Aweak phenotype associated with novel ABO*A allele variant c.106delinsGG.

BACKGROUND AND OBJECTIVES: Discrepancy between forward and reverse ABO grouping could be due to several reasons including genetic mutations of the alleles encoding group specific transferase. The healthy donors found with weak A antigen were investigated to ascertain the allele responsible for variation. MATERIALS AND METHODS: Standard serological methods were employed using commercial antisera. The molecular sequencing was performed on DNA with enrichment library prep kit and a custom designed overlapping probe panel. Binary alignment mapping files, generated on board the Illumina MiSeq instrument and aligned to the GRCh37/Hg19 reference genome, were uploaded to the QIAGEN CLC genomics workbench software (version. 20) where variant call files were generated and analyzed. RESULTS: Red blood cells (RBCs) of six healthy donors, showing weak mix-field agglutination by anti-A and anti-A, B and plasma with absence or weakly reacting anti-A, were investigated serologically. The RBCs incubated with anti-A yield positive elution and their saliva lacked A but possessed H antigen thereby classifying as a historical known phenotype Aend. Family study on 4 probands showed inheritance of the trait. Molecular studies revealed presence of ABO*A allele carrying rare novel variant referred to as c.106delinsGG in line with HGVS recommendation that was thought to be responsible for the variant of A. CONCLUSION: Six cases serologically defined as Aweak were found to be associated with novel allele ABO*A (c.106delinsGG). The Aweak phenotype with the novel allele has not been displayed on International Society of Blood Transfusion database, though c.106delinsGG is listed in the UCSC genome browser under rs782544248.

Does commonly used femoral components of total knee arthroplasty fit well in the Indian population?

Background: 20 % of patients remain dissatisfied post-Total Knee Arthroplasty. We intend to find the correlation between sizes of commonly used femoral components and morphometric data of distal femur in Indian population. Materials and methods: Prospective observational study in 178 knees (178 individuals) was conducted on Magnetic Resonance Imaging scans (Axial section). The anteroposterior dimension at intercondylar notch (AP), anteroposterior dimension on the medial (MAP) and lateral (LAP) femoral condyle, total mediolateral width (ML), width of medial condyle (MLM), lateral condyle (MLL) and intercondylar distance (ICD) and aspect ratio (AR) were measured on males and females separately. These measurements were then analyzed keeping in view the available sizes of three latest knee arthroplasty systems (Attune CR, Next Gen II, Genesis II) to look for correlation and best fitting system. Results: On observation between values of male and female femur, a significant difference was seen in all the parameters (p-value<0.0001) except ICD (p-value 0.6591). On scatter plots, Attune was found to be nearer to the line of best fit compared to other two implant companies in both males and females. Outliers were highest in cases of NextGen II (45 % in males and 46 % in females) whereas it was lowest in the case of Attune (12.5 %in males and 41 % in females). Conclusion: Attune CR was seen to fit best in the Indian population followed by Genesis II and NextGen II. These femoral implants are designed as per the sizes of the Western population and the Caucasians are oversized for the Indian subcontinent, especially female patients, thus needing improvement in design/sizes. Level of evidence: III.

Effect of early menopause on cognition and brain morphology in an Urban Indian Cohort.

BACKGROUND: Evidence for the effect of early menopause on cognition among older women is not consistent and is scant among the Indian population. METHODS: We aimed to examine the effect of early menopause (≤45 years) on cognitive performance and brain morphology among older dementia-free females of the TLSA cohort using a multiple linear regression analysis. RESULTS: In a sample of 528 women, 144 (27%) had early menopause. The linear regression analysis showed that women with early menopause performed poorly in cognition and had lesser total gray matter volume [ß = -11973.94, p = 0.033], left middle frontal [ß = -353.14, p = 0.033], and left superior frontal [ß = -460.97, p < 0.026] volume. CONCLUSION: Dementia-free women with early menopause had poorer cognition, lower total gray matter, and frontal lobe. More research is needed to explore the link between earlier menopause and cognitive decline and develop ways to address it. HIGHLIGHTS: Evidence on the effect of early menopause on brain morphology is inconsistent and scant in low and middle-income countries, such as India. In a cohort of dementia-free individuals in urban Bangalore, we observed that participants with early menopause had significantly lower cognitive performance and lower total gray matter and frontal lobe volume. We recommend increasing awareness of this fact among the medical community and the general public. There is an urgent need to explore the underlying biological mechanism and to discover effective interventions to mitigate the effect.

Role of green and sustainable practices in shaping the future of medical imaging technology: A cross-sectional multi-stakeholder analysis among students, radiographers, and academic experts.

INTRODUCTION: The detection and treatment of diseases like COVID, diabetes, cancer, cardiovascular conditions, etc., have made medical imaging technology more necessary, so it is expected that the demands of imaging modalities are also increasing and are major contributors to carbon emissions in the healthcare industry. Hence, the Radiology departments, like the rest of the healthcare industry should adapt the procedures to become more sustainable. METHODS: A total of 1016 respondents completed the online survey to assess the perception, current practices, and challenges in adopting green and sustainable practices in medical imaging. The radio technologists, teaching faculties, and students of medical imaging were recruited for the study. The survey tool was distributed to the closed groups through social media and emails. RESULTS: The majority of participants (66.6%) highlighted the importance of green and sustainable practices in medical imaging whereas only 21.06% of participants seem to have implemented these practices. Most of the participants give positive responses on the use of zero-lead aprons (77%), refurbished medical systems (85.8%), and eco-friendly packaging (89.5%). The mixed response was received from waste segregation and energy-saving measures. The majority (60.3%) of them have no formal education or training. However, they have a good attitude towards the willingness to adopt green practices. CONCLUSIONS: There is a gap between perception and implementation of green and sustainable practices due to leadership and information barriers. Comprehensive training for stakeholders of medical imaging is crucial to fully integrate sustainability practices, possibly through webinars or educational modules. IMPLICATIONS FOR PRACTICE: The study's findings shed light on how important medical imaging stakeholders view green and sustainable practices as well as potential obstacles to their implementation at the local level whilst suggesting the need for exclusive training on these practices to promote sustainability.

Association of serum ferritin trends with liver enzyme patterns in ß-thalassemia major: A longitudinal correlational study.

Background: ß-Thalassemia major patients require lifelong blood transfusions, leading to iron overload and liver injury. This study examines the longitudinal association between serum ferritin and liver function over 5 years in pediatric patients. Methods: This retrospective study included 582 transfusion-dependent thalassemia patients aged 1-18 years. Serum ferritin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and albumin were measured annually. Correlation and linear regression analyses assessed associations between ferritin trajectories and liver enzymes. Results: Mean ferritin rose from 1820 ± 960 ng/mL at baseline to 4500 ± 1900 ng/mL at year 5, indicating worsening iron overload. AST and ALT levels also steadily climbed over follow-up, whereas albumin declined slightly. Ferritin correlated positively with AST (r = 0.675, P < 0.01) and ALT (r = 0.607, P < 0.01), but not with albumin (r = -0.143, P = 0.153) annually. The regression interaction term showed within-patient ferritin increases over time were independently associated with escalating AST and ALT (P < 0.05), after adjusting for confounders. Conclusion: Rising ferritin levels predict progressive liver injury in regularly transfused pediatric thalassemia patients. Tighter control of iron overload may help preserve hepatic function.

Variations in origin level of superior mesenteric artery, inferior mesenteric artery and coeliac trunk in indian population.

OBJECTIVE: The abdominal aorta is a continuation of the thoracic aorta and gives off coeliac trunk, superior mesenteric artery & inferior mesenteric artery. The focus of our study is to evaluate variations in origin level in coeliac trunk, Superior Mesenteric artery, Inferior Mesenteric artery, and Aortic bifurcation in the Indian population and compare with various demographics. MATERIALS AND METHODS: The study was retrospective and the local ethics committee approval was taken before starting it. 300 patients who were of more than 18 years of age and required CECT studies were included in this. The vertebral origin level of the arteries from Abdominal Aorta and Aortic Bifurcation level was analyzed. RESULTS: The most common origin level of Coeliac trunk for both males and females was T12-L1 Disc level. The most common origin level of Superior Mesenteric Artery was L1 Upper level. The most common origin level of Inferior Mesenteric Artery was L3 Upper level. The most common origin level of Superior Mesenteric Artery was L5 Lower level. There was no statistical difference between the origin of any arteries in Males and Females in the Indian Population. CONCLUSION: As per our study in the Indian population and the published literature it is realized that there are significant variations in origins of Coeliac Trunk, Superior Mesenteric artery, Inferior Mesenteric artery and Abdominal Aorta bifurcation in different populations. ADVANCES IN KNOWLEDGE: This study elaborates on potential Anatomical Variations in Indian Population, particularly Mumbai City population. Also, our study compares it to different countries' data and their results in variations found in Abdominal Aorta branches.

Linking Non-alcoholic Fatty Liver Disease Severity With Metabolic Syndrome Features: An Integrative Study on Clinical and Radiological Fronts.

Introduction Non-alcoholic fatty liver disease (NAFLD) has become a widespread cause of chronic liver disease, ranging from simple steatosis to severe conditions like non-alcoholic steatohepatitis (NASH) and cirrhosis. Despite its similarity to alcohol-induced liver damage, NAFLD affects individuals with no significant alcohol consumption. This study explores the association between NAFLD, bone mineral density (BMD), insulin resistance, and subclinical inflammation, focusing on the Asian Indian population. The primary objective was to investigate the relationship between NAFLD and BMD, insulin levels, and markers of subclinical inflammation, hypothesizing that patients with NAFLD exhibit lower BMD, possibly linked to insulin resistance and inflammation. Methodology A cross-sectional study with 100 subjects aged 18-50 years (50 cases with NAFLD and 50 controls) was conducted. Exclusion criteria included excessive alcohol consumption, drug-induced fatty liver, severe organ dysfunction, infections, pregnancy, and acute or chronic illness. Data were collected through clinical examinations, anthropometric measurements, biochemical investigations, ultrasound diagnosis of NAFLD, and dual-energy X-ray absorptiometry (DEXA) scans for BMD assessment. Statistical analysis employed the chi-squared tests, t-tests, and Wilcoxon rank-sum tests. Results NAFLD patients had higher body mass index (BMI), waist-to-hip ratio, and markers of insulin resistance and inflammation compared to non-NAFLD controls. DEXA scans revealed significantly lower BMD in NAFLD cases, along with a higher prevalence of osteopenia. Positive correlations were observed between BMD and insulin resistance. The study contributes to understanding the link between NAFLD and lower BMD in the Asian Indian population, emphasizing the impact of insulin resistance and inflammation on bone health. The literature review supports the relevance of exploring NAFLD as an independent risk factor for low BMD. Conclusion This case-control study underscores the significant association between NAFLD and lower BMD in the Asian Indian population. Despite limitations, the findings highlight the importance of further research with larger samples and comprehensive assessments to elucidate the interplay between NAFLD, metabolic factors, and bone health.

Changes in alcohol consumption and binge drinking during the COVID-19 pandemic among American Indians residing in California and Oklahoma.

Background: This study explored the increased quantity and frequency of alcohol use in the American Indian (AI) population during the COVID-19 pandemic.Objectives: The aims of this study were to explore possible associations between covariables and both binge drinking and alcohol consumption during COVID-19.Methods: This cross-sectional survey study analyzed data from a sample of AI individuals (63% female) residing in California (n = 411) and Oklahoma (n = 657) between October 2020-January 2021. Analysis included summary statistics and multivariable logistic regression, including a variety of socio-economic, COVID-19 concern, and tobacco and marijuana use variables.Results: One or more alcohol binge episodes were reported between October 2020-January 2021 in 19.3% of participants and elevated overall alcohol consumption was reported by 21.6% of participants. Higher odds of elevated alcohol consumption occurred in women and those following more social distancing measures. The odds of binge drinking or elevated alcohol consumption in those using both marijuana and tobacco (aOR/ adjusted odds ratio:18.9, 95% CI = 8.5, 42.2, and aOR:3.9, 95% CI = 1.7, 8.6, respectively) were higher compared to those using neither. Similarly, the odds of binge drinking or elevated alcohol consumption in those using tobacco only (aOR:4.7, 95% CI = 2.9, 7.7 and aOR: 2.0, 95% CI = 1.1, 3.5, respectively) were higher compared to those using neither.Conclusions: This study found high rates of alcohol use and bingeing during the COVID-19 pandemic. Offering collaborative, culturally sensitive, and affordable support services are important components of intervention and preparation for future stressful events on local, as well as global levels.

Spectrum of rare and common mitochondrial DNA variations from 1029 whole genomes of self-declared healthy individuals from India.

Mitochondrial disorders are a class of heterogeneous disorders caused by genetic variations in the mitochondrial genome (mtDNA) as well as the nuclear genome. The spectrum of mtDNA variants remains unexplored in the Indian population. In the present study, we have cataloged 2689 high confidence single nucleotide variants, small insertions and deletions in mtDNA in 1029 healthy Indian individuals. We found a major proportion (76.5 %) of the variants being rare (AF<=0.005) in the studied population. Intriguingly, we found two 'confirmed' pathogenic variants (m.1555 A>G and m.14484 T>C) with a frequency of ∼1 in 250 individuals in our dataset. The high carrier frequency underscores the need for screening of the mtDNA pathogenic mutations in newborns in India. Interestingly, our analysis also revealed 202 variants in our dataset which have been 'reported' in disease cases as per the MITOMAP database. Additionally, we found the frequency of haplogroup M (52.2 %) to be the highest among all the 18 top-level haplogroups found in our dataset. In comparison to the global population datasets, 20 unique mtDNA variants are found in the Indian population. We hope the whole genome sequencing based compendium of mtDNA variants along with their allele frequencies and heteroplasmy levels in the Indian population will drive additional genome scale studies for mtDNA. Furthermore, the identification of clinically relevant variants in our dataset will aid in better clinical interpretation of the variants in mitochondrial disorders.

Establishing Apolipoprotein-B and non-high-density-lipoprotein-C goals in Indian population: A Cross-sectional study.

BACKGROUND: Defining lipid goals solely on low-density lipoprotein-cholesterol (LDL-C) levels in Indian population may cause misclassification due to high prevalence of hypertriglyceridemia and small dense LDL-C particles. International guidelines now recommend Apoliporotein-B (Apo-B) and non-high-density lipoprotein-cholesterol (non-HDL-C) levels as alternative targets. In this study, we used a cross-sectional representative population database to determine Apo-B and non-HDL-C cut-offs corresponding to identified LDL-C targets and compared them to international guidelines. METHODS: A community-based survey carried out in urban Delhi and adjacent rural Ballabhgarh provided lipid values for 3047 individuals. The Spearman correlation coefficient was used to evaluate the degree of relationship between Apo-B and LDL-C and non-HDL-C. Cut-off values for Apo-B and non-HDL-C were established using receiver operator curve analysis correlating with guideline-recommended LDL-C targets. RESULTS: Spearman's rank correlations between Apo-B and LDL-C (0.82) and non-HDL-C and LDL-C (0.93) were significant (p < 0.05). Proposed corresponding cut-off values for LDL-C of 55, 70,100,130 and 160 mg/dl for Apo-B and non-HDL-C in our population were 75.3, 75.5, 91.3, 107.6, 119.4 mg/dL and 92.5,96.5, 123.5, 154.5, 179.5 mg/dL respectively. However, in those with triglycerides >150 mg/dl the corresponding Apo-B and non-HDL-C values were 85.1, 92.7, 103.5, 117.5 and 135 mg/dL and 124.5, 126.5, 147.5, 167.5 and 190.5 mg/L respectively. CONCLUSION: Based on this study we provide Apo-B and non-HDL cut-offs corresponding to target LDL-C values in Indian patients with and without high triglycerides. It is noted that in individuals with triglycerides ≥ 150 mg/dl, the Apo-B levels are much higher than the values recommended by guidelines.

Functional Disability Due to Chronic Low Back Pain in the Geriatric Population of a Tertiary Care Hospital in North India: A Cross-Sectional Study.

Background Chronic low back pain (CLBP) is one of the painful and disabling conditions affecting the young as well as the geriatric population. There is a limited body of research to find out the impact of CLBP and functional disability on geriatric adults in the Indian region. Aim This study aims to determine the prevalence of functional disability due to CLBP in the geriatric population and to investigate the correlation between functional disability due to CLBP and other sociodemographic factors. Methodology A total of 157 geriatric adults were enrolled in the study, fulfilling the inclusion and exclusion criteria. Basic sociodemographic data, along with a clinical-radiological examination, was recorded. The Numeric Pain Rating Scale (NPRS), the Roland and Morris Disability Questionnaire, and the Quebec Back Pain Disability Scale were used as study tools. Summary measures (frequency, mean, median, etc.) are calculated according to the level of measurement of variables. The point prevalence of functional disability due to CLBP in the geriatric population, along with 95% confidence intervals, has been calculated. The prevalence estimates were estimated and calculated with SD variables using a t-test, chi-square test, or Fisher's exact test under bivariate analysis. The linear/logistic regression analysis was used to control for the effects of covariates. A significance level of 5% was set for all analyses due to the exploratory nature of the study. Statistical significance was considered at p < 0.05. Results According to the Roland and Morris Disability Questionnaire, 29% (N = 46) of the study geriatric participants had a severe disability, 45% (N = 70) had a moderate disability, and 26% (N = 41) had a mild disability. According to the Quebec Back Pain Disability Scale, 34% (N = 53) had scored more than 50, and 66% (N = 104) had scored less than 50. Statistically significant correlations have been found between the level of functional disability and intensity of pain (NPRS score), gender, associated illness, current and past occupation, and clinical diagnosis of CLBP (p < 0.05). Conclusion The prevalence of functional disability due to CLBP is higher in the geriatric population. It is associated with many influencing sociodemographic factors like gender, occupation, associated musculoskeletal illness, the intensity of low back pain, and clinico-radiological diagnosis. Early identification and timely interventions to reduce functional disability due to CLBP and associated risk factors are the need of the hour. Regular back muscle exercises, ergonomic modifications, and modification of activities of daily life are recommended to prevent functional disability due to CLBP.

Normative values of skeletal muscle mass, strength and performance in the Indian population.

BACKGROUND AND OBJECTIVES: Skeletal muscle is characterized by its mass, strength and performance. These normative values are pivotal in defining sarcopenia. Sarcopenia is associated with poor outcome of numerous medical and surgical conditions. This study aimed to establish normative benchmarks for skeletal muscle mass, strength and performance within the context of the Asian (Indian) population. METHODS: Our investigation utilized the computed tomography (CT) skeletal muscle index (SMI), handgrip strength (HGS), gait velocity and chair-stand test to construct reference values for muscle characteristics in the Indian population. RESULTS: The SMI analysis incorporated 1485 cases of acute abdomen (54.7%) males). The calculated SMI (kg/m2) was 38.50 (35.05-42.30) in males and 36.30 (32.20-41.20) in females (p = 0.510). The study also involved 3083 healthy individuals (67.6% males) evaluated for muscle strength and performance between August 2017 and August 2018. Notably, HGS (kg force) was recorded at 34.95 (26.50-43.30) in males and 25.50 (18.60-31.20) in females (p < 0.001). Gait velocity (metres/second) exhibited values of 1.25 (1.04-1.56) in males and 1.24 (1.03-1.56) in females (p = 0.851). Additionally, chair-stand test (seconds) results were 10.00 (9.00-13.00) in males and 12.00 (10.00-14.00) in females (p < 0.001). CONCLUSIONS: The investigation determined that males had greater muscle strength and performance than females. But gender wise, there was no significant difference in muscle mass. Interestingly, our population's muscle parameters were consistently lower compared to western literature benchmarks. These normative values will help to define sarcopenia parameters in our population, which have prognostic value in multiple ailments.

Are TomoFix Locking Plates Really Anatomical for Indian Population?

Purpose: The use of a TomoFix plate can be a challenge in Asian population who inherently have smaller tibial bones. This study aims to find out the normal proximal tibial morphometric measurements in Indian population and to compare the Medial Anterior Radius of Curvature (MAROC) of proximal tibia with the Proximal Part Radius of Curvature (PPROC) of the available TomoFix plates, to estimate conformity of the fit between them. Methods: Retrospective Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) based proximal tibial measurements were performed on 824 knees, 664 females and 160 males (604 patients). The mean MAROC, mean MAROC in males and mean MAROC in females were compared to the PPROC of TomoFix plates. Results: The radiological measurements revealed a mean AP length of 45.22 ± 3.79 mm, mean ML width of 69.04 ± 5.01 mm and mean MAROC of 21.88 ± 2.11 mm. The mean MAROC in males was 24.07 ± 2.1 mm, whereas in females it was 21.35 ± 1.75 mm. The mean MAROC, mean MAROC in males and mean MAROC in females when compared to the PPROC of Standard TomoFix plate (38 mm), Small TomoFix and Anatomical TomoFix plates (30 mm) showed a significant difference (p < 0.01), indicating that the radius of curvature of the plate does not match the radius of curvature of the anteromedial tibial plateau. Conclusion: The TomoFix plates, including Small (Asian Version) and Anatomical plates, are relatively large for the Indian population. Our study may help the implant to designers develop a plate that will better suit the Indian population, improving results and reducing hardware-related complications of MOWHTO.

Angiographic Patterns of Young Patients with Coronary Artery Disease in an Indian Population.

BACKGROUND: The incidence of coronary artery disease has continued to rise in recent decades, even in the developing world, affecting a broad spectrum of the population including young adults less than forty years. This is attributable to the rise in prevalence of conventional risk factors like diabetes mellitus, hypertension, smoking, dyslipidemia, and obesity. Although a significant number of studies have been done on the angiographic profile of patients with coronary artery disease, only a few of these studies were done in young patients and most of the studies were limited to northern India. AIMS AND OBJECTIVES: In this study, we aimed to determine the angiographic profile of young patients ≤ 40 years in a tertiary care centre in southern India. MATERIALS AND METHODS: A retrospective analytic study was conducted at the Meditrina Specialist Hospital, Kollam, Kerala, India. Individuals of both genders with age ≤ 40 years who were diagnosed with coronary artery disease between June 2021 and May 2022 were included. RESULTS: A total of 74 patients were included, out of which 62 were male and 12 were female. The mean ± SD age of the participants studied was 36.38 ± 3.99 years Amongst patients who had significant coronary artery disease, 24 (57.14%) had single vessel disease, 13 (31.00%) had double vessel disease, and 5 (11.86%) had triple vessel disease. The left anterior descending (LAD) artery was found to be the most frequently involved in all patterns of coronary artery disease (CAD). Male gender and diabetes were the most common risk factors for CAD present in 29.3% of patients studied. CONCLUSION: Male gender and diabetes were responsible for the relatively high incidence of premature CAD in this study with single vessel disease being the most prevalent finding. The LAD artery was the most commonly affected followed by RCA and LCX with right PLB being the least vessel involved.

CONTEXTE: L'incidence de la maladie coronarienne n'a cessé d'augmenter, touchant un large éventail de la population, y compris les jeunes adultes de moins de quarante ans au cours des dernières décennies, même dans le monde en développement. Cela est attribuable à l'augmentation de la prévalence de facteurs de risque conventionnels tels que le diabète sucré, l'hypertension, le tabagisme, la dyslipidémie et l'obésité. Bien qu'un nombre significatif d'études aient été réalisées sur le profil angiographique des patients atteints de maladie coronarienne, seules quelques-unes de ces études ont porté sur des patients jeunes et la plupart des études étaient limitées au nord de l'Inde. OBJECTIFS: Dans cette étude, nous visons à déterminer le profil angiographique des jeunes patients de ≤ 40 ans dans un centre de soins tertiaires du sud de l'Inde. MATÉRIAUX ET MÉTHODES: Une étude analytique rétrospective a été menée à l'hôpital spécialisé Medtrina de Kollam, Kerala, Inde. Les individus de deux sexes âgés de ≤ 40 ans, diagnostiqués avec une maladie coronarienne entre juin 2021 et mai 2022, ont été inclus. RÉSULTATS: Au total, 74 patients ont été inclus, parmi lesquels 62 étaient des hommes et 12 étaient des femmes. L'âge moyen ± SD des participants était de 36,38 ± 3,99 ans. Parmi les patients présentant une maladie coronarienne significative, 24 patients (57,14 %) avaient une maladie à un seul vaisseau, 13 patients (31,00 %) avaient une maladie à deux vaisseaux et 5 patients (11,86 %) avaient une maladie à trois vaisseaux. L'artère interventriculaire antérieure (LAD) était la plus fréquemment impliquée dans tous les types de maladie coronarienne (MC). Le sexe masculin et le diabète étaient les facteurs de risque les plus courants pour la MC, présents chez 29,3 % des patients étudiés. CONCLUSION: Le sexe masculin et le diabète étaient responsables de l'incidence relativement élevée de la MC précoce dans cette étude, la maladie à un seul vaisseau étant la constatation la plus courante. L'implication de la LAD est la plus fréquente, suivie de la RCA et de la LCX, la branche droite PLB étant la moins impliquée. MOTS-CLÉS: Maladie coronarienne; Angiographie coronaire, Profil ; Jeunes, Population indienne.

Decoding Cardiovascular Health: Carotid Intima-Media Thickness and Its Association With Coronary Artery Disease in the Indian Population.

Background Coronary artery disease, as well as other cardiovascular diseases, poses a significant health burden globally. Understanding the relationship between clinical variables and coronary artery disease is crucial for effective management. This study explores the link between carotid intima-media thickness and different risk factors in the Indian population. Aims and objectives The primary objective of this study is to investigate the correlation between coronary artery disease and carotid intima-media thickness in a cohort of Indian individuals. Secondary objectives include analyzing the impact of demographic factors, lifestyle choices, and biomarkers on coronary artery disease risk. Methodology This study adopts an analytic, prospective case-control design spanning 18 months from July 2022 to December 2023. The research is conducted in a hospital setting, utilizing data from patients undergoing coronary angiography. The case group comprises 42 patients diagnosed with coronary artery disease, while the control group consists of 18 age-matched individuals without coronary artery disease. Demographic details, lifestyle factors, and biomarker levels are assessed. Statistical analyses involve Fisher's exact tests, chi-square tests, ANOVA, and independent sample t-tests. Primary outcome measures include the association between carotid intima-media thickness and coronary artery disease, as well as the impact of demographic and lifestyle factors on coronary artery disease risk. Secondary outcome measures involve the predictive capability of carotid intima-media thickness through receiver operating characteristic (ROC) curve analysis. Results Significant findings include a notable association between gender and coronary artery disease, with a statistically significant relationship observed for smoking, alcohol consumption, and hypertension. Biomarkers such as high-sensitivity C-reactive protein (hs-CRP) and carotid intima-media thickness exhibit highly significant differences in coronary artery disease patients compared to controls. Conclusions This study underscores the importance of carotid intima-media thickness as a potential predictor for coronary artery disease in the Indian population. Gender, lifestyle choices, and certain biomarkers significantly influence coronary artery disease risk. These findings contribute to a nuanced understanding of coronary artery disease etiology and risk stratification. This study sheds light on the intricate interplay of clinical factors influencing coronary artery disease in the Indian population, paving the way for enhanced risk assessment and preventative strategies.

Sexual dimorphism and topological variability in fingerprint ridge density in a north-west Indian population.

The science of fingerprints is very crucial in criminal investigation as it helps identify perpetrators or victims of a crime. Fingerprint ridge density (FPRD), which refers to the number of ridges within a specific area on the epidermal skin layer of the distal phalanges in humans, has been found to differ between males and females. This study attempts to estimate the sex from FPRD and evaluates the diversity in FPRD across several topological areas. The study involves 208 participants (120 males, 88 females) between the ages 18 to 25 years from a North-west Indian population. Fingerprints were collected, and FPRD was accessed in radial, ulnar, and proximal areas as recommended by Gutierrez-Redomero et al. (Forensic Sci Int 180(1):17-22, 2008). FPRD has been quantified using the techniques described by Acree (Forensic Sci Int 102(1):35-44, 1999). When evaluating FPRD in the lateral pocket loops and twin loops, the proximal-side core was considered. The study reveals that males have a mean fingerprint ridge density of 12.82 ridges/25 mm2 while females have 13.01 ridges/25 mm2. Females have higher fingerprint ridge density solely in the proximal area; males have higher fingerprint ridge density in both radial and ulnar areas. In conclusion, this research underscores the potential of fingerprint ridge density as a parameter for investigating population variations and individual identification. Future studies on fingerprint ridge density in India's diverse population will help establish reference ranges, allowing for sex and likely population group estimation, making it a valuable tool for preliminary examinations and exclusion criteria for sex estimation in crime scene investigations.

Nationwide Etoricoxib Injection Clinical Experience (NICE): Real-World Evidence in Indian Patients.

Introduction Pain is a major health issue globally. Etoricoxib, a highly selective COX-2 inhibitor, given orally, has been found to be efficacious and safe in the management of acute and chronic pain. Oral etoricoxib has been extensively studied; however, there is a lack of research exploring the use of etoricoxib via alternative routes, specifically intramuscular (IM) injection. This study aimed to evaluate the effectiveness and safety of an innovative and novel formulation of IM etoricoxib injection 90 mg/mL in the management of patients with acute pain in India. Method This was a real-world, multicenter, retrospective, observational study to investigate the effectiveness and safety of IM etoricoxib injection in the management of patients with acute pain in India (outpatient setting). The clinical data of 383 patients from 42 centers across India were collected from November 2022 to April 2023. Following approval from the site investigator, comprehensive patient-level information encompassing demographic and clinical variables as well as comorbidities was collected and entered into a case report form. Approval from the Independent Ethics Committee (IEC) and Institutional Review Board (IRB) was sought. The safety and effectiveness at 30 minutes and 60 minutes of IM etoricoxib injection were then analyzed. Results Among the studied patients, etoricoxib was used for the management of knee arthritis, fracture, post-traumatic pain, postoperative cases, acute back pain, back injury, torn ligament, and muscle strain and sprain. Of 383 patients, 98.17% had moderate-to-severe pain at baseline on the visual analogue scale (VAS) (0 being no pain and 10 being severe unbearable pain). The percentage of patients with severe pain reduced to only 6.78% and 4.17% at 30 minutes and 60 minutes, respectively. The improvement in the VAS score was statistically significant from baseline to 30 minutes and 60 minutes, and at 60 minutes compared to 30 minutes (p < 0.0001). More than half the patients (56.91%) had no pain at the site of the injection. Most of the doctors (70.23%) opined that the IM etoricoxib injection was better than their currently used NSAID injections for pain relief. Only 12.79% of patients required rescue analgesia post-IM etoricoxib injection. IM etoricoxib injection was well tolerated as 98.69% of the patients did not experience or report any adverse events post-IM injection. Conclusion This real-world, multicenter, retrospective, observational study across India demonstrated that the innovative and novel formulation of etoricoxib (90 mg/mL IM injection) was effective and well-tolerated in the management of acute pain. Overall, this study provides valuable insights into the real-world effectiveness and safety of IM etoricoxib injections, suggesting it could be a promising therapy for the management of acute pain for optimal patient benefit.

The genomic landscape of CYP2D6 variation in the Indian population.

Aim: The CYP2D6 gene is highly polymorphic, causing large interindividual variability in the metabolism of several clinically important drugs. Materials & methods: The authors investigated the diversity and distribution of CYP2D6 alleles in Indians using whole genome sequences (N = 1518). Functional consequences were assessed using pathogenicity scores and molecular dynamics simulations. Results: The analysis revealed population-specific CYP2D6 alleles (*86, *7, *111, *112, *113, *99) and remarkable differences in variant and phenotype frequencies with global populations. The authors observed that one in three Indians could benefit from a dose alteration for psychiatric drugs with accurate CYP2D6 phenotyping. Molecular dynamics simulations revealed large conformational fluctuations, confirming the predicted reduced function of *86 and *113 alleles. Conclusion: The findings emphasize the utility of comprehensive CYP2D6 profiling for aiding precision public health.

Interdevice Agreement between a Smartphone and a Commercial Pupillometer.

Background: The reliability of dynamic pupillometry parameters varies from one pupillometer to another, making it difficult to standardize the values for any particular device. Hence, further studies are required to evaluate the agreement of various pupillometer devices and explore their utility in routine clinical settings. Aim: This study sought to evaluate the agreement between smartphone and commercial pupillometer measurements in routine clinical settings. Methods: The study included pupillary measurements obtained by a single investigator from 100 healthy participants (200 eyes) with each pupillometer. Pupillary measurements taken by a smartphone pupillometry application (reflex pupillary light reflex analyzer by Brightlamp [Indianapolis, IN, USA]) were compared with a commercial pupillometer (neurological pupil index-200, NeurOptics Inc., Irvine, USA). Results: The comparison of descriptive statistics revealed a statistically significant difference between the smartphone and commercial pupillometers for various parameters, including maximum diameter, minimum diameter, constriction velocity (CV), maximum CV, and dilatation velocity (P < 0.05), except for latency (P = 0.36). The intraclass correlation coefficient revealed poor agreement between the two devices (<0.50). Conclusion: The measurements by smartphone pupillometry application were found to be unreliable, indicating that they may not be an ideal substitute for commercial pupillometers in their present form in the Indian population. Further studies with larger sample size as well as improvements in the processing and interpretation of the measurements by the software, are needed to determine its utility in routine clinical settings.

Assessing the sensitivity and specificity of myositis-specific and associated autoantibodies: a sub-study from the MyoCite cohort.

OBJECTIVES: Myositis-specific and associated autoantibodies are important biomarkers in routine clinical use. We assessed local testing performance for myositis autoantibodies by comparing line immunoassay (LIA) to protein radio-immunoprecipitation and identifying clinical characteristics associated with each myositis autoantibody in the MyoCite cohort. METHODS: Serum samples from patients within the MyoCite cohort, a well-characterised retro-prospective dataset of adult and juvenile idiopathic inflammatory myopathy (IIM) patients in Lucknow, India (2017-2020), underwent LIA at Sanjay Gandhi Postgraduate Institute of Medical Science (SGPGIMS), Lucknow. Immunoprecipitation of 147 IIM patient serum samples (125 adult-onset, 22 juvenile-onset) was conducted at the University of Bath, with researchers blind to LIA results. LIA performance was assessed against Immunoprecipitation as the reference standard, measuring sensitivity, specificity, and inter-rater agreement. Univariate and multivariate logistic regression determined clinical associations for specific MSA. RESULTS: Immunoprecipitation identified myositis autoantibodies in 56.5% (n = 83) of patient samples, with anti-Jo1 (n = 16; 10.9%) as the most common, followed by anti-MDA5 (n = 14, 9.5%). While LIA showed good agreement for anti-Jo1, anti-PL7 and anti-PL12 (Cohen's κ 0.79, 0.83, and 1, respectively), poor agreement was observed in other subgroups, notably anti-TIF1γ (Cohen's κ 0.21). Strongly positive samples, especially in myositis-specific autoantibodies, correlated more with immunoprecipitation results. Overall, 59 (40.1%) samples exhibited non-congruence on LIA and Immunoprecipitation, and κ values for LIA's for anti-TIF1γ, anti-Ku, anti-PmScl, anti-Mi2, and anti-SAE ranged between 0.21-0.60. CONCLUSION: While LIA reliably detected anti-Jo1, anti-PL7, anti-PL12, anti-MDA5, and anti-NXP-2, it also displayed false positives and negatives. Its effectiveness in detecting other autoantibodies, such as anti-TIF1γ, was poor.