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Introduction: Lung cancer carries the highest cancer-related mortality rates worldwide. Despite all recent advances, the mortality from lung cancer is still rising. A better understanding of the risk factors may help us predict responses to chemotherapy for better management. Aim: To evaluate predictors of response to chemotherapy in advanced Non-Small Cell Lung Cancer (NSCLC) patients. Materials and Methods: This was a prospective cohort study conducted in the Department of Pulmonary Medicine at Government Medical College and Hospital, Chandigarh, India. A total of 60 confirmed cases of advanced (stage IIIB and IV) NSCLC patients were enrolled consecutively for a duration of two years. Baseline clinical parameters, routine blood tests, spirometry, exercise capacity using the 6 Minute Walk Test Distance (6MWTD), and Computed Tomography (CT)-based tumour size were recorded. Certain pre-defined patient, disease, and therapy-related factors (age, gender, dyspnoea, baseline blood tests, tumour size, histology, etc.) were evaluated for their possible role as predictors of treatment response in advanced NSCLC patients. A positive response was defined if the response to chemotherapy was Complete Response (CR) or Partial Response (PR), and a negative response if the response was Progressive Disease (PD) or Stable Disease (SD) as per revised RECIST (Response evaluation criteria in solid tumors) 1.1 criteria. Variables between the two groups were compared using the Mann-Whitney U test and Chi-square test. To find out the factors that may predict response to treatment, univariate and multivariate logistic regression analysis were used. Results: Out of a total of 60 confirmed cases of NSCLC patients, only 40 patients were able to complete the four cycles of chemotherapy. The mean age of the patients was 58.5±9.6 years. There were a total of 35 males (87.5%) and five females (12.5%) in the study. Out of 40 patients, 27 (67.5%) had squamous cell carcinoma and 13 (32.5%) had adenocarcinoma. On univariate analysis, Neutrophil-Lymphocyte Ratio (NLR) had a statistically significant association with tumour response (p<0.001). On multivariate analysis, advanced age (p=0.05) and high (>3.81) NLR (p=0.002) were found as independent predictors of poor response to chemotherapy. Conclusion: Pre-treatment high NLR and advanced age are significant factors for a poor response to chemotherapy treatment in advanced NSCLC patients. [ABSTRACT FROM AUTHOR]

The degradation of ambient air quality is a pressing global concern, and India, as a developing nation, has witnessed a rapid surge in industrial activities in recent decades. This surge has resulted in numerous Indian cities ranking among the world's most polluted urban areas. Chandigarh, strategically positioned within the Indo-Gangetic plains (IGP), has not escaped this distressing trend, experiencing a significant spike in air pollution levels. This study focuses on comprehending and addressing the air quality issues in Chandigarh, shedding light on the evolution of air pollution trends and their dependence on meteorological factors. Notably, the study reveals that, with the exception of O3, pollutant concentrations surge during the rice stubble burning season. These pollutants persist in the atmosphere for prolonged periods, exacerbating the situation during winter due to lower temperatures and heightened use of fossil fuels for heating by low-income households. In contrast, the wheat stubble burning period does not significantly impact pollutant concentrations. The study also identifies a spring peak in surface O3 concentrations, attributed to favorable high temperatures that promote the photochemical reactions responsible for this phenomenon, a distinctive feature in South Asia and the Himalayas. An examination of the connection between pollutant concentrations and meteorological parameters underscores that elevated pollutant levels, except for CO, are linked to lower relative humidity and temperatures. This suggests that current development patterns have contributed to the escalation of air pollution in Chandigarh, necessitating urgent interventions to preserve the city's aesthetics and the health of its residents. Furthermore, to model and monitor pollutant behavior in Chandigarh, more extensive and extended studies are imperative. Both short-term and long-term investigations into the environmental and health impacts of air pollutants, including primary and secondary pollutants, are of paramount importance. These endeavors are essential for the well-being of both the environment and the population of Chandigarh. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airway and the lung to noxious particles or gases. Sputum production is a cardinal feature in COPD. Airway clearance techniques have been the mainstay of management. Oscillating positive expiratory pressure (OPEP) devices are handheld devices that provide a combination of positive expiratory pressure (PEP) with high frequency oscillations which involve exhaling against a resistance that is fluctuating. It encourages airflow within secretions, whereas oscillations induce vibrations within airway wall to displace secretions into airway lumen and help in expectoration. Methods: A randomized control trial was conducted at the department of pulmonary medicine, Government Medical College & Hospital, Chandigarh, in which 50 patients with stable COPD were enrolled for one-and-half years. After taking proper history, they were subjected to spirometry, six-minute walk test, and were asked to fill the St. George's Respiratory Questionnaire (SGRQ) and COPD Assessment Test (CAT). These patients were randomized into group A (intervention group) and group B (control group), where group A was prescribed Aerobika OPEP device for daily use for a period of three months. After three months of use of device, the patients were again subjected to assessment parameters and inquired about any exacerbation within the three-month period. Results: At the end of three months were compared with baseline results. The median change in FEV1, FVC, 6MWD from baseline in group A was significantly more as compared to group B (FEV1: P < 0.001; FVC: P < 0.001; 6MWD: P = 0.08), whereas SGRQ score showed a significant improvement in both the intervention and control groups (P < 0.001) and CAT score showed significant improvement in comparison to the control group (P < 0.001). The median change in 6MWD and CAT from baseline in group A was significantly more as compared to group B (SGRQ: P < 0.001; CAT: P < 0.001), whereas it was not significant in case of SGRQ (P = 0.233). There was no significant difference in the incidence of exacerbation in the two groups (P = 0.19). The device did not help in controlling the rate of exacerbation in the present study at three months. Conclusion: Stable COPD patients who were given OPEP therapy as an adjunct to the standard drug therapy showed improvement in the spirometry parameters, exercise capacity and symptom burden in comparison to the drug only group. [ABSTRACT FROM AUTHOR]

Introduction: Folates perform an integral task in DNA synthesis, methylationand repair. Methylenetetrahydrofolate Reductase (MTHFR) potrays a key part in the metabolism of folate and regulates the equilibrium between the various forms of folate for DNA synthesis and DNA methylation. MTHFR irrevocably transforms 5,10 methylenetetrahydrofolate to 5-methyltetrahydrofolate, the principal circulating folate and the carbon donor for remethylation processes. MTHFR is vastly polymorphic in the general population. Materials and Methods: It was a case-control study conducted during March 2010 to September 2011 in the Department of Pulmonary Medicine in collaboration with the Department of Biochemistry at Government Medical College and Hospital, Chandigarh, to see whether any association exists between the variants of one carbon metabolism, MTHFR polymorphisms (C677T and A1298C), and lung cancer. Twenty biopsy proven lung cancer patients and 20 age and sex matched cancer-free controls were selected. Results: The mean serum folate in cases was higher (12.84 ng/mL±7.527 ng/mL) as compared to controls (4.46 ng/ mL±1.346 ng/mL), suggesting that high levels of serum folate are associated with lung cancer. There was no significant variance in the levels of vitamin B12 and plasma homocysteine between cases and controls. No MTHFR polymorphism C677T was seen in the blood and the bronchial biopsy samples of all cases as well as blood samples of all the controls. The MTHFR polymorphism A1298C was present in the blood as well as bronchial biopsy samples of cases as well as blood of controls. Thus, in the present study, there was no relation of this polymorphism with lung cancer. Conclusion: Polymorphisms in MTHFR may contribute to lung cancer. More research on the basis of cellular and molecular mechanisms of lung cancer is urgently needed to aid in understanding of pathogenesis of the disease. [ABSTRACT FROM AUTHOR]

Introduction: Violence, due to assaults is now being described as a major public health issue. This study concentrates on the injuries sustained by victims of assault, coming to the Emergency Department of a Tertiary Care Hospital so as to gather and compile data regarding the burden of assault cases in this region. Aim: Comprehensive analysis of injuries sustained by the victims of assault, coming to the casualty of a tertiary care hospital. Materials and Method: This was a study of 400 consecutive assault cases coming to the casualty of Government Medical Collage and Hospital, Chandigarh, during the period June 2021 to September 2021. Afore mentioned data was compiled, analysed and results drawn. Results: Of the 400 cases studied, 78.8% were males. Majority of the victims belonged to the age group of 21-30 years, 35.8%; urban victims comprised 72.5%. Majority of the patients were married, 76%. Most of the patients were accompanied by their relatives, 44%. Majority of the incidents occurred at or near the residence of the victims, 56.5%, at evening to midnight, 52%. Revenge, 35% was the main reason of assault. In 65.5% cases, assailants were known. Head and face was the commonest site of injury 60.6%, followed by upper limb, 23.5%. Commonest injuries were lacerations, 40.8%, followed by abrasions, 28.1%. Five hundred fifty five injuries were simple in nature, while 65 were grievous. Conclusion: The increasing incidence and frequency of assault cases is adding further burden to the medico-legal workload of the tertiary care hospitals and justifies the need for appointing medico-legal experts at primary and secondary health care centers to deal effectively with such cases so as to reduce this burden at the ever busy tertiary care centers. [ABSTRACT FROM AUTHOR]