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Biomedical subjects

Rohini Handa

Publications and source records attributed to Rohini Handa.

10 recordsLinked to original sources

Osteoarthritis phenotypes: advancing precision medicine through clinical, structural, and molecular stratification.

PURPOSE: Osteoarthritis (OA) is now understood as a heterogeneous syndrome driven by diverse biological, biomechanical, metabolic, genetic, and molecular mechanisms. This variability explains differences in disease progression and treatment response, challenging the traditional "one-size-fits-all" approach. This review highlights OA phenotyping as a key step toward precision medicine, focusing on clinical, structural, and molecular classifications that inform individualized care. METHODS: A narrative review was conducted using a non-systematic search of major databases and Osteoarthritis Research Society International sources (2010-2026). Evidence was thematically synthesized across clinical, imaging, and molecular domains to characterize OA phenotypes and their potential relevance to precision medicine. RESULTS: Multiple OA phenotypes were identified: inflammatory, metabolic, biomechanical, cartilage-subchondral, pain-sensitization, and aging/senescence. These exhibit distinct clinical features, risk factors, and therapeutic responses. Imaging-based phenotypes (e.g., inflammatory, meniscus-cartilage, subchondral bone, atrophic, hypertrophic) and molecular endotypes (low turnover, structural damage, systemic inflammation) further refine stratification. Pain-structure discordance is notable in sensitization phenotypes and may predict poorer surgical outcomes. Joint-specific variations and emerging genomic and epigenetic insights underscore disease complexity. Advances in imaging, biomarkers, and machine learning may enable earlier detection and patient clustering, though clinical application remains limited. CONCLUSION: Phenotype- and endotype-based classification represents a critical advancement toward precision OA management. Tailored interventions based on stratification hold promise for improving outcomes; however, clinical translation remains limited by overlapping phenotypes, lack of validated biomarkers, and inconsistent results from phenotype-driven trials. Wider clinical adoption requires standardized definitions, validation across joints, and integration of multimodal diagnostic tools into routine practice.

Humans↗

Autonomic dysfunction in systemic lupus erythematosus.

The objectives were to study the frequency and pattern of autonomic dysfunction in systemic lupus erythematosus (SLE). Fifty-one patients of SLE and 30 age- and sex-matched healthy controls were studied prospectively using a standard battery of noninvasive tests. Autonomic symptoms were seen in 37% patients. On laboratory testing incipient dysfunction was seen in 9 (18%) cases and 1 (3%) control, while atypical involvement was seen in 11 (21%) cases and 6 (20%) controls. Autonomic dysfunction did not correlate with disease duration, lupus activity, disease damage, any particular organ involvement or the presence/absence of peripheral neuropathy. Autonomic neuropathy is not uncommon in lupus and may exist independent of peripheral neuropathy. There are no specific clinical predictors. The clinical significance of autonomic dysfunction detected by laboratory testing warrants longitudinal studies.

Adult↗

Quality of life in Indian patients with rheumatoid arthritis.

PURPOSE OF STUDY: Rheumatoid arthritis (RA) is a multisystem disease with various extra-articular manifestations (EAMs). Health-related quality of life (HRQOL) issues are assuming increasing importance in chronic rheumatic diseases like RA. No data on QOL in RA is available from the Indian subcontinent. There is also a paucity of literature on the impact of EAMs on HRQOL in RA. The objective of this study was to address these lacunae. METHODS: The study group comprised 81 patients with RA from a rheumatology clinic in India. Quality of life was estimated by the generic HRQOL measure: World Health Organization quality of life instrument (WHOQOL-Bref). Disease activity in RA was measured by calculating Disease Activity Score-28 (DAS28). RESULTS: The mean HRQOL scores of the patients were 12.0+/-2.8, 13.2+/-2.7, 14.4+/-2.9 and 13.3+/-2.6 in the physical, psychological, social, and environmental domains of the WHOQOL-Bref respectively. Age, gender, disease duration, educational status, constitutional symptoms, rheumatoid factor positivity, erosions and deformities did not influence HRQOL. Disease activity had a negative influence on the physical and psychological domains. Patients with EAMs had significantly higher DAS28 scores compared to patients without EAMs. Even after adjustment for disease activity, patients with EAMs had lower HRQOL scores than patients without these features (statistically significant for physical domain). CONCLUSIONS: The physical domain of HRQOL is most affected in Indian patients with RA. Increasing disease activity and presence of EAMs worsens the quality of life.

Adult↗

Management of osteoporosis: the Indian perspective.

Osteoporosis is a common but neglected problem in India. The major challenges to management are lack of awareness and resource constraints. The management is also hampered by the non-availability of normative data for bone mineral density in Indians. Subclinical vitamin D deficiency is widespread. The drugs available in the country include calcium, vitamin D, hormone replacement therapy, raloxifene, alendronate, risedronate, calcitonin and teriparatide. Bisphosphonates (alendronate) constitute the mainstay of treatment in India. There is a need for evidence based, context specific and resource sensitive guidelines.

Age Factors↗