Natl Med J India
· 2026 · PMID 41729496
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Background Although the National Medical Commission (NMC) mandates regular feedback for undergraduate students, it is not often practised. Lack of time and knowledge on giving feedback are reasons often cited by teachers...Background Although the National Medical Commission (NMC) mandates regular feedback for undergraduate students, it is not often practised. Lack of time and knowledge on giving feedback are reasons often cited by teachers. In a mixed-method study, we assessed the effectiveness of a training workshop for faculy on the 'feedback process' and the effect of giving constructive feedback to students in microbiology on bridging learning gaps. Methods A core team of nine facilitators was trained in the importance of feedback and methods to provide feedback. The Kirkpatrick model was used for measuring training effectiveness. Sixty-two consenting students attended a regular teaching session for a pre-decided competency, followed by a reasoning-based assessment. Students scoring <60% (group A) received individual feedback, and those scoring >60% (group B) received feedback in groups. This was followed by another regular teaching session for a related competency and assessment. Reflections were noted from both students and facilitators. Themes generated and satisfaction indices were calculated. Results Facilitators were happy with the workshop and felt satisfied with the feedback session conducted by them. There was a significant improvement in the performance of students after the feedback session, especially for group A (median score pre-feedback=4.5; post-feedback=7.5; out of 10). Most (93.5%) students strongly agreed that the feedback session was helpful in making them aware of their learning gaps (satisfaction index=93.54) and facilitated the bridging of the gaps. Students wanted feedback sessions to continue across all competencies and other subjects as well. Conclusion It is possible to improve student performance by conducting a faculty development workshop emphasizing the need and process of giving feedback.
Murali S, Manavalan S, Vidyasagar S
… +1 more, Raj B
Natl Med J India
· 2026 · PMID 41729495
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Kounis syndrome (KS), also known as allergic angina, is a type-1 hypersensitivity reaction affecting the coronary vessels, leading to vasospasm. It manifests like an acute coronary syndrome on the electrocardiogram and i...Kounis syndrome (KS), also known as allergic angina, is a type-1 hypersensitivity reaction affecting the coronary vessels, leading to vasospasm. It manifests like an acute coronary syndrome on the electrocardiogram and is often underdiagnosed. Foods (such as peanuts and fish) and medications (mostly antibiotics and analgesics) are the common triggers. We report a 30-year-old patient who developed KS following a multivitamin injection.
Rana P, Chandra M, Chandra K
… +5 more, Dahuja S, Varughese B, Roy V, Kapoor S, Rao M
Natl Med J India
· 2026 · PMID 41729492
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Background Depression is a major psychiatric comorbid condition of type 2 diabetes mellitus (T2DM). Serotonin, the major neurotransmitter implicated in depression, is a tryptophan derivative. Tryptophan is chiefly metabo...Background Depression is a major psychiatric comorbid condition of type 2 diabetes mellitus (T2DM). Serotonin, the major neurotransmitter implicated in depression, is a tryptophan derivative. Tryptophan is chiefly metabolised through the kynurenine pathway with indolamine-2,3-dioxygenase (IDO) as the rate-limiting enzyme. Hence, serum tryptophan and kynurenine concentrations and their ratio (K/T ratio) as a measure of IDO activity are possible biomarkers of depression in T2DM. Methods Severity of depression in adults with T2DM attending a primary care facility in Delhi was rated using the Hamilton Depression Rating Scale (HAM-D 17 items). Baseline serum tryptophan and kynurenine concentrations, along with their ratio, were estimated. A follow-up HAM-D rating was done after 16 weeks of standard therapy and the quantum HAM-D score improvement was correlated with the K/T ratio. Results Of 106 people with T2DM screened for depression, 52 had syndromal depression and were recruited for the study. There was no significant association between age, sex, marital status, religion, serum tryptophan, and kynurenine levels with respect to the severity of depression, but the mean K/T ratio was significantly higher among those with severe depression (p<0.05). There was a significant correlation between serum kynurenine and HAM-D score improvement at 16 weeks. Conclusion K/T ratio, a measure of IDO activity, was found to be a severity marker for depression in T2DM, without any prognostic significance. Further studies are required to explore the K/T ratio as a state marker, severity marker, and prognostic biomarker of depression in people with T2DM.
Natl Med J India
· 2026 · PMID 41729490
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Evaluation of pyrexia of unknown origin should include a search for opportunistic infections. Cytomegalovirus (CMV) pneumonitis is a rare opportunistic infection that can occur in immunocompromised patients. We present a...Evaluation of pyrexia of unknown origin should include a search for opportunistic infections. Cytomegalovirus (CMV) pneumonitis is a rare opportunistic infection that can occur in immunocompromised patients. We present an unusual case of CMV pneumonia diagnosed in an apparently healthy individual whose serology for HIV was negative.
Natl Med J India
· 2026 · PMID 41645994
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Japan's modern history begins with the Meiji Restoration in 1868. Prior to that, Japan was largely a secluded society (Sakoku). The first medical journal in Japan was in the pre- Meiji era and was the Taisei-mei-i-ikô (A...Japan's modern history begins with the Meiji Restoration in 1868. Prior to that, Japan was largely a secluded society (Sakoku). The first medical journal in Japan was in the pre- Meiji era and was the Taisei-mei-i-ikô (A Compendium of Articles by Renowned Western Doctors), published from 1836 to 1842. Its editor was Mituskuri Genpo; the journal comprised translations of Dutch journals to Japanese (for the first six issues) and Chinese script (for the last two issues). In 1869, William Willis, a British doctor, established the Nikko Kibun (Records of Daily Lectures). From December 1869 to 1870, a Dutch physician, Antonius F. Bauduin, published 11 monthly issues of a journal, which he also titled Nikko Kibun. In 1872, Stuart Eldridge, an American native, published Kin- Sei-I-Setsu (Journal of Modern Medicine), the first Japanese medical journal to publish articles by researchers based in Japan. June 1873 saw the first journal edited by a Japanese physician; Bun-en-Zasshi (Journal of Literary Bower), edited by Motonori Tashiro. We propose that the Journal of Literary Bower happens to be an erroneous translation, and the term should mean Journal of Culture and Thought. Among the 69 medical journals established in Japan between 1873 and 1889, 23 ceased to exist within 1 year.
Verma P, Khullar G, Ganguly S
… +7 more, Rao PN, Nair P, Tiwary A, Roy S, Revankar CR, Raut S, Jha A
Natl Med J India
· 2026 · PMID 41645993
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Cutaneous tuberculosis (CTB) is an important type of extrapulmonary tuberculosis (EPTB), especially in countries where the tuberculosis (TB) load is high. It is reported from all over the globe with varying incidence, af...Cutaneous tuberculosis (CTB) is an important type of extrapulmonary tuberculosis (EPTB), especially in countries where the tuberculosis (TB) load is high. It is reported from all over the globe with varying incidence, affecting all age groups, and it presents with different clinical forms depending upon the host, environmental and pathogen-related factors. Diagnosis of CTB, especially in atypical forms, is a challenge, even with newer molecular methods, as most cases are paucibacillary. CTB can be considered a neglected disease as there is a paucity of epidemiological data, awareness and research about it. With an aim to end tuberculosis in the near future, it is important to understand the distribution and determinants of CTB. This article, the first of two articles on this subject, reviews the present literature on epidemiology, pathogenesis, clinical features and types of CTB, including its associations and investigations.
Natl Med J India
· 2026 · PMID 41645992
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Background There is minimal literature on the spectrum and long-term outcomes of acute kidney injury (AKI) from tropical countries. Methods Patients with AKI without underlying chronic kidney disease (CKD), were recruite...Background There is minimal literature on the spectrum and long-term outcomes of acute kidney injury (AKI) from tropical countries. Methods Patients with AKI without underlying chronic kidney disease (CKD), were recruited from March 2017 to December 2018 to assess their outcomes. Survivors were followed for a year post-discharge. A linear model with fixed effects was created to compare the estimated glomerular filtration rate (eGFR) trajectories of patients with and without CKD at the end of follow-up. Results A total of 529 patients with AKI were recruited, of which 288 (54.4%) were hospital-acquired AKI. Infections and sepsis were the most common aetiologies for community-acquired AKI and hospital-acquired AKI. The overall mortality rate was 42.9% (n=227). The ICU stay (HR 1.78; 95% CI 1.08-2.93), mechanical ventilation (HR 1.98; 95% CI 1.09-3.54), and the requirement for inotropic support (HR 2.36; 95% CI 1.65-3.39) were independent risk factors of in-hospital mortality. Among 156 subjects with long-term follow-up, 70 (44.9%) developed CKD after a median follow-up of 12 months. Age (p<0.001) and hospital-acquired AKI (p=0.014) were significant predictors, whereas ICU stay and comorbid conditions did not influence the GFR trajectories. CKD patients showed a lower eGFR from the first follow-up (p<0.001). Conclusions AKI is associated with significant mortality. Even after an apparent recovery, around half the survivors progress to CKD at the end of 1 year.
Natl Med J India
· 2026 · PMID 41645991
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Background Patients of ovarian cancer who respond to the initial chemotherapy (CT) regimen may respond again to the same drugs after relapse. We aimed to evaluate the survival of patients with recurrent ovarian cancer (R...Background Patients of ovarian cancer who respond to the initial chemotherapy (CT) regimen may respond again to the same drugs after relapse. We aimed to evaluate the survival of patients with recurrent ovarian cancer (ROC) treated with second-line CT drugs such as liposomal doxorubicin, paclitaxel/carboplatin, and/or bevacizumab. Methods Electronic medical records of ovarian cancer patients registered between January 2009 and December 2017 were reviewed to identify those with ROC. Data regarding demographics, clinical characteristics, treatment, recurrence, vital status at last contact, etc. were retrieved. The log-rank test was applied to compare the Kaplan-Meier curves for survival analysis. Results A total of 119 cases met the inclusion criteria. The median age at diagnosis and relapse was 49 and 51 years, respectively. The medians for progression-free survival (PFS) and post-relapse survival (PRS) were 19 (95% CI 10.34-21.66) months and 34 (95% CI 37.17-56.83) months, respectively. The PFS was significantly higher among premenopausal women (p=0.025). Patients treated with paclitaxel/carboplatin-based second-line CT had significantly higher PRS compared to those treated with liposomal doxorubicin/carboplatin (p<0.001). Overall survival was also significantly different between the stage groups (p=0.003). Conclusions The 5-year PFS rate in ROC treated with second-line CT is <20%. The rate of secondary recurrence is moderately high, leading to reduced survival. Paclitaxel/carboplatin-based second-line CT significantly increases PRS among ROC patients. The probability of mortality increases as the stage advances.