The Journal of the Association of Physicians of India最新文献

{"title":"Study of Depression, Anxiety, Somatic Symptoms, and Quality of Life in Patients with Chronic Kidney Disease on Maintenance Hemodialysis in a Tertiary Hospital in Chennai.","authors":"Suresh Kanna Subramaniam, Vinjamuri Ramachandra Rao","doi":"10.59556/japi.74.1691","DOIUrl":"10.59556/japi.74.1691","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is associated with substantial psychological morbidity, particularly among patients receiving maintenance hemodialysis (MHD). Depression, anxiety, and somatic symptoms adversely affect health-related quality of life (HRQoL), yet these factors remain under-recognized in routine clinical practice.</p><p><strong>Objectives: </strong>To assess the prevalence and severity of depression, anxiety, and somatic symptoms and to evaluate their association with quality of life among patients with CKD undergoing maintenance hemodialysis.</p><p><strong>Materials and methods: </strong>This hospital-based cross-sectional observational study included 50 adult patients with CKD receiving maintenance hemodialysis at a tertiary care hospital in Chennai. Participants were assessed using the Hospital Anxiety and Depression scale (HADS), Somatic Symptom scale-8 (SSS-8), and World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Data were analyzed using R software. Categorical variables were compared using the Chi-square test, and a <i>p</i>-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Psychological distress and somatic symptom burden were common among patients undergoing maintenance hemodialysis. Female participants demonstrated a higher prevalence of abnormal depression scores, whereas abnormal anxiety scores were more frequent among males; however, these differences were not statistically significant (anxiety: <i>p</i> = 0.053; depression: <i>p</i> = 0.170). No significant associations were observed between age, CKD stage, or overall quality-of-life quartiles and HADS anxiety or depression scores (<i>p</i> > 0.05). A highly significant association was observed between SSS-8 quartiles and somatic symptom severity (<i>p</i> < 0.0001), indicating that higher somatic symptom scores were associated with greater symptom burden.</p><p><strong>Conclusion: </strong>Depression, anxiety, and somatic symptoms are common among patients with CKD receiving maintenance hemodialysis. Although most demographic and clinical variables were not significantly associated with psychological distress, greater somatic symptom burden was strongly associated with higher SSS-8 scores. Routine psychological assessment using validated screening tools may facilitate early identification and comprehensive management of psychological morbidity in patients undergoing maintenance hemodialysis.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 9","pages":"38-42"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep, Quality of Life, and the Intricate Relationship with Good Health.","authors":"Anupam Prakash, Ghan Shyam Pangtey, Ramesh Aggarwal","doi":"10.59556/japi.74.1711","DOIUrl":"https://doi.org/10.59556/japi.74.1711","url":null,"abstract":"","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 9","pages":"11-12"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Needle through Time: Celebrating 21 Years of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in Pulmonary Medicine!","authors":"Preyas J Vaidya, Prashant N Chhajed","doi":"10.59556/japi.74.1710","DOIUrl":"https://doi.org/10.59556/japi.74.1710","url":null,"abstract":"","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 9","pages":"13-14"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Textbook of Reproductive Rheumatology.","authors":"Sham Santhanam","doi":"10.59556/japi.74.1713","DOIUrl":"https://doi.org/10.59556/japi.74.1713","url":null,"abstract":"","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 9","pages":"105"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives on Newer Antiobesity Drugs (Semaglutide and Tirzepatide) among Healthcare Professionals Treating Obesity in South Asia: A Cross-sectional Survey.","authors":"Khushboo Agarwal, Lakshmi Nagendra, Saptarshi Bhattacharya, Sourabh Sharma, Abm Kamrul-Hasan, Nitin Kapoor, Dina Shreshtha, Sambit Das, Shehla Sheikh, Rucha Mehta, Aswin Pankaj, Musarrat Riaz, Sanjay Kalra","doi":"10.59556/japi.74.1709","DOIUrl":"10.59556/japi.74.1709","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity has reached epidemic proportions in South Asia, contributing significantly to metabolic diseases and economic burdens. Newer antiobesity medications (AOMs), such as semaglutide and tirzepatide, show promising efficacy but face barriers such as high costs and limited familiarity among healthcare professionals (HCPs) in low- and middle-income countries (LMICs). This study explored perceptions, prescribing practices, efficacy, safety concerns, and barriers to AOM use among HCPs managing obesity in South Asia.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted from May to September 2025 among 552 HCPs (physicians, endocrinologists, bariatric surgeons, nephrologists, gastroenterologists, and dieticians) specializing in obesity care, recruited via social media groups using convenience sampling. The questionnaire, developed from prior surveys and pilot-tested, assessed knowledge, attitudes, and practices regarding AOMs. Descriptive analysis was performed using SPSS version 21.</p><p><strong>Results: </strong>Of 552 responses, 86.4% were from India. Endocrinologists (62.9%) and internists (21.6%) dominated, with varied experience levels. Key factors influencing prescriptions included efficacy (83%), affordability (75.9%), and safety (58.9%). Reported efficacy was high with 51.7% of the patients achieving > 10% weight loss. Barriers encompassed high costs (93.8%), side effect fears (46.2%), and poor adherence (41.3%). Biosimilars were available to 52.7%, with 78.6% of HCPs open to them if efficacy/safety matched originators.</p><p><strong>Conclusions: </strong>South Asian HCPs recognize AOMs' transformative potential but are hindered by costs, safety, and access. Biosimilars could enhance equity, but require robust data and regulation. Targeted education, reimbursement policies, and region-specific evidence are essential to optimize AOM integration in obesity management.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 9","pages":"67-70"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Uncommon Cause of Refractory Pleural Effusion.","authors":"Priya Sharma, Robin Singh Bhatti, Deepansh Gupta","doi":"10.59556/japi.74.1704","DOIUrl":"https://doi.org/10.59556/japi.74.1704","url":null,"abstract":"","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 9","pages":"102-104"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Consensus Statement on the Role of Bisoprolol across the CV Continuum.","authors":"Aditya Kapoor, Dayasagar Rao V, Sadanand R Shetty, Aniruddha Dharmadhikari, Ajit R Bhagwat, Sadananda Ks, B C Srinivas, Soumitra Kumar, P K Hazra, Thomas Alexander, K Kannan, G Justin Paul, Manish Bansal, Prashant Kumar Sahoo","doi":"10.59556/japi.74.1694","DOIUrl":"https://doi.org/10.59556/japi.74.1694","url":null,"abstract":"<p><strong>Abstract: </strong>Cardiovascular disease (CVD) remains the leading cause of death globally, affecting populations in both developed and low- and middle-income countries. Although age-adjusted mortality rates from coronary artery disease (CAD) have declined in regions such as the United States and Europe, sudden cardiac death continues to account for a significant proportion of CVD-related fatalities. The concept of the \"cardiovascular continuum,\" introduced more than a decade ago, describes the progressive nature of CVD-beginning with modifiable risk factors such as hypertension, diabetes, and smoking, which collectively drive oxidative stress, endothelial dysfunction, and inflammation. Over time, these pathophysiological changes lead to atherosclerosis and end-organ damage, often well before clinical symptoms become apparent.</p><p><strong>Abstract: </strong>In India, the burden of CVD has risen sharply in recent decades, particularly due to increasing rates of coronary heart disease and cerebrovascular events. Emerging evidence identifies an elevated resting heart rate as an independent predictor of adverse cardiovascular outcomes, particularly in individuals with hypertension, myocardial infarction (MI), and heart failure (HF). Among available pharmacological options, beta-blockers-particularly bisoprolol-have demonstrated strong efficacy in managing angina, atrial fibrillation (AF), and heart failure with reduced ejection fraction (HFrEF). By acting at multiple stages of the cardiovascular continuum, bisoprolol provides both symptomatic relief and disease-modifying effects, underscoring its importance in contemporary cardiovascular management.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 9","pages":"83-92"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efflux Pump Inhibitors: Revisiting an Old Strategy in the Era of Antimicrobial Resistance.","authors":"Tanvi Naik, Nitin Chintaman Gawari, Ajith Kumar, A V Tilak","doi":"10.59556/japi.74.1643","DOIUrl":"https://doi.org/10.59556/japi.74.1643","url":null,"abstract":"<p><strong>Abstract: </strong>Antimicrobial resistance (AMR) is a growing global threat that undermines the effectiveness of existing antibiotics and complicates the treatment of infectious diseases. Among the multiple mechanisms driving resistance, bacterial efflux pumps play a critical but often underappreciated role by actively expelling antibiotics from the cell and reducing intracellular drug concentrations. These pumps are widely distributed across gram-positive and gram-negative bacteria and contribute to multidrug resistance against several major antibiotic classes. Importantly, efflux-mediated resistance is frequently an early and reversible step, allowing bacteria to survive initial antimicrobial exposure and acquire additional resistance mechanisms. Efflux pump inhibitors (EPIs) have therefore long been explored as adjuncts to antibiotic therapy. Experimental studies, particularly with natural compounds, have shown that EPIs can restore antibiotic susceptibility and enhance drug efficacy despite having little intrinsic antibacterial activity. However, clinical translation has been limited by issues related to toxicity, selectivity, pharmacokinetics, and redundancy of efflux systems. Recent advances in molecular and structural biology have renewed interest in this strategy by enabling more rational, mechanism-based EPI design. In the context of a shrinking antibiotic pipeline, revisiting efflux pump inhibition offers a promising complementary approach to prolong the usefulness of existing antibiotics and combat multidrug-resistant infections.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 9","pages":"98"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Profile of Patients Presenting with Scrub Typhus at a Tertiary Care Center in Eastern India: A Cross-sectional Study.","authors":"Jyoti Prakash, Anjani Kumar, Janmeshwar Prasad, Pratibha Modi","doi":"10.59556/japi.74.1700","DOIUrl":"https://doi.org/10.59556/japi.74.1700","url":null,"abstract":"<p><strong>Background: </strong>Scrub typhus is a reemerging rickettsial infection in India and remains an important cause of acute febrile illness with the potential for severe multi-organ involvement if diagnosis and treatment are delayed. Data from eastern India remain limited.</p><p><strong>Objectives: </strong>To delineate the clinical and laboratory profile of patients diagnosed with scrub typhus admitted to a tertiary care center in eastern India.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted at All India Institute of Medical Sciences (AIIMS) Patna, including adult patients (>15 years) with serologically confirmed scrub typhus admitted between January and December 2023. Demographic details, clinical features, laboratory parameters, and complications were retrieved from medical records. Descriptive statistics were used for analysis.</p><p><strong>Results: </strong>A total of 69 patients were included; 58.0% were male. Fever was the most common presenting symptom (94.2%), followed by headache (66.7%) and myalgia (53.6%). Eschar was identified in 10.1% of patients. Thrombocytopenia was present in 82.6%, hyperbilirubinemia in 65.2%, and acute kidney injury in 20.3%. Meningoencephalitis occurred in 13.0%, while hypotension/shock and acute respiratory distress syndrome (ARDS) were infrequent (4.3 and 1.4%, respectively).</p><p><strong>Conclusion: </strong>Scrub typhus commonly presents as acute febrile illness with significant hematological and hepatic involvement. Eschar, though specific, was infrequently observed. High clinical suspicion and early recognition are crucial to prevent complications.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 9","pages":"26-31"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotics in Heart Failure: A Narrative Review.","authors":"Taranpreet Kaur, Ritu, Pranus Kohli, Sumeet Angral, Boudhayan Das Munshi, Kirandeep Kaur","doi":"10.59556/japi.74.1702","DOIUrl":"https://doi.org/10.59556/japi.74.1702","url":null,"abstract":"<p><strong>Abstract: </strong>Infections commonly cause acute decompensation and poor outcomes in heart failure (HF), a major global health burden. Patients with heart failure are particularly vulnerable to infections related to the respiratory, urinary, skin, and devices because of systemic inflammation, immune dysfunction, changes in the gut barrier, and repeated exposure to healthcare facilities. The use of empirical antibiotics without confirmation due to overlapping symptoms between infection and heart failure is frequently associated with extended hospital stays, drug toxicity, and antibiotic resistance. While early targeted therapy improves outcomes in confirmed infections, evidence points to limited benefit and possible harm from unnecessary antibiotics. To maximize management in this susceptible population, careful diagnostic evaluation, stewardship, and customized prescribing are crucial.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 9","pages":"93-97"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}