Mean Neutrophil-lymphocyte Ratio Values Research Articles

The role of neutrophil to lymphocyte ratio with wound healing in open tibial fracture grade IIIA

Introduction: Open fractures of the tibia are challenging injuries to treat. The neutrophil-lymphocyte ratio (NLR) has been used to predict poor prognosis in various orthopedic conditions. This study aims to analyze the role of NLR in the wound healing of patients with open fractures. Methods: This is a retrospective study with data taken from all patients with grade IIIA open tibial fractures admitted to the hospital for treatment between January 2018 and June 2023. The initial NLR value and wound healing state were recapped after 6 weeks of follow-up. A statistical analysis between NLR values and wound healing state was done to measure the significance between variables. Results: There were 49 participants included in this study. Our current study found a significant difference between the mean NLR value of the healed and nonhealed wound (12.59±11.2 vs 10.46±7.9, P =0.015). The mean NLR in the healed group was significantly higher than in the nonhealed group. Calculating NLR involves dividing the absolute count of neutrophils by the total count of lymphocytes, which can be obtained through a complete blood count test. This ratio offers valuable insights into the balance between inflammatory and anti-inflammatory responses in the body. Conclusion: The NLR was significantly higher in the healed group than in the nonhealed group. Further research with higher-quality studies might be needed to prove its prognostic factor.

Understanding the Etiopathogenesis of Non-Arteritic Anterior Ischemic Optic Neuropathy with Laboratory Findings.

The role of inflammation and hemostasis in non-arteritic anterior ischemic optic neuropathy (NAION) was investigated by examining related blood tests. The predictive values of these laboratory indicators and their effects on prognosis were reviewed. In this study, 48 patients diagnosed with NAION and 50 healthy volunteers were included. All subjects underwent full ophthalmological examination. All patients were treated with oral corticosteroids (methylprednisolone 1 mg/kg/day) for 15 days after that corticosteroid medication was reduced and stopped. Each patient was monitored at least for 12 months. The mean platelet volume (MPV), platelet distribution width (PDW), neutrophil/lymphocyte ratio (NLR), and red cell distribution width (RDW) values were recorded. These findings were compared with control group. The mean MPV, RDW, and NLR values were significantly higher in NAION group (respectively, p<0.001, p=0.006, and p<0.001). There was no statistically significant difference between group 1 and group 2 in PDW values, but the mean PDW value was higher in the patient group compared to the control group (p=0.435). Based on the receiver operating characteristic (ROC) curve, the NLR had the strongest predictive value. This was followed by MPV, RDW, and PDW with lower diagnostic predictive values. MPV, NLR, and RDW were found to be elevated and have diagnostic predictive values in NAION patients. Easily accessible and simple laboratory methods could help us show systemic inflammation and ischemic events in NAION patients. As a result, inflammatory reactions besides ischemic changes may play a role in the etiopathogenesis of NAION. These biomarkers can be evaluated to ensure that patients with risk factors for the development of NAION.

Differences in Neutrophil Lymphocyte Ratio (NLR) between Sepsis and Septic Shock Patients in a Tertiary Hospital in Indonesia

Sepsis is a severe medical condition characterized by organ dysfunctions resulting from the body's response to an infection. Septic shock is a complication of sepsis that involves circulatory, cellular, and metabolic disturbances. The body's response to infection is typically marked by an increase in neutrophils and a decrease in lymphocytes, leading to increased Neutrophil Lymphocyte Ratio (NLR). This study aimed to investigate the differences in NLR between sepsis and septic shock patients treated at Dr. H. Abdul Moeloek Provincial Hospital, Lampung, Indonesia. This study utilized a comparative analytic study approach with a cross sectional design. A total of 96 sepsis patients who met the inclusion and exclusion criteria treated during the period January 2018 - December 2020 at Dr. H. Abdul Moeloek Provincial Hospital, Lampung, Indonesia, were included in this study. The study found that most of sepsis patients showed an increase in neutrophils (89.58%), a decrease in lymphocytes (94.79%), and elevated NLR values (87.5%). The mean NLR value of septic shock patients (20.10±5.89) was significantly higher than that of sepsis patients (18.01±1.35) (p=0.025). It indicates that the NLR value increases significantly in patients who develop septic shock compared to those with sepsis alone. The findings suggest that NLR could be a potential biomarker for septic shock diagnosis. However, the effectiveness of NLR in predicting the severity of sepsis and determining the risk of mortality in these patients still needs to be examined by conducting studies that involve a larger sample size.

The correlation of neutrophil-lymphocyte ratio and ENLIST ENL severity scale in type 2 leprosy reactions

Link of Video Abstract: https://youtu.be/PlVYFXCyDlY Introduction: Type 2 leprosy reaction or Erythema Nodosum Leprosum (ENL) is an episode of acute inflammation that appears in the clinical course of leprosy. In ENL, antigen-antibody immune complex responses and the complement immune system are suspected. The Neutrophil-Lymphocyte Ratio (NLR) is an easy, inexpensive, and usable parameter related to clinical outcome and disease severity. The ENLIST ENL Severity Scale (EESS) is the world's first validated ENL severity scale. This study aimed to determine correlations between the NLR and the EESS in type 2 leprosy reactions. Methods: Observational analytic study with a cross-sectional approach was used in this study. The sample of the study was 30 subjects with type 2 leprosy reactions. The recording of basic data and examination of the study subjects included assessing the degree of severity using the ENLIST ENL severity scale and measuring the neutrophil-lymphocyte ratio. Statistical analysis was performed using Pearson's correlation coefficient, with p≤0.05 considered statistically significant. Results: The research subjects with the highest distribution were in the age group &lt;40 years (73.33%) and male (66.67%). The mean EESS score was 7.97 ± 1.73, with the category of the highest degree of severity in all subjects being mild (60.0%). The mean NLR value for all issues was 7.60 ± 3.58. There was a significantly strong positive correlation between NLR and EESS in type 2 leprosy reactions (p&lt;0.001, r=0.653). Conclusions: There was a strong correlation between NLR and EESS in type 2 leprosy reactions.

Systemic inflammatory markers for distinguishing uncomplicated and complicated acute appendicitis in adult patients.

This study aimed to investigate the predictive power of serum systemic inflammatory markers including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-eosinophil ratio (MER), and C-reactive protein (CRP) levels for distinguishing uncomplicated and complicated acute appendicitis in adult patients admitted to the emergency department (ED). This retrospective, cross-sectional, observational, and single-center study enrolled 212 consecutive adult patients with acute appendicitis who were admitted to the ED of our tertiary care university hospital between January 1, 2019 and December 31 2021. Patients were divided into two groups (Group I, uncomplicated acute appendicitis; Group II, complicated appendicitis) according to their surgical findings and histopathological examination. Systemic inflammatory markers measured on admission were compared among patients to identify factors associated with complicated acute appendicitis. A total of 132 patients, 83 male (62.9%) and 49 female (37.1%), were included in the study. The mean age was 34.7±13.40 years. Based on the histopathological examination, the number of patients in Group I was 103 (78.03%) and 29 (21.96%) in Group II. Laboratory findings on admission revealed no significant differences between Groups I and II patients in terms of mean serum NLR, MER, and CRP values (p=0.096, p=0.248, and p=0.297, respectively). However, the mean serum PLR in Group II patients was statistically significantly higher than those in Group I (p=0.032). The mean serum monocyte and monocyte fraction (%) values were significantly lower, and the mean serum neutrophil fraction (%) value was higher in Group II patients compared to those with Group I. Receiving operator characteristic (ROC) analysis identified a serum PLR cutoff value of ≥133.73 for distinguishing uncomplicated and complicated acute appendicitis in adult patients, with 60% sensitivity and 58.4% specificity. In addition, ROC analysis revealed a cutoff monocyte fraction (%) level of ≤6, with 72% sensitivity and 64% specificity, for distinguishing uncomplicated and complicated acute appendicitis in adult patients. Our findings indicate that the mean serum NLR, MER, and CRP values measured on admission to ED in adult patients with acute appendicitis could not predict complicated acute appendicitis. However, mean serum PLR and neutrophil and monocyte counts can be useful in distinguishing complicated cases.

Prognostic implications of neutrophil lymphocyte ratio in acute myocardial infarction

Background: Neutrophil Lymphocyte Ratio (NLR) is a readily available marker that conveys important information about the complex inflammatory activity in the vascular bed during the active phase of the syndrome. Hence it provides relevant information regarding the risk of mortality in patients who are admitted with acute myocardial infarction. Objectives: To estimate the neutrophil lymphocyte ratio in STEMI and NSTEMI of acute myocardial infarction. Materials and Methods: A total of 190 patients with acute myocardial infarction who fulfilled the inclusion criteria were selected. The neutrophil lymphocyte ratio was calculated in STEMI as well as NSTEMI and the value was compared. Patients were then categorized into three groups based on NLR . The relation of neutrophil lymphocyte ratio with the morbidity and mortality of acute myocardial infarction was then studied. Results : The mean age of patients in this study was 59.46± 15.29 years. In this study ,63.1 % were males and 37.9 % were females. The mean NLR value in acute myocardial infarction in this study was 6.175 ± 2.26.The mean NLR value among patients with STEMI is 6.49±2.30 while among patients with NSTEMI is 5.86± 2.17.

The effects of testosterone on transgender males on carotid intima-media thickness and serum inflammatory markers compared within patients with polycystic ovary syndrome

Objective: To evaluate the effects of testosterone on carotid intima-media thickness (CIMT) and serum inflammatory markers compared within transgender males (TGM-Former called female-to-male) and polycystic ovary syndrome (PCOS). Methods: The prospective observational study included 30 TGM, 30 patients with PCOS, and 30 healthy women. Groups were compared for CIMT and hematologic inflammatory markers white blood cell (WBC), lymphocyte/monocyte ratio (LMR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and mean platelet volume (MPV). Results: The CIMT of the TGM group was 0.48 ± 0.09 mm was significantly higher than PCOS (0.41 ± 0.09 mm, p = .005) and the control group (0.38 ± 0.7 mm, p = .001). The mean NLR, LMR, and MPV values were similar (p > .05). TGM had higher WBC levels compared to control women (p = .029). TGM had significantly lower PLR compared to PCOS and the control group (p = .001). CIMT were related to age (r = .390, p = .04) and body mass index (BMI) (r = .392, p = .03) in TGM. Conclusion: Increased CIMT in TGM individuals is not associated with inflammation; it seems to be a deleterious effect of exogenous testosterone exposure. Since increased CIMT may be a sign of serious cardiovascular problems developing in the future, it is suggested that it will be beneficial for these individuals should undergo clinical and radiological evaluation at regular intervals.

COMPARATIVE EVALUATION OF NEUTROPHIL-LYMPHOCYTE RATIO IN CHRONIC PERIODONTITIS PATIENTS WITH TYPE 2 DIABETES MELLITUS BEFORE AND AFTER NON-SURGICAL PERIODONTAL THERAPY (NSPT)

Background: The neutrophil-lymphocyte ratio (NLR) acts as an indicator of subclinical inflammation. Inflammatory marker NLR significantly increases in prediabetic and diabetic patients. Periodontal therapy can contribute to diabetes control in diabetic patients with periodontitis. Aims and Objectives: The aim of this study is to evaluate Neutrophil Lymphocyte ratio in type 2 diabetes mellitus patients before and after Non-surgical periodontal therapy. Materials and Methods: A cross-sectional prospective study was carried with a sample size of 90 patients having Type 2 Diabetes Mellitus. Venous blood samples were collected from each patient at baseline and 1 month after delivering NSPT. NLR was assessed and comparatively evaluated before and after treatment. Results: There are significant differences in NLR values of diabetic patients at baseline and at one month post non-surgical periodontal therapy (p = 0.004). Mean NLR values are higher in diabetic patients at baseline (2.07 ± 0.55) compared to mean NLR of 1.37 ±0.46 one month after delivering NSPT. Conclusion: Non-surgical periodontal therapy significantly reduces the NLR in diabetic patients. NSPT may augment diabetes control in patients with Type 2 Diabetes Mellitus.

Investigation of EGF, IL1-α and IL-6 levels and selected hematological parameters (NLR, MPV) in patients with the chronic cholesteatomatous otitis media.

In this study we aimed to investigate epidermal growth factor (EGF), interleukin (IL1)-α and IL-6 levels, and hematological parameters in the serum samples of patients with chronic cholesteatomatous otitis media (CCOM). This prospective included 40 patients who underwent surgery due to CCOM between June 2020 and May 2021. The stage of middle ear cholesteatoma was determined on each chart using the EAONO/JOS system. The control group comprised of 30 adults who were scheduled for septoplasty over the same period in our hospital, had no otological complaints, and had normal otological findings. The demographic, clinical, and laboratory data of the patients were obtained from the electronic medical record system of our hospital. The serum EGF, IL1-α and IL-6 levels, and hematological parameters (neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV)) were compared between the CCOM and control groups. Seven patients had Stage 1 and 33 patients had Stage 2 middle ear cholestatoma. There was no statistically significant difference between the CCOM and control groups in terms of age and gender (p=0.092 and p=0.616, respectively). The serum EGF and IL1-α levels of the CCOM group were statistically significantly higher than those of the control group (p=0.047 and p=0.013, respectively). No statistically significant difference was observed in the serum IL-6 levels of the CCOM and control groups (p=0.675). There was also no significant difference between the CCOM and control groups in terms of the mean NLR and MPV values ​​(p=0.887 and p=0.164, respectively). There was no significant difference between the Stage 1 and Stage 2 cholesteatoma subgroups in terms of the mean EGF, IL1-α, IL-6 levels (p=0.204, p=0.557 and p=0.613, respectively), and the mean NLR and MPV values (p=0.487, p=0.439, respectively). Increased serum EGF and IL1-α levels in patients with CCOM suggest that these cytokines may play a role in cholesteatomatous epithelial hyperproliferation.

The Severity of COVID-19 and its Correlation with Inflammation Biomarkers

Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov2) or Covid-19 has been spread quickly and caused 5 million deaths until February 2022. Severe symptoms of the infection may lead to death that prompt appropriate clinical diagnosis and adequate treatment going to be necessary. Covid-19 shows a severe inflammatory response which causes an imbalance in the immune response. Therefore, circulating biomarkers that can represent inflammation and immune status are potential predictors for the prognosis of COVID-19 patients. This study aims to know the role of Neutrophil-Lymphocyte Ratio (NLR), Neutrophil Monocyte Ratio (NMR), and Lymphocyte-monocyte Ratio (LMR) as inflammatory biomarkers for the severity of Covid-19.&#x0D; Methodology: This study is a single-center retrospective cohort study. The sample of this study was taken by consecutive sampling with complete clinical data from 893 Covid-19 patients from Andalas University Teaching Hospital from April 2020 to September 2021. This study uses SPSS Version 25.0 for data management and analysis.&#x0D; Result: Most of the degrees of Covid-19 infection were mild degrees as many as 597 people with an NLR average value of 2.07 (0.27-34.50), and NMR average value of 7.86 (3-46), an LMR average value of 3.67 (0.25-25), an ANC value of 3.990 (945-45). 14,608). Most of the degrees of infection in patients with negative PCR results were moderate degrees as many as 70 people with a mean NLR value of 9.0694 (0.51-47.50), a mean NMR value of 18.6199 (1.15-47.50), and a mean LMR was 3.0324 (0.29-19.50), the ANC value was 9769.73 (1.088-37,219). There was a relationship between the degree of Covid-19 infection and the NLR value (p=0.144), as well as the LMR (p=0.000), NMR(p=0.000), and ANC (p=0.000). There was no relationship between the degree of infection in the negative PCR patient group and the NLR value (p=0.000), as well as the LMR (p=0.700), NMR(p=0.120), and ANC (p=0.90).&#x0D; Conclusion: The severity of Covid-19 symptoms could be predicted through inflammatory biomarkers such as NLR, LMR, and NMR.

Nanotechnology in Metformin Delivery: Fasting Blood Sugar and Neutrophil-Lymphocyte Ratio of Diabetic Rat Model

Diabetes Mellitus (DM) is a chronic inflammatory disease characterized by hyperglycemia and increasing the neutrophil-lymphocyte ratio (NLR). Metformin has been widely used to treat hyperglycemia. Metformin nanoparticles can improve bioavailability and may reduce inflammation. This study aims to analyze the effectiveness of metformin nanoparticles delivery through fasting blood glucose (FGB) level and NLR in the diabetic rat model. This study used 16 white male Wistar rats, 8 weeks of age, and body weight (BW) 250-350 grams. The streptozotocin (STZ) 40 mg/kg BW were injected i.p. Rats were divided into 4 groups; K1: normal control; K2: negative control (diabetes model); K3: diabetes model treated with metformin 100mg/Kg BW; K4: diabetes model treated with nanoparticle metformin 100mg/kg BW. Blood analysis tests were conducted using the Pentra hematology analyzer. Data were analyzed using the Graphpad Prism program with the nonparametric Kruskal Wallis test. The K3 group showed a periodical decrease in FBG level from day 7 to day 28 by 122 ± 11.31 mg/dL, and the mean NLR value was 0.48 ± 0.3 x 103/uL. Group of K4 periodically decreased in FBG level, indicating that it was closer to normal than K3. The result showed that at day 28.79 ± 15.39 mg/dL, the mean NLR value slightly increased compared to the K3 group by 0.54 ± 0.3 x103/uL. The statistical tests showed a significant difference between the level of FBG (p 0.0089) but no significant difference in NLR (p 0.347). Metformin nanoparticles could decrease FBG levels and effectively reduce the NLR in the diabetic rat model.

Role of neutrophil-lymphocyte ratio and mean platelet volume in the outcome of atherosclerotic peripheral vascular disease interventions

Purpose: Classically, neutrophils have been neglected in the pathophysiology of atherosclerosis. However, recent studies have highlighted their role. Similarly, the role of platelets in peripheral artery disease (PAD) has become evident now. The significance of neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) has been independently studied and found that elevated values are associated with poor outcomes of atherosclerotic peripheral vascular disease interventions. However, the measure of association of NLR and MPV to the outcomes of intervention has not been studied. Hence, this study was undertaken to examine the measure of association of NLR and MPV to the outcomes of atherosclerotic peripheral vascular disease interventions. Methodology: This is a prospective study conducted between January 1, 2020, and September 30, 2021, with 6 months of follow-up. Patients aged 21 years or more, diagnosed to have atherosclerotic peripheral vascular disease, and undergoing interventions (endovascular and open procedure) are included in the study. Patients <21 years, not willing for any intervention, and with acute presentations were excluded. The primary endpoint assessed is graft patency at 6 months, and the secondary endpoints assessed are clinical improvement (which is a combined measure of change in ankle–brachial index, Rutherford grade, and ulcer status) at 1 and 6 months, redo procedure, and amputations within the follow-up period. Results: From January 2020 to September 2021, a total of 156 patients with atherosclerotic peripheral vascular disease fulfilled the inclusion and exclusion criteria. We observed that in 109 (69.9%) patients who had completed 6-month follow-up, 91 (83.5%) patients had graft patency and 18 (16.5%) patients had occluded graft. Independent receiver operating characteristic curve analysis of MPV and NLR showed that lower mean NLR and MPV values (cutoff taken as 10.15 for MPV) are associated with increased graft patency at 6 months than higher mean NLR and MPV values (NLR, P < 0.001; MPV, P = 0.024). Discriminant analysis model developed with MPV and NLR as the set of predictors showed that NLR and MPV together are good predictors of graft patency at 6 months (Wilk's lambda: χ2 = 45.54, P < 0.001). However, logistic regression analysis has shown that, in comparison to NLR, MPV is not a strong predictor of graft patency. Lower mean NLR value was associated with lower amputation rate (P < 0.001), lower mortality rate (P < 0.001), and higher clinical improvement rate at 1st month (P < 0.001) and at 6 months (P < 0.001) than patients with higher mean NLR. However, there was no statistically significant difference between two groups in predicting chance of redo procedure (P = 0.424). There was no statistically significant difference between the mean MPV values among patients who underwent amputation (P = 0.864), died (P = 0.640), or had redo procedure (P = 0.883), except for clinical improvement outcome where lower mean MPV value was associated with higher rate of clinical improvement at 1st month (P < 0.001) and 6 months (P < 0.001) than higher mean MPV value. Conclusion: In patients with atherosclerotic peripheral vascular disease, NLR value is a better predictor of outcomes after intervention than MPV, and lower mean NLR values are associated with increased rate of graft patency, clinical improvement, fewer amputations, and deaths.

Neutrophil-lymphocyte ratio as an inflammatory biomarker of diabetic nephropathy among type 2 diabetes mellitus patients: A comparative cross-sectional study.

This study aimed to determine the neutrophil-lymphocyte ratio (NLR) as an inflammatory biomarker among type 2 diabetes mellitus (T2DM) patients with diabetic nephropathy (DN). A comparative cross-sectional study design was conducted on 199 T2DM patients attending Bole 17 Health Center, Addis Ababa, Ethiopia. The urine albumin test was done by the MICRAL-II test strip. Fasting blood sugar was measured by a glucometer. Complete blood count was analyzed using an automated hematology analyzer (HUMAN GmbH, Wiesbaden, Hesse, Germany). The student's t-test, a chi-square test, and Pearson correlation were applied to analyze the data. Out of the 199 diabetes mellitus patients, 45 (22.6%) and 154 (77.4%) were found with DN and without DN, respectively. Interestingly, the mean NLR value (2.66 ± 0.49) was found significantly higher in diabetic patients with DN compared to the mean NLR (1.65 ± 0.20) in diabetes patients without DN (p < 0.0001). The NLR showed positive significant correlation with variables such as age (r = 0.162, p = 0.023), duration of disease (r = 0.52, p < 0.0001), absolute neutrophil count (r = 0.712, p < 0.0001), total white blood cell count (r = 0.162, p = 0.022), systolic blood pressure (r = 0.338, p < 0.0001), and diastolic blood pressure (r = 0.731, p < 0.0001). On the other hand, negatively significant correlation was found between NLR and absolute lymphocyte count (r = -0.770, p < 0.000). The NLR was significantly increased in T2DM patients with DN, suggesting that inflammation and endothelial dysfunction could be an integral part of the pathogenesis of DN, and therefore, this ratio may be considered as a predictor and a prognostic biomarker of DN.

Examination of the Relation Between Audiometric Configuration and Hematological Parameters in Idiopathic Sudden Sensorineural Hearing Loss.

Among the hematological parameters, neutrophil/lymphocyte ratio (NLR) and platelet/ lymphocyte ratio (PLR) have been associated with inflammatory state, microvascular damage and ischemia. It is well-known that these ratios increase in idiopathic sudden sensorineural hearing loss (ISSHL). In ISSHL, different audiographic features may reflect different disease mechanisms. This study aimed to investigate whether there were differences in NLR and PLR among patient groups with different audiometric configurations. Patients meeting the study inclusion criteria were divided into four groups according to their audiogram configurations. Mean NLR and PLR values of the patient groups were compared among themselves and versus control group. The study was conducted with 166 participants. Mean NLR values were 3.07 ± 2.48, 3.30 ± 2.70, 5.24 ± 3.71, 3.57 ± 3.19 and 1.51 ± 0.68 for ascending, flat, descending and total/subtotal audiometric configuration groups and control group, respectively. Mean PLR values were 145.2 ± 126.7, 130.9 ± 57.8, 192.2 ± 94.4, 143.7 ± 70.8 and 94.1 ± 24.7 for ascending, flat, descending, total/subtotal audiometric configuration groups and control group, respectively. Both NLR and PLR were significantly greater in patients from all configuration groups than in control group (p < 0.05). In addition, the group with descending audiometric configuration showed significantly higher mean NLR and PLR compared to other audiometric configuration groups (p < 0.05). The highest level of inflammation was detected in the ISSHL patient group with high frequency hearing loss and descending audiographic configuration.

Prediction of Gestational diabetes: Role of neutrophil to lymphocyte ratio at booking visit

Introduction: Gestational Diabetes Mellitus (GDM) affect up to approximately 10% of all pregnancies. Various markers of inflammation have been shown to predict the future diabetes risk and Neutrophil Lymphocyte Ratio (NLR) level is significantly correlated with metabolic syndrome criteria. However, very few studies investigated any possible association between NLR and development of GDM. Objectives• To compare the NLR among GDM group and control group.• To identify an optimal cut-off value of NLR in predicting GDM. Methods: A longitudinal observational study in all pregnant women who are in their first trimester at antenatal clinic, Teaching Hospital, Kandy for six months was carried out with a Full Blood Count at the first trimester and Oral Glucose Tolerance Test (OGTT) at the 24-28 weeks of gestation. Sample size was 361 and non-probability convenient sampling technique was applied. Results: Mean NLR value was 3.16 (SD=1.84) and the difference between GDM and non GDM mothers was not significant. Left upper most value for NLR of the ROC curve is 1.32 and when it is used as the cut off value the sensitivity is 99.6% and the specificity is 21.2%. Conclusions and recommendations: NLR positively correlates with the OGTT values done at 24-28 weeks of gestation, which can be used as a predictor at early booking visit. There is no significant difference between the mean value of participants with or without GDM. Prediction of GDM by NLR should be further studied in a well-targeted study population with wide methodology.

Nötrofil lenfosit oranı: Papiller tiroit kanserini multinodüler guatrdan gerçekten ayırt eder mi?

Aim: The aim of this study is to reveal the value of preoperative neutrophil lymphocyte ratio in differential diagnosis between papillary thyroid carcinoma, papillary thyroid microcarcinoma and benign multinodular goiter. Materials and methods: Patients with papillary thyroid carcinoma, papillary thyroid microcarcinoma, and multinodular goiter whose histopathological diagnosis was confirmed by postoperative pathology reports were included in the study. Results: The TSH levels were statistically significantly different among the groups (p &amp;lt; 0.001). The intergroup comparison revealed that the TSH levels were significantly lower in the multinodular goiter group compared to the papillary thyroid carcinoma and papillary thyroid microcarcinoma groups (p &amp;lt; 0.001, p0.001). The mean neutrophil count was 4.98 ± 1.19 in the papillary thyroid carcinoma group, 4.68 ± 1.33 in the papillary thyroid microcarcinoma group, and 4.59 ± 1.40 in the multinodular goiter group. The neutrophil counts of the groups were found to be significantly different (p = 0.013). The papillary thyroid carcinoma group had a significantly higher neutrophil count than the multinodular goiter group. The mean Neutrophil lymphocyte ratio value was 2.20 ± 0.71 in the papillary thyroid carcinoma group and 2.02 ± 0.92 in the multinodular goiter group. Neutrophil lymphocyte ratio values were significantly higher in the the papillary thyroid carcinoma group (p = 0.006). Conclucion: We believe that increased neutrophil lymphocyte ratio may be an indicator of underlying malignant disease in patients with thyroid nodules in the preoperative period.

Is the neutrophil/lymphocyte rate as effective as CURB-65 in the patient management of the community-acquired pneumonia patients admitted to the Emergency Medicine?

Objectives: The aim of this study was to identify the patients with community-acquired pneumonia (CAP) in emergency departments, and to compare CURB-65 scoring system and Neutrophil/Lymphocyte Ratio (NLO) which are some of the commonly used blood parameters to make an inpatient or outpatient decision quickly and effectively. Methods: This study was performed retrospectively by examining the files of 442 patients who were admitted to the adult emergency department of Bursa Yüksek İhtisas Training and Research Hospital between September 1, 2017 and October 31, 2018. The demographic characteristics, physical examination findings, laboratory results, hospitalizations, and CURB-65 scores of the patients included in the study were recorded on a pre-prepared paper and electronic form and statistical analyzes of these data were conducted. Results: Two hundred and fifty-five (57.69%) patients were male and the mean age was 70.93 years. The mean NLO value was 9.85, the mean MPV value was 8.62, the mean eosinophil value was 0.15 and the mean CURB-65 score was 1.85. When the post hoc paired group comparison was conducted for the mean NLR, it was found that the other groups differed from each other except the groups admitted to the intensive care unit and the service. Glasgow Coma Scale score and CURB-65 score were found to be significant predictors for hospitalization to service and intensive care unit (p &amp;lt; 0.05). Conclusions: We think that NLR may be useful in decision-making process, especially in prospective studies, although the use of NLR in patients with CAP is not statistically significant. In this study, we also examined that CURB-65 is an effective scoring system in the management of this patient group.

Comparison of Lymphocyte Neutrophil Ratio in Head Injury Patients with Blood and without Intracranial Bleeding in Dr. M. Djamil Hospital

A B S T R A C TBackground: Head injuries occur every 15 seconds worldwide, with patientsdying every 12 minutes. The value of the Neutrophil Lymphocyte Ratio (NLR) is afactor that influences the assessment and prognostic value of patients withintracranial hemorrhage and without intracranial hemorrhage in head injury.The aim of this study was to determine the relationship between increased NLRbased on the severity of head injury patients with or without intracranialhemorrhage. Methods: This study is a retrospective cross sectional study of headinjury patients with hemorrhage and without intracranial hemorrhage who weretreated at Dr. M. Djamil Hospital Padang in 2020 from May to December 2020.Data was collected in the Medical Records Department of Dr. M. Djamil HospitalPadang who met the inclusion and exclusion criteria. Results : A total of 92patients were included in the inclusion criteria for this study. The results showedthat the mean NLR value in head injury patients was 11.72 with a variation of7.31. The mean NLR level based on the severity of mild head injury was 10.15with a variation of 6.38. The mean NLR level of moderate head injury severity was12.70 with a variation of 7.09. The mean NLR level of severe head injury, was14.69 with a variation of 9.30. The results showed that there was no difference inthe mean of NLR levels in mild head injury patients with hemorrhage and withoutintracranial hemorrhage. The results showed that there was a significantrelationship between NLR levels in moderate head injury patients withhemorrhage (14.20) and without intracranial hemorrhage (7.20) (p value = 0.029),whereas in severe head injury it could not be assessed because there was nosample without hemorrhage. Conclusion: There is an association betweenincreased NLR and intracranial bleeding in moderate head injury patients

Study of neutrophil-lymphocyte ratio (NLR) in recent onset type 2 diabetes mellitus

Introduction: The prevalence of type 2 diabetes mellitus (T2DM) is increasing steadily, assuming an epidemic proportion throughout the world. Most of this increased burden will come from developing countries. Studies show an increasing role of inflammation in the pathophysiology of diabetes. Estimation of neutrophil-lymphocyte ratio (NLR) could be a simple, inexpensive marker to stratify at-risk diabetes patients. This study aimed to estimate the NLR and CRP levels as a measure of systemic inflammation in diabetics compared to healthy controls. We also investigated if NLR was lower in diabetics with good glycemic control. Methods: A cross-sectional comparative study, conducted in a tertiary hospital on 60 patients with T2DM and 69 healthy controls after voluntary informed consent. Anthropometric parameters, fasting plasma glucose, Lipid profile, CBC, CRP, and HbA1c were measured for all participants. Results: The diabetic group showed significantly higher waist circumference(p=0.007) mean TG (p=0.003), VLDL-c (p=0.001), LDL-c (p=0.010), TG/HDL-c (p=0.001), HbA1c (p=0.00001), MPV (p=0.002), NLR (p=0.006), and CRP (p=0.004) values and lower HDL-c values (p=0.039) as compared to the control group. No significant difference was seen in BMI, Waist -Hip ratio, total cholesterol, and total cholesterol/HDL-c values between the two groups. Among the diabetics, only HDL-c (p=0.018) and TG/HDL-c ratio (p=0.049) differed significantly with glycemic control.Conclusion: Diabetics had higher inflammatory markers (NLR, CRP) as compared to controls. Dyslipidemia (high TG, low HDL-c with high TG/HDL-c) and a higher waist circumference were seen in diabetics. Diabetics with fair control of glycemia (HbA1c &lt; 7%) did not demonstrate lower NLR levels indicating that meticulous glycemic control may not ameliorate the chronic inflammation seen in diabetics until dyslipidemia is corrected.Â

Assessing the role of systemic inflammation in the etiopathogenesis of advanced stage keratoconus.

Purpose:It was aimed to compare the levels of inflammation-related parameters, such as neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), in patients with advanced keratoconus (KC) and healthy controls. Also, we evaluated the relationships between these parameters and several corneal topography values used in the KC diagnostic index.Methods:Forty patients with advanced and 40 healthy volunteers were included in this study. In the KC group, 20 patients were nonprogressive KC and 20 patients were progressive KC. In all participating individuals, we evaluated detailed ophthalmologic examination findings and complete blood count data, while corneal topographic measurements were also recorded in patients with KC.Results:The mean NLR value was 2.3 ± 1.19 in the progressive KC group; nonprogressive KC values were 1.99 ± 1.69 and 1.81 ± 0.72 in the control group. Mean PLR value was 113.24 ± 48.44 in the progressive KC group, nonprogressive KC values were 96.47 ± 31.04 and 104.09 ± 35.14 in the control group. No statistically significant difference was found between patients with progressive KC, nonprogressive KC, and healthy volunteers in terms of mean NLR and PLR values (P > 0.05). NLR values were found to demonstrate significant positive correlations with the corneal topography parameters, Symmetry Index front (r = 0.278, P = 0.025), KC Vertex front (r = 0.247, P = 0.048), and Baiocchi Calossi Versaci front (r = 0.273, P = 0.028); there was no significant relationship between corneal topography parameters and PLR values.Conclusion:Although there was no significant difference between the progressive KC, nonprogressive KC, and control groups in inflammation parameters such as NLR and PLR, a positive correlation was observed between the NLR value and some corneal topography findings used in the diagnosis of KC. The role of inflammation in the etiology of KC can be better understood by clinical studies and laboratory tests conducted with prospective studies involving a higher number of patients.