The Indian Journal Of Medical Research[JOURNAL]
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200 papers
Ocular surface alterations in critically ill patients: An observational study.
Chaudhary V, Sen S, Agrawal A … +2 more , Jain A, Imchen MT
Indian J Med Res · 2026 Jan · PMID 41934419 · Full text
Background and objectives Critically ill patients in intensive care units (ICUs) are vulnerable to ocular surface disorders due to impaired protective mechanisms, mechanical ventilation, sedation, and adverse environment...
Background and objectives Critically ill patients in intensive care units (ICUs) are vulnerable to ocular surface disorders due to impaired protective mechanisms, mechanical ventilation, sedation, and adverse environmental conditions. This study aimed to evaluate the prevalence and pattern of ocular surface alterations in ICU patients, identify associated risk factors, and determine microbial profiles in infective kerato-conjunctivitis. Methods An observational study was conducted on patients admitted in ICU for more than 72 h. Data on demographics, systemic diagnoses, ocular examinations, including Schirmer's test for severity of dry eye, conjunctival swab cultures, and corneal status were collected and analysed. Results Of the 280 patients, with mean ICU stay of 12.6 + 5.1 days, 200 (71.4%) had corneal abnormalities. Keratitis/corneal ulcer was most common (n=88, 31.4%), followed by punctate keratopathy (n=58, 20.7%) and corneal erosion (n=54, 19.3%). Lagophthalmos (n=82, 29.3%) and severe dry eye were significantly associated with corneal pathology (P<0.001). Common pathogens included Klebsiella sp. and Staphylococcus species. Longer ICU stay and higher severity of illness correlated with increased ocular morbidity. Poor GCS scores, dry eye severity, mechanical ventilation, and conjunctival status were also significant contributors. Interpretation and conclusions This study documents the high burden of ocular surface disordersin ICU patients and emphasises the need for routine ocular assessments and structured preventive protocols. Integrating simple eye care measures can mitigate visual complications and enhance overall ICU care quality.
The girl child in India: Investing early for equity.
Raj A
Indian J Med Res · 2026 Jan · PMID 41934418 · Full text
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Decentralised clinical trials in India: Stakeholders' perspectives.
Biswas A, Dalal J
Indian J Med Res · 2026 Jan · PMID 41934417 · Full text
Background and objectives Decentralised clinical trials leverage digital technologies to enhance trial accessibility, patient engagement, and improve operational efficiency in clinical research. This study assesses the a...
Background and objectives Decentralised clinical trials leverage digital technologies to enhance trial accessibility, patient engagement, and improve operational efficiency in clinical research. This study assesses the adoption of these trials among 47 Indian clinical research site professionals from a global survey (n=288). Methods A sub-analysis of a global cross-sectional survey conducted between August-September 2024 assessed respondents' roles, experience, trial types, therapeutic areas, perceived benefits, challenges, patient satisfaction, and expectations from the Indian researchers involved in decentralised clinical trials. Data were analysed using descriptive statistics, weighted averages (scale: 1=significant challenge to5=significant benefit), and mean rank analysis. Results Hybrid trials (n=33;71%) were more prevalent than full trials (n=14;29%). Frequently adopted components included home health visits and remote monitoring (n=10;16% each), particularly in oncology (n=8;17%) and cardiovascular trials (n=7;15%). Key perceived benefits included improved patient convenience (mean score: 3.8) and enhanced participant diversity (3.5). The most significant challenges were limited digital literacy (2.3) and regulatory uncertainty (mean rank 6.1). Patient satisfaction averaged 4.0, with 83% of respondents anticipating continued growth in adoption of hybrid trials. Interpretation and conclusions Hybrid decentralised clinical trials offer promising avenues to enhance inclusivity and efficiency in India's clinical research landscape, especially for non-communicable diseases. Gaps in digital literacy and regulatory uncertainties hinder their scale-up. Strategic investments in workforce training, digital infrastructure, and regulatory clarity are critical to unlocking the full potential of decentralised trials.
Emergence of SARS-CoV-2 omicron subvariant NB.1.8.1 in India: Genomic evolution, transmission patterns, and public health implications.
Sharma S, Manikyam HK
Indian J Med Res · 2026 Jan · PMID 41934416 · Full text
Background and objectives The NB.1.8.1 Omicron subvariant has demonstrated notable epidemiological relevance in India, though without evidence of a marked increase in severity compared to prior Omicron waves. Understandi...
Background and objectives The NB.1.8.1 Omicron subvariant has demonstrated notable epidemiological relevance in India, though without evidence of a marked increase in severity compared to prior Omicron waves. Understanding its genomic trajectory and policy implications is critical. Methods This was a retrospective convergent mixed-methods study integrating genomic sequencing (GISAID, INSACOG), epidemiological counts (ICMR, WHO, CDC), and policy/advisory analysis (MoHFW, WHO-SEARO). Data were analysed across January-May 2025 using prevalence tracking, hospitalisation comparisons, and thematic policy review. Results Genomic analyses showed NB.1.8.1 carrying lineage-defining spike mutations (A435S, V445H, T478I) linked to transmissibility and immune escape. While prevalence rose in China, India reported <5% share. Hospitalisation burdens remained lower in India than in China. India's policy response showed increasing alignment between genomic surveillance outputs and subsequent public health advisories, with targeted booster promotion and enhanced surveillance in high-incidence States. Interpretation and conclusions NB.1.8.1 illustrates the dynamic evolutionary trajectory of SARS-CoV-2. India's adaptive genomic surveillance and flexible public health frameworks contributed to mitigating clinical severity, though surveillance gaps and rural under-reporting remain concerns. Sustained genomic tracking, booster equity, and real-time advisory mechanisms are needed to strengthen preparedness.
Clinically actionable alterations in Indian breast cancer patients derived through whole transcriptome sequencing.
Gardi N, Chaubal R, Gandhi KA … +9 more , Kadam A, Singh A, Raja AS, Vanmali V, Hawaldar R, Sale S, Joshi S, Badwe R, Gupta S
Indian J Med Res · 2026 Jan · PMID 41934415 · Full text
Background and objectives Genomic studies are essential for identifying mutations that may influence key aspects of breast tumours, such as susceptibility, aggressiveness, and response to treatment. There are deficient m...
Background and objectives Genomic studies are essential for identifying mutations that may influence key aspects of breast tumours, such as susceptibility, aggressiveness, and response to treatment. There are deficient molecular and genomic data from Indian breast cancer patients. Methods mRNA from primary breast cancer samples were subjected to next-generation transcriptome (mRNA) sequencing on an Illumina platform, in duplicates and triplicates to generate 30-60 M reads/sample. PAM50, and absolute intrinsic molecular subtyping (AIMS) gene expression-based classifiers were used for intrinsic subtyping. Variants were called using, GATK, MuTect2, VarScan2, and VarDict, followed by filtering for somatic and non-synonymous changes. Germline variants were excluded using public databases. ClinVar annotations prioritised pathogenic variants, and the STRING algorithm was used for network analysis. Results A total of 207 RNA-Seq datasets from 97 breast cancer patients were analysed. There was good concordance between the immunohistochemical receptor and AIMS classification for all subtypes, but there was discordance between immunohistochemical and PAM50 subtypes within the ER-positive/HER2-positive subgroup, wherein only 38.5% (n= 5) were classified as HER2-like by gene expression classification. Variant analysis identified 145 high-confidence somatic mutations, with TP53 (n=46, 47%) and PIK3CA (n=33, 34%) being the most frequent. Additional actionable mutations in BRCA1, BRCA2, FGFR2, PTEN, AKT1, and mTOR pathways were identified. At least one actionable mutation was found in 52% of patients. Fusion transcript analysis identified 91 recurrent fusions, including novel partners with ERBB2, MED1, and CDK12, suggesting the possibility of unique molecular events. Interpretation and conclusions This study demonstrates that Indian breast cancer patients exhibit molecular subtypes and actionable mutations comparable to Caucasian cohorts.
Sickle cell disease in Jharkhand: A registry-based evaluation of disease burden and healthcare needs.
Prasad A, Kumari A, Kumar K … +7 more , Chaudhuri PK, Shakya S, Chauhan G, Kumari S, Kisku AV, Kumar A, Guria RT
Indian J Med Res · 2026 Jan · PMID 41934414 · Full text
Background and objectives Sickle cell disease poses a significant healthcare burden across several regions and states in India. We present findings from a sickle cell anaemia registry in the State of Jharkhand, a tribal...
Background and objectives Sickle cell disease poses a significant healthcare burden across several regions and states in India. We present findings from a sickle cell anaemia registry in the State of Jharkhand, a tribal predominant state situated in Eastern India, to provide an insight into the clinico-epidemiological profile and need-based management of sickle cell anaemia. Methods Sickle cell disease Registry at Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand was started in the year 2022 and it has 334 sickle cell disease patients recruited over two and a half years. This clinical research provides systematically captured comprehensive data of sickle cell anaemia patients with HbSS genotype, including demographics, clinical presentation, laboratory findings, treatment modalities, complications, and their outcomes. Results Clinical manifestations varied from mild to severe, with the most common presentation being vaso-occlusive crises (n=257, 94.5%). A significant proportion of patients required blood transfusion n=260, (95.6%). Hydroxyurea the mainstay of treatment, was taken regularly by 136, (50%) of patients, whereas n=68, 25% were irregularly taking hydroxyurea medication and n= 68, 25% never took it. Regular intake of hydroxyurea therapy was significantly associated with reduction in pain crises and a decreased need for blood transfusion. Interpretation and conclusions Establishment of hydroxyurea monitoring units, monitoring of blood transfusion through appropriate investigations, increased utilisation of iron chelation therapy, and identification of patients with increased stroke risk can lead to improved patient care, escalated awareness and reduced rate of hospitalisation in sickle cell disease.
Efficacy and safety of Vosoritide in achondroplasia: A systematic review and meta-analysis.
Pahuja M, Prakash C, Umrao A … +1 more , Chatterjee NS
Indian J Med Res · 2026 Jan · PMID 41934413 · Full text
Background and objectives Achondroplasia, a rare autosomal dominant disorder caused by FGFR3 mutation, is treated with vosoritide, a C-type natriuretic peptide analogue. This review aimed to assess vosoritide's efficacy...
Background and objectives Achondroplasia, a rare autosomal dominant disorder caused by FGFR3 mutation, is treated with vosoritide, a C-type natriuretic peptide analogue. This review aimed to assess vosoritide's efficacy and safety to guide clinical practice and healthcare policy decisions. Methods Advanced search was performed on three databases. The included articles underwent screening, data extraction, and quality evaluation, culminating in a qualitative synthesis. The protocol was registered on PROSPERO (CRD42024541795). Results Out of 752 records screened, six were incorporated in this systematic review. The trials included daily injections of vosoritide (2.5-30 µg/kg) in phase II study and at 15 µg/kg in all other studies to patients with achondroplasia aged 3 months to 18 years. Safety assessments were done for all patients (n=156) having received vosoritide. Efficacy was assessed using annualised growth velocity and height Z score as the primary outcomes andserum collagen X-marker concentrations, bone age progression, and serum immunogenicity as secondary outcomes. Overall, the articles demonstrated good quality with minimal bias. Interpretation and conclusions Vosoritide showed significant improvement in the annualised growth velocity, height z score and standing height in patients with achondroplasia aged 3 months to 18 years as compared to placebo. The safety assessment recorded adverse events in all patients (n=156) enrolled, usually mild (grade 1), self-limiting and limited to local injection site reactions. Studies with longer duration (till puberty), a large sample size and its effect on medical complications, are required to establish its effectiveness in the patients of achondroplasia.
Psychosocial challenges of drug-resistant tuberculosis: A qualitative study in Deoghar, Eastern India.
Babu R, Juhi A
Indian J Med Res · 2026 Jan · PMID 41934412 · Full text
Background and objectives Despite therapeutic advancements, patients with drug-resistant TB (DR-TB) experience substantial psychosocial challenges that adversely affect treatment adherence and outcomes. Limited research...
Background and objectives Despite therapeutic advancements, patients with drug-resistant TB (DR-TB) experience substantial psychosocial challenges that adversely affect treatment adherence and outcomes. Limited research has explored these psychosocial barriers. This study aimed to explore the psychosocial challenges encountered by DR-TB patients from diagnosis through treatment completion. Methods A cross-sectional qualitative study was conducted in the department of Pulmonary Medicine at a tertiary care hospital in eastern India from November to December 2023. Using criterion sampling, 20 DR-TB patients who had successfully completed treatment were recruited. Semi-structured, face-to-face interviews were conducted in Hindi, audio-recorded, transcribed verbatim, and thematically analysed using QDA Miner Lite software following Braun and Clarke's six-step framework. Results Six major themes emerged: (i) Diagnosis-related challenges such as delays, lack of awareness, and misguidance; (ii) Physical and mental health impact, including severe drug-related side effects leading to distress and suicidal thoughts; (iii) Emotional instability, marked by fear, anxiety, and hopelessness; (iv) Family isolation and disruption of social relationships due to stigma and misconceptions; (v) Lack of social support, resulting in discrimination and reduced self-esteem; and (vi) Financial burden, including job loss, treatment-related costs, and debt. Interpretation and conclusions Psychosocial barriers substantially influence treatment adherence and overall well-being among DR-TB patients. Integrating mental health services, strengthening counselling, addressing stigma, and providing financial assistance within the National TB Elimination Program (NTEP) are essential to improve patient support, adherence, and clinical outcomes.
First-trimester two-hour post-challenge glucose and HbA1c as early predictors of gestational diabetes mellitus: A prospective cohort study.
Khandelwal R, Nigam A, Chaubey S
Indian J Med Res · 2026 Jan · PMID 41934411 · Full text
Background and objectives Traditional gestational diabetes mellitus (GDM) screening at 24-28 wk occurs after foetal exposure to maternal hyperglycemia during critical developmental windows. Our objective was to investiga...
Background and objectives Traditional gestational diabetes mellitus (GDM) screening at 24-28 wk occurs after foetal exposure to maternal hyperglycemia during critical developmental windows. Our objective was to investigate whether first-trimester glycaemic parameters within currently accepted normal ranges could predict subsequent GDM development. Methods In this prospective cohort (May 2023-December 2024), 270 women with singleton pregnancies were enrolled at 8-12 wk gestation with normal glycaemic values (FPG <92 mg/dL, 1-h <180 mg/dL, 2-h <153 mg/dL, HbA1c <5.9%). All underwent a 75 g OGTT and HbA1c testing in the first trimester and repeat OGTT at 24-28 wk for GDM diagnosis (IADPSG criteria). Results GDM prevalence was 15.9%. Women who developed GDM had significantly higher first-trimester 2-h post-challenge glucose [116.7±15.4 vs. 99.0±16.6 mg/dL (6.5±0.9 vs. 5.5±0.9 mmol/L), P<0.001] and HbA1c [5.30±0.30% vs. 4.90±0.37% (34±3.3 vs. 30±4.0 mmol/mol), P<0.001] compared to those who maintained normal glucose tolerance. ROC analysis identified optimal cut-offs: 2-h glucose ≥112 mg/dL (6.2 mmol/L) (sensitivity 79.1%, specificity 81.9%, AUC 0.799) and HbA1c ≥5.4% (36 mmol/mol) (sensitivity 60.5%, specificity 88.4%, AUC 0.805). A combined model incorporating 2-h glucose, HbA1c, and family history achieved the highest performance (AUC 0.866, sensitivity 69.8%, specificity 89.0%, diagnostic accuracy 85.9%). Newborns of GDM mothers had significantly higher birth weights (3366.4±399.0g vs. 2935.8±427.0g, P<0.001). Interpretation and conclusions First-trimester 2-h glucose ≥112 mg/dL and HbA1c ≥5.4%, even within normal ranges, effectively predict GDM. Combined assessment improves predictive accuracy, supporting early first-trimester risk stratification and timely intervention to enhance maternal and neonatal outcomes.
Temporal dynamics & determinants of antibiotic resistance gene profiles in the infant gut during the first year of life.
Mahesh S, Mutreja A, Shetty V … +5 more , Kamath VG, Aroor S, Madhav A, Sinha P, Ballal M
Indian J Med Res · 2025 Dec · PMID 41648984 · Full text
Background & objectives To evaluate the progressive changes in the antibiotic resistance gene (ARG) profile by investigating their presence at different time points in the gut of infants during early life. Methods Stool...
Background & objectives To evaluate the progressive changes in the antibiotic resistance gene (ARG) profile by investigating their presence at different time points in the gut of infants during early life. Methods Stool samples of 54 full-term healthy infants at birth at 6, 14, and 36 wk were processed to examine the presence of 20 antibiotic-resistance genes. McNemar's test was used to check the statistical significance of the change in prevalence of genes across various time points. Chi-square test and logical regression were performed to evaluate the influence of clinical and demographic factors on the carriage of ARGs during early life. Results Infants predominantly carried genes that conferred resistance to beta-lactams (80.6%), macrolides (MSLB) (70%), and the sulphonamide (61%) class of antibiotics. ARG carriage peaked at 6 wk and 14 wk with a significant increase in the proportion of genes like blaTEM, catB, oqxA, sul1, ermB, tet, blaSHV (P: <0.05) from birth to 6 wk. Caesarean-section [P = 0.001; odds ratio (OR): 6.93; confidence interval (CI): 2.06-23.26] and maternal exposure to cephalosporins postpartum (P value = 0.013; OR: 4.16; CI: 1.31-13.17) had a significant influence on the increased carriage of the blaCTX-M gene at 6 wk of life. Interpretation & conclusions Our findings demonstrate that infants carry a diverse range of ARGs, with peak prevalence observed at 6 and 14 wk. Delivery mode and maternal antibiotic exposure significantly impact ARG carriage, emphasising the need for targeted interventions to reduce antibiotic resistance in early life.
Perceptions of medical students on language concordance in doctor-patient communications.
Gupta L, Satyanarayan MD
Indian J Med Res · 2025 Dec · PMID 41648983 · Full text
Background & objectives Language concordance-the ability of doctors to communicate with patients in their preferred language-is known to improve clinical outcomes and patient satisfaction. Medical undergraduates often fa...
Background & objectives Language concordance-the ability of doctors to communicate with patients in their preferred language-is known to improve clinical outcomes and patient satisfaction. Medical undergraduates often face communication barriers with patients. This study aimed to assess the perceptions of undergraduate medical students regarding native language proficiency in clinical settings and its impact on doctor-patient relationships. Methods A descriptive, questionnaire-based cross-sectional study was conducted among 409 MBBS students across various academic years in Karnataka, to assess students' views on language use in clinical interactions, its benefits, and barriers, using a 5-point Likert scale. Responses were analysed using descriptive statistics and the Kruskal-Wallis test for inter-year comparison. Open-ended responses underwent thematic analysis. Results Of the 409 participants, 26.2 per cent were non-native Kannada speakers. A majority agreed that language concordance enhances empathy, rapport, and effective communication with patients. Most students supported the inclusion of local language learning in the curriculum and recognised its role in improving clinical skills such as history-taking. Thematic analysis highlighted key concerns, including patient interaction challenges, clinical skill development, and student-led strategies to overcome language barriers. Interpretation & conclusions Medical students perceive language concordance as a vital component of effective clinical communication and patient care. There is strong support for structured, longitudinal local language training within the MBBS curriculum.
Serum uric acid levels in patients with different phenotypes of polycystic ovary syndrome.
Akkus C, Oner O, Okan Kilic A … +2 more , Ucar Toros M, Duran C
Indian J Med Res · 2025 Dec · PMID 41648982 · Full text
Background & objectives Polycystic ovary syndrome (PCOS) is a common endocrinopathy in reproductive-aged women, frequently associated with insulin resistance, obesity, and increased cardiovascular risk. Serum uric acid,...
Background & objectives Polycystic ovary syndrome (PCOS) is a common endocrinopathy in reproductive-aged women, frequently associated with insulin resistance, obesity, and increased cardiovascular risk. Serum uric acid, linked to oxidative stress and endothelial dysfunction, may contribute to the cardiometabolic complications of PCOS. Although hyperuricemia is common in PCOS, differences in serum uric acid among phenotypes remain unclear. This study compared serum uric acid across PCOS phenotypes, hypothesising that classic, obese phenotypes would exhibit higher levels due to synergistic metabolic and hormonal effects. Methods A total of 180 women with PCOS [phenotypes A(n=96), B (n=19), C (n=35), and D (n=30)] and 51 age-matched controls were included. PCOS was diagnosed according to the revised 2003 Rotterdam criteria, and phenotyping was based on the presence of hyperandrogenism, oligo-anovulation, and polycystic ovarian morphology. Fasting serum uric acid levels were measured using the uricase method, and hyperuricemia was detected as ≥6.0 mg/dL. Analyses were performed using the Shapiro-Wilk test for normality, Levene's test for homogeneity, and appropriate parametric or non-parametric tests with Holm correction for multiple comparisons. Results Among 231 women evaluated, age distributions were similar between groups. Median body mass index (BMI) and waist circumference (WC) were higher in the PCOS cohort, most prominently in Phenotype A (both P<0.001). Serum uric acid was significantly higher in Phenotype A [4.8 (2.7-8.9) mg/dL] than in controls [4.1 (2.7-6.3) mg/dL] and Phenotype C [4.2 (2.6-5.8) mg/dL] (both P<0.001). Hyperuricemia was more frequent in PCOS than in controls (P=0.035), occurring predominantly in Phenotype A. Most hyperuricemic patients were obese; notably, no obese controls were available for comparison. Serum uric acid levels were positively associated with BMI (Spearman rho=0.452, +) and WC (0.412, P<0.001), yet in BMI categories, no significant differences were found in serum uric acid among phenotypes. Interpretation & conclusions Among PCOS patients, elevated serum uric acid is significantly associated with the classic hyperandrogenic phenotype (Phenotype A) and may also be related to obesity, emphasising the importance of monitoring serum uric acid in obese classical PCOS females, particularly those presenting with Phenotype A.
In conversation with Dr. John P. Ioannidis: On meta-research, metrics, gaming, and top 2 per cent scientists.
Arjuman A
Indian J Med Res · 2025 Dec · PMID 41648981 · Full text
Abstract loading — click title to view on PubMed.
New thalassemia mutations from West Bengal.
Shaw J, Bhattacharyya M, Chakrabarti S
Indian J Med Res · 2025 Dec · PMID 41648980 · Full text
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Disability-inclusive health systems & the quest for Viksit Bharat.
Singh S
Indian J Med Res · 2025 Dec · PMID 41648979 · Full text
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Effectiveness of single-dose albendazole against soil-transmitted helminth infection in children: A longitudinal study in a tribal dominated district of Odisha, India.
Sethi SK, Mandal N, Pattanaik AA … +9 more , Jnyanajyoti M, Kanungo S, Gouda SS, Bhattacharya D, Kaur H, Panda PP, Behera AK, Pati S, Palo SK
Indian J Med Res · 2025 Dec · PMID 41648978 · Full text
Background & objectives Soil-transmitted helminth (STH) infections, primarily caused by Ascarislum bricoides, Trichuris trichiura, and Ancyclostoma duodenale, significantly impact child growth and cognitive development i...
Background & objectives Soil-transmitted helminth (STH) infections, primarily caused by Ascarislum bricoides, Trichuris trichiura, and Ancyclostoma duodenale, significantly impact child growth and cognitive development in endemic regions. This study aimed to evaluate the effectiveness of a single 400 mg dose of albendazole in treating STH infections among children aged 1-15 yr in Nabarangpur, Odisha, India, and to assess the influence of socio-demographic factors on treatment outcomes. Methods This longitudinal study included 1246 children across 18 clusters. Among them, 203 STH-positive children received albendazole, with stool samples collected on Days 14, 28, and 42 post-treatment. Egg counts were measured using the Kato-Katz method. Cure rates and egg reduction rates (ERR) were calculated, and repeated measures ANOVA was used to assess the impact of schooling, gender, tribal status, and geography on treatment efficacy. Results Albendazole demonstrated high effectiveness in reducing egg counts, with an ERR of 96.2 per cent for A. lumbricoides and 93.8 per cent for A. duodenale. Cure rates were suboptimal, at 66.7 per cent and 52.94 per cent, respectively, falling below WHO-recommended thresholds. Gender and geographic location influenced baseline egg counts, with females and children in Nabarangpur showing higher initial burdens. Reductions were consistent across schooling and tribal groups. Interpretations & conclusions Although albendazole effectively reduced infection intensity, its lower cure rates for hookworms highlight the need for region-specific and gender-sensitive interventions. Integrating treatment with WASH (Water, Sanitation, and Hygiene) programs and health education may improve long-term control. Monitoring resistance patterns and exploring combination therapies could further enhance treatment efficacy.
Young adult immunization initiative (YUVA/YAII): A policy framework for India's life-course vaccination strategy.
Bhatt LK
Indian J Med Res · 2025 Dec · PMID 41648977 · Full text
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Barriers to effective management of drug-resistant tuberculosis in India, insights into patient & health system challenges: An exploratory review.
Rai S, Sen A, Shah H … +1 more , Patel J
Indian J Med Res · 2025 Dec · PMID 41648976 · Full text
The emergence of drug-resistant tuberculosis (DR-TB), especially multi drug resistant tuberculosis (MDR-TB), is increasingly threatening the effectiveness of India's National TB Elimination Program (NTEP). This review se...
The emergence of drug-resistant tuberculosis (DR-TB), especially multi drug resistant tuberculosis (MDR-TB), is increasingly threatening the effectiveness of India's National TB Elimination Program (NTEP). This review seeks to analyse the patient and health system challenges concerning the management of DR-TB and seeks to find appropriate solutions to maximize the programmatic impact. A systematic literature search was carried out on PubMed, Embase, Scopus and Google Scholar for articles published between 2015 and 2024 focusing on the treatment challenges in India's MDR or extensive drug resistant (XDR) TB. Factors regarding care access, adherence to treatment, and systemic barriers were prioritised. We accepted qualitative, retrospective, and cross-sectional designs; clinical trials and non-English publications were excluded. We included 15 eligible studies thematically. The socioeconomic factors, barriers to access to care were paired with a stigma, low disease awareness and care responsibility at home. This was alongside a high pill burden and adverse drug effects. Alcoholism and psychosocial depression comorbidities with poorly supportive social environments further worsened adherence. Gaps in the health system included insufficient drug resistance testing, delay in diagnostics, a lack of healthcare personnel, inadequate referral chains, and inconsistent treatment regimens. Lack of streamlined referral pathways and non-standardised treatment regimens posed problematic operational challenges. Weak involvement from the private sector and lack of training and supervision of frontline workers also contributed to operational gaps. Policy gaps included limited program scope, inadequate funding, or lack of universal health coverage. While urban areas faced coordination issues with the private sector, rural areas contended with further delays in diagnostics. A comprehensive strategy is essential when dealing with patients with DR-TB in India. Aligning psychosocial support, enhanced funding, and multisector coordination with infrastructure and better access to conflicting diagnostics can improve local contexts and targets NTEP's TB elimination goals.
Need & strategies for prioritisation of rehabilitation research in India.
Mullerpatan R, Rauch A, Mudau Q … +5 more , Bappirambharath MA, Khedekar S, Tobgay T, Gangakhedkar RR, Grover A
Indian J Med Res · 2025 Dec · PMID 41648975 · Full text
Background & objectives India faces the highest rehabilitation need in South East Asia. Rehabilitation research is essential to define the gap between the need and available rehabilitation services at all levels of healt...
Background & objectives India faces the highest rehabilitation need in South East Asia. Rehabilitation research is essential to define the gap between the need and available rehabilitation services at all levels of healthcare in both urban and rural settings for individuals across life span. Methods A comprehensive rapid literature search was conducted in two scientific databases namely - PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL); and two scientific registries, namely - Clinical Trials Registry India and Shodhganga, to report the current status of rehabilitation research in India. Articles published in English (1801 till 2024), reporting studies pertinent to rehabilitation services such as physiotherapy, occupational therapy, speech rehabilitation, audiology rehabilitation, prosthetics and orthotics and clinical trials and doctoral theses pertinent to rehabilitation were included. Results A total of 10,692 and 546 research articles were identified in PubMed and CINAHL, respectively. Findings of rapid literature search suggested that the volume and level of research evidence pertinent to rehabilitation are considerably low vis-a-vis the huge and diverse need for rehabilitation services in rural-tribal and urban settings in India. Secondly, the spectrum of rehabilitation research is largely clinical research. Interpretation & conclusions Present findings underscore an urgent need to prioritize context-specific rehabilitation research in India. The results highlight the need for encompassing a wider focus of rehabilitation research including health system and health policy research, extending beyond clinical research. A strategic research framework is proposed which presents a multi-level approach to prioritize, execute and accelerate rehabilitation research for accessible and effective rehabilitation services for all individuals in need, across life-span, at all healthcare levels.
Association of polycystic ovarian syndrome with inflammatory single nucleotide polymorphism for IL-1 & IL-6 genes: A case-control study.
Benjamin JJ, Ramaswamy P, Kuppusamy MK … +6 more , Vembu R, Rajamani K, Puttaswamy N, Narayanasa MK, Mathews RR, Koshy T
Indian J Med Res · 2025 Dec · PMID 41648974 · Full text
Background & objectives Persistent mild inflammation is considered as a main contributor to the altered genesis of polycystic ovary syndrome (PCOS), with numerous studies reporting elevated serum levels of inflammatory m...
Background & objectives Persistent mild inflammation is considered as a main contributor to the altered genesis of polycystic ovary syndrome (PCOS), with numerous studies reporting elevated serum levels of inflammatory markers. This inflammatory state may be attributed to genetic variants, particularly single nucleotide polymorphisms (SNP), that alter cytokine regulation. This study investigated the association of PCOS and inflammatory SNPs including interleukin (IL) such as IL-1β rs1143634, IL-1β rs16944, IL-6 rs1800795, IL-6 rs1800797, IL-6 rs1800796, IL-1RN; and tumour necrosis factor-alpha (TNF-α). Methods A total of 250 women volunteered for the study; of which 100 were diagnosed with PCOS and 150 were healthy controls. Serum levels of IL-6, IL-1β, and TNF-α were measured using enzyme-linked immunosorbent assay (ELISA). Genotyping was analysed using polymerase chain reaction (PCR), PCR-restriction fragment length polymorphism (PCR-RFLP), or real-time PCR (RT-PCR). Genotype distributions amid groups were compared using the Chi-square test. Results Women with PCOS exhibited elevated serum levels of IL-1β than those of healthy controls which was considerably significant (P<0.001). The heterozygous genotypes of IL-1RN and IL-6 rs1800796 were seen more frequently in the control group (P=0.02), suggesting a potential inverse association. Interpretation & conclusions SNPs in IL-1 and IL-6 genes may influence susceptibility to PCOS and could confer a protective role in women of South Asian Indian origin.
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