Indian Journal of Medical Research最新文献

Background & objectives Interstitial lung diseases (ILD) cause progressive symptoms and decline in lung functions which impact health-related quality of life (HRQoL). Although HRQoL is gaining wider acceptance as an endpoint for disease perception, limited data is available regarding the same in Indians with ILD. Hence, this study was undertaken to assess HRQoL and its correlation with lung function parameters in individuals with ILD in a tertiary care setting in south India. Methods A hundred and fifty-nine consecutive patients with ILD were recruited between June 2022 to December 2023. HRQoL was assessed using the ILD specific K-BILD, generic EQ-5D-5L and an adapted version of the validated PESaM questionnaires. Correlation between various domains of the three questionnaires and lung function parameters was analyzed followed by linear regression analysis. Results The study population consisted predominantly of females (64.1%), with CTD-ILD being the most common ILD (40.8%). HRQoL impairment was noted, predominantly affecting the 'breathlessness and activity' domain and significant correlation was noted between K-BILD and EQ-5D-5L across domains. On regression analysis, FVC, 6-minute walk distance and desaturation were independent predictors of HRQoL. Type of ILD and disease duration did not have a significant association with HRQoL measures. Interpretation & conclusions 'Breathlessness and activity' domain of HRQoL was affected the most in participants with ILD. Forced vital capacity, six-minute walk distance and exercise induced desaturation were independent predictors of HRQoL among individuals with ILD.

Background & objectives Hypertension is a significant modifiable risk factor for cardiovascular diseases (CVDs) and premature mortality worldwide, particularly affecting low- and middle- income countries (LMICs). This study focused on evaluating self-care practices among hypertensive affected individuals in urban slum areas of Mysuru city, India, and explore associated factors and their relationship with hypertension control levels. Methods A community based cross-sectional study was carried out from March 2022 to August 2023, enrolling 650 hypertensive affected individuals from 63 urban slums of Mysuru city. Data on sociodemographic characteristics, self-care practices, and hypertension control were collected using structured questionnaires and standardized scales. Descriptive statistics and chi-square tests were used for data presentation and analyses. Results Among the participants, 62.9 per cent reported poor self-care awareness, and only 37.1 per cent had good self-care awareness. Factors such as age group, education, occupation, type of family, marital status, socioeconomic status, and hypertension control showed significant associations with self-care scores (P≤0.001). However, no significant association was found between gender and self-care scores. Interpretation & conclusions This study highlights the critical need for comprehensive interventions integrating self-care awareness into existing health programmes to address the growing burden of hypertension, particularly in urban slum populations. By prioritizing self-care education and empowerment, healthcare stakeholders can equip individuals with the necessary knowledge and skills for effective hypertension management, thus improving health outcomes at individual level and also reducing public health impact of hypertension.

Background & objectives Overcoming the challenge of early diagnosis of prostate cancer (PCa) by exploring molecular biomarkers is urgently needed. With this objective, this study was designed to explore the biomarker and therapeutic potential of miRNA (miR)-363-3p in PCa pathogenesis. Methods Total participants (n=188) were enrolled, and blood and tissue samples were collected from individuals categorized into the control group (n=55), benign prostate hyperplasia (BPH) group (n=60), PCa group (n=48), and castration-resistant PCa (CRPC) group (n=25). MiR expression profiling was carried out using quantitative polymerase chain reaction (qPCR), and biomarker analysis was conducted employing receiver operating characteristics (ROC) curve. The miR-363 target genes were predicted by in silico tools like Target Scan and starBasev 2.0 and its expression was validated by qPCR and association among them was established by using the STRING database. Results The results showed that the tumour-suppressive nature of miR-363-3p in both PCa tissues and serum were significantly higher than the control with a greater area under curve (AUC) was 0.969 (sensitivity: 85%; specificity 100%) and 0.988 (sensitivity: 97.5%; specificity: 87.5%), respectively. The targetome analysis of miR-363-3p revealed five target genes-NRAS, E2F3, PTEN, MDM2, and CCNE2 which were strongly associated with cell division and proliferation. The expression analysis of the target genes showed a significant tumour-suppression of PTEN gene and significant upregulation of oncogenic genes such as NRAS, E2F3, MDM2, and CCNE2. Interpretation & conclusions Collectively, the findings of this study suggest that miR-363-3p may be a potential biomarker in differentiating individuals with PCa and CRPC from healthy controls. The miR-363-3p triggers various oncogenic genes (MDM2, NRAS, E2F3, CCNE2) and tumour suppressor genes (PTEN) that are actively involved in PCa progression and development.

Background & objectives Cancer contributes to decreasing life expectancy, especially in low- and middle- income countries (LMIC) and countries in transition where resources for diagnosis and care are limited. As the world population is ageing, and by 2050, two-thirds of the population in LMIC will be elderly, the greater impact of cancer on the expectation of life in years at a given age of an adult will be seen in these countries. Methods Estimated cancer mortality for older adults (60 yr or above) was estimated using statistics available on Globocan 2020 platform (gco.iarc.fr). This platform provided the number of deaths and age-standardized truncated mortality rates (per 100,000) by sex and continent. We calculated the projected cancer deaths in 2040 by applying the projection model, considering a stable rate. Results Globally, with an estimated 7.5 million deaths, cancer deaths in older population represented a total of 71.2 per cent of all cancer-related deaths. The truncated age-adjusted mortality rate among the older population (both sexes) was estimated as 615.1 deaths per 100,000 and the mortality rate was 62.6 per cent higher in elderly (60 yr or above) males as compared to elderly females. The overall future cancer death among the elderly was estimated to increase from 7.05 to 12.7 million deaths, representing a total 80.2 per cent increase in deaths by 2040. Interpretation & conclusions The projected mortality increase will challenge existing healthcare systems, especially in lower or lower medium-income countries where resources are limited. Elderly patients are at an elevated risk of adverse outcomes due to the high prevalence of co-morbid conditions. Geriatric oncology will play an important role in the coming years to ensure the overall health and well-being of elderly patients, which needs to be supported by good stratified data on elderly cancer.

Background & objectives The newer technique using an innovative volume conductivity scatter (VCS) technology is emerging as a surrogate for sepsis diagnosis. The VCS technology offers a more objective method to measure cell volume (V), characterize conductivity (C) and light scatter (S) directly from more than 8,000 white blood cells (WBCs). However, diagnostic performance of VCS parameters in sepsis has not been extensively tested in routine hospital emergency settings. Therefore, the present study aimed to investigate the diagnostic and prognostic performance of VCS markers of neutrophils in our local hospital emergency setting. Methods It was an observational analytical study with 41 cases of sepsis and 43 healthy controls aged above 18 yr. Individuals with acute coronary syndrome and individuals with already diagnosed Human Immunodeficiency Virus (HIV) infection were excluded from the study. Results The mean neutrophil volume (MNV) values were not significantly different between cases and controls (P 0.138) whereas mean neutrophil conductance (MNC) and mean neutrophil scatter (MNS) measurements were significantly higher among cases as compared to controls (both P-values <0.001). According to Receiver Operating Characteristics (ROCs) curve analysis, MNV in our study failed to show statistically significant discriminatory ability in sepsis (AUC 0.54) whereas MNC (AUC 0.98) and MNS (AUC 0.95) showed marked discriminatory ability in diagnosing sepsis in this study cohort. Interpretation & conclusions Among VCS parameters, MNV failed as a standalone biomarker of sepsis in routine emergency setting whereas MNC and MNS had statistically significant diagnostic and discriminatory accuracies among hospitalized affected individuals with sepsis.

Background & objectives Subclinical joint bleed is a matter of concern in individuals with hemophilia on prophylaxis. Ultrasonography (USG) is mostly used for the screening of subclinical bleeds in such individuals but it has its own limitations. Thus a more comprehensive technology is required for the detection of the same. This study undertook to evaluate the efficacy of infrared thermography (IRT) for detection of subclinical joint bleeds and its comparison with ultrasonography and MRI (Magnetic Resonance Imaging), considering MRI as the gold standard. Methods Forty eight asymptomatic individuals with hemophiliacs on prophylaxis and 15 healthy males as controls were recruited. IRT, USG and MRI were done in all participants included in the study. FLIR camera systems were used for the capture of thermograms of the joints in both the study groups. Results The mean of maximum temperature difference>0.5K (ΔT max >0.5K) as compared to a healthy joint was considered as significant. Subclinical bleeds were detected in 23.9, 7.29 and 27.08 per cent participants by IRT, USG and MRI respectively. Sensitivity and specificity of IRT and USG was detected to be 88.4 and 97.67 per cent, and 26.9 and 99 per cent, respectively. Interpretation & conclusions The findings of this study suggest that IRT is an effective tool for detection of subclinical joint bleeds in individuals with hemophilia and can be used for the monitoring of the joints in such individuals.

Background & objectives Oral and genital HPV infection in men may be a source of cervical diseases in their women partners as well as disease in themselves. This study aimed to evaluate and compare the performance of Hybrid Capture 2 (HC2) in physician-collected cervical samples and qPCR in self-collected urine and oral gargle samples of women and men, respectively, for hr-HPV infection status and genotyping. Methods One thousand and two hundred biological samples were collected from 200 women (urine, oral gargle, and cervical smear) and 200 men (urine and oral gargle) visiting a referral hospital in the remote Himalayan State of Sikkim. The extracted genomic DNA from urine and gargle samples were profiled for hr-HPV genotypes using quantitative polymerase chain reaction (qPCR) and HC2 for cervical samples. Results In women, hr-HPV was detected in 17.5 per cent of cervical samples by HC2, 25.5 per cent of urine, and 7 per cent of gargle samples by qPCR. For men, hr-HPV was detected in 8 per cent urine and 5 per cent gargle samples by qPCR. Among the HPV-positive women, 56 per cent of urine samples and 20 per cent of oral samples showed single-genotype infection, while the remaining had multiple genotypes. Amongst the HPV-positive men, 62.7 per cent of urine samples and 85.7 per cent of oral samples showed single-genotype infection while the remaining had multiple genotypes. Compared to Pap, the area under ROC was good for HC2 (AUC=0.89) and for qPCR (AUC= 0.852). Interpretation & conclusions HC2 for cervical and qPCR-based HPV DNA assay for urine and gargle sample is suitable for risk profiling for cervical cancer (CC) and oral cancer (OC) screening programmes.