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

{"title":"Effects of Omega-3 Fatty Acids on Tobacco Craving in Tobacco Users: A Single-blind, Randomized, Placebo-controlled Study.","authors":"Anjali Singh, Narsingh Verma, Surya Kant, Ajay Kumar Verma, Adarsh Tripathi, Kshitij Bhardwaj","doi":"10.59556/japi.74.1471","DOIUrl":"https://doi.org/10.59556/japi.74.1471","url":null,"abstract":"<p><strong>Background: </strong>Tobacco use and its smoke produces oxidative stress in the body, which eventually triggers cell damage by lipid peroxidation. Smokers report lower levels of omega-3 fatty acids (FAs) in their serum as compared to nonsmokers. Omega-3 deficiency impairs neurotransmission, resulting in hypofunctioning of the mesocortical system, which is a reward and dependency system that can raise tobacco cravings, disrupting tobacco quitting efforts. Omega-3 polyunsaturated fatty acid (PUFA) regulates stress, anxiety, and negative emotions that are associated with tobacco urges. Limited research has assessed the supplementation effect of omega-3 PUFA [in the form of alpha-linolenic acid (ALA)] on tobacco craving.</p><p><strong>Aim: </strong>We aimed to explore the effects of omega-3 PUFA (ALA) on the frequency of tobacco use per day, tobacco dependence, and tobacco craving when compared to placebo in regular tobacco users.</p><p><strong>Materials and methods: </strong>Regular tobacco users (<i>n</i> = 83) recruited from the Tobacco Cessation Clinic were randomly allocated to two groups. Group I was the omega-3 PUFA group, supplemented with 10 mL/day of omega-3 PUFA in the form of ALA (5.1 gm) for 180 days, and the other group received a placebo for the same duration. The outcome was evaluated by means of a case record form (for demographic parameters), self-reports of tobacco use (for frequency of tobacco use per day), as well as psychometric measures (for tobacco dependence and tobacco craving). The evaluations were carried out at baseline and after 180 days of intervention.</p><p><strong>Results and conclusion: </strong>The frequency of tobacco use per day, tobacco dependence, and tobacco craving were found to be significantly decreased (p < 0.0001) in the group receiving omega-3 PUFA (ALA) at the end of supplementation. This is a novel approach that ALA supplementation reduces tobacco cravings in regular tobacco users in comparison to a placebo. Thus, omega-3 FAs may be an adjuvant tool in quitting tobacco use by reducing nicotine dependence and tobacco craving. Further studies are necessary with large samples to understand the possible association and explore the probable nonpharmacological approaches for tobacco cessation.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"75-80"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723679","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":"Factors Contributing to COVID-19 Mortality In-hospital and after Discharge: Results of an Ambivalent Cohort Study from a Tribal District of Kerala, India.","authors":"Chandrasekharan Pariyarath, Anisha Sharahudeen, Nair Sajesh Balarajan, Sony P Sunny, Binija M Joy, A Ajith, Retna Valli, B K Ajitha, Vineeth Gladson, Chandni Radhakrishnan, Surendran T Anish","doi":"10.59556/japi.74.1312","DOIUrl":"https://doi.org/10.59556/japi.74.1312","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The morbidity and mortality burden of the COVID-19 pandemic was high in socioeconomically deprived areas. Identifying the factors associated with in-hospital mortality in such settings will help physicians prioritize the scarce resources for the more needy individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To study the demographic, clinical, and biochemical factors associated with in-hospital mortality in COVID-19 patients in Wayanad, Kerala, India. We also report the incidence of post-COVID symptoms and the mortality rate in the survivors of COVID-19 pneumonia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;The study design was a record-based retrospective cohort, and the study participants were 402 patients admitted with moderate to severe COVID-19 at the secondary care hospital of Wayanad, Kerala, India, during late 2020 and early 2021. In-hospital mortality was the major outcome variable, and we expressed the mortality risk in terms of relative risks (RRs). Factors associated with the same were assessed using Chi-square, Fisher's exact tests, and &lt;i&gt;t&lt;/i&gt;-tests depending upon the type of exposure variable. Dose-response relationships were assessed using Chi-square for trend. A subgroup of consented survivors (&lt;i&gt;n&lt;/i&gt; = 156) was followed to study the post-COVID symptoms and mortality rate outside the hospital. We constructed binary logistic models to find out the independent predictors of mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The patient group (&lt;i&gt;n&lt;/i&gt; = 402) was composed of individuals aged 18-95 years, and two-thirds (&lt;i&gt;n&lt;/i&gt; = 258) were men. The in-hospital mortality rate was 17.7%. The risk of mortality increased with age, multimorbidity, and extent of hypoxia, peripheral oxygen saturation/fraction of inspired oxygen [SpO&lt;sub&gt;2&lt;/sub&gt;/FiO&lt;sub&gt;2&lt;/sub&gt; (SF)] ratio, D-dimer, serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), serum creatinine, and blood urea. The case fatality rate (CFR) had a dose-response relationship with the number of comorbidities. Out of the individual comorbidities analyzed, systemic arterial hypertension [RR = 1.5 (1.16-1.83)], cancer [RR = 4.7 (1.38-15.6)], and neurological disorders [RR = 5.8 (1.6-21.16)] were significantly associated with mortality in the hospital. According to the binary logistic regression analysis, age, hypoxia at the time of admission, intensive care unit (ICU) admission, serum creatinine, and SF ratio were the significant predictors of mortality. Most of the patients (73%) complained of some symptoms during follow-up. Easy fatigability and tiredness were the most common post-COVID symptoms, followed by exertional breathlessness, myalgia, decreased sleep, weight loss, and cough.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The physician should prioritize patients with multimorbidity and markers of organ involvement to save lives in resource-poor settings during pandemics and large infectious disease outbreaks affecting the commun","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"43-49"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723686","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":"\"Academic Overdose\" among Healthcare Professionals.","authors":"Rajesh Agrawal","doi":"10.59556/japi.74.1426","DOIUrl":"https://doi.org/10.59556/japi.74.1426","url":null,"abstract":"<p><strong>Introduction: </strong>\"Academic overdose (AO) leads to a state of mental and emotional saturation with constant academic input, to the point that learning and productivity decline and may lead to mental exhaustion and burnout, affecting quality of life (QOL).\" Medical conferences (MC) are essential for knowledge dissemination, academic recognition, and professional transformation. This AO stems from the pressure to present research, networking, and demanding clinical and academic responsibilities. Adding to this are unlimited, exhaustive, and irritating queries from patients and attendants arising from internet searches.</p><p><strong>Discussion: </strong>In recent years, the frequency of MCs and continuous medical educations (CMEs) has increased across local, national, and international levels. While this growth offers educational opportunities, it has also led to content redundancy, extended sessions, and a lack of audience engagement. The healthcare professionals (HCPs) have high academic expectations to be achieved in multiple domains, such as position, sustainability, promotions, and excellence in clinical practice; they also maintain scholarly, educational, and administrative responsibilities, and balancing these is highly challenging and may lead to emotional exhaustion and burnout, exacerbated by academic preparation for MC presentations. MCs have various advantages and disadvantages and require structural reforms to attract more participants and to be recognized as being of very high standards. Restructuring of MCs seems logical, and MCs must remain accessible, affordable, and academically oriented.</p><p><strong>Conclusion: </strong>MCs offer learning, innovations, professional networking, and knowledge and experience sharing, while at the same time needing to be more inclusive, ethical, cost-effective, and image-building opportunities. Associated risks of exhaustion, sleep deprivation, burnout, and financial constraint necessitate restructuring of MCs.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"110-112"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724015","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 Clinical Profile of Transverse Myelitis with Special Reference to Outcomes: A 5-Year Retrospective Study.","authors":"Himabindu Pendem, Dhanya Sureddy, M Dhanaraj","doi":"10.59556/japi.74.1461","DOIUrl":"https://doi.org/10.59556/japi.74.1461","url":null,"abstract":"<p><strong>Introduction: </strong>Transverse myelitis (TM), a rare inflammatory condition affecting the spinal cord, presents with a rapid onset of bilateral motor and sensory symptoms with or without bladder/bowel and sexual dysfunction. Recent studies are attempting to identify its improvement, worsening, or conversion to multiple sclerosis, and the factors that determine these outcomes. The present study aims to assess the immediate and long-term outcomes of TM and to determine the factors associated with them.</p><p><strong>Materials and methods: </strong>The study involved a retrospective review of hospital records of 30 patients diagnosed with TM between 2018 and 2022, followed by a telephonic interview to assess their present outcomes.</p><p><strong>Results: </strong>Median age of the patients was 40 years [Interquartile range (IQR) = 30-48.5], with 53% males. About 76.7% had longitudinally extensive transverse myelitis (LETM). Onset was acute in 63.3%. Half (50%) of the patients had paraparesis. MRI spine showed involvement of the long segment in 65.5% and the short segment in 24.1%. At the end of treatment, 43.3% patients improved partially, and 16.7% improved completely. At follow-up, nearly 30% of the respondents reported complete recovery, while 8.3% reported worsening. One patient (3.33%), with an acute onset of TM, quadriparesis, bowel involvement, sexual dysfunction, and long spinal segment involvement, converted to multiple sclerosis at follow-up. 25% of patients with initial partial improvement showed complete improvement at follow-up.</p><p><strong>Conclusions: </strong>Acute onset LETM cases can potentially convert to multiple sclerosis. Patients who show early improvement, whether partial or complete, have higher chances of complete recovery at follow-up.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 4","pages":"62-67"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724041","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":"Diabetic Retinopathy: Does 12 Weeks of Intensive Lifestyle Intervention Cause Any Improvement?","authors":"Priyal Meghsham Talmale, Mrunal Phatak, Puja Bang","doi":"10.59556/japi.74.1437","DOIUrl":"https://doi.org/10.59556/japi.74.1437","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic retinopathy (DR) is a microvascular disorder occurring due to the long-term effects of diabetes mellitus and is the most common cause of severe vision loss in adults. Diabetic retinopathy may lead to vision-threatening damage to the retina, eventually leading to blindness.</p><p><strong>Aim: </strong>To study the effect of 12 weeks of intensive lifestyle intervention program on diabetic retinopathy using OCT and VEP.</p><p><strong>Setting and design: </strong>Quasi-experimental study conducted in the Department of Physiology in collaboration with the Department of Ophthalmology at AIIMS, Nagpur.</p><p><strong>Materials and methods: </strong>75 patients of type 2 diabetes mellitus with a duration of >5 years were recruited as per the inclusion and exclusion criteria. After taking clinical history and anthropometry parameters, visual evoked potential and optical coherence tomography were done. Then, a 1.5-hour lifestyle intervention session was conducted. Followed by follow-up visits on 15th, 30th, and 45th days, done with biweekly follow-up in between through telephonic/ WhatsApp group.</p><p><strong>Results: </strong>Modification in dietary pattern, regular exercise, healthy sleep schedule, and stress management showed a reduction in latencies and no major changes in amplitudes, but overall mild improvement was observed in PRVEP and FVEP. Also, in the retinal nerve fiber layer, mild changes along with a reduction in the severity of thickening of the retinal nerve fiber layer (RNFL) of both eyes were seen, but no major changes in central macula thickness were observed.</p><p><strong>Conclusion: </strong>Lifestyle modifications play a crucial role in the improvement of diabetic retinopathy.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 3","pages":"90-92"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445083","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":"Association between Androgenic Hair Patterns and Prostate Cancer Risk in South Indian Men: A Case-control Study from the Cauvery Delta.","authors":"Jayaprakash Narayanan, V Ezhil Sundar, Sri Akshay Mathi","doi":"10.59556/japi.74.1414","DOIUrl":"https://doi.org/10.59556/japi.74.1414","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PCa) is one of the most common malignancies in men worldwide. Androgens influence both prostate growth and hair patterns. Androgenic alopecia (male-pattern baldness) and excessive male-pattern body hair (hypertrichosis) have been hypothesized as clinical markers of long-term androgen exposure. Previous Western studies have reported mixed results on whether early-onset or severe androgenic alopecia correlates with increased prostate cancer risk. Data in South Indian (Dravidian) populations is lacking.</p><p><strong>Objective: </strong>To examine the association between androgenic hypertrichosis, androgenic alopecia, and prostate cancer in Dravidian men from the Cauvery Delta region of Tamil Nadu, India.</p><p><strong>Materials and methods: </strong>We conducted an age-stratified, population-based case-control study among men in the Cauvery Delta. The cases consisted of 117 men with pathologically confirmed adenocarcinoma of the prostate (diagnosed 2010-2015). Controls were 123 men with benign prostatic hyperplasia (BPH) from the same hospital registries, frequency-matched by age. Individuals with incomplete data or non-Dravidian (North Indian) ancestry were excluded. Trained investigators performed face-to-face interviews, directly observing and recording postpubertal body hair growth (indicative of androgenic hypertrichosis) and scalp hair loss (androgenic alopecia classified by the Norwood scale). Statistical analysis included multivariate discriminant analysis (Wilks' Lambda), one-way ANOVA for continuous variables, chi-square cross-tabulation, and computation of Cramer's V statistic to assess association strength. A two-tailed <i>p</i>-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>The age distributions of cases and controls were comparable. The prevalence of androgenic hypertrichosis and alopecia did not differ significantly between prostate cancer cases and BPH controls. Cramer's V analysis showed that prostate cancer status accounted for only 1.1% of the variance in hypertrichosis (Cramer's V ≈ 0.011) and 1.5% of the variance in alopecia (Cramer's V ≈ 0.015).</p><p><strong>Conclusion: </strong>In this case-control study of Dravidian men from Tamil Nadu, we observed no significant association between androgenic alopecia or hypertrichosis and prostate cancer. These findings contrast with data from Western cohorts, suggesting that interethnic variation in androgen receptor polymorphisms, follicular sensitivity, and environmental exposures may modulate prostate cancer risk differently. Further research is needed to elucidate how androgenic traits influence prostate carcinogenesis across different ethnic groups.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 3","pages":"42-45"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445308","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 Study on Prevalence of Malarial Retinopathy among Malaria Cases and to Determine Its Presence as a Marker of Severe Malaria: Observations from Eastern India.","authors":"Rupak Chatterjee, Tania Ray Bhadra, Nandini Chatterjee, Shatavisa Mukherjee, Prantiki Halder, Kumkum Sarkar, Indradeb Chatterjee, Bibhuti Saha, Partha Sarathi Karmakar, Netai Pramanik, Shambo Samrat Samajdar","doi":"10.59556/japi.74.1438","DOIUrl":"https://doi.org/10.59556/japi.74.1438","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Malarial retinopathy refers to a constellation of changes seen in severe or complicated malaria cases. These include: retinal whitening, vessel changes-whitening, tramlining, retinal hemorrhages, and papilledema. There are very few Indian studies on this entity. Since retina can be easily visualized by direct ophthalmoscopy, this study was done to determine prevalence of malarial retinopathy among malaria cases and to determine relationship between malarial retinopathy and severity of the disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;The study was done at Indoor and Outdoor Departments of Tropical Medicine, School of Tropical Medicine (STM), Kolkata, with the support of the Department of Ophthalmology, Regional Institute of Ophthalmology (RIO), Medical College, Kolkata. Adult malaria cases, both complicated/severe and uncomplicated, were included. Patients unable or unwilling to cooperate with eye examination, contraindications to tropicamide eye drops (angle closure glaucoma or known allergy to product), severe corneal scarring or cataracts hindering view by ophthalmoscopy, diabetes mellitus, hypertension, intracranial space occupying lesions, epilepsy, alcohol use, chronic renal failure, age &gt; 60 years and any other known ocular/systemic disease that can cause retinopathy changes were excluded. Severe malaria was diagnosed as per the WHO criteria. Cases with acute febrile illness of other causes were taken in control arm, and normal population subjects were taken as controls. All patients were assessed clinically, followed by appropriate laboratory investigations and then direct ophthalmoscopic examination was done. Ocular findings were be collaborated with severity of illness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 71 malaria cases were included in our study. Among them, 12 cases were of severe malaria, and rest of the cases were uncomplicated. Of the 12 severe malaria cases, 8 were &lt;i&gt;Plasmodium vivax&lt;/i&gt;, 3 were &lt;i&gt;Plasmodium falciparum&lt;/i&gt;, and 1 was mixed. Uncomplicated malaria cases were mostly &lt;i&gt;P. vivax&lt;/i&gt; (35 out of 59). Features suggestive of malarial retinopathy were noted in 9 out of 12 cases of severe malaria (75%) and 2 out of 59 cases of uncomplicated malaria (3.4%). We noted two cases of retinal changes-one case of retinal whitening in falciparum malaria and one case of vivax malaria with retinal hemorrhage in the uncomplicated group. Both of the cases subsequently needed admission for recurrent vomiting, reduced urine output, and severe weakness 40 dengue cases were included in control arm of AFI cases-20 DHF cases and 20 cases of DF with warning signs. Among them, retinal hemorrhage was noted in one case of DHF (2.5%). Out of 40 sepsis cases, retinal hemorrhage was seen in one case (2.5%). No retinal changes were noted among 40 other AFI cases which included scrub typhus, enteric fever, chikungunya, and acute viral hepatitis. Also, no abnormality was detected on ophthalmoscopy in ","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 3","pages":"62-67"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445325","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":"Distinct Risk Profiles in Posterior vs Anterior Circulation Strokes: A Prospective Study from Western India.","authors":"Keertan Chinthamaduka, Prakash V Makwana","doi":"10.59556/japi.74.1327","DOIUrl":"https://doi.org/10.59556/japi.74.1327","url":null,"abstract":"<p><strong>Background: </strong>Anterior (ACS) and posterior circulation strokes (PCS) differ in clinical presentation, vascular pathology, and associated risk factors.</p><p><strong>Objectives: </strong>The aim of the study was to compare vascular risk profiles, clinical characteristics, neuroimaging findings, and outcomes between ACS and PCS patients in a hospital-based cohort.</p><p><strong>Methods: </strong>A prospective observational study was conducted at a tertiary care hospital, from January to December 2021. Consecutive patients with confirmed anterior or posterior circulation stroke were included. Demographics, National Institutes of Health Stroke Scale (NIHSS) scores, vascular risk factors (hypertension, diabetes, dyslipidemia, smoking, metabolic syndrome), presenting symptoms, computed tomography (CT) imaging findings, and outcomes [modified Rankin Scale (mRS) at discharge, mortality] were recorded. Univariate and multivariate logistic regression analyses were performed.</p><p><strong>Results: </strong>Among 376 stroke patients analyzed, 274 (72.9%) had ACS and 102 (27.1%) had PCS. PCS patients were significantly younger (54.6 vs 61.2 years; <i>p</i> = 0.003), with a higher prevalence of hypertension (78.4 vs 62.8%; <i>p</i> = 0.008), current smoking (45.1 vs 28.8%; <i>p</i> = 0.002), metabolic syndrome (41.2 vs 28.5%; <i>p</i> = 0.02), and poor glycemic control (HbA1c >8% in 51.2 vs 38.6%; <i>p</i> = 0.04). PCS presented more often with vertigo (78.4%), ataxia (62.7%), and visual symptoms (54.9%), while ACS typically presented with hemiparesis and aphasia. Despite lower NIHSS scores, brainstem infarcts in PCS accounted for most in-hospital deaths. Multivariate analysis identified hypertension, smoking, age <55, and metabolic syndrome as independent predictors of PCS.</p><p><strong>Conclusion: </strong>PCS affect a younger demographic and are independently associated with modifiable metabolic and vascular risk factors. Their atypical presentation and distinct risk profile call for targeted screening and prevention strategies, particularly in younger Indian adults.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 3","pages":"17-21"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445069","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":"Complicated Kartagener Syndrome Presenting as Type II Respiratory Failure: A Case report.","authors":"Poonam Gupta, Ajeet Kumar Chaurasia, Surendra Kumar Gupta","doi":"10.59556/japi.74.1141","DOIUrl":"https://doi.org/10.59556/japi.74.1141","url":null,"abstract":"<p><p>We report a case of a 22-year-old male who was previously treated for asthma from childhood, and his repeated respiratory infections prompted the physician to start antitubercular therapy (ATT) thrice, suspecting pulmonary tuberculosis despite being sputum acid-fast bacillus (AFB) negative every time. Diagnosis of Kartagener syndrome (autosomal recessive inheritance having a triad of bronchiectasis, chronic sinusitis, situs inversus, and strongly associated with infertility) was made in this case at our tertiary care referral hospital, but it was already too late when he presented with life-threatening bilateral pneumonia, bilateral pleural effusion with type II respiratory failure, and associated cystitis warranting mechanical ventilation, and he succumbed because of extremely and irreversibly damaged lungs.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 3","pages":"7-11"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445107","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":"Clinicopathological Spectrum and Biomarker Profile of Male Breast Cancer: A Retrospective Study from a Tertiary Care Center in South India.","authors":"Sanjana Reddy Potu, Vishesh Gumdal, Deepak Koppaka, Hema Sireesha Natti, Pragna Sagar Rapole, Touseef Ahmed Hussein Syed","doi":"10.59556/japi.74.1427","DOIUrl":"https://doi.org/10.59556/japi.74.1427","url":null,"abstract":"<p><strong>Introduction: </strong>Male breast cancer (MBC) accounts for <1% of breast malignancies yet often presents at advanced stages, particularly in low- and middle-income countries where awareness is limited. This study sought to define the clinicopathological spectrum, biomarker profile, and treatment outcomes of MBC in a South Indian tertiary cancer center.</p><p><strong>Objectives: </strong>To analyze the demographic features, clinical presentation, pathological characteristics, biomarker distribution, treatment modalities, and outcomes of MBC cases managed at our center between 2019 and 2025.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed all male patients with histologically confirmed breast carcinoma managed between 2019 and 2025 at ESIC Medical College and Hospital, Hyderabad. Demographic, clinical, pathological, biomarker, and treatment data were retrieved from hospital records and supplemented by follow-up contact.</p><p><strong>Results: </strong>A total of 15 patients (mean age 60 years, range 31-74) were identified. Median delay from symptom onset to diagnosis was 6 months. All presented with a retroareolar mass, frequently accompanied by nipple retraction or skin changes. Most patients had advanced disease: Stage III (<i>n</i> = 9, 60.0%) and Stage IV (<i>n</i> = 4, 26.7%). Invasive ductal carcinoma was universal. Hormone receptor positivity was seen in 80%, HER2 positivity in 40%, and a triple-positive phenotype in 26.7%. Treatment strategies were stage- and biomarker-driven: 86.7% underwent surgery, endocrine therapy was prescribed for all HR+ cases, HER2-directed therapy was delivered when feasible, and CDK4/6 inhibitors were used in selected advanced HR+ tumors. At last follow-up, 9 patients (60%) remained alive with disease control, while 2 succumbed to progression.</p><p><strong>Conclusion: </strong>MBC in this cohort was characterized by delayed diagnosis, advanced presentation, and a high prevalence of HER2-positive tumors. Multimodality, biomarker-guided therapy achieved durable control in many patients, underscoring the urgent need for awareness initiatives, earlier detection, and equitable access to targeted therapies in India.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 3","pages":"56-58"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445145","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}