Vyas P, Joshi D, Kanabar K
… +7 more, Parmar M, Vadodariya J, Patel K, Patel B, Dave S, Patel M, Modi G
Natl Med J India
· 2026 · PMID 41645987
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Background Long-term Covid-19 symptoms have the potential to negatively impact health and quality of life. We evaluated the incidence and predictors of long Covid-19 among hospitalized patients. Methods We prospectively...Background Long-term Covid-19 symptoms have the potential to negatively impact health and quality of life. We evaluated the incidence and predictors of long Covid-19 among hospitalized patients. Methods We prospectively collected clinical data of 393 patients diagnosed as Covid-19 positive and admitted to our hospital. At 1-year follow-up, all vital parameters and laboratory investigations were recorded. A multiple logistic regression model was used to determine predictors of long Covid-19. Results Long Covid-19 was found in 34.4% of patients at 1-year follow-up. Most commonly reported symptoms were joint pain (40%), fatigue (33%), and dyspnoea (22.9%). Severity of disease at the time of admission (1.5; 95% Confidence Interval [CI] 1.09-2.2; p=0.01), high body-mass index (BMI) (1.1; 95% CI 1.03-1.13; p=0.003) and increased age (1.02; 95% CI 1.00-1.04; p=0.02) were independent predictors of long Covid-19 on follow-up. Conclusion Almost one-third of patients were diagnosed with long Covid-19 at 1-year follow-up. Severity of disease at the time of admission, increased BMI, and increased age were independent predictors of long Covid-19.
Natl Med J India
· 2026 · PMID 41645986
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Background Chronic kidney disease (CKD) is associated with accelerated cardiovascular (CV) risk, particularly due to subclinical atherosclerosis. Carotid intima-media thickness (CIMT) is a non-invasive marker of early at...Background Chronic kidney disease (CKD) is associated with accelerated cardiovascular (CV) risk, particularly due to subclinical atherosclerosis. Carotid intima-media thickness (CIMT) is a non-invasive marker of early athero-sclerotic changes. Altered mineral metabolism in CKD, also known as CKD-mineral bone disorder (CKD-MBD), may contribute to vascular damage. We evaluated the association between CIMT and mineral metabolism markers in people with diabetes who had pre-dialysis CKD. Methods A cross-sectional observational study was done in 110 adults with diabetes and pre-dialysis CKD. Biochemical markers including serum phosphate, intact parathyroid hormone (iPTH), fibroblast growth factor (FGF)-23, and 24-hour urinary phosphate were analyzed. CIMT was measured using B-mode ultrasonography. Correlation and regression analyses were performed. Results CIMT showed significant positive correlations with serum phosphate, FGF-23, iPTH, and serum creatinine, and negative correlations with nephron index and urinary phosphate excretion. Serum phosphate >6 mg/dl strongly predicted CIMT >0.9 mm. Conclusion Mineral metabolism markers, particularly serum phosphate and FGF-23, are significantly associated with subclinical atherosclerosis in CKD. Monitoring these parameters may aid in assessment of early CV risk in patients with CKD.
Natl Med J India
· 2025 · PMID 41645985
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Background Integration of smart mobile devices (SMD) like smartphones and digital tablets into medical practice continues to be hindered despite the benefits of access to guidelines at the point of care and patient safet...Background Integration of smart mobile devices (SMD) like smartphones and digital tablets into medical practice continues to be hindered despite the benefits of access to guidelines at the point of care and patient safety. The barriers include administrator attitudes, perceptions about how patients would receive it, shyness about accessing it in the presence of coworkers, and perceived attrition in medical education. We aimed to understand the perceptions of doctors, medical students, and patients about the use of SMDs in patient care areas. Methods A cross-sectional survey of doctors, medical students, and patients across multiple states in India was conducted. Data were collected using a validated questionnaire after ethical clearance and participant consent. A sample size of 385 was estimated for each group (95% confidence interval, alpha error 0.5, power 80%). Results 406 doctors, 425 medical students, and 418 patients responded to the survey. 92% doctors, 96% medical students, and 57% patients owned an SMD. 81% doctors had used an SMD for patient care, with a little over 50% having used it in front of their juniors, and only 34% approved the use in patient contact areas. 99% medical students used SMD for studying; 93% advocated it to their juniors for learning, but only 68% used it in front of their juniors, and 29% in front of their patients. About 90% patients were ready for doctors to use SMDs in front of them, with over 75% agreeing that SMD use will lead to better and safer care. Conclusions SMDs are widely used in the patient care area and for medical education. Some perceived barriers such as patient perceptions about doctors require behavioural change and acceptance of changing times.
Rana S, Choudhary R, Sharma A
… +2 more, Sangwan S, Kiran S
Natl Med J India
· 2025 · PMID 41645984
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Eosinophilic pneumonia is rare and characterized by excessive accumulation of eosinophils in the alveolar macrophages and interstitium. The presentation can be acute or chronic. The patient can also present with respirat...Eosinophilic pneumonia is rare and characterized by excessive accumulation of eosinophils in the alveolar macrophages and interstitium. The presentation can be acute or chronic. The patient can also present with respiratory failure requiring intensive support. These patients may have bronchial asthma at presentation or may be diagnosed with the same later. Diffuse alveolar haemorrhage, a rare complication of idiopathic chronic eosinophilic pneumonia, is life-threatening requiring urgent and aggressive investigation and management. We report a young male who had pneumonia and haemoptysis and was diagnosed to have idiopathic chronic eosinophilic pneumonia and diffuse alveolar haemorrhage.
Chehrehgosha M, Eskandari N, Pahlavanzadeh B
… +1 more, Badeleh Shamushaki MT
Natl Med J India
· 2025 · PMID 41645981
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Background One of the most important indicators of mental health in old age is life satisfaction. We aimed at verifying the psychometric properties of the Life Satisfaction Index-A (LSIA), used to evaluate life satisfact...Background One of the most important indicators of mental health in old age is life satisfaction. We aimed at verifying the psychometric properties of the Life Satisfaction Index-A (LSIA), used to evaluate life satisfaction and well-being, among older Iranians. Methods The forward-backward procedure was used for translating the English version of the LSIA into Persian. Thereafter, face and content validity were done by 15 specialists. Confirmatory factor analysis (CFA) was done for construct validity. Reliability was evaluated by using the Cronbach's alpha method. Statistical analysis was performed using Mplus 7.4. p<0.05 was considered statistically significant. Results In the face validity, more than 90% of all questions had an impact score above 1.5, content validity ratio (CVR) >0.6, and content validity index (CVI) >0.8. CFA showed that the first-level factors 'resolution and fortitude', 'Zest' and 'congruence between desired and achieved goals in life' explain the first factor of the second level which is 'the perception of reality', and the first level factors 'positive self-concept' and 'mood tone' explain the second factor of the second level which is 'mental perception'. The proposed structural model showed acceptable to the data and Cronbach's alpha for the LSIA's dimensions ranged between 0.89 and 0.95. Conclusion The findings suggest that the LSIA appears to be an appropriate instrument for older adults in Iran, but it needs further validation to explore different sub-cultural aspects in the older Iranian population.
Malhotra S, Mani K, Lodha R
… +10 more, Bakhshi S, Mathur VP, Gupta P, Kedia S, Sankar MJ, Kumar P, Kumar A, Ahuja V, Sinha S, Guleria R
Natl Med J India
· 2025 · PMID 41645980
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Background Transmission of the delta variant resulted in a surge of SARS-CoV-2 cases in New Delhi, India, during the early half of the year 2021. Healthcare workers (HCWs) received vaccines on priority for the prevention...Background Transmission of the delta variant resulted in a surge of SARS-CoV-2 cases in New Delhi, India, during the early half of the year 2021. Healthcare workers (HCWs) received vaccines on priority for the prevention of infection. We estimated the effectiveness of the BBV152 vaccine among HCWs against SARS-CoV-2 infection, hospitalization, or death. Methods This retrospective cohort study was done at a multi-speciality tertiary care public-funded hospital in New Delhi, India. 12 237 HCWs participated in the study. The intervention was the BBV152 whole virion inactivated vaccine (Covaxin, Bharat Biotech Limited, Hyderabad, administered two doses four weeks apart). The outcome measures were vaccine effectiveness against any SARS-CoV-2 infection, symptomatic infection, or hospitalization or death. Results The mean (SD) age of HCWs was 36 (11) years, 66% were men, and 16% had comorbid conditions. After adjusting for potential covariates-age, sex, health worker type category, body mass index, and comorbid conditions, the vaccine effectiveness (95% confidence interval) in fully vaccinated HCWs and >14 days after receipt of the second dose was 44% (37 to 51, p<0.001) against sympto-matic infection, hospitalization or death due to SARS-CoV-2, and 61% (37 to 76, p<0.001) against hospitalization or death, respectively. The partial dose was not effective. Conclusion The BBV152 vaccine, with complete two doses, offered a modest response to SARS-CoV-2 infection in real-life situations against a backdrop of high delta variant community transmission.
Dhawan A, Chatterjee B, Bhargava R
… +15 more, Chopra A, Mandal P, Rao R, Ambekar A, Mishra A, Agrawal A, Bhuyan D, Khess CRJ, Sidana A, Dalal P, Kandasamy A, Shankar MU, Singh RKL, Parkar S, Khan AW
Natl Med J India
· 2025 · PMID 41645979
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Background In the Indian context, there is no recent data on substance use among school students. We report on the pattern of substance use and associated factors among school students in a cross-sectional nationwide sur...Background In the Indian context, there is no recent data on substance use among school students. We report on the pattern of substance use and associated factors among school students in a cross-sectional nationwide survey conducted in 10 cities of India. Methods From each city, data from 200 students each from three schools (urban-government, urban-private, rural school) were collected. Within each school, a section from each grade (VIII, IX, and XI/XII) was randomly selected. Finally, 5920 students (boys 52.4%, mean [SD] age 14.7 [1.6] years) self-administered the questionnaire in the classroom setting. Results There were 15.1% students who reported lifetime, 10.3% past year, and 7.2% past month use of any substance, including tobacco, with most being used occasionally. Substances used in the past year were tobacco (4%), alcohol (3.8%), opioids (2.8%), cannabis (2%), inhalants (1.9%), and sedatives (0.6%). Substance use was significantly higher among boys than girls and higher with increasing grades. Past year users had significantly high/very high total difficulties score on the Strengths and Difficulties Questionnaire (15.0 [5.1]) compared to non-users (13.4 [5.7]; p<0.001). There was a significant difference between substance users and non-users in the subscales conduct problem, hyper-activity, emotional problems, and in the impact score (p<0.001). Past year users compared to non-users reported higher 'substance use (any)' by family members (p<0.001) and peers (p<0.001). Conclusions A substantial proportion of school students reported using psychoactive substances, mostly for occasional use. School-based prevention efforts are required on a wide scale in the country. We recommend early identification and intervention for substance use in school settings.
Natl Med J India
· 2025 · PMID 41645973
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This article sheds light on a medical bimonthly, the Madras Journal of Medical Science (MJMS), which was active between 1850 and 1854. A unique aspect of MJMS was that it was published by the apothecaries and dressers of...This article sheds light on a medical bimonthly, the Madras Journal of Medical Science (MJMS), which was active between 1850 and 1854. A unique aspect of MJMS was that it was published by the apothecaries and dressers of the Madras Subordinate Medical Service for their professional development. Similar to any professional journal of the mid-19th century, this journal included a few original case reports (referred to as literary contributions) by the apothecaries and dressers working with the Madras Medical Establishment (MME). This journal also included a few paraphrased articles from contemporary British medical journals, as well as featuring some locally relevant information related to the medical profession. This effort, aimed at academic growth, made by the subordinate medical staff of MME and not by the mainstream, higher-qualified medical personnel, impresses as valiant and daring.
Natl Med J India
· 2025 · PMID 41645972
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We describe a 4-year-old girl with a white reflex since birth, who presented with orbital retinoblastoma, complicated with orbital myiasis as a result of lack of compliance to treatment. The patient was managed with orbi...We describe a 4-year-old girl with a white reflex since birth, who presented with orbital retinoblastoma, complicated with orbital myiasis as a result of lack of compliance to treatment. The patient was managed with orbital exenteration followed by adjuvant radiation therapy. This case highlights the critical need for creating public health awareness and the importance of early medical attention to prevent such devastating conditions.
Natl Med J India
· 2025 · PMID 41645971
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Background The doctor-patient relationship is an important component of modern medicine. It is essenstial to respect the patient's views while also conveying the appropriate treatment protocols to them. We aimed to deter...Background The doctor-patient relationship is an important component of modern medicine. It is essenstial to respect the patient's views while also conveying the appropriate treatment protocols to them. We aimed to determine the characteristics that the general public in India considers important in a 'Good doctor' who would treat them or a member of their family. Methods We did a cross-sectional questionnaire-based study including 402 participants. The questionnaire consisted of 21 physicians' characteristics, with 7 characteristics in each of 3 domains: professional expertise, humanism, and autonomy. Participants were asked to select 4 qualities they valued most. Descriptive statistics were calculated and summarized. Categorical variables were analysed using the Chi-square test. The level of significance was set at 5%. Results The majority of patients (273) wanted their doctor to provide a clear explanation of their disease, while 218 patients wanted their doctor to be honest about their illness. The most commonly preferred domain was autonomy (84.3%), 75.1% chose humanism as the preferred characteristic while 74.6% favoured professional expertise. Conclusion The growing exposure to health education has changed people's perceptions from 'only doctors decision' to 'shared decision-making'. Open and transparent communication with patients reinforces trust in the doctor- patient relationship and must go hand in hand with humanism and professional competence.
Natl Med J India
· 2025 · PMID 41645969
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The National Medical Commission implemented a competency-based medical curriculum (CBME) for medical students from 2019 to enhance their learning, emphasising self-directed learning, life-long learning, and professional...The National Medical Commission implemented a competency-based medical curriculum (CBME) for medical students from 2019 to enhance their learning, emphasising self-directed learning, life-long learning, and professional skills. The new curriculum emphasises novel teaching- learning (TL) methods like problem-based learning (PBL), and emphasis has been placed on the psychomotor and affective domains of learning in addition to the cognitive domain. Despite the shift in TL methods, the potential opportunities and challenges in adopting the PBL-based approach are under-discussed in the Indian literature. We discuss PBL as a mode of TL in psychiatry in the CBME.
Natl Med J India
· 2025 · PMID 41645968
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Background Antenatal education helps in enhancing a woman's belief in herself, her ability to cope with birth, and achieving the desired outcome from coping behaviour, which will lead to a positive birth experience. Heal...Background Antenatal education helps in enhancing a woman's belief in herself, her ability to cope with birth, and achieving the desired outcome from coping behaviour, which will lead to a positive birth experience. Health professionals should impart antenatal education to enhance a mother's belief about her behaviour during childbirth. We aimed to develop and assess the effect of a supportive educational intervention on child birth self-efficacy amongst primipara mothers with a fear of childbirth. Methods We included in our study, 200 primipara mothers at 24-28 weeks of pregnancy with a fear of childbirth. They were screened for fear of childbirth using the Wijma Delivery Expectany Questionnaire-A (WDEQ-A) scale and then randomly allocated to the experimental and control groups. After the childbirth allocation assessment, self-efficacy was assessed using the childbirth self-efficacy inventory. The control group received routine care, and the experimental group received two sessions of intervention, one between 24 and 28 weeks and the second between 32 and 36 weeks of pregnancy. At 37 and 38 weeks of pregnancy, selected mothers in both groups were again assessed for childbirth self-efficacy. Results Following the interventions, there was a significant difference between the groups on post-intervention scores for childbirth self-efficacy (p<0.001). Conclusions Educational interventions can improve self-efficacy of expectant primipara mothers.