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BackgroundThyroid dysfunction (TD) and metabolic syndrome (MetS) are known risk factors for atherosclerotic cardiovascular disease (ASCVD). TD is risk factor for ASCVD mediated by the effects of thyroid hormones on lipid metabolism and blood pressure hence the components of MetS. It is possible that coexistence of these two disease entities and unrecognized TD in patients with MetS might substantially increase ASCVD risk. Moreover, little is known about the relationship between TD and the components of MetS. Thus, the purpose of this study was to evaluate the pattern of TD in patients with MetS and its relationship with components of the MetS.MethodsA total of 358 previously diagnosed patients with MetS were recruited in the study. The thyroid function test parameters were measured to classify TD at Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Nepal. Statistical analyses were performed using SPSS version 16.0 to evaluate pattern and relationship.ResultsThe overall prevalence of TD in patients with MetS was 31.84% with high prevalence of subclinical hypothyroidism (29.32%). We found no evidence of a relationship between TD and components of MetS, although there was significant difference in waist circumference between four groups of TD.ConclusionPatients with MetS had subclinical hypothyroidism greatly. Although there was no evidence of any relationship between thyroid status and all components of MetS, TD should be taken into account when evaluating and treating patients with MetS to reduce the impending risk.

BackgroundIPF is a progressive, irreversible fibrotic interstitial lung disease. We performed size-based quantitation of pulmonary arterial remodelling in IPF, examined the role of EndMT and effects on lung physiology.MethodsResected lung tissues from 11 normal controls (NC), and 13 IPF patients, were differentially stained using the Movat Pentachrome technique. Size-based classification for pulmonary arteries was conducted in NC and IPF tissues. For each pulmonary artery, arterial size, luminal diameter, thickness of the intima, media, adventitia, and elastin deposition was quantified using Image ProPlus7.0 software. In addition, immunohistochemical staining was performed for EndMT markers and collagen.ResultsLarge and medium size arterial numbers were significantly reduced in IPF compared to NC (p<0.0001). Intima thickness was highest in the arterial range of 200–399 μm and 600–1000 μm (p<0.0001), while medial and adventitial thickness was significant across 200–1000 μm (p<0.05) compared to NC. Medial thickness was found to significantly affect the diffusing capacity of the lungs for carbon monoxide (DLCO) (r’=−0.8, p=0.01). Total arterial elastin in IPF was higher across all arterial ranges except 100–199 μm in IPF than NC, with the greatest differences in 200–399 μm (p<0.001) and 600–1000 μm (p<0.001). Total elastin also negatively correlated with DLCO (r’=−0.63, p=0.04) in IPF. An increase in EndMT markers and collagen type I/ IV was observed.ConclusionsThis is the first study demonstrating size-based differences in pulmonary arteries in IPF and its detrimental effect on lung physiology. The process of EndMT might be central to these vascular remodelling changes and could be a potential novel therapeutic target.

The forced oscillation technique (FOT) is a non-invasive method to assess airway function by emitting oscillatory signals into the respiratory tract during tidal ventilation. This opinion piece discusses the current use, trialled modification and future directions in utilizing FOT as a novel diagnostic tool for early detection of small airway changes in smokers. The published evidence to date has shown that FOT parameters could be a sensitive diagnostic tool to detect early respiratory changes in smokers. Multiple frequencies and the frequency dependence of resistance and reactance can provide the most valuable and early information regarding smoking induced changes in airways. Considering its non-invasiveness, lower level of discomfort to patients than spirometry, feasibility, and cost effectiveness, it could be the first-choice diagnostic technique for detection of early respiratory changes in smokers. The finding of FOT could further be supported and correlated with inflammatory markers.

Introduction: Nepal like many other developing countries in the world is witnessing the rapid ageing of population. Quality of life (QOL) of elderly people is becoming even more relevant towards an ageing society. In Nepal, less is known regarding special needs and quality of life of elderly people either in familial situations or in old age residences. Objectives: The present study was undertaken to assess and compare the quality of life of elderly living with the family and in old age home. Methodology: A Cross sectional descriptive study was conducted from October 2016 to April 2017 among elderly population aged 60 years and above. A total of 50 elderly people were enrolled from old age home (OAH) using total enumeration sampling technique and equal number of sample was selected from the family setting. QOL of elderly was assessed using WHOQOL-BRIEF questionnaire after taking informed consent from the participants. Data was analyzed using SPSS. Results: The mean scores of QOL domains were better among the age group 60-70 years, males, married, literates and who had children. The mean scores of QOL in physical, psychological and environmental domains were better in elderly living with the family than living in OAH. Low scores were found on social domain among elderly compared to other domain irrespective of their residence. Conclusion: QOL score among elderly is average, while social relationship domain of QOL scores was found to be low. Social activities should be expanded for these residents in order to promote social health. The QOL which each individual possesses is very important in all aspects be it physical, psychological, social & environmental. Furthermore, programs that help elderly people live in their own homes and social environments should be promoted.BIBECHANA 16 (2019) 221-227