Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Accurate estimation of biomass production and partitioning efficiency in castor (Ricinus communis L.)

Not AvailableThere is continuous leaf fall due to senescence from 35-60 days after sowing (DAS) till harvest depending on crop duration in castor which is not quantified in general for computation of total dry matter (TDM) and harvest index (HI). By calculating HI with the TDM at harvest of the plant which excludes senesced fallen leaf weight gives high HI values than actually are. In castor, major emphasis is on selecting genotypes with high partitioning efficiency which is shown by high HI. Hence, an experiment was conducted during 2013-15 for two years to devise suitable methodology for quantification of senesced fallen leaf fall while working out plant dry matter. Senesced fallen leaf was collected, quantified, factor for estimation of senesced leaf weight was developed using linear regression equation and model was validated. The equations derived for estimation of TDM and HI from senesced leaf include: TDM with senesced leaf weight = 1.217 * TDM without senesced leaf weight and HI with senesced leaf weight = 0.805* HI without senesced leaf weight. This factor can be used for accurate estimation of TDM at harvest and HI to enhance the quality of data for selection of genotypes with high partitioning efficiency.Not Availabl

Comparative evaluation of efficacy of tetracycline fibres and nanobiofusion gel as a local drug delivery agent in chronic periodontitis: A clinical study

Introduction: Local drug delivery agents (LDD) in the management of periodontitis has gained acceptance and popularity compared to systemic drugs for its decreased risk in development of resistant flora, opportunist infection and side effects. Tetracycline fibers and Nanobiofusion gel (NBF) are one such antimicrobial agents that have a wide spectrum of action. Objective: To evaluate the clinical efficacy of administering Tetracycline fibers and NBF gel as an adjunct to Scaling and root planning (SRP) in chronic periodontitis patients. Materials and methods: A total of 20 patients (40 sites) with chronic periodontitis having probing pocket depth 5-7mm are selected and grouped into two groups. Group A in which sites are treated by SRP followed by sub gingival placement of NBF gel, where as in Group B the sites are treated by SRP followed by sub gingival placement of tetracycline fibers. Clinical evaluation of all parameters are taken at baseline, 2 weeks and 3months. Results: At the end of the 3 months Group 2 showed greater reduction in the pocket depth and also showed a significant gain in the CAL (2.0 mm) as compared to Group 1.&nbsp

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