Indian Journal of Medical Research最新文献

{"title":"An analysis of novel endothelial biomarkers to ascertain their role as prognostic indicators in severe COVID-19 illness.","authors":"Roshan Raj, Radhika Katragadda, Aditya Iyer, C P Anupama, Venkatesh Kelur Govidarajan, Lakshmi Priya, Sri Priya, Uma Devi, Kaveri Krishnasamy","doi":"10.25259/IJMR_915_2024","DOIUrl":"https://doi.org/10.25259/IJMR_915_2024","url":null,"abstract":"<p><p>Background & objectives COVID-19 is a complex disease that affects multiple systems and causes inflammation due to the SARS-CoV-2 virus's attraction to ACE-2 receptors. The severity of the disease ranges from mild upper respiratory tract infections to multi-organ failure and disseminated intravascular coagulation. Critical clinical features, such as respiratory failure, myocarditis, acute kidney injury, and a hypercoagulable state, are common in severe COVID-19 illness. Identifying patients at higher risk of rapid disease progression leading to severe complications and death is crucial. Available biomarkers lack specificity and accuracy in identifying the severity of COVID-19 infections. Therefore, there is a need to identify specific endothelial biomarkers that can predict early organ damage, facilitate effective management of patients, and categorise multisystem involvement during COVID-19 infection. Methods The participants constituted laboratory-confirmed COVID-19-positive patients with influenza-like illness (ILI) features under home isolation or moderate to severe acute respiratory infection (SARI) manifestations requiring admission. The chosen markers were analysed using the Human Luminex multiplex bead-based assay system. Results Our study revealed that certain markers, such as intercellular adhesion molecule (ICAM) and Galectin-3 were elevated in all COVID-19-positive patients, while others, like vascular cell adhesion molecule (VCAM), Angiopoietin-2, Thrombomodulin, and tumour necrosis factor receptor 1 (TNFR1) were specifically elevated in patients requiring admission. Such findings indicated the potential of some biomarkers in disease prognostication. Interpretation & conclusions Effective management of COVID-19 requires proper risk stratification. The findings of our investigation underscore the necessity for additional research to confirm the clinical utility and importance of these biomarkers and to fully leverage their capabilities in informing the management of severe COVID-19 disease.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 3","pages":"298-305"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating tumour DNA as a promising biomarker for breast cancer diagnosis & treatment monitoring.","authors":"Riddhi Ursekar, Rohan Chaubal, Khushboo A Gandhi, Elizabeth Talker, Jaya Chitra, Aishwarya Raja, Rushikesh Sunil Mukhare, Ankita Singh, Anushree Kadam, Mrudula Madhav, Shwetali Pandey, Sudeep Gupta","doi":"10.25259/IJMR_1291_2024","DOIUrl":"https://doi.org/10.25259/IJMR_1291_2024","url":null,"abstract":"<p><p>Breast cancer contributes a large fraction to mortality among women diagnosed with cancer. It is important to monitor residual disease and extend the lead time to detect relapse in high-risk patients. Minimally invasive techniques that utilise circulating biomarkers are being explored for their potential in diagnosis, prognosis, and disease monitoring of breast cancer. Circulating biomarkers have been investigated as tools for breast cancer diagnosis, prognosis, prediction, and monitoring of therapeutic response and resistance. Among these, circulating tumour cells and cell-free plasma DNA (cfDNA) derived from tumour cells (circulating tumour DNA i.e. ctDNA) have been integrated into clinical trial designs. Among all circulating biomarkers, ctDNA stands out as a promising biomaterial with great potential as it is thought to mirror the tumour's evolution. However, its clinical utilisation is hampered mainly by gaps in knowledge of its biological properties and specific characteristics. The development of robust and standardised methods for assessing circulating biomarkers is essential for realising the potential of personalised medicine. This review aims to summarise the characteristics of ctDNA and its role in breast cancer, drawing from both basic and translational research to provide insights into its clinical application. This review suggests that ctDNA has the potential to be a non-invasive, real-time surrogate for tumour tissue-based biomarkers. In conclusion, circulating biomarkers have the potential to revolutionise breast cancer diagnosis, prognosis, and treatment monitoring, but the development of standardised methods for their assessment is essential. ctDNA, in particular, shows great promise as a liquid biopsy tool, but further research is needed to understand its biology and ensure its clinical utility fully.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 3","pages":"267-277"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Out-of-pocket payments & catastrophic healthcare expenditure for non-communicable diseases: Results of a State-wide STEPS survey in north India.","authors":"Pooja Kansra, Sumit Oberoi, Anurag Garg","doi":"10.25259/IJMR_625_2024","DOIUrl":"https://doi.org/10.25259/IJMR_625_2024","url":null,"abstract":"<p><p>Background & objectives Non-communicable diseases have been designated as 'public health priority' globally, and they are accountable for debility, morbidity, and mortality. Thus, the present study aims to estimate the out-of-pocket payment, catastrophic healthcare expenditures and household wage loss. Methods Field research was conducted with an adapted survey questionnaire. Data from 576 individuals from various healthcare facilities in Punjab were collected using a convenience sampling approach. The out-of-pocket and catastrophic healthcare expenditures (CHE) were estimated using descriptive statistics and indices, viz., headcount overshoot and mean positive overshoot. Lastly, logistic regression models were applied to identify determinants of catastrophic health expenditure. Results The study findings showed that most respondents incurred a high out-of-pocket payment for inpatient care. Further, at any threshold level, the incidence of catastrophic health was highest among diabetic patients. The intensity of catastrophic healthcare expenditure with diabetes and hypertension exceeded the five per cent threshold bracket. Logistic regression results revealed that the odds of incurring catastrophic healthcare expenditure were highest among respondents diagnosed with diabetes, chronic obstructive pulmonary disease (COPD), and stroke. Interpretation & conclusions The study recommends that the government health insurance scheme 'Ayushman Bharat-Mukh Mantri Sehat Bima Yojana (AB-MMSBY)' must include outpatient and pre- and post-diagnostic costs incurred by respondents diagnosed with cardiovascular disease (CVD), COPD, and diabetes in Punjab. Therefore, respondents with diabetes mellitus (i.e., specifically type-1 patients) must be covered under health insurance benefits.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 3","pages":"229-238"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of baseline serum ferritin in newly diagnosed multiple myeloma cases: A retrospective study from southern India.","authors":"Reshmy G S, Gopika Vyas, Mrudula E V, Neeraj Sidharthan, Sajitha Krishnan, Georg Gutjahr, Anjaly S Nair, Merin Mathew","doi":"10.25259/IJMR_1065_2024","DOIUrl":"https://doi.org/10.25259/IJMR_1065_2024","url":null,"abstract":"<p><p>Background & objectives Ferritin levels, crucial for iron homeostasis, may hold prognostic significance in multiple myeloma (MM) due to their responsiveness to inflammation. The objective of this study was to evaluate the prognostic significance of baseline serum ferritin levels in predicting progression-free survival (PFS) and overall survival (OS) in newly diagnosed south Indian patients with multiple myeloma. Methods We retrospectively analysed records of 152 newly diagnosed multiple myeloma (NDMM) patients, grouping them by ferritin levels: group 1 with low ferritin (LF) (<300 ng/ml, n=68) and group 2 with high ferritin (HF) (≥300 ng/ml, n=84). Cox Proportional Hazard Models were used to identify prognostic risk factors for PFS and OS. Results NDMM patients with elevated diagnostic ferritin levels exhibited significantly higher levels of creatinine (P=<0.0001), lactate dehydrogenase (LDH, P=0.005), C-reactive protein (CRP, P=0.02), erythrocyte sedimentation rate (ESR, P=0.04), rate of disease progression (P=0.002), and death (P=0.011), along with a notable decrease in albumin (P=<0.0001) and haemoglobin (P=0.04) compared to MM patients with low ferritin levels. Time-to-event analysis revealed shorter PFS (P=0.0053) and OS (P=0.014) in the HF group. Elevated ferritin independently predicted progression [HR=2.59, 95% confidence interval (CI): 1.29-5.16, P=0.006] and was associated with increased mortality risk (HR=2.93, 95% CI: 1.19-7.24, P=0.02). Hazard ratios for progression and mortality increased with an increase in ferritin levels. Ferritin showed a weak positive correlation with plasma cell per cent (r=0.122, 95% CI: -0.07-0.31). Ferritin also provided better prediction (25.8 and 32.4%) of PFS and OS than CRP (14.7 and 15.8%). Interpretation & conclusions High ferritin levels in multiple myeloma are linked to worse prognosis and poor outcomes, highlighting the need for further research to validate and expand these findings.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 3","pages":"306-314"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reversing intellectual disabilities in Down syndrome: Hopes or hypes?","authors":"Chong Teik Lim, Cheng Wei Lim, Pike See Cheah, King Hwa Ling","doi":"10.25259/IJMR_646_2025","DOIUrl":"https://doi.org/10.25259/IJMR_646_2025","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 3","pages":"203-206"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunological memory in infected & exposure näive individuals one year post SARS-CoV-2 vaccination.","authors":"Priti Das, Chakrakodi N Varun, M A Ashwini, Muralidharan Kesavan, Vasanthapuram Ravi, Anita Desai","doi":"10.25259/IJMR_923_2024","DOIUrl":"https://doi.org/10.25259/IJMR_923_2024","url":null,"abstract":"<p><p>Background & objectives COVID-19 has affected millions and wreaked havoc on global healthcare systems as well as a devastating impact on the economies of various nations. Vaccines are highly pivotal in promoting an appropriate immune response. Understanding the effectiveness and stability of the vaccines is essential as these may differ across populations. Hence, this study explored the durability and efficacy of the COVISHIELD (ChAdOx1 nCoV-A) vaccine among healthcare workers (HCWs). Methods In this study, 84 HCWs who received two doses of COVISHIELD and had no breakthrough infections or precautionary doses were assessed. Participants were categorised into four groups (A, B, C, and D) based on pre-immunisation antibody status and SARS-CoV-2 RT-PCR results. Group A had prior infection and IgG antibodies, group B had RT-PCR positivity without detectable antibodies, group C had IgG antibodies without RT-PCR testing, and group D was exposure-näive. Humoral immunity was assessed by measuring IgG antibodies to the spike protein, while cell-mediated immunity was evaluated through SARS-CoV-2-specific T-cell markers and immunophenotyping. Results Over one year, a significant decrease in anti-spike IgG levels was observed in all groups (P<0.0001). It was observed that memory B cells declined significantly among all the groups over a period of one year [group A (P<0.0001), group B (P=0.0080), group C (P=0.0158), and group D (P=0.0004)]; no significant decrease inactivated T-cells was observed over a year. The mean of anti-spike IgG levels in samples from exposed participants (group A, B, C) versus non-exposed (group D) was significantly higher (P<0.0001). Interpretation & conclusions These findings indicate the need for regular booster doses of vaccination due to the waning of immunity by the vaccine. We also demonstrate that hybrid immunity (a combination of immune response post-natural infection and vaccination) provides better protection than vaccination alone.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 3","pages":"287-297"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification & genetic & virological characterisation of a human case of avian influenza A (H9N2) virus from Eastern India.","authors":"Agniva Majumdar, Varsha Potdar, Veena Vipat, Shailesh Pawar, Sheetal Jadhav, Manohar Lal Choudhary, Satish Gaikwad, Sachin Keng, Deeksha Tare, Ananya Chatterjee, Susmita Goswami, Sutapa Hazra, Sumit Dutt Bhardwaj, Neetu Vijay, Labanya Mukhopadhyay, Shanta Dutta, Nivedita Gupta","doi":"10.25259/IJMR_1376_2024","DOIUrl":"10.25259/IJMR_1376_2024","url":null,"abstract":"<p><p>Background & objectives A three-year-old male child from West Bengal, India, with severe acute respiratory symptoms, was confirmed in the laboratory with LPAI H9N2 virus infection under the Indian Council of Medical Research (ICMR) - Pan India Acute Respiratory Infections (ARI) / Severe Acute Respiratory Infections (SARI) surveillance through the Virus Research and Diagnostic Laboratories network. Methods Common respiratory viruses were detected by real-time PCR, followed by subtyping of Influenza A for seasonal and avian viruses. The identified H9N2 virus was isolated and further characterised, including whole genome sequencing. Antibody response was performed in serum samples of the case and family members. Results Complete genome sequencing revealed a G1 lineage (Middle East B sub-lineage). Bayesian evolutionary analyses of the HA gene of Indian H9N2 poultry strains showed three clusters of multiple introductions at the estimated node age of 1999 based on the Human strain A/India/NIV/1519/2024(H9N2) and the other poultry viruses from India evolved with 4.49 × 10-3 substitutions per site per year. The isolated H9N2 virus showed a high EID50 titre of 108.25/200 µl with avian-type receptor specificity. The antibodies against the H9N2 virus were only detected in the study case and not in close contacts confirming limited human-to-human transmission. The virus was found to be sensitive to neuraminidase inhibitors oseltamivir and zanamivir. Interpretation & conclusions Systematic avian influenza surveillance in both birds and humans is required for the early detection of newly evolved viruses.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 3","pages":"257-266"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal demography, clinical characteristics, & outcomes at an obstetric intensive care unit of a tertiary-care teaching maternity hospital in the Kashmir Valley.","authors":"Elias Mir, Shazia Ashraf Khan, Perveena Fareed, Huzaifa Ashraf, Fehim Jeelani Wani","doi":"10.25259/IJMR_1081_2024","DOIUrl":"https://doi.org/10.25259/IJMR_1081_2024","url":null,"abstract":"<p><p>Background & objectives Obstetric patients often need admission to intensive care units (ICUs). The data on these patients are scarce and heterogeneous. We studied the profile of obstetric patients admitted to our ICU. Methods The records of obstetric patients admitted to the ICU at the Government Lalla Ded Hospital, Srinagar, Jammu and Kashmir, India, dedicated to obstetrics and gynaecology patients, were analysed retrospectively from March 2022 to February 2023.This included demography, co-morbidities, pre-admission surgeries/procedures, clinical characteristics, and outcomes (death/discharge/transfer). Results Out of 525 obstetric ICU patients, the majority were admitted for obstetric causes (94.66%) and after surgery (84.38%), mostly (66.59%) after caesarean section (CS). Hypertension (35.23%) and anaemia (32.76%) were the most common co-morbidities. The majority were admitted for hypertensive disorders of pregnancy (HDP; 34.47%) or post-partum haemorrhage (PPH; 24.71%) or complications. Only two per cent of CS and one per cent of vaginal delivery (VD) patients needed ICU admission. The maternal ICU mortality rate was 6.53 per cent (0.15% of total deliveries). Only 6.66 per cent needed transfer to non-obstetric or multi-specialty care. Admission with heart disease [Hazard ratio; HR=8.26, 95% Confidence interval (CI)=0.01-67.17,P<0.05], after intra-uterine foetal death (IUFD; HR=5.17, 95% CI=1-26.75, P<0.05), or after laparotomy for ectopic pregnancy (EP; HR=50.2, CI=1.43-1766.87, P<0.05) and need for invasive mechanical ventilation (IMV; HR=35.5, CI=3.14-401.75, P<0.05) or inotropic support (IS; HR=12.06, CI=1.96-74.19, P<0.05) increased while admission after VD (HR=0.10, CI=0.01-0.73, P<0.05) decreased mortality risk. Interpretation & conclusions HDP and PPH were the most common maternal presentations in obstetric ICUs. Maternal mortality was low. Patients with heart diseases, IMV/IS requirement, and those admitted after IUFD or laparotomy for EP had increased, while patients admitted after VD had decreased mortality risk in the ICU.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 3","pages":"278-286"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The syndemic of incarceration, violence victimisation, needle/syringe sharing, & HIV infection: A population-based study of men who inject drugs in India.","authors":"Venkatesan Chakrapani, Lakshmi P V M, Alexander C Tsai, Vijin Pandara Purayil, Pradeep Kumar, Rajesh Kumar, Chinmoyee Das, Shobini Rajan","doi":"10.25259/IJMR_1307_2024","DOIUrl":"https://doi.org/10.25259/IJMR_1307_2024","url":null,"abstract":"<p><p>Background & objectives Only a few studies to date have described how violence victimisation, incarceration experience, and needle/syringe sharing synergistically interact to increase HIV risk among people who inject drugs (PWID) in India. Methods We analysed cross-sectional data on 19,902 men who inject drugs, recruited in the 2014/15 Integrated Bio-Behavioural Surveillance study of India's National AIDS Control Organisation. The outcome was human immunodeficiency virus (HIV) status. Syndemic exposures included past-year incarceration, past-year severe physical violence victimisation, and needle/syringe sharing. Regression models included covariates such as age, education, marital status, inconsistent condom use, HIV knowledge, and HIV programme exposure. We tested interactions using linear probability (additive scale) and logistic (multiplicate scale) regression models and examined causal pathways via path analysis. Results In this study, the HIV prevalence was found to be 9.9 per cent among men who inject drugs. We estimated substantial rates of needle/syringe sharing (17.8%), past-year incarceration (10.2%), and severe violence victimisation (3.8%). Among those incarcerated, 28 per cent injected drugs in prison. HIV seropositivity was associated with needle/syringe sharing [Adjusted odds ratio (aOR)=1.33; 95% Confidence interval (CI), 1.08-1.63], but not with violence victimisation or incarceration. In the logistic regression models, a significant two-way interaction was found between needle/syringe sharing and violence victimisation (semi-elasticity=0.65; 95% CI, 0.01-1.29) and a three-way interaction between needle/syringe sharing, violence victimisation, and incarceration (semi-elasticity=1.86; 95% CI, 0.51-3.20). In the linear probability regression models, we estimated a three-way additive interaction (relative excess risk of interaction=0.21; 95% CI, 0.03-0.28). Using path analysis, we estimated statistically significant indirect effects of both incarceration (b=0.02; 95% CI 0.01, 0.03) and severe violence victimisation (b=0.01; 95% CI, 0.008 to 0.02) on the HIV status, operating through their effects on needle/syringe sharing. Interpretation & conclusions Incarceration, violence victimisation, and needle/syringe sharing synergistically interacted to magnify HIV risk among men who inject drugs. These findings suggest the presence of a syndemic. Integrated interventions addressing these co-occurring conditions (e.g., needle/syringe exchange in prisons, violence prevention) may be necessary to effectively reduce HIV transmission among PWID in India.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 3","pages":"248-256"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sweat conductivity test - can it be a cheaper alternative to sweat chloride analysis for diagnosis of cystic fibrosis in low resource setting?","authors":"Arun Jose, Priyanka Medhi, Sneha Deena Varkki, Thondaiman Loganathan, Pamela Christudoss, Reka Karuppusami","doi":"10.25259/IJMR_1754_2024","DOIUrl":"https://doi.org/10.25259/IJMR_1754_2024","url":null,"abstract":"<p><p>Background & objectives Availability of sweat chloride analysis, the gold standard test for diagnosis of Cystic Fibrosis (CF) faces significant challenges in India. This study aimed to compare sweat conductivity using Sweat-Chek™ Sweat Analyzer against sweat chloride analysis using the 926 Sherwood chloride analyser and assess if sweat conductivity test can guide CF diagnosis in resource-poor settings. Methods In this retrospective study sweat chloride analysis and sweat conductivity were simultaneously performed on samples collected via Macroduct® system from patients referred for sweat testing. CF diagnosis was based on sweat chloride levels: ≥60 mmol/l confirmed CF, 30-59 mmol/l was borderline, and <30 mmol/l excluded CF. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), and area under curve (AUC) were calculated via ROC curve. Spearman's rho was employed to analyse the correlation between methods. Results Both tests were performed on 118 children of which 106 samples were adequately collected. CF was diagnosed in 11 children. Sweat conductivity ≥ 80 mmol/l diagnosed CF with 100 per cent sensitivity, specificity, PPV, and NPV. Likewise, a value ≤ 49 mmol/l predicted absence of CF with 100 per cent sensitivity, 91.36 per cent specificity, 78.13 per cent PPV, and 100 per cent NPV. Spearman's rho of 0.93 (P< 0.001) showed a strong correlation between the two methods. Intermediate conductivity values also correlated well (rs 0.62, P< 0.003) with intermediate sweat chloride levels. Interpretations & conclusions Sweat conductivity reliably identified CF in the study population including those children with borderline levels, suggesting the possibility of its use in resource-limited settings where sweat chloride analyzers are unavailable.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 3","pages":"207-214"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}