Indian Journal of Medical Research最新文献

{"title":"Global strategies for preventing type 2 diabetes: A public health perspective.","authors":"Joseph M Pappachan, Ambika P Ashraf","doi":"10.25259/IJMR_1617_2024","DOIUrl":"10.25259/IJMR_1617_2024","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 5","pages":"391-395"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906955","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 expression & biochemical analysis in alkaptonuria caused by a founder pathogenic variant across different age groups from India.","authors":"Suneetha Susan Cleave Abraham, Anitha Barney, Sony Mohan, Praisy Joy, Paramasivam Ganesan, Sweta Das, Cleetus Cherupanakkal, Arun Jose, Rekha A, Andrea Zatkova, Sumita Danda","doi":"10.25259/ijmr_1900_23","DOIUrl":"10.25259/ijmr_1900_23","url":null,"abstract":"<p><p>Background & objectives Alkaptonuria (AKU) is an autosomal recessive disease wherein biallelic pathogenic variants in the homogentisate 1,2- dioxygenase (HGD) gene encoding the enzyme homogentisate 1,2 dioxygenase cause high levels of homogentisic acid (HGA) to circulate within the body leading to its deposition in connective tissues and excretion in urine. A homozygous splice donor variant (c.87+1G>A) has been identified to be the founder variant causing alkaptonuria among Narikuravars, a group of gypsies settled in Tamil Nadu. Methods Blood and urine samples of 30 homozygous splice site donor variant individuals (2 groups aged 7-20 and 21-83 yr, with 9 and 21 individuals, respectively), carriers and 30 wild-type individuals from the Narikuravars were collected during field visits after obtaining informed consent. Clinical evaluation and genetic counselling were done. The plasma and urine HGA levels were estimated by high-performance liquid chromatography. RNA was extracted from the peripheral blood and reverse transcribed. Sanger sequencing was done to check the consequence of the splice donor variant. Relative quantification of the cDNA in the three groups was done by real-time qPCR (RT-qPCR) studies using reference genes followed by Pearson's correlation analysis. Results In our cohort, among the affected alkaptonuria individuals, the minimum age for eye pigmentation detected was 23 yr. Similarly, the minimum age for back pain and any joint pain was 30 yr and 38 yr, respectively. Sequencing of the cDNA confirmed exon 2 skipping in affected individuals. In comparison to the normal individuals, the affected individuals showed reduced HGD expression. HGD relative expression showed a significant correlation (P<0.05) with mean plasma HGA levels in the younger (≤22 yr) age group but not in the older one. There was also a significant correlation (P<0.05) of reduced HGD expression with back pain in the 21-37 yr age group. Increasing age showed a positive correlation with circulating mean plasma HGA levels and a negative correlation with excreted HGA. Interpretation & conclusions As per the authors' knowledge, this is the first study to confirm the functional effect by RT-PCR of this highly prevalent founder HGD variant causing alkaptonuria in the Narikuravar community. Both plasma and urinary HGA levels correlated well with the gene expression of this variant and could serve as potential markers of AKU severity for those with this variant.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 5","pages":"448-456"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906931","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":"Synergizing medical education & health services in India: A 'boon-to-be' with constitutional amendment.","authors":"Rakesh Chander Kalaivanan, Yogender Malik, Suresh Bada Math","doi":"10.25259/IJMR_350_2024","DOIUrl":"10.25259/IJMR_350_2024","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 5","pages":"407-409"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907057","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":"Essential programme on immunization in WHO South-East Asia: A five-decade journey of saving millions of lives & ending diseases.","authors":"Vinod Kumar Bura, Rahul Srivastava, Anil Kumar Chawla, Tondo Opute Emmanuel Njambe, Sudhir Khanal, Lucky Sangal, Shreya Jha, Sunil Bahl","doi":"10.25259/IJMR_1527_2024","DOIUrl":"10.25259/IJMR_1527_2024","url":null,"abstract":"<p><p>Vaccination is one of the most successful and cost-effective interventions designed by science which has helped in preventing millions of deaths, especially in children. The Expanded Programme on Immunization (EPI) was established by World Health Organization (WHO) in 1974 to develop immunization programmes throughout the world with polio, measles, diphtheria, tetanus, tuberculosis and whooping cough. The WHO South-East Asia Region (SEAR) has a disproportionately high burden of infectious diseases and has greatly benefitted from the EPI as compared to other regions with more than 90 per cent of the population having access to vaccines. The story of vaccines in South-East Asia is a testament to scientific progress, global collaboration, and unwavering commitment to public health. This article aims to discuss the journey of EPI in the WHO SEAR.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"267-278"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779914","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":"Adult vaccination in India: A rapid review of current status & implementation challenges.","authors":"Arunaloke Bhattacharyya, Sheikh Mohammed Shahabuddin","doi":"10.25259/IJMR_1521_2024","DOIUrl":"10.25259/IJMR_1521_2024","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Background & objectives The expanded programme on immunization launched in India in 1978, with its focus on preventing six diseases in children (tetanus, diphtheria, pertussis, poliomyelitis, typhoid, and childhood tuberculosis), was widened in its scope in 1985-86. This new avtaar, the Universal Immunization Programme (UIP), incorporated measles vaccine for children and rubella and adult diphtheria vaccines for pregnant women. We conducted this rapid review on adult immunization relevant for India, as recent COVID-19 experience revealed how newly emergent or re-emergent pathogens could have their onslaughts on the elderly and adults with comorbidities. Methods Three different bibliographic databases, namely PubMed, Scopus and Ovid were searched electronically to access the articles published in peer-reviewed journals. Relevant consensus guidelines by in-country professional groups were also collated. We conducted deduplication and screening of the outputs of these searches (1242 bibliographical records). Finally, 250 articles were found eligible for inclusion. As trials on the reduction of morbidities, mortalities and hospitalizations in adults due to proposed vaccines under Indian consensus guidelines were not available, no meta-analysis was conducted. Results Evidence from articles finally included in this synthesis were grouped under (i) preventing viral and bacterial infections in adults; (ii) adult vaccination and awareness tools; (iii) vaccine hesitancy/acceptance; and (iv) adult vaccination guidelines. In-country research revealed the need for introducing the Human Papilloma Virus (HPV) vaccine in adolescence or early-adulthood to prevent ano-genital cancers in elderly and later life. Importantly HPV prevalence among cervical cancer patients varied between 88 to 98 per cent in Andhra Pradesh, Odisha and Delhi. The importance of conducting regular surveillance of pneumococcal diseases and influenza, as well as tweaking the vaccines accordingly, was revealed in other articles. A poor uptake of influenza vaccine (≤2%) in adults (≥45 yr) was documented. The uptake of hepatitis B vaccine in Health Care Workers (HCWs) in Delhi and Mumbai was of concern and ranged from 55 to 64 per cent. The vulnerability of HCWs to rubella was investigated in a paediatric ophthalmic hospital in Madurai: a tenth of the selected HCWs were rubella seronegative and mounted good protective immunity following RA 27/3 vaccine administration. An outbreak of measles in college students in Pune emphasized the phenomenon of waning immunity. Similarly, a study in the infectious disease hospital in Kolkata and in-patients in Delhi revealed a lack of protective immunity against diphtheria and tetanus in adults. The researchers estimated the economic benefits of providing a typhoid vaccine to a household to be US$ 23 in a middle-income neighbourhood and US$ 14 in slum settings. The authors highlighted the importance of preventive strategies, finding that the cost of sev","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"279-292"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779212","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":"Vaccine, vaccination & personal decision making.","authors":"Samiran Panda","doi":"10.25259/IJMR_1734_2024","DOIUrl":"10.25259/IJMR_1734_2024","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"255-258"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779968","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":"Typhoid & paratyphoid vaccine development in the laboratory: a review & in-country experience.","authors":"Suparna Chakraborty, Santasabuj Das","doi":"10.25259/IJMR_1382_2024","DOIUrl":"10.25259/IJMR_1382_2024","url":null,"abstract":"<p><p>Enteric fever is caused by the infection of Gram-negative bacteria, Salmonella enterica serovar Typhi and Salmonella enterica serovar Paratyphi (S. Paratyphi) A, B and C, through contaminated food and water. The disease almost exclusively affects the populations living in low- and middle-income countries, with the World Health Organization Southeast Asian Region (WHO SEAR) having the highest endemicity. Despite humans being the sole reservoir of infection and antibiotics and vaccines are made available, the disease was not taken up for elimination until recently due to several biological and technical reasons, including the lack of accurate and region-specific disease surveillance data in the real-time diagnostic inaccuracy of acute infections, difficulty in identifying the chronic asymptomatic carriers who are the major reservoirs of infection and the absence of a political will. However, there is now a renewed interest and effort to control the disease in the endemic areas with the help of better surveillance tools to monitor disease burden, wider availability of more accurate blood culture methods for diagnosis, and above all, cost-effective typhoid conjugate vaccines (TCVs) that can provide a high level of durable protection, particularly against the multidrug-resistant strains and to the age group most commonly affected by the disease. However, despite the commercial availability of a few TCVs, they are still in the development stage. Several questions need to be answered before they are taken up for routine immunization in countries like India. Furthermore, typhoid vaccines with a wider coverage, including additional efficacy against Salmonella Paratyphi A and B and preferably the non-typhoidal Salmonella (NTS) serovars, for which no vaccines are currently available would be more desirable. We have developed several subunit vaccine candidates containing the glycoconjugates of the surface polysaccharides of typhoidal and non-typhoidal Salmonellae and an intrinsic Salmonella protein that functions as both antigen and adjuvant. We also developed a novel mouse model of oral Salmonella Typhi infection to test the candidate vaccines, which demonstrated broad protective efficacy against Salmonella spp. through the induction of humoral and cell-mediated immunity as well as memory response.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"379-390"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779967","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 the COVID-19 vaccination on feto-maternal outcomes: A prospective cohort study among Indian pregnant women.","authors":"Aravind P Gandhi, J S Thakur, Madhu Gupta, Kathirvel Soundappan, Kapil Goel, Gopal Singh, Tarundeep Singh","doi":"10.25259/IJMR_1014_2024","DOIUrl":"10.25259/IJMR_1014_2024","url":null,"abstract":"<p><p>Background & objectives Studies on the effects of COVID-19 vaccination among pregnant women in Asian settings, more specifically in India, are scarce. The present study evaluated the feto-maternal outcomes among Indian pregnant women who received the COVID-19 vaccine. Methods A prospective cohort study was undertaken among 430 pregnant women from two primary health centres (PHC) in Chandigarh, India during 2021-2022. The feto-maternal outcomes evaluated in the study included abortions, live birth/stillbirth, term/pre-term/post-term delivery, mode of delivery (normal vaginal/caesarean section/forceps), birth weight and intrauterine growth retardation. Results Of the 430 study participants, 295 pregnant women received COVID-19 vaccines, with an uptake rate of 68.6 per cent. Majority of vaccinated women (280- who completed the study) were in their second trimester (133, 47.5%), while 92 (32.9%) were in their third, and 55 (19.6%) were in their first trimester when they were enrolled in the study. Neonatal intensive care unit (NICU) admission was significantly lower among the vaccinated pregnant women, while other feto-maternal and neonatal outcomes were similar between vaccinated and unvaccinated pregnant women. Interpretation & conclusions The findings of this study suggest COVID-19 vaccination in pregnant women in India might be safe, in terms of feto-maternal outcomes.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"371-378"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779958","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":"Vaccines for neglected tropical diseases: Learnings from COVID-19.","authors":"Lalit Kant","doi":"10.25259/IJMR_1548_2024","DOIUrl":"10.25259/IJMR_1548_2024","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"319-322"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779970","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":"Pre- & post-vaccine trends in pneumococcal serotypes & antimicrobial resistance patterns.","authors":"Sreeram Chandra Murthy Peela, Sujatha Sistla, Geetha Nagaraj, Vandana Govindan, Ravi Kumar Lingegowda Kadahalli","doi":"10.25259/ijmr_1811_23","DOIUrl":"10.25259/ijmr_1811_23","url":null,"abstract":"<p><p>Background & objectives The Pneumococcal vaccines were introduced under the Universal Immunization Programme (UIP) in 2021 in India. Drawing from the collective experience of various nations, it is anticipated that there will be a substantial shift in serotype patterns following the introduction of this vaccine. The available data is limited to years until 2018 when the vaccine was introduced in only five States. The present study was carried out to estimate the changes in serotypes and antimicrobial resistance patterns pre- and post-vaccine introduction from a tertiary care centre. Methods All isolates from various clinical specimens in the pre-vaccine era (January 2015-July 2021, except for 2019) and post-vaccine era (August 2021- March 2023) were included. Antimicrobial susceptibility was tested using disc diffusion or VITEK2, and serotyping was performed using the Quellung test (post-vaccine introduction) or sequential multiplex PCR (pre-vaccine introduction). The Chi-square or Fisher exact test was used to identify associations between antimicrobial resistance and serotypes. The z-test for proportions was used to identify significant changes in serotype frequencies between the pre- and post-vaccine era; P<0.05 was considered as the level of significance. Results Overall, the resistance rates increased for most of the antibiotics in the post-vaccine era, and there was no significant increase in the non-vaccine serotypes. The proportion of serotypes 19F and 15B/C increased, and serotypes 23F and 14 reduced in the post-vaccine era. The majority of the 19F and 19A isolates (89.7% and 80%, respectively) were multidrug resistant in the post-vaccine era. Interpretation & conclusions Introducing pneumococcal vaccination reduced the burden of many vaccine serotypes, while the burden of non-vaccine serotypes slightly increased. Most of the vaccine serotypes (like 19F and 19A) that persisted in the post-vaccine era were drug resistant.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 3&4","pages":"354-361"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779949","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}