European Journal of Molecular & Clinical Medicine

Knee osteoarthritis is a common cause of severe pain and functional limitation. Total knee arthroplasty is an effective procedure to relieve pain, restore knee function, and improve quality of life for patients with end stage knee arthritis. The aim of this study was to investigate the inflammatory process in patients with primary knee osteoarthritis before surgery and in subsequent periods following total knee arthroplasty. A prospective study of 14 patients undergoing primary total knee replacements was conducted from October 2014 to May 2015 in our institution. The patients were evaluated by monitoring serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), knee skin temperature and clinical status. Measurements were carried out preoperatively and postoperatively on day 2 and 2nd week, 6th week, 14th week and 24th week during follow-up review. The CRP was elevated on the 2nd postoperative day but fell to preoperative values at two weeks postoperatively. CRP returned to within the normal range by six weeks postoperatively. In addition, the postoperative ESR showed a slow rise with a maximum level at two weeks after surgery and returned to within normal range at 14 weeks postoperatively. The difference in skin temperature between operated and contralateral knee had a mean value of 3.9C at two weeks. The mean value decreased to 3.4C at six weeks, 2.3C at 14 weeks, and 1.0C at 24 weeks. The difference in skin temperature decreased gradually and eventually there was no statistically significant difference at 24 weeks after surgery. A sustained elevation in serum CRP, ESR, and skin temperature must raise the concern of early complication and may suggest the development of postoperative complication such as haematoma and or infection.

Background: TB and HIV form a lethal combination, as each fuels the progress of the other in the infected patients. This study assessed the haematological parameters of pulmonary tuberculosis (PTB) patients with and without HIV infection attending the shyam shah medical college, Rewa. Aims: To study hematological parameter namely Hb (Hemoglobin), total RBC count, Total WBC count, ESR (Erythrocyte Sedimentation Rate) and platelets in pulmonary tuberculosis. Methods: To analytical study of all 120 (TB with HIV 60 / TB without HIV 60)  TB patients who were attending Department of Medicine, Shyam Shah Medical College, Rewa (M.P.). And patientsrefered from Anti-retroviral therapy centre, with sputum positivity for AFB (acid fast bacillius).Results: In our study, 83.3% were males and 16.6 % were females in the TB with HIV group. 70% of patients were in the age group of 25 – 45 years in the TB with HIV group, whereas 86.6% of patients were in age group of 25 – 45 years in the TB without HIV. 90% of patients were underweight with BMI less than 18.5, in TB with HIV group, and 73.3% of patients were underweight in TB without HIV group. 80% were anemic in the TB with HIV and 66.6% were anemic in TB without HIV group. 63.4% of patients with TB and HIV had thrombocytopenia, whereas only 10% of patients had thrombocytopenia in TB without HIV group. patients with tuberculosis per se have increased ESR count, whereas TB-HIV coinfection has drastically reduced the ESR count. Among patients with TB and HIV 83.3% of patients had ESR less than 60 mm/hr., whereas 96.6% of TB without HIV patients had ESR greater than 60 mm/hr. since, ESR is a marker of chronic inflammatory states like TB and HIV is a immunosuppressive state, the co-infection of TB with HIV has drastically reduced ESR values in these patients.Conclusion:ESR values are drastically reduced in TB patients with HIV, rather TB patients per se. hence, an ESR less than 60 mm / hr in pulmonary tuberculosis patients should arouse a suspicion of underlying immunocompromised state.