Indian Journal of Medical Research最新文献

{"title":"Risk factors for readmission of COVID-19 ICU survivors: A three-year follow up.","authors":"Estrela Caamaño, Laura Velasco Rodrigo, Sergio Garcia-Ramos, Alberto Calvo Garcia, Silvia Ramos Cerro, Mercedes Power, Jose Manuel Asencio, Patricia Piñeiro, Javier Hortal, Ignacio Garutti","doi":"10.25259/IJMR_726_2024","DOIUrl":"https://doi.org/10.25259/IJMR_726_2024","url":null,"abstract":"<p><p>Background & objectives Evidence suggests that individuals who have been hospitalised due to COVID-19 are more susceptible to future mortality and readmission, thereby imposing a substantial strain on their quality of life. The available data on intensive care unit (ICU) survivors, particularly in terms of long-term outcomes, is notably insufficient. This study focused on the long-term outcomes for ICU survivors of COVID-19, specifically readmission and mortality, as well as possible risk factors that could lead to their need for readmission. Methods We conducted a prospective observational study of 505 individuals admitted to the ICU of a tertiary care hospital between March 2020 and March 2021. Follow up concluded in January 2024. We evaluated the need for hospital and ICU readmissions, examining potential risk factors, including patient comorbidities, clinical situation at the time of the previous hospital and ICU admission, and evolution and treatment in the ICU. As a secondary objective, we determined the prevalence of long-term mortality. Results Among 341 ICU survivors, 75 (22%) required hospital readmission, with a median time to readmission of 415 days (IQR: 166-797). The most frequent cause of readmission was respiratory conditions (29.3%). The median hospital stay during readmission was six days. Independent risk factors for hospital readmission included age, elevated creatinine levels at ICU admission, and length of stay in the ICU. Of the 75 readmitted to the hospital, 19 required ICU readmission. Ten individuals died following hospital discharge. Interpretation & conclusions Patients requiring ICU admission due to COVID-19 have a significant risk of hospital readmission, particularly those with advanced age, elevated creatinine levels at ICU admission, and longer ICU stays.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 2","pages":"190-198"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993985","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":"Effect of structured counselling on postpartum contraceptive acceptance: A cluster randomized controlled trial, Puducherry.","authors":"Susmitha P S, Venkatachalam Jayaseelan, Vignesh Rajan, Murali Subbaiah, Khadeeja Nasreen V P, Anandalakshmi V","doi":"10.25259/IJMR_887_2024","DOIUrl":"https://doi.org/10.25259/IJMR_887_2024","url":null,"abstract":"<p><p>Background & objectives As per District Level Household Survey-III, there are 44 million people with unmet contraceptive needs in India. Contraception uptake in postpartum is around 17 per cent within six months and 33 per cent within six to 12 months post-delivery. Through our study, we aimed to access the effectiveness of a structured counselling session on acceptance of postpartum contraception within six wk after delivery among third-trimester pregnant women in Puducherry. Methods A randomised controlled trial was conducted among 236 third-trimester antenatal women receiving care from four selected primary health centres in Puducherry between March 2023 and February 2024. Antenatal women undergoing intervention received a structured counselling session with audio-visual aid along with a health education booklet & controls received standard care. They were followed up six wk postpartum. The chi-square test was used to compare the effectiveness of intervention, and P<0.05 was considered significant. Relative risk with a 95 per cent confidence interval was calculated to measure the strength of association. Results Among 221 (93.6%) participants who completed the study, 78 (66.7%) out of 117 in the intervention arm and 25 (21%) out of 119 in the control arm accepted any contraceptive method at six wk postpartum. The contraceptive acceptance was significantly higher in the intervention arm, with a three-fold increase compared to the control arm [RR: 3.21 95% confidence interval (CI): 2.22-4.61; P<0.001]. Additionally, there was a significant improvement in knowledge levels among mothers in the intervention group. Interpretation & conclusions The findings demonstrate that the structured counselling sessions with audiovisual aids and educational materials enhanced postpartum contraceptive uptake and improved knowledge levels among mothers. Our intervention has the potential for broader implementation in routine maternal health services and would improve postpartum contraceptive acceptance at the national level.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 2","pages":"134-141"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965109","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":"Cancer prevention through lifestyle modification.","authors":"Devi Nandakumar, Ruhi Dixit, Manoj Pandey","doi":"10.25259/IJMR_405_2025","DOIUrl":"https://doi.org/10.25259/IJMR_405_2025","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 2","pages":"109-111"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003637","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":"Leprosy research updates: Shaping the future of global health.","authors":"Patricia Duarte Deps, Indira Kahawita, Rie Yotsu, Saba M Lambert","doi":"10.25259/IJMR_195_2025","DOIUrl":"https://doi.org/10.25259/IJMR_195_2025","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 2","pages":"120-124"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020011","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":"The desat-max in 2-chair test appears to be a worthwhile parameter to identify sickness: An appraisal.","authors":"Parthasarathi Bhattacharyya, Wrick Chakraborty, Mintu Paul, Sayoni Sengupta, Dipanjan Saha","doi":"10.25259/IJMR_952_2024","DOIUrl":"https://doi.org/10.25259/IJMR_952_2024","url":null,"abstract":"<p><p>Background & objectives The 2-chair test (2CT) has recently been proposed as a cardiopulmonary reserve-specific assessment of post-exercise recovery response. The objective of this study was to find out the most appropriate parameter of 2CT to categorically differentiate between 'normal' and symptomatic diseased population. Methods In a prospective manner, we recruited a random cohort of symptomatic patients attending our outpatient department (OPD) with different respiratory diseases. We also selected another cohort of 'normal' persons from the willing attendants of the patients who had no symptoms and revealed no abnormality on chest X-ray and spirometry. Persons belonging to both groups were requested to mark their 'sickness' on a scale of 0 to 10 ('0' meaning none and '10' meaning maximum possible) under the PPSS (patient-perceived sickness score) and were subjected to perform 2CT. All the test variables related to pulse rate and peripheral capillary oxygen saturation (SpO2) changes were noted for both groups. The 'symptomatic' and 'normal' persons were compared based on the 2CT variables to find the well-performing discriminatory parameter. Results The comparison of 2CT variables of 419 patients and 30 'normal' controls revealed that the PR change max, maximum SpO2, minimum-SpO2, and desat-max can significantly differentiate between the two. However, the desat-max correlated to the PPSS best. The VIP plot, primary component analysis, and pattern-hunter representation further substantiated this. Interpretation & conclusions The desat-max appears to be a sensitive parameter to differentiate the normal from the symptomatic diseased population. Further research in this area is warranted.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 2","pages":"174-181"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013091","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":"Faecal microbiota transplantation for recurrent Clostridiodes difficile infection & its global regulatory landscape.","authors":"Isha Deepti, Bijaya Chettri, Anjali Mehra, Ann Merin Pinheiro, Ramya Ravi","doi":"10.25259/IJMR_818_2024","DOIUrl":"https://doi.org/10.25259/IJMR_818_2024","url":null,"abstract":"<p><p>For recurrent Clostridioides difficile infection (rCDI), faecal microbiota transplantation (FMT) is a known and useful treatment that involves introducing faeces from a healthy individual into the digestive tract of a diseased person. Clostridioides difficile is a substantial global health burden due to its high death rate in elderly populations and its ability to produce colitis and diarrhoea. Despite being used since millennia, FMT has recently become more well-known and two FMT products, namely Vowst and Rebyota also received FDA approval. Different nations address regulation in different ways. For instance, FMT is regulated as a drug in the US but is classified as a medicinal product in the UK. The regulatory frameworks among various European countries also vary; a working group, citing FMT as a transplant product, has requested for complete regulation. There are other classifications as well; in Australia, FMT is categorised as a biologic by the Therapeutic Goods Administration. Research indicates that FMT is beneficial in various illnesses, apart from CDI, due to its impact on the gut flora. Challenges include insufficient FMT product characterisation, ethical concerns, and limited hospital accessibility. There are still issues with data accessibility, security, and privacy, especially considering FMT's commercialisation. The official FMT recommendation for recurrent CDI is emphasised from the perspective of public health, with the argument that early implementation could limit antibiotic overuse and prevent antibiotic resistance. Initiatives like the Universal Stool Bank concept aim to streamline donor selection and distribution procedures to minimise operational restrictions.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 2","pages":"113-119"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006323","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":"Caesarean section delivery & determining factors in northeastern State, India: A Bayesian spatio-temporal analysis of areal data.","authors":"Kh Jitenkumar Singh, Krishna Kumar, Deboshree Das, Nongzaimayum Tawfeeq Alee, Md Asif Khan, Saurabh Sharma, Jeetendra Yadav, Nirendra Singh Haobijam, Ravleen Kaur Bakshi","doi":"10.25259/IJMR_1057_2024","DOIUrl":"https://doi.org/10.25259/IJMR_1057_2024","url":null,"abstract":"<p><p>Background & objectives Caesarean Section (CS) is a crucial life-saving surgical procedure for maternal delivery when normal delivery is ruled out for the safety of mother and infant. This study investigated the spatio-temporal pattern of CS rates to assess the significant factors boosting this delivery in the northeastern States of India. Methods We analysed cross-sectional data from three rounds of the National Family Health Survey (NFHS 3, NFHS 4, and NFHS 5). We estimated the relative risk (RR) of CS delivery and assessed the global and local spatial autocorrelation for each year from 2011 to 2019. Furthermore, the posterior median RR with credible interval was estimated using Bayesian Spatio-temporal modelling with Markov Chain Monte Carlo simulation. Results The CS rates in the northeastern States have escalated by nearly 15 per cent over the last two decades, from 5.4 per cent in 2001 to 19.9 per cent in 2019. Furthermore, we observed a substantial increase in the high-high Local Indicator of Spatial Analysis clusters from 2011 to 2019. The estimated posterior median RR exceeded one for four significant predictors: maternal age, maternal education, obesity, and household wealth status. This analysis also revealed that the estimated spatio-temporal trend displayed a clear upward trend in CS risk during the nine-year study period. Interpretation & conclusions This study found a substantial increase in CS delivery rate over the nine-year period (2011 to 2019) in the northeastern States of India. The findings of the study provide important policy input for strengthening healthcare intervention and regulations by initiating targeted programmes to monitor and avert excessive use of CS facilities in districts with high CS delivery.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 2","pages":"159-166"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993981","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":"Gene polymorphism Mu opioid receptor & its impact on naltrexone treatment response in alcohol-dependent individuals: A pilot study from north India.","authors":"Rizwana Quraishi, Ram Kumar, Siddharth Sarkar, Ravindra Rao, Atul Ambekar","doi":"10.25259/IJMR_141_2024","DOIUrl":"https://doi.org/10.25259/IJMR_141_2024","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 2","pages":"199-201"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965468","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":"Assessment of the suitability of the dried blood spot (DBS) samples for detection of Treponemal antibodies using in vitro assays.","authors":"Sangeeta Kulkarni, Varsha Kale, Pallavi Vidhate, Suvarna Sane, Sumathi Muralidhar, Rohit Chawla, Bhaswati Bandopadhyay, Sandhya Sawant, Pramod Deoraj, Sachin Jadhav, Hemant Bhosale, Sandip Shirsath, Priyanka Jagtap, Mayuri Borate, Shivali Kamal, Smita Mishra, Bhawna Rao, Abdul Arif Khan, Arati Mane, Madhuri Thakar","doi":"10.25259/IJMR_1195_2024","DOIUrl":"https://doi.org/10.25259/IJMR_1195_2024","url":null,"abstract":"<p><p>Background & objectives This study was performed to assess the suitability of dried blood spot (DBS) samples for the serological screening of syphilis. Methods Two hundred paired DBS and plasma samples collected from six sexually transmitted infection (STI) clinics during the year 2023 were tested using three kits -Treponema pallidum haemagglutination assay (TPHA), Syphilis Total Ab and ErbaLisa Syphilis after standardization of the dilutions of the DBS elutes and considering the results of the paired plasma samples as a true status. Results The TPHA showed 89 per cent sensitivity and 100 per cent specificity, the EIA-Syphilis Total Ab. Kit showed 100 per cent sensitivity and 97 per cent specificity, whereas ErbaLisa syphilis showed 89 per cent sensitivity and 100 per cent specificity. However, one kit Syphilis ELISA (Oscar Medicare Pvt. Ltd., New Delhi) did not show agreement with the paired plasma samples at any dilution and was not considered suitable for the testing of DBS samples. The agreement between the plasma and DBS results was found to range from 94.5 to 98.5 per cent with a kappa agreement score of 0.89 for TPHA, ErbaLisa, and 0.97 for ELISA-Syphilis Total Ab. Interpretation & conclusions The findings of this study confirmed that the DBS samples can be used for the detection of anti-treponemal antibodies using the above-validated kits and thus may be a valuable tool in surveillance and epidemiological surveys conducted in India. The study also highlighted the need for validation of any plasma/serum syphilis antibody detection assay on DBS samples before using it on DBS samples.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 2","pages":"152-158"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012729","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":"Challenges in medicine procurement through GeM in a tertiary care hospital in northeast India.","authors":"Anuj Vashisht, Jithesh Vishwanathan, Shruti Vashisht, Chetan Sood, Puneet Sarin, K Rahul Ray","doi":"10.25259/IJMR_944_2024","DOIUrl":"10.25259/IJMR_944_2024","url":null,"abstract":"<p><p>Background & objectives The procurement of medical items (drugs and consumables) through the Government e-marketplace (GeM) is a recent initiative. This study aimed to comprehensively assess the bottlenecks, procedural pitfalls, and delays impacting the supply chain in the procurement process of a tertiary care hospital in northeast India. Methods A retrospective analysis was conducted on the procurement data obtained from the hospital's procurement cell over 12 months. The study primarily focused on the total demand for medicines and consumables through the e-portal and compared it with the actual quantity/quality received by healthcare facilities. Results The initial demand was placed for 1507 medicines and 1219 medical consumables. However, the healthcare facility received only 695 (46.1%) medicines and 945 (77.5%) consumables. Major bottlenecks identified were non-quotation of medicines, price negotiation rejections, and vendor failure to supply. Interpretation & conclusions This study identifies a few bottlenecks: non-quotation by vendors, price negotiation rejections and failure to supply medicines and consumables by the vendors in procurement through the GeM. Efforts like flexibility in matching previous purchase rates, International Organisation for Standardisation/World Health Organization (ISO/WHO) qualified vendor base at the GeM level and porting in reliable pharmaceutical companies must be directed towards optimising procurement processes and enhancing supply chain management to bridge the identified gaps and promote seamless healthcare delivery.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"161 1","pages":"32-37"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556658","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}