Pragmatic Evaluation of Growth Hormone Stimulation Tests in Short Stature.

Introduction: To assess the performance of growth hormone stimulation tests (GHSTs) in the evaluation of short stature. Methods: It was a single-centre retrospective study carried out in children evaluated for short stature between January 2005 to March 2020. The clonidine stimulation test (CST) and glucagon stimulation test (GST) were used to assess growth hormone (GH) reserve (GST was performed only when peak GH levels were between 5 to ≤10 ng/mL on CST). A GH level of <5 ng/mL on CST or ≤10 ng/ml on both was used to corroborate GH deficiency. Results: A total of 556 children were eligible for this study. The mean (SD) age was 12.9 (3.5) years, and 66.3% were male. The peak GH level [median (IQR)] was 5.50 ng/ml (1.90 - 7.50) on CST (at 60 minutes) and 7.45 ng/ml (2.15 - 10.77) on GST (at 120 minutes). On restricting sampling to two time points, the false positive rate was 13.6% on CST (60, 90 minutes) and 11.5% on GST (120, 150 minutes). Similarly, restricting to three time points was associated with a false positive rate of 8.5% on CST (60, 90, 120 minutes) and 3.8% on GST (90, 120, 150 minutes). Using the treating clinician-determined diagnosis of GHD as a reference standard, the optimal cut-off of peak GH on CST was 7.79 ng/ml (sensitivity: 83.8%; specificity: 89.4%). Conclusion: Restricting the GH sampling to fewer time points is associated with an increase in the false positivity rate (FPR).

Evolving Landscape of Diabetes Epidemic in Southeast Asia: Insights from National Family Health Survey.

Background: Limited evidence on diabetes prevalence trends from the Indian subcontinent prompted this study to estimate the trends in diabetes prevalence using the National Family Health Survey (NFHS) data. Method: A cross-sectional survey carried out between 2015-2016 (NFHS-4) and 2019-2021 (NFHS-5) in a nationally representative sample of adults (aged 20 to 54 years) was used. Diabetes was defined as the presence of: diagnosed diabetes (self-reported), fasting plasma glucose (FPG) ≥ 126 mg/dl, or a random plasma glucose (RPG) ≥200 mg/dl. "Fasting" was defined as the last food intake >8 hours and "random" as irrespective of the last meal. Diagnosed diabetes was defined as the presence of "self-reported diabetes" and undiagnosed diabetes was defined as FPG > 126 mg/dl or RPG ≥200 mg/dl. Findings: The crude prevalence of total diabetes increased from 3.5% (95% confidence interval (CI): 3.46-3.55) in 2015-2016 to 3.99% (95% CI: 3.94-4.04) in 2019-2021, a relative change of 14%. The increase was more in the poorest (1.77% vs 2.48%; P < 0.001) as compared to the rich (5.35%% vs· 5.43%; P = 0.847), rural areas (2.71% vs 3.38%; P < 0.001) as compared to urban (4.95% vs. 5.26%; P = 0.051), in normal weight individuals (1.87% vs. 2.16%; P < 0.001) as compared to obese (7.12% vs. 7.03%; P = 0.384). Interpretation: While the absolute prevalence of diabetes is highest amongst individuals residing in urban areas belonging to the rich wealth centile, the relative increase in the prevalence is disproportionately higher in those residing in rural areas, belonging to the poorest wealth centiles and having normal weight.

Isolation and characterization of alkalotolerant Pseudomonas sp. strain ISTDF1 for degradation of dibenzofuran.

An alkalotolerant Pseudomonas strain was enriched and isolated from effluent of the pulp and paper industry. This strain was able to degrade dibenzofuran and utilize it as a sole source of energy and carbon. The GC-MS based detection of various intermediary metabolites of biodegradation suggested the involvement of angular as well as lateral pathway of dibenzofuran biodegradation. The GC-MS based detection of various intermediary metabolites of biodegradation suggested the involvement of angular as well as lateral pathway of dibenzofuran biodegradation. This diverse dioxygenation property of the strain allowed it to utilize various recalcitrant chlorinated xenobiotics and PAHs compounds. This strain showed optimum utilization (~85%) of dibenzofuran (200 mg l⁻¹) within 36 h at pH 10 at 40 °C. The growth of the strain was supported by a wide range of environmental conditions such as temperature, pH, and concentration of dibenzofuran, suggesting that it can be used for in situ bioremediation of dioxin-like compound.