Expert opinion on diagnosis and management of Severe Asthma in low and middle income countries (LMIC) with focus on India.

Objective: In this document, 9 Indian experts have evaluated the factors specific to LMICs when it came to Severe Asthma (SA) diagnosis, evaluation, biologic selection, non-biologic treatment options, and follow-up.

Data Sources: A search was performed using 50 keywords, focusing on the Indian/LMICs perspective, in PubMed, Cochrane Library, and Google Scholar. The key areas of the search were focused on diagnosis, phenoendotyping, non-biological therapies, selecting a biologic, assessment of treatment response, and management of exacerbation.

Diagnostic yield of CBNAAT in the diagnosis of extrapulmonary tuberculosis: A prospective observational study.

Background: Extrapulmonary Tuberculosis (EPTB) accounts for 15%-53% of all TB cases. In recent years, cartridge-based nucleic acid amplification test (CBNAAT) has emerged as an important diagnostic tool since the diagnostic yield is higher. We conducted this study to evaluate the diagnostic yield of CBNAAT in EPTB.

Neurospecific fabrication and toxicity assessment of a PNIPAM nanogel encapsulated with -tephrostachin for blood-brain-barrier permeability in zebrafish model.

Biocompatible Poly(N-isopropylacrylamide) (PNIPAM) nanogels (NGs) were developed at 40-65 nm to deliver -Tephrostachin (TT) in zebrafish brain. Neurospecific PNIPAM NGs are functionalized with polysorbate 80 (PS80) to overcome the Blood Brain Barrier (BBB). The TT loaded with NG (NG + TT) was confirmed in UV-spectroscopy and transmission electron microscopy (TEM) with 90% efficiency of controlled release at 37 °C.

Proportion of rapid eye movement sleep related obstructive sleep apnea (REM related OSA) in patients with sleep disordered breathing: A cross sectional study.

Background And Objectives: Obstructive sleep apnea (OSA) during rapid eye movement (REM) stage of sleep is gaining importance in recent years. This study was done to determine the proportion of REM-related OSA and its associated polysomnographic features.

Methods: One hundred forty-two patients were included in the study.

An Unusual Posterior Mediastinal Mass - Ectopic Thyroid within the Oesophagus.

Presence of ectopic thyroid tissue in unusual locations is a rare phenomenon. Herein we present the case of a 55 year old lady, who on evaluation of dyspnoea was detected to have a mediastinal mass. Initial radiological evaluation showed the presence of a mass arising from the wall of the oesophagus which was presumed most likely to be leiomyosarcoma.

A red herring, a wild-goose chase, and an unexpected diagnosis of concomitant malignancy and sarcoidosis.

A 49-year-old male was evaluated in our hospital for chronic cough, cervical lymphadenopathy, and a testicular mass. As a part of the management, he underwent a cervical lymph node biopsy, which showed metastatic deposits from papillary carcinoma thyroid. Subsequently, he underwent orchidectomy for suspected testicular malignancy, but the biopsy showed discrete granulomatous inflammation consistent with sarcoidosis.

Assessing health-seeking behavior among Asthma and COPD patients in urban South India.

Context: Health-seeking behavior of patients with chronic obstructive pulmonary disease (COPD) and asthma and the diagnosis told to them by doctors before they reach tertiary care is not well documented.

Aims: This study aimed at describing the health-seeking behavior of asthma and COPD patients before they present to a tertiary care hospital in Trivandrum in South India.

Methods And Materials: The hospital-based cross-sectional study was done at one government and one private tertiary care hospital in Trivandrum, Kerala, including diagnosed COPD and asthma patients.

Proteome Based de novo Sequencing of Novel Conotoxins from Marine Molluscivorous Cone Snail Conus amadis and Neurological Activities of Its Natural Venom in Zebrafish Model.

Background: Conus amadis is a carnivorous snail found abundantly in coastal waters of India. Despite its abundance in southern coastal waters of India and the fact that most of the conotoxin act in neuronal system, research work on Conus amadis venom was not much focused. So we have made a brief study on the venom complex of Conus amadis to identify the library of novel conotoxins and to screen the natural venom for neurological function.

Lung contusion.

Lung contusion usually follows blunt trauma to the chest. If not properly diagnosed and adequately treated, it could at times be fatal as well. This case is being presented to highlight the radiological findings of this condition.

Intralobar sequestration.

Bronchopulmonary sequestration is a rare anomaly of the lung which is characterized by the presence of a mass of lung tissue which has no connection with the normal bronchopulmonary tree. Sequestration is of two types - intralobar and extralobar, of which intralobar is the more common one. Patients typically present with recurrent hemoptysis, which at times can be massive or with recurrent respiratory tract infections.

An unusual complication of a common gynaecological procedure.

A case of bilateral, but more of massive right sided transudative pleural effusion associated with bilateral ureteric trauma following laparoscopy for endometriosis is reported. The diagnosis of urinothorax was confirmed by demonstrating a pleural fluid to serum creatinine ratio of greater than one. Management of ureteric injury by insertion of Double J (DJ) stents on both sides resulted in resolution of the pleural effusion.

Crevicular fluid and serum concentrations of progranulin and high sensitivity CRP in chronic periodontitis and type 2 diabetes.

Introduction: This study was designed to correlate the serum and gingival crevicular fluid (GCF) levels of progranulin (PGRN) and high sensitivity C-reactive protein (hs CRP) in chronic periodontitis and type 2 diabetes mellitus (DM).

Design: PGRN and hs CRP levels were estimated in 3 groups: healthy, chronic periodontitis, and type 2 DM with chronic periodontitis.

Results: The mean PGRN and hs CRP concentrations in serum and GCF were the highest for group 3 followed by group 2 and the least in group 1.

Gingival crevicular fluid and serum cystatin c levels in periodontal health and disease.

Cystatin C (CSTC) is an inhibitor of cysteine proteinases and could play a protective and regulatory role under inflammatory conditions. The present study was designed to assess the concentration of CSTC in gingival crevicular fluid (GCF) and serum, to find out their association if any, in periodontal health and disease. 30 subjects were selected divided into 3 groups consisting of 10 subjects in each group based on clinical parameters: periodontally healthy group, gingivitis group and chronic periodontitis group, while, chronic periodontitis group after 8 weeks of the treatment (scaling and root planing) constituted after periodontal therapy group.

Undifferentiated connective tissue disease with pulmonary involvement.

Pulmonary involvement in collagen vascular diseases is extremely common. It is usually seen in the well described dyscollagenoses and in mixed connective tissue diseases (MCTD). However, there is a lesser known entity called Undifferentiated Connective Tissue Disease (UCTD) which can also involve the lung.

Prioritization of candidate SNPs in colon cancer using bioinformatics tools: an alternative approach for a cancer biologist.

The genetics of human phenotype variation and especially, the genetic basis of human complex diseases could be understood by knowing the functions of Single Nucleotide Polymorphisms (SNPs). The main goal of this work is to predict the deleterious non-synonymous SNPs (nsSNPs), so that the number of SNPs screened for association with disease can be reduced to that most likely alters gene function. In this work by using computational tools, we have analyzed the SNPs that can alter the expression and function of cancerous genes involved in colon cancer.

Study of orthophosphate, pyrophosphate, and pyrophosphatase in saliva with reference to calculus formation and inhibition.

Background: A large amount of calculus may hamper the efficacy of daily oral hygiene and thereby accelerate plaque formation. Salivary concentrations of orthophosphate and pyrophosphate are important in preventing calculus formation. Activity of orthophosphate, pyrophosphate, and pyrophosphatase was studied in whole saliva in calculus-forming groups and plaque-forming groups.