Prevalence of hypothyroidism in type 2 diabetic adult Indian females and its correlation with age, HbA1c, BMI and duration of diabetes

Background: Patients with type 2 diabetes mellitus are more prone to thyroid disorders. Hypothyroidism in them leads to an aggravation of microvascular complications. Screening for thyroid dysfunction in diabetic patients will allow early treatment of hypothyroidism. The aim of this study was to assess the prevalence of hypothyroidism in patients with type 2 diabetes mellitus and its correlation with age, HbA1c, BMI and duration of diabetes. Methods: This was a cross sectional study that was conducted at department of medicine GSVM medical college, Kanpur. 200 female patients with type 2 diabetes mellitus attending the outpatient department without any prior history of thyroid disease, chronic liver disease or acute illness were recruited for the study. Results: Our study describes 14% prevalence of hypothyroidism (subclinical hypothyroidism 13.5%) among 200 diabetic subjects. Hypothyroidism was more common in older age group maximum seen in age group 70-79 years (66.7%). Hypothyroidism was more common in subjects having diabetes for a longer duration; maximum seen in 25-30 years group (40%). No correlation was found between BMI and hypothyroidism. Conclusions: The prevalence of hypothyroidism was 14% among female patients with type 2 diabetes mellitus in this study. Overt hypothyroidism was 0.5 % and subclinical hypothyroidism was more common (13.5%) among the study subjects. Hypothyroidism was more common in older age group. and in subjects having diabetes for longer duration. No corelation was found between prevalence of hypothyroidism and body mass index (BMI)

Quantitative assessment of airway and parenchymal components of chronic obstructive pulmonary disease using thin-section helical computed tomography

Purpose: The purpose of this study was to diagnose and characterise chronic obstructive pulmonary disease (COPD) into its forms, patterns, and severity using MDCT. Material and methods: In this prospective study, spirometric and MDCT evaluation was done in 52 consecutive patients diagnosed with COPD. In each patient six segmental bronchi were evaluated for CT morphometric indices of bronchial wall thickness (BWT) and wall area percentage (WAP). Quantitative evaluation of emphysema was done using inbuilt software, and volume of emphysematous lung was determined using percentage low attenuation area (LAA). COPD was categorised into the following: emphysema predominant; airway predominant; or mixed phenotypes, and severity grading was assigned as mild, moderate, or severe. Results: Centrilobular was the predominant emphysema pattern occurring alone (36.5%) or in combination with paraseptal changes (34.6%). Among COPD phenotypes, emphysema predominant was the commonest (44.3%), followed by mixed (30.8%), and bronchitis predominant (25.0%). The mean BWT in the airway-predominant group was significantly higher (1.94 ± 0.28 mm) than in the emphysema-predominant subgroup (1.79 ± 0.23 mm) with a p value of 0.005. Conclusion: MDCT is an indispensable tool in quantitative and qualitative evaluation of COPD patients. Measurement of CT indices like BWT, WAP, and %LAA can reliably categorise COPD into phenoty

Role Of Social & Psychological Factors In Drug Default In Patients Of Pulmonary Tuberculosis

Research Problem: What is the influence of social and psychological factors on drug default in patients of pul­monary tuberculosis? Objective: To assess the role of social and psychological factors in drug default in patients of pulmonary tubercu­losis. Study Design: Hospital - based study by questionnaire method Setting and Participants: Patients of pulmonary tubercu­losis attending Out Patient Department of Tuberculosis and Respiratory Diseases, J.N. Medical College Hospital, A.M.U., Aligarh. Sample Size: 136 defaulters and 86 treated cases of pulmonary tuberculosis. Study Variables: Social factors, psychological factors, drug default and pulmonary tuberculosis. Outcome Variables: Association of social and psycho­logical factors with drug default in pulmonary tuberculo­sis patients. Statistical Analysis: By chi - square test and significance at 5% level. Result: Important social factors influencing drug default were joint family (74.27%), lack of money (22.06%) and uncooperative family (11.7%). Psychiatric morbidity among defaulters was significantly high (68.39%). Conclusion: Patient compliance depends on many psy­chological (e.g. psychiatric morbidity, type of personal­ity), and sociological,factors (including economic status of patient, nature of family, its environment, interaction between patient and doctor and patient's own attitude and idea about his disease). Age, sex, residence, religion and education did not show any significant contribution towards drug default

Mutations in RpoB Gene and Their Association with Rifampicin-resistance Levels in Clinical Isolates of Mycobacterium Tuberculosis

Present study was aimed to identify most frequent mutations in rpoB gene region and to evaluate the association between mutations in rpoB gene and resistance levels to Rifampicin in clinical isolates of Mycobacterium tuberculosis of different geographical regions of India. A total of 100 clinical isolates of Mycobacterium tuberculosis were included in this study. Drug susceptibility testing against first line anti-tuberculosis drugs was performed on LJ medium by conventional minimal inhibitory concentration (MIC) method and the mutation(s) in rpoB gene of M. tuberculosis isolates were analyzed by sequencing method. Of the 100 M. tuberculosis isolates, 31 (31.0%) and 18 (18.0%) were found resistant and susceptible for all four first-line anti-tuberculosis drugs. The genetic mutations were observed in 96% (72/75) rifampicin-resistant M. tuberculosis isolates, while 4% (3/75) of rifampicin-resistant isolates did not have any mutation in rpoB gene. The mutation TCG531TTG (Ser531Leu) was found as most common and frequent mutation in 69.3% (52/75) of rifampicin-resistant isolates of M. tuberculosis with MIC level (≥ 512mg/l). The mutation at codon 511 was associated with low degree (128mg/l) of rifampicin-resistance, deletions at codons 514-516 or substitution at codon 516 were found to be associated with moderate degree (256mg/l) of rifampicin-resistance and mutations at codon 526, 531 were associated with the high degree (512mg/l) of rifampicin-resistance in M. tuberculosis isolates of Indian origin. The findings of this study will be useful for the development of raid and more specific indigenous molecular tools for the early diagnosis of multidrug-resistant tuberculosis in the country

Assessment of the N-PCR Assay in Diagnosis of Pleural Tuberculosis: Detection of M.tuberculosis in Pleural Fluid and Sputum Collected in Tandem

The nonspecific clinical presentation and paucibacillary nature of tuberculous pleuritis remains a challenge for diagnosis. Diagnosis of tuberculous pleural effusion depends on the demonstration of the presence of tubercle bacilli in the sputum, pleural fluid, or pleural biopsy specimen, or demonstration of granuloma in pleura by histological examination. We examined the clinical utility of the diagnosis of pleural tuberculosis using the in house N-PCR assay, AFB smear microscopy and culture. Besides pleural fluid the inclusion of sputum in the efficacy of diagnosis of pleural tuberculosis was scrutinized.Pleural fluid and sputum samples of 58 tuberculous and 42 non-tuberculous pleural effusion patients were processed for AFB smear microscopy, culture and the N-PCR assay. Mycobacteria were detected exclusively in tuberculous pleural effusion samples. None of the non-tuberculous pleural effusion samples were positive for mycobacteria. Comparative analysis showed that the N-PCR assay had the highest sensitivity. Inclusion of sputum along with pleural fluid increased N-PCR sensitivity from 51.7 to 70.6% (p<0.0001).This improved sensitivity was reflected in AFB smear microscopy and isolation by culture. The sensitivity enhanced on inclusion of sputum from 3.4 (p = 0.50) to 10.3% (p = 0.038) for AFB smear microscopy and for isolation of mycobacteria from 10.3(p = 0.03) to 22.4% (p = 0.0005). Thirteen isolates were obtained from 58 pleural tuberculosis patients. Eleven mycobacterial isolates were identified as M. tuberculosis and two as M. fortuitum and M. chelonae. Complete concordance was seen between the biochemical identification of isolates and the N-PCR identification of mycobacterial species prior to isolation.To the best of our knowledge this is the first PCR based report on utility of sputum for diagnosis of pleural tuberculosis. The present study demonstrates that a combination of pleural fluid with sputum sample and N-PCR improved the diagnosis of pleural tuberculosis

Prevalence and Genotypes of Mycobacterium Avium Subspecies Paratuberculosis in Large Ruminants of Eastern Uttar Pradesh, North India

Uttar Pradesh is the fourth largest, most populous and leading milk and meat producing state in India. Despite the huge livestock population, information on the status of paratuberculosis homogeneity and heterogeneity of Mycobacterium avium subspecies paratuberculosis (MAP) isolates of eastern Uttar Pradesh is non-existent. Present study was aimed to estimate the presence of MAP in large ruminants (Cattle and Buffaloes) of eastern Uttar Pradesh. A total 108 fecal samples were collected from farmer's herds of large ruminants (cattle and buffaloes) from different geographical regions (Chandauli, Mughalsarai, Gazipur, and Naugarh) of eastern Uttar Pradesh and screened for the presence of MAP infection using microscopic examination, direct IS900 PCR and culture on Herrold egg yolk (HEY) medium. The isolates recovered on HEY medium were subjected to molecular identification and genotyping using IS900 PCR and IS1311 PCR-REA method, respectively. Of the 108 fecal samples, 25 (23.14%) and 11 (10.18%) samples were positive for the presence of acid-fast bacilli and growth on HEY medium, respectively. Species-wise, 17.5, 7.5% and 26.5, 11.7% fecal samples from cattle and buffaloes were found positive for the presence of acid-fast bacilli and growth on HEY medium, respectively. Isolates recovered on HEY medium with mycobactin J were positive for IS900 sequence and genotyped as Bison Type using IS1311 PCR-REA method. Present study is the first report on the presence of MAP infection and ‘Bison Type' genotype of MAP in eastern Uttar Pradesh. These findings will be useful for the intervention of effective control measures in order to reduce the prevalence of MAP infection in domestic livestock species and prevent its spread to the human population in the regions

Electromagnetic interference shielding performance of carbon nanostructure reinforced, 3D printed polymer composites

We report the electrical, mechanical and electromagnetic interference (EMI) shielding performance of polypropylene random copolymer (PPR)/multi-wall carbon nanotube (MWCNT) nanocomposites enabled via customized fused filament fabrication process. The electro-conductive PPR/MWCNT filament feedstocks were fabricated via shear-induced melt-blending process that allows 3D printing of nanoengineered composites even at higher MWCNT loading (up to 8 wt%). The uniform dispersion of MWCNTs in PPR matrix confirmed via Raman spectroscopy and scanning electron microscopy facilitates better mechanical, electrical and EMI shielding performance. The results furthermore show enhanced shielding properties and higher attenuation for the nanocomposites printed in 90° direction (~ − 37 dB for 8 wt% MWCNT loading). Effective interfacial adhesion between the beads with lesser extent of voids (confirmed via micro-computed tomography) endorsed low transmission loss in nanocomposites printed in 90° direction compared to samples printed in 0° direction. Surface architected structure (frustum shape) reveals higher specific shielding effectiveness (maximum ~ − 40 dBg−1cm3, + 38%) over the plain structure. The realization of excellent shielding effectiveness (~ 99.9% attenuation) of additive manufacturing-enabled PPR/MWCNT nanocomposites demonstrates their potential for lightweight and strong EMI shields

Predominance of Ancestral Lineages of Mycobacterium tuberculosis in India

Molecular epidemiologic findings suggest an ancient focus of TB

Whole Genome Sequencing of Mycobacterium tuberculosis Clinical Isolates From India Reveals Genetic Heterogeneity and Region-Specific Variations That Might Affect Drug Susceptibility

Whole genome sequencing (WGS) of Mycobacterium tuberculosis has been constructive in understanding its evolution, genetic diversity and the mechanisms involved in drug resistance. A large number of sequencing efforts from across the globe have revealed genetic diversity among clinical isolates and the genetic determinants for their resistance to anti-tubercular drugs. Considering the high TB burden in India, the availability of WGS studies is limited. Here we present, WGS results of 200 clinical isolates of M. tuberculosis from North India which are categorized as sensitive to first-line drugs, mono-resistant, multi-drug resistant and pre-extensively drug resistant isolates. WGS revealed that 20% of the isolates were co-infected with M. tuberculosis and non-tuberculous mycobacteria species. We identified 12,802 novel genetic variations in M. tuberculosis isolates including 343 novel SNVs in 38 genes which are known to be associated with drug resistance and are not currently used in the diagnostic kits for detection of drug resistant TB. We also identified M. tuberculosis lineage 3 to be predominant in the northern region of India. Additionally, several novel SNVs, which may potentially confer drug resistance were found to be enriched in the drug resistant isolates sampled. This study highlights the significance of employing WGS in diagnosis and for monitoring further development of MDR-TB strains