Medical Journal Armed Forces India最新文献

{"title":"An evaluation of first-year medical students’ perspectives on hands-on learning of living anatomy using ultrasonography in anatomy","authors":"Pauline Shanthi Prabahar,&nbsp;Femina Sam,&nbsp;Jenny Jacob,&nbsp;John Kandam Kulathu Mathew,&nbsp;Suganthy Rabi","doi":"10.1016/j.mjafi.2024.11.016","DOIUrl":"10.1016/j.mjafi.2024.11.016","url":null,"abstract":"<div><h3>Background</h3><div>Cadaveric dissection has been the gold standard teaching tool and often medical students find it challenging to visualize the functioning human. Point-of-care ultrasound is the future stethoscope and hence, the study aimed to validate students’ perceptions on hands-on ultrasound session.</div></div><div><h3>Methods</h3><div><span>Ultrasound hands-on sessions on upper limb (UL) and lower limb (LL) extremities were given to 100 undergraduate students of 2 batches by trained anatomy faculty. The learning targets were met to achieve a parallel presentation of anatomic structures in dissection and ultrasound demonstration. Feedback questionnaires were collected using a 5-point </span>Likert scale followed by a focus group discussion.</div></div><div><h3>Results</h3><div>The students that responded [n = 144 (upper limb), n = 148 (lower limb)] perceived that hands-on session enhanced understanding of 3D anatomy and improved anatomical knowledge of structures seen in dissections, and could identify artery, vein, and movement of tendons real time in the living body (100%). Ultrasound sonography<span> sessions reinforced the structural relations by confirming the structures in UL (98.6%) and surface anatomy of peripheral vessels in LL (100%). Students felt that handling the machine, the probe, and its orientation was easier (UL-97.9%, LL-99.3%). It motivated them to learn anatomy well in the dissection hall (UL-97.9%, LL-100%). They agreed that they could interpret the ultrasound images with ease (UL- 94.2%, LL-97.4%) and the focus group discussion was strongly positive.</span></div></div><div><h3>Conclusion</h3><div>With the implementation of competency-based curriculum, early clinical exposure of medical students to ultrasound increases their learning motivation and interest to apply their anatomical knowledge to clinical practice.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 4","pages":"Pages 427-434"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148478655","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":"Diaphragmatic hernia in elderly: An unusual cause of secondary polycythemia","authors":"Debabrata Brahma,&nbsp;Nishant Roy,&nbsp;Anup Singh","doi":"10.1016/j.mjafi.2025.06.007","DOIUrl":"10.1016/j.mjafi.2025.06.007","url":null,"abstract":"<div><div>Polycythemia vera (PV) is a myeloproliferative neoplasm classically characterized by erythrocytosis associated with a high risk of thromboembolic events. Chronic pulmonary hypoxia is one of the most common causes of secondary polycythemia. We present a rare case of a 72-year-old elderly male patient who presented with generalized body weakness and recurrent cough with expectoration for 15 years. Investigation showed raised hemoglobin, hematocrit, and serum erythropoietin levels. Contrast-Enhanced Computed Tomography (CECT) of the thorax revealed a defect in the left hemidiaphragm of size 5.7 cm containing the stomach, pancreatic body, and colon as content, causing contralateral mediastinal shift with loss of lung volume. He was managed with therapeutic phlebotomy and reported significant improvement in fatigue. The significant loss of lung volume due to the diaphragmatic hernias evidenced by the CECT thorax, was postulated as the cause of secondary polycythemia in our case. The case highlights the rare presentation of congenital diaphragmatic hernia late in the elderly and the importance of its early diagnosis to prevent complications like recurrent respiratory infection and secondary polycythemia.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 4","pages":"Pages 494-497"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148478554","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":"Piezosurgery vs conventional sequential osteotomy for implant site preparation: An umbrella review of their effects on implant stability and marginal bone loss","authors":"K.S.V. Ramesh,&nbsp;P.A. Vijay kumar,&nbsp;P.S. Gautami,&nbsp;N.V.S.G. Sruthima,&nbsp;P. Mohan Kumar,&nbsp;K. Anil Kumar,&nbsp;M. Venkata Lakshmi","doi":"10.1016/j.mjafi.2025.12.016","DOIUrl":"10.1016/j.mjafi.2025.12.016","url":null,"abstract":"<div><div>Implant site preparation is essential for osseointegration and implant stability. Conventional sequential osteotomy, though effective, generates heat and may compromise bone healing. Piezosurgery, an ultrasonic technique, is proposed to minimize trauma, improve secondary stability, and reduce peri-implant marginal bone loss (MBL). This umbrella review evaluates its effectiveness compared to conventional sequential osteotomy. A systematic search of PubMed, Scopus, Cochrane, and PROSPERO was conducted up to February 2025, following PRISMA guidelines. Systematic reviews and meta-analyses comparing piezosurgery and conventional sequential osteotomy were included. The AMSTAR 2 and Glenny checklists assessed methodological quality. Outcomes analyzed included implant stability, MBL, implant survival, and operation time. Nine systematic reviews were included. AMSTAR 2 analysis rated the selected reviews as low-quality, with two achieving moderate quality. Implant survival rates were similar between techniques. While primary stability showed no significant difference, piezosurgery improved secondary stability. MBL outcomes were comparable. Piezosurgery reduced postoperative pain, swelling, and inflammation but required significantly longer surgical time. Piezosurgery and conventional sequential osteotomy yield similar implant survival and MBL outcomes. While piezosurgery may improve secondary stability and postoperative comfort, evidence does not confirm clinical superiority. However, its long-term benefits over conventional sequential osteotomy remain unclear and the extended operative time may limit its practical application.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 4","pages":"Pages 390-399"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148478684","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":"To assess the impact of uncollected laboratory reports in a polyclinic outpatient setting of an Apex Medical College","authors":"Sumit Dahiya,&nbsp;Arti Sarin,&nbsp;Saroj Kumar Patnaik,&nbsp;Satya Choubey","doi":"10.1016/j.mjafi.2025.07.002","DOIUrl":"10.1016/j.mjafi.2025.07.002","url":null,"abstract":"<div><h3>Background</h3><div>The healthcare system relies extensively on laboratory services. Increasing demand for diagnostics has led to financial challenges, with laboratory budgets rising by 25–40% in response to an 8–10% annual increase in workload. During administrative rounds at the place of study, it was found that a number of reports have not been collected, raising concerns about facility overuse, patient engagement, and increased costs.</div></div><div><h3>Methods</h3><div>This retrospective study was conducted in a Polyclinic setting from 01 April 2022 to 31 October 2022 to assess the administrative and financial impact of uncollected test reports through data analysis.</div></div><div><h3>Results</h3><div>Out of 87,650 patients, 22.23% (19,493) were advised blood investigations, resulting in 48,527 samples. Among uncollected reports, 4022 investigations belonging to 2549 patients were analysed, 43% were male and 54% female. The highest noncompliance was seen in patients aged 19–30 years (24.5%). For severity analysis, reports where severity could not be determined (n = 66) were excluded. Among the remaining uncollected reports (n = 2433), 79% (1939) were classified as “Normal/Borderline,” and 21% (494) as “Abnormal,” based on established laboratory reference ranges. Uncollected investigations accounted for 8.28% of all tests and 7.96% of the total cost (₹ 8,07,346/-). These findings highlight the need for interventions to improve report retrieval, enhance patient engagement, and optimise healthcare resource utilisation.</div></div><div><h3>Conclusion</h3><div>Age-related trends indicate a need for targeted interventions, particularly in groups with a higher proportion of abnormal results. After excluding cases where severity could not be determined, laboratory results among uncollected reports showed 79% “Normal/Borderline” and 21% “Abnormal.” The financial impact of uncollected investigations accounted for 7.96% (₹ 8,07,346/-) of the total cost, highlighting the importance of addressing patient noncompliance for efficient resource utilisation.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 4","pages":"Pages 450-458"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148478692","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":"Abdominal compartment syndrome: Case series of a rare lifethreatening syndrome in paediatric intensive care unit","authors":"Abhinav Vishwakarma,&nbsp;Safal Muhammad MK,&nbsp;Sateesh R,&nbsp;Bal Mukund,&nbsp;Vivek Bhat","doi":"10.1016/j.mjafi.2025.05.001","DOIUrl":"10.1016/j.mjafi.2025.05.001","url":null,"abstract":"<div><div>Abdominal compartment syndrome (ACS) is an uncommon life-threatening syndrome usually seen after significant fluid or blood leaks inside the abdominal space, the commonest being intraabdominal fluid leaks and intra-abdominal bleeding. ACS results in end organ dysfunction caused by increased intra-abdominal pressure resulting in decreased perfusion pressure and multi-organ failure if not recognised early and treated. We present three cases from our hospital requiring intensive care treatment due to abdominal compartment syndrome. All cases were identified timely and appropriate interventions from multidisciplinary team lead to successful outcome.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 4","pages":"Pages 489-493"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148478662","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":"Penile nodules with concurrent intravesical BCG-associated tuberculous granulomatous prostatitis: An unusual case report","authors":"S.B. Viswaroop,&nbsp;Ganesh Gopalakrishnan","doi":"10.1016/j.mjafi.2025.04.009","DOIUrl":"10.1016/j.mjafi.2025.04.009","url":null,"abstract":"<div><div><span>Intravesical Bacillus Calmette-Guérin (BCG) related complications are known to present in a myriad of forms. We report an unusual presentation of subcutaneous penile nodules without balanitis<span> or glans ulceration with concomitant </span></span>granulomatous<span> prostatitis<span> following the induction course of BCG for bladder cancer.</span></span></div><div>Levels of evidence are not applicable.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 4","pages":"Pages 485-488"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148478654","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 assessment of liver viability/injury based on ATP quantification of liver tissue at baseline and normothermic machine perfusion","authors":"S. Vidhya Lakshmi,&nbsp;Eliz Thomas,&nbsp;Swaminathan Sambandam","doi":"10.1016/j.mjafi.2025.06.001","DOIUrl":"10.1016/j.mjafi.2025.06.001","url":null,"abstract":"<div><h3>Background</h3><div>Orthotopic liver transplantation is a life-saving procedure for patients with end-stage liver disease. However, liver graft preservation remains a challenge, limited by ischemia-reperfusion injury. Normothermic machine perfusion (NMP) has emerged as a promising alternative. This study aimed to evaluate the functional viability and histological integrity of porcine livers preserved using an indigenously developed, costeffective NMP machine, and to correlate ATP depletion with liver injury during perfusion.</div></div><div><h3>Methods</h3><div>Four Yorkshire pigs (35-40 kg) underwent liver retrieval and ex-situ perfusion using a custom-designed NMP. Liver function was monitored through bile production, lactate levels, blood gas analysis, and liver enzymes at 1-hour intervals over 8 hours. Liver biopsies were taken at baseline, 4 hours, and 8 hours for histopathological analysis and adenosine triphosphate (ATP) quantification using immunohistochemistry. ATP depletion was evaluated as a marker of liver viability.</div></div><div><h3>Results</h3><div>The machine maintained functional viability, evidenced by stable bile production and minimal liver enzyme elevation, despite ATP depletion. Histopathological analysis revealed minimal damage in livers with &lt; 50% ATP depletion, while significant injury (necrosis) was observed in livers with &gt; 50% ATP depletion. ATP depletion correlated with functional impairment and liver injury, suggesting its potential as a predictive marker for liver viability.</div></div><div><h3>Conclusion</h3><div>The indigenously developed NMP machine effectively preserved liver function and structural integrity in porcine livers. ATP depletion is a reliable indicator of liver viability, and this system holds promise for improving graft preservation in liver transplantation, particularly for marginal grafts. Further studies with larger sample sizes are necessary for clinical validation.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 4","pages":"Pages 442-449"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148478661","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":"N-of-1 behavioural medicine: Revolutionizing health promotion in public health through personalized intervention","authors":"Sudip Bhattacharya,&nbsp;Amarjeet Singh,&nbsp;Suneela Garg,&nbsp;Ashoo Grover,&nbsp;Saurabh Varshney","doi":"10.1016/j.mjafi.2024.04.004","DOIUrl":"10.1016/j.mjafi.2024.04.004","url":null,"abstract":"<div><div>Behavioural medicine, at the intersection of behavioural science and medicine, aims to understand how behaviour influences health and to design interventions for better quality of life<span><span>. Focusing on the interplay between behaviours, psychological processes, and biological factors, the field applies behavioural principles to prevent, diagnose, and treat medical conditions. Its key components include application of psychosocial and behavioural paradigms for the analysis of health promotion<span>, disease prevention, and adherence to medical treatment. In public health, behavioural medicine plays a pivotal role by contributing to initiatives promoting healthy behaviours, identifying risk factors, and addressing </span></span>social determinants of health. Despite its potential to contribute to this field, behavioural medicine has limitations, including the complexity of human behaviour and challenges in sustaining long-term behaviour change. In modern era medicine, focus is on evidence-based practice. In this context, N-of-1 trials, or single-subject trials, introduce a personalized approach to behavioural medicine research. The logic for the focus on individual patients is that ‘each person is unique’. These trials focus on individual patients, systematically implementing and evaluating behavioural interventions over multiple cycles. By randomizing and blinding interventions, collecting repeated measures of outcomes, and prioritizing patient-centred outcomes, N-of-1 trials offer a nuanced understanding of how specific interventions impact individual health. While literature on N-of-1 trials in behavioural medicine is limited, they hold promise in tailoring interventions to individuals, addressing the diverse and dynamic nature of human behaviour in health contexts.</span></div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 4","pages":"Pages 377-380"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148478688","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":"Intermittent phototherapy vs continuous phototherapy for treatment of neonatal hyperbilirubinemia: A randomized control trial","authors":"Gopalakrishnan Shridhar ,&nbsp;Sarvesh Kohli ,&nbsp;Bhaskar Bharadwaj ,&nbsp;Reema Solanki ,&nbsp;Karthik Ram Mohan ,&nbsp;Shuvendu Roy ,&nbsp;K.M. Adhikari","doi":"10.1016/j.mjafi.2025.05.007","DOIUrl":"10.1016/j.mjafi.2025.05.007","url":null,"abstract":"<div><h3>Background</h3><div><span>Though safe, phototherapy has short and long-term side-effects. This </span>randomized control trial<span> (RCT), evaluated the efficacy and safety of intermittent versus continuous phototherapy in treatment of neonatal hyperbilirubinemia<span>. The aim of this study was to compare intermittent versus continuous phototherapy for treatment of nonhemolytic neonatal hyperbilirubinemia<span> and the primary objective was to compare rate of decline of bilirubin between neonates treated with intermittent versus continuous phototherapy.</span></span></span></div></div><div><h3>Methods</h3><div>RCT conducted over two years. All late preterm (≥ 35 weeks) and term neonates requiring phototherapy as per AAP 2004 guidelines (Low and Medium risk groups) were eligible for inclusion and were randomized to either continuous or intermittent phototherapy using serially numbered opaque sealed envelopes, after informed parental consent.</div></div><div><h3>Results</h3><div>Among 130 neonates, randomized in a 1:1 allocation ratio, mean (±SD) TSB at enrolment was 17.1 (±1.1) and 17.3 (±1.3) mg/dl; p value 0.35, and the rate of fall of bilirubin was 0.14 (0.08 to 0.20 IQR) and 0.16 (0.10 to 0.18 IQR) mg/dl/hr; p value 0.88 in the continuous and intermittent phototherapy groups respectively. The mean (95% CI) difference between the two groups was 0.010 (-0.0165 to 0.0365) mg/dl/hr, within the pre-defined limits of non-inferiority (Δ=0.05 mg/dl/h). The median duration of phototherapy was lower, (24 (12 to 24) hours in the intermittent phototherapy group as compared to 34 (26 to 44) hours in the continuous phototherapy group; p value 0.09.</div></div><div><h3>Conclusion</h3><div>Intermittent phototherapy (with 12 hours on and 12 hours off cycles), along with clinical and lab monitoring was as effective as continuous phototherapy in the treatment of non-hemolytic neonatal hyperbilirubinemia.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 3","pages":"Pages 324-330"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147854061","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":"Biochemical markers in first-episode psychosis: A case-control study","authors":"Ritwik Mishra ,&nbsp;Surender Sharma ,&nbsp;S. Shashivadhanan ,&nbsp;M.D. Niyaz ,&nbsp;Ankit Singal ,&nbsp;G.S. Bhalla ,&nbsp;Neha Sharma","doi":"10.1016/j.mjafi.2026.01.007","DOIUrl":"10.1016/j.mjafi.2026.01.007","url":null,"abstract":"<div><h3>Background</h3><div>It is being increasingly realized that immunological dysregulation and alteration of levels of cytokines play an important role in the etiology of psychotic symptoms, particularly of first-episode psychosis (FEP). Earlier studies have theorized that disrupted levels of interleukin-6 (IL-6) and interleukin-10 (IL-10) and other cytokines like C-reactive protein and tumor necrosis factor-alpha (TNF-α) play a role in symptom development in FEP patients. The study was done to evaluate serum levels of IL-6, IL-10, and IL-10-to-IL-6 ratio in FEP patients versus a healthy control population.</div></div><div><h3>Methods</h3><div>A case-control study was conducted with 120 individuals (60 FEP patients and 60 healthy controls age and sex matched) at a tertiary care facility in Western Maharashtra from January 2023 to December 2023. The serum levels of IL-6 and IL-10 were analyzed using enzyme-linked immunosorbent assay. Independent t-tests were used to analyze data for continuous variables and odds ratios (ORs) with 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>FEP patients exhibited IL-10 levels significantly higher than controls (6.39 ± 1.17 pg/mL vs 4.42 ± 0.58 pg/mL; p &lt; 0.001) and lower IL-6 levels than controls (3.98 ± 0.56 pg/mL vs 4.31 ± 0.39 pg/mL; p &lt; 0.001). The average IL-10-to-IL-6 ratio was also significantly different in FEP cases at 1.65 ± 0.46 and controls at 1.03 ± 0.11, with p &lt;0.001. High IL-10 (OR = 2.85; 95% CI: 1.35–6.04) and high IL-10-to-IL-6 ratio (OR = 2.11; 95% CI: 1.02–4.39) were both significantly correlated with FEP, while high IL-6 levels were inversely correlated with FEP (OR = 0.41; 95% CI: 0.20–0.86). Mean body weight of FEP patients was also decreased significantly compared with controls (68.6 kg vs 72.7 kg; p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>FEP patients have increased levels of IL-10, reduced levels of IL-6, and an increased IL-10-to-IL-6 ratio. Change in concentration of these cytokines could be involved in pathophysiology. The reduced body weight among the FEP patients may suggest underlying constitutional or metabolic factors that predispose them to the illness.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 3","pages":"Pages 350-355"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147854725","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}