Interstitial lung diseases are frequently associated with sleep disturbances that adversely affect health-related quality of life (HRQoL), yet these remain under-recognized. This study aimed to assess sleep quality and sleep disordered breathing in patients with ILD and evaluate their association with HRQoL. In this cross-sectional study, conducted at a tertiary care centre in India, adults with a confirmed diagnosis of ILD were enrolled. Sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI) and HRQoL using King’s Brief ILD and EQ-5D-5 L questionnaires respectively. Consenting participants underwent level I polysomnography. Linear regression was used to identify risk factors independently associated with HRQoL measures. Of the 100 participants included, 69 underwent polysomnography. Poor sleep quality (PSQI > 5) was observed in 75
Language barriers in healthcare can lead to communication disruption, misdiagnosis, poor health literacy, increased time and cost, and emotional distress for patients and healthcare workers. Extant literature demonstrates that linguistic barriers hindered access to healthcare and reduced quality of care among multilingual populations of India. The current study examines patient and healthcare provider perspectives on the perceived effects of language barriers on health communication, quality of care and patient experience in the multilingual state of Karnataka, India. The research was conducted with 50 participants—including 25 patients and 25 healthcare workers—with the studied population speaking 11 languages in total. The study involved administering surveys and interviews among the participants, conducting inductive reflexive thematic analysis following Braun and Clarke's framework using NVivo 15, and examining participant demographics with SPSS version 26. Participants reported that language discordance contributed to reduced quality of care, increased time and cost of care, and added stress to patients and providers in the clinical setting. The study also examined the precipitating factors of language barriers, including social pressures and systemic deficiencies. Results highlight the need to address language barriers in Karnataka's multilingual healthcare system. Patient and provider input suggests that interdisciplinary action and the use of modern clinical translation technology may mitigate linguistic barriers and increase access to quality healthcare and improved health literacy.
Nephrotic syndrome (NS) is one of the most common kidney diseases in children characterised by heavy proteinuria, edema, and hypoalbuminemia. Most cases in children over one year are idiopathic with higher incidence in Asian and Black populations. The hallmark of idiopathic NS is podocyte injury. However, the pathogenesis is not completely understood and is possibly due to a complex interplay of immune dysfunction, circulating factors, podocyte factors and genetics. NS often follows a relapsing-remitting course with a subset continuing to experience relapse in adulthood. Corticosteroids are the primary treatment, and further management is guided by steroid responsiveness and relapse pattern. Children with frequently relapsing course need steroid sparing immunosuppressive medications to sustain remission and prevent steroid related toxicity. Management of steroid resistant NS remains a clinical challenge with limited therapeutic options. Those with frequently relapsing or steroid resistant NS are at risk of complications such as severe edema, infections, acute kidney injury and thromboembolism as well as medication related adverse effects. These patients require monitoring and long term follow up and should be co-managed with subspecialist. Patient and family education including training in home monitoring of proteinuria and maintaining medication records forms an integral part of management strategy. While overall long-term kidney outcome is good for steroid sensitive NS, children with steroid resistant NS who are also multidrug resistant are at high risk of disease related morbidity and progression to end stage kidney disease.
Although recognized, the field has yet to fully explore the mechanisms and solutions to Immune effector Cell-Associated Hematotoxicity (ICAHT) - a major contributor to long term morbidity and mortality following CAR therapy. About 20–40
