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Author(s): M. Yogesh [1]; Roshni Vamja [1]; Vijay Vala [2]; Arya Ramachandran [1]; Bhumika Surati [1]; Jay Nagda (corresponding author) [1] INTRODUCTION Metabolic-associated fatty liver disease (MAFLD) has emerged as [...], Background: Female healthcare workers have unique occupational stressors and lifestyle factors that may increase their risk of metabolic disorders. This study aimed to investigate the utility of the fatty liver index (FLI) as a predictor of metabolic syndrome among female employees in the healthcare sector. Methods: This cross-sectional study included 450 female healthcare workers aged ≥18 years, employed in various roles at a tertiary healthcare facility in Gujarat. Clinical examination, anthropometric measurements, and biochemical tests were conducted. FLI was calculated, and metabolic syndrome was diagnosed using harmonized criteria. Logistic regression analysis evaluated predictors. Results: T he mean age was 44.2 ± 7.8 years, and the prevalence of metabolic syndrome was 61%. Increasing the FLI category was significantly associated with a worsening metabolic profile. The odds of hypertension, diabetes, metabolic syndrome, and cardiovascular disease progressively increased with higher FLI levels (P < 0.001), denoting a dose-response relationship. FLI demonstrated good diagnostic accuracy for metabolic syndrome with an area under the curve (AUC) of 0.86 (95% CI: 0.81 - 0.89). An FLI cutoff ≥30 provided an optimal balance of sensitivity (71%) and specificity (41%) for predicting metabolic syndrome. Conclusion: FLI demonstrates a strong association with metabolic syndrome and related comorbidities in a dose-dependent manner. FLI can be a simple, low-cost screening tool to identify high metabolic risk individuals in resource-limited settings. Keywords: Cardiovascular diseases, diabetes mellitus, fatty liver index, metabolic syndrome, nonalcoholic fatty liver disease

ABSTRACT: Background: Hypertension prediction using anthropometry and bioimpedance offers practical advantages for screening. We aimed to analyze various anthropometric and bioelectrical impedance (BIA) estimates as predictive markers of prehypertension and hypertension. Methods: This cross-sectional analysis included 432 adult participants recruited from the medicine outpatient department of a tertiary hospital. Blood pressure measurements; anthropometric measurements of weight, body mass index, waist circumference, and hip circumference; and BIA (Omron HBF 375) were performed for body fat%, resting metabolic rate, visceral fat level, and skeletal muscle percentage. Results: Of the 432 participants comprising 220 males and 212 females, 36.8% were normotensive, 42% were prehypertensive, and 21% were hypertensive. Visceral fat (r 0.662, 95% CI: 0.60–0.72, P < 0.001) and resting metabolic rate (r 0.589, 95% CI: 0.52–0.65, P < 0.001) had the highest positive correlation, while skeletal muscle percentage (r -0.551, 95% CI: -0.62 to -0.48, P < 0.001) had a negative correlation with systolic blood pressure according to bivariate analysis. According to the receiver operating characteristic curve analysis for predicting hypertension, visceral fat volume had an area under curve (AUC) of 0.913, and resting metabolic rate had an AUC of 0.968, indicating the best predictive accuracy. Conclusion: Multiple BIA estimates, including high visceral fat content, resting metabolic rate, and adipose marker levels combined with low skeletal muscle percentage, were strongly associated with hypertension. Our analysis suggested the superiority of bioimpedance predictors over anthropometry-based prediction modeling alone for screening for hypertension in clinical practice. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Characterizing risk factors for drug-resistant tuberculosis (TB) is critical to guide targeted interventions in high-burden settings like India. We aimed to identify socioeconomic, lifestyle, and clinical factors associated with drug-sensitive and drug-resistant TB acquisition. Materials and Methods: A comparative cross-sectional study recruited 350 bacteriologically confirmed TB patients registered under the National Tuberculosis Elimination Program (NTEP) in Gujarat, India, and 300 matched participants without active/past TB. Multinomial logistic regression analyzed risk factors for 200 drug-sensitive and 150 drug-resistant TB cases compared to participants without active or past TB. Results: Key factors independently associated with higher adjusted odds ratios (aOR) of both TB types included low socioeconomic status (SES) (drug-sensitive TB: aOR 1.7, 95% CI 1.2-2.5; drug-resistant TB: aOR 2.2, 95% CI 1.3-3.7), crowding (>5 persons/room) (drug-sensitive TB: aOR 1.6, 95% CI 1.1-2.3; drug-resistant TB: aOR 1.9, 95% CI 1.2-2.9), undernutrition (drug-sensitive TB: aOR 1.6, 95% CI 1.1-2.3; drug-resistant TB: aOR 2.0, 95% CI 1.2-3.2), smoking (drug-sensitive TB: aOR 1.5, 95% CI 1.0-2.3; drug-resistant TB: aOR 1.7, 95% CI 1.1-2.7), and indoor air pollution (drug-sensitive TB: aOR 1.5, 95% CI 1.0-2.2; drug-resistant TB: aOR 1.8, 95% CI 1.2-2.8). Conclusion: Marked social determinants and clinical risks drive heightened susceptibility for both TB types in India, while prior inadequate treatment and nosocomial exposures selectively enable additional drug resistance. Holistic prevention policies jointly targeting transmission, vulnerability, and curative factors are imperative. [ABSTRACT FROM AUTHOR]

Background: β-Thalassemia major patients require lifelong blood transfusions, leading to iron overload and liver injury. This study examines the longitudinal association between serum ferritin and liver function over 5 years in pediatric patients. Methods: This retrospective study included 582 transfusion-dependent thalassemia patients aged 1-18 years. Serum ferritin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and albumin were measured annually. Correlation and linear regression analyses assessed associations between ferritin trajectories and liver enzymes. Results: Mean ferritin rose from 1820 ± 960 ng/mL at baseline to 4500 ± 1900 ng/mL at year 5, indicating worsening iron overload. AST and ALT levels also steadily climbed over follow-up, whereas albumin declined slightly. Ferritin correlated positively with AST (r = 0.675, P < 0.01) and ALT (r = 0.607, P < 0.01), but not with albumin (r = -0.143, P = 0.153) annually. The regression interaction term showed within-patient ferritin increases over time were independently associated with escalating AST and ALT (P < 0.05), after adjusting for confounders. Conclusion: Rising ferritin levels predict progressive liver injury in regularly transfused pediatric thalassemia patients. Tighter control of iron overload may help preserve hepatic function. [ABSTRACT FROM AUTHOR]

Background & Objectives Although thiazide diuretics are frequently used to treat hypertension, they may also raise the risk of syncope and falls. The purpose of this study was to look at the relationship between hypertension individuals' use of thiazide diuretics and falls or syncope. Methods This retrospective cohort study, conducted between March 2019 and March 2024, included 236 individuals with hypertension taking thiazides and 236 controls not taking thiazides. Data from electronic medical records were extracted, including demographic, clinical, laboratory, and outcome data. The main outcome was the occurrence of syncope episodes or falls. Logistic regression analyses examined associations between various factors and falls/syncope risk. Results The study included 236 study participants taking thiazides (118 men, 118 women) and 236 controls not taking thiazides (118 men, 118 women). Study participants taking thiazides had a higher prevalence of hyponatremia (57 study participants, 24.1% vs. 31 study participants, 13.1%), hypokalaemia (52 study participants, 22% vs. 32 study participants, 13.6%), hypercalcemia (37 study participants, 15.7% vs. 17 study participants, 7.2%), metabolic alkalosis (89 study participants, 37.7% vs. 52 study participants, 22%), acute kidney injury (59 study participants, 25% vs. 30 study participants, 12.7%), and chronic kidney disease (89 study participants, 37.7% vs. 59 study participants, 25%) compared to controls (all P <0.05). The prevalence of falls/syncope events was significantly higher in the thiazide group (76 study participants, 32.2%) compared to the non-thiazide group (46 study participants, 19.5%), with a P value of 0.002. Multivariate analysis showed increased falls/syncope risk with age [adjusted odds ratio (AOR)=1.38], congestive heart failure (AOR=2.12), longer thiazide duration (AOR=1.21), hyponatremia (AOR=1.68), hypokalaemia (AOR=1.72), metabolic alkalosis (AOR=1.68), acute kidney injury (AOR=1.85), and decreased eGFR (AOR=1.22 per 10 ml/min/1.73m2 decrease). Interpretation & Conclusion Thiazide diuretic use in hypertensive patients is related to syncope, potentially mediated by electrolyte disturbances and renal impairment. These results highlight the importance of careful monitoring and individualized treatment approaches when prescribing thiazide diuretics to hypertensive patients. [ABSTRACT FROM AUTHOR]