Hematological and clinical profiling of chronic obstructive pulmonary disease: a comprehensive study.

Chronic obstructive pulmonary disease (COPD) presents as a multifaceted clinical landscape with various hematological manifestations. Among these, polycythemia and anemia pose distinct challenges. While the prevalence of polycythemia has decreased in recent years, anemia remains a prevalent concern, impacting patient outcomes. This study investigated the incidence and clinical characteristics of polycythemia in COPD patients, focusing on a diverse cohort in India. Methodological approaches included comprehensive evaluations of clinical parameters, pulmonary function, and hematological profiles. Results revealed significant variations in COPD severity, pulmonary function, and respiratory symptoms among patients with different hemoglobin levels. The findings shed light on the complex interplay between hematological variations and clinical manifestations in COPD, providing valuable insights for disease management strategies.

Modeling of mercury deposition in India: evaluating emission inventories and anthropogenic impacts.

Mercury (Hg), a ubiquitous atmospheric trace metal posing serious health risks, originates from natural and anthropogenic sources. India, the world's second-largest Hg emitter and a signatory to the Minamata Convention, is committed to reducing these emissions. However, critical gaps exist in our understanding of the spatial and temporal distribution of Hg across the vast Indian subcontinent due to limited observational data. This study addresses this gap by employing the GEOS-Chem model with various emission inventories (UNEP2010, WHET, EDGAR, STREETS, and UNEP2015) to simulate Hg variability across the Asian domain, with a specific focus on India from 2013 to 2017. Model performance was evaluated using ground-based GMOS observations and available literature data. Emission inventory performance varied across different observational stations. Hence, we employed ensemble results from all inventories. The maximum relative bias for Total Gaseous Mercury (TGM) and Gaseous Elemental Mercury (GEM; Hg0) concentrations is about ±20%, indicating simulations with sufficient accuracy. Total Hg wet deposition fluxes are highest over the Western Ghats and the Himalayan foothills due to higher rainfall. During the monsoon, the Hg wet deposition flux is about 65.4% of the annual wet deposition flux. Moreover, westerly winds cause higher wet deposition in summer over Northern and Eastern India. Total Hg dry deposition flux accounts for 72-74% of total deposition over India. Hg0 dry deposition fluxes are higher over Eastern India, which correlates strongly with the leaf area index. Excluding Indian anthropogenic emissions from the model simulations resulted in a substantial decrease (21.9% and 33.5%) in wet and total Hg deposition fluxes, highlighting the dominant role of human activities in Hg pollution in India.

Transforming growth factor-ß in tumor microenvironment: Understanding its impact on monocytes and macrophages for its targeting.

TGF-ß is a pivotal cytokine that orchestrates various aspects of cancer progression, including tumor growth, metastasis, and immune evasion. In this review, we present a comprehensive overview of the multifaceted role of transforming growth factor ß (TGF-ß) in cancer biology, focusing on its intricate interactions with monocytes and macrophages within the tumor microenvironment (TME). We specifically discuss how TGF-ß modulates monocyte and macrophage activities, leading to immunosuppression and tumor progression. We conclude with the current translational and clinical efforts targeting TGF-ß, recognizing the promising role of this strategy in immunooncology.

Transforming growth factor ß (TGF-ß), a pivotal cytokine, plays a crucial role in maintaining homeostasis and influencing cancer development by affecting various cell types. In cancer, TGF-ß initially suppresses tumor cell growth but later contributes to tumor progression and metastasis, presenting challenges in developing therapeutics targeting this cytokine. Mechanistically, TGF-ß impacts diverse cellular processes through canonical Smad and non-Smad pathways, that explains its diverse regulation of different, sometimes opposing, cellular processes.In the context of immunity, exposure to TGF-ß renders immune cells immunosuppressive, hindering their ability to fight tumor development. This article explores the effects of TGF-ß on monocytes and macrophages, highlighting its role in creating an immunosuppressive tumor microenvironment (TME) required for tumor survival and growth. The article provides an update on recent studies that underscore the potential of TGF-ß inhibition in modulating the immune response within the TME, thereby enhancing the effectiveness of cancer immunotherapy.Overall, this review article delves into the multifaceted role of TGF-ß in cancer biology, with a specific focus on its interactions with monocytes and macrophages. It underscores the knowledge gaps and the importance of targeting TGF-ß signaling in tumor-associated monocytes and macrophages as a promising therapeutic approach in TGF-ß secreting tumors.

Investigating a novel therapeutic composition for dry eye syndrome management: In vitro and in vivo studies.

Dry eye syndrome (DES) presents a significant challenge in ophthalmic care, necessitating innovative approaches for effective management. This research article introduces a multifaceted strategy to address DES through the development of ocular inserts utilizing advanced technologies such as hot-melt extrusion (HME) and the CaliCut post-extrusion system. The formulation includes key ingredients targeting different layers of the tear film and associated inflammation, including hydroxypropyl cellulose (HPC), polyethylene glycol (PEG), castor oil, and dexamethasone. The study incorporates a Design of Experiments (DoE) approach, integrating HME and the precise stretching and cutting technique of CaliCut for manufacturing consistency and dimensional control of the inserts. The developed insert(s) have been systematically characterized for their physicochemical properties, release profile, and in vivo efficacy. In silico molecular docking studies have also been conducted to assess the binding affinities of formulation components with ocular mucin, elucidating their binding affinities. Preliminary results demonstrate promising potential for the developed insert in managing DES, offering preservative-free treatment, sustained drug delivery, and improved patient compliance. This study highlights the integration of advanced technologies and formulation strategies in ocular drug delivery for effective DES management.

Meta-learning for real-world class incremental learning: a transformer-based approach.

Modern natural language processing (NLP) state-of-the-art (SoTA) deep learning (DL) models have hundreds of millions of parameters, making them extremely complex. Large datasets are required for training these models, and while pretraining has reduced this requirement, human-labelled datasets are still necessary for fine-tuning. Few-shot learning (FSL) techniques, such as meta-learning, try to train models from smaller datasets to mitigate this cost. However, the tasks used to evaluate these meta-learners frequently diverge from the problems in the real world that they are meant to resolve. This work aims to apply meta-learning to a problem that is more pertinent to the real world: class incremental learning (IL). In this scenario, after completing its training, the model learns to classify newly introduced classes. One unique quality of meta-learners is that they can generalise from a small sample size to classes that have never been seen before, which makes them especially useful for class incremental learning (IL). The method describes how to emulate class IL using proxy new classes. This method allows a meta-learner to complete the task without the need for retraining. To generate predictions, the transformer-based aggregation function in a meta-learner that modifies data from examples across all classes has been proposed. The principal contributions of the model include concurrently considering the entire support and query sets, and prioritising attention to crucial samples, such as the question, to increase the significance of its impact during inference. The outcomes demonstrate that the model surpasses prevailing benchmarks in the industry. Notably, most meta-learners demonstrate significant generalisation in the context of class IL even without specific training for this task. This paper establishes a high-performing baseline for subsequent transformer-based aggregation techniques, thereby emphasising the practical significance of meta-learners in class IL.

Metastatic Calcification in Allograft Kidney Due to Persistent Secondary Hyperparathyroidism: A Rare Cause of Graft Dysfunction.

Successful kidney transplant corrects mineral and bone disorderto a large extent; however, disorders can persistin up to 80% ofrecipients.We describe a case of persistent hyperparathyroidism with graft dysfunction and metastatic calcification in graft biopsy. A 48-yearold renal transplant recipient developed graft dysfunction 3 weeks after kidney transplant. During pretransplant workup, the recipient was found to have severe secondary hyperparathyroidism (intact parathyroid hormone level of 2000 pg/mL), which was managed and well controlled before transplant. Graft dysfunction was evaluated using algorithmic approach. Prerenal causes, tacrolimus toxicity, and infections were ruled out. Graft biopsy revealed several foci of tubular and parenchyma calcific deposits (microcalcinosis) with tubular injury. The patient was restarted on medical management of hyperparathyroidism, and he showed improvement over 6 weeks, along with creatinine level returning to nadir value. Vascular and graft calcification is an independent predictor of long-term graftfunction and overall mortality. This report describes the challenges that we faced in diagnosis and management of persistent hyperparathyroidism, as no randomized controlled trials and guidelines are available.

Heterogeneity of Salmonella enterica lipopolysaccharide counteracts macrophage and antimicrobial peptide defenses.

Salmonella enterica is comprised of over 2,500 serovars, in which non-typhoidal serovars (NTS), Enteritidis (SE), and Typhimurium (STM) are the most clinically associated with human infections. Although NTS have similar genetic elements to cause disease, phenotypic variation including differences in lipopolysaccharide (LPS) composition may control immune evasion. Here, we demonstrate that macrophage host defenses and LL-37 antimicrobial efficacy against SE and STM are substantially altered by LPS heterogeneity. We found that SE evades macrophage killing by inhibiting phagocytosis while STM survives better intracellularly post-phagocytosis. SE-infected macrophages failed to activate the inflammasomes and subsequently produced less interleukin-1ß (IL-1ß), IL-18, and interferon λ. Inactivation of LPS biosynthesis genes altered LPS composition, and the SE LPS-altered mutants could no longer inhibit phagocytosis, inflammasome activation, and type II interferon signaling. In addition, SE and STM showed differential susceptibility to the antimicrobials LL-37 and colistin, and alteration of LPS structure substantially increased susceptibility to these molecules. Collectively, our findings highlight that modification of LPS composition by Salmonella increases resistance to host defenses and antibiotics.

Exploring the promise of regulator of G Protein Signaling 20: insights into potential mechanisms and prospects across solid cancers and hematological malignancies.

RGS (Regulator of G protein signaling) proteins have long captured the fascination of researchers due to their intricate involvement across a wide array of signaling pathways within cellular systems. Their diverse and nuanced functions have positioned them as continual subjects of scientific inquiry, especially given the implications of certain family members in various cancer types. Of particular note in this context is RGS20, whose clinical relevance and molecular significance in hepatocellular carcinoma we have recently investigated. These investigations have prompted questions into the prevalence of pathogenic mutations within the RGS20 gene and the intricate network of interacting proteins that could contribute to the complex landscape of cancer biology. In our study, we aim to unravel the mutations within the RGS20 gene and the multifaceted interplay between RGS20 and other proteins within the context of cancer. Expanding on this line of inquiry, our research is dedicated to uncovering the intricate mechanisms of RGS20 in various cancers. In particular, we have redirected our attention to examining the role of RGS20 within hematological malignancies, with a specific focus on multiple myeloma and follicular lymphoma. These hematological cancers hold significant promise for further investigation, as understanding the involvement of RGS20 in their pathogenesis could unveil novel therapeutic strategies and treatment avenues. Furthermore, our exploration has extended to encompass the latest discoveries concerning the potential involvement of RGS20 in diseases affecting the central nervous system, thereby broadening the scope of its implications beyond oncology to encompass neurobiology and related fields.

Disrupting Maternal Behavior and Inducing Cannibalism Due to Valproic Acid: An Unexplored Insight.

Introduction: Valproic acid (VPA) is the most widely used chemical to develop the preclinical model of autism spectrum disorder (ASD). However, in addition to inducing autism, it causes different teratogenic effects like teeth malformation, tail kink, and abnormal body growth in offspring. So far, no study has explored VPA-induced maternal misbehavior, miscarriage, and maternal cannibalism. We aimed to determine the cannibalistic effects of VPA in pregnant female Wistar rats and VPA's influence on causing miscarriage frequency. Methods: Our study was conducted on pregnant Wistar rats. On gestation day (GD) 12.5, they were treated with VPA (600 mg/kg intraperitoneal) dissolved in saline at 250 mg/mL concentration. The observations were mean litter size, mean male/female pups, mean mortality, maternal cannibalism, mean number of pups alive, cannibalism of malformed pups, miscarriage, survival analysis of pups, and odds and risk ratio were calculated for deaths observed in both study (control and VPA-treated) groups. The study was conducted till the weaning period. Results: VPA-exposed pregnant females portrayed significantly decreased litter size (P<0.0001), significantly higher cannibalistic behavior (P=0.0023), and significantly higher cannibalism of malformed pups (P=0.0484) than the control group. VPA had caused complete pregnancy loss (miscarriage) in 5 pregnant females. Moreover, the VPA group's mortality percentage (P=0.0019) was significantly higher than the control group. Conclusion: Overall, VPA has marked teratogenic effects (anatomical and morphological changes in offspring) with maternal behavior disruption, which causes cannibalism in Wistar female rats. The current manuscript findings can aid in investigating the novel mechanisms involved in maternal behavior disruption during the development of the VPA autism model.

Torsemide in the Management of Pulmonary Edema.

Pulmonary edema, either cardiogenic or noncardiogenic, is caused by fluid accumulation in the alveolar spaces. Cardiogenic pulmonary edema (CPE), one of the causes of congestive heart failure (CHF), is treated with loop diuretics. Torsemide and furosemide were found to be useful in the treatment of CHF-associated pulmonary edema due to their ability to lower pulmonary capillary pressure and left ventricular end-diastolic pressure, respectively. Pharmacological features of torsemide, such as greater bioavailability, higher absorption rate, and efficacy, make it a better alternative for treating pulmonary edema than the regularly used loop diuretic, furosemide. Torsemide administered intravenously was found to be both efficacious and well tolerated in CPE. However, more research is needed to determine its usefulness in non-CPE.

An Ultrasound-Activated Supramolecular Modulator Enhancing Autophagy to Prevent Ventricular Arrythmias Post-Myocardial Infarction.

Ventricular arrhythmias (VAs) triggered by myocardial infarction (MI) are the leading cause of sudden cardiac mortality worldwide. Current therapeutic strategies for managing MI-induced VAs, such as left stellate ganglion resection and ablation, are suboptimal, highlighting the need to explore safer and more effective intervention strategies. Herein, we rationally designed two supramolecular sonosensitizers RuA and RuB, engineered through acceptor modification to generate moderate reactive oxygen species (ROS) to modulate VAs. Both RuA and RuB demonstrated high ultrasound (US)-activated ROS production efficiency, with singlet oxygen (1O2) quantum yield (ΦΔ) of 0.70 and 0.88, respectively, surpassing ligand IR1105 and the conventional sonosensitizer ICG (ΦΔ =0.40). In vitro, RuB, at a modest concentration and under US intensity notably boosts pro-survival autophagy in microglia BV2 cell. To improve in vivo stability and biocompatibility, RuB was further encapsulated into DSPE-PEG5000 to prepare RuB NPs. In vivo studies after microinjection of RuB NPs into the paraventricular nucleus and subsequent US exposure, demonstrated that RuB NPs-mediated US modulation effectively suppresses sympathetic nervous activity (SNA) and inflammatory responses, thereby preventing VAs. Importantly, no tissue injury was observed post RuB NPs-mediated US modulation. This work pioneers the design of long-wave emission supramolecular sonosensitizers, offering new insights into regulating cardiovascular diseases.

An Unusual Case of Metastasis to Bilateral Breasts Masquerading as Disseminated Tuberculosis in a 17-Year-Old Girl with Quadriplegia-Where Is the Primary? An Unsolved Mystery.

Invasive breast cancer, no special type, is the most frequent subtype of breast malignancy encountered as compared to secondary breast cancer. The most common tumors metastasizing to the breast include lymphoma and melanoma. Rhabdomyosarcoma (RMS) is a common soft-tissue neoplasm in the paediatric population, often seen in regions such as the head and neck, genitourinary system, trunk, and extremities. While metastatic RMS to the breast is uncommon, it tends to occur primarily in adolescent girls, with the alveolar variant being the most frequently encountered. In this case presentation, we describe the unique instance of a 17-year-old girl admitted to the hospital with quadriplegia which on initial clinical evaluation was diagnosed as disseminated tuberculosis involving the spine (Pott's spine), but on further cytologic and histopathologic assessment revealed the unexpected diagnosis of rhabdomyosarcoma. This case draws attention to the unusual occurrence of rhabdomyosarcoma metastasis to bilateral breasts, that to with an embryonal morphology, and underscores the challenge of identifying the primary site of this rare manifestation.

Intricate relationship between cancer stemness, metastasis, and drug resistance.

Cancer stem cells (CSCs) are widely acknowledged as the drivers of tumor initiation, epithelial-mesenchymal transition (EMT) progression, and metastasis. Originating from both hematologic and solid malignancies, CSCs exhibit quiescence, pluripotency, and self-renewal akin to normal stem cells, thus orchestrating tumor heterogeneity and growth. Through a dynamic interplay with the tumor microenvironment (TME) and intricate signaling cascades, CSCs undergo transitions from differentiated cancer cells, culminating in therapy resistance and disease recurrence. This review undertakes an in-depth analysis of the multifaceted mechanisms underlying cancer stemness and CSC-mediated resistance to therapy. Intrinsic factors encompassing the TME, hypoxic conditions, and oxidative stress, alongside extrinsic processes such as drug efflux mechanisms, collectively contribute to therapeutic resistance. An exploration into key signaling pathways, including JAK/STAT, WNT, NOTCH, and HEDGEHOG, sheds light on their pivotal roles in sustaining CSCs phenotypes. Insights gleaned from preclinical and clinical studies hold promise in refining drug discovery efforts and optimizing therapeutic interventions, especially chimeric antigen receptor (CAR)-T cell therapy, cytokine-induced killer (CIK) cell therapy, natural killer (NK) cell-mediated CSC-targeting and others. Ultimately use of cell sorting and single cell sequencing approaches for elucidating the fundamental characteristics and resistance mechanisms inherent in CSCs will enhance our comprehension of CSC and intratumor heterogeneity, which ultimately would inform about tailored and personalized interventions.

Design, synthesis, in silico, and in vitro evaluation of pyrrol-2-yl-phenyl allylidene hydrazine carboximidamide derivatives as AChE/BACE 1 dual inhibitors.

Alzheimer's disease (AD) manifests as a progressive decline in cognitive function and mental behavior. Targeting two crucial enzymes associated with AD, acetylcholinesterase (AChE) and BACE 1 (Beta-site APP Cleaving Enzyme), in combination, holds promise for therapeutic breakthroughs. In this study, 40 derivatives of pyrrol-2-yl-phenyl allylidene hydrazine carboximidamide were designed based on prior research. These derivatives underwent synthesis and assessment for their inhibitory potential against AChE and BACE 1. ADME predictions indicated favorable physicochemical properties for these compounds. The findings offer novel avenues for exploring the dual inhibition of AChE and BACE 1 as a promising therapeutic strategy for AD.

Gut Microbiota Defines Functional Direction of Colonic Regulatory T Cells with Unique TCR Repertoires.

Intestinal microbiota and selected strains of commensal bacteria influence regulatory T (Treg) cell functionality in the colon. Nevertheless, whether and how microbiota changes the transcriptome profile and TCR specificities of colonic Tregs remain to be precisely defined. In this study, we have employed single-cell RNA sequencing and comparatively analyzed colonic Tregs from specific pathogen-free and germ-free (GF) mice. We found that microbiota shifts the activation trajectory of colonic Tregs toward a distinct phenotypic subset enriched in specific pathogen-free but not in GF mice. Moreover, microbiota induced the expansion of specific Treg clonotypes with shared transcriptional specificities. The microbiota-induced subset of colonic Tregs, identified as PD-1- CXCR3+ Tregs, displayed enhanced suppressive capabilities compared with colonic Tregs derived from GF mice, enhanced production of IL-10, and were the primary regulators of enteric inflammation in dextran sodium sulfate-induced colitis. These findings identify a hitherto unknown gut microbiota and immune cell interaction module that could contribute to the development of a therapeutic modality for intestinal inflammatory diseases.

ATP mimetics targeting prolyl-tRNA synthetases as a new avenue for antimalarial drug development.

The prolyl-tRNA synthetase (PRS) is an essential enzyme for protein translation and a validated target against malaria parasite. We describe five ATP mimetics (L95, L96, L97, L35, and L36) against PRS, exhibiting enhanced thermal stabilities in co-operativity with L-proline. L35 displays the highest thermal stability akin to halofuginone, an established inhibitor of Plasmodium falciparum PRS. Four compounds exhibit nanomolar inhibitory potency against PRS. L35 exhibits the highest potency of ∼1.6 nM against asexual-blood-stage (ABS) and ∼100-fold (effective concentration [EC50]) selectivity for the parasite. The macromolecular structures of PfPRS with L95 and L97 in complex with L-pro reveal their binding modes and catalytic site malleability. Arg401 of PfPRS oscillates between two rotameric configurations when in complex with L95, whereas it is locked in one of the configurations due to the larger size of L97. Harnessing such specific and selective chemical features holds significant promise for designing potential inhibitors and expediting drug development efforts.

Replacing Inorganic Source of Zinc with Zinc Hydroxy Chloride: Effects on Health Status, Hemato-biochemical Attributes, Antioxidant Status, and Immune Responses in Pre-ruminant Crossbred Calves.

The current research aimed to assess the feasibility of using Zn hydroxy chloride (ZnOHCl) as an alternative to ZnSO4 in pre-ruminant crossbred calves. Twenty-four male crossbred calves (Tharparkar × Holstein Friesian) were categorized into four groups according to body weight and age (body weight 31 kg; age 10 days). Experimental calves were kept on a similar feeding regimen except that different groups were supplemented with either 0 mg Zn/kg DMI (Zn-0), 80 mg Zn/kg DMI as ZnSO4 (ZnS-80), 40 mg Zn/kg DMI as ZnOHCl (ZnH-40), or 80 mg Zn/kg DMI as ZnOHCl (ZnH-80). All the calves were fed for 90 days as per ICAR (2013) feeding standard to fulfill their nutrient requirements for growth rate of 500 g/day. The study observed the influence of different sources and varying levels of Zn supplementation over a 90-day experimental period on health status, hemato-biochemical attributes, antioxidant status, immune responses, and plasma minerals and erythrocyte Zn concentrations. The data was examined using a randomized complete block design (RCBD) with fixed effects of treatment, period, and their interaction. The results indicated that irrespective of the sources and levels of Zn, supplementation did not lead to significant changes in health status as assessed by fecal score, nasal score, ear score, and eye score. Hematological parameters remained unchanged following supplementation with different sources and levels of Zn. Zn-supplemented groups showed higher levels of total protein, globulin, and alkaline phosphates (ALP) compared to the non-supplemented group. However, no significant variations were detected within the Zn-supplemented groups. Zinc supplementation significantly increased total antioxidant capacity (TAC), antioxidant enzyme activity, total immunoglobulin (Ig), immunoglobulin G (IgG), cell-mediated immunity (CMI), and humoral immunity (HI); however, no significant variations were detected among Zn-supplemented groups. Zn supplementation enhanced plasma and RBC Zn concentration without affecting the plasma concentration of other minerals. However, among the Zn-supplemented groups, 80 mg Zn/kg DMI as ZnOHCl resulted in the highest RBC Zn concentration. The study results demonstrate that Zn supplementation enhanced biomarkers of zinc status, antioxidant levels, and immune responses in pre-ruminant crossbred calves. Nevertheless, no significant variations were observed between the different Zn sources (ZnSO4 and ZnOHCl) utilized in this study. Research suggests that ZnOHCl could be a feasible alternative to ZnSO4 in the diet of pre-ruminant crossbred calves.

Burden of Portal Hypertension Complications Is Greater in Liver Transplant Wait-Listed Registrants with End-Stage Liver Disease and Type 2 Diabetes.

BACKGROUND AND AIMS: Impact of type 2 diabetes mellitus (T2DM) in patients with end-stage liver disease (ESLD) awaiting liver transplantation (LT) remains poorly defined. The objective of the present study is to evaluate the relationship between T2DM and clinical outcomes among patients with LT waitlist registrants. We hypothesize that the presence of T2DM will be associated with worse clinical outcomes. METHODS: 593 patients adult (age 18 years or older) who were registered for LT between 1/2010 and 1/2017 were included in this retrospective analysis. The impact of T2DM on liver-associated clinical events (LACE), survival, hospitalizations, need for renal replacement therapy, and likelihood of receiving LT were evaluated over a 12-month period. LACE was defined as variceal hemorrhage, hepatic encephalopathy, and ascites. Kaplan-Meier and Cox regression analysis were used to determine the association between T2DM and clinical outcomes. RESULTS: The baseline prevalence of T2DM was 32% (n = 191) and patients with T2DM were more likely to have esophageal varices (61% vs. 47%, p = 0.002) and history of variceal hemorrhage (23% vs. 16%, p = 0.03). The presence of T2DM was associated with increased risk of incident ascites (HR 1.91, 95% CI 1.11, 3.28, p = 0.019). Patients with T2DM were more likely to require hospitalizations (56% vs. 49%, p = 0.06), hospitalized with portal hypertension-related complications (22% vs. 14%; p = 0.026), and require renal replacement therapy during their hospitalization. Patients with T2DM were less likely to receive a LT (37% vs. 45%; p = 0.03). Regarding MELD labs, patients with T2DM had significantly lower bilirubin at each follow-up; however, no differences in INR and creatinine were noted. CONCLUSION: Patients with T2DM are at increased risk of clinical outcomes. This risk is not captured in MELD score, which may potentially negatively affect their likelihood of receiving LT.

Prediction of Different Risk Factors in Relation to Hyperlipidemia Using Framingham Risk Score and Cholesterol Risk Score in a Tertiary Care Hospital.

BACKGROUND: A condition that affects the circulatory system of the human body is referred to as a cardiovascular disease (CVD). Cardiovascular diseases (CVDs) are responsible for a significant number of fatalities globally. Annually, CVDs result in the demise of 17.9 million people, which accounts for 31% of all fatalities on a global scale. OBJECTIVE: The objective of the study was to assess the demographic profile of diabetic and nondiabetic patients suffering from cardiovascular disease. The aim of the study is to predict risk factors in relation to hyperlipidaemia using two different scales, the Framingham Risk Scale (FRS) and the Cholesterol Risk Calculator (CRC), and to determine the frequency of hypercholesterolemia in relation to CVD. METHODS: A cross-sectional study was conducted in Guru Gobind Singh Medical College and Hospital, Punjab, India. RESULTS: The mean age of patients was found to be M= (51.23), SD= (9.348) years, and among 331 patients (52.6%) were female patients. The mean of Framingham Risk Score was found to be (29.07%). The Framingham Risk Score was found significant with gender and calorie intake below the recommended dietary allowances of the patient (p=0.001). The Framingham Risk Score was found significant with physical activity and employment status of the patients (p= 0.001). In linear regression, the Framingham Risk Score was found significant with the lipid profile of the patients (p=0.001) i.e., the higher the value of cholesterol level, the higher the Framingham Risk Score. The chi-square test showed a significant relation between Cholesterol Risk Score and employment status, physical activity, calorie intake, gender, and occupation of the patients (p=0.001, p=0.001, p=0.001, p=0.004) respectively. CONCLUSION: The present study demonstrated that patients with high Framingham risk score and cholesterol risk score are at increased risk of diabetes and cardiovascular disease. The present study concludes that the FRS is higher in patients below RDA, patients doing low physical activity, and sedentary workers. In order to provide proper assistance and counselling, healthcare professionals must continuously analyze each patient's risk factor for CVD and barriers to healthy and preventive behaviors. There is a lack of comprehensive studies comparing the effectiveness of the Framingham Risk Score and Cholesterol Risk Score in predicting hyperlipidemia and associated cardiovascular risks within the context of a tertiary care hospital setting.