suicidal ideation were assessed via Pearson’s and Spearman’s coefficients. Receiver operating characteristic (ROC) analysis was used to evaluate predictive performance. Results: CRP levels were significantly elevated in MDD cases compared to controls (5.82 ± 1.42 mg/L vs. 2.61 ± 1.03 mg/L, p < 0.00001), while LDH levels were significantly reduced (158.0 ± 18.0 U/L vs. 182.1 ± 15.0 U/L, p < 0.00001). However, neither biomarker correlated significantly with HDRS scores (CRP: r = 0.08; LDH: r = 0.06) or suicidal ideation (CRP: AUC = 0.57; LDH: AUC = 0.56). Effect sizes for group differences were large (Cohen’s d = 2.30 for CRP, –1.41 for LDH). Conclusions: CRP and LDH may serve as accessible diagnostic biomarkers for distinguishing MDD from healthy states, but their limited association with symptom severity and suicidal ideation restricts their utility in risk stratification. Broader, multimodal biomarker frameworks are needed for clinical application in personalized psychiatry.

Background: Chronic stress is known to dysregulate the hypothalamic–pituitary–adrenal (HPA) axis, leading to altered cortisol secretion and immune system dysfunction. Disruption in diurnal cortisol rhythms has been implicated in various stress-related disorders. This study aimed to evaluate HPA axis function in individuals with chronic stress by analyzing salivary cortisol profiles and circulating immune biomarkers. Materials and Methods: A cross-sectional study was conducted involving 60 participants aged 25–45 years, divided equally into two groups: chronic stress (n=30) and healthy controls (n=30). Stress levels were assessed using the Perceived Stress Scale (PSS). Salivary cortisol samples were collected at four time points: upon awakening, 30 minutes post-awakening, mid-afternoon, and bedtime. Serum levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP) were measured using ELISA. Data were analyzed using independent t-tests and Pearson correlation coefficients. Results: Participants with chronic stress exhibited a significantly flattened diurnal cortisol slope compared to controls (mean slope −0.18 ± 0.03 vs. −0.31 ± 0.02; p<0.001). Morning cortisol levels were markedly lower in the stress group (8.2 ± 1.1 ng/mL) than in controls (13.6 ± 1.3 ng/mL; p<0.001). Elevated levels of IL-6 (4.8 ± 0.6 pg/mL vs. 2.3 ± 0.4 pg/mL), TNF-α (6.5 ± 0.9 pg/mL vs. 3.2 ± 0.7 pg/mL), and CRP (2.9 ± 0.5 mg/L vs. 1.1 ± 0.3 mg/L) were observed in the stressed group (p<0.01 for all). A significant negative correlation was found between cortisol slope and IL-6 levels (r = −0.62, p<0.01). Conclusion: Chronic stress is associated with HPA axis dysregulation, characterized by blunted cortisol rhythms and elevated pro-inflammatory immune markers. These findings underscore the role of stress-induced neuroendocrine-immune interactions in disease susceptibility.

Hypertension is one of the most important risk factors for cardiovascular diseases (CVD), particularly ischemic heart disease and stroke (sequelae of hypertension). By compromising endothelial function and encouraging atherosclerosis, inflammatory markers like C-reactive protein (CRP), interleukins (ILs), and tumour necrosis factor-alpha (TNF-α) have been associated with a poor prognosis in individuals with hypertension in CVD studies. A straightforward, affordable, and generally available haematological measure, the neutrophil-to-lymphocyte ratio (NLR) has garnered increasing attention in recent years. Neutrophils and lymphocytes make up NLR, which represents a balance between immunological responses and inflammation. While lymphocytes play a significant role in controlling immunological responses, neutrophils are crucial for the acute inflammatory response. There is no study available about Neutrophil to lymphocyte ration in newly detected hypertension patient. In addition to this correlation of NL Ratio is never studied with Staging of Hypertension hence this is an area of interest. Material and Methods: The present cross-sectional study was conducted from May 2023 to November 2024 in the Department of General Medicine, School of Medical Sciences & Research, Sharda Hospital, Greater Noida, Uttar Pradesh among 100 newly detected hypertensive patients as per inclusion and exclusion criteria, with Age & Sex matched 100 controls.  Results: Of the individuals in the case and control groups, 56% and 4%, respectively, had left ventricular hypertrophy (LVH) was seen amongst 56% of cases and 4% of controls which was statistically significant with p-value <0.01 when the chi square test was used. The case group had higher mean neutrophil %, lymphocyte %, and NLR than the control group. Mean NLR in stage 1 and stage 2 hypertension showed statistically significant increase in value as the BP rises. Hence mean NLR was significantly more in stage 2 hypertension as compared to stage 1 hypertension as p-value=0.007. The Pearson correlation test revealed a substantial positive link between NLR and hypertension staging (r=0.44, p<0.01), meaning that when NLR increases, so do SBP and DBP.  Conclusion: Our study demonstrated a rise in NLR levels as the severity of hypertension increases. Our findings suggest that neutrophils and lymphocytes may be implicated in inflammation, which may be a significant factor in the development of hypertension. These results could be helpful in elucidating the pathophysiological process of hypertension and in the creation of novel treatment strategies that target low-grade inflammation in order to manage hypertension and hypertensive damage.

Background: Type 2 diabetes mellitus (T2DM) is associated with a significantly increased risk of cardiovascular disease (CVD). Inflammation plays a critical role in the pathogenesis of atherosclerosis, and high-sensitivity C-reactive protein (hs-CRP) is an established marker of systemic inflammation. This study aimed to assess the association between hs-CRP levels and cardiovascular risk in patients with T2DM. Methods: A cross-sectional study was conducted among 100 patients with T2DM attending a tertiary care hospital. hs-CRP levels were measured, and cardiovascular risk was assessed using the Framingham Risk Score. Patients were categorized into low, moderate, and high cardiovascular risk groups. Statistical analysis included ANOVA and Pearson’s correlation coefficient. Results: Among 100 participants, 35% were categorized as high cardiovascular risk. Mean hs-CRP levels significantly increased across low (2.1 ± 0.9 mg/L), moderate (3.8 ± 1.2 mg/L), and high (6.2 ± 2.0 mg/L) risk groups (p < 0.001). A strong positive correlation (r = 0.684, p < 0.001) was observed between hs-CRP levels and Framingham scores. Conclusion: Elevated hs-CRP levels are strongly associated with higher cardiovascular risk in T2DM patients. hs-CRP may serve as an effective adjunctive marker in cardiovascular risk prediction and management in diabetic individuals.