ABSTRACT
Background: C-reactive protein (CRP) is a valuable biomarker of sepsis. Levels of CRP increase very rapidly in response to infection, and decrease just as rapidly with the resolution of the condition. The aim of the research was to study, C-reactive protein levels in patients of sepsis and to study the pattern of CRP levels in patients of Sepsis with hypertension, diabetes, smokers and alcoholics.Methods: This prospective observational cohort study was conducted from December 2016 to September 2018 in 100 cases of sepsis. Patients presenting in emergency with sepsis were included as subjects. C- reactive protein was measured in every patient at the time of admission and after 72 hours. Facts related to history, clinical examination and biochemical parameters were recorded in a pretyped proforma. Data were analyzed using SPSS software.Results: Males outnumbered females. Most of the patients40(40%) were in the age group of less than 30 years age group. CRP levels were markedly elevated in patients with diabetes mellitus (92.2±102.63) as compared to patients with hypertension (36.66±26.97) or both (24.20±12.87). CRP levels were higher in alcoholics (60.59±44.20) as compared to smokers (13.37±10.96). CRP levels decreased significantly after 72 hours compared to CRP levels at the time of admission (p <0.001) across all patients suggestive of acute infection.Conclusions: Serial CRP measurement, rather than a single determination at the time of admission, is cheap and valuable in the diagnosis of sepsis and in monitoring the response to therapy. CRP levels shows exaggerated response in diabetes mellitus and alcoholics with sepsis in this study.
ABSTRACT
Background: Adenosine deaminase has been proposed to be a useful surrogate marker for tuberculosis in pleural, pericardial and peritoneal fluids. Studies have confirmed high sensitivity and specificity of Adenosine deaminase for early diagnosis of extra pulmonary tuberculosis. Aim: To assess the diagnostic level of ADA in tubercular serosal effusion and to determine its sensitivity and specificity. Methods: The study was carried out on 120 patients suffering from serosal effusion (50 pleural, 50 peritoneal, and 20 cases of pericardial effusion) . Detailed clinical history, physical examination and routine and relevant investigation of all patients including ADA estimation by GALANTI AND GIUSTI method was done. Results: ADA Level in tuberculous pleural effusion ranged from 45-160 U/L with a mean level of 100U/L and sensitivity and specificity of 100% (p<0.001, highly significant). ADA level in tuberculous peritoneal effusion ranged from 35-135 U/L with a mean level of 92U/L and sensitivity and specificity of 100% and 95% respectively (p<0.001, highly significant). ADA level in tubercular pericardial effusion ranged from 63-117 U/L with a mean level of 90U/L and sensitivity and specificity of 100% and 83.3% respectively (p<0.005, very significant).In toto serosal fluid ADA level estimation offers high degree of sensitivity and specificity of about 100% and 94.6% respectively, Conclusion: ADA was found positive with a mean value of 100U/L, 92U/L and 90 U/L in tubercular pleural, peritoneal and pericardial effusion respectively with overall 100% sensitivity and 94.6% specificity and cutoff value of 40 U/L.