RADIOLOGICAL EVALUATION OF INTERSTIAL LUNG DISEASES ON HIGH RESOLUTION COMPUTED TOMOGRAPHY IN TERTIARY CARE CENTRE OF NORTH INDIA

ABSTRACT Objective: This study assessed the various HRCT patterns of interstitial lung diseases and to differentially diagnose ILD based on their clinical findings and distribution patterns. Materials and methods: The study was conducted in the Department of Radiodiagnosis, Government Medical College & Rajindra Hospital, Patiala, Punjab, India. 43 patients with clinical suspicion of ILD were enrolled in the study. HRCT scans of the chest were done in all the cases taken in the study. Results: The mean age (± SD) was 54.1 ±13.1 years. Maximum patients 15 (34.9%) belonged to the age group of 51-60 years. We found slight female preponderance with females accounting for 53.5% and males accounting for 46.5% of the caseload. The most common presenting complaint was dyspnea on exertion (83.7%) followed by cough in 69.8%. The most frequent HRCT finding was septal thickening (90.7%), followed by tractional bronchiectasis (83.7%), fibrotic changes (72.1%), GGOs (65.1%), honeycombing (58.1%). Based on HRCT findings, the most common HRCT pattern was the typical UIP pattern (58.1%), followed by the NSIP pattern. The final diagnoses were made based on clinic-radiological findings and by the exclusion of other possibilities. The most common ILD reported was IPF (39.5%), followed by CTD-ILD (20.9%), and SR-ILD (13.9%). This is followed by iNSIP (11.6%), Hypersensitivity pneumonitis (6.9%), and cryptogenic organizing pneumonia (2.3%). Conclusion: HRCT is a valuable technique for evaluating various ILDs even when chest X-rays are normal. It can differentially diagnose ILDs based on their clinical findings and distribution patterns. KEYWORDS: HRCT, ILD, UIP, NSIP, IP

Reproductive behavior of newly married women in rural Punjab, India: A longitudinal study

Introduction: In India, little is known about the reproductive behavior during earlier years of married life of women, when they are more vulnerable to reproductive ill health and early child bearing with very few interventions available. Objective: The objective of this study is to follow a cohort of newly married women immediately after marriage until their first pregnancy outcome to gain an insight into their reproductive behavior so that important opportunities could be identified for intervention. Subjects and Methods: A community-based longitudinal study was carried out in 15 villages of Ludhiana District under the Rural Health Training Centre of Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab. All marriages of the male residents that took place in these villages from January 1, 2013, to December 31, 2013 were enrolled. Thus, a cohort of 195 newly married women was identified over a period of 1 year and followed every month till first pregnancy outcome. The analysis was performed using SPSS version 20 statistical software. Results: Mean age at marriage for newly married women was 22.9 ± 3.0 years. Majority of them conceived within 1st year of marriage (79.5%) while 10.8% of women did not conceive till the end of follow-up period. Mean age at first pregnancy was 23.4 ± 3.1 years with mean interval between marriage and first pregnancy of 5.4 ± 6.1 months. Nearly, three-fourth of pregnancies resulted in live births while adverse pregnancy outcome including still births and abortions was seen in 15.9% of the study cohort. Conclusions: Overall findings indicate optimistic picture for married young women, but critical opportunities should be utilized to promote health of these women in a journey toward safe motherhood

Rise of the 5th estate: how online public discourse on Najib Razak’s 1MDB scandal foreshadowed Pakatan Harapan’s win in the 14th general election

Public discourse commonly takes place in public forums of free media. The 4th estate provides an external dimension to the democratic check and balance to the executive (1st estate), the legislative (2nd estate), and the judiciary (3rd estate). This paper discusses the rise of a social media 5th estate, as exemplified by online public discourse surrounding the 1 Malaysia Development Berhad (1MDB) scandal, and the country’s ensuing electoral change of government. Drawing upon thematic analyses of 1MDB-related comments in the official Facebook page of Free Malaysia Today, this paper illustrates the rise of a social media 5th estate in the run-up to Pakatan Harapan’s win in the Malaysian 2018 14th General Election. Since international public disclosure in 2015 of former Malaysian premier Najib Razak’s purported siphoning of billions of ringgit from 1MDB, the scandal continues to be a trending topic on Malaysian social media. The online discourse of 1MDB evolved from heated posts discussing Najib’s culpability and criticism of his Barisan Nasional administration, into support to the opposition Pakatan Harapan coalition, particularly in the run-up to the 14th Malaysian General Elections (GE14) that was held on 9th May 2018. Pakatan Harapan’s win, following the social media support, exemplifies the power of a netizen-fuelled 5th estate

Promoter polymorphisms in IL-6 gene influence pro-inflammatory cytokines for the risk of osteoarthritis

BackgroundInterleukin-6 (IL-6) gene regulates IL-6 levels, interplay of which has been found to influence pathophysiology of osteoarthritis (OA). Polymorphism within promoter region of IL-6 gene and its association with plasma levels of pro-inflammatory cytokines; IL-6, interleukin 1-beta (IL-1β) and tumor necrosis factor–alpha (TNF-α) remained to be investigated in Punjab region of India, where OA is highly prevalent.MethodsSix single nucleotide polymorphisms (SNPs) in the promoter region of IL-6 gene; rs1800795 (−174G/C), rs1800796 (−572G/C), rs1800797 (−597G/A), rs2069827 (−1363G/T), rs12700386 (−2954G/C) and rs10499563 (−6331G/T) were investigated by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 279 confirmed osteoarthritis patients and 287 controls. Plasma levels of pro-inflammatory cytokines; IL-6, IL-1β and TNF-α were measured by sandwich Enzyme Linked Immunosorbent Assay (ELISA).ResultsAllele frequency spectrum after adjusting the effect of systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low density lipoprotein (LDL), triglycerides (TG) and body mass index (BMI) revealed that major allele G of rs1800795 and T of rs10499563 were significantly associated with increased risk of OA (P ConclusionThe present study discovered susceptibility (GGGGCT) and protective (CGAGGC) haplotypes within promoter region of IL-6 gene which influenced the plasma levels of IL-6 and IL-1β for the risk of osteoarthritis in the population of Punjab, India.</div

Establishing reference ranges and normal values for coagulation screening in healthy Indian male volunteers enrolled for a longitudinal study

Background: The study was designed for establishing reference ranges and normal values for coagulation screening in healthy Indian male volunteers. At present, there are no standard parameters established for coagulation screening assays of Indian population. The parameters used as a reference in the coagulation assays are of Western origin. We know that ethnicity of the western population is different from the Indian population which may result in a different set of reference ranges of the coagulation assay. It is necessary to determine the mean normal values for the coagulation assay, namely prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen in an Indian population. The aim of the study was to establish the reference ranges of coagulation assays for all future experiments on the cohort. Methods: Six hundred healthy male volunteers were sampled and underwent coagulation testing at a seven hundred-bedded hospital at Jammu (Jammu). Fresh normal pool plasma (FNPP) was prepared concurrently and investigated (n = 50 volunteers). In the study population, the arithmetic means of the coagulation assay were as follows: PT: 13.00 s, APTT: 34 s, TT: 17.3 s, and fibrinogen: 298 mg/dl (19 s), and in the FNPP, it was 12.8 s, 33.2 s, 17 s, and 298 mg/dl (19 s), respectively. Results: The reference range of coagulation screening in our study was established as the following values: PT: 10.7–15.3 s, APTT: 26.8–41.2 s, TT: 12.8–21.7 s, and fibrinogen: 223–372 mg/dl. This study has set a reference range of normal values for coagulation assay screening in longitudinal studies where these tests were repeated on the same set of individuals at six-month interval for the subsequent 3 years. Conclusion: We see no effect of age on Coagulation cascade in our study. Overall mean values resembled with various age groups in coagulation cascade. These parameters of Coagulation cascade set a standard for high altitude studies where these tests are in normal procedure

Investigation of eNOS gene polymorphism exposes a genetic association between endothelial dysfunction and osteoporosis in postmenopausal women

Objectives:To investigate the association of genetic polymorphisms of endothelial nitric oxide synthase (eNOS) gene with endothelial dysfunction associated osteoporosis in postmenopausal women of Punjab, India.Methods:The study involved 456 postmenopausal women having endothelial dysfunction categorized according to women with (n=236) and without osteoporosis (n=220). Bone mineral density (BMD) and reactive hyperemia index (RHI) were evaluated together with six SNPs within the eNOS gene (rs2070744, rs1799983, rs1800780, rs3918181, rs891512 and rs1808593).Results:A moderate association between RHI and BMD at femoral neck (r2=0.213, P=0.002) and lumbar spine (r2=0.267, PConclusion:A susceptibility haplotype CTAAAT within eNOS gene is associated with double the possibility of endothelial dysfunction affiliated osteoporosis in postmenopausal women of Punjab, India.</div

Genetic scores of ENOS, ACE and VEGFA genes are predictive of endothelial dysfunction associated osteoporosis in postmenopausal women

© 2021 by the authors. Licensee MDPI, Basel, Switzerland. The present study aimed to examine the participation and contribution of endothelial nitric oxide synthase (eNOS), angiotensin converting enzyme (ACE) and vascular endothelial growth factor (VEGFA) genes for the risk of endothelial dysfunction (ED)-associated osteoporosis risk in postmenopausal women of Punjab, India. Women with ED were categorized into women with osteoporosis (n = 346) and women without osteoporosis (n = 330). They were examined for selected SNPs within eNOS, ACE and VEGFA genes. Linear regression analysis revealed a positive association of ED with bone mineral densities (BMDs) at femoral neck (r2 = 0.78, p < 0.001) and lumbar spine (r2 = 0.24, p = 0.001) after Bonferroni correction. Three susceptibility haplotypes were exposed within eNOS (CTAAAT), ACE (ACDG) and VEGFA (GATA) genes. Bearers of CTAAAT (OR 2.43, p = 0.007), ACDG (OR 2.50, p = 0.002) and GATA (OR 2.10, p = 0.009) had substantial impact for osteoporosis after correcting the effects with traditional risk factors (TRD).With uncertainty measure (R2h) and Akaike information criterion (AIC), best fit models showed that CTAAAT manifested in multiplicative mode (β ± SE: 2.19 ± 0.86, p < 0.001), whereas ACDG (β ± SE: 1.73 ± 0.54, p = 0.001) and GATA (β ± SE: 3.07 ± 0.81, p < 0.001) expressed in dominant modes. Area under receiver operating characteristic curve using weighted risk scores (effect estimates) showed substantial strength for model comprising TRD + GATA (AUC = 0.8, p < 0.001) whereas, model comprising TRD + GATA + CTAAAT exhibited excellent ability to predict osteoporosis (AUC = 0.824, p < 0.001)