Indian Journal of Medical Research最新文献

{"title":"Publication-Equivalent as the new single currency of research impact: The ICMR-Impact of Research and Innovation Scale (ICMR-IRIS).","authors":"Rajiv Bahl","doi":"10.25259/IJMR_2106_2025","DOIUrl":"10.25259/IJMR_2106_2025","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":" ","pages":"135-138"},"PeriodicalIF":2.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, biochemical & molecular spectrum of adrenoleukodystrophy: A single centre experience.","authors":"Somesh Kumar, Meenakshi Bothra, Neha Choudhary, Mohammed Faruq, Renuka Suravajhala, Sunita Jetly, Sunil Kumar Polipalli, Arun Kumar, Komal Uppal, Prashanth Suravajhala, Ravindra K Saran, Madhulika Kabra, Seema Kapoor","doi":"10.25259/IJMR_782_2024","DOIUrl":"https://doi.org/10.25259/IJMR_782_2024","url":null,"abstract":"<p><p>Background & objectives Adrenoleukodystrophy (ALD), caused by a mutation in the ABCD1 gene has a heterogenous clinical spectrum. Very long chain fatty acid (VLCFA) levels, neuroimaging findings and genetic analysis play a role in the final diagnosis. This paper presents a single centre experience on clinical, biochemical and molecular characteristics of ALD. Methods In this cross-sectional study, 35 individuals with ALD were included. Apart from their clinical characterisation, evaluation of their VLCFA levels was done. VLCFA levels and their ratios were also analysed in 383 healthy controls, and ROC curves were prepared to identify suitable cut-offs for the Indian population. Molecular characterisation by ABCD1 gene sequencing was also done. Molecular modelling techniques were used to ascertain the structural effect of mutations in those carrying novel variants in the ABCD1 gene. Results Adolescent ALD (13/35, 37.1%) was the most common subtype identified in our study, and muscle weakness (19/29, 65.5%) was the most common clinical feature. At cut-offs of 0.907 and 0.604 (µmol/3.2mm punch), C24:0 and C26:0 LPCs, respectively, were found to have a sensitivity and specificity of 100 per cent each for the identification of ALD. Sequencing of ABCD1 gene revealed that the mutations were most commonly seen in exon 1. Out of the four novel variations in ABCD1 gene identified in our study, a three-dimensional visualisation of the ABCD-1 gene revealed that three of them resulted in significant alterations in the protein structure, while no changes at the protein level was reported for the g.11476 [G>A] mutation. Interpretation & conclusions This study highlights the importance of considering the ratios of VLCFAs, along with the individual values, for establishing ALD diagnosis. We also identified a mutational hotspot in exon 1 of the ABCD1 gene, which may also help strategize the preliminary screening of the ABCD1 gene.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"162 2","pages":"237-245"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Road traffic accidents & climatic factors in an urban area in Kerala, India: A time series approach.","authors":"Aparna Sabari, Aswathy Sreedevi, Abhilash Sukumarapillai, Thayyil Valappil Sathianandan, Jeby Jose Olickal, Kavumpurathu Raman Thankappan","doi":"10.25259/IJMR_854_2025","DOIUrl":"https://doi.org/10.25259/IJMR_854_2025","url":null,"abstract":"<p><p>Background & objectives Road traffic accidents (RTAs) are increasing globally and its relationship with climatic factors are less studied. This study aimed to determine the trends and patterns of RTAs and its relationship with climate factors in Urban Ernakulam district, Kerala. Methods This retrospective analysis used 47,582 RTA records from the Crime Records Bureau, Ernakulam City Police, Kerala, India and daily meteorological data of 2,149 days (2018-2023) from the department of Atmospheric Science, Cochin University for Science and Technology, Kerala. The combined dataset was analysed using Python, with descriptive statistics, time series analysis, autocorrelation function (ACF) analysis, and the seasonal autoregressive integrated moving average (SARIMA) model conducted. Results Of the total RTAs, one-fifth (n=9817, 20.6%) occurred in 2023. Two wheelers (motorcycles) were the most common (n=27515, 57.8%) vehicle type, minor roads were the most frequent sites (n=29801, 62.6%), and over-speeding contributed to over one third (n=17489, 36%) of the RTAs. RTAs were most common (n=15829, 33.3%) in the afternoon 12.00-18.00 PM and the majority (n=33799 ,71%) of RTA victims suffered grievous injuries. Minimum temperature (<21.71°C) and rainfall (<2.15 mm) were significantly associated with RTAs. Lower minimum temperatures had a negative correlation with RTAs during winter (-0.21 to -0.28) in 2022-23, and the monsoon season (-0.20 to -0.26) in 2020-21. Higher rainfall was negatively correlated (-0.2 to - 0.22) with RTAs during the monsoon in 2018-19. Grievous injury patterns were influenced by past three-month trends and recurring cycles every three yr, reflecting a mix of short-term seasonal, medium-term biennial, and long-term triennial factors. Interpretation & conclusions Adverse weather conditions such as lower temperatures and less rainfall increased the risk of RTAs. Long term studies, free from external interruptions, are needed to get deeper insights into these relations. Targeted interventions and advisories to reduce RTAs, especially before monsoon season are essential.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"162 2","pages":"155-162"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunotherapy in the current era: Transforming the landscape of cancer treatment.","authors":"Aditya Dhanawat, Kunal Jobanputra, Amit Joshi","doi":"10.25259/IJMR_376_2025","DOIUrl":"https://doi.org/10.25259/IJMR_376_2025","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"162 2","pages":"252-255"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metformin use & asthma outcomes in patients with concurrent diabetes & bronchial asthma: A systematic review & meta-analysis.","authors":"A B M Kamrul-Hasan, Joseph M Pappachan, Parth Jethwani, Shinjan Patra, Lakshmi Nagendra, Deep Dutta, Mohammad Delwar Jahan Khan, Saptarshi Bhattacharya","doi":"10.25259/IJMR_431_2025","DOIUrl":"https://doi.org/10.25259/IJMR_431_2025","url":null,"abstract":"<p><p>Background & objectives Limited data exist on the effects of metformin on asthma outcomes in patients having type 2 diabetes (T2D) along with asthma. This meta-analysis seeks to determine whether metformin influences asthma outcomes in these patients. Methods Studies involving adults with T2D and asthma, using metformin in the intervention group and other glucose-lowering drugs in the control group, were systematically searched through databases. The primary outcome was the adjusted risk of asthma exacerbations in metformin users (MU) vs. non-metformin users (non-MU). Other outcomes included asthma-related emergency room visits, hospitalisations, and the need for rescue steroids. Meta-analysis was conducted using RevMan with random-effects models. Outcomes were reported as hazard ratios (HRs) with 95 per cent confidence intervals (95% CI). Results Six retrospective cohort studies with moderate overall risk of bias, involving 317,905 patients, were included. The risk of asthma exacerbation was comparable in MU and non-MU (HR 0.95, 95% CI: 0.86, 1.04, P=0.27). The risk of asthma-related emergency room visits appeared lower in MU than in non-MU, though the difference did not gain statistical significance (HR 0.63, 95% CI: 0.39, 1.01, P=0.06). The two groups also had statistically identical risks of asthma-related hospitalisations (HR 0.76, 95% CI: 0.54, 1.07, P=0.12) and use of rescue steroids (HR 0.95, 95% CI: 0.87, 1.03, P=0.24). However, after excluding a study from Taiwan (n=115486), a significantly lower risk of asthma exacerbation (HR 0.89, 95% CI: 0.83-0.97, P=0.005) and asthma-related hospitalisations (HR 0.68, 95% CI: 0.49-0.93, P=0.02) was observed in MU. Interpretation & conclusions Metformin therapy for T2D does not influence asthma outcomes; however, certain outcomes appear to improve when a Taiwanese study is excluded. Such results must be considered cautiously, as the included studies are observational and have a moderate risk of bias. Randomised controlled trials with diverse global representation are essential for clarifying the relationship between metformin use and asthma outcomes.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"162 2","pages":"187-196"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of venous lactate values on blood gas analyser versus laboratory autoanalyser: A preliminary study.","authors":"Aparajita Shashank Kale, Smita Tripathi, Shalu Gupta","doi":"10.25259/IJMR_816_2025","DOIUrl":"https://doi.org/10.25259/IJMR_816_2025","url":null,"abstract":"<p><p>Background & objectives Lactate can be estimated by point-of-care testing (POCT) devices such as blood gas analysers (BGA) as well as central lab autoanalysers (AA); both have their advantages. Studies have compared lactate and electrolyte values on arterial blood; none used venous samples which are preferred in children. We planned to compare venous lactate by BGA and AA in children admitted to Paediatric Intensive Care Unit (PICU). Methods Fifty children aged one month to 18 yr admitted in PICU were included in the study after parental consent. Paired venous samples were collected in heparinised syringes for BGA, in fluoride containing vacutainers for AA and were analysed immediately. Results Lactate levels were assessed in 29 male and 21 female children [Median age: 4 yr interquartile range (IQR)=1-10)]. AA reported higher lactate levels but mean difference between two methods (0.34±1.56 mmol/L) was not statistically significant (P= 0.062). The methods showed statistically significant correlation [95% confidence interval (CI), Spearman correlation coefficient (rs)=0.816, P=<0.001]. Bland Altman plot showed 95 per cent of paired values had differences which was within limits of agreement (-2.71, +3.39); differences were more variable above 2 mmol/L. Both devices classified multiple samples into different clinically significant ranges. Interpretation & conclusion Venous lactate by BGA and AA was found comparable, but critical values requiring clinical intervention were not reported similarly by both analysers. Variability between them was higher at higher venous lactate levels (>2 mmol/L) which represent critically ill children. Use of the same analyser, either BGA or AA, is therefore recommended for monitoring.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"162 2","pages":"246-251"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From diagnosis to treatment: Streamlining TB care pathways in the hilly terrains of Shimla district.","authors":"Suman Thakur, Vivek Chauhan, Pratibha Thakur, Ravinder Kumar, Gopal Beri","doi":"10.25259/IJMR_7_2025","DOIUrl":"https://doi.org/10.25259/IJMR_7_2025","url":null,"abstract":"<p><p>Background & objectives Tuberculosis (TB) remains a significant public health challenge in resource-limited settings like Shimla District, Himachal Pradesh, where delays in anti-tubercular treatment (ATT) initiation persist due to geographic and systemic barriers. This study aimed to evaluate the effectiveness of quality improvement interventions in reducing treatment delays using plan-do-study-act (PDSA) cycles. Methods The study implemented three interventions targeting different operational barriers: decentralising treatment initiation by routing diagnostic results to local TB units, enabling treatment initiation during holidays through accredited social health activists (ASHAs), and enhancing communication between molecular testing laboratories and peripheral units via multimedia groups. Data on delays (≥3 days) were collected from the Nikshay portal and analysed pre- and post-intervention. Results The interventions significantly reduced treatment delays, with the proportion of delayed cases dropping from 31 to 15 per cent after the first intervention. While the second intervention sustained a delay rate of 16 per cent, the third intervention further improved timeliness in rural hospitals, highlighting the critical role of efficient communication systems. However, resistance from healthcare providers in district hospitals limited the overall impact of the interventions. Operational challenges such as overburdened molecular laboratories and delays in updating results on the Nikshay portal were also identified. Interpretation & conclusions Quality improvement strategies, including decentralisation, holiday coverage, and enhanced communication, effectively reduced ATT initiation delays, particularly in rural settings. Addressing systemic inefficiencies and engaging stakeholders are critical for sustained improvements. These findings offer scalable solutions for TB programmes in similar resource-constrained contexts, contributing to global TB control goals.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"162 2","pages":"169-174"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vector control at a crossroad: Grappling with multiple challenges.","authors":"Ashwani Kumar, Dharani Govindasamy","doi":"10.25259/IJMR_1953_2025","DOIUrl":"https://doi.org/10.25259/IJMR_1953_2025","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"162 2","pages":"131-134"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rational use of antibiotics at primary & secondary healthcare facilities in district Panchkula, Haryana, North India: A cross-sectional study.","authors":"Adarsh Bansal, Madhu Gupta, Nusrat Shafiq, Atul Saroch, Jayashree Muralidharan, Neeraj Arora, Mukta Kumar, Sonia Trikha","doi":"10.25259/IJMR_1146_2025","DOIUrl":"https://doi.org/10.25259/IJMR_1146_2025","url":null,"abstract":"<p><p>Background & objectives Antimicrobial prescriptions by doctors are crucial in managing acute illnesses but contribute significantly to antimicrobial resistance if misused. This study aimed to assess the rational use of antibiotics in outpatient public healthcare settings in Panchkula, Haryana. Methods A cross-sectional study was conducted across 18 primary and two secondary healthcare facilities in the district of Panchkula, Haryana. Antimicrobial prescriptions (n=945) were assessed for comprehensiveness and rationality using the pretested and validated antimicrobial prescription assessment tool and standard treatment guidelines. World Health Organisation's anatomic therapeutic chemical and defined daily dose index (WHOCC-ATC/DDD) was used to calculate defined daily dose (DDD) for adult prescriptions, and days of therapy (DOT) were calculated for paediatric patients. We used descriptive statistics to summarise the findings and chi-square test to compare the proportions of rational and irrational prescriptions. Results Of 945 antibiotic prescriptions, only 0.4 per cent (n=4) of prescriptions were comprehensive. Among prescriptions eligible for rationality assessment (n=647, 68.5%) antibiotic therapy was indicated in 44 per cent (n=285), of which only 3.5 per cent (n=33) were rational, 20.2 per cent (n=191) moderately rational and 76.3 per cent irrational (n=721). Irrational prescriptions were most common in respiratory (n=415, 95%), gastrointestinal (n=105, 92.9%), and dermatological (n=21, 76%) ailments. The completeness of the prescriptions was low, with information on dosage of antibiotics (n=265, 28%), laboratory investigations (n=331, 35%), diagnosis (n=94, 10%), and co-morbidities (n=96, 10%). The prescribed antibiotic doses exceeded the WHO-DDD recommendations, with irrational prescribing significantly higher among paediatric prescriptions (89.6%) as compared with adult prescriptions (74.3%; adjusted odds ratio 1.36, 95% confidence interval 1.1-1.7, P<0.001). Interpretation & conclusions Antibiotic prescriptions in primary and secondary care outpatient departments demonstrated widespread irrationality, highlighting the importance of implementing a comprehensive antimicrobial stewardship programme in these settings.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"162 2","pages":"175-185"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin B12 modulates D-galactose-induced renal dysfunction.","authors":"M Nagaraju, Krishna Kalyan Kalahasti, Udaykanth Suryavanshi, S Sreenivasa Reddy, G Bhanuprakash Reddy","doi":"10.25259/IJMR_529_2025","DOIUrl":"https://doi.org/10.25259/IJMR_529_2025","url":null,"abstract":"<p><p>Background & objectives Age-related renal impairment presents a significant challenge in contemporary clinical practice. Cellular senescence and oxidative stress are the key contributors to chronic kidney disease (CKD) during aging. Senescence is triggered by advanced glycation end products (AGEs), hyperphosphatemia, and higher glucose levels, which lead to renal dysfunction by inducing inflammation, endoplasmic reticulum (ER) stress, fibrosis, and apoptosis. Further, vitamin B12 is known to influence biological ageing and has been suggested to improve kidney function in the elderly; however, the underlying mechanisms require further investigation. In this study, we investigated the potential of vitamin B12 in mitigating renal dysfunction using a D-galactose-induced aging rat model. Methods Twelve-month-old male Wistar rats were grouped into Control, D-galactose (300 mg/kg/day), and D-galactose + vitamin B12 supplementation groups (n=6). Renal dysfunction was evaluated by kidney function markers (creatinine, albumin, urea, and BUN), renal damage markers (kidney injury molecule-1 [KIM-1], lipocalin-2 [LCN-2], fatty-acid binding protein-1 [FABP-1], and tissue inhibitor of metalloproteinase-1 [TIMP-1]), and histopathology (glomerular changes). Signalling mechanisms of cellular senescence, phosphate metabolism, inflammation, fibrosis, and renal apoptosis were analysed by qRT-PCR and immunoblotting. Results Vitamin B12 supplementation attenuated renal dysfunction by alleviating the senescence-induced accumulation of AGEs and hyperphosphatemia. Furthermore, vitamin B12 administration conferred renal protection by subsiding inflammation, fibrosis, and apoptosis through modulation of the RAGE-NFkB, pPERK-GSK3β, and JNK signalling pathways. Vitamin B12 supplementation mitigated hyperphosphatemia by mediating the Klotho-FGF23 axis. Interpretation & conclusions The findings provide evidence for vitamin B12 supplementation in managing renal aging.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"162 2","pages":"211-219"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}