Immune system gets activated in RHD patients leading to formation of different antibodies, and they are also related to the type of lesion. ACL antibodies are present in females with isolated mitral regurgitation, while AECA are present in both the genders with mixed valvular heart disease. Anti GBM antibodies are not seen in RHD patients.

Objective: To determine the role of CRP, white cell count, and granulocytosis in accurately diagnosing acute appendicitis. The sensitivity, specificity, positive predictive value negative predictive values of these tests was calculated.   Methodology: This cross-sectional study was conducted in the immunology department of the Children’s Hospital and University of Child Health Sciences, Lahore over a period of six months from July 2019 to December 2019. A total of 91 suspected patients with acute appendicitis were included. The blood samples were collected from the patients and immediately sent to the lab for estimating serum CRP, WBC count and Neutrophil Percentage (Nu %). The sensitivity, specificity, positive predictive value, and accuracy were calculated for each test, and then the combined sensitivity, specificity, positive predictive value, and accuracy were calculated. Results: The mean values of CRP, WBC, and Nu % were 59.44 mg/L, 15.30 uL, and 76% respectively, among the 71 patients with acute appendicitis. The mean values of CRP, WBC, and Nu % in another group of patients with non-specific abdominal pain were 29.13mg/L, 9.05/uL, and 62.93 percent, respectively.  The sensitivity, specificity, accuracy, positive predictive value, and negative predictive values of these 3 tests 93.87%, 83.63%, 88.5%, 92% and 63.63% respectively. Conclusion: The combination of clinical indications and symptoms, as well as tests of serum CRP, WBC count, and neutrophils percentage, can improve pre-surgical decision-making and rescue children from both negative surgery and appendix complications if left untreated.

Introduction: Myocardial infarction (MI) is diagnosed by history of typical angina chest pain of prolonged duration along with ST segment elevation and ECG and or raised cardiac biomarkers.  Increased levels of CRP are associated with increased risk of HTN, DM and ischemic heart disease. Increased intake of trans fatty acids lead to increased levels of CRP, endothelial dysfunction and ischemic heart disease. Vessel wall is damaged after the inflammation and CRP is a marker of inflammation, so it can predict the cardiovascular disease. Objective: The objective of this study is to determine the level of high sensitivity CRP in MI patients with or without diabetes mellitus. Materials and methods: Total 60 patients were enrolled in the study. Patients having age from 40 to 70 years, diabetic patients and non-diabetic (male) and patients with acute myocardial infarcted patients were included. Patients having heart disease other than MI, patients less than 40 years were excluded. Level of high sensitivity CRP of patients of MI was analyzed by using chemiluminescence technique. High sensitivity CRP was analyzed quantitatively. Results: In this study 60 individuals with AMI were divided into two groups based on presence(n=30) 50% and absence (n=30) 50% of diabetes mellitus. The mean age of the population was 58.32 ± 11.24 years. Levels of high sensitivity CRP were distributed in four groups, the first group includes hsCRP < 10 mg/l, group-2 includes hsCRP 11-50 mg/l, group-3 comprises levels of hsCRP from 51-100mg/l and group-4 includes hsCRP level from 101-150mg/l. Both groups of AMI patients without and with DM had significantly higher levels of hsCRP as 40% and 31% patients have CRP level lies in group 3 and group 4 respectively. Moreover, the diabetic patients had higher levels of hsCRP as 50% of diabetic patients having levels of hsCRP fall in category of group 3 whereas only 13.3% non-diabetic patients have hsCRP falls in category of group 3. And this difference is statistically significant with the p value (p=0.007). Conclusion: The raised hsCRP is seen in AMI patients with history of diabetes, smoking and hypertension as compared to those AMI patients who had no previous history of all these risk factors.