Indian J Med Res
· 2026 Jul · PMID 42397814
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Background and objectives Sickle cell disease is a major haemoglobin disorder, and foetal haemoglobin (HbF) remains the strongest modifier of disease severity. Hydroxyurea is the standard HbF-inducing drug, but many pati...Background and objectives Sickle cell disease is a major haemoglobin disorder, and foetal haemoglobin (HbF) remains the strongest modifier of disease severity. Hydroxyurea is the standard HbF-inducing drug, but many patients show limited response. Curcumin and resveratrol are natural polyphenols with low toxicity. This study evaluated their individual and combined effects on HbF induction in K562 cells and primary CD34⁺ cells. Methods K562 cells were treated with curcumin, resveratrol, and hydroxyurea at increasing doses. Viability was measured by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, and IC₅₀ values (half maximal inhibitory concentration) were calculated. Drug combinations were tested in fixed ratios, and synergy was analysed using CompuSyn and SynergyFinder. CD34⁺ cells were isolated by MACS (magnetic-activated cell sorting) and differentiated for 14 days. Treatments began on day 3, and HbF levels were measured by ELISA. Results Curcumin showed the lowest IC₅₀ (74.8-66.3 µM), followed by resveratrol (84.3-75.2 µM), and hydroxyurea (140-131.9 µM) (p<0.05 for all comparisons). All compounds maintained over 70% viability at sub-IC₅₀ doses in both K562 and CD34⁺ cells. The strongest synergy was observed in the curcumin + resveratrol combination (Combination index (CI) 0.55±0.03; Loewe score 39.7±3.1), indicating a strong synergistic interaction despite model-specific differences. HbF induction followed the same trend and was consistent across experimental replicates. Curcumin raised HbF to 16.8% (1.9-fold), resveratrol to 12.5% (1.4-fold), and hydroxyurea to 21.2% (2.3-fold). Curcumin + resveratrol showed the highest induction at 24.92% (2.7-fold). In SCD CD34⁺ cells, the same combination produced 27.8% relative to untreated baseline. Interpretation and conclusions The strong synergy reflects the complementary action of antioxidant, epigenetic, and nitric-oxide-linked pathways. Minimal HbF rise in normal CD34⁺ cells indicate disease-specific responsiveness. Curcumin and resveratrol together form a potent and safe strategy for enhancing HbF and may serve as an effective adjunct therapy for SCD.
Bhatnagar T, Ravichandran JS, Kathiresan J
… +34 more, Ponnaiah M, Aggarwal HK, Bhalla A, Bhardwaj P, Bhuniya S, Chakravarty J, Choudhury R, Dube S, Gupta BK, John M, Kannauje PK, Kapoor M, Kataria S, Mukherjee S, Pakhare A, Patnaik L, Rana RK, Ray BK, Ruban ACPP, Saxena R, Shah A, Shameem M, Shivnitwar SK, Talukdar A, Upadhyay R, Vohra R, Yadav A, Saravanakumar D, Krishna NS, Vaman RS, Mukherjee A, Kumar G, Murhekar M, Young Adult Thrombotic Event Study Group
Indian J Med Res
· 2026 Jul · PMID 42397813
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Background and objectives Myocardial infarction (acute coronary artery thrombotic event) in young adults is known to be associated with certain comorbidities and lifestyle factors. The causal relationship between COVID-1...Background and objectives Myocardial infarction (acute coronary artery thrombotic event) in young adults is known to be associated with certain comorbidities and lifestyle factors. The causal relationship between COVID-19 vaccination and thrombotic events has been debated globally, with varying risks being reported across populations and vaccine platforms. Considering reports of myocardial infarction and other thrombotic events in apparently healthy individuals, this study was conducted to determine the association between COVID-19 vaccination, lifestyle, medical risk factors, and thrombotic events among young adults in India. Methods We conducted a multicentric matched case-control study across 25 tertiary hospitals in India between October 2021 and January 2023. Cases were 18-45-yr-old hospitalised patients with new arterial or venous thrombotic events. Hospitalised cases and controls were matched by admission date (±7 days). Data on exposure factors were obtained through hospital records and telephonic interviews. Conditional logistic regression was used to estimate matched odds ratios (mOR) with confounder adjustments guided by a directed acyclic graph. Results We analysed 432 cases (1293 controls) of acute myocardial infarction and 767 cases (2,144 controls) of any thrombotic event. Acute myocardial infarction was associated with previous history of any thrombotic event [Matched Odds Ratio (mOR) 60.0; 95% Confidence interval (CI): 11.4, 315.1], comorbidities [adjusted mOR (amOR) 4.6; 95% CI: 2.0-10.5], ever smoking (amOR 3.5; 95% CI: 2.3-5.3) and family history of thrombotic event (mOR 3.3; 95% CI: 1.7-6.5). Receiving two or more doses of any COVID-19 vaccine (amOR 0.8; 95% CI: 0.3-2.8) was not associated with acute myocardial infarction. Analyses showed an association of any thrombotic event with prior history of thrombotic event, comorbidities, ever smoking, prior COVID-19 hospitalisation and family history of thrombotic event. There was no association between any thrombotic event and two or more doses (amOR 1.0; 95% CI: 0.5-2.0) of any COVID-19 vaccination. Similar associations were seen when analysed separately for CovishieldTM and CovaxinTM. Interpretations and conclusions Among young Indian adults, thrombotic events were driven by traditional risk factors and prior severe COVID-19 illness. No increased risk of thrombotic events, including myocardial infarction, was identified with COVID-19 vaccination given the widespread SARS-CoV2 infection during the study period. We emphasise the importance of addressing modifiable cardiovascular risk factors and monitoring of young adults with comorbidities, prior thrombotic events or severe COVID-19.
Thenarangam S, P S P, Vasireddy P
… +6 more, Vishnoi S, Shree S S, R C P, Epparapally S, Palika R, Madhari RS
Indian J Med Res
· 2026 Jun · PMID 42295725
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Background and objectives In India, national nutrition programmes emphasise age-appropriate, nutrient-dense complementary foods for young children. This study aimed to optimise nutrient-dense complementary foods for chil...Background and objectives In India, national nutrition programmes emphasise age-appropriate, nutrient-dense complementary foods for young children. This study aimed to optimise nutrient-dense complementary foods for children aged 12-35 months using locally sourced ingredients and a mixture design approach, in alignment with the Nutrition Norms of the Poshan 2.0 Programme under Schedule II of the National Food Security Act, 2013 (NFSA 2013), revised in 2023. Methods D-optimal mixture design is an advanced statistical design of experiments method used to determine the ideal proportions of ingredients in a mixture, where components sum to 100%. We used this design to optimise the proportions of cereals, pulses, milk powder, nuts, seeds, and oil to maximise iron, calcium, and zinc content while minimising phytate-to-mineral molar ratios. The optimised complementary base mix was standardised into three variants: one with reduced refined sugar and two without added refined sugar (one savoury-based mix and one dates powder-based mix). Mineral and phytic acid contents were analysed using standard analytical methods. Sensory evaluation was conducted using a nine- point hedonic scale with a semi-trained institutional panel. Results All optimised formulations met revised NFSA, 2013 nutrient standards for energy, protein, fat, carbohydrates, and key essential micronutrients, while reducing phytate-to-mineral molar ratios within practical formulation limits. Sensory evaluation showed good overall acceptability for all variants, with a mean score above 7.0. The savoury-based mix achieved the highest overall acceptability, followed by the reduced refined sugar-based mix and the dates powder-based mix. Interpretation and conclusions The findings demonstrate that a systematic formulation approach can be used to develop nutrient-dense, complementary food mixes with reduced or no added refined sugar using locally available ingredients without compromising micronutrient adequacy and sensory acceptability, supporting their potential relevance for public nutrition programmes.
Manna S, Mukherjee R, Kandpal V
… +3 more, Zode M, Kulkarni B, Lyngdoh T
Indian J Med Res
· 2026 Jun · PMID 42295724
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Background and objectives Hypothyroidism is the most common thyroid disorder during pregnancy and, if not managed adequately, increases the risk of adverse foeto-maternal outcomes. The present systematic review and meta-...Background and objectives Hypothyroidism is the most common thyroid disorder during pregnancy and, if not managed adequately, increases the risk of adverse foeto-maternal outcomes. The present systematic review and meta-analysis was conducted to assess the prevalence of hypothyroidism among Indian pregnant women and related foeto-maternal outcomes. Methods A systematic search was conducted across PubMed, Google Scholar, and preprint servers to identify observational studies reporting the prevalence of hypothyroidism and associated foeto-maternal outcomes among Indian pregnant women. A random-effects model was utilised to pool effect sizes, and heterogeneity was assessed using I2 statistic. Funnel plots, along with Begg's and Egger's tests, were used to assess publication bias. Data were analysed using STATA version 17. Results A total of 60 studies were included. The pooled prevalence of hypothyroidism among pregnant women was 17% [95% confidence interval (CI): 14%, 19%] with subclinical hypothyroidism at 15% (95% CI: 12%, 18%) and overt hypothyroidism at 3% (95% CI: 3%, 4%). In women with subclinical hypothyroidism, the pooled prevalence of adverse maternal outcomes was 9% (95% CI: 6%, 11%), while the prevalence of adverse foetal outcomes was 11% (95% CI: 9%, 14%). The pooled prevalence was 18% for preterm birth (95% CI: 11%, 25%), 17% for low birth weight (95% CI: 10%, 25%), 7% for intrauterine death (95% CI: 2, 14%), and 2% for stillbirth (95% CI: 0, 4%). Among women with overt hypothyroidism, the prevalence of adverse maternal and foetal outcomes was 12% (95% CI: 10%, 15%) and 14% (95% CI: 11%, 17%), respectively. The pooled prevalence was 22% for low birth weight (95% CI: 13%, 31%), 16% for preterm birth (95% CI: 9%, 24%), 16% for intrauterine death (95% CI: 7%, 27%), and 6% for stillbirth (95% CI: 1%, 13%). Most studies used trimester-specific TSH cut-offs based on the American Thyroid Association guidelines. One fourth (n=15) of the 60 studies applied alternative thresholds, with upper limits for normal TSH varying from 4.0-10.0 mIU/L. Interpretation and conclusions The rising burden and adverse consequences of hypothyroidism in pregnancy demand urgent attention. Uniform, evidence-based screening and management practices must be implemented at all levels of care. There is a pressing need for India-specific diagnostic cut-offs and large-scale prospective studies to inform treatment thresholds and long-term outcomes.
Vaishya R, Gupta BM, Sab M C
… +2 more, Vaish A, Arjuman A
Indian J Med Res
· 2026 Jun · PMID 42295722
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Background and objectives Indian Journal of Medical Research (IJMR), established in 1913, is a cornerstone of Indian biomedical scholarship. This bibliometric study evaluated the highly cited publications (HCPs; ≥100 cit...Background and objectives Indian Journal of Medical Research (IJMR), established in 1913, is a cornerstone of Indian biomedical scholarship. This bibliometric study evaluated the highly cited publications (HCPs; ≥100 citations) to describe their profiles (themes and institutions). Methods From 14,834 Scopus-indexed records (1945-2024), 187 HCPs (1957-2022) were analysed using MS Excel and VOSviewer for citation trends, co-authorship networks (country, organisation, author), co-word analysis, and subject mapping across domains. Metrics included total citations (TC), citations per paper (CPP), and total link strength (TLS). Results Highly cited publications amassed 33,830 citations (average CPP: 180.9), with a predominance of review articles (58.3%; CPP: 197.6). Temporal peaks occurred in 2004-2015, stabilising post-2016. Communicable diseases led thematically (e.g., bacterial infections: 33 papers, 5,478 TC; virology: 23 papers, 3,432 TC), followed by non-communicable foci like diabetes (21 papers). India dominated (148 papers; >70%), with All India Institute of Medical Sciences (AIIMS)-New Delhi (23 papers; CPP: 181.5) and Indian Council of Medical Research (ICMR) (15 papers; CPP: 216.7) as hubs in a 12-cluster network (472 links; TLS: 447). International collaborations were limited (12.8%; CPP: 155.1), and so were external (national and international) funding (5.9%). Author networks emerging from the HCPS (5 clusters; 165 links; TLS: 170) centered on ICMR-AIIMS synergies; keywords clustered around metabolic ('diabetes mellitus': 17 occurrences) and infectious motifs. Interpretation and conclusions The findings of this analysis suggests that the IJMR reflects India's strengths in biomedical research, with a focus on review-based research and topics addressing the country's disease burden thus far. However, stronger national and international collaborations, along with improved research funding, are needed to enhance the global impact of its published research.
Indian J Med Res
· 2026 Jun · PMID 42295721
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Background and objectives Chronic kidney disease (CKD) is a major non-communicable cause of premature mortality and disability in India, yet no study has systematically evaluated the State-level trajectories and inequali...Background and objectives Chronic kidney disease (CKD) is a major non-communicable cause of premature mortality and disability in India, yet no study has systematically evaluated the State-level trajectories and inequalities underpinning its burden. Methods We extracted age-standardised incidence, prevalence, mortality, and disability-adjusted life-years (DALY) estimates for CKD (ICD-10: N18-N19) from the global burden of disease (GBD) 2023 database for the period 1990-2023. Estimated annual percentage change (EAPC) was calculated using log-linear regression. States were classified into clusters based on burden relative to the national age-standardised rate and trend direction. Socioeconomic gradients were assessed using the socio-demographic index (SDI), concentration curves, and concentration indices. Uncertainty intervals (UIs) were incorporated. Results In 2023, across Indian States the incidence ranged from 226.4 to 316.4 per 100,000, prevalence from 10,452 to 12,539 per 100,000, mortality from 6.71 to 19.84 per 100,000, and DALYs from 312.2 to 666.4 per 100,000. National EAPCs showed declining trends for incidence (-0.45%), prevalence (-0.22%), mortality (-0.90%), and DALYs (-1.10%). However, high-burden States such as Telangana and Punjab had sustained elevated mortality and DALYs despite declining trends. Concentration indices demonstrated significant pro-poor inequality for mortality [confidence interval (CI) -0.12] and DALYs (CI -0.24). Locally estimated scatterplot smoothing (LOESS) models revealed non-linear SDI relationships, with high-SDI States achieving lower mortality but persistent high prevalence. Interpretations and conclusions CKD poses a substantial and unequal burden across India, with widening disparities in mortality and disability. Targeted State-level interventions, early detection programmes, and equitable renal care infrastructure are urgently needed to reduce geographic inequity and achieve national NCD targets.
Indian J Med Res
· 2026 Jun · PMID 42295720
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Background and objectives The alternate day and the intermittent regimens of isotretinoin are efficacious in treating moderate acne vulgaris with low cumulative doses. The former regimen has been found to be superior in...Background and objectives The alternate day and the intermittent regimens of isotretinoin are efficacious in treating moderate acne vulgaris with low cumulative doses. The former regimen has been found to be superior in comparative studies using weight-based dosing. The fixed dosing of the two regimens has not been explored in a head-to-head trial. The objective was to compare the efficacy and safety of these regimens at fixed dosages in treating grade 2 facial acne vulgaris. Methods It was a randomised, single-blinded, non-inferiority trial. Sixty patients aged 18 years and above with grade 2 facial acne were randomised into two groups: Group A received 20 mg isotretinoin on alternate days, and Group B received 30 mg daily for one wk per month for four months. Results The mean acne load in group A and B reduced to 5.63±4.87 and 5.63±4.87 from 22.60±10 and 28.70±18.10, respectively. The percentage of participants achieving a significant response was 96.7% and 93.3% in group A and B (P=0.28). The estimates were within the non-inferiority margins. The acne load progressively decreased with greater effect size as the treatment continued. Relapse to pretreatment score was not detected. Side effects were comparable between the groups. The cost was significantly higher with the alternate regimen. Interpretation and conclusions The daily intermittent regimen is non-inferior to alternate day regimen at fixed dosages in significantly improving grade 2 facial acne vulgaris with similar side effect profiles. The daily intermittent regimen, also with a lower cost, is thus preferrable.
Indian J Med Res
· 2026 Jun · PMID 42295719
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Background and objectives Chronic musculoskeletal disorders (MSDs) are a significant contributor to pain and disability worldwide, with burden varying across different regions. The study aimed to estimate the prevalence...Background and objectives Chronic musculoskeletal disorders (MSDs) are a significant contributor to pain and disability worldwide, with burden varying across different regions. The study aimed to estimate the prevalence of chronic MSDs in Puducherry, assess health-seeking behaviour, and evaluate the economic burden associated with MSD-related healthcare. Methods A community-based concurrent mixed-method study was conducted in selected areas of Puducherry. Households were selected using systematic random sampling, and individuals were chosen using simple random sampling. The WHO-ILAR COPCORD questionnaire identified individuals with MSDs. Direct and indirect costs from a patient perspective were assessed using a structured questionnaire. Data were collected through Epicollect5 and analysed using STATA v14. Prevalence was reported as proportions with 95% confidence intervals (CI). Focused group discussions (FGDs) were conducted to identify challenges in seeking healthcare. Results Among 400 participants, the prevalence of chronic MSDs was 16% (95% CI: 12.5-19.9), with the majority reporting mild disability and more common in women, but there was no urban-rural difference. Around half (48.4%) of participants reported out-of-pocket expenditures (OOPE) in the past three months, with a higher proportion in urban (53.8%) compared to rural areas (45.9%). The median expenditure was ₹204, with urban participants spending ₹308 and rural participants ₹154. FGDs revealed that while many initially preferred private facilities for quicker access to pain medications, they later returned to public facilities due to financial constraints. Interpretation and Conclusions The prevalence of chronic musculoskeletal disorders is high in Puducherry, particularly among women and older adults, causing mild disability. Despite a preference for government healthcare, many incurred out of pocket expenditures, highlighting financial challenges in accessing care.
Pandey R, Vishwakarma S, Gupta V
… +4 more, Arya N, Das S, Chowdhary R, Kumar A
Indian J Med Res
· 2026 Jun · PMID 42295718
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Background and objectives Hypoxia is the critical hallmark of solid tumours, including oral squamous cell carcinoma (OSCC), which is the most prevalent cancer in the Indian subcontinent. Sphingosine kinase 1 (SphK1) is a...Background and objectives Hypoxia is the critical hallmark of solid tumours, including oral squamous cell carcinoma (OSCC), which is the most prevalent cancer in the Indian subcontinent. Sphingosine kinase 1 (SphK1) is a known oncogene that is upregulated in most cancers, including OSCC. However, its regulation in the development and progression of OSCC is unknown. The objective of the study was to determine the regulation of SphK1 via hypoxia-inducible factors (HIFs) in OSCC. Methods Tumour and adjacent normal tissues from 70 OSCC patients were collected and snap frozen. Quantitative real-time PCR (qRT-PCR) measured SPHK1, HIF1A, HIF2A expression, and the downstream target of HIF-1α expression. Spearman correlation analysis assessed the association between SPHK1 and HIF1A/HIF2A. Tongue squamous cancer cells, SCC-9 and SCC-25, were treated with CoCl2 or 1% oxygen to induce hypoxia, with or without KC72F (a HIF-1α inhibitor). The SPHK1 promoter was cloned into a pGL3 vector, and luciferase reporter assays were performed in SCC-9 and SCC-25 cells. Stable SphK1 knockdown cells were generated using shRNA. Results HIF1A was overexpressed in 73% of oral squamous cell carcinoma (OSCC) tumours, strongly correlating with SPHK1 expression. Stabilising HIF-1α through CoCl₂ or hypoxia-induced SPHK1 expression was reversed by the HIF-1 inhibitor. The knockdown of SPHK1 in OSCC cells reduced the stability of HIF-2α, but not HIF-1α. Interpretation and conclusion Our study revealed that SPHK1 expression is upregulated through HIF-1α, which in turn stabilises HIF-2α. Thus, inhibition of SphK1 along with HIF-2α might be beneficial for the management of OSCC.
Shete A, Sahay RR, Kumar A
… +7 more, D M P, Munj V, Patil DY, Yadav S, Kini Y, Fernandes P, Yadav PD
Indian J Med Res
· 2026 Jun · PMID 42295717
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Background and objectives Kyasanur Forest Disease (KFD) is a tick-borne viral haemorrhagic fever endemic to Western Ghats in India, necessitates rapid and accurate field-based diagnostics for effective outbreak response...Background and objectives Kyasanur Forest Disease (KFD) is a tick-borne viral haemorrhagic fever endemic to Western Ghats in India, necessitates rapid and accurate field-based diagnostics for effective outbreak response and timely patient management. Traditional diagnostic methods require laboratory infrastructure, sometimes limiting timely case detection in resource limited settings. We evaluated the diagnostic performance, usability, and operational feasibility of a point of care (POC) assay for detection of KFD virus under field conditions. Methods We assessed a real-time PCR-based portable point-of-care (PoC) test for KFD virus on retrospective clinical samples (n=247) that were obtained from the Goa and Karnataka States in the year 2024. The assay's sensitivity, specificity, and turnaround time (TAT) were assessed in comparison with gold standard real time RT-PCR assay. Operational feasibility and validation was carried out in field laboratory setting in Shivamogga, Karnataka, and North Goa. Results Out of 247 samples analysed, the PoC assay was 97-100% sensitive and 95-98% specific in two sites with less turnaround time than gold standard test. High diagnostic accuracy was demonstrated by the assay which require minimal training for its field application. Interpretation and conclusions The real-time PCR-based PoC assay performed well under field conditions for a reliable and early detection of KFD virus infection. This PoC assay represents a practical and time-efficient diagnostic approach for field use and has the potential to be incorporated into existing KFD surveillance.
Rangarajan A, Natarajan T, Lakshminarayanan S
… +3 more, Sundersingh S, Subramani J, Gopisetty G
Indian J Med Res
· 2026 Jun · PMID 42295716
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Background and objectives Gastric cancer, the fifth most diagnosed malignancy worldwide and seventh in India, exhibits high metabolic activity and marked heterogeneity. In this study, we performed targeted metabolomic pr...Background and objectives Gastric cancer, the fifth most diagnosed malignancy worldwide and seventh in India, exhibits high metabolic activity and marked heterogeneity. In this study, we performed targeted metabolomic profiling of gastric cancer biopsies obtained through esophagogastroduodenoscopy in a South Indian cohort. Methods Targeted metabolite profiling was conducted using liquid chromatography-mass spectrometry (LC-MS) analysis. Pathway enrichment and biomarker evaluation were performed using MetaboAnalyst 6.0, incorporating univariate analysis and receiver operating characteristic (ROC) curve assessment. Results LC-MS based analysis of tumour (n=25), paired normal (n=25), and normal gastric mucosa (n=3) samples revealed distinct metabolic alterations associated with gastric cancer. The metabolic profiles of tumours and paired normal tissues were similar when compared with normal mucosa, suggesting a potential field effect in gastric carcinogenesis. A total of 58 metabolites were identified, of which 44.8% comprising peptides, amino acids, and their derivatives showed marked upregulation in tumours, indicating enhanced amino acid metabolism. Elevated uracil and uridine levels suggested altered pyrimidine metabolism, reflecting increased nucleotide turnover and supporting rapid DNA/RNA synthesis. Pathway analysis highlighted modulation of arginine biosynthesis, serine-one carbon metabolism, and nucleotide metabolism in gastric cancer tissues. ROC analysis identified ornithine and citrulline as potential discriminators in gastric cancer. Interpretation and conclusions Our findings reveal differentially altered metabolites in gastric cancer that are predominantly involved in arginine, serine one-carbon, and nucleotide metabolism. Ornithine and citrulline were identified as potential diagnostic biomarkers and therapeutic targets.
Indian J Med Res
· 2026 Jun · PMID 42295715
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Background and objectives Melanin, as a virulence factor, plays an important role in protecting Cryptococcus against the host immune response. The demonstration of a melanin-producing colony in vitro helps in proper iden...Background and objectives Melanin, as a virulence factor, plays an important role in protecting Cryptococcus against the host immune response. The demonstration of a melanin-producing colony in vitro helps in proper identification of this fungus. This study aimed to assess 3 locally available natural seeds in designing a culture medium for supporting growth of Cryptococcus and melanin production. Methods Cryptococcus neoformans previously identified and stocked were tested on flaxseed, black til, and Garden cress containing culture medium separately, where Niger seed agar served as positive control. Melanin production was visually measured using direct observation and also using Whatman No.1 filter paper. The quantitative measurement was done by using spectrophotometric analysis after 48 h of incubation at 37℃. Results All three seed-based culture media developed for Cryptococcus supported its growth, and melanin production was significantly more in colonies grown on garden cress agar than on black til and flaxseed agar. Difference between garden cress medium and Niger seed medium was not significant (P=0.818). Interpretation and conclusions Garden cress seed agar was found to be suitable for supporting melanin production in Cryptococcus neoformans. Further use of these seeds in preparation of readymade dehydrated medium can also be elucidated.
Trimukh Parsure A, Gupta SS, Jakasania A
… +3 more, Kothekar P, Sathe H, Giri M
Indian J Med Res
· 2026 Jun · PMID 42295714
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Background and objectives Adverse childhood experiences are known to impact lifelong health, while safe, stable, and nurturing relationships act as protective factors. Frontline workers (FLW) in India, are well-positione...Background and objectives Adverse childhood experiences are known to impact lifelong health, while safe, stable, and nurturing relationships act as protective factors. Frontline workers (FLW) in India, are well-positioned to support at-risk families but often lack structured training on these topics. This study assessed the effectiveness of a training programme in improving FLWs' knowledge and self-perceived competencies regarding these topics, and its impact on nurturing relationships among high-risk families. Methods A quasi-experimental single-group pre-post study was conducted in Central India. Thirty FLWs were enrolled, of whom 25 completed training and follow up assessments. The intervention comprised a co-developed, participatory training module covering adverse childhood experiences, safe, stable, and nurturing relationships, community engagement, and referral pathways. FLWs' knowledge and self-perceived competencies were assessed at baseline, 1 month, and 6 months using a 23-item validated tool. High-risk families identified by trained FLWs, were assessed for safe, stable, and nurturing relationships outcomes at baseline and 6 months using a 14-item scale. In-depth interviews explored implementation experiences. Results FLWs' mean scores improved from 0.47 (SD=0.17) at baseline to 0.82 (SD=0.06) at 1 month and 0.80 (SD=0.05) at 6 months (P<0.001). No significant change was observed in safe, stable and nurturing relationships outcomes (7.53 to 7.54; P=0.15). Interviews highlighted improved awareness but cited barriers like workload, inadequate follow up, and supervision. Interpretation and conclusions Training enhanced FLWs' competencies, but this did not translate into family-level outcomes.
Choudhary N, Seervi N, Bhargava A
… +1 more, Khichar S
Indian J Med Res
· 2026 Jun · PMID 42295713
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Background and objectives Emerging evidence indicates a complex relationship between glycated haemoglobin (HbA1c) levels and motor symptom severity in Parkinson's disease. Both elevated (>6.1%) and low (<5.3%) HbA1c have...Background and objectives Emerging evidence indicates a complex relationship between glycated haemoglobin (HbA1c) levels and motor symptom severity in Parkinson's disease. Both elevated (>6.1%) and low (<5.3%) HbA1c have been linked to increased disability. This study examined the association between HbA1c levels and motor symptoms in patients with Parkinson's disease from Jodhpur, India. Methods A cross-sectional observational study was conducted at the department of Neurology, Mathura Das Mathur Hospital, Jodhpur between March 2023 and February 2024. One hundred patients with Parkinson's disease patients fulfilling the UK Parkinson's Disease Society Brain Bank (UKPDSBB) criteria were enrolled. Participants underwent HbA1c testing, motor evaluation with the Unified Parkinson's Disease Rating Scale (UPDRS III) in ON and OFF states, and cognitive screening with the Montreal Cognitive Assessment (MoCA). Patients were categorised into three groups based on HbA1c: ≤4.9% (Low), 5.0-5.9% (Normal-to-Prediabetic), and ≥6.0% (High). Disease duration and medication history were also recorded. Results No significant group differences were found for age, sex, body mass index (BMI), or disease duration, between the three groups, based on HbA1c levels. UPDRS and MoCA scores differed significantly across HbA1c categories (P<0.001). Higher HbA1c strongly correlated with worse motor outcomes (UPDRS ON: Spearman's ρ=0.90; OFF: ρ=0.84) and poorer cognition (MoCA: ρ= -0.79). Interpretation and conclusions Elevated HbA1c levels were significantly associated with greater motor impairment and cognitive dysfunction in Parkinson's disease. These findings highlight the potential role of metabolic dysregulation in progression of Parkinson's disease and underscore the need for longitudinal studies to clarify causal links and therapeutic implications.
Chauhan A, Sinha A, Patel Y
… +3 more, Nimavat P, Chauhan S, Pati S
Indian J Med Res
· 2026 Jun · PMID 42295712
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Background and objectives Tuberculosis (TB) and viral hepatitis (hepatitis B and C) co-infection is a significant threat in low-and middle-income countries like India. To optimise treatment protocols and prevent liver-re...Background and objectives Tuberculosis (TB) and viral hepatitis (hepatitis B and C) co-infection is a significant threat in low-and middle-income countries like India. To optimise treatment protocols and prevent liver-related complications, it is essential to estimate the burden of these co-infections. This systematic review and meta-analysis were conducted to determine the prevalence of hepatitis B and C co-infection with tuberculosis in India. Methods In line with PRISMA guidelines, a systematic search of PubMed, Scopus, Embase, CINAHL, and Web of Science was conducted for English-language observational studies published up to January 6, 2026, that reported hepatitis B or C co-infection among TB patients in India. Pooled prevalence estimates were calculated using a random-effects model, heterogeneity was assessed using the I2 statistic, and risk of bias was evaluated using the Joanna Briggs Institute (JBI) critical appraisal tool. Results A total of 11 studies with 4502 participants reporting hepatitis B or C co-infections in among TB patients in India were included. The pooled prevalence of hepatitis B was 10% [95% Confidence Interval (CI):5%-16%], while the pooled prevalence of hepatitis C was 6% (95% CI:5%-7%). Among TB patients co-infected with HIV, the pooled prevalence of hepatitis B was 17% and pooled prevalence of hepatitis B among drug-resistant TB patients was 11%. Higher rates were reported in Southern and Western India. Interpretation and conclusions High prevalence of hepatitis B and C co-infections among TB patients in India suggests the need for integrated screening and management of these co-infections within the national programme strategies.