Indian Journal of Medical Research最新文献

{"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":"What will it take to expand the pre-exposure prophylaxis to prevent new HIV infections in India?","authors":"Aditya Gaur, Natella Rakhmanina","doi":"10.25259/IJMR_2102_2024","DOIUrl":"10.25259/IJMR_2102_2024","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"527-529"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364592","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}

{"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":"Intervention strategy for Rapid Grower Mycobacteria outbreak among post-laparoscopic surgical site infection patients in a tertiary care hospital.","authors":"Nupur Pal, Raja Ray, Somenath Kundu, Prasanta Kumar Maiti","doi":"10.25259/ijmr_138_24","DOIUrl":"10.25259/ijmr_138_24","url":null,"abstract":"<p><p>Background & objectives The emergence of Rapid Grower Mycobacteria (RGM) infections recently produced a great challenge among surgeons following laparoscopic surgical site infection. Infections caused by atypical mycobacteria may be overlooked due to limitations of proper diagnostic infrastructure and unawareness in the resource-limited set-up. In this study, we proposed an intervention strategy for RGM infection among patients having post-laparoscopic surgical site infections in our hospital. Methods Five hundred sixty-five samples were collected within one year (April 2018- March 2019) from the surgery outpatient department (OPD), suspecting atypical mycobacteria infection following surgery. Samples were processed in the microbiology department by conventional staining and culture. RGM was diagnosed up to the species level by both conventional and molecular methods [line probe assay (LPA)]. The antibiogram was performed by the microbroth dilution method on the RAPMYCOI kit as per Clinical and Laboratory Standard Institute (CLSI) guidelines. Simultaneous source identification was carried out. Results A biofilm-producing Mycobacterium abscessus strain was detected from the plastic disinfection tray of the surgical operation theatre (OT), which may be the continuous source of iatrogenic post-surgical infection. RGM prevalence among suspected patients was 19.47 per cent, and around 92 per cent of them were from laparoscopic surgery. Antibiotic sensitivity, as per CLSI guidelines, showed most of them (88.8%) were resistant to commonly given antibiotic clarithromycin. Most sensitivity was to antibiotics amikacin, tobramycin, moxifloxacin, and doxycycline. The game-changing intervention related to this outbreak scenario was the introduction of gas-plasma sterilization and maintaining strict asepsis in surgical operation theatre. Interpretation & conclusions Based on the analysed data, we proposed an intervention strategy in our hospital for treating and preventing RGM infection. Such an approach will help arrest the RGM-outbreaks in future.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"625-629"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364568","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":"Recent HCMV infection in early pregnancy associates with congenital transmission & adverse pregnancy outcome: A prospective cohort study.","authors":"Harsha Chandrashekhar Palav, Varsha Sakharam Padwal, Shilpa Milind Velhal, Sapna Yadav, Gauri Sanjay Bhonde, Varsha Kalsurkar, Sachee Agrawal, Reena Set, Jayanthi Shastri, Forum Shah, Ira Shah, Purnima Satoskar, Vainav Patel, Vikrant Madhukar Bhor","doi":"10.25259/IJMR_89_2024","DOIUrl":"10.25259/IJMR_89_2024","url":null,"abstract":"<p><p>Background & objectives Human Cytomegalovirus (HCMV) infection, leading to >90 per cent seropositivity in women of reproductive age from India, is the largest cause of congenital infections worldwide. HCMV infection status was prospectively monitored together with congenital transmission (cCMV) and adverse pregnancy outcomes (APO) in a public health setting where maternal or neonatal screening was not in practice. Methods Eighty three pregnant women, with (n=45) and without (n=38) bad obstetric history (BOH), were monitored for HCMV infection by ELISA-(IgM, IgG, IgG avidity) for all TORCH (Toxoplasma, Rubella, HCMV, HSV 1 & 2) pathogens along with HCMV-specific chemiluminescent microparticle immunoassay (CMIA) and nested polymerase chain reaction (PCR). Descriptive statistics were applied on data sets to determine associations between maternal infection status, pregnancy outcome and cCMV in 52 mother-neonate dyads. Results Combined avidity, PCR-based and HCMV IgM screening, compared to the latter alone, was successful in identifying incident infection during early pregnancy. Pregnancy loss was associated strongly with BOH and concurrent HCMV infection. Features associated with APO and cCMV, were high PCR positivity (first trimester) and high rates of HCMV-specific IgM and intermediate IgG avidity (P=0.0211, 0.0455). Also, recent HCMV infection (intermediate IgG avidity), observed mainly in the BOH group, but not recurrent infection (IgM positivity), in first and second trimesters, was associated with neonatal saliva positivity and adverse outcomes, including neonatal death (P=0.0762). Exposure to other TORCH pathogens, while detected, did not include IgM positivity or low/intermediate IgG. Conclusion This study highlights the significance of conducting early, multi-pronged screening for maternal HCMV infection during pregnancy, especially in public health settings with high HCMV seroprevalence.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"614-624"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364575","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}