Indian Journal of Medical Research最新文献

{"title":"Thiazide diuretics use & risk of falls & syncope among hypertensives: A retrospective cohort study.","authors":"M Yogesh, Mohil Karangia, Jay Nagda, Freya Kankhara, Parth Anilbhai Parmar, Nandan Shah","doi":"10.25259/IJMR_638_2024","DOIUrl":"10.25259/IJMR_638_2024","url":null,"abstract":"<p><p>Background & Objectives Although thiazide diuretics are frequently used to treat hypertension, they may also raise the risk of syncope and falls. The purpose of this study was to look at the relationship between hypertension individuals' use of thiazide diuretics and falls or syncope. Methods This retrospective cohort study, conducted between March 2019 and March 2024, included 236 individuals with hypertension taking thiazides and 236 controls not taking thiazides. Data from electronic medical records were extracted, including demographic, clinical, laboratory, and outcome data. The main outcome was the occurrence of syncope episodes or falls. Logistic regression analyses examined associations between various factors and falls/syncope risk. Results The study included 236 study participants taking thiazides (118 men, 118 women) and 236 controls not taking thiazides (118 men, 118 women). Study participants taking thiazides had a higher prevalence of hyponatremia (57 study participants, 24.1% vs. 31 study participants, 13.1%), hypokalaemia (52 study participants, 22% vs. 32 study participants, 13.6%), hypercalcemia (37 study participants, 15.7% vs. 17 study participants, 7.2%), metabolic alkalosis (89 study participants, 37.7% vs. 52 study participants, 22%), acute kidney injury (59 study participants, 25% vs. 30 study participants, 12.7%), and chronic kidney disease (89 study participants, 37.7% vs. 59 study participants, 25%) compared to controls (all P<0.05). The prevalence of falls/syncope events was significantly higher in the thiazide group (76 study participants, 32.2%) compared to the non-thiazide group (46 study participants, 19.5%), with a P value of 0.002. Multivariate analysis showed increased falls/syncope risk with age [adjusted odds ratio (AOR)=1.38], congestive heart failure (AOR=2.12), longer thiazide duration (AOR=1.21), hyponatremia (AOR=1.68), hypokalaemia (AOR=1.72), metabolic alkalosis (AOR=1.68), acute kidney injury (AOR=1.85), and decreased eGFR (AOR=1.22 per 10 ml/min/1.73m2 decrease). Interpretation & Conclusion Thiazide diuretic use in hypertensive patients is related to syncope, potentially mediated by electrolyte disturbances and renal impairment. These results highlight the importance of careful monitoring and individualized treatment approaches when prescribing thiazide diuretics to hypertensive patients.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 1","pages":"99-106"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556774","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":"Expanding the women's health paradigm beyond reproductive boundaries.","authors":"Hrishikesh Munshi, Tabassum Khan, Sandhya Anand, Rahul Gajbhiye","doi":"10.25259/IJMR_1428_2024","DOIUrl":"10.25259/IJMR_1428_2024","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 1","pages":"38-42"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556671","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":"Leveraging artificial intelligence to promote COVID-19 appropriate behaviour in a healthcare institution from north India: A feasibility study.","authors":"Madhur Verma, Moonis Mirza, Karan Sayal, Sukesh Shenoy, Soumya Swaroop Sahoo, Anil Goel, Rakesh Kakkar","doi":"10.25259/IJMR_337_2024","DOIUrl":"10.25259/IJMR_337_2024","url":null,"abstract":"<p><p>Background & Objectives Non-pharmacological interventions (NPI) were crucial in curbing the initial COVID-19 pandemic waves, but compliance was difficult. The primary aim of this study was to assess the changes in compliance with NPIs in healthcare settings using Artificial intelligence (AI) and examine the barriers and facilitators of using AI systems in healthcare. Methods A pre-post-intervention study was conducted in a north-Indian hospital between April and July 2022. YOLO-V5 and 3D Cartesian distance algorithm-based AI modules were used to ascertain compliance through several parameters like confidence threshold, intersection-over-union threshold, image size, distance threshold (6 feet), and 3D Euclidean Distance estimation. Validation was done by evaluating model performance on a labelled test dataset, and accuracy was 91.3 per cent. Interventions included daily sensitization and health education for the hospital staff and visitors, display of information, education and communication (IEC) materials, and administrative surveillance. In-depth interviews were conducted with the stakeholders to assess the feasibility issues. Flagged events during the three phases were compared using One-way ANOVA tests in SPSS. Results Higher social distancing (SD) compliance events were flagged by the module in the intervention phase compared to the pre-intervention and post-intervention phases (P<0.05). Mask non-compliance was significantly lower (P <0.05) in the pre-intervention phase and highest in the post-intervention phase, with varied differences between different intervention phases in the registration hall and medicine out-patient department (OPD). The modules' data safety, transfer, and cost were the most common concerns. Interpretation & conclusions AI can supplement our efforts against the pandemic and offer indispensable help with minimal feasibility issues that can be resolved through adequate sensitization and training.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 1","pages":"81-90"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556765","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":"Guiding therapy by fractional exhaled nitric oxide & impulse oscillometry parameters in non-asthmatic individuals with chronic cough.","authors":"Hong Duan, Yan Xiong, Shuguang Xiong, Qing Zhou","doi":"10.25259/IJMR_307_2024","DOIUrl":"10.25259/IJMR_307_2024","url":null,"abstract":"<p><p>Background & objectives Chronic airway inflammation and airway hyperresponsiveness are typical pathophysiological features of cough variant asthma. However, the characteristics of airway inflammation and airflow restriction in individuals with non-asthmatic chronic cough and their guiding value of clinical treatment remain to be determined. This study explored the characteristics and correlations between fractional exhaled nitric oxide (FeNO) and impulse oscillometry (IOS) in non-asthmatic individuals with chronic cough. It also investigated the possibility of chronic cough developing into asthma. Methods In total, 65 study participants with negative bronchial provocation test (BPT) were included in this retrospective study. Data were extracted from chronic cough patients' electronic medical records, including the demographics, FeNO, IOS and spirometric parameters before and after BPT. Study participants were divided into high-FeNO group (FeNO≥25 ppb) and low-FeNO group (FeNO< 25 ppb) based on FeNO levels. The correlation between the markers was investigated using the Spearman rank correlation test. Results We observed that individuals with non-asthmatic chronic cough exhibited significant increases in Z5, Fres, R5 and R5-R20 after BPT compared to before BPT. In addition, the IOS values of Z5, Fres, R5, and Rc were higher in the low-FeNO group than in the high-FeNO group, but a decrease in FEV1. Correlation analysis: IOS parameters showed a negative correlation with FeNO. However, there were positive correlations of FeNO with FEV1 and PEF. Interpretation & conclusions Our findings showed that individuals with non-asthmatic chronic cough may have varying levels of small airway resistance and inflammation severity. A combined use of FeNO and IOS measurements is conducive to the early clinical treatment of individuals with non-asthmatic chronic cough.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 1","pages":"65-71"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556675","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":"Lung cancer screening in India: Preparing for the future using smart tools & biomarkers to identify highest risk individuals.","authors":"Nithya Ramnath, Prasanth Ganesan, Prasanth Penumadu, Douglas Arenberg, Alex Bryant","doi":"10.25259/ijmr_118_24","DOIUrl":"10.25259/ijmr_118_24","url":null,"abstract":"<p><p>There is a growing burden of lung cancer cases in India, incidence projected to increase from 63,708 cases (2015) to 81,219 cases (2025). The increasing numbers are attributed to smoking (India currently has nearly 100 million adult smokers) and environmental pollution. Most patients present with advanced disease (80-85% are incurable), causing nearly 60,000 annual deaths from lung cancer. Early detection through lung cancer screening (LCS) can result in curative therapies for earlier stages of lung cancer and improved survival. Annual low-dose computerized tomography (LDCT) is the standard method for LCS. Usually, high-risk populations (age>50 yr and >20 pack-years of smoking) are considered for LCS, but even such focused screening may be challenging in resource-limited countries like India. However, developing a smart LCS programme with high yield may be possible by leveraging demographic and genomic data, use of smart tools, and judicious use of blood-based biomarkers. Developing this model over the next several years will facilitate a structured cancer screening programme for populations at the highest risk of lung cancer. In this paper, we discuss the demographics of lung cancer in India and its relation to smoking patterns. Further, we elaborate on the potential applications and challenges of bringing a smart approach to LCS in high-risk populations in India.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"561-569"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364571","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":"Beyond Biryani: The Making of a Globalized Hyderabad.","authors":"Lalit Kant","doi":"10.25259/IJMR_2167_2024","DOIUrl":"10.25259/IJMR_2167_2024","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"639-641"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364451","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":"Deviations of prescriptions from standard guidelines.","authors":"Bhalchandra T Rane, Abhijeet V Tilak, Suresh V Dange, Sharvari Chimaso Kate Bhosale","doi":"10.25259/IJMR_930_2024","DOIUrl":"10.25259/IJMR_930_2024","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"637"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364509","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":"Authors' response.","authors":"Yashashri Shetty, Sandhya Kamat, Raakhi Tripathi, Urwashi Parmar, Ratinder Jhaj, Aditya Banerjee, Sadasivam Balakrishnan, Niyati Trivedi, Janki Chauhan, Preeta Kaur Chugh, C D Tripathi, Dinesh Kumar Badyal, Lydia Solomon, Sandeep Kaushal, Kanchan Gupta, M Jayanthi, G Jeevitha, Suparna Chatterjee, Kalyan Samanta, Chetna Desai, Samidh Shah, Bikash Medhi, Rupa Joshi, Ajay Prakash, Pooja Gupta, Atanu Roy, Sujith Chandy, Jaya Ranjalkar, Heber Rew Bright, Harihar Dikshit, Hitesh Mishra, Sukalyan Saha Roy, Nilima Kshirsagar","doi":"10.25259/IJMR_2113_2024","DOIUrl":"10.25259/IJMR_2113_2024","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"637-638"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364499","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":"Molecular epidemiology of human papillomavirus variants in cervical cancer in India.","authors":"Nita Sharma, Harish Changotra, Manpreet Kaur","doi":"10.25259/ijmr_212_24","DOIUrl":"10.25259/ijmr_212_24","url":null,"abstract":"<p><p>Background & objectives Cervical cancer (CC) has been documented as the fourth most common cancer worldwide. Persistent infections with high-risk human papillomavirus (hr-HPV) have been suggested in the development of CC. Although prophylactic vaccines are available for the prevention of prevalent hr-HPV types, intra-type variations exist within a particular HPV type that has varying oncogenic potential as well as the mechanism of pathogenicity and varying neutralization by antibodies. Therefore, we carried out a systematic review to determine the distribution of HPV intra-typic variations in different geographical locations of India and their reported implications. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed to retrieve relevant articles from the standard databases using appropriate keywords. Consequently, 17 articles were included in the current review after screening based on inclusion and exclusion criteria. Results The majority of articles included in this review reported variations within the HPV16 E6 gene, followed by the L1 and E7 genes. Analysis of available data indicated the differential regional distribution of some variations. These variations have also been reported to impact the biological functions of various viral proteins. Interpretation & conclusions The distribution of lineages varied with the different genomic regions sequenced. Additionally, there were certain unique and common variations in the HPV genome with respect to geographical regions. Hence, we suggest the identification of region-specific variations for the development of diagnostic and prognostic interventions.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"531-551"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364573","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":"Wastewater-based genomic surveillance of SARS-CoV-2 in vulnerable communities in Mumbai.","authors":"Pratibha Prakash Kadam, Tejal Mestry, Nerges Mistry, Kayzad Soli Nilgiriwala","doi":"10.25259/ijmr_299_24","DOIUrl":"10.25259/ijmr_299_24","url":null,"abstract":"<p><p>Background & objectives The global impact of COVID-19, with over 45 million cases and 533,300 deaths in India alone, necessitates effective surveillance methods. Traditional approaches face challenges in detecting pre-symptomatic and asymptomatic cases, prompting the exploration of wastewater-based epidemiology (WBE). This study focuses on Mumbai's vulnerable slums, aiming to assess the potential of WBE as an alternative surveillance method. Methods Genomic surveillance of SARS-CoV-2 was conducted in Mumbai's vulnerable settings (slums) for 11 months (August 2022 to June 2023). Wastewater samples from open drains and sewage treatment plants were correlated with reported COVID-19 cases in the city. Early detection of emerging viral variants and seasonal variations in viral load were explored. Results Correlations were identified between wastewater samples and reported COVID-19 cases in Mumbai's vulnerable slums, with early detection occurring three weeks before clinical diagnoses, underscoring the potential utility of WBE. Genomic sequencing provided insights into the viral variants, identifying shifts in predominant variants. Seasonal variations showed higher viral concentrations in summer and monsoon, potentially associated with accelerated droplet evaporation in early summer and droplet-based transmission during mid-summer and monsoon. Interpretation & conclusions Wastewater-based epidemiology emerges as a cost-effective and rapid early warning system, providing crucial insights into virus behaviour and evolution. Particularly significant for countries like India, WBE aids in outbreak monitoring and targeted interventions. The global integration of wastewater surveillance emphasizes its importance in comprehensive pandemic monitoring, establishing it as an integral component of public health strategies worldwide.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"570-577"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364590","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}