Introduction: Acute appendicitis is one of the most common problems requiring emergency surgery. Diagnosis is based on history, physical examination and laboratory findings. Rate of misdiagnosis of appendicitis especially in female is up to 23.2%. Some basic laboratory examinations such us white blood cell count, CRP and ESR have been suggested as aids in the diagnosis of acute appendicitis. But results are controversial Objective: This study was designed to consideration of association rate of leukocytosis, increased CRP and ESR in acute appendicitis Materials and Methods: In this prospective study, 158 patients were admitted with clinical diagnosis of acute appendicitis from September 2001 to March 2002 in Poursina hospital in Rasht. Blood samples for WBC, CPR and ESR were sent to the laboratory preoperatively. Then sensitivity, specificity, PPV and NPV of these tests were determined and analyzed.Results: There were 98 males (62%) and 60 females (38%). The mean age was 28.41 years (range 3 to 70 years). 146(92.4%) patients have histologically confirmed appendicitis and 12(7.6%) had normal appendix. Sensitivity, specificity, PPV and NPV for leukocytosis were in order: 84.2%, 33.3%, 93.9% and 14.8%; for increased CRP were in order 79.4%, 25%, 92.8% and 9.09%, and for increased ESR were: 69.2%, 8.3%, 90.2%, 22% in orderly. When all tests are used for diagnosis, these criteria were 54.8%, 66.6%, 95.2% and 10.8% respectively. In attention to sensitivity and value of positive (PPV) and increased WBC, CRP and ESR, it can be resulted that positivity of these tests in suspected appendicitis can strengthen the clinical diagnosis but lowered value of negative (NPV) tests showed that the negativity of each test or all tests together can not verify acute appendicitis.Conclusion: In presence of Leukocytosis, increased CPR&ESR probability of appendicitis was increased in clinically acute appendicitis. But normal value of WBC, CRP& ESR doesn't rule out acute appendicitis.

The erythrocyte sedimentation rate (ESR) is a laboratory test commonly used to detect the presence of inflammation or inflammatory disorders in the body. Studies indicate that ESR levels are naturally higher in women compared to men. This differenece may be attributed to various factors, including hormonal changes associated with the menstrual cycle, pregnancy, and menopause, as well as more prevalent pathological conditions in women, such as anemia and autoimmune diseases. This article provides a comprehensive analysis of the factors contributing to higher ESR levels in women, gender-based differences in this parameter, and its associated clinical implications.

Infection is a common complication of diabetic foot that needs hospital admission and surgical intervention.Diabetic foot occurs in one of each ten diabetic patients. Diabetic foot complications are osteomyelitis, arthritis and abscess formation. Radiography, isotope scans, MRI and CT-scan are the procedures that help diagnosis of these complications but these are not always cost effective or available. If ESR and CRP level could help us to determine depth and width of diabetic foot ulcer and the possibility of presence of osteomyelitis, we can cost saving and begin appropriate therapy very soon. A retrospective chart review of 35 diabetic patients admitted to the Rassol Akram Hospital with diagnosis of osteomyelitis or cellulites of the foot during a 2-year periods (1999-2000) was performed. Depth and width of ulcer, presence or absence of osteomyelitis, ESR and CRP level are compared in this group. A retrospective review of 35 diabetic patients that admitted to this hospital only for control of blood glucose also was performed as control group. In this survey ESR and CRP level in diabetic foot group was higher than control group(P.value=0.00), and in diabetic foot with osteomyelitis was higher than diabetic foot without osteomyelitis(P.value=0.001 for ESR and P.value=0.00 for CRP). CRP level in large ulcers were higher than small ulcers(P.value=0.001). ESR and CRP level in patients with long duration of admission were higher than patients with short duration (P.value=0.00 for ESR and P.value=0.001 for CRP). We concluded that higher ESR and CRP level is seen in diabetic foot with osteomyelitis and higher CRP level is indicated of the presence of large ulcer and if patient with diabetic foot has a high ESR and CRP level, need a long period of treatment. We concluded that in diabetic foot only when ESR and CRP level is high investigation for presence of osteomyelitis could be necessary.

In this study, attempts were made to recovery the used turbine blades made up of INCONEL738 by Electro Slag Remelting (ESR) method. Using an appropriate slag and addition of metallic aluminum, the original composition was maintained and the amount of oxygen, hydrogen and nitrogen remained in the acceptable level. In order to explore the effect of remelting with ESR on the microstructure, tensile properties and age hardening behavior of the investigated alloy, the as-cast and wrought samples were solution treated at 1120oC and aged at 845oC for different lengths of time. The results showed that the microstructure, tensile properties and age hardening behavior of ESR melted INCONEL738 are similar to corresponding standard values and hence, the ESR method was found appropriate to be used to recovery the INCONEL738 alloy from the used turbine blades.