1.Biomarkers of Major Depressive Disorder: Knowing is Half the Battle
Sahil MALIK ; Ravinder SINGH ; Govind ARORA ; Akriti DANGOL ; Sanjay GOYAL
Clinical Psychopharmacology and Neuroscience 2021;19(1):12-25
Major depressive disorder (MDD) is a heterogeneous disease which is why there are currently no specific methods to accurately test the severity, endophenotype or therapy response. This lack of progress is partly attributed to the complexity and variability of depression, in association with analytical variability of clinical literature and the wide number of theoretically complex biomarkers. The literature accessible, indicates that markers involved in inflammatory, neurotrophic and metabolic processes and components of neurotransmitters and neuroendocrine systems are rather strong indicators to be considered clinically and can be measured through genetic and epigenetic, transcriptomic and proteomic, metabolomics and neuroimaging assessments. Promising biologic systems/markers found were i.e., growth biomarkers, endocrine markers, oxidant stress markers, proteomic and chronic inflammatory markers, are discussed in this review.Several lines of evidence suggest that a portion of MDD is a dopamine agonist-responsive subtype. This review analyzes concise reports on the pathophysiological biomarkers of MDD and therapeutic reactions via peripheral developmental factors, inflammative cytokines, endocrine factors and metabolic markers. Various literatures also support that endocrine and metabolism changes are associated with MDD. Accumulating evidence suggests that at least a portion of MDD patients show characteristics pathological changes regarding different clinical pathological biomarkers. By this review we sum up all the different biomarkers playing an important role in the detection or treatment of the different patients suffering from MDD. The review also gives an overview of different biomarker’s playing a potential role in modulating effect of MDD.
2.Is Quadriceps-Strengthening Exercises (QSE) in MedialCompartment Knee Osteoarthritis with Neutral and Varus Malalignment a Paradox? – A Risk-Appraisal of StrengthTraining on Disease Progression
Garg R ; Krishna A ; Daga R ; Arora S ; Puri S ; Kumar M
Malaysian Orthopaedic Journal 2024;18(No.1):73-83
Introduction: The present inquiry seeks to investigate
whether the current regimens of QSEs (QuadricepsStrengthening Exercises) aggravate the disease while
mitigating symptoms.
Materials and methods: A comparative study was
conducted on 32 patients with medial compartment
osteoarthritis of knees. While the neutral group of 16 patients
was constituted of those with an anatomical-lateral-femorotibial-angle (aFTA) 176-180º, varus group comprised an
equal number of patients with an aFTA >180º. A home-based
12-week strength-training program involving weekly visits
to hospital for supervised sessions was administered. The
outcome measures were visual-analog-scale (VAS), medial
patello-femoral joint tenderness (MPFJT), time-up-and-gotest (TUGT), stair-climb test, step test, WOMAC, IKDC
scores, aFTA, hip-knee-ankle (HKA) angle, lateral-tibiofemoral-joint-separation (LTFJS), and horizontal-distancefrom-centre-of-knee-to-Mikulicz-line.
Results: There was a significant increase in quadriceps
strength (p<0.01) in both groups. Values for neutral group
with VAS score (p=0.01), MPFJT (p=0.01), TUGT (p=0.01),
timing of the stair climb test (p=0.01), WOMAC (p<0.01),
and IKDC (p=0.03) were better compared to varus group
with VAS score (p=0.13), MPFJT (p=0.03), TUGT (p=0.90),
timing of stair climb test (p=0.68), WOMAC (p<0.02), and
IKDC (p=0.05). Varus group also showed an increase in
aFTA and LTFJS in 12 patients, increase in HKA in 11, and
increase in horizontal distance from the centre of knee to the
Mikulicz line in 7 patients.
Conclusion: The present study brings to the fore the
paradoxical role played by QSEs in management of medial
knee OA. While there is a radiological progression of the
disease in both neutral and varus mal-aligned knees more so
in the latter than the former.