Dengue is a vector-borne disease caused by the dengue virus (DENV) of family Flaviviridae. Dengue fever is common in both developed and developing countries. Globally, approximately 400 million cases of dengue fever are reported annually, resulting in approximately 22000 fatalities. Dengue cases in India have progressively increased in the last decade. In recent years, substantial progress has been made in understanding various aspects of dengue, including its pathogenesis, diagnosis, prevention strategies, immunological responses, and the role of vectors in its transmission. The transmission of a positive RNA virus occurs through Aedes mosquitoes, specifically Aedes aegypti and Aedes albopictus. This virus is associated with a wide spectrum of symptoms, ranging from mild undifferentiated fever to severe hemorrhagic fever and shock, posing a potential threat to human health. There are 4 types of antigenically distinct dengue serotypes (DENV-1 to DENV-4) and among them, DENV-2 is more lethal and extremely severe. To overcome the severity of dengue, Dengvaxia is administered to children 9 to 16 years old with evidence of previous dengue infection. The diagnosis of dengue is carried out by ELISA-based non-structural protein (NS1) and immunoglobulin tests. However, there are no specific biomarkers to identify severe disease progression. Climatic factors and temperature play an important role in complex interaction among host, vector, and virus to manifest the severity of dengue. There is a need for the refinement of climate-based disease forecasting models in India to effectively control the spread of dengue. The mosquito repellent should be used periodically to kill or repel the Aedes mosquito to prevent the spread of dengue in humans. 

Recent advances on pathogenesis, diagnosis, prevention, immunological aspects, and vectors of dengue: A review

Background & Objectives: Interstitial lung disease (ILD) in rheumatoid arthritis (RA) is a serious complication with varied prevalence ranging from 4% to as high as 68%, with varied presentation. Immunosuppressants and antifibrotics are used in the management of RA ILD. The clinicodemographic profile and presentation in our country need to be further explored. We assessed the efficacy and safety profile of antifibrotic drugs in combination with immunosuppressants among RA ILD patients. Methods: A prospective observational study was conducted in the Interstitial Lung Disease (ILD) Clinic in the Department of Pulmonary Medicine, All India Institute of Medical Sciences Raipur, India, between January 2022 to January 2023. RA patients with dyspnea and chronic cough were referred to us for evaluation of ILD. Patients underwent clinical examination, complete lung function study including spirometry, single breath diffusion capacity for carbon monoxide (DLCO), six-minute walk test, and high-resolution computed tomography of the thorax. Quality of life was assessed using the King's Brief Interstitial Lung Disease (KBILD) questionnaire. Results: Two hundred eighteen RA patients were evaluated and out of these, 43 (20.8%) had features of ILD on high-resolution computed tomogram (HRCT) thorax. Twenty-six (2.18%) met the inclusion criteria for starting antifibrotics. The mean ± SD. age of the patients was 52.96 ± 14.04 and the majority (77%) were females. Fourteen (53.38%) patients had usual interstitial pneumonia (UIP)/probable UIP pattern and 12 (46.22%) had nonspecific interstitial pneumonia (NSIP) patterns on HRCT. Out of 26 patients, 24 (92.3%) were started on antifibrotics. Fourteen (53.8%) patients were on nintedanib and 10 (38.4%) were on pirfenidone. The mean ± SD forced vital capacity (FVC)% predicted was 62.5 ± 20.04. The mean ± SD. The DLCO percentage predicted was 54.4 ± 22.8. Twenty-two (84.6%) patients did not experience any side effects. The mean ± SD. KBILD score was 59.9 ± 11.17 and was similar in both sexes. Conclusion: In our study, the prevalence of RA ILD was nearly 20.8% and more common in females. Twenty-four (2%) patients were included for antifibrotic treatment. There was an improvement in lung function at the end of six months, but the change was not significant. All patients tolerated antifibrotics well without any serious adverse events. 

Antifibrotics in the Management of Rheumatoid Arthritis-Associated Interstitial Lung Disease: Prospective Real-World Experience From an Interstitial Lung Disease Clinic in India

Cystic fibrosis-related diabetes (CFRD) is a common complication of cystic fibrosis and can be present in over 50% of adults with the disease. CFRD is associated with poorer clinical outcomes, including accelerated pulmonary function decline and excess morbidity. The management of CFRD is complex and differs from that of type 1 and type 2 diabetes mellitus such that clinicians responsible for the care of people with CFRD must work closely with colleagues across a number of different specialities and disciplines. This review aims to discuss why a multi-disciplinary approach is important and how it can be harnessed to optimize the care of people with CFRD.

/pdf/cystic-fibrosis-related-diabetes-optimizing-care-with-a-5439p7n4xn.pdf

Cystic fibrosis-related diabetes: optimizing care with a multidisciplinary approach

Objective: To explore predictive hematological parameters on admission which are associated with mortality in NS1 positive dengue shock syndrome patients. Methods: Demographic characteristics, hematological parameters, and the outcome of NS1 positive dengue shock syndrome patients without any comorbidity and coexisting infections were collected from the Intensive Care Unit and the results were compared between the survivor and non-survivor groups. Results: The mean age was (30.77±11.48) years and 56 (56.6%) patients were males. Out of the total 99 patients, 72 (72.27%) patients were successfully discharged and 27 (27.27%) patients eventually succumbed to death. The most common hematological finding was thrombocytopenia (95.95%), followed by anemia (52.52%) and decreased mean platelet volume (37.37%). After controlling other variables, logistic regression analysis showed that absolute neutrophil count and mean platelet volume were associated with mortality. Conclusions: Total leucocyte count, absolute neutrophil count, and total platelet count are significantly higher, and mean platelet volume is significantly lower in the non-survivor group as compared to the survivor group. Absolute neutrophil count and mean platelet volume are predictors associated with mortality.

Hematological indices as predictors of mortality in dengue shock syndrome: A retrospective study

Diabetes mellitus a disease with various macro and micro vascular complications due to its various metabolic dysregulations, is well known to involve lungs in long run in both type 1 and 2 diabetes mellitus, causing tremendous burden on health care system. Common simple lung function tests alone are likely to underestimate the prevalence and degree of lung dysfunction in diabetes, but newer noninvasive tests of lung mechanical function provide a more sensitive assessment of peripheral airway function, hence by establishing a marker and risk factors for pulmonary involvement in diabetic individuals, cases with high risk for pulmonary involvement can be found before hand and proper medical therapy can be started for primary prophylaxis of same, Hence in this study we tried to find out any correlation between serum adiponectin levels and pulmonary dysfunction in patients of type 2 diabetes mellitus, which shows a significant role of adiponectin as early marker of the disease with p value of 0.04, the decrease in serum adiponectin level is also associated with more severe disease, hence adiponectin levels can be used as early markers of pulmonary dysfunction in diabetic patients.

Study of Correlation between Diabetic Pulmonopathy with Serum Adiponectin Levels in Patients of Type 2 Diabetes Mellitus.

BACKGROUND
Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown etiology marked by symmetric, peripheral polyarthritis. RA has a prevalence of 1-2% in the general adult population. The mortality rate in patients with RA increases during the course of the disease, with a tendency to accelerate after 15 yearsAim: To study the pulmonary manifestations and their severity using [Disease Activity Score (DAS)-28 score] in patients of RAMaterials and methods: Present study was conducted in the Department of Medicine, Sardar Patel Medical College and Associated Group of Hospitals Bikaner, Bikaner, Rajasthan, India, on 100 patients. This study was a cross-sectional, observational study conducted over 1 year. Consecutive cases of RA patients attending the outpatient department or admitted to the medicine wards were selected according to the inclusion and exclusion criteriaResults: Pulmonary manifestation was present in a total of 38% of cases, while the remaining 62% of cases had no pulmonary manifestation. The presence of comorbidity and C-reactive protein (CRP) was significantly associated with pulmonary manifestation in RA patients. On high-resolution computed tomography (HRCT), the most common finding was interstitial lung disease (ILD) (60.5%), with usual interstitial pneumonia (UIP) as the most common pattern. On performing a pulmonary function test (PFT), 33 patients (86.84%) had an abnormal result, with restrictive as the most common patternConclusion: The patients of RA, especially those with advanced age, long duration of disease, male sex, and associated comorbidity, should be screened for pulmonary complications of RA using X-ray chest and PFT, supplemented by HRCT chest wherever required.

/pdf/pulmonary-manifestations-in-patients-of-rheumatoid-arthritis-3a7y2kpe.pdf

Pulmonary Manifestations in Patients of Rheumatoid Arthritis and its Correlation with Severity of Disease.

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Papers

Hematological indices as predictors of mortality in dengue shock syndrome: A retrospective study

Study of Correlation between Diabetic Pulmonopathy with Serum Adiponectin Levels in Patients of Type 2 Diabetes Mellitus.

Pulmonary Manifestations in Patients of Rheumatoid Arthritis and its Correlation with Severity of Disease.