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

{"title":"Risk of Tuberculosis with the Use of Inhaled Corticosteroids in Delhi/NCR.","authors":"Nalini Kurri, Sonali Chitkara, Adesh Gadpayle","doi":"10.59556/japi.74.1472","DOIUrl":"https://doi.org/10.59556/japi.74.1472","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) is a global health concern caused by Mycobacterium tuberculosis, primarily affecting the lungs. In addition to TB, chronic respiratory conditions like Chronic Obstructive Pulmonary Disease (COPD) and asthma are becoming more prevalent globally. Inhaled corticosteroids (ICS) are commonly used for COPD and bronchial asthma management, but some recent studies suggest a potential association between ICS usage and an increased risk of TB, raising concerns that they may lower lung immunity and enhance tuberculosis infection.</p><p><strong>Aims and objectives: </strong>This research study was performed with an aim to investigate whether there is a link between inhaled corticosteroids (ICS) use and the risk of developing tuberculosis (TB) in COPD patients. The primary objective is to study whether the use of inhaled corticosteroids increases the risk of tuberculosis infection. The secondary objective is to compare the risk of TB in vulnerable populations with underlying comorbidities using inhaled corticosteroids.</p><p><strong>Materials and methods: </strong>This is an observational, analytical study conducted over 2 months in patients with COPD who have been receiving inhaled corticosteroids for more than 2 years.</p><p><strong>Results: </strong>A total of 97 COPD patients on ICS were recruited and categorized into TB (<i>n</i> = 4) and non-TB (<i>n</i> = 93) groups based on final outcomes. The mean ICS duration for the non-TB and TB groups was 24.8 and 48.0 months, respectively.</p><p><strong>Conclusion: </strong>Despite being on ICS for more than 2 years, there was no significant correlation between ICS usage and TB infection. However, the study highlighted the significance of a prior TB history as a risk factor for increased reactivation (p < 0.001). Additionally, anemia was observed in reactivated TB cases, suggesting potential implications for identifying underlying chronic diseases in COPD patients.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"82-87"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723666","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":"Effectiveness of Simulation Training on Students' Confidence and Competence in Performing Basic Life Support.","authors":"Sushanta Kumar Mishra, Sriya Lalithya Challagolla, Jakkam Ram Narayana Reddy, Somanath Dash","doi":"10.59556/japi.74.1311","DOIUrl":"https://doi.org/10.59556/japi.74.1311","url":null,"abstract":"<p><strong>Background: </strong>Basic life support (BLS) is a critical skill for healthcare professionals. Traditional teaching approaches may not sufficiently ensure retention or practical proficiency. Simulation-based training offers a dynamic learning environment with opportunities for practice and feedback.</p><p><strong>Objectives: </strong>This study aimed to assess the effectiveness of simulation-based BLS training in improving (1) competence and (2) confidence among undergraduate medical students.</p><p><strong>Materials and methods: </strong>A quasi-experimental pre/posttest design was employed with two parallel groups (simulation vs traditional lecture-based instruction). Sixty undergraduate medical students were recruited and randomly assigned. Competence was assessed using an objective structured clinical examination (OSCE)-based performance checklist. Confidence was measured via a validated Likert-scale questionnaire. Pre- and post-training evaluations were conducted.</p><p><strong>Results: </strong>Simulation-trained students demonstrated significantly higher posttest competence scores (<i>p</i> < 0.05) and reported increased confidence (<i>p</i> < 0.05) compared to the control group. Within-group comparisons also showed significant improvement from pre- to posttest in both metrics for the simulation group.</p><p><strong>Conclusion: </strong>Simulation-based training significantly enhances students' competence and confidence in performing BLS. These findings support its integration into medical curricula to foster critical life-saving skills.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"40-42"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723525","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":"Assessment of WHO Core Drug Use Indicators in a Government Teaching Hospital of Assam: Evidence from Prescription Audit Data.","authors":"Lavita Hazarika, Hiteswar Saikia, Anju L Saikia","doi":"10.59556/japi.74.1424","DOIUrl":"https://doi.org/10.59556/japi.74.1424","url":null,"abstract":"<p><strong>Background: </strong>With the rise of irrational drug prescriptions, leading to polypharmacy, increased health care costs, drug interactions, and risks of adverse drug reactions, irrational antibiotic prescribing, overuse of injections, and hospitalization, it has become important to monitor drug use patterns.</p><p><strong>Materials and methods: </strong>With the objective to assess the drug use indicators of a government teaching hospital of Assam using WHO Core Drug Use Indicators, 700 prescriptions from OPDs of various specialties were assessed prospectively from the hospital dispensary and details of core drug use indicators were noted and analyzed for each in a proforma as per WHO recommendation on investigating drug use in health care facilities. Descriptive statistics were used thereafter to express the results.</p><p><strong>Results: </strong>The WHO core prescribing indicators analysis revealed that the average number of drugs per encounter was 3.6. The percentage of drugs prescribed by generic name was 37%, with only 6% being injectable drugs; however, 39.14% of prescriptions included one or more antibiotics. Only 37% of the drugs prescribed were from the NLEM.</p><p><strong>Conclusion: </strong>This study highlights that only prescriptions involving injectable drugs were in accordance with WHO recommendations, while the other parameters exceeded the WHO-recommended values.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"54-56"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722629","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":"Neck Circumference: A Screening Tool for Predicting Metabolic Syndrome in Obese Children.","authors":"Srinivasan Thiagarajan, S P Tharanidharan","doi":"10.59556/japi.74.1467","DOIUrl":"https://doi.org/10.59556/japi.74.1467","url":null,"abstract":"<p><strong>Background: </strong>In recent days, neck circumference (NC) has been suggested as a screening technique for overweight individuals because it is easy to measure, does not require instruments such as a stadiometer or weighing scale, and does not require calculations as in body mass index (BMI). Moreover, NC correlates with many fat-related anthropometric measurements and cardiovascular risk factors.</p><p><strong>Aims: </strong>The objective of this study was to find the association of higher NC with metabolic syndrome (MetS), insulin resistance (IR), and other metabolic complications.</p><p><strong>Settings and design: </strong>Tertiary care teaching hospital, cross-sectional study.</p><p><strong>Methods and materials: </strong>A total of 211 overweight and obese children aged between 5 and 13 years were recruited. Anthropometric parameters such as weight, height, NC, and waist circumference (WC) were measured. Fasting blood glucose, total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL) cholesterol, aspartate transaminase (AST), and alanine transaminase (ALT) were estimated. Homeostasis model assessment of insulin resistance (HOMA-IR) and MetS were derived.</p><p><strong>Statistical analysis used: </strong>Independent <i>t</i>-test and Chi-square analysis were applied for continuous and categorical variables, respectively, to find the association.</p><p><strong>Results: </strong>Out of 79 children in the high-NC group, 11 had MetS, whereas only 4 had MetS in the low-NC group of 132 children, which was statistically significant (X² = 8.87; <i>p</i> = 0.003). Logistic regression analysis showed a significant association between high neck circumference and waist circumference (<i>p</i> = 0.00; AOR = 1.164).</p><p><strong>Conclusions: </strong>High NC reflects high BMI and can predict MetS in overweight and obese children.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"92-95"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723702","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":"The Enigma Called Health for All.","authors":"Nandini Chatterjee","doi":"10.59556/japi.74.1473","DOIUrl":"https://doi.org/10.59556/japi.74.1473","url":null,"abstract":"<p><p>It is 2026, and we have another World Health Day at our doorstep-with a slogan for the betterment of health and well-being of the world at large. This time, the WHO slogan for World Health Day 2026 (April 7) is \"Together for health, stand with science.\"</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723721","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":"<i>Fasciolopsis buski</i> Diagnosed by Upper Gastrointestinal Endoscopy.","authors":"Sk Mahiuddin Ahammed, Dipankar Paul, Ayan Basu, Yogiraj Ray, Nazneen Nahar Begam","doi":"10.59556/japi.74.1457","DOIUrl":"https://doi.org/10.59556/japi.74.1457","url":null,"abstract":"<p><p>A 36-year-old male patient from rural South Bengal, India, presented to our hepatology outpatient department (OPD) with upper abdominal discomfort, anorexia, indigestion, and chronic diarrhea with passage of loose stools 3-4 times per day for 6 weeks. He was afebrile without any weight loss. He did not give any history of skin changes, arthralgia, or oral ulceration. He gave a history of consumption of water chestnuts. He had no history of travel or intake of alcohol or any medications. Physical examination did not reveal any lymphadenopathy, thyroid mass, organomegaly, or abdominal mass. Blood reports showed anemia with a hemoglobin of 78 gm/L (normal range 130-170 gm/L), and total leukocyte count showed eosinophilia (12%). Liver function test showed mild hypoalbuminemia. Human immunodeficiency virus, hepatitis B virus surface antigen, and antihepatitis C virus antibody were nonreactive. Abdominal ultrasonography was normal. Initial stool examination was normal. On upper gastrointestinal (GI) endoscopy, multiple flat, leaf-like, fleshy structures attached to duodenum were found, which were extracted endoscopically (Fig. 1 and Supplementary Video S1). They were morphologically identical to adult form of <i>Fasciolopsis buski</i> (3.5 cm × 1.5 cm × 0.5 cm) (Figs 2 and 3). He was treated with tablet praziquantel (75 mg/kg, in three divided doses for 1 day). The next day, stool examination showed eggs of <i>F. buski</i> (morphologically, eggs of <i>F. buski</i>, <i>Fasciola hepatica</i>, and <i>Fasciola gigantica</i> are similar) (Fig. 4). A few adult worms of <i>F. buski</i> were also expelled through feces for 2 days. From the 3rd day onward, stool examination did not show any eggs or adult forms of <i>F. buski</i>, and he was asymptomatic for a 6-month follow-up period.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"112-113"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723995","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 Attempt to Achieve Holistic Health by Improving Spiritual, Emotional, and Psychological Wellbeing: A Clinical Trial Using an Eastern Spirituality-based Intervention in Indian Context.","authors":"Anirban Pal, Purnava Mukhopadhyay, Mayukh Chattopadhyay","doi":"10.59556/japi.74.1459","DOIUrl":"https://doi.org/10.59556/japi.74.1459","url":null,"abstract":"<p><strong>Background and aims: </strong>Spirituality is an important fourth dimension of health. Spiritual wellbeing is a subconstruct of spirituality and an important contributor to overall wellbeing. Health cannot be conceived as \"holistic\" without including \"spiritual wellbeing.\" The researchers attempt to look at the effects of an Eastern spirituality-based intervention on spiritual, emotional, and psychological wellbeing to achieve holistic health.</p><p><strong>Methods: </strong>A total of 140 participants were randomized to attend either 6 \"spirituality\" sessions (1 session each week) or \"usual care\" pseudo sessions. The outcome parameters were measured pre- and postintervention. The spiritual wellbeing was measured by Spiritual Wellbeing Scale (SWBS) and WHO quality of life: spirituality, religiousness, and personal beliefs scale (WHOQOL-SRPB). Emotional wellbeing was measured by Depression, Anxiety, and Stress Scale (DASS-21), and psychological wellbeing by WHO-5 Wellbeing Scale. Repeated measures ANOVA tests were used for statistical analysis.</p><p><strong>Results: </strong>The spirituality sessions improved the SWBS scores (treatment effect size: medium, ηp² = 0.1253) and WHOQOL-SRPB scores (treatment effect size: small, ηp² = 0.04952) significantly. In addition, DASS-21 scores: S stress (treatment effect size: medium, ηp² = 0.09784), A anxiety (treatment effect size: medium, ηp² = 0.08542), and D depression (treatment effect size: medium, ηp² = 0.0761), and WHO-5 wellbeing scores (treatment effect size: medium, ηp² = 0.112) also improved.</p><p><strong>Conclusion: </strong>An Eastern spirituality-based intervention improved the spiritual, emotional, and psychological wellbeing of Indian participants. Addressing spiritual wellbeing will help one toward achieving the goal of \"holistic\" health. Future studies will help to corroborate the results.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"24-30"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722611","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":"Systematic Review of Topical Capsaicin 0.075% for the Treatment of Neuropathic Pain: Efficacy, Safety, and Tolerability.","authors":"Viswanathan Mohan, Mangesh Tiwaskar, Muthukumaran Jayapaul, Sarath Menon, Abhay Nene, Sonali Gokhalay, Vaibhavi Wakchoure","doi":"10.59556/japi.74.1470","DOIUrl":"https://doi.org/10.59556/japi.74.1470","url":null,"abstract":"<p><strong>Background: </strong>Neuropathic pain, characterized by nerve damage, can significantly impact quality of life. Traditional treatments often fall short, prompting the exploration of topical therapies such as capsaicin. This systematic review aims to evaluate the efficacy, safety, and tolerability of topical capsaicin in treating neuropathic pain.</p><p><strong>Methods: </strong>A systematic review of clinical studies assessing the topical use of capsaicin for neuropathic pain of different etiologies, including painful diabetic peripheral neuropathy (DPN) and postherpetic neuralgia (PHN), was conducted. Data were extracted regarding pain relief and adverse effects. A systematic review of literature identified through database searches, including PubMed and ScienceDirect, was conducted using the search term \"topical capsaicin.\"</p><p><strong>Results: </strong>A total of 22 studies were included (placebo-controlled: <i>n</i> = 13; active-controlled: <i>n</i> = 4; uncontrolled: <i>n</i> = 4; comparison of two capsaicin formulations: <i>n</i> = 1). Topical capsaicin demonstrated significant efficacy in reducing pain intensity and improving quality of life across various neuropathic pain conditions. Localized adverse effects were reported but were generally tolerable and occurred more often in the first week of treatment. Comparisons between 0.025% and 0.075% formulations indicated that the higher concentration is generally more effective. The development of a new roll-on formulation of capsaicin retains efficacy while reducing adverse effects.</p><p><strong>Conclusion: </strong>Topical capsaicin 0.075% is a promising and effective option for neuropathic pain management, providing meaningful pain relief and improved quality of life with a manageable and favorable safety profile. Further research is needed to evaluate long-term efficacy and explore combination treatment approaches.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"e6-e12"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723713","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":"Examination and Validation of Neutrophil-Lymphocyte Ratio as a Perioperative Risk Assessment Biomarker in Major Noncardiac Surgical Patients: An Observational Cross-sectional Study.","authors":"Shalini Nangalia, Sugata Dasgupta, Arpita Choudhury, Karan Kumar Pathak","doi":"10.59556/japi.74.1462","DOIUrl":"https://doi.org/10.59556/japi.74.1462","url":null,"abstract":"<p><strong>Background and aims: </strong>Neutrophil-lymphocyte ratio (NLR) can predict prognosis of disease in patients suffering from cerebrovascular accidents, ischemic heart disease, infectious diseases, sepsis, etc., that can cause increased postoperative morbidity and prolonged stay in hospital. So, NLR can be a potential preoperative risk assessment and stratification biomarker. Our study aims to estimate any correlation between preoperative NLR and coexisting medical and surgical disease and to validate NLR against American Society of Anesthesiologists Physical Status (ASA PS) Classification System, Revised Cardiac Risk Index (RCRI), Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score, and Gupta's postoperative respiratory failure risk in Indian patients.</p><p><strong>Materials and methods: </strong>This observational, cross-sectional study was conducted in the preanesthesia check-up clinic. Information regarding sociodemographic profile, primary surgical disease, hematological investigations, that is, complete blood count, neutrophil count, lymphocyte count, NLR, and coexistent medical disease was collected, and ASA PS, RCRI, ARISCAT score, and Gupta's postoperative respiratory failure risk were calculated for each study subject. Data were analyzed using standard statistical tests.</p><p><strong>Results: </strong>Age, congestive cardiac failure, smoking, malignancy, and beta blockers usage were associated with elevated NLR. NLR was found to have a significant relationship with anesthesia risk indices: ASA PS, RCRI, ARISCAT, and Gupta's postoperative respiratory failure risk.</p><p><strong>Conclusion: </strong>Significant association has been observed between increased NLR and occurrence of systemic illness. NLR also has a significant association with ASA PS Classification System, RCRI, ARISCAT score, and Gupta's postoperative respiratory failure risk. So, NLR may serve as a valuable biomarker in preoperative risk stratification.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"69-74"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723728","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":"Comparison of qSOFA Score and NEWS2 Score in Sepsis Patients Admitted in Emergency Department and ICU as Prognostic Markers of Patient Outcome.","authors":"Kumar Anupam, Kamal Kumar Sawlani, Ambuj Yadav, Shyam Chand Chaudhary, Kauser Usman, Arzoo Sharma, Virendra Atam","doi":"10.59556/japi.74.1319","DOIUrl":"https://doi.org/10.59556/japi.74.1319","url":null,"abstract":"<p><strong>Background: </strong>Sepsis causes high short-term mortality in emergency and ICU settings. Quick sequential organ failure assessment (qSOFA) and national early warning score 2 (NEWS2) are bedside tools for early risk stratification, yet comparative evidence remains limited.</p><p><strong>Objectives: </strong>To compare qSOFA and NEWS2 for predicting 7-day and 28-day mortality and length of stay in adult sepsis patients.</p><p><strong>Methods: </strong>This prospective observational study was conducted over 1 year (March 2024-February 2025) at a tertiary care center in northern India. A total of 874 patients aged 18-65 years admitted with sepsis were enrolled. On-admission qSOFA and NEWS2 scores were recorded. Outcomes included 7-day, 28-day mortality and length of hospital stay.</p><p><strong>Results: </strong>Among 874 patients, NEWS2 showed higher sensitivity than qSOFA for 7-day (63.1% vs 35.1%) and 28-day mortality (64.1% vs 37.3%), with comparable specificity (~86%). Area under receiver operating characteristic curve (AUROC) values favored NEWS2 for 7-day (0.627 vs 0.606) and 28-day mortality (0.629 vs 0.609).</p><p><strong>Conclusion: </strong>In adults with sepsis, the NEWS2 score showed higher sensitivity and marginally better prognostic accuracy than qSOFA for predicting short-term mortality and hospital stay. NEWS2 may therefore serve as a more reliable bedside tool for early identification of high-risk patients in emergency and ICU settings.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"36-39"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723480","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}