Background: Presence of metabolic syndrome in an individual substantially increases his risk of developing cardiovascular disease and type 2 diabetes mellitus. Occurrence of both obesity and type 2 DM have reached epidemic proportions in India. Metabolic syndrome is considered to be a proinflamatory state associated with low grade systemic inflammation. C-reactive protein is a robust biomarker of this chronic systemic inflammation. Higher values of high sensitivity C-reactive protein (hs-CRP) are associated with metabolic syndrome and its components and provides additional prognostic information on future development of cardiovascular events in them. Methods: 50 patients aged 18 years and above with metabolic syndrome, and 50 age and sex matched controls attending OPD or admitted to medicine department wards of Bangalore Medical College were enrolled for this cross sectional study. The new IDF criteria were used for the diagnosis of metabolic syndrome. A fasting blood sample was drawn for estimation of hs-CRP, blood glucose and lipid profile. Waist circumference, height and weight were measured at the same time. The results were tabulated and analysed. Results: There was a statistically significant difference in values of various demographic parameters like BMI, waist circumference, BP and biochemical parameters like blood sugar, lipid profile between cases and controls. Patients with metabolic syndrome had higher mean value of hs-CRP (8.3±1.04 Vs 1.6±0.79mg/l) with a p value <0.001. Conclusions: Patients with metabolic syndrome had significantly higher levels of hs-CRP when compared to controls and hs-CRP levels increased linearly with increasing number of metabolic syndrome components. Hence hs-CRP can probably be used as a surrogate marker of chronic inflammation in patients with metabolic syndrome.

No abstract

Background: Community acquired pneumonia refers to pneumonia contracted by a person with little or no contact with health care system. Following endotoxemia the number of circulating neutrophils increases while lymphocyte counts decrease. Combining both parameters seems a logical step and the ratio of neutrophil and lymphocyte counts is increasingly used in several clinical circumstances. Initially, this so-called neutrophil-lymphocyte count ratio (NLCR) was studied as an infection marker in ICU patients and found to correlate well with disease severity and outcome, according to APACHE-II and SOFA scores. In the current study, we explored the value of the NLCR in patients admitted with Community acquired pneumonia. Aims and Objectives: 1) To find out the value of Neutrophil-Lymphocyte Count Ratio (NLCR)in Community Acquired Pneumonia (CAP). 2) To study Neutrophil-Lymphocyte Count Ratio (NLCR) as prognostic indicator in Community Acquired Pneumonia (CAP). Materials and Methods: This prospective study was conducted on minimum of 100 patients admitted to hospitals from November 2015 to September 2017 from Bangalore. After admission of cases based on CURB-65 scores, a detailed history and clinical examination was done along with chest x-ray to establish the diagnosis. Before taking into the study all patients had signed the informed consent. Routine haematological investigations done on day 1,3 & 7 were carried out. Serum c-reactive protein levels, Urea nitrogen levels, Sputum for culture and sensitivity and Acid-fast bacilli (AFB) was done on the same day of admission. ANC (Absolute neutrophil count), ALC (Absolute lymphocyte count) and NLCR were calculated. Results: Our study included age groups above 18yrs. Majority of the patients in the study were between 58-67 years (30%) followed by 48-57 years (27%). As the CURB-65 score increased from score 0 to score 4–5, the NLCR consistently increased, while the lymphocyte counts consistently decreased. In patients who died there was a significantly higher NLCR at presentation compared to patients that survived (15.18±3.55 versus 11.73±3.01, p-value,0.003). Conclusion: In our study increased NLCR carried poor prognosis which correlated with high CURB65 score and ICU admission. In patients who died there was a significantly higher NLCR at presentation compared to patients those survived.