Indian Journal of Medical Research最新文献

{"title":"Reframing clinical research frameworks: Case for a shift from a biomedical to a biopsychosocial one.","authors":"Jaideep C C Menon, Raman Krishna Kumar, Sanghamitra Pati","doi":"10.25259/IJMR_2598_2025","DOIUrl":"10.25259/IJMR_2598_2025","url":null,"abstract":"<p><p>The medical science progressed rapidly over the last century. Certain diseases have been eradicated and some others are on the verge; with a progressive increase in life expectancy. The currently followed biomedical, disease centred, reductionist approach to medicine has helped diagnose earlier, probe deeper, and treat in a targeted manner. The downside to the biomedical, reductionist approach is that the part becomes more important than the whole. Ludwig von Bertalanffy's systems theory (1968), emphasised that the whole is greater than the sum of its parts. Building on this perspective, Engel proposed the biopsychosocial model, suggesting that psychological and social factors, while dependent on biological processes, cannot be fully explained by them. He further described the dynamic interactions between these levels of the biopsychosocial hierarchy as emergent properties that shape health and illness. Correspondingly, clinical research too is largely modelled on the reductionist, biomedical approach. It is indisputable that the social, psychological, and behavioural determinants of health contribute to the pathology and health outcomes, all of which are considered in the biopsychosocial framework. We look at the pros and cons of the reductionist system and weigh in on the biopsychosocial approach in modelling clinical research given that it factors for the non-medical determinants of health and disease.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"163 3","pages":"341-344"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes in current smokers versus former smokers undergoing concurrent chemoradiotherapy for head and neck cancer.","authors":"Samreen Zaheer, Aditi Agrawal, Arshida P, Mohammad Akram","doi":"10.25259/IJMR_1931_2025","DOIUrl":"10.25259/IJMR_1931_2025","url":null,"abstract":"<p><p>Background and objectives Head and neck cancers are aggressive tumours with a multidisciplinary treatment strategy. Concurrent chemoradiotherapy is recommended for locally advanced cases. The carboxyhaemoglobin level is higher in smokers, resulting in a hypoxic environment and radio resistance, which affect treatment outcomes. Data for effect of continued smoking is not available in the Indian setting. This study aims to compare treatment response, failure rate, patterns, and progression-free survival in current smokers vs. former smokers receiving definitive concurrent chemoradiotherapy for head and neck cancer. Methods We conducted this retrospective observational study in patients receiving definitive chemoradiotherapy for head and neck cancer with two groups: current smokers and former smokers. Both arms received weekly 40 mg/m2 cisplatin along with radiotherapy. Endpoints included treatment response, progression-free survival, and failure patterns. Results There were fewer complete treatment responses and more failures in current smokers receiving CRT, with a significant difference in progression-free survival. Interpretation & conclusions Continued smoking during definitive chemoradiotherapy for head and neck cancers resulted in poorer treatment outcomes. Integrating tobacco cessation in oncological care should be a standard of care in managing head and neck cancers.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"163 3","pages":"415-419"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological considerations regarding comparison group verification in maternal COVID-19 research.","authors":"Sunil Kumar Raina","doi":"10.25259/IJMR_41_2026","DOIUrl":"10.25259/IJMR_41_2026","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"163 3","pages":"420"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New tools and policies herald a major advance in tuberculosis diagnosis.","authors":"Patricia Hall-Eidson, Madhukar Pai","doi":"10.25259/IJMR_923_2026","DOIUrl":"10.25259/IJMR_923_2026","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"163 3","pages":"265-268"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are HRP2/3 deletions silently crippling malaria rapid diagnostic tests?","authors":"Sreedevi S R, Ramesh Holla, Mithun Rao, Bhaskaran Unnikrishnan, Shrinivasa B M, Vani H Chalageri","doi":"10.25259/IJMR_2856_2025","DOIUrl":"10.25259/IJMR_2856_2025","url":null,"abstract":"<p><p>Background and objectives The gold standard for diagnosing malaria is peripheral smear. Histidine-rich protein 2 (HRP2)-based rapid diagnostic tests (RDTs) are particularly used for P. falciparum (pf) infections. These tests are easily accessible and are simple to use. The rising incidence of pfhrp2 and pfhrp3 gene deletions has put malaria diagnostics through RDT kit at risk, leading to false-negative results that may affect patient management. Methods The search string used was: 'pfhrp2' OR 'pfhrp3' OR 'HRP2' OR 'HRP3' OR 'hrp2/3' AND 'malaria' OR 'Plasmodium falciparum' AND deletion OR 'deletion rate' OR prevalence OR 'RDT failure'. A total of 148 studies were gathered from PubMed and Google scholar. After screening, a total of 28 published studies and the WHO documents were included. Results High rates of gene deletion have been reported, ranging from 2.4 to 57.8%, with low range in Chhattisgarh, India (3.8%) and Brazil (∼18.3% dual deletions), to extreme levels in Southern Ethiopia (57.8%). These deletions are believed to be the result due to the widespread use of HRP2-based RDTs. The diagnostic performance of RDTs considerably declines in regions where the WHO-recommended 5% threshold for deletion prevalence is exceeded. Surveillance techniques like PCR, whole-genome sequencing, and digital droplet PCR (ddPCR) are needed for effective detection and monitoring in these regions. Interpretation and conclusions The widespread and regional variation of pfhrp 2/3 gene deletions stance a serious challenge to malaria diagnosis using HRP-based RDTs. Alternatives to HRP-based tests in high-deletion areas and adopting novel diagnostic tools are essential for effective malaria detection and elimination strategies.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"163 3","pages":"295-303"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of chronic pain in the general population: A systematic review and meta-analysis.","authors":"Ashok Kumar Saxena, Neha Singh, Geetanjali T Chilkoti, Michell Gulabani, Rajeev Kumar Malhotra","doi":"10.25259/IJMR_1935_2025","DOIUrl":"10.25259/IJMR_1935_2025","url":null,"abstract":"<p><p>Background and objectives Chronic pain represents a significant health concern affecting a large segment of society. To date, no systematic review and meta-analysis has evaluated the prevalence of chronic pain in the general population aged 18 to 95 years. The present study aimed to assess prevalence of chronic pain in this age group and examine its variation across age, sex, geographical regions, and psychosocial factors. Methods Cochrane Library, PubMed, and MEDLINE, were searched by combining combination of two categories of keywords (prevalence, chronic pain, epidemiology, population-based study, meta-analysis) in the general population till May 2024. Results A total of 52 studies with 2,89,490 participants were included to ascertain the global prevalence of six types of chronic pain: non-specific chronic pain, fibromyalgia, chronic lower back pain, chronic back pain, chronic widespread pain, and chronic musculoskeletal pain. The overall pooled random-effect prevalence percentage of chronic pain was 26.99%. The chronic pain prevalence percentage was significantly higher in those above 45 yr of age (46.7%), compared to 24.2% in those between 18-45 yr (P<0.001). The prevalence of chronic pain was higher in women as compared to men (31.42% vs. 21.63%) (P=0.07). Interpretation and conclusions The present global meta-analysis of chronic pain across the age group of 18-95 yr, observed a higher prevalence in women and in those alone 45 years of age. There was no geographical difference.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"163 3","pages":"355-370"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of vaso-occlusive crisis among sickle cell disease patients in India: A community-based multi-centric study.","authors":"Shaily B Surti, Shubhangi Patel, Yogita Sharma, Deepa Bhat, Parikipandla Sridevi, Jatin Sarmah, Madhusmita Bal, Manoranjan Ranjit, Rabindra Kumar Jena, Bontha V Babu","doi":"10.25259/IJMR_2879_2025","DOIUrl":"10.25259/IJMR_2879_2025","url":null,"abstract":"<p><p>Background and objectives Morbidity burden of sickle cell disease (SCD) in India has been underestimated till now due to a lack of nationwide data on the prevalence of clinical outcomes, including the most prevalent clinical manifestations like vaso-occlusive crises (VOCs). This multi-centric study reports the epidemiological characteristics of VOCs among SCD patients in India. Methods This is a prospective, community-based, multi-centre cohort study with fortnightly home visits conducted over 12 months in five SCD-endemic districts of India. A cohort of 252 patients was followed up, and data regarding any illness related to SCD and its management in the previous fortnight were collected using a structured questionnaire. Results Out of the total 252 SCD patients followed up, 223 (88.5%) patients reported 2118 crises in a year [8404 episodes per 1000 patients-year; 95% confidence interval (CI): 8040-8760]. Pain anywhere in the body was the most prevalent symptom [97.3% (n=217) of the participants, with 7 (3-13) median (IQR) episodes per patient in a year]. Among total crisis episodes, 48.7% (n=1031) of the episodes were treated at a health facility. Interpretation and conclusions A higher number of crisis episodes reported among the majority of the patients demystifies the notion that SCD is milder and less severe in India. The lower utilization of healthcare resources among SCD patients raises a serious concern.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"163 3","pages":"371-378"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smartboard for PowerPoint-based lectures in undergraduate paediatric education: A randomised controlled trial.","authors":"Nikita Diwan, Yashwant Kumar Rao, Tanu Midha, Anjoo Agarwal, Vimala Venkatesh, Anika Rao","doi":"10.25259/IJMR_2213_2025","DOIUrl":"10.25259/IJMR_2213_2025","url":null,"abstract":"<p><p>Background and objectives Interactive digital tools such as smartboards are increasingly being used in education, yet robust evidence from low- and middle-income countries (LMICs) is limited. This study compared Smartboard- and PowerPoint-based teaching in undergraduate paediatrics and assessed their impact on knowledge retention and learner engagement. Methods A single-centre, open-label, parallel-group randomised controlled trial was conducted among 360 MBBS students (second, third, and final years). Participants were stratified by academic year and baseline test scores, then randomly assigned to Smartboard or PowerPoint groups. Identical paediatric topics were taught using standardised lesson plans. The primary outcome was knowledge retention, assessed through objective structured clinical examinations (OSCEs) immediately, and at 1- and 2-month follow up. Secondary outcomes included student and faculty feedback. The trial was prospectively registered with the Clinical Trials Registry-India (CTRI/2025/04/083965). Results Immediate pooled OSCE performance was comparable (Smartboard: 47.2% Grade A vs. PowerPoint: 41.1%, P=0.29). At 1-month follow-up (primary outcome), Smartboard students achieved higher Grade A scores across all years combined (46.1% vs. 40.3%, P=0.028). Smartboard participants also showed superior retention at 2 months in third- (P=0.002) and final-year (P=0.049) cohorts. Students reported greater engagement (66.1% vs. 51.9%; absolute difference 14.2% points), attention (68.1% vs. 33.9%; difference 34.2% points), and recall (46.1% vs. 22.8%; difference 23.3% points). Faculty rated Smartboards higher for engagement (100% vs. 33.3%; difference 66.7% points), but preferred PowerPoint for ease of preparation (83.3% vs. 33.3%; difference 50.0% points). Interpretation and conclusions Smartboard-based teaching improved long-term knowledge retention, engagement, and attention compared with PowerPoint, particularly at 1 month and among senior students. Interactive digital tools may enhance learning outcomes in LMIC settings.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"163 3","pages":"334-340"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to cancer care in the Northeast region, India: A scoping review.","authors":"Redolen Rose Dhar, Reshmi Bhageerathy, Ramesh Holla","doi":"10.25259/IJMR_1714_2025","DOIUrl":"10.25259/IJMR_1714_2025","url":null,"abstract":"<p><p>Background and objectives Cancer is a major health issue globally, and in India's Northeast Region (NER), it is experiencing the highest incidence, particularly among rural and tribal communities. However, screening rates are low, awareness is limited, and access to care is challenged by isolation, poor infrastructure, financial constraints, and dependence on traditional medicine. To address these gaps, this scoping review aimed to synthesise evidence on the multidimensional barriers to cancer care in the NER, examine how socioeconomic, cultural, health system, logistical, and geographical factors influence care-seeking behaviour, and identify facilitators that could improve access to screening, diagnosis, and treatment. Methods A scoping review was conducted following the Arksey and O'Malley framework and reported in accordance with PRISMA-ScR guidelines. PubMed, Scopus, Web of Science, and EMBASE were searched for studies published from January 2010 to June 2025. Eligible studies that examined barriers or facilitators to cancer care in the 8 Northeastern States were thematically synthesised. Results Twelve studies were included; barriers were categorised into socioeconomic, health system, cultural, logistical, and geographical domains. Key issues included financial hardship, low health literacy, inadequate infrastructure, transport difficulties, and limited insurance coverage. Facilitators included family support, trust in community health workers, health education, outreach services, and financial incentives. Interpretation and conclusions Cancer care access in the NER is constrained by multidimensional barriers but supported by community and system- level facilitators. Decentralised services have expanded financial protection, and culturally tailored interventions are critical to strengthening cancer care in the region.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"163 3","pages":"345-354"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A community-based study of antibiotic consumption in an urban health training centre area of Ahmedabad city.","authors":"Rashmi Sharma, Parita Nisarg Patel, Nirmika Rutul Patel, Sanju Amrutlal Gajjar, Brijesh Punjabhai Patel, Aaryesh Chandegara, Nirav Kantilal Bapat","doi":"10.25259/IJMR_452_2025","DOIUrl":"10.25259/IJMR_452_2025","url":null,"abstract":"<p><p>Background and objectives The rise of antibiotic resistance is a global health crisis, and the irrational use of antibiotics is the major contributing factor. Therefore, it is essential to understand the antibiotic usage in the community to estimate the prevalence of antibiotic usage and its association with various co-variates and to evaluate the consumption pattern of antibiotic usage in the catchment areas of the Urban Health Training Centre of a medical college in Ahmedabad City. Methods An observational, community-based cross-sectional study was conducted in 3 phases during May-Aug 2024. Estimated sample size was 315 individuals who were ill anytime in last three months or consumed drugs and were selected from 15 clusters identified by cluster sampling method. Information was gathered on a structured questionnaire, and statistical parameters such as prevalence, prevalence ratios, confidence interval, and chi-square test were calculated in MS Excel. Results The screening of 2278 participants yielded 349 eligible participants as per inclusion criteria and 117 (33.5%) of them consumed 152 antibiotics during the previous three months. Sociodemographic determinates like age, sex and qualification of treatment provider showed significant association with antibiotic usage. Use of antibiotics was higher 55 (42.6%) in children than in adults 62 (28.1%). As per AWaRe classification (WHO), 3/4th of the participants (59.9%) consumed the watch group, more than half (50.4%) consumed the Access group and 2 (1.7%) consumed the Reserve group of antibiotics. Antibiotics are prescription only drugs, still in 37.5% of cases, antibiotics, even those from the Watch group, were obtained without a prescription. Interpretation and Conclusions Overall, a concerning trend of antibiotic use without prescriptions was witnessed, specifically in the 'Watch' category of antibiotics. It highlights the need for improved prescribing practices and public education to prevent misuse of antibiotics.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"163 3","pages":"327-333"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}