Background & Aim: The patients suspected of appendicitis are evaluated by history, physical examinations and laboratory results. The aim of this study was to assess the diagnostic value of C-reactive protein in patients with suspected acute appendicitis.Patients & Method: In a prospective study, 299 patients with acute abdominal pain who had been admitted to hospital for observation were enrolled. Serum CRP measurements were performed and the results were compared with the final results of histopathology or follow-up results. The results were analyzed using Chi-square test and their accuracy, sensitivity, specificity, and positive and negative predictive values were determined.Results: The findings showed that the accuracy of CRP test in diagnosing appendicitis was 70% (CI=Confidence Interval 95% from 65% to 74.4%), the sensitivity was 80.7%(CI95% from 71.2% to 87.6%), the specificity was 65.4% (CI95% from 58.8% to 71.5%), and the positive and negative predictive values were 49.3% (CI95% from 41.3% to 57.4%) and 89.0%(CI95% from 83.2% to 93.0%) respectively. The odds ratio was 8 (CI95% from 4.3 to 14.4).Conclusion: The results of CRP test can help a surgeon rule out or confirm the diagnosis of appendicitis in suspicious cases.

BACKGROUND AND OBJECTIVE: Preeclampsia is one of the most prevalent diseases in pregnancy that include proteinuria and hypertension and can be associated with morbidity and mortality in mother and neonate. Endothelial cell dysfunction and inflammation are considered to have a crucial role in the pathophysiologic mechanism of preeclampsia. A systemic inflammatory response involves both the immune system and the clotting and fibrinolytic system. The aim of this study was to determine the association of fibrinogen and C-reactive protein (CRP) with the severity of preeclampsia.METHODS: This cross-sectional study was performed on 44 normal pregnant women, 35 cases with mild preeclampsia and 19 cases with severe preeclampsia that referred to Shahid Yahyanejad hospital, Babol, Iran. All of patients were primigravida and single pregnancy, cases over the age of 15 and gestational age of 30 to 40 weeks. Patients didn’t receive betamethasone in last week. The diagnosis of preeclampsia is made whose blood pressure reaches 140/90 mmHg or greater with proteinuria (trace or greater in random urine samples). Blood sample were taken from all subjects to measure CRP and fibrinogen and send to single laboratory. Then the groups were compared.FINDINGS: The mean of CRP was significantly different in control (2.28±0.81) and mild preeclampsia group (4.91±5.99) (p=0.03), and there was not significant difference between control (2.28±0.81) and severe preeclampsia group (3.8±3.05). The mean of fibrinogen was not significantly different in control group (360.5±62.35) and mild preeclampsia (344.71±65.07) and severe preeclampsia groups (340.95±78.62).CONCLUSION: Results show that CRP increased in mild preeclampsia in comparison with control group but there was not significant difference between fibrinogen level in control group with mild and severe preeclampsia.

Background: Dermatophytosis is common cutaneous fungal disease with worldwide distribution. Interleukin8 (IL-8) realized from keratinocytes in the presence of dermatophytic antigens causes induction of acute responses in dermatophyte infection and subsequently production of acute phase proteins occurs in hepatocytes. C-reactive protein (CRP) and Mannose-binding lectin (MBL) are acute phase proteins. Since few researches in the case of acute phase proteins in dermatophytic infections has been accomplished, this study has been designed for determining serum CRP and MBL levels in patients affected to dermatophytosis.Methods: This was a cross sectional study and samples were carried out on 96 healthy individuals and 105 patients affected to dermatophytosis with non probable and in access procedure. For isolation and identification of dermatophyte direct microscopic examination, culturing and complementary examinations were done and for determination of serum CRP and MBL levels in healthy individuals and in patients ELISA test were used. For investigation of relevance between variables, Chi-square, Fisher exact, Mann-Whitney and Roc curve analysis were used and p< 0.05 was considered as meaningful level.Results: The median serum CRP level in healthy individuals and in patients group was 3.31±3.32 mg/ml and 16.60±35.96 mg/ml (p<0.001) respectively and the median serum MBL level was 1.53±1.87 mg/ml and 1.97±2.03 mg/ml (p=0.039) respectively. CRP (p<0.001) and MBL (p=0.042) were determined meaningful parameters for dermatophytosis. MBL deficiency (MBL concentrations <1 mg/ml) was higher in control subjects (56.2%) than in patients (41.0%). Conclusion: Findings of this study indicate increased concentrations of CRP and MBL in patients affected to dermatophytosis and their role in this infection. Probably observation of high frequency of MBL deficiency in healthy individuals in compare with patients group indicates that it is not predisposing factor in affecting to dermatophytosis.

Introduction. The relation between inflammation and coronary artery disease has been shown by several studies. The prognostic value of C-reactive protein in acute coronary syndromes is well established. There are few studies addressing the relation between CRP level and severity of coronary artery disease. In our study this issue is investigated.Methods. This is a cross sectional analytical study that was done in spring and summer of 2003 on 130 patients with stable angina in Chamran Hospital in Isfahan. The blood was tested for CRP level on the day of angiography, the angiographic films were interpreted by three cardiologists. After data collection the relation between angiography score and CRP level was tested by linear regression test.Results. There was no linear relation between CRP level and angiographic score in overall patients (P>0.05). But there was a linear relation between these (P<0.05) two variables in female subgroup of patients.Discussion. At present there is no evidence of direct relation between serum CRP level and severity of coronary artery disease.

Introduction: Aggressive periodontitis is associated with widespread systemic inflammation. Creactive protein is known as a mediator capable of establishing a connection between periodontal disease and several systemic diseases. Some studies have shown that C-reactive protein is superior to cholesterol in predicting cardiovascular problems and death as a result of cerebrovascular accidents. Previous studies have demonstrated the relationship between periodontitis and high serum levels of C-reactive protein in various societies. The present study compared the effect of periodontal surgeries and conventional non-surgical treatment modalities on C-reactive protein level variations in patients with moderate-to-advanced generalized periodontitis.Materials and Methods: In this clinical trial, 80 systemically healthy individuals with an age range of 28-37 years, who had moderate-to-advanced generalized periodontitis, were selected and divided into two equal groups of 40. One group was treated by conventional periodontal modality (scaling) and the other was treated by surgery. The subjects’ medical and periodontal parameters, including Creactive protein serum levels, pocket depth, bone loss and clinical attachment loss, were measured before and six months after treatment. Data was analyzed by SPSS 15 software using independent and paired t-tests (a=0.05).Results: The results showed that both treatment modalities decreased C-reactive protein serum levels, with the surgical treatment having a greater role in the decrease without any significant differences. Both treatment modalities significantly decreased pocket depths, but there was no significant reduction in the attachment loss and bone loss.Conclusion: It appears surgical periodontal treatment results in a greater decrease in C-reactive protein levels compared to non-surgical techniques but further studies are necessary.

Introduction: Coronary artery disease (CAD) is among the most common, serious, chronic and life- threatening illnesses in the world. CAD represents a spectrum of conditions, with acute myocardial infarction at one end of it and silent ischemia at the other. There is growing evidence on importance of prognosis of C- reactive protein (CPR) in unstable angina and this protein is a maker of an adverse prognosis.Materials and Methods: In this cross- sectional research. We study all of the patients that admitted in the coronary care unit of the Shahid Rahimi hospital with unstable angina (n=32) and acute myocardial infarction (n=32), but exclude the patients with exclusion criteria.Complete clinical data and blood samples for laboratory measurements were collected on admission. A baseline ECG were obtained at entry and 12 hours later. A CFM echocardiogram was performed within initial 24 hours. Serum CPR levels were measured on admission and at time of hospital discharge. All patients were followed up for 14 days after discharge.Findings: Patients with MI showed a striking higher CPR during the duty period than with UA. The occurrence of cardiac events at 14 day follow up was related to CPR level at 48 hours and hospital discharge (p=0.02). CPR levels correlated inversely with ejection fraction (r=-0.44).Conclusion: Our data demonstrated that the CPR were significantly higher in patients with acute myocardial infraction than patients with unstable angina. Elevated levels of CPR were associated with cardiac vents out of hospital during a 14-day follow up.

Background & Aim: One the most common problems of patients on maintenance hemodialysis is sleep disorders that depends on comorbidities, age, morning dialysis shift, blood pressure and female gender. In addition, nocturnal and daytime sleep abnormalities are accompanied with cardiovascular and infectious diseases. On the other hand, inflammatory processes play an important role in individuals with end-stage renal disease (ESRD) undergoing hemodialysis, and may affect the levels of additional inflammatory molecules, such as serum C-reactive protein (CRP) which is accompanied with the aggravation of atherosclerosis, protein-dependent malnutrition and cardiovascular diseases.Therefore, the aim of this study was to evaluate the relationship between serum CRP level and the severity of sleep disorders in patients undergoing maintenance hemodialysis; no such study has been conducted in Iran or elsewhere.Patients and Methods: This analytical cross-sectional study was performed on 158 chronic hemodialysis patients (with hemodialysis duration of ³6 months) in Autumn 2005. The patients underwent hemodialysis trice a week (each time 3.5-4 hours). They completed Modified Post Sleep Inventory (PSI) questionnaire to assess sleep related disturbances in 3 forms of sleep: bedtime (PSI1), nocturnal sleep (PSI2) and awakening (PSI3). Simultaneously, a peripheral blood sample was taken for quantitive CRP level before initiating hemodialysis course. The data were collected, described and analyzed using SPSS V.13 software.Results: Statistically significant correlation was found between serum CRP level and PSImean (rs=0.191 and P=0.016).This correlation was more notable in females (rs=0.345 and P=0.002), patients with hemodialysis duration of 48 Months (rs=0.364 and P=0.001) and during nocturnal sleep (PSI2) (rs=0.249 and P=0.002). Whereas, no significant relationship was found between serum CRP level either with age categories or other forms of sleep disorder.Conclusion: The results of our study show that recommending anti-inflammatory treatment in patients on chronic hemodialysis for sleep disturbances is reasonable and rationale.

Introduction: Several studies have shown the independent association of high plasma C-reactive protein (CRP) levels with adverse prognosis in patients with acute myocardial infarction (MI). The aim of this study was to assess the prognostic value of quantitative CRP (Q-CRP) to predict MI in patients with unstable angina. Materials & Methods: This cohort study was carried out between December 2003 & June 2004 in Tehran Heart Centre. 121 patients with unstable angina were selected. Q-CRP of these patients was measured and 10 mg/L considered as a cut-off point value for Q-CRP. Patients divided into two groups according to their Q-CRP cut-off value. Group A with QCRP _10 mg/L (n= 68) and group B with Q-CRP<10 mg/L (n= 53). All patients weremonitored for development of MI during the period of hospitalisation. The results were analysed to find out predictive value of Q-CRP in MI prognosis. Results: The mean age of patients was 60±7 year, 72 (59.5%) male and 49 (40.5%) female. Mean CRP value of participants was 14.42±7/3 (4-60 mg/L). MI was developed in four (5.8 %) patients in group A and in one (1.8%) patient in group B. There was no significant correlation between Q-CRP level and MI development (P>0.38). The sensitivity, specificity, positive and negative predictive values of Q-CRP in this study was 98.3%, 58.5%, 80% and 19.5% respectively.Conclusion: Although there was no significant correlation between Q-CRP level and MI development, in area with limited facilities, Q-CRP can be used for categorization of subjects with high and low risk of MI in unstable angina patients.