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To evaluate the shared genetic etiology of type 2 diabetes (T2D) and coronary heart disease (CHD), we conducted a genome-wide, multi-ancestry study of genetic variation for both diseases in up to 265,678 subjects for T2D and 260,365 subjects for CHD. We identify 16 previously unreported loci for T2D and 1 locus for CHD, including a new T2D association at a missense variant in HLA-DRB5 (odds ratio (OR) = 1.29). We show that genetically mediated increase in T2D risk also confers higher CHD risk. Joint T2D-CHD analysis identified eight variants-two of which are coding-where T2D and CHD associations appear to colocalize, including a new joint T2D-CHD association at the CCDC92 locus that also replicated for T2D. The variants associated with both outcomes implicate new pathways as well as targets of existing drugs, including icosapent ethyl and adipocyte fatty-acid-binding protein.

Combining the design flexibility and rapid prototyping capabilities of additive manufacturing with photocatalytic and plasmonic functionalities is promising for the development of next-generation SERS applications such as point of care diagnostics and in situ monitoring of chemical reactions in fuels and chemical processing. Laser powder bed fusion (LPBF) is a well-matured additive manufacturing technique which generates metallic structures through localised melting and joining of metal powders using a laser. LPBF reduces material wastage during manufacturing, is applicable to a wide range of metals and alloys, and allows printing of complex internal structures. This feature article elaborates the use of soot templating, chemical vapour deposition and electroless plating techniques for grafting plasmonic and semiconductor nanoparticles on the surface of LPBF manufactured metallic substrates. The capability to fabricate different types of intricate metallic lattices using additive manufacturing is demonstrated and technical challenges in their adequate functionalization are elaborated. The developed methodology allows tailoring of the substrate structure, composition, morphology, plasmonic and photocatalytic activities and thus unveils a new class of recyclable SERS substrates. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of hypokalemia among COVID-19 patients and assess its impact on the patients management. Study type, settings & duration: It was a cross-sectional study conducted at Mayo Hospital, Lahore from July 2020 to January 2021. Methodology: A total of 212 SARS-COV-2 positive patients who had developed severe disease were enrolled. Based on the level of potassium, the patients were classified as mild, moderate and severe hypokalemia cases. Data was collected using a structured questionnaire including demography, clinical presentations and medication including use of anticoagulant and steroids. Results: Of the total 210, 46 (21.9%) patients had hypokalemia and among them 23 (11%) showed mild, 17 (8.1%) moderate and 6 (2.9%) severe hypokalemia. Out of 210, 17 (23.9%) patients were treated with hydrocortisone, 11 (17.4%) with methylprednisolone and 18 (23.3%) with dexamethasone and no significant difference was seen in development of hypokalemia (p =0.630). Similarly, 39 (21.4%) patients were given enoxaparin and 7 (24.1%) were given heparin, but no significant association was found between the type of anticoagulant being given and hypokalemia (p =0.754). No significant difference was observed with respect to gender in the development of hypokalemia (p =0.782). Conclusion: This study showed that hypokalemia was a significant clinical manifestation among SARS-COV-2 patients. Further it was noted that treatment regime used for COVID-19 management and gender of the patients are not a risk factor for developing the hypokalemia. [ABSTRACT FROM AUTHOR]

Mammalian immune system is a complex amalgam of diverse cellular and noncellular components such as cytokines, receptors and co-receptors. FAM26F (family with sequence similarity 26, member F) is a recently identified tetraspanin-like membrane glycoprotein which is predicted to make homophilic interactions and potential synapses between several immune cells including CD4+, CD8+, NK, dendritic cells and macrophages. Various whole transcriptome analyses have demonstrated the differential expression of FAM26F in several bacterial, viral and parasitic infections, in certain pathophysiological conditions such as liver and heart transplantation, and in various cancers. The complete understanding of transcriptional regulation of FAM26F is in its infancy however it is up regulated by various stimulants such as polyI:C, LPS, INF gamma and TNF alpha, and via various proposed pathways including TLR3, TLR4 IFN-β and Dectin-1. These pathways can merge in STAT1 activation. The synergistic expression of FAM26F on both NK-cells and myeloid dendritic cells is required to activate NK-cells against tumors via its cytoplasmic tail, thus emphasizing therapeutic potential of FAM26F for NK sensitive tumors. Current review provides a comprehensive basis to propose that FAM26F expression level is at least a hallmark for IFN-γ-lead immune responses and thus can proficiently be regarded as an early diagnostic marker. Future investigation dissecting the role of FAM26F in activation of various immune cell populations in local amplification by cell–cell contact is crucial to provide the missing link imperative for elucidating the relevance of this protein in immune responses. [ABSTRACT FROM AUTHOR]

Background: The pituitary gland also known as the "master gland," is involved in maintaining the homeostasis of various body functions. The pituitary gland is comprised of adenohypophysis and neurohypophysis, and stays in an indent in the sphenoid bone called sella turcica. Objective: To determine the diagnostic accuracy of dynamic contrast Magnetic Resonance Imaging (MRI) in symptomatic patients with pituitary macroadenoma keeping histopathology as gold standard. Methods: Cross-sectional study carried out in Department of Radiology, Tertiary Care Hospital, Lahore from May 2019 to Oct 2020. Prospective. One hundred and one patients (101) were enrolled. Dynamic contrast magnetic resonance imaging (MRI) of patients was performed on 1.5 Tesla GE MRI machine using head coil. Transsphenoidal endoscopic surgery of seventy-five patients was done due to their progressing symptoms and out of these four patients lost to follow up. All the available post operative specimens were reviewed by experienced histopathologist and were labelled as positive and negative for pituitary macroadenoma. Results: Mean age of patients (n=71) was 37.4 years. Out of 71 patients, MRI showed pituitary macroadenoma in 64 patients (90.1%) of which two were false positives. 3 patients (4.2%) showed pituitary microadenoma, 1 (1.4%) represented meningioma, 1 (1.4%) showed craniopharyngioma and 2 (2.8%) showed pituitary hyperplasia. Sensitivity was found to be 96.9%, specificity was 71.4%, positive predictive value (PPV) was 96.9%, negative predictive value (NPV) was 71.4% and accuracy of dynamic contrast MRI in detecting pituitary macroadenoma was 94.3%. Conclusion: Dynamic contrast MRI is an authentic and non-invasive diagnostic imaging modality due to its better soft tissue contrast, multiplanar images and no risk of ionizing irradiation that allows the detection of pituitary macroadenoma with high sensitivity, specificity and accuracy. It also provides practical information about the interrelation of the gland with adjoining anatomical structures and helps to schedule medical or surgical treatment. [ABSTRACT FROM AUTHOR]

There has been a tremendous increase in the consumption of high-energy (ED) drinks in the last decade. This has been equally popular among teenagers and adults of both genders and is marketed to boost energy, alertness, and performance and prevention of fatigue. Although ED contains a variety of ingredients such as taurine, guarana, L-carnitine and multivitamins, it is the caffeine that plays a significant role in affecting different systems such as cardiovascular (arrhythmias), neurological (seizures) and neuropsychiatric system (agitation and suicidal ideation). Symptoms of caffeine intoxication include palpitation, rise in blood pressure, insomnia, seizures, tremors and irritability, gastrointestinal symptoms, disturbance of sleep cycle and in rare cases death. However, in this review, we focused mainly on cardiovascular symptoms in addition to contents, mode of action and pharmacokinetics of ED. As several studies point towards mortality due to arrhythmias after drinking ED, it is important to concentrate on these deleterious effects. [ABSTRACT FROM AUTHOR]

Background: Ankylosing spondylitis, a chronic disease, in which spinal inflammation develops which continuously causes backache and inadequacy in the functions of spine. Anti-inflammatory medications are available but along with that, assessment of inflammatory markers is obligatory to assess disease activity. Objective: To determine association between neutrophil to lymphocyte ratio and activity of disease in patients of ankylosing spondylitis on etanercept therapy. Study type settings & duration: This quasi experimental trial was conducted at Department of Rheumatology, Mayo Hospital, Lahore from September 2019 to March 2020. Methodology: Patients of aged 41-49 years of both genders diagnosed with ankylosing spondylitis and were taking etanercept as medication for 6 months were enrolled. Blood samples were taken at baseline and after 6 months of therapy and analyzed for assessment of neutrophil lymphocyte ratio (NLR) and ASDAS score. Data was entered, decoded and analyzed using SPSS version 22. Results: The mean age of the participants was 45.03 (±2.44) years and majority of them 24 (80%) were males. The mean NLR was 2.9 (±1.0) at baseline which reduced significantly to 1.6 (±0.5) after six months therapy (p <0.05). Similarly the mean baseline ASDAS was 3.8 (±0.9) which significantly reduced to 2.4 (±0.6) after six months of therapy (p <0.05). There was statistical significant positive correlation between NLR and ASDAS i.e. r=0.659 (p <0.05). Conclusion: NLR and activity of disease showed positive correlation in patients with ankylosing spondylitis, which illustrated that NLR can also be used as a key predictor of inflammation that makes it a dependable tool for assessing activity of disease in patients of ankylosing spondylitis on Etanercept therapy. [ABSTRACT FROM AUTHOR]