The Indian Journal Of Medical Research[JOURNAL]
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200 papers
Tuberculosis prophylaxis and long-term safety in adalimumab biosimilar therapy: The need for strengthened vigilance.
C S C, Nevil S, Charles SA
Indian J Med Res · 2026 Apr · PMID 42165718 · Full text
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Screening of hepatitis C virus in dried plasma spots among people who inject drugs and attending syringe exchange programme in Delhi, India.
Quraishi R, Kumar R, Singh S … +2 more , Sarkar S, Rao R
Indian J Med Res · 2026 Apr · PMID 42165717 · Full text
This study investigated the use of dried plasma spots (DPS) in a community-based non-treatment-seeking population of people who inject drugs (PWID) for HCV testing. Individuals attending targeted intervention (TI) servic...
This study investigated the use of dried plasma spots (DPS) in a community-based non-treatment-seeking population of people who inject drugs (PWID) for HCV testing. Individuals attending targeted intervention (TI) services were approached. The sociodemographic and drug use history were recorded. Blood samples were collected, dried plasma spots were prepared, and HCV screening was done. The participants (n=188) were with mean (SD) age of 27.44 (6.21) yr. HCV prevalence was found to be 69.7%. A good correlation (r=0.90; P<0.05) was observed between plasma and DPS samples, with sensitivity 98.5%, specificity 100%, and accuracy 98.9%. This method has the potential to screen HCV in a community setting.
Prevalence, patterns and parental perceptions of excessive screen time among children aged 2-4 years: A cross-sectional study from a rural setting of Haryana, India.
Singh S, Bairwa M, Haldar P … +1 more , Nongkynrih B
Indian J Med Res · 2026 Apr · PMID 42165716 · Full text
Background and objectives Excessive screen time in toddlers and preschool-aged children, defined by World Health Organization as daily screen exposure exceeding 60 min, has been extensively studied in urban settings and...
Background and objectives Excessive screen time in toddlers and preschool-aged children, defined by World Health Organization as daily screen exposure exceeding 60 min, has been extensively studied in urban settings and high-income countries. However, evidence from rural contexts remains scarce. So, the objective of this study was to estimate the prevalence of excessive screen time among children aged 2-4 yr in a rural population of North India and understand related parenting practices. Methods A community-based cross-sectional study was conducted in four villages of Haryana, India among 282 children. A pre-tested, semi-structured interview schedule was administered to parents to assess weekly screen time duration and frequency, type of content, context of exposure and parental perceptions. Factors associated with excessive screen time were analysed using Poisson regression to estimate the adjusted prevalence ratio. Results The prevalence of excessive screen time was 50.5% [95% confidence interval (CI): 44.5-56.5%]. Screen use was primarily for entertainment (71.1%) or as a parenting tool (50%). Smartphones (75.2%) and televisions (57.1%) were the most commonly used devices. Most children viewed age-appropriate content, predominantly cartoons. A majority of parents perceived screen time as harmful (92%) and had attempted to restrict it (90%). Excessive screen time was associated with earlier age of screen use (<24 months) [aPR 1.4 (1.1-1.8), P=0.004] and use of devices during meals [aPR 1.4 (1.1-1.7), P=0.015 ]. Interpretation and conclusions Excessive screen time was prevalent among half the rural children. Furthermore, this was associated with earlier exposure and mealtime screen use.
Retraction: Efficacy & safety of chlorthalidone vs. hydrochlorothiazide in hypertension: A systematic review & meta-analysis.
Indian J Med Res · 2026 Apr · PMID 42165715 · Full text
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Leptospiral uveitis: A late complication of systemic leptospirosis.
Rathinam SR, Vedhanayagi R, Thundikandy RT … +2 more , Sundar B, Kohila J
Indian J Med Res · 2026 Apr · PMID 42165714 · Full text
Background and objectives Leptospirosis is an important animal borne disease that primarily affects farmers in tropical countries. As a late complication, it causes ocular inflammation, uveitis. We are presenting ocular...
Background and objectives Leptospirosis is an important animal borne disease that primarily affects farmers in tropical countries. As a late complication, it causes ocular inflammation, uveitis. We are presenting ocular signs of leptospiral uveitis. Methods In this retrospective observational study, we have reviewed the data from clinical and laboratory records of microscopic agglutination test (MAT) positive, uveitis patients seen between 1994 and 2017 at the uveitis department of a university affiliated ophthalmology postgraduate institute in Tamil Nadu, South India. Results Out of a total of 75,150 new uveitis cases with different aetiologies seen in 24 years, 3,658 (4.9%) had clinical diagnosis of leptospiral uveitis. Of them, 1,268 (34.7%) patients were positive for leptospiral serological test. Of them, follow-up details were available for 876 patients. Of 876, 650 (74.2%) were men, 482 (55%) were farmers. 1224 eyes of 876 patients were found to have uveitis. The most common ocular signs were vitreous membranous opacities seen in 814 eyes (66.5%) followed by retinal phlebitis in 347 (28.4%), optic disc hyperaemia in 260 eyes (21.2%), and hypopyon in 208 eyes (17%). Active choroiditis/retinitis were never seen. Topical, oral or periocular steroid injections were used to treat uveitis. Inflammatory control was achieved in 96% of the patients. Two or more-line visual improvement was seen in 700 out of 740 (94.5%) eyes. Interpretation and conclusions Ocular involvement is an important immunological complication of systemic leptospirosis. Recognition of this entity is vital, especially in young males in whom other immunological uveitis are also common.
E-protein variability in Zika virus strains: A possible new O-glycosylation site and its implications.
Kori L, Chandra A, Mukhopadhyay L … +2 more , Verma K, Gupta N
Indian J Med Res · 2026 Apr · PMID 42165713 · Full text
Background and objectives Zika virus (ZIKV) is a flavivirus transmitted by the bite of infected Aedes mosquito. In 2015-16, Brazil reported cases of ZIKV virus infection followed by Guillain-Barre syndrome and congenital...
Background and objectives Zika virus (ZIKV) is a flavivirus transmitted by the bite of infected Aedes mosquito. In 2015-16, Brazil reported cases of ZIKV virus infection followed by Guillain-Barre syndrome and congenital birth defects. India has reported ZIKV virus infections sporadically since 2016, without adverse events. This prompted us to conduct this in-silico investigation and identify reasons for this variation. The objective was to study ZIKV envelope protein (E-protein) to identify possible mutations and their potential role in virus entry into the host cell. Methods Using multiple sequence alignments, we compared the genomic sequences from eleven ZIKV strains with maximum genomic data available in the NCBI database, followed by phylogenetic analysis. ZIKV E-protein structures with mutations were generated using AlphaFold and used for molecular dynamic simulation, followed by protein 3D structure and residues interaction analysis. Results We identified 2 major ZIKV clades - ZIKV Senegal strain (African lineage, Accession No. MF510857, 1984) is an ancestral strain representing one clade, while the remaining strains belong to the second major clade, with the Indian strain being closest to the Senegal strain genomically. The Senegal strain also has a significant mutation at residue no. 120 of the E-protein (Alanine to Threonine), which is absent in other strains. Interpretation and conclusions We found a mutation in the ZIKV Senegal strain at residue no. 120 (Alanine Threonine), here Threonine is interacting with Serine residue at position 64. This interaction is known for post-translational O-glycosylation of E-protein, which may reduce the efficacy of envelope-based therapies. To the best of our knowledge, this is the first report of a putative O-glycosylation site on the E-protein of a ZIKV strain, which is an important therapeutic target, and our finding needs further in vitro validation.
Extensively drug-resistant gram-negative sepsis in a neonatal intensive care unit from western India: A retrospective cohort study.
Yadav B, Gupta N, Sasidharan R … +4 more , Tak V, Sharma A, Nag VL, Singh AK
Indian J Med Res · 2026 Mar · PMID 42024915 · Full text
Background and objectives Extensively drug-resistant (XDR) Gram-negative bacterial sepsis is an emerging threat in neonatal intensive care units (NICU). We aimed to determine the epidemiology, pathogen profile, and outco...
Background and objectives Extensively drug-resistant (XDR) Gram-negative bacterial sepsis is an emerging threat in neonatal intensive care units (NICU). We aimed to determine the epidemiology, pathogen profile, and outcome of neonates with XDR Gram-negative sepsis. Methods This retrospective cohort study was conducted in a newly established NICU in Western India. Data of all neonates admitted between July 2016 and June 2021 were analysed. Standard CDC definitions were used to classify antimicrobial resistance. Results Among 1230 neonates, 31.4% (n=387) had clinically suspected sepsis and 11.5% (n=141) had culture-positive sepsis, accounting for 194 sepsis episodes. Gram-negative sepsis occurred in 117 neonates, of whom 38.4% (45/117) had XDR Gram-negative sepsis. One-third of these isolates were XDR, predominantly Klebsiella (n=21,44%), Acinetobacter (n=18,37%), and Escherichia species (n=6, 13%). Nearly 60% (28/48) of XDR Gram-negative isolates were obtained from outborn neonates, and 60% (n=17) were isolated within 48 h of admission. Mortality was significantly higher in neonates with XDR sepsis (21/45, 46.7%) compared with multidrug-resistant (13/41, 31.7%) and drug-sensitive Gram-negative sepsis (4/31, 12.9%) (P=0.009). Interpretation and conclusions The high burden of extensively drug-resistant Gram-negative sepsis and its association with increased mortality underscore the urgent need for strengthened antimicrobial stewardship and surveillance in neonatal intensive care units.
Barriers and facilitators to cancer care in the Northeast region, India: A scoping review.
Dhar RR, Bhageerathy R, Holla R
Indian J Med Res · 2026 Mar · PMID 42024914 · Full text
Background and objectives Cancer is a major health issue globally, and in India's Northeast Region (NER), it is experiencing the highest incidence, particularly among rural and tribal communities. However, screening rate...
Background and objectives Cancer is a major health issue globally, and in India's Northeast Region (NER), it is experiencing the highest incidence, particularly among rural and tribal communities. However, screening rates are low, awareness is limited, and access to care is challenged by isolation, poor infrastructure, financial constraints, and dependence on traditional medicine. To address these gaps, this scoping review aimed to synthesise evidence on the multidimensional barriers to cancer care in the NER, examine how socioeconomic, cultural, health system, logistical, and geographical factors influence care-seeking behaviour, and identify facilitators that could improve access to screening, diagnosis, and treatment. Methods A scoping review was conducted following the Arksey and O'Malley framework and reported in accordance with PRISMA-ScR guidelines. PubMed, Scopus, Web of Science, and EMBASE were searched for studies published from January 2010 to June 2025. Eligible studies that examined barriers or facilitators to cancer care in the 8 Northeastern States were thematically synthesised. Results Twelve studies were included; barriers were categorised into socioeconomic, health system, cultural, logistical, and geographical domains. Key issues included financial hardship, low health literacy, inadequate infrastructure, transport difficulties, and limited insurance coverage. Facilitators included family support, trust in community health workers, health education, outreach services, and financial incentives. Interpretation and conclusions Cancer care access in the NER is constrained by multidimensional barriers but supported by community and system- level facilitators. Decentralised services have expanded financial protection, and culturally tailored interventions are critical to strengthening cancer care in the region.
Smartboard for PowerPoint-based lectures in undergraduate paediatric education: A randomised controlled trial.
Diwan N, Rao YK, Midha T … +3 more , Agarwal A, Venkatesh V, Rao A
Indian J Med Res · 2026 Mar · PMID 42024913 · Full text
Background and objectives Interactive digital tools such as smartboards are increasingly being used in education, yet robust evidence from low- and middle-income countries (LMICs) is limited. This study compared Smartboa...
Background and objectives Interactive digital tools such as smartboards are increasingly being used in education, yet robust evidence from low- and middle-income countries (LMICs) is limited. This study compared Smartboard- and PowerPoint-based teaching in undergraduate paediatrics and assessed their impact on knowledge retention and learner engagement. Methods A single-centre, open-label, parallel-group randomised controlled trial was conducted among 360 MBBS students (second, third, and final years). Participants were stratified by academic year and baseline test scores, then randomly assigned to Smartboard or PowerPoint groups. Identical paediatric topics were taught using standardised lesson plans. The primary outcome was knowledge retention, assessed through objective structured clinical examinations (OSCEs) immediately, and at 1- and 2-month follow up. Secondary outcomes included student and faculty feedback. The trial was prospectively registered with the Clinical Trials Registry-India (CTRI/2025/04/083965). Results Immediate pooled OSCE performance was comparable (Smartboard: 47.2% Grade A vs. PowerPoint: 41.1%, P=0.29). At 1-month follow-up (primary outcome), Smartboard students achieved higher Grade A scores across all years combined (46.1% vs. 40.3%, P=0.028). Smartboard participants also showed superior retention at 2 months in third- (P=0.002) and final-year (P=0.049) cohorts. Students reported greater engagement (66.1% vs. 51.9%; absolute difference 14.2% points), attention (68.1% vs. 33.9%; difference 34.2% points), and recall (46.1% vs. 22.8%; difference 23.3% points). Faculty rated Smartboards higher for engagement (100% vs. 33.3%; difference 66.7% points), but preferred PowerPoint for ease of preparation (83.3% vs. 33.3%; difference 50.0% points). Interpretation and conclusions Smartboard-based teaching improved long-term knowledge retention, engagement, and attention compared with PowerPoint, particularly at 1 month and among senior students. Interactive digital tools may enhance learning outcomes in LMIC settings.
A community-based study of antibiotic consumption in an urban health training centre area of Ahmedabad city.
Sharma R, Patel PN, Patel NR … +4 more , Gajjar SA, Patel BP, Chandegara A, Bapat NK
Indian J Med Res · 2026 Mar · PMID 42024912 · Full text
Background and objectives The rise of antibiotic resistance is a global health crisis, and the irrational use of antibiotics is the major contributing factor. Therefore, it is essential to understand the antibiotic usage...
Background and objectives The rise of antibiotic resistance is a global health crisis, and the irrational use of antibiotics is the major contributing factor. Therefore, it is essential to understand the antibiotic usage in the community to estimate the prevalence of antibiotic usage and its association with various co-variates and to evaluate the consumption pattern of antibiotic usage in the catchment areas of the Urban Health Training Centre of a medical college in Ahmedabad City. Methods An observational, community-based cross-sectional study was conducted in 3 phases during May-Aug 2024. Estimated sample size was 315 individuals who were ill anytime in last three months or consumed drugs and were selected from 15 clusters identified by cluster sampling method. Information was gathered on a structured questionnaire, and statistical parameters such as prevalence, prevalence ratios, confidence interval, and chi-square test were calculated in MS Excel. Results The screening of 2278 participants yielded 349 eligible participants as per inclusion criteria and 117 (33.5%) of them consumed 152 antibiotics during the previous three months. Sociodemographic determinates like age, sex and qualification of treatment provider showed significant association with antibiotic usage. Use of antibiotics was higher 55 (42.6%) in children than in adults 62 (28.1%). As per AWaRe classification (WHO), 3/4th of the participants (59.9%) consumed the watch group, more than half (50.4%) consumed the Access group and 2 (1.7%) consumed the Reserve group of antibiotics. Antibiotics are prescription only drugs, still in 37.5% of cases, antibiotics, even those from the Watch group, were obtained without a prescription. Interpretation and Conclusions Overall, a concerning trend of antibiotic use without prescriptions was witnessed, specifically in the 'Watch' category of antibiotics. It highlights the need for improved prescribing practices and public education to prevent misuse of antibiotics.
Diagnostic accuracy and safety of Cy-Tb for detection of tuberculosis infection: A multicentric study from India.
Singh M, Hussain T, Modi B … +24 more , Nair S, Kumar S, Alvi Y, Bhutia KD, Joshi S, Patel P, Oza J, Gautam R, Solanki H, Kar CD, Hota PK, K L SD, Kalliath A, Bhutia R, Pradhan A, Pantula SV, Valluri VL, Rade K, Joshi RP, Mattoo SK, Chalga MS, Khan AM, Rani R, Pati S
Indian J Med Res · 2026 Mar · PMID 42024911 · Full text
Background and objectives Only 10% of the individuals infected with Mycobacterium tuberculosis (MTB) manifest active tuberculosis. Interferon-γ release assay (IGRA) and tuberculin skin test using purified protein derivat...
Background and objectives Only 10% of the individuals infected with Mycobacterium tuberculosis (MTB) manifest active tuberculosis. Interferon-γ release assay (IGRA) and tuberculin skin test using purified protein derivative (PPD) are used to identify tuberculosis (TB) infection. We aimed to study the comparative performance of Cy-Tb (the SIILTIBCY skin test) and PPD with IGRA as the reference standard. Methods In step-I, 30 TB patients and 32 IGRA-negative health controls; in step-II, 2651 participants aged 1 to 85 yr; and in step- III, 647 household contacts of TB patients aged 1-18 years old were enrolled. Blood for IGRA was drawn immediately prior to intra-dermal administration of Cy-Tb (the SIILTIBCY skin test) or PPD. The size of induration of Cy-Tb ≥5 mm or PPD ≥ 10mm after 48 to 72 h were considered positive. Combined Data from step II and step III were analysed for sensitivity, specificity, agreement, and kappa-coefficient with IGRA as the reference standard using Stata version 14.2. Results The step-I results for Cy-Tb showed 90% specificity, 93.8% specificity, and an agreement of 91.9% with IGRA and a Cohen's kappa coefficient of 0.83. Combined analysis of step-II and step-III data revealed sensitivity of 82.6% (95% CI 79.1-85.8), specificity of 71.1% (95% CI 68.2-73.8), agreement of 74.8%, and kappa of 0.5 for Cy-Tb. PPD showed sensitivity and specificity of 71.0% (95% CI 66.7-75.0) and 71.9% (95% CI 69.0-74·6), respectively with 71.6% agreement and kappa of 0.4 with IGRA. Interpretation and conclusions Performance of Cy-Tb was comparable to that of PPD with IGRA as reference standard. Cy-Tb skin test can be used for diagnosis of TB infection.
Surveillance and assessment of medical device-associated adverse events in a tertiary care hospital: An observational study.
T V, Bollineni S, F T … +3 more , Ganachari P, Khan MSA, Prasad S
Indian J Med Res · 2026 Mar · PMID 42024910 · Full text
Background and objectives Medical devices are essential in hospitals for diagnosis and treatment but may also cause unintended adverse events. Materiovigilance plays a crucial role in detecting, reporting, and preventing...
Background and objectives Medical devices are essential in hospitals for diagnosis and treatment but may also cause unintended adverse events. Materiovigilance plays a crucial role in detecting, reporting, and preventing such events to safeguard patients. This study aimed to monitor, assess, and report medical device-associated adverse events (MDAEs) in a tertiary care hospital and to identify the devices most frequently implicated. Methods A prospective observational study was conducted at a tertiary care hospital in Bengaluru, India, from May 2023 to January 2024. Daily ward rounds were carried out in collaboration with the biomedical team to identify device-related issues. Confirmed MDAEs were documented using the standard reporting forms of the Materiovigilance Programme of India (MvPI). Results Among 1,100 medical devices in use, 31 (2.81%) were associated with adverse events. Most affected patients were females, with an average age of 61 years. Frequently implicated devices included disposable syringes and intravenous (IV) cannulas. The common events included thrombophlebitis, blocked or damaged needles, and elevated serum creatinine following contrast use. Most adverse events involved Class B devices. Causality assessment classified the majority as probable or possible. Interpretation and conclusions The overall frequency medical device associated of adverse events associated was low. However, the findings underscore the importance of continuous device surveillance. Strengthening awareness and structured reporting under MvPI can improve early detection, timely intervention, and long-term patient safety in clinical practice.
Epidemiology of vaso-occlusive crisis among sickle cell disease patients in India: A community-based multi-centric study.
Surti SB, Patel S, Sharma Y … +7 more , Bhat D, Sridevi P, Sarmah J, Bal M, Ranjit M, Kumar Jena R, Babu BV
Indian J Med Res · 2026 Mar · PMID 42024909 · Full text
Background and objectives Morbidity burden of sickle cell disease (SCD) in India has been underestimated till now due to a lack of nationwide data on the prevalence of clinical outcomes, including the most prevalent clin...
Background and objectives Morbidity burden of sickle cell disease (SCD) in India has been underestimated till now due to a lack of nationwide data on the prevalence of clinical outcomes, including the most prevalent clinical manifestations like vaso-occlusive crises (VOCs). This multi-centric study reports the epidemiological characteristics of VOCs among SCD patients in India. Methods This is a prospective, community-based, multi-centre cohort study with fortnightly home visits conducted over 12 months in five SCD-endemic districts of India. A cohort of 252 patients was followed up, and data regarding any illness related to SCD and its management in the previous fortnight were collected using a structured questionnaire. Results Out of the total 252 SCD patients followed up, 223 (88.5%) patients reported 2118 crises in a year [8404 episodes per 1000 patients-year; 95% confidence interval (CI): 8040-8760]. Pain anywhere in the body was the most prevalent symptom [97.3% (n=217) of the participants, with 7 (3-13) median (IQR) episodes per patient in a year]. Among total crisis episodes, 48.7% (n=1031) of the episodes were treated at a health facility. Interpretation and conclusions A higher number of crisis episodes reported among the majority of the patients demystifies the notion that SCD is milder and less severe in India. The lower utilization of healthcare resources among SCD patients raises a serious concern.
Evolutionary analysis and immunoinformatic-based epitope prediction of dengue virus serotype 2 strains from Sri Lanka.
Gunawardane DS, Navarathna A, Kulasinghe PA … +2 more , Jayakanth TC, Dayananda PD
Indian J Med Res · 2026 Mar · PMID 42024908 · Full text
Background and objectives To investigate the phylogenetic and evolutionary relationships of dengue virus 2 (DENV-2) strains in Sri Lanka and identify probable antigenic B and T cell epitopes in the envelope gene region....
Background and objectives To investigate the phylogenetic and evolutionary relationships of dengue virus 2 (DENV-2) strains in Sri Lanka and identify probable antigenic B and T cell epitopes in the envelope gene region. Methods Phylogenetic analysis was conducted on the envelope gene region of Sri Lankan DENV-2 strains alongside globally homologous sequences. Selection pressure analysis identified codons under diversifying and purifying selection. Epitope prediction was performed to detect probable antigenic B and T cell epitopes. Results The sequences belonged to two major lineages of the cosmopolitan genotype: major lineage A and F from various geographical regions. Phylogenetic analysis showed segregation into distinct clades, with close sub-clustering of Sri Lankan strains with those from China, Malaysia, Myanmar, Taiwan, and Reunion Island. Selection pressure analysis revealed two sites under diversifying selection, with numerous sites under purifying selection. Epitope prediction detected several linear B and T cell epitopes with probable antigenicity within the envelope gene region. Interpretation and conclusions This study highlights the widespread dominance of the cosmopolitan genotype in Sri Lanka and underscores the role of air travel and human migration in viral transmission and global strain introduction. The presence of diversifying selection at two E gene sites alongside widespread purifying selection suggests evolutionary pressures on viral fitness. The identified B and T cell epitopes represent potential targets for universal vaccine development and therapeutic interventions.
Expression levels of miRNA 22-5p and miRNA 337-5p in bladder cancer.
Dagdeviren MA, Oguzkan SB, Ozaslan M … +1 more , Erturhan MS
Indian J Med Res · 2026 Mar · PMID 42024907 · Full text
Background and objectives MicroRNAs (miRNAs) are small, non-coding RNA molecules that regulate gene expression at the post-transcriptional level and play critical roles in tumour development and progression. Bladder canc...
Background and objectives MicroRNAs (miRNAs) are small, non-coding RNA molecules that regulate gene expression at the post-transcriptional level and play critical roles in tumour development and progression. Bladder cancer requires reliable molecular biomarkers for diagnosis and prognosis; the roles of certain miRNAs remain insufficiently explored. This study aimed to investigate the expression profiles of miR-22-5p and miR-337-5p in bladder cancer and to evaluate their associations with clinicopathological characteristics. Methods Paired tumour and adjacent non-tumorous bladder tissue samples were collected from 50 patients undergoing transurethral resection of bladder tumour. Quantitative PCR was performed using RNA U6 as the reference gene. Expression differences were analysed, and correlations with clinicopathological features were assessed. Results Both miR-22-5p and miR-337-5p were downregulated in tumour tissues compared to normal tissues. miR-22-5p expression showed a marked reduction in bladder cancer, while miR-337-5p downregulation reached borderline statistical significance. Correlation analyses revealed no association between miR-22-5p expression and clinical variables; however, miR-337-5p expression was significantly correlated with patient age and disease duration. Interpretation and conclusions Altered expression of miR-22-5p and miR-337-5p may contribute to bladder cancer pathogenesis. miR-22-5p appears as a potential tumour suppressor, while miR-337-5p expression is influenced by clinical parameters such as age and disease duration, highlighting their potential roles as prognostic and therapeutic biomarkers.
Association of GCKR and GLIS3 gene polymorphisms with gestational diabetes mellitus: A case-control study.
Muruganantham JK, Kandasamy V, Veerabathiran R
Indian J Med Res · 2026 Mar · PMID 42024906 · Full text
Background and objectives Gestational diabetes mellitus (GDM) increases the chances of negative consequences for both the mother and the foetus. It shares genetic and physiological characteristics with type 2 diabetes me...
Background and objectives Gestational diabetes mellitus (GDM) increases the chances of negative consequences for both the mother and the foetus. It shares genetic and physiological characteristics with type 2 diabetes mellitus (T2DM), particularly insulin resistance and impaired insulin secretion. While gene variants involved in glucose metabolism, such as those in glucokinase receptor (GCKR) and GLI similar 3 (GLIS3), have been linked to diabetes risk, their association with GDM in South Indian populations remains underexplored. Methods This study comprised 195 patients with GDM and 195 normoglycemic pregnant women of South Indian ethnicity. GDM diagnosis was recognised using an oral glucose tolerance test. Genotyping of GCKR (rs780094) and GLIS3 (rs701847, rs7020673, rs10814916) were performed using Tetra-ARMS PCR and validated through Sanger sequencing. Associations between genotypes and the risk of GDM were assessed using logistic regression. Results Women with GDM exhibited significantly higher age, body mass index, blood pressure, and adverse metabolic profiles. There was a strong genotype-specific correlation between GDM and the GCKR rs780094 CT genotype. When dominant models and the AG genotype were used, rs701847 exhibited the strongest correlation with GLIS3. rs10814916 was linked through the AC genotype, whereas rs7020673 only demonstrated a connection under the recessive model. In women with GDM, HOMA-IR was significantly higher (P<0.001). Interpretation and conclusion This study highlights significant associations between GCKR and GLIS3 polymorphisms and the risk of GDM in South Indian women, supporting the role of ethnicity-specific genetic screening in predicting GDM risk.
Procedures to implement the Supreme Court of India directives to withdraw/withhold life-sustaining medical treatment.
Vallath N, Parvathy V, Padhi P … +3 more , Johny T A, Krishnakumar M, Varghese PS
Indian J Med Res · 2026 Mar · PMID 42024905 · Full text
In 2018, the Supreme Court of India legally recognised the rights of patients with terminal illness through the judgement in Common Cause (A Registered Society) v. Union of India and Another, (2018) 5 SCC 1. The processe...
In 2018, the Supreme Court of India legally recognised the rights of patients with terminal illness through the judgement in Common Cause (A Registered Society) v. Union of India and Another, (2018) 5 SCC 1. The processes prescribed to withhold or withdraw artificial life-support medical treatments became practical after the 2023 amendment. The law aimed to ensure the dignified dying of sick individuals whose condition was deemed terminal and irreversible. Healthcare institutions can comply with the Court's guidelines in their entirety only after the concerned State Governments activate specific processes. Karnataka state activated the legal mandates by early 2025. Using an implementation case study, we describe the institutional processes to uphold the ethical and legal mandates when withholding/withdrawing life-support treatment (WH/WD-LST) in a mentally incompetent, terminally ill elderly patient, admitted to a tertiary care hospital in Karnataka. It aims to clarify, (i) validation of 'Advance-Medical-Directive', or the living will; (ii) sequential institutional processes for WH/WD-LST as per ethical and legal mandates; (iii) constitution of the primary, secondary medical boards (PMB, SMB); (iv) reporting formats for PMB, SMB evaluations, and (v) the templates relevant to institutional administrators to convey the mandated details of WH/WD-LST to their jurisdictional judiciary magistrate of first class. The impressions and impact of activating the living will and WH/WD-LST on the family, on patient care, for the professionals, and for the institution are described in brief.
Are HRP2/3 deletions silently crippling malaria rapid diagnostic tests?
S R S, Holla R, Rao M … +3 more , Unnikrishnan B, B M S, Chalageri VH
Indian J Med Res · 2026 Mar · PMID 42024904 · Full text
Background and objectives The gold standard for diagnosing malaria is peripheral smear. Histidine-rich protein 2 (HRP2)-based rapid diagnostic tests (RDTs) are particularly used for P. falciparum (pf) infections. These t...
Background and objectives The gold standard for diagnosing malaria is peripheral smear. Histidine-rich protein 2 (HRP2)-based rapid diagnostic tests (RDTs) are particularly used for P. falciparum (pf) infections. These tests are easily accessible and are simple to use. The rising incidence of pfhrp2 and pfhrp3 gene deletions has put malaria diagnostics through RDT kit at risk, leading to false-negative results that may affect patient management. Methods The search string used was: 'pfhrp2' OR 'pfhrp3' OR 'HRP2' OR 'HRP3' OR 'hrp2/3' AND 'malaria' OR 'Plasmodium falciparum' AND deletion OR 'deletion rate' OR prevalence OR 'RDT failure'. A total of 148 studies were gathered from PubMed and Google scholar. After screening, a total of 28 published studies and the WHO documents were included. Results High rates of gene deletion have been reported, ranging from 2.4 to 57.8%, with low range in Chhattisgarh, India (3.8%) and Brazil (∼18.3% dual deletions), to extreme levels in Southern Ethiopia (57.8%). These deletions are believed to be the result due to the widespread use of HRP2-based RDTs. The diagnostic performance of RDTs considerably declines in regions where the WHO-recommended 5% threshold for deletion prevalence is exceeded. Surveillance techniques like PCR, whole-genome sequencing, and digital droplet PCR (ddPCR) are needed for effective detection and monitoring in these regions. Interpretation and conclusions The widespread and regional variation of pfhrp 2/3 gene deletions stance a serious challenge to malaria diagnosis using HRP-based RDTs. Alternatives to HRP-based tests in high-deletion areas and adopting novel diagnostic tools are essential for effective malaria detection and elimination strategies.
Prevalence of chronic pain in the general population: A systematic review and meta-analysis.
Kumar Saxena A, Singh N, Chilkoti GT … +2 more , Gulabani M, Kumar Malhotra R
Indian J Med Res · 2026 Mar · PMID 42024903 · Full text
Background and objectives Chronic pain represents a significant health concern affecting a large segment of society. To date, no systematic review and meta-analysis has evaluated the prevalence of chronic pain in the gen...
Background and objectives Chronic pain represents a significant health concern affecting a large segment of society. To date, no systematic review and meta-analysis has evaluated the prevalence of chronic pain in the general population aged 18 to 95 years. The present study aimed to assess prevalence of chronic pain in this age group and examine its variation across age, sex, geographical regions, and psychosocial factors. Methods Cochrane Library, PubMed, and MEDLINE, were searched by combining combination of two categories of keywords (prevalence, chronic pain, epidemiology, population-based study, meta-analysis) in the general population till May 2024. Results A total of 52 studies with 2,89,490 participants were included to ascertain the global prevalence of six types of chronic pain: non-specific chronic pain, fibromyalgia, chronic lower back pain, chronic back pain, chronic widespread pain, and chronic musculoskeletal pain. The overall pooled random-effect prevalence percentage of chronic pain was 26.99%. The chronic pain prevalence percentage was significantly higher in those above 45 yr of age (46.7%), compared to 24.2% in those between 18-45 yr (P<0.001). The prevalence of chronic pain was higher in women as compared to men (31.42% vs. 21.63%) (P=0.07). Interpretation and conclusions The present global meta-analysis of chronic pain across the age group of 18-95 yr, observed a higher prevalence in women and in those alone 45 years of age. There was no geographical difference.
Reframing clinical research frameworks: Case for a shift from a biomedical to a biopsychosocial one.
C Menon JC, Kumar RK, Pati S
Indian J Med Res · 2026 Mar · PMID 42024902 · Full text
The medical science progressed rapidly over the last century. Certain diseases have been eradicated and some others are on the verge; with a progressive increase in life expectancy. The currently followed biomedical, dis...
The medical science progressed rapidly over the last century. Certain diseases have been eradicated and some others are on the verge; with a progressive increase in life expectancy. The currently followed biomedical, disease centred, reductionist approach to medicine has helped diagnose earlier, probe deeper, and treat in a targeted manner. The downside to the biomedical, reductionist approach is that the part becomes more important than the whole. Ludwig von Bertalanffy's systems theory (1968), emphasised that the whole is greater than the sum of its parts. Building on this perspective, Engel proposed the biopsychosocial model, suggesting that psychological and social factors, while dependent on biological processes, cannot be fully explained by them. He further described the dynamic interactions between these levels of the biopsychosocial hierarchy as emergent properties that shape health and illness. Correspondingly, clinical research too is largely modelled on the reductionist, biomedical approach. It is indisputable that the social, psychological, and behavioural determinants of health contribute to the pathology and health outcomes, all of which are considered in the biopsychosocial framework. We look at the pros and cons of the reductionist system and weigh in on the biopsychosocial approach in modelling clinical research given that it factors for the non-medical determinants of health and disease.
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