Screening for absolute fracture risk using FRAX tool in men and women within 40-90 years in urban population of Puducherry, India

Background: Osteoporosis is presently considered as one of the major non-communicable world health hazards. It predominantly affects post-menopausal women, elderly men and women. The aim of the study was to assess fracture risk among men and women within 40-90 years in urban population of Puducherry, India and detect the most prevalent risk factors for fractures.Methods: This is a cross-sectional study done over a period of two months (July - August 2015) involving a sample size of 500 participants, 250 in each gender. Using the FRAX (Fracture Risk Assessment) tool the major osteoporotic fracture risk percentage (MOFR) and hip fracture risk (HFR) were obtained without femoral neck bone mineral density. Chi-square test was applied to test association and p<0.05 considered statistically significant.Results: The mean age of males (57.2±12.7 years) was higher than females (52.5±2.6 years). Out of 500 participants, 18 and 95 participants were found to satisfy the criteria of ≥20% MOFR and ≥3% HFR respectively. The average MOFR was 4.5±6.7 and 4.0±4.6 for women and men respectively. The mean HFR was 1.8±4.0 and 1.8±3.3 for women and men respectively. The requirement of treatment did not differ significantly between gender (44 females versus 51 males). Eight male participants and 9 female participants were advised for further evaluation with a DEXA scan. Conclusions: The FRAX tool provides an aid to enhance patient assessment by the integration of clinical risk factors especially as an osteoporosis screening tool with/without the combination of bone mineral density. It is an effective tool, particularly in developing countries like India, where most of the patients cannot afford expensive investigations like DEXA. People with high risk can be subjected to further evaluation and management, thereby reducing the health resources

In Silico Bioinformatics Followed by Molecular Validation Using Archival FFPE Tissue Biopsies Identifies a Panel of Transcripts Associated with Severe Asthma and Lung Cancer

Severe asthma and lung cancer are both heterogeneous pathological diseases affecting the lung tissue. Whilst there are a few studies that suggest an association between asthma and lung cancer, to the best of our knowledge, this is the first study to identify common genes involved in both severe asthma and lung cancer. Publicly available transcriptomic data for 23 epithelial brushings from severe asthmatics and 55 samples of formalin-fixed paraffin-embedded (FFPE) lung cancer tissue at relatively early stages were analyzed by absolute gene set enrichment analysis (GSEA) in comparison to 37 healthy bronchial tissue samples. The key pathways enriched in asthmatic patients included adhesion, extracellular matrix, and epithelial cell proliferation, which contribute to tissue remodeling. In the lung cancer dataset, the main pathways identified were receptor tyrosine kinase signaling, wound healing, and growth factor response, representing the early cancer pathways. Analysis of the enriched genes derived from the pathway analysis identified seven genes expressed in both the asthma and lung cancer sets: BCL3, POSTN, PPARD, STAT1, MYC, CD44, and FOSB. The differential expression of these genes was validated in vitro in the cell lines retrieved from different lung cancer and severe asthma patients using real-time PCR. The effect of the expression of the seven genes identified in the study on the overall survival of lung cancer patients (n = 1925) was assessed using a Kaplan–Meier plot. In vivo validation performed in the archival biopsies obtained from patients diagnosed with both the disease conditions provided interesting insights into the pathogenesis of severe asthma and lung cancer, as indicated by the differential expression pattern of the seven transcripts in the mixed group as compared to the asthmatics and lung cancer samples alone

Pattern of Anxiety and Depression with Associated Factors in Oral Lichen Planus: A Questionnaire Based Study

Introduction: Oral lichen planus (OLP) is a common oral disease affecting 0.5 to 2.2% of general population. It is considered as a chronic inflammatory autoimmune disorder and may be associated with additional factors like viral and chemical agents, medications, stress, anxiety, and depression. This study aimed to determine the role of anxiety and depression in the clinical status of oral lichen planus. Methodology: The study included 30 OLP patients reporting to the Department of Oral Medicine and Radiology. The clinical diagnosis of OLP was done based on WHO diagnostic criteria, followed by psychological analysis of each patient using Hamilton Anxiety and Depression Rating Scales (HARS and HDRS). Results: The study demonstrated the presence of anxiety and depression in OLP patients and also showed association of symptoms of OLP with the degree of anxiety and depression. Conclusion: It is beneficial to recommend psychological therapy alongwith the standard OLP therapy for successful treatment

Biochemical and molecular mechanisms associated with Zn deficiency tolerance and signaling in rice (Oryza sativa L.)

In this study, zinc (Zn) deficiency caused a significant reduction in growth parameters and tissue Zn concentrations in BRRI 33 (sensitive) but not in Pokkali (tolerant). The increase of proton extrusion in both genotypes under high pH suggests that it gets triggered as a common consequence of reducing pH and solubilization of Zn. Real-time PCR showed pronounced upregulation of OsZIP4, OsDMAS1, OsNAS2 and OsPCS1 in Zn-deficient roots of Pokkali, and to a lesser extent in BRRI 33 only for OsZIP4 and OsPCS1. This suggests that OsDMAS1, OsNAS2 and OsPCS1 functions as secondary consequences leading to higher chelation and uptake of Zn under Zn deficiency in Pokkali. Further, a major increase in CAT, POD, SOD, GR and key metabolites suggests that high antioxidant defense plays a critical role in Zn deficiency tolerance in Pokkali. Further, Pokkali self-grafts and plants having Pokkali rootstock combined with BRRI 33 scion showed no significant decline in plant height, root dry matter and Zn concentration along with upregulation of Zn transporters (OsZIP4 and OsIRT1) under Zn deficiency, suggesting that signal driving mechanisms for Zn deficiency tolerance mechanisms are generated in the root and Zn-inefficient BRRI 33 is not capable of producing signals or sensing them

Evaluation of national pandemic management policies--A hazard analysis of critical control points approach

Analyses of pandemic preparedness policies revealed weaknesses in control systems of European nations. This reinforces the need to support countries in their endeavours to prevent and contain pandemics. A Hazard Analysis and Critical Control Points (HACCP) was applied to a generic plan to identify weaknesses in pandemic management policies, in order to develop recommendations for improving national pandemic management systems. Policy components considered in our analysis are command and control, early case detection and disease surveillance, and community containment management. The main critical areas identified in national pandemic control were: communication systems among all institutions and levels involved in pandemic management, guidelines and regulations describing how key personal and institutions should operate during a pandemic, training and dissemination of information to health care personnel involved in outbreak management. The HACCP analysis highlighted the need for agreed communication structures, clear division of responsibilities and harmonised policy guidelines at all levels of pandemic management. Being prepared is the key to successfully coordinate and implement response measures when a pandemic emerges.HACCP SARS Pandemic influenza Pandemic preparedness plans Pandemic preparedness Pandemic response