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Background: Fournier's gangrene (FG) is a severe, rapidly progressing form of necrotizing fasciitis primarily affecting the perineal and genital regions, associated with high morbidity and mortality rates ranging from 20-40%. Early identification of prognostic factors is crucial for improving patient outcomes. This study aims to evaluate theObjective: effectiveness of the Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as predictors of mortality in patients with Fournier's gangrene. We conducted a single-center retrospective cohort studyMethods: involving 106 patients diagnosed with FG at the Institute of Nephro Urology, Bangalore, from 2018 to 2023. Data on demographics, comorbidities, laboratory results, and outcomes were collected. The NLR and PLR were calculated from initial admission laboratory data, with cutoffs set at NLR ?8 and PLR >140. Statistical analysis was performed using IBM SPSS Stats 25.0, with p < 0.05 considered significant. Thirteen patients (12.27%) died during hospitalization.Results: Significant differences in temperature, heart rate, and comorbidities were observed between survivors and deceased patients. High NLR (?8) was found in 76.92% of deceased patients (p = 0.013), and elevated PLR (>140) was seen in 84.61% (p = 0.027). Multivariate analysis indicated that diabetes mellitus, high NLR, and high PLR were significant predictors of mortality (p < 0.05). Elevated NLR and PLR are significant prognostic factors for mortality inConclusion: patients with Fournier's gangrene. Patients with high NLR, high PLR, and diabetes mellitus require proactive management to improve outcomes. Further multi-institutional prospective studies are warranted to validate these findings.
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Introduction: COVID-19, a global pandemic, has been linked to biochemical parameters such as Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), Total Leucocyte Count (TLC), Neutrophil/Lymphocyte Ratio (NLR), Lactate Dehydrogenase (LDH), and liver function tests, which correlate with disease severity. Prothrombotic markers like D-Dimer and Fibrinogen levels, along with the CT Severity Index (CTSI) indicating lung involvement, are associated with clinical worsening. This study aims to observe biochemical and chest radiological profiles in moderate to severe COVID-19 patients and explore any correlations between them. Methodology: A hospital-based cross-sectional observational study was conducted at a Medical College and Hospital in Kolkata, involving 80 symptomatic COVID-19 patients with SpO? ?94%. Patients with liver, kidney, chronic inflammatory diseases, COPD, malignancy, or asthma were excluded. Results: Out of 80 patients, 29 had moderate and 51 had severe illness. Statistically significant differences were observed in TLC, ESR, CRP, AST, ALT, A:G ratio, LDH, Fibrinogen, and D-Dimer between moderate and severe cases. The CTSI correlated significantly with TLC, NLR, CRP, AST, ALT, A:G ratio, LDH, Fibrinogen, and D-Dimer. CTSI values also differed significantly between moderate and severe COVID-19 cases. Conclusion: Biochemical markers such as ESR, TLC, CRP, liver enzymes, LDH, D-Dimer, and Fibrinogen can help predict disease severity. These markers also correlate with radiological severity in COVID-19.
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Background: The ability to predict clinical outcomes in Non-ST Segment Elevation Myocardial Infarction (NSTEMI) could potentially lead to better risk stratification and treatment management. This systematic review aims to evaluate the predictive value of systemic biomarkers on the clinical outcomes among NSTEMI patients. Methods: A comprehensive search across PubMed, Web of Science and Scopus was conducted, adhering to PRISMA Statement 2020 guidelines. Original clinical studies involving NSTEMI patients with measured systemic biomarkers were considered. Keyword combinations included the following: 'NSTEMI', 'systemic biomarkers', 'clinical outcomes', 'major adverse cardiac events', and/or 'mortality. Results: We included 7 studies in total pooling in 863 participants, with biomarkers such as Syntax score, Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Matrix Metallopeptidase 9 (MMP-9), and Perforin (P), among others. All systemic inflammation (SI) biomarkers were found significantly elevated in patients with high Syntax scores. ROC values for major adverse cardiac events (MACE) ranged from 0.592 to 0.637, and for overall mortality from 0.524 to 0.761. Monocytic MMP-9 mRNA levels were found increased in patients with NSTEMI (0.9 +/- 0.3 relative units (RU)). Positive correlations were found between cardiac troponin I plasma concentrations and the frequency of Perforin-positive cells during the first week after the NSTEMI. Conclusion: Systemic biomarkers, including Syntax score, NLR, PLR, MMP-9, and Perforin, show potential predictive value for clinical outcomes in NSTEMI patients. Their use could aid in early risk stratification and management. However, more large-scale, multicenter studies are warranted to validate these findings.
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Introducción: Los parámetros hematológicos proporcionan al equipo médico marcadores pronósticos útiles en la evolución clínica de la enfermedad de COVID-19. El objetivo fue analizar la relación entre la evolución desfavorable de los valores hematológicos y el óbito de los pacientes internados con COVID-19. Metodologia: El estudio es observacional, correlacional y longitudinal. Se realizó la revisión de fichas clínicas de los pacientes mayores a 18 años internados entre enero y marzo del 2021. Se registró en una planilla Excel el resultado de los parámetros hematológicos al ingreso, a las 48 horas, a los 8 días y al egreso. Los datos fueron analizados con Epi Info 7.1 (CDC, Atlanta) según estadística descriptiva. Resultados: De 144 pacientes, se observaron 68 (47,2%) muertes, con predominio del sexo masculino (63,2%) y, mayores a 60 años (47,1%). Los factores asociados a mortalidad fueron la hipertensión (52,9% vs 31,6%; p=0,009), la diabetes (50% vs 26,3%; p=0,003) y, la obesidad (41,2% vs 25%; p=0,039). Los parámetros hematológicos desfavorables asociados a la mortalidad se presentaron a partir de los 8 días de internación con leucocitosis (64,1% vs 33,3%; p=0,003), linfopenia (96,8% vs 79%; p=0,008), neutrofilia (98,5% vs 87,7%; p=0,029) y, un elevado índice neutrófilo/linfocito (INL) (96,9% vs 75,4%; p=0,001). Discusión: Los parámetros hematológicos que se asociaron con la mortalidad fueron leucocitosis con neutrofilia, linfopenia e INL elevado. Estos parámetros podrían tener valor pronóstico en el seguimiento para contribuir en el manejo de estos pacientes.
Introduction: Hematological parameters provide the medical team with useful prognostic markers in the clinical evolution of COVID-19 disease. The objective was to analyze the relationship between the unfavorable evolution of hematological values and the death of patients hospitalized with COVID-19. Methodology: The study is observational, correlational, and longitudinal. A review of the clinical records of patients over 18 years of age hospitalized between January and March 2021 was carried out. The results of the hematological parameters at admission, at 48 hours, at 8 days and at discharge were recorded in an Excel spreadsheet. The data were analyzed with Epi Info 7.1 (CDC, Atlanta) according to descriptive statistics. Results: Of 144 patients, 68 (47.2%) deaths were observed, with a predominance of males (63.2%) and those over 60 years of age (47.1%). The factors associated with mortality were hypertension (52.9% vs 31.6%; p=0.009), diabetes (50% vs 26.3%; p=0.003) and obesity (41.2% vs 25 %; p=0.039). The unfavorable hematological parameters associated with mortality occurred after 8 days of hospitalization with leukocytosis (64.1% vs 33.3%; p=0.003), lymphopenia (96.8% vs 79%; p=0.008), neutrophilia (98.5% vs 87.7%; p=0.029) and a high neutrophil/lymphocyte ratio (NLR) (96.9% vs 75.4%; p=0.001). Discussion: The hematological parameters that were associated with mortality were leukocytosis with neutrophilia, lymphopenia, and elevated NLR. These parameters could have prognostic value in follow-up to contribute to the management of these patients.
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Background: Neutrophil–lymphocyte ratio (NLR) is a valuable indicator for evaluating inflammatory response and red blood cell distribution width (RBDW), a routinely available biomarker of likely erythropoietic dysfunction, which may be associated with adverse outcomes after cardiac surgery. This study aimed to investigate the association between these two readily available haematological parameters, with the poor outcomes in paediatric patients undergoing cardiac surgery. Methods: A comprehensive review of medical records for paediatric patients who underwent cardiac surgery at our tertiary care centre between April 2022 and June 2023 was carried out. RBDW and NLR values were collected from complete blood count reports obtained on admission to the ICU. Demographic data, surgical details, and postoperative complications were also recorded. A receiver operating characteristic (ROC) curve and multivariable logistic regression were applied to identify the prognosis performance of preoperative NLR and RBDW for poor outcomes. Results: The study included 219 patients meeting the inclusion criteria of which a total of 90 (41%) children experienced at least one of the poor outcomes. Preoperative NLR (AUC=0.88, 95%CI 0.36–0.70, cut off? 4.2) and RBDW (AUC=0.88, 95%CI 0.39–0.73, cut off? 18.5%) showed prognostic significance in the perioperative period. Conclusion: This retrospective observational study highlights a significant association between elevated Red Blood Cell Distribution Width (RBDW) and Neutrophil Lymphocyte Ratio (NLR) values and poor outcomes in paediatric patients undergoing cardiac surgery. These readily available haematological parameters could serve as potential prognostic indicators for identifying patients at risk of poor outcomes.
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Granulomatosis with polyangiitis (GPA) is a rare vasculitis affecting small vessels. Hallmark features include necrotizing granulomas and pauci-immune complex vasculitis, which most commonly affects the upper respiratory tract, lungs, and kidneys. In these patients, we must initiate early treatment to prevent irreversible organ damage and death. Here, we describe three cases that were treated at tertiary care teaching hospital in Gujarat, India.
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Background: Diabetes mellitus (DM) is not a single entity, but a clinical syndrome characterized by hyperglycemia resulting from deficiency of insulin secretion or decreased sensitivity of the tissues to insulin. In India, on average, 40,000 legs are being amputated each year, of which 75% are neuropathic including secondary infection, which can be certainly avoided. Neutrophil-to-lymphocyte ratio (NLR) is recommended as a measure of subclinical inflammation. Hence, it could be possible to find a correlation between NLR ratio and micro and macrovascular complications of diabetes mellitus. Aims and Objectives: Primary: To study the relationship between the presence of diabetic foot ulcer (DFU) and NLR. Secondary: To study neutrophil–lymphocyte ratio as an economical and easy accessible inflammatory marker for predicting and follow-up of micro and macrovascular complications of diabetes mellitus such as foot ulcer. Materials and Methods: This study includes diabetic mellitus patients aged above 18 years with foot ulcer (cases) and without foot ulcer (controls) admitted in H.S.K hospital during the study period. Blood sample was drawn from each patient for necessary biochemical investigation. Statistical Analysis: Statistical analysis was performed using Spacecraft Plasma Interaction Software. Mean, standard deviation, proportions, and Chi-square tests were used to compare between two groups. Results: There is statistically significant correlation between DFU and NLR with a P = 0.000. Conclusion: Mean NLR was significantly higher in cases than controls. Current study proved a positive association between NLR and DFU. NLR is directly calculated from the neutrophil and lymphocyte counts and can be obtained easily from a complete blood cell count during admission and follow up. Hence, rising values of NLR during follow help prognosticate subclinical inflammation and imminent complications like DFU.
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Background: Considering the adverse effect of PROM on birth outcomes and the condition of mother and fetus, early identification of risk factors of PROM and their control can reduce the occurrence of adverse outcomes for mother and fetus and improve their health. This study was conducted with the aim of comparing PLR and NLR in women with PROM and women with preterm delivery. Methods: This case-control study was conducted on 155 women with PPROM as case group and 155 women with preterm delivery as control group. Age, gestational age, type of delivery, baby's birth weight, gravida, parity, APGAR score, rate of hospitalization in Neonatal Intensive Care Unit (NICU), occurrence of neonatal sepsis and development of respiratory distress syndrome (RDS) were recorded from women's medical records. Also, the results of blood tests and PLR and NLR values were calculated for each pregnant woman. Collected data were analyzed by statistical methods in SPSS version 24. Results: The average gestational age and weight of babies at birth time in the case group were significantly lower than those with preterm delivery. The mean of NLR in case group with 4.8±2.5 was significantly higher than control group with 4.2±2.2. The mean of PLR in case group with 111.5±47.6 was significantly higher than control group with 100.98±43.4. Conclusions: The high values of PLR and NLR in the women with PROM compared to women with preterm delivery can be a marker to identify the risk of PPROM in pregnant women.
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RESUMEN Introducción: El melanoma lentiginoso acral (MLA) es el cuarto tipo de melanoma cutáneo y es el subtipo más común en algunos países de América Latina y Asia. El índice neutrófilo-linfocito (NLR) es un marcador inflamatorio que ha demostrado tener utilidad como herramienta pronóstica en varias neoplasias malignas. Objetivo: El objetivo del estudio fue evaluar si el NLR tiene valor pronóstico en la MLA. Se realizó un estudio retrospectivo que incluyó pacientes con MLA entre 2010 y 2015. Métodos: Se empleó un diseño observacional, analítico, y de tipo cohorte retrospectiva. Se trabajó con una población total de 69 pacientes con el diagnóstico de melanoma acral lentiginoso. Para el análisis estadístico se empleó el paquete estadístico SPSS versión 26. Se realizaron modelos de regresión proporcional de Cox univariados y multivariados. Resultados: Se incluyeron un total de 69 pacientes con MLA. La mediana de edad fue 68 años, con predominio del sexo femenino (55%). La mayoría de los pacientes tenían T4 (34%), compromiso ganglionar (57,1%) y Clark III (34,4%). En el análisis univariado, el nivel de Clark III/IV, la anaplasia, la infiltración linfocitaria, el estadio III-IV y el NLR se asociaron con el pronóstico. En el análisis multivariado, el NLR >3,5 (HR 3,9, IC 95% 1,5-10,3, p=0,005) y el nivel de Clark III-IV (HR 3,5, IC 95% 1,6-7,8, p= 0,002) se asociaron con mala supervivencia general (SG). Conclusiones: El NLR es un factor pronóstico independiente de supervivencia en la MLA.
ABSTRACT Introduction: Acral lentiginous melanoma (ALM) is the fourth type of cutaneous melanoma and is the most common subtype in some countries in Latin America and Asia. The neutrophil-lymphocyte ratio (NLR) is an inflammatory marker that has been shown to be useful as a prognostic tool in several malignant neoplasms. Objective: The objective of the study was to evaluate whether NLR has prognostic value in ALM. A retrospective study was conducted that included patients with ALM between 2010 and 2015. Methods: An observational, analytical and retrospective cohort design was used. We worked with a total population of 69 patients with the diagnosis of acral lentiginous melanoma. For the statistical analysis, the SPSS statistical package version 26 was used. Univariate and multivariate Cox proportional regression models were performed. Results: A total of 69 patients with ALM were included. The median age was 68 years, with a predominance of females (55%). Most patients had T4 (34%), lymph node involvement (57.1%), and Clark III (34.4%). In univariate analysis, Clark level III/IV, anaplasia, lymphocytic infiltration, stage III-IV, and NLR were associated with prognoses. In the multivariate analysis, NLR >3.5 (HR 3.9, 95% CI 1.5-10.3, p=0.005) and Clark level III-IV (HR 3.5, 95% CI 1.6-7.8, p= 0.002) were associated with poor overall survival (OS). Conclusions: NLR is an independent prognostic factor for survival in ALM.
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Background: High blood pressure, commonly termed hypertension, is becoming more common in both developing and industrialized nations, making it a worldwide health concern. An increase in blood pressure is broadly categorized into prehypertension and hypertension based on JNC VIII criteria. Prehypertension is a state in between normal blood pressure and high blood pressure, and it is linked with injury to target organs and subclinical atherosclerosis an easy and non-invasive way to look into autonomic dysfunction in those who are pre-hypertensive is to measure heart rate variability (HRV). Neutrophil-to-lymphocyte ratio (NLR) is a cheap, simple, and novel hematological parameter of oxidative stress and pro-inflammatory marker and has recently emerged as a useful indicator to predict cardiovascular risk and adverse outcomes in patients with hypertension. Aims and Objectives: The aim of the study is to assess the correlation between cardiovascular autonomic function using HRV and NLR in pre-hypertensive individuals and to find out if NLR can be used as a marker to detect autonomic dysfunction. Materials and Methods: HRV is recorded in a supine position with eyes closed in the study population. About 2 mL of venous blood was collected from the individuals to measure NLR using an automated hematology analyzer. Results: The mean values of time domain indices showed significant reduction and frequency domain indices low frequency (LF) values were significantly higher and high frequency (HF) values were significantly lower in pre-hypertensive. The mean NLR was significantly higher in pre-hypertensive individuals. Time domain indices showed a negative correlation with NLR. HF values were negatively correlated and LF values were positively correlated with NLR. Conclusion: NLR was increased in pre-hypertensive individuals which suggest that people in pre-hypertensive state are also at risk of developing cardiovascular and cerebrovascular complications. This study showed a positive association between NLR and sympathetic activity and a negative association between NLR and parasympathetic activity. This concludes that NLR could be used as a marker to assess autonomic dysfunction in them.
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ABSTRACT Background: Since to the prognosis of lung squamous cell carcinoma is generally poor, there is an urgent need to innovate new prognostic biomarkers and therapeutic targets to improve patient outcomes. Objectives: Our goal was to develop a novel multi-gene prognostic model linked to neutrophils for predicting lung squamous cell carcinoma prognosis. Methods: We utilized messenger RNA expression profiles and relevant clinical data of lung squamous cell carcinoma patients from the Cancer Genome Atlas database. Through K-means clustering, least absolute shrinkage and selection operator regression, and univariate/multivariate Cox regression analyses, we identified 12 neutrophil-related genes strongly related to patient survival and constructed a prognostic model. We verified the stability of the model in the Cancer Genome Atlas database and gene expression omnibus validation set, demonstrating the robust predictive performance of the model. Results: Immunoinfiltration analysis revealed remarkably elevated levels of infiltration for natural killer cells resting and monocytes in the high-risk group compared to the low-risk group, while macrophages had considerably lower infiltration in the high risk group. Most immune checkpoint genes, including programmed cell death protein 1 and cytotoxic T-lymphocyte-associated antigen 4, exhibited high expression levels in the high risk group. Tumor immune dysfunction and exclusion scores and immunophenoscore results suggested a potential inclination toward immunotherapy in the "RIC" version V2 revised high risk group. Moreover, prediction results from the CellMiner database revealed great correlations between drug sensitivity (e.g., Vinorelbine and PKI-587) and prognostic genes. Conclusion: Overall, our study established a reliable prognostic risk model that possessed significant value in predicting the overall survival of lung squamous cell carcinoma patients and may guide personalized treatment strategies. (Rev Invest Clin. 2024;76(2):116-31)
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Background: Liver resection, a crucial surgical intervention for hepatic conditions, involves removing a portion of the liver, addressing benign and malignant lesions. The Pringle's maneuver, an intermittent portal in?ow control, is frequently used perioperatively during liver resection. To assess whether Pringles maneuver during liver resection as a method of in?owAim: control has any in?uence on operative outcome. Between July 2013 and March 2015, 80 liver resection cases werePatients and Methods randomly divided into Group A (Pringle's maneuver) and Group B (Non-Pringle's). Both groups received selective low CVP anesthesia. After excluding 14 cases, the remaining 66 cases underwent minor or major hepatectomy (?3 segments). Assessments included blood lactate, Neutrophil-to-Lymphocyte Ratio, liver enzymes tests, and bilirubin levels on days 1, 3, and 5. In Group A, major and rightResults: hepatectomies showed increased blood loss, higher transfusion needs, and prolonged hospital stays. Elevated liver enzymes, lactate levels, and Neutrophil-to-Lymphocyte ratio on day one was observed in Group A. Group A experienced signi?cantly higher-Grade B & C liver failure, postoperative hyperglycaemia, and mortality (?ve deaths attributed to liver failure). Univariate analysis revealed age, comorbidity, liver condition, resection type, bloodless procedure, duration, N/L ratio, lactate level, and 50-50 criteria signi?cantly correlated with morbidity and mortality (p<0.05). Pringle's manoeuvre in liver resection extends hospital stay, heightens transfusion requirement, and raisesConclusion: complications, particularly in diseased livers. Elevated blood lactate and Neutrophil-to-Lymphocyte ratio reliably predict postoperative liver failure and mortality.
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Background: Diabetes mellitus (DM) is a common metabolic disorder leading to microvascular and macrovascular complications. Chronic inflammation accelerates the development of complications associated with DM. Measurement of inflammatory mediators is not practically feasible. Neutrophil–lymphocyte ratio (NLR) serves as a cheap, reliable, and valid marker for assessing inflammatory activity. Aims and Objectives: (i) To evaluate the correlation of NLR and microalbuminuria in DM patients; (ii) to evaluate the correlation of NLR with HbA1c; and (iii) to evaluate the correlation of platelet count with microalbuminuria. Materials and Methods: One hundred patients of either sex with DM were evaluated for microalbuminuria, NLR, HbA1c, and platelet count after obtaining institutional human ethics committee clearance. NLR was evaluated for correlation with microalbuminuria and HbA1c. Platelet count was also evaluated for correlation with microalbuminuria. Results: Mean NLR of male patient was 2.1 and female was 2.33. The mean microalbuminuria level in male patient was 527.03 mcg/mg of creatinine and female was 215.36 mcg/mg of creatinine. There was a moderate degree of correlation of microalbuminuria with increased NLR. The study showed a strong correlation between NLR, microalbuminuria, HbA1c, and platelet count. Conclusion: NLR has a strong correlation with microalbuminuria and could be used to assess the onset and progression of diabetic nephropathy.
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Objectives: The role of immunological disturbance in bipolar disorder (BD) and schizophrenia has been highlighted by some studies. There are few studies available that compared the inflammatory markers between schizophrenia and BD, but only one study demonstrated the difference in terms of neutrophil/lymphocyte ratio (NLR) and Platelet/lymphocyte ratio (PLR) between them. So this study was conducted to compare the NLR and PLR values among schizophrenia, bipolar mania, and healthy controls in order to find out a potential biomarker for these disorders. Material and Methods: Eighty consecutive patients suffering from bipolar mania, 80 suffering from schizophrenia, and 80 healthy controls were recruited in the psychiatric center situated at a tertiary care hospital. Blood samples of all groups were transferred to the laboratory for complete blood count analysis. Thereafter, all the groups were compared by applying proper statistics. Results: Significant higher level of neutrophil count and NLR value was seen in both bipolar mania and schizophrenia groups compared to healthy controls. There was no difference observed between schizophrenia and the bipolar mania group regarding NLR, PLR, neutrophils, lymphocytes, and platelets values. Conclusion: NLR has appeared as a potential marker in our study, and it reflects a state of low-grade inflammation in both schizophrenia and bipolar mania. BD and schizophrenia have been considered as part of one continuum, which is also supported by the findings of our study. These markers can help in the prognosis and treatment of at least a subsection of patients and also are inexpensive and easy to assess.
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Background: To evaluate the relationship of overall survival (OS) and progression?free survival (PFS) with the derived neutrophil?lymphocyte ratio (dNLR), neutrophil?lymphocyte ratio (NLR), lymphocyte?monocyte ratio (LMR), and platelet?lymphocyte ratio (PLR) in patients with epidermal growth factor receptor (EGFR)?mutant non?small cell lung cancer (NSCLC). Methods: The study included 43 patients with EGFR?mutant metastatic NSCLC. The dNLR, NLR, LMR, and PLR values were calculated using the baseline complete blood counts before and after treatment with erlotinib. Results: The NLR value had the best diagnostic test performance with a sensitivity of 91.3%. dNLR, NLR, LMR, and PLR were found to be significant for the prediction of OS and PFS. While the delta dNLR and NLR values were significant for OS, only the delta NLR value was significant for PFS. Conclusions: The dNLR, NLR, LMR, and PLR values were found to be significant in the prediction of OS and PFS in erlotinib?treated metastatic NSCLC. Further clinical studies are needed to determine the ideal target?specific tyrosine kinase inhibitor in cases of metastatic NSCLC presenting with the EGFR?activating mutation.
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Background: Cervical cancer is the second most common cancer among females worldwide. The role of platelets in cancer progression and metastasis have been evaluated in various cancers. This study is done to assess the association between platelet parameters and invasive squamous cell carcinoma of the cervix. Materials and Methods: Eighty cases of squamous cell carcinoma of the cervix were retrospectively collected from the medical record department. Values of platelet parameters such as platelet count, mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), platelet?large cell ratio (P?LCR), platelet?lymphocyte ratio (PLR), platelet?neutrophil ratio (PNR), and platelet?monocyte ratio (PMR) are collected from automated hematology analyzer. These values were compared with 80 healthy controls which were randomly selected. Values of platelet parameters were also compared among Federation Internationale de Gynecolgie et d’Obstetrique (FIGO) stages in 80 cases. Result: Mean ± standard deviation (SD) for platelet count, MPV, PDW, PCT, P?LCR, PLR, PNR, and PMR among cases were 316 ± 100.37 × 109/L, 9.98 ± 0.96, 11.11 ± 2.27, 0.31 ± 0.092, 24.09 ± 7.62, 179.35 ± 85.53, 63.89 ± 42.10, and 492.29 ± 192.86, respectively, and in controls were 300.30 ± 79.40 × 109/L, 9.97 ± 0.83, 10.97 ± 1.80, 0.59 ± 2.65, 23.94 ± 6.81, 137.72 ± 50.52, 60.07 ± 26.68, and 563.65 ± 602.55, respectively. The PLR between cases and controls was statistically significant. The platelet count and PCT between stages was statistically significant wherein the values increased from stage II to stage IV. Conclusion: Platelet parameters are importance in cervical cancer. PLR, platelet count, and PCT are platelet parameters that can be used as predictors and prognostic parameters in cervical cancer. These parameters are cost?effective and can be considered in low resource settings. However, a multicentric study with a larger sample size should be done to extrapolate the findings for patient care.
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Background: It had been observed that there is relationship of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) with disease severity in children with COVID-19 and post-COVID, multisystem inflammatory disease in children (MIS-C). Study conducted to determine NLR and PLR correlation with this disease severity.Methods: Prospective descriptive analytical study conducted at the children抯 hospital and university of child health sciences, Lahore. Consecutive confirmed cases of COVID-19 infection and post-COVID, MIS-C diagnosed on the basis of RT-PCR from nasopharyngeal swab and antibody test admitted from March 2020 to October 2021 were included through consecutive sampling. Complete blood (CBC) was done and NLR and PLR was determinedResults: Majority 198 (74.2%) of the 267 patients had a diagnosis of COVID-19 and 69 (25.8%) were post-COVID MIS-C. There was a male preponderance 177 (66.3%) and the mean age was 6.1�7 years (95% CI: 5.62-6.74). Majority children had mild disease 80 (30%), 34 (12.7%) were critical and there were 37 (13.8%) deaths. Underlying comorbidity was present in 55 (20.6%). As the severity of symptoms changed from asymptomatic to severe disease, there was a significant rise of mean NLR from 1.88�40 to 5.47�77 respectively (p<0.001). PLR however, failed to show any kind of association with severity of the symptoms (p=0.922).Conclusions: NLR served as a marker of disease severity among pediatric patients suffering from COVID-19 and MIS-C. However, PLR failed to show any relation with disease severity.
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Background: Aim of study was to analyse clinical and laboratory features and outcome of COVID-19 patients admitted in second wave of pandemic (April1 to May 31, 2021) (SW) and compare with covid 19 patients in third wave (TW). Methods: COVID-19 positivity were confirmed in both SW and TW. Demographic features, symptoms and duration were recorded. X ray chest was done at the time of admission and for monitoring. Complete blood count, C reactive protein, renal function tests, liver function tests, LDH and D dimer levels were done. The positive patients were categorized as mild, moderate and severe based on the clinical, imaging and laboratory features. Results: Among 297 patients screened, 171 patients were diagnosed as positive (57.5%). 107 patients were admitted (62.5%). (M:F ratio - 1.74:1). The most common symptoms for hospitalization were fever, cough and shortness of breath. Though 38 patients had neutrophilia, only 16 of them presented with high NLR ratio. Consolidation on chest X-ray was present in all patients but the degree varied. 38 patients required ICU admission and oxygen support. 18 patients succumbed to disease. Among 140 patients (TW) (December 1 to January 31 2022, 69 (43.1%) were positive. Only 12 patients required hospitalisation. The only symptom was high fever. The NLR ratio ranged from 1-6 and never went beyond 6. All patients were discharged after 2-3 days. Conclusions: The demographic features, co morbidities, presenting symptom of fever and X ray findings were similar in both waves. But the NLR ratio was never beyond 6 in TW. This was probably due to early reporting and vaccination status of the population and less virulent strain of the virus in TW. The present study confirmed that raised NLR and low levels of oxygen saturation at the time of admission are important predictors of disease severity.
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@#Introduction: Understand the progression of colorectal cancer from the beginning until the advance stages is difficult and challenging. However, this could be overcome with a good animal model. Methods: In this study, a modified approach had been used to develop colorectal cancer model. The model was developed and monitored from colitis formation until the late stage of colorectal cancer. The changes of neutrophil lymphocyte ratio (NLR), serum microRNAs and infiltrate neutrophil in different stages of colorectal cancer were assessed in this study. Results: Results showed that the progression of the disease is correlated with NLR as early as the formation of colitis (r=0.121, p<0.026). Meanwhile, the size of the tumor at each stage is also associated with the NLR value (r=0.185, p<0.0012). In the serum microRNAs study, it was found microRNAs expression in blood serum change in different stages of colorectal cancer. In the early stage of colitis formation, miR223 (> 3 fold expression, p < 0.0025) were abundantly found in the blood serum. Meanwhile in others stage mild (miRNA345 > 2.5 fold, p<0.0011), moderate (miRNA347 & miR512 > 3 fold, p<0.002) and severe (miR31 & miR145 > 2 fold, p<0.0001) microRNAs were also found expressed differently. The quantities of infiltrate neutrophil were varied in different stages of the disease. Conclusion: This study provides an insight into the immunity and molecular level of colorectal cancer and it allows a progressive monitoring on the changes in the molecular, cellular and histological level.
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Objective To investigate the expression of neutrophil extracellular traps (NETs) and phagocytic function in the peripheral blood of patients with hepatic alveolar echinococcosis (HAE), and to examine their correlations with clinical inflamma tory indicators and liver functions. Methods A total of 50 patients with HAE admitted to Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qinghai University from August 2022 to June 2023 were enrolled, while 50 age- and gender-matched healthy individuals from the Centre for Healthy Examinations of the hospital during the same period served as controls. The levels of NETs markers neutrophil myeloperoxidase (MPO) and neutrophil elastase (NE) were measured using enzyme-linked immunosorbent assay (ELISA). Peripheral blood neutrophils were isolated using density gradient centrifugation, stimulated in vitro using phorbol 12-myristate 13 acetate (PMA), and the levels of MPO and citrullination histone H3 (CitH3) released by neutrophils were quantified using flow cytometry. The phagocytic functions of neutrophils were examined using flow cytometry. In addition, the correlations of MPO and NE levels with clinical inflammatory indicators and liver biochemical indicators were examined using Spearman correlation analysis among HAE patients. Results The peripheral blood plasma MPO［(417.15 ± 76.08) ng/mL vs. (255.70 ± 80.84) ng/mL; t = 10.28, P < 0.05］, NE［(23.16 ± 6.75) ng/mL vs. (11.92 ± 3.17) ng/mL; t = 10.65, P < 0.05］and CitH3 levels［(33.93 ± 18.93) ng/mL vs. (19.52 ± 13.89) ng/mL; t = 4.34, P < 0.05］were all significantly higher among HAE patients than among healthy controls, and a lower phagocytosis rate of neutrophils was detected among HAE patients than among healthy controls［(70.85 ± 7.32)% vs. (94.04 ± 3.90)%; t = 20.18, P < 0.05］, and the ability to produce NETs by neutrophils was higher among HAE patients than among healthy controls following in vitro PMA stimulation. Pearson correlation analysis showed that the phagocytosis rate of neutrophils correlated negatively with platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), interleukin-6 (IL-6) level and C-reactive protein (CRP) level (rs = −0.515 to −0.392, all P values < 0.05), and the MPO and NE levels positively correlated with inflammatory markers NLR, PLR, CRP and IL-6 (rs = 0.333 to 0.445, all P values < 0.05) and clinical liver biochemical indicators aspartic transaminase, alanine aminotransferase, direct bilirubin and total bilirubin among HAE patients (rs = 0.290 to 0.628, all P values < 0.001). Conclusions Excessive formation of NETs is found among HAE patients, which affects the phagocytic ability of neutrophils and results in elevated levels of inflammatory indicators. NETs markers may be promising novel biomarkers for early diagnosis, monitoring, and severity assessment of liver disease.