The Indian Journal Of Medical Research[JOURNAL]
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200 papers
Burden of scrub typhus in north-eastern region of India: A systematic review and meta-regression analysis.
Kharkongor R, Yanglem W, Dkhar B … +5 more , Lyngdoh M, Warlarpih B, Albert S, Varghese GM, Sarkar R
Indian J Med Res · 2026 Jun · PMID 42295711 · Full text
Background and objectives Scrub typhus is endemic in India and neighbouring countries. India's north-eastern region (NER) is geographically and ecologically distinct from the rest of the country, with variations in clima...
Background and objectives Scrub typhus is endemic in India and neighbouring countries. India's north-eastern region (NER) is geographically and ecologically distinct from the rest of the country, with variations in climate, ecology, land use patterns, and population behaviours, heightening the risk of scrub typhus among the residents. Scrub typhus remains an under-explored zoonotic disease in the region. Methods A systematic review was conducted to estimate the burden of scrub typhus in the NER of India. Six databases were searched for studies on the prevalence, seroprevalence, and case fatality rate of scrub typhus in NER. A meta-regression analysis was conducted to ascertain the sources of heterogeneity. Results A total of 718 studies were retrieved from the included databases. Twelve hospital-based prevalence studies spanning 7 States and 4 community-based seroprevalence studies spanning 5 States met the eligibility criteria. The prevalence of scrub typhus among patients with febrile illness and/or clinically suspected cases ranged from 7-36%, while seroprevalence among healthy individuals ranged from 0.8-45%; the case fatality rate ranged from 3-13%. Multivariable meta-regression identified region (P=0.004) and sample size (P=0.003) as significant moderators for prevalence, but not for seroprevalence. Interpretation and conclusions This review highlights the under-recognised burden of scrub typhus in the NER of India. Studies, though limited, underscore the need for better epidemiological data, enhanced surveillance, and community-based research, particularly in high-risk areas.
Arterial blood gas analysis in risk stratification of acute carbon monoxide poisoning.
Ke J, Yin L, Gao Y … +2 more , Hu J, Zhu D
Indian J Med Res · 2026 Jun · PMID 42295710 · Full text
This single-centre retrospective cohort study demonstrates that arterial blood gas (ABG) parameters independently stratify ICU admission risk in acute carbon monoxide poisoning (ACOP) beyond carboxyhemoglobin (COHb). Amo...
This single-centre retrospective cohort study demonstrates that arterial blood gas (ABG) parameters independently stratify ICU admission risk in acute carbon monoxide poisoning (ACOP) beyond carboxyhemoglobin (COHb). Among 124 ACOP patients, the acidosis group (pH<7.35) had a higher ICU admission rate [44.8%, 95% Confidence Interval (CI): 26.8%∼63.7%] than the normal pH (17.7%, 95%CI: 10.1%∼27.5%) and alkalemia groups (12.5%, 95%CI: 1.6%∼38.3%, P<0.001), with a median COHb of 33.1%. The acidosis group presented severe metabolic disturbance (median lactate 7.60 mmol/L, GCS 7). Spearman analysis showed arterial lactate was more strongly associated with disease severity markers than COHb. Multivariate logistic regression confirmed GCS score, COHb, arterial lactate, and HCO3 as independent predictors for ICU admission.
Household food insecurity in urban slums and its association with nutritional status of under-five children in Salem District, Tamil Nadu.
Arumugam DP, Ramasamy U
Indian J Med Res · 2026 Jun · PMID 42295709 · Full text
Background and objectives Household food security is defined as physical and economic access to sufficient, safe, and nutritious food for an active and healthy life. Evidence suggests that urban poor are more food insecu...
Background and objectives Household food security is defined as physical and economic access to sufficient, safe, and nutritious food for an active and healthy life. Evidence suggests that urban poor are more food insecure (51%-Delhi and 74.6%-Vellore) than rural poor. Food insecurity adversely affects under-five children's nutritional status. This study aimed to assess prevalence, determinants, and its association with child-nutrition in urban slums of Salem district, Tamil Nadu. Methods A community-based cross-sectional study was conducted among 363 randomly selected households between January to September 2023 using multi-stage random sampling. Data were collected from primary-care-givers using a validated-semi-structured-questionnaire (USAID-HFIAS) followed by measurement of daily raw food consumption and anthropometry of under-five children. Statistical analysis was performed in SPSSv16.0 using Chi-square/Fisher's test, ANOVA and regression with P<0.05 taken as significant. Results Household food insecurity prevalence was 82.1%, with 20.1% severe. Mean food consumption was significantly lower among insecure households. Determinants included age/gender of household head, single earning member, dependents, and irregular use of public distribution system. Children with normal nutrition had 2.75 [P<0.05;95% confidence interval (C.I):1.31-5.75] times odds of belonging to secure households. Interpretation and conclusions Food insecurity was closely linked to under-five malnutrition, underscoring the need for interventions addressing affordability and structural factors such as housing, healthcare access, and resource distribution.
Minimum diet diversity and its association with nutrient intake among non-pregnant and non-lactating women residing in Delhi.
Sachdeva B, Puri S, Aeri BT
Indian J Med Res · 2026 Jun · PMID 42295708 · Full text
Background and objectives Indian women are disproportionately affected by nutritional deficiencies and are vulnerable to malnutrition. Minimum dietary diversity, an indicator of dietary diversity, has been used widely fo...
Background and objectives Indian women are disproportionately affected by nutritional deficiencies and are vulnerable to malnutrition. Minimum dietary diversity, an indicator of dietary diversity, has been used widely for pregnant and lactating mothers or rural Indian women; however, there is a deficit of data on dietary diversification among non-pregnant, non-lactating women living in urban areas. This study aimed to assess the Minimum dietary diversity and its association with nutrient intake among non-pregnant, non-lactating NPNL women of Delhi. Methods A cross-sectional study was conducted among 400 women (25-49 years) in Delhi. Two-day 24 hr dietary recall (weekend and weekday) and diet quality questionnaire were used to collect the nutrient intake and diet diversity data, respectively. Minimum dietary diversity by Food and Agriculture Organisation was utilised to calculate the diet diversity score. Binary logistic regression and multivariate linear regression analysis were conducted to find predictors of adequate diet diversity and an association between nutrient intake and dietary diversity score, respectively. Results: The mean dietary diversity score was 4.1±1.21, and the prevalence of adequate diet diversity was noted to be 38%. Higher age [Odds ratio (OR):1.05; 95% confidence interval (CI):1.01-1.09; P=0.018] high household income (OR:1.00; 95%CI:1.00-1.00; P=0.008) and higher education (OR:59.06; 95%CI: 7.61-457.90; P<0.001) were identified as the predictors of better minimum dietary diversity. A higher minimum diet diversity was significantly associated with protein, mono-unsaturated fatty acids and retinol intake. Interpretation and conclusions There is poor dietary diversity and micronutrient adequacy among women in Delhi.
Development and psychometric testing of a parental knowledge, attitude, and practices questionnaire on pentavalent vaccine safety.
Fathima F, Nosenoor MM
Indian J Med Res · 2026 Jun · PMID 42295707 · Full text
Background and objectives Pentavalent vaccine safety awareness significantly influences parental acceptance, yet evidence-based knowledge, attitudes, and practices related to adverse events following pentavalent vaccinat...
Background and objectives Pentavalent vaccine safety awareness significantly influences parental acceptance, yet evidence-based knowledge, attitudes, and practices related to adverse events following pentavalent vaccination remain underexplored. This study aimed to develop and psychometrically validate the knowledge, attitude, and practices on pentavalent vaccine safety questionnaire to assess parental perspectives on pentavalent vaccine safety. Methods A sequential mixed-methods psychometric validation study was conducted in three stages: instrument development, pilot testing, and large-scale psychometric evaluation. Healthcare professionals were purposively sampled, while parents or caregivers of infants scheduled for pentavalent vaccination in rural Karnataka, South India, were selected via convenience sampling (pilot) and stratified random sampling (large-scale). Results An initial 50-item close-ended questionnaire, covering knowledge, attitude, and practice domains, was drafted through literature review and refined by an expert panel. Content validity was confirmed with content validity ratio ≥0.6 and content validity index ≥0.8, resulting in 34 retained and 16 revised items. Pilot testing in 24 rural parents and validation in 321 rural parents demonstrated acceptable internal consistency (Cronbach's alpha ≥0.7) and test-retest reliability (intraclass correlation coefficient ≥0.8). Discriminant validity was observed with significantly higher practice score differences for parents with prior adverse immunisation events exposure (n=24). Exploratory factor analysis of 11 thematic domains identified three factors explaining 43.9% of total variance, confirming construct validity. Interpretation and conclusion The knowledge, attitude, and practices on pentavalent vaccine safety questionnaire is a valid and reliable tool identifying gaps in parental knowledge, attitude and practice related to awareness and reporting of pentavalent vaccine safety, supporting improved monitoring and public trust.
Quantitative fibrinogen disorders: A retrospective study from a tertiary care centre in India.
Jain M, Shukla H, Kushwaha R … +3 more , Mishra S, Yadav G, Verma N
Indian J Med Res · 2026 May · PMID 42237844 · Full text
Background and objectives Congenital fibrinogen disorders encompass both quantitative and qualitative abnormalities of fibrinogen, characterised by variable bleeding or thrombotic tendencies. Due to their rarity and vari...
Background and objectives Congenital fibrinogen disorders encompass both quantitative and qualitative abnormalities of fibrinogen, characterised by variable bleeding or thrombotic tendencies. Due to their rarity and varied presentations, delays in diagnosis are common, which can significantly impact patient outcomes. This study was conducted to describe the clinical and demographic profiles of patients with congenital quantitative fibrinogen disorders over a 20-year period (2003-2024) at a tertiary care centre. Methods A retrospective analysis was conducted using laboratory records to identify 17 patients with quantitative fibrinogen disorders, characterised by prolonged prothrombin time (PT), activated partial thromboplastin time (APTT), and undetectable or low fibrinogen levels. Only 10 out of 17 patients could be contacted for follow up. The clinical presentation, including scoring of bleeding symptoms using the International Society on Thrombosis and Haemostasis - Bleeding Assessment Tool (ISTH-BAT), as well as demographic variables such as age of onset, first visit to our hospital, and diagnostic delays, were recorded. Treatment and follow up data were recorded. Results Majority of patients showed symptoms in the neonatal period, with umbilical bleeding as the most common initial manifestation, followed by post-traumatic and cutaneous bleeding. Despite early symptom onset, a median diagnostic delay of four years was observed. Seven cases were under regular follow up with on-demand therapy. Three patients died during follow up. Most of the cases received fresh frozen plasma. Interpretation and conclusions This study describes the clinical profile of quantitative fibrinogen disorders and emphasises the importance of increased awareness, early diagnosis, and standardised management in these patients. Given the significant risk of bleeding, proactive measures such as patient education and close monitoring are crucial.
Gestational weight gain and adverse pregnancy outcomes among pregnant women attending primary health centres in Puducherry: Results from the JANMAM pregnancy cohort.
Patel N, Sagili H, Sahoo J … +4 more , Vairappan B, Kulkarni B, Mina Locks L, Lakshminarayanan S
Indian J Med Res · 2026 May · PMID 42237843 · Full text
Background and objectives Inappropriate gestational weight gain is a significant risk factor for adverse pregnancy outcomes. Women in low- and middle-income countries, often receive insufficient attention on weight manag...
Background and objectives Inappropriate gestational weight gain is a significant risk factor for adverse pregnancy outcomes. Women in low- and middle-income countries, often receive insufficient attention on weight management during antenatal care. We estimated the proportions of inadequate and excessive gestational weight gain (GWG) and identified the associated factors. We also examined the relationship between GWG and adverse pregnancy outcomes. Methods A prospective cohort study was conducted among 465 pregnant women recruited from six primary health centres in Puducherry, India. Participants were enrolled at less than 14 weeks of gestation and were subsequently monitored at delivery and two months postpartum. Multivariable linear regression identified factors associated with GWG, while multivariable log-binomial regression assessed the association between GWG and adverse pregnancy outcomes. Results Total 408 women were included in the final analysis; of these, 48.5% [95% confidence interval (CI): 43.6-53.5; n=198] had inadequate GWG and 19.1% (95% CI: 15.4-23.3; n=78) had excessive GWG. Women from joint families, nulliparous women, and those in higher socioeconomic classes gained significantly more weight (1.08 kg, 1.89 kg, and 1.57 kg, respectively; P<0.05). Compared to underweight women, overweight/obese women gained 2.4 kg less GWG (P<0.001). The proportions of caesarean deliveries, gestational diabetes mellitus, and Neonatal Intensive Care Unit admissions were higher in women with inadequate GWG (34.7%, 18.7%, and 10.4%, respectively, P>0.05) and excessive GWG (45.3%, 14.5%, and 16%, respectively, P>0.05) compared to those with adequate GWG. Interpretation and conclusions In our cohort, nearly half of the pregnant women experienced inadequate GWG, and only one-third achieved adequate GWG. The study identified family type, socioeconomic status, parity, and pre-pregnancy BMI as significant predictors of GWG.
Addressing methodological and analytical pitfalls on medical devices related adverse events.
Chatterjee R, Hazra A, Chatterjee S
Indian J Med Res · 2026 May · PMID 42237842 · Full text
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Veeramani S, Murugesh SR, A M G … +1 more , Palaksha S
Indian J Med Res · 2026 May · PMID 42237841 · Full text
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Clinical profile, intensive care needs, outcome, and predictors of mortality in children with severe sepsis: Secondary analysis of FerriPedS study.
Pai K, Nallasamy K, Bansal A … +4 more , Muralidharan J, Bhatia P, Rawat A, Angurana SK
Indian J Med Res · 2026 May · PMID 42237840 · Full text
Background and objectives Sepsis remains a leading cause of mortality among children worldwide. This study aimed to describe clinical profile, intensive care needs, outcome, and predictors of mortality among children wit...
Background and objectives Sepsis remains a leading cause of mortality among children worldwide. This study aimed to describe clinical profile, intensive care needs, outcome, and predictors of mortality among children with severe sepsis. Methods This secondary analysis of FerriPedS study was conducted in a tertiary pediatric intensive care units (PICU) in North India involving 115 children (3 months-12 yr) with severe sepsis. Data were collected regarding clinical details, laboratory investigations, organ dysfunction, intensive care needs, and outcome. Univariate and multinomial logistic regression analyses were used to determine predictors of mortality among severity score, organ dysfunction, serum ferritin, and PICU needs. Results The median (IQR) age was 3 (1-7) years, and common diagnoses were community acquired pneumonia (CAP) (n=45 39.1%), scrub typhus (n=16, 13.9%), and CNS infections (n=12,10.4%). Mortality was 27.8% (n=32). Non-survivors had significantly higher Pediatric Risk of Mortality-III (PRISM III) score, serum ferritin, and daily Pediatric logistic organ dysfunction-2 (PeLOD-2) score. Higher proportion of non-survivors had positive blood culture at admission, coagulopathy, hepatic dysfunction, shock, acute respiratory distress (ARDS), acute kidney injury (AKI), and multiple organ dysfunction score (MODS); and required invasive mechanical ventilation, vasoactive drugs, blood products, and RRT. On multinomial logistic regression analysis, PRISM-III, ARDS, and AKI were independent predictors of mortality. Interpretation and conclusions In children with severe sepsis, the common etiologies included CAP, scrub typhus, and CNS infections, and characterised by high mortality (27.8%). PRISM-III score, ARDS, and AKI were independent predictors of mortality.
Molecular, serological, and epidemiological characterisation of a hepatitis A virus outbreak in Maharashtra, India, 2025.
Tomar S, Hansraj Pise K, Ramdasi A … +9 more , Hundekar S, Deoshatwar AR, Thorat N, Jawalkar P, Ayachit P, Mahesh Kulkarni P, Nagargoje BB, Vishwanath Tandale B, Shete Aich A
Indian J Med Res · 2026 May · PMID 42237839 · Full text
Background and objectives Hepatitis A virus (HAV) remains a major cause of jaundice outbreaks globally, with 158.9 million infections reported in 2019 despite a 63% decline in mortality since 1990. Improved sanitation in...
Background and objectives Hepatitis A virus (HAV) remains a major cause of jaundice outbreaks globally, with 158.9 million infections reported in 2019 despite a 63% decline in mortality since 1990. Improved sanitation in many regions has shifted the age of primary infection from early childhood to older children and adults, increasing the risk of symptomatic and severe disease. In April-May 2025, we investigated an outbreak of HAV caused hepatitis that occurred in Rajur village, Ahilyanagar district, Maharashtra. A total of 327 suspected cases of acute hepatitis were reported, mainly affecting older children and young adults. Methods Suspected acute hepatitis cases were identified by clinical presentation and their epidemiological and clinical data were collected by questionnaire. Serum, stool, and potable water samples were collected and tested by anti-HAV IgM ELISA and/or real-time RT-PCR to confirm outbreak aetiology. Full HAV genome sequences were obtained from selected RT-PCR positive specimens. Results The age-specific attack rate for the 327 acute hepatitis cases was the highest in children aged 10-19 years (11.97%) and lowest in those ≥ 50 years. Anti-HAV IgM antibodies were detected in 32 of 45 (71.1%) available serum samples, and HAV RNA was detected in 7 of 22 (31.8%) serum and 19 of 31 (61.3%) stool samples tested. All 7 potable water samples tested negative for HAV RNA. Genomic analysis revealed strain details relevant to disease severity, providing insights into circulating HAV lineages in India. Interpretation and conclusions The findings highlight the need for continuous surveillance, genomic monitoring, and targeted prevention strategies to protect vulnerable, previously unexposed populations.
Untangling weight from height: A generalised body mass index (gBMI) approach to evaluating child and adolescent nutritional status in India.
Majumder R, Kurpad AV, Sachdev HS … +3 more , Kuriyan R, Thomas T, Ghosh S
Indian J Med Res · 2026 May · PMID 42237838 · Full text
Background and objectives Weight-for-height (WHZ) and body mass index (BMI)-for-age (BAZ) are commonly used to assess child overnutrition but have limitations: they conflate skeletal growth with body weight, correlate wi...
Background and objectives Weight-for-height (WHZ) and body mass index (BMI)-for-age (BAZ) are commonly used to assess child overnutrition but have limitations: they conflate skeletal growth with body weight, correlate with height, and inadequately distinguish fat from lean mass, particularly during puberty. This study proposes an India-specific generalised body mass index (gBMI), an age- and sex-specific power-type index adapted from Benn's concept, to better capture adiposity. Methods Exponent parameters for gBMI were estimated using healthy-child data, selected by WHO selection criteria, from the National Family Health Survey (NFHS-3,4,5) and the Comprehensive National Nutrition Survey (CNNS), comprising 12,466 children under 5 years and 6,487 aged 5-19 years. Polynomial regression to model age- and sex-specific variation in the weight-height relationship was used to estimate the exponents of height, and growth curves were generated using generalised additive models for location, scale, and shape (GAMLSS) with location scale and shape (LMS) methods. Validation employed independent data from 457 urban schoolchildren aged 5-16 years in Bengaluru, including fat and lean mass measured by dual-energy X-ray absorptiometry (DXA). Results The exponent varied with age (1.3 in infancy, ∼2.9 in pubertal boys, 2.7 in girls, stabilising at ∼2 in late adolescence). Unlike BMI, gBMI residuals showed near-zero correlation with height. gBMI-for-age Z-scores (gBAZ) showed lower wasting in children under 5 years (10.7% vs. 19.2% using WHZ) and higher adolescent overnutrition (8.7% vs. <1% using BAZ). Validation showed stronger association of gBAZ with body fat (r=0.70) than BAZ (r=0.65). Interpretation and conclusions The gBMI provides an adaptable, height-independent, and adiposity-sensitive index for assessing malnutrition and obesity in children and adolescents. Its use could refine nutritional surveillance and interventions, with potential wider applicability with longitudinal evaluations.
Patterns of pregabalin misuse: Need for intervention.
Sarvepalli T, Mewada S, Shukla S … +1 more , Kalaiselvan V
Indian J Med Res · 2026 May · PMID 42237837 · Full text
Background and objectives Pregabalin, an antiepileptic drug with anxiolytic and analgesic properties, has been increasingly misused for recreational purposes. This article aimed to assess the extent and patterns of prega...
Background and objectives Pregabalin, an antiepileptic drug with anxiolytic and analgesic properties, has been increasingly misused for recreational purposes. This article aimed to assess the extent and patterns of pregabalin misuse in India from a global perspective using pharmacovigilance data. Methods A retrospective post-market observational study was conducted using VigiBase reports on pregabalin-related adverse drug reactions between January 2011 to April 2024. Data extraction and analysis were performed between April to May 2024. Relevant reports were identified using MedDRA term and analysed at global and Indian levels. Results Among 40,582,030 adverse drug reactions (ADRs) in VigiBase, 163,476 involved pregabalins globally. Of these, 8,058 pregabalin abuse-related reports were identified, mainly intentional product misuse (n=3,560; 44.17%), intentional product use issue (n=2,203; 27.34%), and drug abuse (n=1,701; 21.11%). Globally, the USA reported the higher number of pregabalins ADRs, (n=96,867; 59.2%), followed by the Republic of Korea 9.4%, Japan 3.8% and France 3.6%. In India, 50 pregabalin-abuse reports were identified; of which drug abuse (n=26, 52%), intentional overdose (n=13, 26%), intentional product misuse (n=13, 26%), intentional product use-issue (n=4, 8%) and substance use disorder (n=1, 2%) were reported in patients within 18-44 yr (n=36, 72%) and predominantly in males (n=45, 90%). About 94% of reports were deemed serious, with 54% (n=27) requiring prolonged hospitalisation. Interpretation and conclusions Pregabalin misuse in India is prevalent, especially among adult men, and is often associated with serious outcomes. These findings emphasise the urgent need for stricter regulation and targeted interventions to limit misuse and reduce associated risks.
Inflammation-driven carcinogenesis in oral cancer: A systematic review of cellular mechanisms and clinical perspectives.
Rastogi M, Katiyar A, Kumar D
Indian J Med Res · 2026 May · PMID 42237836 · Full text
Background and objectives Oral squamous cell carcinoma (OSCC) represents the predominant form of oral cancer and remains a major cause of morbidity and mortality worldwide. Beyond traditional risk factors such as tobacco...
Background and objectives Oral squamous cell carcinoma (OSCC) represents the predominant form of oral cancer and remains a major cause of morbidity and mortality worldwide. Beyond traditional risk factors such as tobacco, alcohol, and betel quid consumption, mounting evidence implicates chronic inflammation as a driving force in oral carcinogenesis. This review synthesises current literature exploring how inflammatory mediators contribute to tumour initiation, progression, and clinical outcomes in OSCC. Methods A systematic search of PubMed, Scopus, Web of Science, Embase, and Cochrane Library databases was conducted according to PRISMA 2020 guidelines. Studies from 2020-2025 examining molecular and clinical interactions between inflammation and OSCC were analysed. Extracted data included inflammatory biomarkers, activated signalling pathways, and prognostic or therapeutic implications. The risk of bias was assessed using the Newcastle-Ottawa Scale and Cochrane RoB-2 tool. The review protocol was registered with PROSPERO (CRD420251141942). Results Forty-three eligible studies revealed that inflammatory cytokines such as TNF-α, IL-6, and IL-1β, together with chemokines like CXCL8, trigger oncogenic cascades involving NF-κB and STAT3, leading to enhanced proliferation, angiogenesis, and epithelial-mesenchymal transition. Oxidative DNA damage and immune suppression mediated by M2 macrophages and PD-1/PD-L1 signalling further facilitate tumour aggressiveness. Elevated COX-2, STAT3, and systemic inflammatory ratios were strongly associated with poor prognosis. Interpretation and conclusions Persistent inflammation acts as a critical determinant in OSCC pathogenesis. Integrating inflammation-related biomarkers and anti-inflammatory therapeutic strategies may improve early detection, prognostication, and patient survival outcomes.
Cancer screening uptake and tobacco-alcohol use among women in Uttarakhand: A district-wise analysis from the 5th National Family Health Survey (NFHS-5).
Kumar S, Kaul P, Kapur K … +4 more , Choudhary D, Rajkumar YA, Arora A, Garg PK
Indian J Med Res · 2026 May · PMID 42237835 · Full text
Background and objectives Screening for cervical, breast, and oral cancer reduces morbidity and mortality, yet uptake in India remains low, particularly in hilly States such as Uttarakhand. This study assesses district-l...
Background and objectives Screening for cervical, breast, and oral cancer reduces morbidity and mortality, yet uptake in India remains low, particularly in hilly States such as Uttarakhand. This study assesses district-level screening patterns among women in Uttarakhand using National Family Health Survey (NFHS-5) data. Methods District-wise self-reported screening among women aged 30-49 years was analysed and categorised as absent (0.0%), moderate (0.1-0.4%), or high (≥0.5%). District-level tobacco and alcohol use among women aged ≥15 years and literacy were also reviewed. Results Screening uptake ranged from absent to moderate across districts. Haridwar (0.90%) and Champawat (0.57%) reported the highest coverage, while several hilly and urban districts, including Tehri Garhwal, Rudraprayag, Pauri Garhwal, Dehradun, and Nainital, reported no uptake. Tobacco use was highest in Bageshwar (7.7%) and Pauri Garhwal (6.4%), whereas alcohol consumption remained low (0.1-0.7%). A moderate negative correlation was observed between literacy and screening- Haridwar showed the uptake despite lower literacy, while more literate districts like Chamoli and Pithoragarh reported lower participation. Interpretations and conclusions Cancer screening uptake among women in Uttarakhand remains low and uneven. Literacy did not ensure greater participation, underscoring the need for stronger outreach, primary care integration, mobile screening in hilly areas, and community mobilisation.
Application of confocal microscopy for detecting tuberculous lymphadenitis.
Patil-Takbhate B, Gore C, Tripathy S
Indian J Med Res · 2026 May · PMID 42237834 · Full text
Tuberculous lymphadenitis, a form of extra-pulmonary tuberculosis, is diagnosed through the detection of Mycobacterium tuberculosis in tissue samples. Lymphadenitis may be caused by both nontuberculous mycobacteria (NTMs...
Tuberculous lymphadenitis, a form of extra-pulmonary tuberculosis, is diagnosed through the detection of Mycobacterium tuberculosis in tissue samples. Lymphadenitis may be caused by both nontuberculous mycobacteria (NTMs) and Mycobacterium tuberculosis complex (MTBC). Here, we highlight the advantage of using a fluorescent dye in combination with Confocal Laser Scanning Microscopy (CLSM) for identifying Mycobacterium tuberculosis in histological sections of lymph node tissue after correlating with Clinical, histopathological, and microbiological findings. CLSM enables the differentiation of non-specific fluorescence from the Mycobacterium tuberculosis fluorescence through the spectral emission method. This method proved effective even in lymph node tissue samples exhibiting weak staining using the Ziehl-Neelsen method. Overall, the integration of fluorescent dye with CLSM visualisation substantially improves bacillary visualisation, facilitates faster processing, and reduces observer fatigue due to the black background.
Nomophobia in India: A systematic review and meta-analysis.
Priya A, Sinha R, Sethia S … +2 more , Rahman MHU, Melwani V
Indian J Med Res · 2026 May · PMID 42237833 · Full text
Background and objectives Nomophobia is characterised by discomfort, anxiousness, and worry caused by separation from a mobile device. It affects the personality, self-esteem, anxiety, along with behavioural changes of t...
Background and objectives Nomophobia is characterised by discomfort, anxiousness, and worry caused by separation from a mobile device. It affects the personality, self-esteem, anxiety, along with behavioural changes of the user. In the era where every aspect of life is dependent on mobile phones, understanding the burden of nomophobia is essential to bring about any intervention. The present study aims to find the prevalence of Nomophobia. Methods We searched the literature in PubMed (MEDLINE) and EMBASE databases by using relevant keywords for the studies published between January 1, 2008, and April 4, 2025. The protocol was registered in PROSPERO (CRD 42023446355). Selected articles were screened based on predetermined inclusion and exclusion criteria. Articles with observational studies in English, having information regarding the proportion of nomophobia in the adult population of India, were included. The Joanna Briggs Institute (JBI) critical appraisal scale for studies reporting prevalence data was used to assess the study quality. Results A total of 25 studies were included in our study, comprising 10607 study participants. The pooled prevalence of nomophobia was found to be 77.6% (95% CI: 74.9% - 80.2.0%). The most common study tools used to detect nomophobia was the Nomophobia Questionnaire (NMP). The sensitivity analysis revealed the pooled prevalence of nomophobia to be 74.9% to 80.2%, ruling out the impact of any one study on the result. Interpretation and conclusion This meta-analysis reveals the significant burden of nomophobia. These findings position nomophobia as a pressing health concern requiring proactive interventions to safeguard mental well-being and productivity in the youth.
Out of pocket expenditure incurred by couples seeking infertility services at tertiary level facilities in India.
Padhan AK, Patil P, Vikani A … +13 more , Sharma D, Sachin O, Somen B, Shankara Bagepally B, Tanwar R, Suri V, V R, M A, P R, Shrivastava D, Patel S, Prinja S, Joshi B
Indian J Med Res · 2026 May · PMID 42237832 · Full text
Background and objectives Diagnosis and treatment of infertility, mostly sought at tertiary facilities, contribute to substantial out-of-pocket expenditure (OOPE). This study estimated OOPE among couples seeking care for...
Background and objectives Diagnosis and treatment of infertility, mostly sought at tertiary facilities, contribute to substantial out-of-pocket expenditure (OOPE). This study estimated OOPE among couples seeking care for endometriosis, male infertility, polycystic ovary syndrome (PCOS), tubal factor, and uterine factor, including costs of diagnosis, management, and intrauterine insemination (IUI). Methods A cross-sectional study was conducted across five tertiary healthcare facilities (three public, two private) selected through convenience sampling to represent different regions. Based on mean (SD) OOPE INR (₹)144,393 (₹130,943), effect size 0.16, α=0.05, and 80% power, the sample was equally distributed across sites and IVF/non-IVF groups, with ∼100 participants per site. Couples were interviewed between April 2022-March 2023. Catastrophic health expenditure was defined as infertility spending exceeding 40% of annual household non-food expenditure. OOPE over the preceding year covered direct medical, non-medical, and indirect costs. Results Annual median OOPE was ₹11,317 (US $136.5) (IQR: ₹4,801-₹19,513) US $, higher in private facilities ₹14,217 ($171.4) (IQR: ₹8,030-₹21,848) than public facilities ₹8,355 ($100.7) (IQR: ₹3,785-₹17,386). Direct medical costs were the major contributor: median ₹5,802 ($69.9) (IQR: ₹2,186-₹11,847) Highest OOPE was for endometriosis ₹15,084 ($181.9) (IQR: ₹8,114-₹20,758), followed by uterine factor and male infertility ₹13,211 ($159.3) (IQR: ₹6,654-₹21,521). OOPE increased with absence of insurance (₹6,919; $83.4), comorbidities (₹2,593; $31.3), IUI (₹2,668; $32.1), and PCOS (₹2,004; $24.1). Catastrophic Health Expenditure was associated with comorbidities (OR=1.61), IUI (OR=1.88), and lower per capita income <₹59,400 ($715.7) (OR=3.44). Overall, 59.4% experienced CHE. Interpretation and conclusions Infertility care imposes substantial out of pocket expenditure in India. Strengthened insurance coverage and public sector investment are critical for equitable access.
Navigating risk in biological quality testing: A guide for emerging laboratories.
Shrivastava R, Goel S, Trivedi N … +2 more , Mishra N, Tewari S
Indian J Med Res · 2026 May · PMID 42237831 · Full text
Biological products are inherently complex and highly sensitive to variations in testing conditions, rendering quality control (QC) testing laboratories particularly vulnerable to high-impact operational, analytical, and...
Biological products are inherently complex and highly sensitive to variations in testing conditions, rendering quality control (QC) testing laboratories particularly vulnerable to high-impact operational, analytical, and biosafety risks. Despite the emphasis on risk-based thinking in international standards, a structured laboratory-specific framework for identifying, assessing, and mitigating risks in biological product QC testing remains insufficiently articulated. This article presents a simplified approach for proactive identification of testing-related and occupational health risks, along with their mitigation and conversion into opportunities. The concept aligns with internationally accepted standards, including ISO/IEC Guide 51, ISO 31000:2018, ISO/IEC 17025:2017, and ICH Q9 guidelines. Implementation of this framework enhances the reliability of results, strengthens regulatory compliance, and improves patient and occupational safety. By addressing the gap in structured risk assessment for biological QC laboratories, the article provides practical guidance for implementing ISO/IEC 17025:2017 Clause 8.5 and enables continuous improvement through systematically converting identified risks into opportunities.
Single point insulin sensitivity estimator as a marker of metabolic syndrome in a South Indian cohort.
Sreekumar S, Eagappan S, Raghavan KS … +1 more , Sridhar S
Indian J Med Res · 2026 May · PMID 42237830 · Full text
Background and objectives Insulin resistance is an important mechanism linking metabolic syndrome, type 2 diabetes mellitus (T2DM) and cardiovascular disease. Accurate assessment of insulin resistance is vital for early...
Background and objectives Insulin resistance is an important mechanism linking metabolic syndrome, type 2 diabetes mellitus (T2DM) and cardiovascular disease. Accurate assessment of insulin resistance is vital for early detection, but existing methods have limitations. The gold standard euglycemic-hyperinsulinemic clamp is impractical for large-scale studies, while homeostatic model assessment for insulin resistance (HOMA-IR) requires fasting insulin measurement. This study aimed to validate single point insulin sensitivity estimator (SPISE), a lipid-based non-invasive test for detection of metabolic syndrome by comparing it with HOMA-IR. The primary objective was to determine a suitable cut-off for SPISE in South Indian population. Methods Between June and December 2024, we conducted a cross-sectional study among 151 adults (>30 years) living in the semi-urban outskirts of Madurai, Tamil Nadu, using systematic random sampling to select participants. Participants were categorised as individuals with metabolic syndrome (n=76) or individuals without metabolic syndrome (n=75) using South Asian-modified National Cholesterol Education Program (NCEP) criteria. Anthropometry, blood glucose, lipid profile, and insulin levels were measured in fasting state. SPISE and HOMA-IR were calculated using the formulas SPISE=600 x HDL-C 0.185/ (TG 0.2 x BMI 1.338) HOMA-IR=[fasting blood glucose (mg/dL) x fasting insulin (µU/mL)]/405. The values were calculated using photometric method for lipid profile and ECLIA for serum insulin levels, and the ideal cut off, sensitivity, and specificity were found using receiver operating characteristic (ROC) analysis. Results Participants with metabolic syndrome showed significantly higher BMI (28.55±3.91 vs. 26.95±4.06) and HOMA-IR (6.56±2.04 vs. 1.89±1.09), and lower SPISE values (4.93±0.82 vs. 5.73±1.48 P<0.05). A SPISE cut-off of 4.05 yielded 89% sensitivity and 88% specificity, outperforming HOMA-IR (sensitivity 64.9%, specificity 70.6%). Area under the curve values were comparable for SPISE (0.662) and HOMA-IR (0.638). Interpretation and conclusions The SPISE index is a simple, non-invasive tool for assessing insulin resistance in the South Indian population, exhibiting superior sensitivity (89%) and specificity (88%) compared to HOMA-IR at a cut-off of 4.05. By utilising routine lipid and anthropometric data rather than expensive insulin assays, SPISE serves as a practical alternative for large-scale metabolic syndrome screening in semi-urban settings. SPISE is a surrogate point of care marker for insulin resistance, suitable for large-scale studies in resource-limited settings. Further multicentre studies are warranted to validate population-specific cut-offs.
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