Erythrocyte Sedimentation Rate Tests Research Articles

Assessment the Role of Erythrocyte Sedimentation Rate and C-Reactive Protein Tests For Prediction Of Rheumatoid Arthritis Activity In Misan Province

Rheumatoid Arthritis (RA) activity was assessed based on erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) tests. The ESR and CRP tests were monitored in 25 Rheumatoid Arthritis diagnosed patients and 25 healthy approved cases of suspected patients from Missan Province. The sample comprised of 25 male and 25 females with ages varied from 21-68 years and body weights from 45 – 112 kg. ESR readings in RA diagnosed patients varied between 22 – 116 averaged 46.8 mm/h in patients case while those recorded in the healthy approvrd cases ranged between 4-18 averaged 8.4 mm/h. Differences between patients and control cases were statistically significant (P < 0.05). This approved that measuring ESR is a valid tool to predict RA among Missan population. CRP test showed only 2 negative results among RA patients compared with 15 negative results in healthy approved cases. CRP values in patients sample ranged between 10 mg/dl in 11 cases and 24 – 48 mg/dl in another 11 cases with only one highly extreme value of 96 mg/dl. In he healthy approved cases, CRP values ranging from 6-12 mg/dl were recorded in 10 cases and negative results in the rest 15 cases. differences were highly significant (p< 0.01) indicating the validity of CRP test to predict RA cases. Both parameters varied among various age groups, gender and body weight classes. Apparantly both ESR and CRP tests may help to find or monitor inflammation in acute or chronic conditions of rheumatoid arthritis.

Development and implementation of the external quality assessment program for erythrocyte sedimentation rate in hematology laboratories in Thailand

Background: The erythrocyte sedimentation rate (ESR) remains the most widely used screening test for monitoring the course of infections, inflammatory diseases, and some types of cancer. Proficiency Testing (PT) programs are unavailable in Thailand for ESR. Objective: This study aimed to develop and initiate the PT program to improve testing quality through evaluation and analysis of the laboratory test results for ESR. Materials and methods: The PT program for ESR was established at the AMS CMU EQA Unit by the ISO/IEC17043:2010 requirements. The unit produced and sent the ESR control materials to participants for laboratory analysis; the test results were returned to the unit. The PT program was carried out in two cycles per year, with two samples in each cycle. The performance of each laboratory was assessed using robust Z score and performance score. Results: ESR control materials presented with satisfactory homogeneity and stability according to ISO 13528: 2015. One hundred and four laboratories were enrolled in the PT program. Of these laboratories, 96 (92.3%) returned their data: 40 (42.7%) used the modified Westergren method, 29 (29.2%), 14 (15.7%), and 13 (12.4%) used Microsed, Mixrate, and other methods, respectively. Satisfactory and questionable performance was obtained in 82/96 (85.4.%) and 8/96 (8.3%), respectively. Unsatisfactory performance was noted at 6/96 (6.3%). The level of excellent performance was achieved by 82 (approx. 85%) of these laboratories. Two main types of errors found from analyzing the received data were (i) specimen processing and (ii) incorrect identification of the analytical method. Conclusion: Our results indicate that the advantage of participation in the PT program for ESR is that the laboratories can monitor and investigate the source of laboratory errors. Therefore, the PT program for ESR testing should become an integral part of the quality assurance system in the laboratory.

Assessment of visual and blood-related parameters among children with sickle cell anaemia at Murtala Muhammad Specialist Hospital in Kano, Nigeria.

Sickle cell disease (SCD) is a prevalent genetic disease worldwide and particularly in Nigeria. Retinopathy is a known complication of SCD, underscoring the need to assess visual parameters in children. This study aimed to evaluate the visual acuity (VA), color vision (CV), packed cell volume (PCV), and erythrocyte sedimentation rate (ESR) of Sickle cell anemic (SCA) patients attending the Sickle cell counseling unit of Murtala Muhammad Specialist Hospital (MMSH) in Kano. It was a descriptive cross-sectional study consisting of 60 participants, including 30 SCA patients and 30 healthy controls without systemic or ocular diseases, aged between 8 and 14 years. Visual acuity, CV, PCV, and ESR were assessed using Snellen Chart, Ishihara chart, Hematocrit test, and Westergren Method respectively. Data were analyzed using SPSS version 22.0. Statistical significance was set at P < 0.05. Both SCA patients and controls demonstrated limited knowledge about VA, CV, and ESR tests, and a significant percentage had never undergone these tests. SCA patients exhibited mild to moderate visual impairment (VI) in both eyes, while controls had no VI. Abnormally low PCV and ESR values were observed in all SCA patients, whereas controls had normal values. Gender differences were observed in ESR levels, with females showing higher levels. Significant differences were found between controls and SCA patients in terms of VA, ESR, and PCV values. There was a general lack of awareness regarding the importance of VA and CV tests in the community. Visual impairment and abnormal PCV and ESR values were exclusive to the SCA patients, indicating their association with the disease.

The long-term impact of vaginal surgical mesh devices on pain clinic and psychological service referrals, anti-inflammatory testing and pelvic scans in UK primary care: A cohort study with the Clinical Practice Research Datalink.

To examine long-term complications in women with stress urinary incontinence (SUI) and pelvic organ prolapse (POP), with and without surgical mesh implants. Longitudinal open cohort study from 1 April 2006 (or 1 April 2012) to 30 November 2018. The Clinical Practice Research Datalink (CPRD) Gold database, which is linked to Hospital Episodes Statistics (HES) inpatient data, the HES Diagnostic Imaging Dataset (DID), Office for National Statistics mortality data and Index of Multiple Deprivation socio-economic status data. Women aged ≥18 years with a diagnostic SUI/POP Read code. Rates are estimated using negative binomial regression. Rates of referrals for: psychological and pain services; urinalysis, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) testing; and pelvic ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) scans. A cohort of 220 544 women were eligible for inclusion; 74% (n = 162 687) had SUI, 37% (n = 82 123) had POP and 11% (n = 24 266) had both. Rates of psychological referrals and CT scans were lower in women with SUI mesh surgery, but this was offset by higher rates of CRP testing in women with SUI or POP mesh, MRI scans in women with SUI mesh, and urinalysis testing and referrals to pain clinics for women with POP mesh. Our results suggest a higher burden of morbidity in women with SUI/POP mesh surgery, and that these women may require ongoing follow-up in the primary care setting.

Investigation of the Clinical Diagnostic Significance of the T-Cell Test for Tuberculosis combined with Erythrocyte Sedimentation Test in Pulmonary Tuberculosis

Objective: To investigate the clinical diagnostic significance of peripheral blood T-cell test (T-spot test) for tuberculosis (TB) infection combined with erythrocyte sedimentation rate (ESR) in pulmonary TB. Methods: 41 patients with a clinical diagnosis of TB during hospitalization from January 2020 to April 2023 in our hospital were selected as the experimental group, and 45 patients without TB (bronchopneumonia patients) were selected as the control group. The diagnostic specificity, sensitivity, and accuracy of the T-spot TB test, ESR test, and the combined test of the two were calculated respectively. Results: The sensitivity, specificity, and accuracy of the T-spot TB test combined with ESR for the diagnosis of TB in the experimental group were significantly higher than the individual results of the T-spot TB test and ESR test alone (P < 0.05). Conclusion: The T-spot TB test combined with the ESR test for TB diagnosis has greater clinical value than carrying out the tests individually.

Laboratory Diagnostics Accuracy for COVID-19 versus Post-COVID-19 Syndrome in Lung Disease Patients with Multimorbidity.

The laboratory tests and identification of risk factors such as comorbidities are essential in the management, treatment and prognosis of patients with chronic respiratory diseases. Performing rigorous monitoring among patients with post-COVID-19 syndrome and early identification of risk factors associated with poor prognosis are crucial in improving patient outcomes. In the present study, 182 patients diagnosed with COVID-19 and PCI during 2020-2022 were included. A clinical and epidemiological evaluation was performed for each patient. Laboratory tests at admission included complete blood count, Erythrocyte Sedimentation Rate (ESR) and biochemical tests. Receiver operating curve (ROC) and area under the curve (AUC) were calculated to compare the diagnostic performance of each parameter. Regarding comorbidities, arterial hypertension, diabetes mellitus and obesity were the most frequent ones. In the case of chronic lung diseases, asthma and Chronic Obstructive Pulmonary Disease (COPD) were the most frequent. Pleurisy was found especially in patients with PCI Variations in serum LDH values were observed, especially in severe forms of COVID-19 in 2020, with a mean value of 481.44 U/L, compared to patients with PCI, whose mean values (122 U/L) were within the biological range of reference. High neutrophil/lymphocyte ratio (NLR) values quantified in this study were especially associated with moderate and severe forms of COVID-19 and also PCI. The Spearman correlation coefficient was determined to measure the correlations between the clinical parameters of all investigated subjects. A value of p < 0.05 was considered statistically significant. The statistical results indicated that serum lactate dehydrogenase (LDH), glucose and C-reactive protein (CRP) are sensitive markers with a diagnostic role in COVID-19, and lymphocyte (Ly) count, CRP, ESR and glucose were evidenced to be target markers in PCI. LDH values were observed to be statistically significant (p < 0.005) in patients with COVID-19 and obesity evaluated in 2021, while Ly count was statistically significant (p = 0.05) in patients with PCI and arterial hypertension. Regarding comorbidities, it has been observed that obesity, arterial hypertension and cardiovascular diseases represent risk factors in COVID-19/PCI, associated especially with the severe forms of the disease.

Complete Blood Count, C-reactive Protein, and Erythrocyte Sedimentation Rate Changes in People with Brucellosis

Background: Brucellosis is a major health and economic problem in many parts of the world, including the Middle East. Blood disorders such as anemia, leukopenia, and thrombocytopenia can be seen in brucellosis. However, laboratory findings of this disease are different. Therefore, this study aimed to investigate the changes in complete blood count (CBC), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in people with brucellosis in Gonabad community health centers.&#x0D; Methods: During the 4 years from May 2016 to May 2019, a prospective study was performed on 221 patients with brucellosis. According to the national guidelines for brucellosis, titers greater than 1/80 for Wright and more than 1/40 for 2-ME were considered positive cases of brucellosis. Using the checklist, information related to CBC, CRP, and ESR test parameters was collected.&#x0D; Results: The results showed that out of 221 patients studied, 58.4% were male and 41.6% were female. The mean age was 44.9±19.8 years for men and 49.3±17.3 years for females. High ESR was seen in 43.4% and positive CRP in 59.7% of patients. Leukopenia in 8.6%, leukocytosis in 9%, neutropenia in 6.8%, neutrophilia in 9.5%, lymphopenia in 3.6%, lymphocytosis in 10%, anemia in 17.2% and thrombocytopenia in 9.5% of patients were seen.&#x0D; Conclusion: Brucellosis in endemic areas should be considered in the differential diagnosis of patients presenting with thrombocytopenia. Also in high Wright titers, CRP is a more valuable indicator than ESR.

مقارنة بين مضادات التخثر المختلفة مثل سترات الصوديوم، EDTA، وهيبارين الليثيوم في اختبار معدل ترسيب كرات الدم الحمراء

Erythrocyte Sedimentation Rate Test (ESR), is one of the major laboratory tests used in diagnostic labs. This study compares and determines the ESR results obtained when using various anticoagulants that might clearly affect the ESR values for both male and female. 100 whole blood samples were collected from the volunteers in Hebron during the time from February 2023 until March 2023. 10 cc of whole blood collected from participants was divided into five different anticoagulants containing tubes The results of the study revealed that there are differences in the ESR value upon each anticoagulant used. A variation between the ESR results values is shown in both male and female samples. Heparin and EDTA are anticoagulants which increase the ESR values in contrast to Sodium Citrate used in the standard method. The researchers concluded that Tri-Sodium Citrate is the best anticoagulant and diluent to be used in laboratories but not EDTA or Heparin.

Early stage of erythrocyte sedimentation rate test: Fracture of a high-volume-fraction gel.

Erythrocyte sedimentation rate (ESR) is a clinical parameter used as a nonspecific marker for inflammation, and recent studies have shown that it is linked to the collapse of the gel formed by red blood cells (RBCs) at physiological hematocrits (i.e. RBC volume fraction). Previous research has suggested that the observation of a slower initial dynamics is related to the formation of fractures in the gel. Moreover, RBC gels present specific properties due to the anisotropic shape and flexibility of the RBCs. Namely, the onset of the collapse is reached earlier and the settling velocity of the gel increases with increasing attraction between the RBCs, while the gel of spherical particles shows the opposite trend. Here, we report experimental observations of the gel structure during the onset of the collapse. We suggest an equation modeling this initial process as fracturing of the gel. We demonstrate that this equation provides a model for the motion of the interface between blood plasma and the RBC gel, along the whole time span. We also observe that the increase in the attraction between the RBCs modifies the density of fractures in the gel, which explains why the gel displays an earlier onset when the aggregation energy between the RBCs increases. Our work uncovers the detailed physical mechanism underlying the ESR and provides insights into the fracture dynamics of an RBC gel. These results can improve the accuracy of clinical measurements.

Charcot arthropathy and acro-osteolysis in a 5-year-old girl with hereditary sensory and autonomic neuropathy type II: A case report

Charcot neuropathic arthropathy is a destructive process that can occur in patients with neuropathy associated with medical diseases such as diabetes. A rare cause of neuropathic arthropathy is congenital insensitivity to pain (CIP) which includes varying degrees of sensory loss and lack of pain perception contributing to absent withdrawal responses. The clinical manifestations of CIP include delayed diagnosis of fractures, joint dislocations, acro-osteolysis, avascular necrosis, osteomyelitis, heterotopic ossification, and Charcot arthropathy. We herein report a case of Charcot arthropathy of ankle joints in a 5-year-old girl with CIP due to underlying hereditary sensory and autonomic neuropathy who had recurrent upper and lower limb fractures with acro-osteolysis. She had an inability to perceive pain from the first year of her life. She also had mild developmental delay. Family history was unremarkable. Blood count, liver and thyroid function tests, erythrocyte sedimentation rate, C-reactive protein, blood electrolytes, blood sugar and other laboratory tests were normal. Charcot neuropathic arthropathy in children is rare and can be a part of congenital diseases like CIP. A high degree of suspicion may lead to early detection and can prevent joint and bone destruction and deformities.

High Adenosine Deaminase Level and Erythrocyte Sedimentation Rate of Intestinal Tuberculosis Patients

BACKGROUND: Currently, laboratory diagnosis of intestinal tuberculosis (ITB) is limited based on clinical manifestations, providing opportunities for alternative laboratory tests to diagnose ITB. At the present time, the role of serum adenosine deaminase (ADA) and hematological tests in ITB patients are not widely known. The objective of this study was to determine the role of ADA and hematological tests in patients suspected with ITB.METHODS: Subjects that were suspected of ITB were classified as ITB group, while subjects with inflammatory bowel disease, hemorrhoid, and intestinal malignancy were classified as non-ITB group. Colonoscopy, histopathological examinations, and hematological test were performed. ADA measurement was also performed with clinical chemistry analyzer based on enzymatic colorimetry principle.RESULTS: Out of 143 subjects, 16 (11.2%) subjects were diagnosed with ITB and 127 (88.8%) subjects were classified as non-ITB group. ADA level and erythrocyte sedimentation rate (ESR) of ITB group were significantly higher than the ones of non-ITB group (p&lt;0.05). Cut-off, sensitivity, and specificity of ADA level were 12.56 IU/L, 75%, and 57%, respectively. Cut-off, sensitivity, and specificity of ESR were 32.5 mm/hour, 81%, and 62%, respectively. Colonoscopy of ITB subjects displayed multiple ulcerations, edema, and hyperemic mucosa. Histopathological examination of ITB subjects exhibited granulomatous inflammation, epitheloid cells, giant cells, and lymphocyte aggregates.CONCLUSION: ADA level and ESR were significantly higher among ITB patients compared with non-ITB patients. Since the sensitivities of ADA and ESR tests were high, the ADA and ESR tests could be considered as a screening test for ITB.KEYWORDS: intestinal tuberculosis, adenosine deaminase, hematological tests

Choosing Wisely and reducing the simultaneous ordering of erythrocyte sedimentation rate and C-reactive protein testing in a large safety net system.

C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are commonly used inflammatory markers. C-reactive protein is more sensitive and specific for monitoring acute inflammation. However, it is commonly co-ordered with ESR despite recommendations against this. Our objective was to reduce unnecessary ESR orders and ESR/CRP co-ordering rates across a large safety net health system. This was a quality improvement project that used a quasi-experimental pre- and postintervention interrupted time-series regression analysis. Patients with a positive COVID-19 test were excluded. We designed a nonintrusive, normative nudge within the ESR order that recommended against co-ordering ESR and CRP. In addition, a best practice advisory triggered when ESR and CRP were simultaneously ordered. The outcome measures were ESR order rates per 1000 patient days in the inpatient setting and per 1000 patient encounters in the outpatient setting, as well as ESR/CRP co-ordering rates. Inpatient ESR orders decreased from 12.02 preintervention to 5.61 per 1000 patient days (-53.3%, P < .001). Outpatient ESR orders decreased from 6.09 to 4.07 per 1000 patient encounters (-33.2%, P < .001). Relative co-ordering rates decreased by 50%. This electronic health record initiative successfully reduced ESR testing across 11 hospitals and 70 ambulatory centers in a safety net setting.

A Comparison Between Somatosensory Evoked Potentials and Spine MRI in the Diagnosis of Non-compressive Myelopathy: Which Is More Accurate?

Non-compressive myelopathy is a neurological disorder due to pathological processes affecting the spinal cord in the absence of clinical and radiological evidence of spinal cord compression. Two commonly used diagnostic tools for non-compressive myelopathy are somatosensory evoked potentials (SSEPs) and magnetic resonance imaging (MRI). SSEPs are a neurophysiological tool used to assess the functional integrity of the spinal cord. MRI, on the other hand, is the mainstay imaging modality used for identifying compressive lesions and other structural abnormalities in the spinal cord.The aim of this study was to test the diagnostic accuracy of SSEPs versus spine MRI in the diagnosis and assessment of the severity of non-compressive myelopathy using the Modified Japanese Orthopaedic Association (mJOA) clinical severity score. Our study included 63 subjects. Whole spine MRI and SSEPs (median and tibial SSEP bilaterally) were done for all subjects; their results were compared according to their relation to the mJOAscore and classified into mild, moderate, and severe. The control group was examined to establish normative data for SSEPresults and compared with cases. Blood investigations such as complete blood count, thyroid function test, A1C, HIVtests, venereal disease research laboratory test, erythrocyte sedimentation rate, C-reactive protein, and antinuclear antibodytests were done. Blood tests for vitamin B12 levels were done for patients who were suspected of sub-acute combined degeneration of the spinal cord; cerebrospinal fluid (CSF) analysis was done for patients suspected of multiple sclerosis (MS), acute transverse myelitis (ATM), or other inflammatory/infectious diseases. CSF was analyzed for cell count, cytology, protein, and oligoclonal bands (if indicated). No mild categories were registered in this study; 30%of patients were moderateand 70%were severe. Causes for non-compressive myelopathy in this study werehereditary degenerative ataxias in 12 (38.71%), ATM in 8 (25.81%), and MS in 5 (16.13%); other causes included vitamin B12 deficiency in 2 (6.45%), ischemia in 2 (6.45%), and an unknown cause in 2 (6.45%). SSEPs showed abnormal results in all patients (31; 100%) whereas MRI showed abnormality in only seven patients (22.6%). SSEPsensitivity for detecting severe cases was around 63.6% while that for MRI was 27.3%. The study concluded that SSEPs were more reliable for the detection of non-compressive myelopathies rather than MRI and correlated better with clinical severity. Performing SSEPs is recommended for all patients with non-compressive myelopathy, especially those with negative imaging.

Spinal Epidural Abscess: Early Suspicion in Emergency Department Using C-Reactive Protein and Erythrocyte Sedimentation Rate Tests.

Spinal epidural abscess (SEA) is an uncommon but serious differential diagnosis of acute spinal pain with high paralysis and mortality rate. This study aims to provide local data on its bioclinical characteristics and evaluate potential strategies to enhance its diagnostic rate in accident and emergency department (AED). A retrospective case study from 2013 to 2019 was conducted in United Christian Hospital. SEA cases were classified as study group, spinal pain due to non-SEA cases were classified as control group. Data collected from study group included symptoms, radiological diagnosis, microbiological culture, treatment, and outcome. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) of both groups were compared to analyze their diagnostic power. In the study group (n = 42), 93% of patients had spinal pain, 55% had fever, 60% had neurological deficits, and only 26% had the classic triad on presentation. Seventy-four percent of patients presented with spinal cord or cauda equina compression in their first magnetic resonance imaging. Mortality rate was 23.8%, and paralysis rate was 7.1%. Diagnostic accuracy in AED was 12%. Admission to orthopedic ward (n = 23) resulted in a significantly lower mean time-to-imaging (4.39 days vs. 14.58 days) and mean time-to-treatment (6.56 days vs. 16.9 days) as compared to other specialties. The area under curves of CRP and ESR were 0.893 and 0.874 respectively, the optimal threshold levels were 45.9 mg/L (sensitivity 82.9%, specificity 79%) and 59.5 mm/hr (sensitivity 87.2%, specificity 80.4%), respectively. Diagnosis of SEA in emergency department based on clinical symptomatology is not reliable due to low incidence of the classic triad, despite a more advanced disease on presentation. We proposed incorporating CRP and ESR tests into evaluation of patients with spinal pain since both tests demonstrated excellent discriminative power in diagnosing SEA.

Impact of chronic Helicobacter pylori infection on inflammatory markers and hematological parameters.

Determining a non-invasive method for Helicobacter pylori (H. pylori) induced gastritis will be of great help especially in the field of pediatrics. In this study, we aimed to evaluate impact of chronic H. pylori infection on inflammatory markers and hematological parameters. 522 patients aged between 2 months and 18 years, with chronic dyspeptic complaints who underwent gastroduodenoscopy were included. Complete blood count, ferritin, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) tests were performed. Platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) values were calculated. From 522 patients 54% had chronic gastritis and 28.6% had esophagitis, while 24.5% of their biopsy samples revealed H. pylori. The mean age of H. pylori positive patients was significantly higher (p<0.05). Females were in the majority in H. pylori positive and negative groups and in the group with esophagitis. The most common complaint in all groups was abdominal pain. In the H. pylori positive group, a significant increase in neutrophil and PLR values, a significant decrease in the NLR value were found. Ferritin and vitamin B12 values were significantly lower in the H. pylori positive group. No significant difference was found in the parameters we compared between the group with and without esophagitis, except for mean platelet volume (MPV). MPV values were significantly lower in the group with esophagitis. Neutrophil and PLR values are practical and easily obtainable parameters related to inflammatory phases of H. pylori infection. They may become useful parameters in the follow-up. H. pylori infection is one of the important causes that trigger iron deficiency and vitamin B12 deficiency anemia. Further large-scale randomized controlled studies are needed to confirm our results.

Serum Elafin as a Potential Marker of Disease Activity in Behçet's Disease.

Elafin is a serine protease inhibitor with anti-inflammatory properties. It is expressed in various epithelial tissues with increased production under inflammatory conditions. Increased tissue elafin expression in Behçet's disease (BD) lesions has previously been demonstrated. We hypothesised that serum elafin might be increased in patients with BD and aimed to assess the relationship of serum elafin with disease activity and organ involvement in BD. Fifty-four BD patients (29 active, 25 inactive) and 30 healthy controls were included in this single-centre case-control study. Serum elafin was measured using ELISA. Complete blood count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) tests were also performed. Serum elafin levels were significantly higher in patients with BD (1.58 ± 0.47 ng/ml, range: 0.67-2.96) compared to controls (1.10 ± 0.28 ng/ml, range: 0.65-1.49) (P < 0.001). Patients with active BD had higher elafin levels than patients with inactive BD (P = 0.008). Active arthritis was associated with an increase in elafin (P = 0.012), while the presence of mucocutaneous symptoms was not. Serum elafin correlated significantly with ESR (P = 0.001). The ideal cut-off value for the diagnosis of BD was determined as 1.24 ng/ml with a sensitivity and specificity of 72.2% and 70.0%, respectively. Serum elafin is significantly increased in patients with BD. It may serve as a marker of disease activity, especially articular involvement.

Clinicoepidemiological study of adverse cutaneous drug reactions among immunocompromised children at a tertiary care hospital.

Highly active antiretroviral therapy (HAART) is used to treat human immunodeficiency virus type 1 (HIV-1). Introduction of antiretroviral therapy (ART) has reduced the HIV/AIDS associated morbidity and mortality significantly. But 25% of all patients discontinue treatment because of adverse drug reactions (ADRs). Adverse cutaneous drug reactions (ACDR) are very common with ART regimens, which may range from mild pruritus, maculopapular rash to serious Steven Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). ACDRs comprise 10%-30% of all reported ADRs. To assess the different types of cutaneous adverse drug reactions in immunocompromised children of less than 18years. This is a retrospective record-based study, conducted at department of Dermatology, Venereology and Leprosy, Government Medical College (GMC)/Government General Hospital (GGH), Suryapet, Telangana, India. Data was collected from the records available at ART centre, from November 2018 to October 2021 GGH, Suryapet. All the HIV infected children ≤18 years who were on ART, were included in this study. Patients of more than 18 years and on other medications were excluded. Demographic data, socio economic status, vaccination status, height, weight, complete blood analysis, complete urine analysis, erythrocyte sedimentation rate, liver and renal function tests and CD4 counts were recorded before initiation of ART. A total of 330 children of less than 18 years were initiated for ART, at ART centre, Government General Hospital, Suraypet. Out of 330 children, 27.8% (92) children developed ACDRs. 58.7% (54) were males and 41.3% (38) were females. Maculopapular rash was seen in 65.2% (60) cases, urticaria was seen in 15.3% (14) cases, Steven Johnson Syndrome (SJS) was seen in 9.8% (9) cases, SJS/TEN overlap was seen in 6.5% (6) cases and toxic epidermal necrolysis (TEN) was seen in 3.2% (3) case. CD4 count was below 300 in 65.3% (60) cases above 300 in 34.7% (32) cases. Gap between initiation of the treatment and onset of reaction was less than one month in 65.3% (60) cases, and more than one month in 34.7% (32) cases.

Complete Blood Count Test in Rheumatology: Not Just a Screening Test.

Rheumatic disorders are chronic and common diseases, which especially involve connective tissue and may be associated with the damage to vital organs such as heart and kidney. Diagnosis, prognosis, determining the probability of severe complications, monitoring and evaluation of the response to treatment in such patients require specialized, expensive and time-consuming laboratory tests. In this review article, we assessed the value of parameters of routine, inexpensive, and available Complete Blood Count (CBC) in detecting disease activity and explaining the prognosis of a number of rheumatic disorders, including systemic lupus erythematosus and rheumatoid arthritis by reviewing the results of searching Google Scholar search engine and PubMed databases over 2000 - 2021. Review of previous articles showed that while traditional Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) tests do not have sufficient specificity to appraise disease activity, CBC derived inflammatory biomarker Neutrophil-to-Lymphocyte Ratio (NLR) is able to assess disease activity and response to treatment in Rheumatoid Arthritis (RA). Also, Mean Platelet Volume (MPV) and NLR can determine the prognosis of renal involvement in Systemic lupus erythematosus (SLE). Although CBC-based parameters are not completely specific and sensitive to rheumatic disorders, but based on the results of previous studies, these parameters, particularly red cell distribution width (RDW), MPV, NLR and platelet to lymphocyte ratio (PLR) are inflammatory biomarkers with a prognostic role in rheumatic disorders that can also assess activity of the disease.

Red blood cell sedimentation rate measurements in a high aspect ratio microchannel.

The erythrocyte sedimentation rate (ESR) test is commonly used in clinical practice for monitoring, screening and diagnosing pathological conditions and diseases related to the inflammatory response of the immune system. Several ESR techniques have been developed over the years improving the reliability, the precision and the duration of the measurement. In the present study a new low cost micro-ESR technique is described providing the major advantage of reducing the measurement time and the blood sample volume by multiple times compared to the commercial methods. Blood samples were obtained from healthy donors within the age group of 24-28 years and the haematocrit was adjusted to 30%, 40% and 50%. The ESR of the samples was measured utilizing a surface tension driven (STD) microfluidic chip and a monitoring device. The evaluation of the method showed a high correlation (0.94, p < 10-5) at all haematocrit levels with the commercial instrument indicating the feasibility of the technique. This micro-ESR technique provides the potential for a simple, low cost and fast tool for ESR measurement using low blood volume acquired by finger prick.

Erythrocyte sedimentation rate in COVID-19 patients treated at the CLAS health center, Nuevo Lurín, 2021

Background: The erythrocyte sedimentation rate (ESR) is used for diagnosis in inflammatory processes, including during the coronavirus disease 2019 (COVID-19) pandemic affecting our population. To determine the values of ESR in the evolution of patients with COVID-19 undergoing treatment at the CLAS Health Center in Nuevo Lurín. Methods: Our research applied a quantitative-observational, descriptive, and longitudinal approach. The sample consisted of 26 male and 19 female patients treated at the study site between February and June 2021, none of whom were in critical condition. To collect all the necessary information, the Capillary or Wintrobe method was used to determine the values of ESR in the evolution of the COVID-19 patients, obtaining different values for the 45 patients seen at the study site. The normal ESR value was 0 - 15mm/h for males and 0 - 20mm/h for females. Results: The initial ESR test in patients positive for COVID-19 showed that only two cases (0.04%) had slightly elevated ESR ranges, while in the rest of the values (95.56%) remained within the normal range. Conclusions: From the results of the capillary velocity of sedimentation method, it can be concluded that patients with COVID-19 in Peru showed no signs of inflammation within their bodies due to the virus.