Diagnostic accuracy of an integrated approach using conventional ultrasonography, and Doppler and strain elastography in the evaluation of superficial soft tissue lesions

Introduction: To assess the diagnostic accuracy of an integrated approach using conventional ultrasonography, colour Doppler ultrasonography, and elastography strain ratios in tandem in the evaluation of superficial soft tissue lesions. Material and methods: Sixty-five subjects were included in this prospective cross-sectional study. Greyscale features and Doppler parameters were recorded. Strain elastography of the non-vascular and non-cystic lesions was performed and strain ratios were calculated. Fine-needle aspiration or biopsy of all the lesions was performed depending on their site and condition. Inter-rater k agreement was used to determine the strength of agreement between imaging-based diagnosis and histopathological diagnosis. A diagnostic test was used to calculate the sensitivity, specificity, positive predictive value, and negative predictive value. A p value of < 0.05 was considered statistically significant. Results: Multiple superficial soft tissue lesions were studied, the majority of which were lipomas, vascular anomalies, and epidermoid cysts. The diagnostic accuracy was very high and varied from 92.31% to 100% for various masses. The imaging-based diagnosis was in agreement with the histopathological diagnosis in 86.15% (n = 56) and disagreement in 13.85% (n = 9) of the cases (p < 0.007). There was very good inter-rater agreement between the imaging-based diagnosis and histopathological diagnosis (κ = 0.818). Conclusions: The combined use of conventional ultrasonography, colour Doppler, and elastography strain ratios provides a very effective non-invasive tool for the diagnosis of superficial soft tissue lesions and may negate the need for unnecessary biopsies. The advantage of this integrated approach using various ultrasound techniques needs no further emphasis

Assessment of agricultural sustainability: A study of farmers growing basmati rice under conventional and fair-trade systems in India

The agricultural sustainability at grass root level in India is under increasing debates, discussions and demonstrations with reasonable evidence towards economic vulnerability, environmental degradation as well as social disharmony. Initiatives like fair-trade are bringing agri-produce of organised farmer groups on premise and proclamation of making greater contributions towards sustainability. This research paper endeavours to identify most relevant factors and indicators for assessing the sustainability and compare for farmers growing basmati rice under fair-trade as well as conventional system. Primary data was collected on a self-administered questionnaire based on identified four factors of sustainability, i.e., economic, environment, social and governance, from farmers growing basmati rice under both, conventional and fair-trade systems. Data was analysed through descriptive statistics, structured equation modelling and discriminant analysis. Findings suggest that performance of fair-trade system on factors of sustainability is significantly better than conventional system and governance is most discriminating factor

A novel predictor of clinical response to methotrexate in patients with rheumatoid arthritis: a pilot study of in vitro T cell cytokine suppression

Objective: Methotrexate (MTX) is an important drug for treatment of rheumatoid arthritis; however, there is variation in the clinical response. MTX inhibits T cell cytokine production, with significant interindividual variability in the dose required. We investigated if the variability in clinical response was related to variability in the in vitro assay. Methods: Patients with disease modifying antirheumatic drug-naive, active RA [1982 American College of Rheumatology (ACR) criteria] seen from September 2005 through January 2006 were enrolled. MTX was started at 10 mg/week and increased monthly by 2.5 mg/week. Baseline whole-blood cultures were set up with anti-CD3, anti-CD28, and increasing doses of MTX. Supernatants were harvested at 96 hours and tumor necrosis factor-α (TNF-α ), interferon-γ (IFN-γ ), and inter-leukin 10 (IL-10) concentrations were estimated by ELISA. The dose of MTX (ID50) required for 50% suppression of production of cytokines and the change in Disease Activity Score-28 (Δ DAS) at 4 months were noted. Results: T cell stimulation resulted in significant increase in cytokine release, and addition of MTX led to a dose-dependent suppression of all 3 cytokines. There was significant negative correlation of Δ DAS with ID50 values for TNF-α (R = -0.62, p &lt; 0.01) and IFN-γ (R = -0.43, p = 0.04). At 4 months, EULAR moderate and ACR 20% responses were achieved by 13 and 16 patients, respectively. EULAR moderate response could be predicted using ROC curves for TNF-α (sensitivity 93%, specificity 86%) and IFN-γ (60% specificity, 71% sensitivity). ACR response was correctly predicted in 14 of 16 ACR 20% responders and in all ACR 50% and ACR 70% responders. Conclusion: An in vitro TNF-α suppression assay may help predict clinical response to MTX in RA

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Not AvailableOnion, Allium cepa, contribution is significant in foreign exchange under vegetables in India. Onion thrips, Thrips tabaci Lindeman, is a potential pest of onion and causes considerable losses in the yield. Onion production as well as infestation of crop pests and diseases is highly related to weather. These losses can be reduced to a considerable extent if their occurrence and severity is known in advance. Indian Agricultural Statistical Research Institute (IASRI) have developed weather based forewarning models on the data taken from Directorate of Onion and Garlic Research (DOGR), Pune. Models have been developed for thirteen dates of sowing for the forewarning of crop age at first appearance of thrips, crop age at peak population of thrips and maximum thrips population. To disseminate the information in effective manner, online software has been developed based on these weather models. Online system has been developed using three-tier architecture. Client layer in implemented using Hypertext Markup Language (HTML), Cascading Style Sheet (CSS) and Java script. Application layer is implemented using Java Server Pages (JSP) and database layer is implemented in Microsoft SQL Server. The models developed were tested with observed and predicted value and percentage deviation was computed.Not Availabl

IL1RN∗ 2 allele of IL-1receptor antagonist VNTR polymorphism is associated with susceptibility to anklyosing spondylitis in Indian patients

Despite strong linkage of ankylosing spondylitis (AS) with human leukocyte antigen (HLA) B27, its contribution to disease susceptibility is only 15%, and additional genetic factors are likely to be involved in AS. Interleukin (IL)-1 locus has been linked to AS in European population. Thus, we studied IL-1 receptor antagonist polymorphism in Indian patients with AS. One hundred and sixty-two patients with AS and ethnically matched healthy controls were included. IL-1Ra variable number tandem repeat polymorphism was studied by polymerase chain reaction (PCR). HLA B27 was done by amplification refractory mutation system PCR. Clinical details regarding severity of articular disease, presence of peripheral arthritis, and extra-articular manifestations were collected. The mean age of these 162 patients was 35 years, and the mean duration of disease was 10.8 years. Of these162 patients, 137 were HLA B27 positive. The commoner alleles-IL-1RN∗ 1 and IL-1RN∗ 2-together accounted for 99.5% of the IL-1RN alleles in the control population and 98.5% of the cases. The allele frequency as well as the carriage rate of allele IL-1RN∗ 2 were significantly higher in patients with AS than the control populations (26.3 vs 16.2% and 41.97 vs 22.5%, respectively; p=0.015 and 0.0002). The IL-1RN∗ 2 allele was not associated with any difference in clinical disease expression. The IL-1RN2 allele is a susceptibility marker for AS in the Indian population but does not influence disease phenotype

Co-circulation of all the four Dengue virus serotypes during 2018–2019: first report from Eastern Uttar Pradesh, India

Dengue fever is an endemic disease in India, transmitted by an infected mosquito bite. In India, the number of concurrent infections and the circulation of multiple dengue virus (DENV) serotypes has increased in recent decades. Molecular surveillance among the DENV serotype is important to keep track of the circulating serotypes, evolutionary changes, and key mutations that can alter the diagnostics. The current study included patients admitted for dengue in the Eastern Uttar Pradesh (E-UP) region during 2018–2019. The genetic characterization of the circulating DENV was accomplished through partial CprM (511 bp) gene amplification via reverse transcriptase polymerase chain reaction and sequencing. Phylogenetic analysis revealed the circulation of all four DENV1-4 serotypes. DENV-2 was the most abundant serotype (44%, 27/61), followed by DENV-3 (32%, 20/61). DENV-1 had a 16% (10/61) predominance, while DENV-4 (6%, 4/61) was found to be the least abundant serotype. DENV-2 genotypes were distributed among lineages I (7.4%), II (85%) and III (7.4%) of genotype IV, DENV-3 to lineage III of genotype III, DENV-1 to genotype III; DENV-2 to lineage B (75%) and C (25%) of genotype I. This primary report on the co-circulation of DENV1-4 serotypes from the E-UP region highlights the requirement of continuous molecular surveillance for monitoring circulating DENV serotypes