Dey R, Mahanta LB, Rahman T
… +1 more, Krishnatreya M
Indian J Med Res
· 2026 Mar · PMID 42024901
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Background and objectives Despite a high incidence of hypopharyngeal cancer in northeast India, the role of dietary patterns and meal timing remains poorly understood. This study examined the association between inter-me...Background and objectives Despite a high incidence of hypopharyngeal cancer in northeast India, the role of dietary patterns and meal timing remains poorly understood. This study examined the association between inter-meal intervals, dietary patterns, and the risk of hypopharyngeal cancer in northeastern India. Methods A hospital-based case-control study was conducted at a tertiary cancer centre in northeastern India, enrolling 300 histologically confirmed cases with hypopharyngeal cancer and 300 frequency-matched controls between May 2023 and August 2024. Dietary intake and inter-meal intervals were assessed using a semi-quantitative food frequency questionnaire. Multivariable logistic regression calculated odds ratios and 95% confidence intervals, adjusting for demographics, socioeconomic status, alcohol consumption, smoking, and tobacco use, including areca nut consumption. Results Prolonged inter-meal intervals (≥5 h) conferred a nearly three-fold increased risk of hypopharyngeal cancer compared to intervals <4 h [adjusted odds ratio (OR) 2.69, 95% confidence interval (CI): 1.56-4.69]. Strong protective effects emerged for citrus fruits (highest tertile OR 0.13, 95% CI: 0.05-0.32) and leafy green vegetables (highest tertile OR 0.21, 95% CI: 0.09-0.49). Coffee consumption was inversely associated with the risk of hypopharyngeal cancer (OR 0.54, 95% CI: 0.30-0.94), while higher milk intake increased the risk of hypopharyngeal cancer (OR 2.06, 95% CI: 1.22-3.52). Interpretation and conclusions We provide epidemiological evidence linking prolonged inter-meal intervals to the risk of hypopharyngeal carcinoma in an Indian population. Meal timing patterns may be as important as dietary composition for cancer prevention, with implications for public health interventions in high-risk populations.
Indian J Med Res
· 2026 Mar · PMID 42024899
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Background and objectives Minimally invasive spinal techniques aim to reduce tissue trauma while maintaining surgical efficacy. Comparative evidence integrating early biochemical muscle injury markers with long-term clin...Background and objectives Minimally invasive spinal techniques aim to reduce tissue trauma while maintaining surgical efficacy. Comparative evidence integrating early biochemical muscle injury markers with long-term clinical and imaging outcomes remains limited. This study evaluated postoperative day 3 biochemical responses, and one-year clinical and MRI-based imaging changes between microsurgical lumbar discectomy (MLD) and percutaneous endoscopic lumbar discectomy (PELD). Methods 192 patients with single-level lumbar disc herniation (L4-L5 or L5-S1) underwent MLD (n=97) or PELD (n=95) between January 2022 and October 2024. Pain and disability were assessed using the visual analogue scale (VAS) and oswestry disability index (ODI) preoperatively and at one year. Serum creatine phosphokinase (CPK), high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6) were measured preoperatively and on postoperative days (POD) 1 and 3. MRI was performed preoperatively and at one year to assess paraspinal muscle cross-sectional area (CSA), fatty infiltration (Goutallier grading), and disc height index. Results Both groups showed significant improvement in VAS and ODI at one year (P<0.05). PELD demonstrated lower POD 1 and 3 CPK, IL-6, and hs-CRP levels (P<0.05), and shorter operative duration (66.3±12 vs. 86±14 min). MRI followup revealed better preservation of muscle CSA and less fatty infiltration in PELD (P<0.05), with comparable disc height maintenance. Interpretation and conclusions While both MLD and PELD achieved similar one-year functional outcomes, PELD demonstrated lower early biochemical markers and superior radiological muscle preservation.
Indian J Med Res
· 2026 Mar · PMID 42024895
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Background and objectives Head and neck cancers are aggressive tumours with a multidisciplinary treatment strategy. Concurrent chemoradiotherapy is recommended for locally advanced cases. The carboxyhaemoglobin level is...Background and objectives Head and neck cancers are aggressive tumours with a multidisciplinary treatment strategy. Concurrent chemoradiotherapy is recommended for locally advanced cases. The carboxyhaemoglobin level is higher in smokers, resulting in a hypoxic environment and radio resistance, which affect treatment outcomes. Data for effect of continued smoking is not available in the Indian setting. This study aims to compare treatment response, failure rate, patterns, and progression-free survival in current smokers vs. former smokers receiving definitive concurrent chemoradiotherapy for head and neck cancer. Methods We conducted this retrospective observational study in patients receiving definitive chemoradiotherapy for head and neck cancer with two groups: current smokers and former smokers. Both arms received weekly 40 mg/m2 cisplatin along with radiotherapy. Endpoints included treatment response, progression-free survival, and failure patterns. Results There were fewer complete treatment responses and more failures in current smokers receiving CRT, with a significant difference in progression-free survival. Interpretation & conclusions Continued smoking during definitive chemoradiotherapy for head and neck cancers resulted in poorer treatment outcomes. Integrating tobacco cessation in oncological care should be a standard of care in managing head and neck cancers.
Zhang X, Qin Q, Yang H
… +7 more, Yu L, Li Y, Sun R, Wang S, Wei X, Chen F, Dong Y
Indian J Med Res
· 2026 Mar · PMID 42024894
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Background and objectives Uric acid is associated with many systemic diseases. Recent evidence demonstrated that high serum uric acid levels in polycystic ovary syndrome (PCOS) could lead to a poor prognosis of in-vitro...Background and objectives Uric acid is associated with many systemic diseases. Recent evidence demonstrated that high serum uric acid levels in polycystic ovary syndrome (PCOS) could lead to a poor prognosis of in-vitro fertilisation. The objective of this study was to explore the association between serum uric acid levels and reproductive outcomes in women with PCOS undergoing intrauterine insemination (IUI) treatment. Methods We included 682 patients with PCOS who underwent IUI treatment between 2015 and 2024. They were stratified into three groups according to the level of serum uric acid: normal (251-360 µmol/L), low (≤250 µmol/L), and high (>360 µmol/L). Pregnancy and obstetric outcomes of patients were evaluated and linked to serum uric acid levels. The primary outcome measures of this study were the clinical pregnancy rate and live birth rate. Secondary outcome measures included the rates of biochemical pregnancy, ectopic pregnancy, miscarriage, and low birth weight. Results There was no significant difference between the three groups with respect to clinical pregnancy rate (23.3% vs. 26.2% vs. 30.4%) and live birth rate (86.2% vs. 81.5% vs. 93.6%). Biochemical pregnancy rate (25.1% vs. 28.2% vs. 35.3%), ectopic pregnancy rate (3.5% vs. 1.9% vs. 3.2%), miscarriage rate (10.4% vs. 16.7% vs. 3.2%), and low-birth-weight rate (14.6% vs. 12.5% vs. 19.4%) were comparable among the three groups.In terms of birth weight, the three study groups showed comparable values (3122.8±81.10 vs. 3095.6±68.96 vs. 3099.5±162.09 g), and no significant difference was observed. These results remained the same after adjusting for baseline clinical characteristics and in-hospital treatment. Interpretation and conclusions Our findings demonstrated that maternal pre-pregnancy serum uric acid level was not significantly related to pregnancy and obstetric outcomes following IUI treatment in women with PCOS.
Amuran GG, Polat B, Türkdoğan D
… +2 more, Ünver O, Akkiprik M
Indian J Med Res
· 2026 Feb · PMID 41949145
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Background and objectives Spinal muscular atrophy (SMA) is an autosomal recessive disorder most often caused by homozygous deletion of exon 7 in the SMN1 gene. Current guidelines recommend initial testing of SMN1 exon 7,...Background and objectives Spinal muscular atrophy (SMA) is an autosomal recessive disorder most often caused by homozygous deletion of exon 7 in the SMN1 gene. Current guidelines recommend initial testing of SMN1 exon 7, with additional analyses if no deletions are found. Commercial kits are typically probe-based; however, LNA (locked nucleic acid)-modified primers provide high sensitivity and specificity at lower cost. We aimed to develop an LNA-based assay for the diagnosis and screening of SMA. Methods Peripheral blood samples (2 mL) were collected from 31 patients diagnosed with SMA, 37 confirmed healthy controls, and 47 carrier parents between September and December 2021. 3' LNA-modified primers were designed for the SMN1, SMN2, and β-actin genes. For each PCR reaction, 20 ng of template DNA was used in a final volume of 20 µL. Products were validated by Sanger sequencing, and ΔCt values were compared with multiplex ligation-dependent probe amplification (MLPA). Results The LNA primers for SMN1, SMN2, and β-actin were designed and optimised to amplify efficiently under uniform polymerase chain reaction (PCR) conditions. PCR results and ΔCt values were fully concordant with MLPA results. Interpretation and conclusions Using only LNA-modified primers, we accurately detected SMN1 and SMN2 presence, absence, and copy numbers, without probes. This assay reliably identified both SMA patients and carriers, supporting its potential for diagnostic and screening purposes.
Pradhan R, Kumari S, Singh AK
… +6 more, Rao AR, Yadav Y, Upadhyay AD, Mehta PK, Dey AB, Dey S
Indian J Med Res
· 2026 Feb · PMID 41949144
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Background and objectives Deposition of β-amyloid and phosphorylated-tau proteins are major neuropathological abnormality in brain of patients with Alzheimer disease. This study aimed to study the role of various serum p...Background and objectives Deposition of β-amyloid and phosphorylated-tau proteins are major neuropathological abnormality in brain of patients with Alzheimer disease. This study aimed to study the role of various serum protein biomarkers to aid in the diagnosis and progression of Alzheimer disease. Methods Blood samples were collected from 96 patients with Alzheimer disease, 75 patients with mild cognitive impairment, and 70 geriatric controls at baseline. The number of patients (Alzheimer disease and mild cognitive impairment) who progressed after 1 year was 12, while the number of non-progressors was 24. Serum levels of β-amyloid1-42 (Aβ1-42), Tau, and phosphorylated-Tau181 (pTau) were quantified using surface plasmon resonance and further validated by Western blot. Results Comparison of proteins between the three groups revealed significantly lower Aβ1-42, higher Tau and pTau protein expression in serum of patients with Alzheimer disease as compared to patients with mild cognitive impairment and controls. In patients who progressed after one year, the baseline concentration of Aβ1-42 protein was significantly higher than their follow-up levels. Tau and pTau levels also increased significantly over the years. In non-progressors, no significant difference was observed in Aβ1-42, Tau, and pTau concentration between the baseline and follow up. Interpretation and conclusions Aβ1-42, Tau, and pTau proteins can serve as potential blood-based biomarkers for the diagnosis and monitoring the progression of Alzheimer disease.
Abhishek A, Chalga MS, Yadav RM
… +36 more, Agarwal K, Vohra V, Tayade A, Kumar A, Varma-Basil M, Mrigpuri P, Manek H, Badhe PV, Gupta S, Bhatt S, Das A, Pandey D, Ponnuraja C, Pati S, Turuk J, Narang P, Athavale A, Shah I, Mohanty SS, George A, Rodrigues R, Mane SS, Mohan A, Chaudhary CR, Pattnaik M, Munje R, Dhingra B, Singh A, Meena RK, Chaturvedy K, Chaudhary D, Singh PK, Patra JK, Sharma A, Sharma M, Singh M
Indian J Med Res
· 2026 Feb · PMID 41949143
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Background and objectives Chest X-rays (CXR) are widely used for screening of thoracic abnormalities, particularly for tuberculosis (TB) in public health settings. However, the lack of trained radiologists in peripheral...Background and objectives Chest X-rays (CXR) are widely used for screening of thoracic abnormalities, particularly for tuberculosis (TB) in public health settings. However, the lack of trained radiologists in peripheral areas limits timely interpretation. This study presents the development and validation of DeepCXR v1.1, an artificial intelligence (AI)-powered tool designed to identify radiological chest abnormalities without relying on metadata or clinical inputs, making it ideal for large-scale screening programmes. Methods In present multicentric study, AI tool was trained on over 282,000 annotated data points from 54,000 CXR images (36,500 abnormal and 17,500 normal) collected from children and adults from 18 centres across 11 States in India. The tool employs a multi-model ensemble architecture including lung segmentation and lesion-specific models to classify images as normal or abnormal. The tool was validated on multiple datasets, and the final independent validation was done on 13927 CXR images collected prospectively from patients coming to the outpatient clinics of the departments of Medicine and Chest of participating centres. Results The tool demonstrated strong generalisability across training and validation datasets, achieving sensitivity of 92.2% [95% confidence interval (CI) 91.6, 92.7] and specificity of 77.4% (95% CI 76.1, 78.6) in a blind prospective validation. Its performance was independently validated by expert committees and health technology assessment panels. Advanced post-processing modules were integrated to enhance detection accuracy, particularly for complex anatomical regions such as the heart and diaphragm. Interpretation and conclusions DeepCXR v1.1, an indigenously developed AI tool for detecting abnormalities in chest X-rays offers a scalable, interpretable, and robust solution for augmenting radiological screening and improving early disease detection. The tool's ability to function offline on basic hardware further supports its use in resource-limited settings.
Indian J Med Res
· 2026 Feb · PMID 41949142
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Background and objectives India's rapid urbanisation, economic liberalisation, and rising fast food consumption are driving a nutritional transition that parallels the growing epidemic of non communicable diseases, parti...Background and objectives India's rapid urbanisation, economic liberalisation, and rising fast food consumption are driving a nutritional transition that parallels the growing epidemic of non communicable diseases, particularly type 2 diabetes mellitus. This study examines the association between fast food expenditure and diabetes prevalence across 18 Indian States, stratified by gender and urban-rural residence. Methods The fast-food attributed diabetes index study (FADIS) utilised publicly available State-level data to evaluate correlations between fast food spending and diabetes prevalence. A novel framework, DIAGRAM (diabetes and intake gradient analysis model), was applied to parse these associations across urban and rural men and women. The WEIGHT (women's elevated intake and glucose-health evaluation tracker) model assessed the prevalence of overweight as a predictor of diabetes in women. Results We found a strong positive correlation between fast food expenditure and diabetes prevalence among urban populations, specifically urban men (r=0.653, P=0.003) and urban women (r=0.619, P=0.0062). Rural patterns were less consistent and weaker. The WEIGHT model identified the prevalence of overweight as a significant contributor to diabetes risk among women. Interpretation and conclusions In this ecological analysis, we found that fast-food expenditure had a strong correlation with diabetes prevalence, particularly among urban men and women. In women, overweight prevalence rather than fast-food expenditure emerged as the significant predictor in multivariable analyses. These findings highlight the need for gender-sensitive and region-specific public health strategies to address India's evolving nutritional transitions and diabetes burden.
Alexander F HN, Muzumder S, Johnson S
… +3 more, Srikantia N, Udayashankara AH, Jayalekshmi R
Indian J Med Res
· 2026 Feb · PMID 41949139
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Diabetes mellitus and cancer are growing global health concerns with a rising prevalence and substantial associated mortality. The study aims to find impact of diabetes mellitus in cancer. A narrative review was conducte...Diabetes mellitus and cancer are growing global health concerns with a rising prevalence and substantial associated mortality. The study aims to find impact of diabetes mellitus in cancer. A narrative review was conducted by analysing evidence from various sources, including meta-analyses, systematic reviews, retrospective studies, database analyses, and cohort studies. The review explored the complex interplay between Diabetes Mellitus and cancer, like cancer incidence, oncology outcome i.e., acute and late toxicities, treatment compliance, overall survival (OS), and quality of life (QoL). Diabetes mellitus increases the risk of developing cancer by 10%. Diabetic patients had higher infection rates [2.6%-52%, odds ratio (OR) 1.38-1.57], increased haematologic toxicity (13%-65.7%, P=0.004), and greater hospital admissions (17.2%-74.5%, OR 2.1, P< 0.001). They received significantly lower cisplatin doses (18%-33% reduction), experienced more surgical delays [adjusted OR 1.16, 95% confidence interval (CI) 1.05-1.27], higher risk of flap failure (RR=1.83, 95% CI 1.18-2.85, P=0.007) and were less likely to undergo breast reconstruction (adjusted OR 0.48-0.54, 95% CI 0.24-1.00). Diabetes mellitus decreases local control by 10-20%, increases mortality by 27-98%, and decreases OS by 18-50% across various cancers. It increases late toxicity and negatively impacts QOL with a 1.3-2.7 times higher risk of grade ≥2 genitourinary and gastrointestinal toxicity in prostate cancer, a twofold increase in grade ≥3 radiation pneumonitis in lung cancer, and a 50% higher incidence of severe peripheral neuropathy in breast cancer, leading to delayed recovery and long-term morbidity. In patients receiving cancer directed therapy, diabetes mellitus increases acute and late toxicities, decreased local control and overall survival, and have poor quality of life.
Das S, Mondal S, Hossain M
… +8 more, Asif M, Sen S, Mondal P, Kumar Chakrabarti A, Saha I, Tripathi SK, Das S, Pati S
Indian J Med Res
· 2026 Feb · PMID 41949138
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Background and objectives Amidst the setting of a worldwide threat posed by antimicrobial resistance, bacteriophages have emerged as novel antibiotic alternatives. This scoping review was conducted to systematically surv...Background and objectives Amidst the setting of a worldwide threat posed by antimicrobial resistance, bacteriophages have emerged as novel antibiotic alternatives. This scoping review was conducted to systematically survey and categorise bacteriophage research conducted in India, focusing on explicit implications for human health. Methods We conducted a scoping review according to PRISMA-ScR guidelines. We searched five databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) without any date restrictions through June 2025. Studies were included if they presented original research on bacteriophages or phage therapy in Indian settings (human, animal, orenvironmental). Data were tabulated on a pre-designed form and classified by application area, study type, and outcomes. Results The initial search of the databases led to 4,756 studies, and ultimately, 111 were included. Studies were predominantly from the laboratory setting, with very few clinical and translational studies. The majority of the included study types were animal models of efficacy and in vitro phage characterisation. Very few were conducted with human subjects or clinical trial designs. Gaps of particular concern are a lack of regulatory framework, clinical trials, pharmacokinetic-pharmacodynamic studies, synthetic biology methods, and One Health integrated surveillance systems. Interpretation and conclusion Bacteriophage research in India is growing but is still underdeveloped in translational areas. Closing the listed shortcomings and keeping the pace with international innovations, such as engineered phages, standardised formulations, and clinical validations, will be critical to realise the full potential of phage therapy in India.
Choudhary HR, Joseph A, Selvamani Y
… +2 more, Bhattacharya D, Pati S
Indian J Med Res
· 2026 Feb · PMID 41949137
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Background and objectives Koraput district in Odisha, India, experiences recurrent anthrax outbreaks among humans and livestock. The effectiveness of anthrax prevention and control depends heavily on community knowledge,...Background and objectives Koraput district in Odisha, India, experiences recurrent anthrax outbreaks among humans and livestock. The effectiveness of anthrax prevention and control depends heavily on community knowledge, attitudes, and practices, yet comprehensive data on these factors are lacking. Methods From July to September 2024, we conducted a mixed-methods, cross-sectional study in selected blocks of Koraput district. Using stratified random sampling, 696 community members were surveyed with a structured questionnaire. Qualitative insights were obtained through consultations with key stakeholders from the health, veterinary, and panchayati raj departments. Results Awareness of anthrax was limited, with 15.3% (n=106) of respondents having knowledge about the disease. Among those who had prior exposure to the disease, a moderate level of knowledge regarding symptoms, transmission, and preventive measures was observed. Although 82.7% (n=474) acknowledged vaccination as a preventive measure, anthrax vaccination coverage among livestock owners was only 11.5% (n=66). High-risk exposure remained prevalent, with 96.4% (n=671) reporting meat consumption, 20.0% (n=134) consuming beef, and 18.5% (n=124) consuming animal blood. In addition, 27.9% (n=160) housed livestock inside their homes, increasing the risk of human exposure. Interpretation and conclusions The study findings revealed that community members had limited knowledge regarding the causes, symptoms, transmission, and prevention of anthrax. These gaps highlight the need for targeted interventions through a coordinated One Health approach involving human, animal, and other allied sectors.
Indian J Med Res
· 2026 Feb · PMID 41949135
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Complicated urinary tract infections (UTIs) caused by extended-spectrum β-lactamase (ESBL)- and AmpC β-lactamase-producing Enterobacterales are increasing in India, driving carbapenem use. Cefepime-enmetazobactam (CPM-EM...Complicated urinary tract infections (UTIs) caused by extended-spectrum β-lactamase (ESBL)- and AmpC β-lactamase-producing Enterobacterales are increasing in India, driving carbapenem use. Cefepime-enmetazobactam (CPM-EMT), a β-lactamase inhibitor active against class A ESBLs and with partial activity against AmpC, but is inactive against metallo-β-lactamases (MBLs). We conducted a narrative review (2018-2025) of PubMed/MEDLINE, ClinicalTrials.gov, and regulatory sources, prioritising randomised trials, surveillance, pharmacokinetic/pharmacodynamic studies, and antimicrobial stewardship programme (AMSP) guidance, with emphasis on Indian resistance trends. In the Phase 3 ALLIUM trial, CPM-EMT achieved superior overall treatment success versus piperacillin-tazobactam in patients with complicated UTI and acute pyelonephritis, including ESBL subgroups. In vitro, CPM-EMT restores cefepime activity against ESBL-producing Enterobacterales; activity against Pseudomonas aeruginosa is variable and largely cefepime-driven. Safety is similar to cefepime; the risk of neurotoxicity increases with renal impairment, supporting renal dose adjustment and prolonged infusion in augmented renal clearance. CPM-EMT is approved in the United States, European Union, and India. CPM-EMT is a carbapenem-sparing option for ESBL/AmpC complicated UTI when MBL risk is low or excluded by rapid carbapenemase testing and local epidemiology. It is not appropriate for empiric use in haemodynamically unstable ICU patients or where carbapenemase prevalence (e.g., NDM-β-lactamase, OXA-48-like, KPC) is high; mechanism-directed alternatives (e.g., ceftazidime-avibactam with or without aztreonam, cefiderocol) are preferred. Evidence gaps include paediatric dosing/safety, Indian real-world comparative outcomes, Pseudomonas-specific efficacy, and cost-effectiveness. Implementation in India should integrate rapid diagnostics, local antibiograms, and optimised dosing within AMSP pathways to preserve carbapenems without compromising outcomes.
Özlü DN, Teke K, Danacıoğlu YO
… +7 more, Emir B, Avci İE, Uslubas AK, Arikan Y, Ayten A, Yılmaz H, Bitkin A
Indian J Med Res
· 2026 Feb · PMID 41949134
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Background and objectives The relationship between sarcopenia and prognosis in patients undergoing chemotherapy for testicular germ cell tumours remains underexplored. We aimed to evaluate the impact of sarcopenia on dis...Background and objectives The relationship between sarcopenia and prognosis in patients undergoing chemotherapy for testicular germ cell tumours remains underexplored. We aimed to evaluate the impact of sarcopenia on disease progression and overall survival in these patients. Methods This retrospective multicentre study included patients who received chemotherapy for testicular germ cell tumours between January 2010 and December 2023. The psoas muscle index was calculated by measuring the cross-sectional area of the psoas muscle at the third lumbar vertebral level and was divided by the square of the height. Patients were divided into two groups based on changes in PMI (before and after chemotherapy): Group 1 (<10% change) and Group 2 (≥10% change). Results A total of 159 patients were analysed. Of these, 113 (71.1%) were in Group 1 and 46 (28.9%) in Group 2. Group 2 showed higher rates of disease progression (26.1% vs. 10.6%) and mortality (8.7% vs. 1.8%) (P=0.023 and P=0.038, respectively). In multivariable analysis, ≥10 % decrease in psoas muscle index [Hazard Ratio (HR)=6.499, P<0.001], rete testis invasion (HR=3.459, P=0.007), and non-seminomatous/mixed histology (HR=5.777, P=0.020) were identified as independent predictors of disease progression. For mortality, only a ≥10 % decrease in psoas muscle index was found to be a significant predictor (HR=5.994, P=0.049). Interpretation and conclusions A reduction in PMI is an independent prognostic factor for both disease progression and mortality in patients undergoing systemic chemotherapy for testicular germ cell tumours.