Dahiya N, Grover A, Agarwal V
… +23 more, Debbarma A, Arun P, Balhara YPS, Bajpai P, Bhan A, Chakrabarti A, Das B, Athokpam RD, Dhaliwal R, Deshpande S, Grover S, James J, Khanna A, Verma P, Singh RL, Mishra P, Ramachandran P, Prakash O, Parveen, Prasad D, Sawant N, Singh R, Singh G
Indian J Med Res
· 2025 Nov · PMID 41520271
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Background & objectives The prevalence of mental health disorders in India is a growing public health concern, yet there is a dearth of initiatives and consensus on prioritising mental health research areas at the nation...Background & objectives The prevalence of mental health disorders in India is a growing public health concern, yet there is a dearth of initiatives and consensus on prioritising mental health research areas at the national level. This paper presents the findings from the modified Delphi-based exercise undertaken by the Indian Council of Medical Research (ICMR) to address this gap. By engaging key stakeholders from diverse sectors-including mental health professionals, State programme officers, health care providers, policymakers, researchers, and civil society representatives-the exercise aimed to identify critical mental health research gaps and develop a blueprint to guide public mental health research in the country. Methods A comprehensive methodology consisting of four steps was followed, including the initial conceptualisation and desk review, a national level brainstorming meeting, restructuring and finalisation of the questions, and prioritisation process. Results Through a rigorous, iterative process of prioritisation and consensus, the top three mental health research questions were identified. These included (i) implementing suicide prevention interventions in schools and colleges, (ii) integrating mental disorder screening and treatment into non-communicable disease care, and (iii) reducing the treatment gap for mental disorders. Conclusion The outcomes of this exercise shall provide valuable insights for mental health research, policy, and resource allocation strategies at the national level.
Mangone FRR, Krepischi ACV, Pavanelli AC
… +3 more, Gatti PHF, Carraro DM, Nagai MA
Indian J Med Res
· 2025 Nov · PMID 41520270
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Background & objectives Genetic instability is frequent in tumour cells and might occur due to an imbalance of homologous recombination (HR). HR is a crucial mechanism of DNA double-strand break (DSB) repair that depends...Background & objectives Genetic instability is frequent in tumour cells and might occur due to an imbalance of homologous recombination (HR). HR is a crucial mechanism of DNA double-strand break (DSB) repair that depends on the formation and resolution of Holliday junctions for genomic stability maintenance. The SMC6 complex with SMC5 is involved in DSB repair. We sought to investigate the association between SMC6 expression, genomic instability, and prognosis of breast cancer. Methods This was an observational retrospective cohort study. We assessed SMC6 expression and copy number variation (CNV) data measured by qRT-PCR and whole-genome comparative genomic hybridization in 33 women with breast cancer who are non-carriers of BRCA1/BRCA2 mutations. According to nuclear staining, the SMC6 protein expression was evaluated on a tissue microarrayer containing 481 samples classified as SMC6low (negative/weak) or SMC6high (moderate/strong). Results SMC6low tumours tend to show higher CNV. SMC6high group presented poorer disease-free survival than the SMC6low group (P=0.050), mainly for the luminal subtype (P=0.005). SMC6low/ERpos were protective biomarkers for recurrence. Interpretation & Conclusions There is a possible association between SMC6 expression and relapse of breast cancer, also suggesting that SMC6 abnormal expression may indicate tumour genetic instability in breast cancer.
Indian J Med Res
· 2025 Nov · PMID 41520269
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Background & objectives Endometriosis, a chronic inflammatory condition, affects approximately 10 per cent of reproductive-age women in India. This study aimed to explore the experiences of women with endometriosis and t...Background & objectives Endometriosis, a chronic inflammatory condition, affects approximately 10 per cent of reproductive-age women in India. This study aimed to explore the experiences of women with endometriosis and their partners. Methods A qualitative exploratory study was conducted in two Indian States. In-depth interviews were conducted with 21 women (18-49 yr) with laparoscopically diagnosed endometriosis and 10 of their male partners. Interviews were conducted in local languages and English, with informed consent. Recordings were transcribed, coded, and analysed using Braun and Clarke's thematic analysis. Results The study revealed significant impacts of endometriosis on both women and men, including decreased quality of life, psychological effects, financial distress, strained intimate relationships and burden of infertility. Women experienced greater impacts, particularly in life opportunities and employment, social life and mental health. Delayed diagnosis and treatment exacerbated women's suffering, compromising their well-being and quality of life. Interpretation & conclusions This study emphasises the need for improved early diagnosis and treatment of endometriosis to mitigate its impact on women and their partners.
Patra S, Tellapragada C, Pathak P
… +4 more, Rao MK, Kalwaje VE, Thavaselvam D, Mukhopadhyay C
Indian J Med Res
· 2025 Nov · PMID 41520268
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Background & objectives Brucellosis, an occupational zoonosis, poses notable difficulties in diagnosis because of the need for secure facilities and the risk of exposure when using culture-based methods. Conventional ser...Background & objectives Brucellosis, an occupational zoonosis, poses notable difficulties in diagnosis because of the need for secure facilities and the risk of exposure when using culture-based methods. Conventional serological tests often suffer from cross-reactivity, highlighting the need for more specific diagnostic markers. The purpose of this study was to understand the differences in whole-cell protein expression of Brucella melitensis isolates from patients with acute and chronic brucellosis and to identify immunodominant proteins that could serve as potential diagnostic markers. Methods The study included 16 blood culture-confirmed patients with acute or chronic brucellosis from a cohort of 185 individuals. Clinical isolates of B. melitensis were subjected to two-dimensional gel electrophoresis (2-DE) and PDQuest software analysis to compare proteomic profiles. Differentially expressed proteins were identified using western blotting with infected human serum samples. Further identification of the protein spots was conducted using Matrix-Assisted Laser Desorption/Ionization - Time-of-flight Mass Spectrometry (MALDI-TOF MS). Results The proteomic analysis of B. melitensis identified an average of 249 protein spots. PDQuest software revealed 65 differentially expressed spots, with 17 of these spots successfully identified via MALDI-TOF MS. Western blot assays demonstrated that human sera containing anti-Brucella antibodies reacted with seven immunodominant protein spots. Among these, the outer membrane porin protein (omp25), aldehyde dehydrogenase, and universal stress protein showed potential for differentiating acute from chronic brucellosis. Interpretation & conclusions The findings indicate that omp25, aldehyde dehydrogenase, and universal stress protein are highly specific to B. melitensis infections and could serve as valuable targets for serodiagnosis.
Arya LK, Kumari A, Kusumesh R
… +4 more, Kumar P, Sinha BP, Kumar M, Kumari N
Indian J Med Res
· 2025 Nov · PMID 41520267
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Background & objectives Pseudomonas aeruginosa is a leading cause of bacterial keratitis, known for its rapid progression, severe corneal damage, and resistance to treatment. Existing animal models exist to study disease...Background & objectives Pseudomonas aeruginosa is a leading cause of bacterial keratitis, known for its rapid progression, severe corneal damage, and resistance to treatment. Existing animal models exist to study disease mechanisms and therapeutic options require specialised conditions or complex procedures. This study aimed to develop a simplified, cost-effective, and reproducible murine model of P. aeruginosa keratitis using Swiss albino mice for translational research applications. Methods Four female Swiss albino mice (6-8 wk old) were maintained under standard conditions. Baseline ocular evaluation was done using a handheld slit lamp. The left corneas were abraded with a sterile 26G needle and inoculated topically with 10 μL of P. aeruginosa (1.0 × 10⁶ CFU/mL, ATCC 19660). The right eyes served as uninfected controls. Clinical signs were assessed on days 1, 2, and 3 using a standardised 0-4 scoring scale. Infection was confirmed through culture, biochemical tests, and PCR targeting the exotoxin A gene. Statistical analysis was performed using one-way ANOVA with Tukey's post hoc test. Results All infected eyes developed progressive keratitis marked by lid swelling, corneal haze, and stromal involvement. Control eyes remained unaffected. Clinical scores increased significantly over time (P< 0.05). Culture and molecular analyses confirmed successful infection. Interpretation & conclusions This simplified Swiss albino mouse model effectively mimics human P. aeruginosa keratitis and enables cost-efficient study of pathogenesis and therapeutic testing. It can facilitate standardised ophthalmic infection research.
Banerjee R, Khan PK, Goswami B
… +20 more, Mahapatra S, Kammilli N, Saini R, Sengupta S, Jena M, Rathore S, Manolla ML, Thomas W, Hembram M, Malhotra B, Sutradhar S, Bingi TC, Mahalakshmi G, Behera D, Mohapatra K, Nath Behera J, Mehta A, Bhandari S, Grover A, Neogi SB
Indian J Med Res
· 2025 Nov · PMID 41520265
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Background & objectives The effects of COVID-19 on neonatal and perinatal outcomes and infant development in low- and middle-income countries have not been well studied. Our study aimed to explore the effect of maternal...Background & objectives The effects of COVID-19 on neonatal and perinatal outcomes and infant development in low- and middle-income countries have not been well studied. Our study aimed to explore the effect of maternal COVID-19 infection on pregnancy, neonatal outcomes, and development of infants. Methods We conducted a retrospective cohort study on women exposed to and not exposed to COVID-19 during pregnancy and their infants (exposed and comparison cohort, respectively). Data were collected through hospital records and interview of mothers. Outcomes included stillbirth, preterm birth, low birth weight, admission to special newborn care unit (SNCU) and attainment of age-appropriate developmental milestones till one year of age. We conducted propensity score matching analysis to address any selection bias. Results Exposure to SARS-CoV-2 was associated with a higher risk of stillbirths [adjusted odds ratio (aOR) 2.63; 95% confidence interval (CI) 1.39, 4.96] and admission to SNCU (aOR 2.57; 95% CI 1.85, 3.58) after adjusting for pregnancy and birth-related covariates. Risk of illness among babies born to COVID-positive mothers was higher [relative risk (RR) 4.23; 95% CI 3.14, 5.69; P<0.001]. Age of attainment of developmental milestones were similar between both cohorts. Interpretation & conclusions Women who contracted COVID-19 in pregnancy were at higher risk of stillbirths, and their babies were more likely to be admitted to the SNCU as compared to their COVID-negative counterparts. There were no clinically meaningful differences between babies of both cohorts in the age at which developmental milestones were attained.
Agarwal RK, Dhanya R, Parmar L
… +15 more, Sedai A, Mani G, Dhar A, Hegde S, Periyavan S, Erappa N, S A, Kumar S, Rengaraj B, G N M, N M, Prasad RN, Fernandes R, Makkam A, Faulkner L
Indian J Med Res
· 2025 Nov · PMID 41520262
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Bhat KD, Bhattacharya H, Jayaraman Y
… +11 more, Perumal V, Ravinder T, Dash A, Pattnaik M, Nahak KC, Kanungo S, Swamy D M N, Kerketta AS, G S, Bhattacharya D, Pati S
Indian J Med Res
· 2025 Nov · PMID 41520259
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Background & objectives Hepatitis B virus (HBV) infection continues to pose a major public health challenge, especially among rural and tribal communities where access to healthcare services is often limited. The present...Background & objectives Hepatitis B virus (HBV) infection continues to pose a major public health challenge, especially among rural and tribal communities where access to healthcare services is often limited. The present study aimed to assess the status of HBV infection among children between 1 to 5 yr of age and to evaluate vaccination coverage in the Mayurbhanj district of Odisha. Methods A cross-sectional study was conducted among children aged 1-5 yr. Blood samples were tested for Hepatitis B surface antigen (HBsAg), antibody to Hepatitis B surface antigen (anti-HBs) and other serological markers to determine infection status and vaccination coverage. Results HBsAg seropositivity, indicating active HBV infection, was detected in 0.6 per cent [95% confidence interval (CI): 0.3-0.9] of the samples. Similarly, anti-HBc was tested positive in 0.4 per cent (95% CI: 0.2-0.8) of children. The combined prevalence of HBV infection-based on positivity for either HBsAg or anti-HBc-was 0.8 per cent (95% CI: 0.5-1.2). Vaccination data were collected for 2,647 (98.0%) children of which 90.9 per cent received the birth dose of Hepatitis B vaccine. A total of 98.1 per cent received pentavalent 1 (Penta 1), whereas 97.3 per cent and 96.1 per cent of children received Penta 2 and Penta 3. However, 72.6 per cent (1,961) had protective levels of antibody (anti-HBs) above the threshold, signifying adequate immune protection and 27.4 per cent had sub-protective anti-HBs levels (<10 IU/mL), indicating insufficient immunity. Interpretation & conclusions The results of this study highlighted the need for targeted interventions-such as improving timely administration of the birth dose, enhancing follow-up for subsequent doses including digital or paper-based tools, implementing a robust tracking and reminder system to ensure HBV vaccination series and increasing awareness through community-based health education-to strengthen acceptance of HBV vaccination in rural and tribal communities.
Indian J Med Res
· 2025 Nov · PMID 41520257
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Background & objectives While originator anti-tumour necrosis factor (TNF) agents have demonstrated good efficacy in the management of axial spondyloarthritis, the therapeutic equivalence and safety profile of their Indi...Background & objectives While originator anti-tumour necrosis factor (TNF) agents have demonstrated good efficacy in the management of axial spondyloarthritis, the therapeutic equivalence and safety profile of their Indian biosimilars remain uncharacterised. This study aimed to evaluate the efficacy and safety of adalimumab biosimilar in patients diagnosed with axial spondyloarthritis. Methods This retrospective, single-centre observational study from India assessed the efficacy and safety of adalimumab biosimilar in axial spondyloarthritis patients with high disease activity. We recorded baseline characteristics, swollen/tender joint counts, and Bath ankylosing spondylitis disease activity index (BASDAI) scores at 0, 12, and 24 wk. The primary outcome was the percentage of patients achieving a BASDAI50 response at 12 wk; adverse events were also monitored. Results The study included 96 axial spondyloarthritis patients (84 male, mean age 29.1 yr) and showed that adalimumab biosimilar was efficacious, with 54per cent achieving BASDAI50 response at 12 weeks and 70 per cent at 24 wk. Mean BASDAI significantly improved from 5.8 at baseline to 2.9 at 12 wk and 2.3 at 24 wk. Safety concerns were minimal, though two patients developed tuberculosis despite prophylaxis. Most patients accessed the biosimilar through government funding, and dose spacing was attempted in a few. Interpretation & Conclusions Adalimumab biosimilar is efficacious in patients with axial spondyloarthritis without major safety concerns.
Indian J Med Res
· 2025 Nov · PMID 41520255
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Background & objectives Dynapenia, an age-related decline in muscle strength independent of muscle mass loss, is increasingly recognised as a predictor of functional decline and adverse health outcomes. This study aimed...Background & objectives Dynapenia, an age-related decline in muscle strength independent of muscle mass loss, is increasingly recognised as a predictor of functional decline and adverse health outcomes. This study aimed to investigate the prevalence and predictors of dynapenia among older adults with low skeletal muscle mass. Methods This hospital-based cross-sectional study included 128 participants aged ≥ 60 yr with low muscle mass determined using the EWGSOP-2 criteria. Assessments included handgrip strength using a Jamar dynamometer, a 4-meter gait speed test, the geriatric depression scale, and the clinical frailty scale. Pearson's correlation was used to assess the relationships between muscle strength parameters, gait speed, frailty scores, and depression scores, followed by multivariate logistic regression. Results Among individuals with low muscle mass, 66 (51.6%) had dynapenia [29 (43.9%) in females; 37 (56.06%) in males]. Handgrip strength strongly and positively correlated with knee extension strength [coefficient correlation (r) = 0.822, P<0.001] and moderately correlated with gait speed (r=0.414, P<0.001). Both strength parameters were inversely correlated with frailty scores (r=-0.367 and r=-0.316, respectively; P<0.001). Multivariable analysis identified female gender [Odds ratio (OR)=7.655, 95% confidence interval (CI): 1.616-36.264, P=0.010], lower socioeconomic status (P<0.001), and gait speed <0.8 m/s (OR=22.664, 95% CI: 2.952-174.010, P=0.003) as predictors of dynapenia. Depression was more prevalent in dynapenia patients [25.8% (n=17) vs. 3.2% (n=2), P<0.001]. Interpretations & conclusions The prevalence of dynapenia was 51.6 per cent among elderly with low muscle mass, with female sex, lower socioeconomic status, and reduced gait speed as significant correlates. Routine strength assessment is warranted in elderly with low muscle mass.
Sharma J, Thakar A, Rath GK
… +16 more, Ghosh P, Mathur P, Meena JK, Bharadwaj M, Shirsat N, Chatterjee NS, Chavan AS, Shamsunder S, Singh S, Gupta S, Gupta TM, Bhatnagar S, Bhatla N, Dhaliwal RS, Kaur T, ICMR-NCI CHNRI Exercise Group
Indian J Med Res
· 2025 Nov · PMID 41520254
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Background & objectives With limited funding and vast array of research ideas, setting priorities becomes essential to ensure effective and efficient use of resources. This study aims to systematically identify key resea...Background & objectives With limited funding and vast array of research ideas, setting priorities becomes essential to ensure effective and efficient use of resources. This study aims to systematically identify key research questions in cancer through stakeholder engagement using the Child Health and Nutrition Research Initiative method which is a new concept in the Indian context. Methods The Indian Council of Medical Research held a research priority-setting exercise on May 7-8, 2024 at All India Institute of Medical Sciences-National Cancer Institute, Jhajjar, Haryana, engaging 84 participants across India using CHNRI methodology. Experts were divided into four thematic groups. In Step I, each group proposed research questions, which were scored based on five predefined criteria (answerability, efficacy, relevance, deliverability, equity) and arranged in descending order. In Step II, the highest-scoring questions were further validated through full-house voting. Questions receiving a consensus of more than two-third were finalised as priorities. Results In Step I, 99 questions were generated which covered descriptive (n=10), development (n=65), discovery (n=14), and delivery research (n=10). Development group questions were subcategorised as Technologies (diagnostics/devices/digital) (n=17), Therapeutics (n=16), Prevention and screening (n=20), and Palliative care and survivorship (n=12). During validation (Step II), 36 questions across all domains received >66 per cent scores, resulting in research priorities. Interpretation & conclusions The priority setting exercise helped in short listing research questions in area of cancer in India and provided actionable guidance to policymakers and funders enabling appropriate usage of limited funds.
Hota S, Das D, Chakrabarti S
… +5 more, Ghosh D, Maity N, Hajra S, Gupta P, Banerjee R
Indian J Med Res
· 2025 Nov · PMID 41520253
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Background & objectives Review of tissue diagnosis is indispensable for any comprehensive tertiary cancer care centre, because a significant bulk of cases are primarily diagnosed peripherally and referred in a hub-and-sp...Background & objectives Review of tissue diagnosis is indispensable for any comprehensive tertiary cancer care centre, because a significant bulk of cases are primarily diagnosed peripherally and referred in a hub-and-spoke model. The primary objective of the study was to estimate the proportion of diagnostic discrepancies of the review cases over a period of one year and to identify the probable factors behind these discrepancies. Methods An observational descriptive retrospective cross-sectional study was planned in the department of Laboratory Medicine in a regional cancer institute of Eastern India encompassing all the cases undergoing review (both slides and tissue blocks) in the period between June 2023 and May 2024. Results Total 2551 cases were submitted for review within the study period. Among them 24 caused extreme diagnostic difficulty only because of poor processing. Total 171 cases among 2551 were found to carry significant diagnostic discrepancy (6.7%). A re-biopsy was advised in 69 cases, as essential. Interpretation & conclusions Although many a times the cost of review or the time consumed may pose a problem, a second opinion or a pathologic review is a patient safety mechanism, especially in the setting of cancer.
George JE, George PS, Nair RA
… +2 more, Jacob JS, Mathew A
Indian J Med Res
· 2025 Nov · PMID 41520252
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Background & objectives Lung cancer is the most diagnosed cancer and leading cause of cancer deaths. We assessed regional patterns in incidence, mortality, morphology, and mortality-to-incidence ratio across 57 populatio...Background & objectives Lung cancer is the most diagnosed cancer and leading cause of cancer deaths. We assessed regional patterns in incidence, mortality, morphology, and mortality-to-incidence ratio across 57 populations, along with tobacco and alcohol use in India. We also estimated time-trends (average annual percent change: AAPC) by gender and age, and forecasted to 2030. Methods We used age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) (per 105 population) estimated AAPC via joinpoint regression and applied auto-regressive integrated moving average (ARIMA) model to forecast rates. Results Higher incidence of lung cancer among men was observed in the south, north and north-east regions of India. Highest ASIR was in Srinagar (39.5) and highest ASMR in Aizawl (27.1). Among women, highest rates were observed in the north-east, particularly in Aizawl (ASIR:33.7, ASMR:23.2). Tobacco use among women remains low outside the north-east, correlating with the patterns of lung cancer. Mortality to incidence ratio was low (<30%) except in a few populations. An increasing-trend in incidence was noted, with the highest AAPC in Thiruvananthapuram (women:6.7) and Dindigul (men:4.3). Adenocarcinoma has emerged as the dominant subtype over 25 yr, with higher prevalence among women, especially in Bengaluru (56.0%). Large-cell carcinoma increased notably in Delhi. By 2030, ASIRs are projected to range from 1.8 (Barshi) to 33.1 (Kollam) in men, and 1.9 (Barshi) to 8.1 (Bengaluru) in women. Interpretation & conclusion The burden of lung cancer in India shows regional disparities, with more adenocarcinoma, especially among women. Incidence is projected to rise, while low mortality to incidence ratio suggests underreported mortality, underscoring the need for better death reporting. Region-specific research beyond tobacco use is essential.
Indian J Med Res
· 2025 Nov · PMID 41520251
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Background & objectives The clinical manifestation of dengue results from a complex and finely balanced interaction between the dengue virus (DENV) and the host immune responses, particularly excessive inflammation drive...Background & objectives The clinical manifestation of dengue results from a complex and finely balanced interaction between the dengue virus (DENV) and the host immune responses, particularly excessive inflammation driven by pro-inflammatory cytokines. Vitamin D is an essential modulator of antiviral innate immunity, capable of reducing cytokine production and viral replication in vitamin D3-differentiated monocyte-derived macrophages (D3-MDM). It also downregulates inflammatory miRNAs, including miRNA-155. This study aimed to investigate serum levels of 25-hydroxyvitamin D [25(OH)D], cytokine production, and the expression of microRNA-155 (miRNA-155) in patients with dengue. Methods Serum samples were collected from 98 dengue-positive patients categorised as dengue without warning signs, dengue with warning signs, or severe dengue, along with 10 healthy individuals as controls. Clinical and laboratory data were also analysed. Results Serum 25(OH)D levels were significantly higher in dengue without warning as compared to other two categories. Although dengue with warning signs patients exhibited higher 25(OH)D levels than those with severe dengue, both groups showed a significant reduction compared to healthy controls. In contrast, miRNA-155 expression was highest in the severe dengue group, followed by dengue with warning signs, dengue without warning signs, and controls. A significant negative correlation was observed between serum 25(OH)D levels and miRNA-155 expression. Lower 25(OH)D concentrations were associated with elevated TNF-α, IL-6, and IFN-γ levels, particularly in patients with warning signs and severe dengue. Interpretation & conclusions These findings suggest a relationship between vitamin D status, miRNA-155 expression, and immune activation during dengue infection. The inverse correlation between 25(OH)D and miRNA-155 highlights their potential as disease severity and progression biomarkers in patients infected by dengue virus.