Search

Classification models pertaining to receiver operating characteristic (ROC) curve analysis have been extended from univariate to multivariate setup by linearly combining available multiple markers. One such classification model is the multivariate ROC curve analysis. However, not all markers contribute in a real scenario and may mask the contribution of other markers in classifying the individuals/objects. This paper addresses this issue by developing an algorithm that helps in identifying the important markers that are significant and true contributors. The proposed variable selection framework is supported by real datasets and a simulation study, it is shown to provide insight about the individual marker's significance in providing a classifier rule/linear combination with good extent of classification. [ABSTRACT FROM AUTHOR]

The classification scenario needs handling of more than one biomarker. The main objective of the work is to propose a multivariate receiver operating characteristic (MROC) model which linearly combines the markers to classify them into one of the two groups and also to determine an optimal cut point. Simulation studies are conducted for four sets of mean vectors and covariance matrices and a real dataset is also used to demonstrate the proposed model. Linear and quadratic discriminant analysis has also been applied to the above datasets in order to explain the ease of the proposed model. Bootstrapped estimates of the parameters of the ROC curve are also estimated. [ABSTRACT FROM PUBLISHER]

Nephropathy is an important and a frequent complication of long-term type II diabetic nephropathy. Strong evidence exists that genetic predisposition plays a major role in the development of diabetic nephropathy. Recent studies have implicated association between angiotensin converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism and nephropathy. The deletion gene polymorphism of ACE gene has been shown to be associated with increased activity of this enzyme. This study examines the association of ACE I/D polymorphism with type II diabetes without nephropathy in 30 patients and type II diabetes with nephropathy in 30 patients. The results of the study suggest the association between the DD polymorphism and type II diabetes with nephropathy. [ABSTRACT FROM AUTHOR]

A response by V. V. S. Naresh and colleagues to a letter to the editor about their article "Angiotensin Converting Enzyme Gene Polymorphism in Type II Diabetics With Nephropathy" in a 2009 issue is presented.

Background Caregivers of cancer patients experience excessive emotional and financial stress. Objective To determine the quality of life (QOL) of caregivers of cancer patients and factors affecting it in caregivers attending the OPD of a governmental tertiary care cancer center in the sub-Himalayan region. Methods A cross-sectional observational study was used. A pre-validated caregiver quality of life (CQOL) questionnaire was completed by consenting caregivers of 96 outpatient attendees. Results The mean total QOL scores were higher in attendants of subjects who did not undergo surgery versus those who underwent surgery (p-value: 0.04) and in those who received 0-5 versus >5 chemotherapy cycles (p-value: 0.015). On subdomain analyses, the burden was significantly greater in caregivers of patients who did not undergo surgery (p-value: 0.02) and had a higher Eastern Cooperative Oncology Group (ECOG) scale (p-value: 0.03). Disruptiveness was significantly higher in married individuals (p-value: 0.01) and those aged between 36 and 60 years (p-value: 0.003). Positive adaptation was worse in caregivers with another family member suffering from chronic illness (p-value: 0.041) and in professional and skilled workers (p-value: 0.03). The greater financial burden was experienced by caregivers belonging to lower socioeconomic status (p-value: 0.03). On putting these factors in the regression model, the non-specific domain of 0-5 cycles had poor CQOL, i.e., higher scores. The burden score was more in ECOG stages 3 and 4 in comparison with stages 1 and 2. Married individuals had significant disruption. Individuals aged between 36 and 60 years perceived more disruption in their lives. A more financial impact was observed on the lower middle and lower class compared to the upper and upper middle class. Conclusion Caregivers of cancer patients experience significant stress and burden. Counseling and social and financial support to caregivers may help improve CQOL., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Singh et al.)

Context: Head and neck squamous cell carcinoma (HNSCC) poses a major health problem and despite the advancements in its diagnosis and management the overall survival has not improved significantly. A search for newer diagnostic and prognostic markers along with fresh molecular targets is required for its prevention and cure., Aims: The study aims to study the expression of cyclooxygenase-2 (COX-2) in HNSCCs and investigate its correlation with the clinicopathological profile of these cases. This study was performed to determine the significance of COX-2 expression in the Indian context., Settings and Design: This study incorporated 90 cases of HNSCCs; both prospectively and retrospectively in a tertiary care center., Materials and Methods: Expression of COX-2 on immunohistochemistry (IHC) was evaluated in correlation with the histological grade, maximum tumor size, tumor depth, nodal status and lymphovascular/perineural invasion (lvi/pni). The study received a waiver from the institutional ethics committee., Statistical Analysis Used: Statistical analysis of the data was done using SPSS software., Results: COX-2 expression was found in 97.8% of the cases. A statistically significant correlation of COX-2 immunopositivity was found with the histological grade, clinical staging (tumor size and nodal status), maximum tumor depth and lvi/pni in our study ( P < 0.05)., Conclusions: COX-2 is expressed by most of the cases in this study. Its expression is related to tumor growth, differentiation and aggressiveness and therefore can be used as a good independent prognostic marker in HNSCCs. There is also possible scope of using it for targeted therapy in HNSCCs., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Oral and Maxillofacial Pathology.)

The aim of the study is to ascertain the level of depression among university students across gender, academic stream, semesters, perception of family environment and relationship with parents, academic performance, and family income. In addition, the study examines the association between students' perceived university academic environment, living arrangements, personal issues, and depression. Seven hypotheses were formulated for verification. A total of 717 students were recruited following the multistage cluster sampling method, and data were collected by a specially designed structured questionnaire, academic achievement record and a standardized University Students Depression Inventory. Findings disclosed that 37.7%, 13.1%, and 2.4% of the students were suffering from moderate, severe, and extremely severe depression. A significant difference was found across semester, that is, semester II students reported a higher level of depression than semester III students. So far as academic stream is concerned, students from humanities and social science were found to be suffering from more depression compared to students from science and management streams. The study further disclosed that the students who reported positive views about the university academic environment and living arrangements had lower level of depression compared to their counterparts. Personal resilience's such as being able to sharing personal problems with others and doing regular exercise were found to be associated with positive mental health. The findings of the study emphasize the need for immediate mental health support services for about 15.6% of the students who were either suffering from severe or extremely severe depression at the University., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Mixed phenotype acute leukemia symbolizes a very small subset of acute leukemia that simply cannot be allocated as lymphoid or myeloid lineage. The 2008 World Health Organisation classification established stringent standard for diagnosis of mixed phenotype acute leukemia, accentuating myeloperoxidase for myeloid lineage, cytoplasmic CD3 for T lineage and CD19 with other B markers for B lineage obligation. Mixed phenotype leukemia is rare and 3-5 % of acute leukmias of all age groups, is associated with poor outcome with overall survival of 18 months. We wish to present two cases of mixed phenotypic acute leukemia who presented with mediastinal masses, were suspected to be T cell lymphoma/leukemia clinically and radiologically. In one case, tissue diagnosis was given as lymphoma for which treatment was given. These cases show that patients diagnosed as lymphoma on histopathology can be cases of mixed phenotype acute leukemia and varying specific treatment protocols and follow up are required. Awareness of these entities will help in proper diagnosis and treatment.

The genetic variants linked with the susceptibility of individuals to VTE are well known; however, the studies explaining the ethnicity based difference in susceptibility to VTE are limited. Present study assesses mutations in six candidate genes contributing to the etiology of VTE in Indian subjects. The study comprised 93 VTE patients and 102 healthy controls. A PCR-RFLP based analysis was performed for nine mutations in the following genes associated with VTE: favtor V Leiden (FVL), prothrombin, tissue factor pathway inhibitor (TFPI), fibrinogen-beta, plasminogen activator inhibitor 1 (PAI-1), and methylene tetrahydrofolatereductase (MTHFR). All the subjects were found to be monomorphic for FVL 1691G/A, prothrombin 20210G/A and TFPI -536C/T mutations. The mutation in the MTHFR gene (677C/T) was observed only in patients. Contrarily, higher frequency of mutation in the PAI-1 -844G/A and the fibrinogen-β -455G/A was observed in controls in comparison to the patients. This study suggests that the PAI-1 -844G/A and fibrinogen-β -455G/A could be protective variants against VTE in Indians. While MTHFR 677C/T mutation was found to be associated, in contrast to other populations, the established genetic variants FVL 1691G/A, prothrombin 20210G/A, and TFPI -536C/T may not be associated with VTE in Indians thus revealing the basis of ethnicity related differences in susceptibility of Indians to VTE.

In a series of 948 patients operated on for primary hyperparathyroidism (HPT) by one surgeon (JNA) from 1952 to 1992, there were 242 (26%) instances of coincidental thyroid and parathyroid disease. Of these, 211 had benign thyroid lesions. In the remaining 31 cases HPT was associated with nonmedullary thyroid carcinoma; all were treated by resection of parathyroid adenomas and thyroidectomy. One patient died of unrelated cause (carcinoma of breast) 11 years following surgery. The remaining 30 patients are living and well 2 to 20 (mean 8.2 years) years after surgery; there was no recurrence or thyroid cancer-related mortality in the series. In contrast to prior reports, only six (20%) of our patients had a history of prior radiotherapy. We suggest that during neck exploration for HPT, the entire thyroid gland be evaluated and all palpable nodules resected and submitted to pathologic study.