The Indian Journal Of Medical Research[JOURNAL]
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200 papers
Saroglitazar and vitamin E vs. lifestyle interventions in metabolic dysfunction associated steatotic liver disease: A 3-arm randomised study.
Tiwari AK, Singh G, Kumar V … +8 more , Yadav DP, Shukla SK, Singh V, Mishra G, Tiwary NK, Anunay A, Singh D, Chaturvedi D
Indian J Med Res · 2026 May · PMID 42237829 · Full text
Background and objectives Lifestyle interventions are a vital component for the management of metabolic dysfunction-associated steatotic liver disease (MASLD). In the present study, we investigated the differential effec...
Background and objectives Lifestyle interventions are a vital component for the management of metabolic dysfunction-associated steatotic liver disease (MASLD). In the present study, we investigated the differential effect of saroglitazar or vitamin E vs. lifestyle interventions only. Methods A total 150 non-diabetic patients aged 19-55 yr were recruited to receive saroglitazar and vitamin E along with lifestyle interventions and lifestyle interventions alone (n=50 in each arm, A, B and C, respectively) for 24 weeks. Liver stiffness measurements and NAFLD fibrosis score were the primary outcomes. The study was registered under Trial registration (CTRI/2022/05/042462). Results Per-protocol analysis was performed in 136 patients (n=46, 47, and 43 in arms A, B and C, respectively). The changes from baseline were not-significant for NAFLD fibrosis score [0.05±0.52, 0.06±0.64 and -0.12±1.0, 95% confidence interval (CI), P =0.41] and liver stiffness measurement [-1.25 (-2.6, -0.2), -1.4 (-3.7, 0.4,) and -0.7 (-1.8, -0.2), P =0.22] in either arm. Changes in secondary outcomes were also not-significant except triglyceride [-13.95 (-61, -18), -4.3 (-28.8, 49) and -13 (-127, 3) P=0.035]. A considerable proportion of patients had at least '2 Kpa reduction' in liver stiffness measurement in arm A (39%) compared to C (19%). Interpretation and conclusions Saroglitazar or vitamin E are similar to lifestyle interventions in improving different non-invasive parameters in MASLD at 24 weeks of intervention.
Immunohistochemical evaluation of glutaminase-1 enzyme in oral squamous cell carcinoma.
Chougule MS, Patil BR, Kotrashetti VS … +3 more , Joshi PS, Patil AM, Pawar SB
Indian J Med Res · 2026 May · PMID 42237828 · Full text
Background and objectives Malignant cells reprogram their metabolism. Glutamine is a major biosynthetic precursor apart from glucose in various cancers. Glutaminase 1 (kidney type) is the rate limiting enzyme in glutamin...
Background and objectives Malignant cells reprogram their metabolism. Glutamine is a major biosynthetic precursor apart from glucose in various cancers. Glutaminase 1 (kidney type) is the rate limiting enzyme in glutamine metabolism, which is increased in cancers of prostate, breast, colorectum, ovary and oral squamous cell. We aimed to evaluate the intensity and extent of immunohistochemical expression of glutaminase1 in various grades of oral squamous cell carcinoma (OSCC) and investigate whether any association exists between the glutaminase 1expression with staging, grading and tumour infiltrating lymphocytes. Methods This retrospective analysis included 98 formalin-fixed, paraffin-embedded tissue blocks of clinically and histopathologically confirmed cases of OSCC. One section was stained with haematoxylin and eosin and the other, immunohistochemically for glutaminase 1(GLS1). Staging, grading, tumour infiltrating lymphocytes were evaluated for their relation with GLS1 immunoscore. Results Statistically significant association was noted between GLS1 immunointensity (P<0.001) immunoextent (P<0.001) and the immunoscore (P=0.007) with the worsening grades of OSCC. There was no significant association between TNM staging P<0.61) and tumour infiltrating lymphocytes with GLS1 immunoscore (P=0.30). Interpretation and conclusions Glutaminase 1 expression increases with worsening grade of OSCC signifying an altered metabolic phenotype as the cancer cells lose differentiation.
Utility and clinical relevance of multiplex PCR panels for diagnosis of central nervous system infections.
Gürler M, Karaoğlu Ç, Yurtcu EE … +2 more , Us E, Karahan ZC
Indian J Med Res · 2026 May · PMID 42237827 · Full text
Background and objectives Multiplex molecular panels for meningitis and encephalitis (M&E) allow rapid detection of multiple pathogens directly from cerebrospinal fluid (CSF) samples. Although their use is expanding, rea...
Background and objectives Multiplex molecular panels for meningitis and encephalitis (M&E) allow rapid detection of multiple pathogens directly from cerebrospinal fluid (CSF) samples. Although their use is expanding, real-world data on their diagnostic yield and clinical relevance remain limited. This study aimed to assess the diagnostic performance, clinical relevance, and usage patterns of multiplex PCR panels for diagnosis of meningitis and encephalitis over a five-year period in a tertiary care hospital. Methods We retrospectively analysed CSF samples tested with multiplex M&E panels between January 2019 and December 2023. Clinical data, test results, and subsequent clinical actions were reviewed. Only the first positive sample per patient was included. Clinical relevance was defined as a documented change in diagnosis or treatment attributed to the panel result. Results Out of 1,491 CSF samples, 122 (8.2%) were positive for at least one pathogen. Viral agents accounted for most detections, with human herpesvirus-6 (n=34, 27.9%), enterovirus (n=14, 11.5%), and herpes simplex virus type-1 (n=10, 8.2%) being most common. Streptococcus pneumoniae (n=13, 10.6%) was the leading bacterial pathogen. Co-detections were observed in (n=18, 14.7%) of positive cases. Only 41% (n=50) of positive results were associated with a clinically relevant action. Repeat testing after an initial negative result had low additional diagnostic yield (n=7, 7.2%), and several tests were ordered for conditions not covered by the panels. Interpretation and conclusions Multiplex PCR panels offer rapid pathogen detection in CNS infections, but inappropriate test utilisation and limited follow up may reduce their clinical impact. Clearer testing criteria and clinician awareness regarding panel contents are essential to improve diagnostic efficiency.
Beyond the prescription: Addressing socio-clinical determinants of asthma care in India.
Koul PA, Saydain G
Indian J Med Res · 2026 May · PMID 42237826 · Full text
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A qPCR-based algorithm for the diagnosis of classic and non-classic Turner syndrome.
Bose C, Mondal S, Saha C … +3 more , Sengupta N, Bhattacharyya NP, Mukhopadhyay S
Indian J Med Res · 2026 May · PMID 42237825 · Full text
Background and objectives Turner syndrome is an X-chromosome aneuploidy which include classic monosomy-X and variants like mosaicism, isochromosome-Xq, etc. It is diagnosed by karyotyping, which is time-staking, laboriou...
Background and objectives Turner syndrome is an X-chromosome aneuploidy which include classic monosomy-X and variants like mosaicism, isochromosome-Xq, etc. It is diagnosed by karyotyping, which is time-staking, laborious and costly. Quantitative real-time PCR (qPCR) offers a faster and cheaper alternative testing strategy, but single- or dual-primer qPCR may miss some variants. This proof-of-concept study was conducted to evaluate multi-primer qPCR in detecting various karyotypes of Turner syndrome. Methods Genomic DNA was extracted from 50 cases with Turner syndrome (45,X=23; 45,X/46, XX=10; isochromosome-Xq=12; 45, X/46, XY=5), 25 control females (46,XX), and 5 males (46,XY). DNA was analysed using fast qPCR with 4 primers targeting Xp-genes (SHOX, ARSE) and Xq-genes (VAMP7, XIST). The ΔΔCT method calculated gene dose relative to 46,XX females, with HBB being the housekeeping gene. Gene cut-offs were ascertained by receiver -operator-curve (ROC) analysis. This was followed by developing an algorithm for detecting classical and non-classical Turner syndrome. Results Using the criteria SHOX <0.752 "OR" ARSE <0.885, all the cases of Turner syndrome were detected with 100% sensitivity and 93.3% specificity. VAMP7 >0.723 detected isochromosome-Xq- Turner syndrome with 87.9% sensitivity, and 72.7% specificity. SHOX < 0.511 differentiated classic Turner syndrome from 45,X/46,XX mosaics with a 70% sensitivity, and 78.3% specificity. Our qPCR-based algorithm showed near-perfect agreement (Cohen's k=0.81) with 100-cell karyotyping, identifying 14 of 15 Turner syndrome cases with low-level mosaicism missed by 30-cell-karyotyping. Interpretation and conclusions A qPCR-based algorithm can be used for the rapid detection of classic and non-classic Turner syndrome, pending further validation studies. However, it cannot detect ring-chromosomes, mosaic-polyploidy and is inadequate to pinpoint the karyotypic subtype of Turner syndrome.
Risk factors of obesity among infants and young children below 2 years of age: A case control study.
Pushparajan RRM, Sreenivasan P, Sarasam AA
Indian J Med Res · 2026 Apr · PMID 42165734 · Full text
Background and objectives Obesity is a chronic disease with its onset as early as infancy. This study was conducted to determine risk factors of obesity in infants and young children below 2 years of age. Methods For thi...
Background and objectives Obesity is a chronic disease with its onset as early as infancy. This study was conducted to determine risk factors of obesity in infants and young children below 2 years of age. Methods For this case-control study, obese children aged 1 month to 2 years were enrolled as cases. Controls were age, sex and calendar matched non-obese children from the same setting (1:1). Sociodemographic characteristics, clinical features and potential risk factors (parental obesity, maternal weight gain during pregnancy, low birth weight, cessation of exclusive breastfeeding before 6 months of age, introduction of semisolid feeds before 6 months of age, formula feeding at enrolment, bottle feeding at enrolment, junk food consumption, and lifestyle diseases in family) were noted. Obesity was defined as weight-for-length or BMI-for-age more than 3 standard deviations above median as per World Health Organization 2006 growth charts. Results Univariate analysis on 52 pairs (22 male pairs) showed maternal pre-conceptional BMI>25 kg/m2, maternal BMI>25 kg/m2 paternal BMI>23 kg/m2, bottle feeding and/or formula feeding at enrolment, cessation of exclusive breastfeeding before 6 months, junk food consumption, and lifestyle diseases in family as risk factors. With multivariable logistic regression, maternal BMI>25 kg/m2 at enrolment [Adjusted odds ratio (aOR) 11.25, 95% confidence interval (CI) 3.66-34.49, P<0.001], formula feeding (aOR 6.13, 95% CI 1.33-28.17, P=0.020) and lifestyle diseases in family (aOR 6.88, 95% CI 1.83-25.88, P=0.004) were identified as significant risk factors. Interpretations and conclusions Risk factors of obesity in children below 2 years of age were included maternal pre-conceptional BMI>25 kg/m2, maternal BMI>25 kg/m2 at enrolment, formula feeding at enrolment, and lifestyle diseases in family.
Evolution of incretin-based therapies: From GLP-1 monotherapy to dual and triple agonists: A new era in metabolic therapy.
Gupta M, Shukla J
Indian J Med Res · 2026 Apr · PMID 42165732 · Full text
Incretin-based therapies have revolutionised the management of metabolic disorders, transitioning from DPP-4 inhibitors to advanced GLP-1 receptor agonists (GLP-1RAs) and next-generation dual and triple agonists. This re...
Incretin-based therapies have revolutionised the management of metabolic disorders, transitioning from DPP-4 inhibitors to advanced GLP-1 receptor agonists (GLP-1RAs) and next-generation dual and triple agonists. This review explores the evolving role of incretin pharmacology in type 2 diabetes mellitus (T2DM), obesity, and metabolic dysfunction-associated steatotic liver disease (MASLD). Literature from PubMed, Scopus, and Google Scholar up to July 2025 was reviewed, emphasising pivotal trials and real-world evidence. While DPP-4 inhibitors offer modest glycaemic benefits, GLP1RAs such as liraglutide and semaglutide have demonstrated significant weight loss and cardiometabolic protection. Dual GIP/GLP-1 agonist tirzepatide and triple agonist retatrutide have shown unprecedented efficacy, with up to 24% body weight reduction and improvement in hepatic and inflammatory markers. Agents like cotadutide and efinopegdutide further expand indications to MASLD and metabolic dysfunction associated steatohepatitis (MASH). Despite promising outcomes, challenges persist in terms of cost, accessibility, and the underrepresentation of low- and middle-income countries in major trials. Pharmacogenomic variability may also influence therapeutic response. Incretin-based multi-agonists offer a transformative, multi-system approach to metabolic disease but require tailored implementation. This review provides an updated synthesis of therapeutic developments and outlines priorities for future research, regulatory policy, and equitable global integration as incretin-based therapies have evolved into a versatile class addressing glycaemic control, weight loss, and cardio-metabolic risk.
Evolving landscape of haemophilia care in India: Balancing innovation, access, and sustainability.
Yanamandra U, Sidharthan N, John JM
Indian J Med Res · 2026 Apr · PMID 42165731 · Full text
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Silent risks of urban water: Reframing water quality as a public health priority in India.
Kuna A
Indian J Med Res · 2026 Apr · PMID 42165730 · Full text
Rapid urbanisation in India has intensified stress on urban water systems, where inadequate sewage treatment, intermittent distribution, and fragmented governance compromise drinking-water quality across diverse city typ...
Rapid urbanisation in India has intensified stress on urban water systems, where inadequate sewage treatment, intermittent distribution, and fragmented governance compromise drinking-water quality across diverse city typologies. These weaknesses disproportionately affect informal settlements, increasing exposure to microbial contamination and chronic toxicants such as nitrate, fluoride, arsenic, and industrial pollutants. Beyond acute infections, growing evidence suggests that urban aquatic environments function as amplification reservoirs for antimicrobial resistance. This perspective synthesises evidence across water, sanitation, environmental surveillance, and health systems to examine how infrastructure gaps and weak integration with public health monitoring sustain preventable disease burdens. It reframes urban water quality as a public health function rather than solely a municipal service, highlighting the limits of infrastructure-centric metrics. Pragmatic interventions, including continuous pressurised supply, strengthened sewage and effluent control, integrated water-quality and disease surveillance, and explicit linkage to AMR containments, should be prioritised, with success measured through reductions in morbidity and resistance.
Quality assurance in rapid diagnostic tests for accurate diagnosis of malaria.
Ahmed N, Yadav A, Ranjha R … +2 more , Anvikar AR, Bharti PK
Indian J Med Res · 2026 Apr · PMID 42165729 · Full text
Early and accurate detection of malaria is essential for appropriate case management, minimizing unnecessary treatment, and supporting surveillance efforts crucial for disease control and elimination. Microscopy has long...
Early and accurate detection of malaria is essential for appropriate case management, minimizing unnecessary treatment, and supporting surveillance efforts crucial for disease control and elimination. Microscopy has long been the reference method for malaria diagnosis. Rapid diagnostic tests (RDTs) have revolutionised point-of-care diagnosis of malaria, with billions of units distributed globally over the past decade. However, ensuring their reliability necessitates rigorous quality assurance measures. Inaccurate test performance can lead to misdiagnosis, inappropriate treatment, increased mortality, and the potential emergence of drug-resistant strains that can lead to delay in achieving the target of malaria elimination. Strengthening quality assurance protocols is crucial to maintain the accuracy of malaria diagnostics, enhancing disease surveillance, and bolstering global malaria elimination initiatives. This paper focuses on the role of quality assurance in optimising the performance and reliability of malaria RDTs. By implementing enhanced quality assurance frameworks, diagnostic accuracy can be safeguarded, toward malaria eradication.
Prophylactic oxytocin infusion for reducing blood loss during elective caesarean delivery: A randomised controlled trial.
Govindan P, Sharma J, N S K … +3 more , Kundra P, Maurya DK, Keepanasseril A
Indian J Med Res · 2026 Apr · PMID 42165728 · Full text
Background and objectives Optimum dose, route, and timing of oxytocin administration to prevent postpartum haemorrhage during caesarean section are uncertain. We compared the effect of oxytocin infusion initiated either...
Background and objectives Optimum dose, route, and timing of oxytocin administration to prevent postpartum haemorrhage during caesarean section are uncertain. We compared the effect of oxytocin infusion initiated either at skin incision or after head delivery on blood loss and ease of foetal head delivery during elective caesarean section. Methods In this open-label, randomised trial with parallel arms, 68 women with singleton pregnancies in cephalic presentation, undergoing elective caesarean delivery at term in a tertiary centre in Puducherry, were enrolled. Randomisation was performed using a simple random approach. Allocation was concealed in sequentially numbered, opaque, sealed envelopes, which were opened after informed consent to allocate participants to receive an oxytocin infusion (6 mIU/min), started either at the time of skin incision (intervention group) or after foetal head delivery (control group). All received oxytocin 5IU bolus after head delivery, followed by infusion for four hours postpartum. The primary outcome was the amount of blood loss. Results Mean blood loss was lower among those started on oxytocin skin incision than the control group (485.8±159.2 mL vs. 589.1±216.6 mL, P=0.029). Median haemoglobin decline was significantly lower in the intervention group (0.6 vs. 1.0 g/dL, P=0.011). Ease of foetal head delivery, need for additional uterotonics, and neonatal outcomes were comparable between the groups. Interpretation and conclusions The initiation of oxytocin at the skin incision may lead to significantly lower blood loss and a lower fall in haemoglobin level compared to its initiation after foetal head delivery among women undergoing elective pre-labour caesarean section at term.
Maternal facilitated tucking versus nurse facilitated tucking for alleviation of pain during neonatal heel lancing: A randomised, two-period, cross-over trial.
Saini MK, Kalyan G, Kaur R … +1 more , Sundaram V
Indian J Med Res · 2026 Apr · PMID 42165727 · Full text
Background and objectives Preterm neonates undergo multiple painful procedures in neonatal intensive care units (NICU). It is difficult for nurses to utilise non-pharmacological pain control measures every time due to lo...
Background and objectives Preterm neonates undergo multiple painful procedures in neonatal intensive care units (NICU). It is difficult for nurses to utilise non-pharmacological pain control measures every time due to low nurse-patient ratio. Mother is a low-cost resource and can be integrated in management of neonatal pain. The current study was planned to compare maternal facilitated-tucking with nurse facilitated-tucking for pain alleviation following heel-lancing in preterm neonates. Methods A Randomised, controlled, two-period, cross-over trial was conducted in a level III NICU of a tertiary care hospital. Participants included preterm neonates (≤35 wk) admitted in NICU. Interventions included: facilitated-tucking provided to preterm neonates during heel-lancing by simulation-trained mothers or nurses. The tucking sequence was randomised (AB/BA sequence). The primary outcome was the premature infant pain profile - revised (PIPP-R) score. The study was registered under Trial registration: CTRI/2023/08/056592. Results Study neonates (n=45) had significantly lower PIPP-R following maternal tucking compared to nurse facilitated tucking: [10.1 (2.9) versus 11.8 (2.8); mean difference (95% CI): -1.7 (-2.8,-0.6); P=0.003]. No period effect and carry-over effects were observed. Pre-post intervention maternal confidence and parenting-self-efficacy scores were significantly higher, and stress levels were significantly lower. Interpretation and conclusions During heel-lancing of preterm neonates in the NICU, tucking performed by simulation trained mothers was associated with a significant reduction in pain compared to tucking performed by nurses.
Saroglitazar for non-obese metabolic-dysfunction associated steatotic liver disease (MASLD): An open-label randomised controlled trial.
Bhagat N, De A, Duseja A … +6 more , C P G, Kumar M, Mehta M, Taneja S, Sahni N, Singh V
Indian J Med Res · 2026 Apr · PMID 42165726 · Full text
Background and objectives Nearly one-third of individuals with metabolic dysfunction-associated steatotic liver disease (MASLD)/non-alcoholic fatty liver disease (NAFLD) are non-obese, yet evidence for pharmacotherapy in...
Background and objectives Nearly one-third of individuals with metabolic dysfunction-associated steatotic liver disease (MASLD)/non-alcoholic fatty liver disease (NAFLD) are non-obese, yet evidence for pharmacotherapy in this subgroup remains limited. This study assessed the safety and effectiveness of saroglitazar among non-obese individuals with MASLD/NAFLD. Methods In this open-label randomised controlled trial (RCT), non-obese [body mass index (BMI) <25 kg/m2] adults with NAFLD/MASLD and raised alanine aminotransferase levels (ALT >50 U/L) were allocated in a 1:1 ratio to either saroglitazar (4 mg/day) combined with lifestyle modification (Group A) or lifestyle intervention alone (Group B) for a period of six months. The trial was registered with clinical trial registry (CTRI/2022/09/046081). The primary outcome was the change in controlled attenuation parameter (CAP). Secondary outcomes included changes in anthropometric measures, insulin resistance, glycaemic indices, lipid profile, ALT, fibroscan-aspartate aminotransferase (FAST) score, hepatic steatosis index (HSI), non-invasive fibrosis markers [liver stiffness measurement (LSM), fibrosis-4 (FIB-4), aspartate aminotransferase to platelet ratio index (APRI),], and adverse events. Results Sixty-six participants (33 per group) completed the study. Both groups showed significant reductions in CAP; however, the median change in CAP did not differ between the two groups [24 dB/m (9-48.8) vs. 14 dB/m (-4.5 to 50); P=0.52]. Alterations in BMI and waist circumference were similar between groups. Homeostasis model assessment-estimated insulin resistance (HOMA-IR) [0.68 (0.14-1.69) vs. -0.51 (-1.12 to 0.44); P=0.03], triglycerides [34 (-1.5 to 76.8) vs. -10 (-28.5 to 20.5) mg/dL; P=0.006], and ALT (43.7±36.7 vs. 28.1±21.5 U/L; P=0.04) were significantly improved in the saroglitazar group. Changes in HSI, FAST score, APRI, FIB-4, and liver stiffness were similar between groups. No serious adverse events were observed. Interpretation and conclusions In non-obese NAFLD/MASLD patients, the combination of saroglitazar with lifestyle changes over a period of six months improved insulin resistance, triglycerides, and ALT but did not confer additional benefit over lifestyle intervention alone for non-invasive hepatic steatosis or liver fibrosis markers.
Exploring the significance of EGFR, MMP-2, MMP-9, HIF-1α, and CAIX as molecular biomarkers in ocular surface squamous neoplasia.
Ramachandran RG, Parameswaran S, Rajagopal R … +2 more , Biswas J, Krishnakumar S
Indian J Med Res · 2026 Apr · PMID 42165725 · Full text
Background and objectives Ocular surface squamous neoplasia (OSSN) encompasses a spectrum of tumours, including conjunctival squamous intraepithelial neoplasia (CSIN), carcinoma in situ (CIS), and invasive squamous cell...
Background and objectives Ocular surface squamous neoplasia (OSSN) encompasses a spectrum of tumours, including conjunctival squamous intraepithelial neoplasia (CSIN), carcinoma in situ (CIS), and invasive squamous cell carcinoma (iSCC). The roles of biomarkers such as epidermal growth factor receptor (EGFR), matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), hypoxia-inducible factor-1α (HIF-1α), and carbonic anhydrase IX (CAIX) in OSSN progression are incompletely understood. This study aimed to investigate their expression patterns in Asian Indian OSSN tumours. Methods This observational immunohistochemistry (IHC) study was conducted on 21 formalin-fixed, paraffin-embedded tissue specimens from patients with CSIN, CIS, or iSCC. OSSN tumours were categorised into Group A (CSIN and CIS) and Group B (iSCC). Immunohistochemical staining was used to assess the expression of EGFR, MMP-2, MMP-9, HIF-1α, and CAIX. Statistical analysis was performed to determine significant differences in biomarker expression between the groups. Results Significantly higher expression of EGFR (P=0.03), MMP-2 (P=0.02), and CAIX (P=0.03) was observed in Group B (iSCC) compared to Group A (CSIN and CIS). MMP-9 expression did not differ significantly between the groups (P=0.14). HIF-1α expression in tumour cells was also not significantly different (P=0.41). HIF-1α expression in inflammatory cells was significantly higher in Group B (iSCC) compared to Group A (P=0.038). Interpretation and conclusions This study suggests that EGFR, MMP-2, and CAIX may play a role in OSSN progression from CSIN/CIS to iSCC. Elevated HIF-1α expression in inflammatory cells highlights the potential involvement of inflammation in OSSN development. These biomarkers may serve as potential therapeutic targets and could also be integrated into diagnostic tools for OSSN.
Barriers to help-seeking for cancer in India: A scoping review.
Dhar RR, Reshmi B, Holla R
Indian J Med Res · 2026 Apr · PMID 42165724 · Full text
Background and objectives Cancer is a leading cause of death in India, with delays in diagnosis and treatment contributing to poor outcomes. Although several studies document these delays, most focus on single cancer typ...
Background and objectives Cancer is a leading cause of death in India, with delays in diagnosis and treatment contributing to poor outcomes. Although several studies document these delays, most focus on single cancer types or specific regions. This review aimed to synthesise evidence across cancers to identify barriers to help-seeking and their implications for cancer control in India. Methods A scoping review was conducted using Arksey and O'Malley and Levac frameworks, guided by the PRISMA-ScR checklist. The protocol was registered on the Open Science Framework. Systematic searches were carried out in PubMed, EMBASE, and Scopus for studies published in English between January 2010 and December 2024. Eligible studies included empirical research on barriers to help-seeking among individuals with cancer in India. Titles and abstracts were screened using Rayyan, followed by full-text review. Data were charted and synthesised thematically. Results Of 349 records screened, 30 studies met the inclusion criteria. Barriers were categorised as: financial and economic, lack of awareness/knowledge, cultural stigma and embarrassment, reliance on alternative medicine, systemic and health system inefficiencies, psychological fear and distrust, family and gender bias, and COVID-19-related disruptions. These factors collectively led to delays in presentation, diagnosis, and treatment of cancer in India. Interpretation and conclusions Delays in cancer care in India arise from intersecting socio-economic, cultural, systemic, and gendered barriers. Strengthening insurance coverage, patient navigation, awareness initiatives, gender-sensitive services, and long-term investments in rural infrastructure and psychosocial support are critical to improving timely cancer care.
Ticks and tick-borne diseases: A call for comprehensive tick surveillance in India under One Health approach.
Kumar R, Manjunathachar HV, Kumar B … +1 more , Ghosh S
Indian J Med Res · 2026 Apr · PMID 42165723 · Full text
Due to ecological diversity and distribution of 106 tick species across fifteen agro-climatic zones, uniform tick control approach in India is neither feasible nor effective. Globally, the economic burden of tick-borne d...
Due to ecological diversity and distribution of 106 tick species across fifteen agro-climatic zones, uniform tick control approach in India is neither feasible nor effective. Globally, the economic burden of tick-borne diseases is estimated at US $14-19 billion annually, while in India the combined losses due to ticks and tick-borne diseases (TTBDs) is approximately 46199.31 million INR (US $595.07 million) per annum. Therefore, there is an urgent need for region-specific data on tick species prevalence and diversity, tick-borne pathogens and patterns of acaricide resistance through a long-term coordinated, sustained TTBDs surveillance programme. The current challenges, ranging from insufficient data and delayed diagnosis to fragmented responses, underscore the critical need for a national, integrated and science-driven TTBDs surveillance network. This system would bridge the information gaps, support early warning systems and build national capacity for managing existing and emerging tick-borne threats. This would also help in the development of locally tailored tick management and disease prevention strategies. This review aims to present an updated overview of the current status of monitoring and surveillance of TTBDs in India. It discusses key challenges in the country and proposes establishing a national TTBD surveillance system by rationalising limited research funds available for vector control programme.
Machine learning-based prediction of inflammation adjusted iron deficiency anaemia using blood cell indices.
Palika R, Dasi T, Parasannanavar DJ … +3 more , Banjara SK, Kulkarni B, Pullakhandam R
Indian J Med Res · 2026 Apr · PMID 42165722 · Full text
Background and objectives Diagnosis of iron deficiency anaemia (IDA), where both anaemia and iron deficiency coexist, is essential to improve the precision of iron treatment. The serum ferritin, a marker of iron deficien...
Background and objectives Diagnosis of iron deficiency anaemia (IDA), where both anaemia and iron deficiency coexist, is essential to improve the precision of iron treatment. The serum ferritin, a marker of iron deficiency, is an acute phase protein, requires adjustment for inflammation prior to using it for diagnosis of IDA. The blood cell indices (referred as complete blood counts, CBC) help in identifying the underlying cause of anaemia and presence of inflammation, both of which could be utilised for differential diagnosis of IDA. We conducted this study to evaluate machine learning (ML) models for predicting inflammation-adjusted IDA from CBC data. Methods We utilised CBC data from National Health and Nutrition Examination Survey (NHANES 2017-2023) of women of reproductive age (15-50 yr age, n=3604) and evaluated the performance of ML models to predict the inflammation adjusted IDA, in terms of sensitivity and specificity. We validated the performance of the optimised random forest (RF)- ML model, on women of reproductive age data set from India (n=381) in predicting the IDA, and haemoglobin response to iron treatment. Results The optimised RF model predicted the inflammation adjusted IDA, solely based on CBC, with sensitivity and specificity of ∼95% either on the test or validation data. In those predicted to have IDA (2.3±1.6 g/dL, n=283), the haemoglobin increments due to iron therapy was markedly higher compared to those predicted to have non-IDA (0.31±0.67 g/dL, n=98). Interpretation and conclusions These findings suggest that it is possible to predict inflammation adjusted IDA with high sensitivity and specificity with ML models using CBC data.
Multi-sensor wearables for chronic heart failure: From signal-rich devices to equitable, implementable pathways.
Vijayasimha M
Indian J Med Res · 2026 Apr · PMID 42165721 · Full text
Abstract loading — click title to view on PubMed.
Authors' Response.
Gopalan A, Gavali M, Yerram K
Indian J Med Res · 2026 Apr · PMID 42165720 · Full text
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Carbapenem resistance and associated resistance genes in enterobacteriaceae and non-enterobacteriaceae in India: A systematic review and meta-analysis.
Khan Z, Bose P, Kumari S … +3 more , Rangnekar A, Panwalkar N, Desikan P
Indian J Med Res · 2026 Apr · PMID 42165719 · Full text
Background and objectives Carbapenems are highly potent antibiotics, and the emergence and spread of carbapenem resistance is a major global public health challenge. This systematic review and meta-analysis investigated...
Background and objectives Carbapenems are highly potent antibiotics, and the emergence and spread of carbapenem resistance is a major global public health challenge. This systematic review and meta-analysis investigated the prevalence of carbapenem resistance in Enterobacteriaceae and non-Enterobacteriaceae in India and delineated the spectrum of genes associated with carbapenem resistance in carbapenem-resistant organisms. Methods A comprehensive systematic review of available electronic databases was conducted in accordance with PRISMA guidelines. Studies on human samples from India reporting phenotypic and genotypic data for carbapenem-resistant Enterobacteriaceae (CRE) and carbapenem-resistant non-Enterobacteriaceae (CRNE) were included. Pooled prevalence rates were determined using a random effects model to account for heterogeneity. Data analyses were performed using Meta-Analysis Online software. Results A total of 45 studies met the inclusion criteria. The pooled prevalence of CRE was 9% (0.07-0.11) and CRNE was 16% (0.09-0.24), with marked heterogeneity (I2=99%, P<0.001). Within Enterobacteriaceae, Escherichia coli and Klebsiella spp. exhibited the highest levels of carbapenem resistance. Among non-Enterobacteriaceae, Acinetobacter spp. and Pseudomonas spp. were the predominant resistant organisms. Genotypic analysis revealed that, among metallo β-lactamases, blaNDM-1 and blaVIM-1 were the most frequently reported genes in CRE and CRNE, while blaOXA-48 was the major determinant in CRE, whereas blaOXA-23 and blaOXA-51 predominated in CRNE, among the serine β-lactamases. Interpretation and conclusions This meta-analysis identified diverse carbapenem-resistant organisms and genetic determinants in both CRE and CRNE. Regional variation in prevalence was evident, with a notable lack of data from Central India. The findings identify lacunae in reporting, emphasise on circulating genes, and highlight the urgent need for strengthening nationwide surveillance to help formulate robust evidence-based strategies for combating carbapenem resistance.
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