Swami Rama Himalayan University

Amyotrophic lateral sclerosis (ALS) is an idiopathic, fatal, and rapidly progressive neurodegenerative disease. At present, neurofilament light (NFL) and phosphorylated neurofilament heavy (pNfH) proteins in biological fluids are commonly known prognostic biomarkers, but their levels stabilize over time. Thus, there is a critical gap in the field to identify unique biomarkers that can aid disease diagnosis, progression and monitoring the therapy response.

To evaluate the presence of extracellular domain of p75 (p75ecd) in urine of ALS patients and healthy control volunteers in the North American cohort.

An enzyme-linked immunoassay (ELISA) and creatinine assay was used to determine the levels of p75ecd and creatinine in the urine of ALS patients and healthy control volunteers respectively. This assay demonstrated clear discrimination in the levels of the p75ecd in the urine samples of ALS patients as compared to healthy individuals.

It was found that the concentration of p75ecd in ALS samples was significantly higher than that of healthy controls group. Additionally, high p75ecd levels were segregated with respect to age, sex, family history, occupation and drug treatment, medication status. Moreover, we observed differential expression patterns among the different stages of the disease. Our results followed the pattern that was observed in the Chinese, and Australian cohort.

Altogether, our results indicate that the development of an efficient system for the detection of elevated levels of p75ecd in the urine could serve as a useful modality for early ALS diagnosis, disease progression, and monitoring the effectiveness of therapeutic interventions.

Pulmonary invasive fungal infections (IFIs), particularly among immunocompromised individuals, are associated with substantial morbidity and mortality. This study aimed to evaluate the clinical profile, underlying risk factors, and diagnostic performance of the galactomannan (GM) antigen assay in the diagnosis of Invasive Pulmonary Aspergillosis (IPA).

A cross-sectional observational study was conducted over 12 months at the Himalayan Institute of Medical Sciences, Dehradun, India. A total of 224 patients with suspected pulmonary IFIs were enrolled. Cases were classified as Proven, Probable, Possible, or No IFI based on the EORTC/MSG, Invasive Fungal Diseases in Adult Patients in Intensive Care Unit (FUNDICU) criteria. Respiratory and serum samples were analysed using direct potassium hydroxide (KOH) microscopy, fungal culture, and GM antigen detection via lateral flow assay. Diagnostic accuracy was determined using standard statistical analyses.

Of the 224 patients, 46.4 % were classified as Proven or Probable IFI, 34.8 % as Possible, and 18.8 % as No IFI. dyspnoea (p = 0.002) was the most strongly associated symptom. Significant risk factors included asthma/COPD (52.9 %, p = 0.001), diabetes mellitus (36.5 %, p = 0.028), immunosuppression (37.5 %, p < 0.001). Fungal culture was positive in 30.3 % of cases, with Aspergillus flavus and A. fumigatus as the predominant isolates. A bronchoalveolar lavage fluid (BALF) GM optical density index (ODI) cut-off of ≥1.0 achieved balanced sensitivity (55.56 %) and specificity (75.86 %).

The GM assay in BALF at an ODI threshold of ≥1.0 showsmodest discriminative ability for the early detection of invasive pulmonary aspergillosis (IPA). Incorporating GM testing alongside conventional diagnostics enhances early identification and facilitates prompt antifungal therapy.

In the present study, the emanation coefficient was calculated for different types of building materials using active and passive methods. Active measurement was carried out using a scintillation detector connected to the sample containing a small chamber (volume ∼ 1582.5 c.c.) for continuous measurement of approx. 240 h. The observed growth curves for radon concentrations were used to estimate the emanation coefficients and the back diffusion rates at the equilibrium concentration inside the chamber, while the passive measurement was carried out with LR 115 type II detectors using the sealed can technique. Seven types (soil, concrete, brick, tile, slate, granite, and sand) of building materials were used for the present experiment in two size ranges: fine grains (0-300 μm) and coarse grains (300-1180 μm) in both types of measurements. The emanation coefficient was found to vary between 0.01 to 0.22 and 0.23 to 0.31 in active and passive measurement, respectively. Maximum values of the emanation coefficient were obtained for fine-grained soil samples and minimum for sand (both fine and coarse). In most cases, coarse grains have shown a higher emanation coefficient as compared to fine ones.