Evaluation of IL-4 and IL-13 Single Nucleotide Polymorphisms and Their Association With Childhood Asthma and Its Severity: A Hospital-Based Case-Control Study.

BACKGROUND AND OBJECTIVES: Asthma is a common, chronic, atopic respiratory disease that is on the rise among children and adults worldwide. Various environmental, genetic, and biological interactions contribute to the surge in susceptibility to this disease. Interleukin (IL) genes, particularly IL-4 and IL-13, have been linked to asthma pathogenesis. The present study aims to investigate the genetic aberrations, specifically single nucleotide polymorphisms (SNPs) of IL-4 and IL-13, and their association with childhood asthma and its severity. METHODS: An unmatched hospital-based case-control study was conducted in a tertiary care hospital in Assam, India. The sample size was calculated to be 120 (60 cases and 60 controls) using the Epi Info software version 7.2 (Centers for Disease Control and Prevention, Atlanta, GA, USA), assuming a confidence interval of 95%, a power of the study at 80%, a ratio of control to cases as 1, a proportion of controls with exposure at 22%, and a proportion of cases with exposure at 46%. A total of 53 clinically diagnosed cases of childhood asthma in the age range of three to 12 years and 39 healthy controls free from respiratory diseases and having no history of asthma and/or allergy of the same age group attending a tertiary care hospital were included in the study. Children who never had asthma or allergies and who did not suffer from any upper or lower respiratory infections for the previous four weeks were considered controls. Prior informed consent and ethical clearance were obtained. Very seriously ill cases and controls were excluded from the study. The genetic investigation used polymerase chain reaction (PCR), followed by restriction fragment length polymorphism (RFLP), to discover SNPs in the IL-4 and IL-13 genes. Sequencing analysis was done for the cases with +2044 G>A of the IL-13 gene in relation to the severity of the disease. The difference in the proportions of specific SNPs between cases and controls was analyzed using the χ2 test (a p-value of <0.05 was considered significant). RESULTS: Both the rs2070874 and rs2243250 polymorphisms of IL-4 showed no statistically significant associations. The mutation of the IL-13 gene in 1111C>T was higher among cases than controls. Both genotypic and allelic distributions of the +2044G>A polymorphism of the IL-13 gene revealed a significant association (p<0.05) with the severity of the disease. CONCLUSION: Genetic aberrations in SNPs of IL-4 and IL-13 are prevalent among the pediatric patients of the study region. The SNP +2044G>A of IL-13 is instrumental in disease manifestation and severity among the pediatric population of the study region.

Knowledge, Attitude, Practice and Preparedness toward COVID-19 Pandemic among Healthcare Workers in Designated COVID Hospitals of a North-Eastern State of India.

The knowledge, attitude, and practice (KAP) of healthcare workers (HCW) toward the COVID-19 pandemic influence their preparedness to accept the preventative measures. This study investigates KAP toward COVID-19 among the HCWs working in two designated COVID hospitals. It was a cross-sectional study. The overall KAP scores were calculated, and the difference in mean scores among various demographic and other variables was tested using t-test and one-way ANOVA. The participants were knowledgeable about transmission modes and disease symptoms and were aware of the preventive measures like hand sanitisations for 96% and 91% for wearing masks. Among the knowledgeable group, 87% were aware of the control measures of COVID-19 infection like isolation and treatment of the infected; quarantine of their close contacts; and 92% had the acquaintance about the avoidance of public transport and crowded places as a safety measure. The HCWs also showed a positive attitude toward keeping distance and staying at home (81.13% strongly agreed) and regularly washing hands (agreed 91%). The mean knowledge, attitude, and practice scores of the study participants were 19.67(±1.85), 27.95(1.81) and 4.61(0.51), respectively. Nurses were found to have significantly better knowledge, attitude, and practice toward COVID-19 than laboratory technicians and pharmacists. HCWs having higher education levels were also found to have better knowledge about COVID-19. The majority of the HCWs who participated in the study also strongly agreed that the referred hospitals are well prepared for infection prevention and control (IPC). Better knowledge, attitude and practices toward COVID-19 may considerably decrease the risk of getting the disease.

Risk Factors of Childhood Asthma Among Patients Attending a Tertiary Care Centre in North-East India.

Introduction: Asthma is a chronic lung illness marked by a reversible airway blockage. Both genetic and environmental factors influence higher asthma rates. The present study aims to assess the various socio-demographic and environmental factors influencing the causation of childhood asthma among patients attending the Paediatric Department of Gauhati Medical College and Hospital (GMCH), Assam. Materials and Methods: A total of 150 clinically diagnosed asthma patients of 3-12 years as cases and patients of the same age group free from respiratory diseases with no history of asthma in a 1:1 ratio as controls were selected. A predesigned and pretested proforma was used to collect data, and written informed consent was obtained from all the legal guardians of the participants. Data were analyzed by chi-square test and binary logistic regression using SPSS V20, considering a p-value <0.05 significant. Results: Urban and male children were found to be at higher risk of developing asthma. Children belonging to the urban locality (OR= 4.53; 95% CI: 1.57-13.09; p<0.05), damp environment (OR= 5.21; 95% CI: 1.23-22.10; p<0.05), lower socioeconomic status (OR= 3.48; 95% CI: 1.34-9.01; p<0.05), presence of pets (OR= 6.77; 95% CI: 1.76-25.99; p<0.05), family history of atopy/ allergy (OR= 43.29; 95% CI: 5.80-323.15 p<0.05), smoking/passive smoking (OR=23.54; 95% CI: 1.41-394.21 p<0.05) and mixed feeding (OR= 4.47; 95% CI: 1.46-13.63 p<0.05) were the significant risk factors of childhood asthma. Conclusion: Children are vulnerable to environmental-induced asthma. Awareness and preventive measures are necessary to control and reduce the burden of childhood asthma.

Relationship Between the Eruption of Third Molar Teeth and the Growing Status of the Assamese Inhabitants of a North-Eastern State of India.

Objectives Even though permanent teeth eruption time may vary, the tooth eruption stage represents a critical developmental milestone, which may help in the monitoring of the child's growing status towards adolescence. This paper aims to evaluate the relationship between the third molar eruption (TME) and investigate any possible association with the body mass index (BMI), which is used to monitor the growth of children and adolescents. Methods We included 1060 student participants aged 14 to 26 years from selected educational institutions in Assam for this study. We performed a conventional clinical dental examination to determine the stages of TME. Moreover, to calculate the individual height and weight, we have carried out a thorough physical examination to assess the BMI and rule out any visible congenital developmental anomalies. Result The overall mean age of the status of no eruption (NE), incomplete eruption (IE), and complete eruption (CE) categories of the third molar in the current research were 17.39±2.273, 18.67±2.282 and 20.33±2.566 years, respectively, and the difference in mean age was statistically significant (p-value <0.05). Among the 1060 participants assessed, 163 (15.38%) were underweight, 625 (58.97%) belonged to the average category, 207 (19.52%) were at risk of being overweight, and 65 (6.13%) were obese. The CE in both average and overweight categories was 109 (17.4%) and 37 (17.9%). Similarly, the NE status of the third molar in the underweight and obese category was 120 (73.6%) and 39 (60.0%), respectively. These differences in the frequency of TME in different BMI categories were found statistically significant (p-value <0.05). Conclusion The result shows a substantial relationship between the mean age of eruption of third molar teeth and BMI among children and adolescents in 14 years to 26 years in the Assamese population. Further, the mean age can be used in forensic age determination.