Pulmonary Involvement in Systemic Lupus Erythematosus Patients in a Tertiary Care Hospital

Introduction: In half of the individuals with systemic lupus erythematosus (SLE), over the course of the disease, pulmonary involvement occurs frequently and is one of the parts in the array of presenting symptoms. But the published research and information on SLE have historically concentrated on renal, central nervous system (CNS), and dermatological manifestations, while the pulmonary effects of SLE have received very less attention. Objective: To know the extent and pattern of pulmonary involvement in SLE patients in a tertiary care hospital. Materials and methods: A cross-sectional observational study was conducted among 70 diagnosed SLE [who fulfilled the revised American College of Rheumatology (ACR) criteria for the classification of SLE] patients attending a tertiary care center. Seventy diagnosed SLE patients who met the updated ACR criteria for the classification of SLE and were enrolled in a tertiary care facility in West Bengal participated in a cross-sectional observational study. After informed consent, clinical examinations, general survey, respiratory examination, cardiovascular examination, and relevant investigations [chest X-ray, pulmonary function test, echocardiography and electrocardiography, and high-resolution computed tomography (HRCT)/chest computed tomography (CT) scan] were performed. Results: The majority of the study subjects belonged to the 21–30 years of age-group (45.7%) and were females. Most of the study subjects were treatment-naïve as they were newly diagnosed. Among the chief presenting complaints, the most common was cough followed by dyspnea and pleuritic chest pain. Chest X-rays showed pleural pathology in 37% of study subjects and pulmonary function tests were found to have a restrictive pattern in 4.3%. Echocardiography documented that 19.6% had pulmonary artery hypertension. HRCT revealed that 19.4% of subjects had definitive findings of interstitial lung diseases (ILD). Conclusion: A substantial contributor to morbidity and death, SLE is a potentially fatal, commonly debilitating autoimmune illness with pulmonary symptoms. Cough was the most common presenting complaint, and the most common radiological abnormality detected was pleural effusion. Spirometry revealed, as expected, a restrictive pattern in most of the cases. Around 29% of cases revealed features suggestive of or confirmatory evidence for intestinal lung disease. As a whole, the prevalence of lung involvement in SLE in the study was 67%. But this being a study with only 70 participants, a further longitudinal is recommended to study disease activity correlation with the incidence of early pulmonary involvement in SLE disease course.

Assessment of Effectiveness of Targeted Intervention Program Under National AIDS Control Program among Injecting Drug Users Across India

Background: High HIV prevalence among injecting drug users (IDUs) remains a cause of concern and are considered key drivers of concentrated epidemic in India. The present paper aims to assess the effectiveness of the targeted intervention (TI) program on the risk behaviors among IDUs across regions of India. Materials and Methods: This paper used the data from the integrated biological and behavioral surveillance 2014–2015 among the IDUs in India. Descriptive statistics and propensity score matching analysis was carried out to understand the effectiveness of the TI program on the new needle/syringe used and needle/syringe shared in the last injecting episode by accounting for the covariates. Results: The matched samples estimate, i.e., average treatment effect on treated of new needles/syringe used and shared in the last injecting episode by those who received needles/syringes from peer educator or outreach workers (PE/ORWs) and those who did not receive was 2.8% (confidence interval [CI]: 0.05–5.6) increase in the use of new needles/syringes and 6.5% (CI: −9.7–−3.3) decrease in the needles/syringes shared in last injecting episode indicating that IDUs who received new needles/syringes from PE/ORWs are more likely to use new needle/syringe and less likely to share needle/syringes to those who did not receive needles/syringes. The results vary across the different regions of India. Conclusion: TI program proves to be an effective initiative in the behavior change among IDUs as substantiated by use of new needles/syringes and decreased sharing of needles/syringes. TI program coverage varies from region to region and may further be expanded to accelerate the program services to prevent HIV/AIDS.

EXPRESSION OF CD44 AS A CANCER STEM CELL MARKER IN ORAL CANCER: A META-ANALYSIS STUDY

Various researches have shown that Cluster of Differentiation 44 (CD44) is one of the valued markers. As it plays an important role in tumor growth and metastasis but studies also suggest it as a cancer stem cell (CSC) marker in oral cancer (OC). Therefore, we aimed to explore association between the expression of CD44 and clinicopathological characteristics along with the OC prognosis.We conducted literature search through PubMed database (till October 22, 2020) to determine and evaluate the clinical and prognostic significance of CD44 expression in OC patients. According to the inclusion criteria we finalized 9 studies with 867 OC cases. We found the positive expression of CD44 in advanced stages was prominently associated with reduced survival rate. Our analysis suggest that higher tumor expression of CD44 may predict poor survival in end staged OC patient

Knowledge, attitude and practices of parents of children with febrile convulsion.

CONTEXT: Parental anxiety and apprehension is related to inadequate knowledge of fever and febrile convulsion. AIMS: To study the knowledge, attitude, and practices of the parents of children with febrile convulsions. SETTINGS AND DESIGN: Prospective questionnaire based study in a tertiary care centre carried over a period of one year. SUBJECTS AND METHODS: 140 parents of consecutive children presenting with febrile convulsion were enrolled. STATISTICAL ANALYSIS USED: Chi-square test. RESULTS: 83 parents (59.3%) could not recognise the convulsion; 90.7% (127) did not carry out any intervention prior to getting the child to the hospital. The commonest immediate effect of the convulsion on the parents was fear of death (n= 126, 90%) followed by insomnia (n= 48, 34.3%), anorexia (n= 46, 32.9%), crying (n= 28, 20%) and fear of epilepsy (n= 28, 20%). Fear of brain damage, fear of recurrence and dyspepsia were voiced by the fathers alone (n= 20, cumulative incidence 14.3%). 109 (77.9%) parents did not know the fact that the convulsion can occur due to fever. The long-term concerns included fear of epilepsy (n= 64, 45.7%) and future recurrence (n= 27, 19.3%) in the affected child. For 56 (40%) of the parents every subsequent episode of fever was like a nightmare. Only 21 parents (15%) had thermometer at home and 28 (20%) knew the normal range of body temperature. Correct preventive measures were known only to 41 (29.2%). Awareness of febrile convulsion and the preventive measures was higher in socio-economic grade (P< 0.05). CONCLUSIONS: The parental fear of fever and febrile convulsion is a major problem with serious negative consequences affecting daily familial life.

Neurofibromatosis-Noonan syndrome or LEOPARD Syndrome? A clinical dilemma.

Neurofibromatosis (NF), Noonan syndrome (NS), and LEOPARD syndrome are all autosomal dominant conditions, each being a distinct clinical entity by itself. Rarely, one encounters cases with features of NF and NS and is termed as the 'Neurofibromatosis-Noonan syndrome' (NF-NS). The authors report a clinical dilemma with major clinical features of the NF-NS syndrome and LEOPARD syndrome co-existing in the same patient. Also, features of Noonan syndrome and LEOPARD syndrome are compared with the case reported.