Natl Med J India
· 2026 · PMID 42325045
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Background Workplace violence is a critical occupational hazard faced by healthcare professionals worldwide, adversely affecting their mental well-being and the quality of healthcare. Assessing the situation and how juni...Background Workplace violence is a critical occupational hazard faced by healthcare professionals worldwide, adversely affecting their mental well-being and the quality of healthcare. Assessing the situation and how junior doctors deal with it is critical. We assessed the prevalence of workplace violence against junior doctors in a tertiary care hospital in Manipur and explored coping strategies amongst those who experienced it. Methods A mixed-method study was conducted from October to November 2023 amongst junior doctors. Data were collected using a self-administered questionnaire and in-depth interviews were conducted amongst those who had experienced workplace violence. Descriptive statistics and Chi-square test were used. p<0.05 was considered statistically significant. Thematic analysis was done to identify codes, categories and themes. Results Of the 124 participants, 55 (44.4%) had experienced workplace violence. Verbal violence was the most common. It was significantly higher among non-academic junior residents (p=0.005) than among interns and those working shifts (p=0.017). Thematic analysis also showed that perpetrators of violence were mainly patients or their relatives and were caused by miscommunication or lack of supplies. During such incidents, they attempted to avoid the situation or sought help from colleagues, and seeking support and disengagement were crucial in coping with the crisis. Conclusion Nearly half the junior doctors experienced workplace violence. A positive work environment for junior doctors with measures to prevent workplace violence is needed. Effective coping mechanisms are crucial during and after a crisis to navigate the incident and its aftermath.
Khullar G, Verma P, Ganguly S
… +7 more, Rao PN, Nair PA, Tiwary AK, Roy S, Dhattarwal N, Revankar CR, Jha A
Natl Med J India
· 2026 · PMID 42325041
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Treatment of cutaneous tuberculosis (CTB) can be challenging due to multiple factors. We discuss the role of Bacillus Calmette Guérin vaccination in the prevention of CTB, complications associated with CTB, drug regimens...Treatment of cutaneous tuberculosis (CTB) can be challenging due to multiple factors. We discuss the role of Bacillus Calmette Guérin vaccination in the prevention of CTB, complications associated with CTB, drug regimens used for treatment in adults and children, various challenges in the management, including drug resistance, existing lacunae, and future directions in the diagnosis and treatment of CTB.
Ograk OE, Eksioglu M, Ozturk TC
… +1 more, Kaymak BA
Natl Med J India
· 2026 · PMID 42325038
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Background We aimed to evaluate the effects of yoga and guided meditation on stress, anxiety, and well-being in emergency medicine residents. Methods We randomly assigned 81 participants to yoga, guided meditation, or co...Background We aimed to evaluate the effects of yoga and guided meditation on stress, anxiety, and well-being in emergency medicine residents. Methods We randomly assigned 81 participants to yoga, guided meditation, or control using a single-level block randomization design. The yoga group attended Hatha yoga classes twice a week, the meditation group learned the technique with audio recordings for independent practice, while the control group received no training. Anxiety (Beck Anxiety Inventory), perceived stress (Perceived Stress Scale), and general well-being (Adult APGAR [Adult access, priorities, growth, assistance, respon-sibility]) were assessed at baseline, week 3, and week 6. Results Significant differences between groups were observed in anxiety scores at the end of 6 weeks (H:15.35, p<0.001). The control group had the highest mean (SD) anxiety score 20.63 (7.70). The yoga and meditation groups showed a significant difference in change in anxiety scores at week 6 (p=0.031). Both intervention groups showed a significant reduction in perceived stress levels compared to the control group (U:22.0, p<0.001; U:147.0, p<0.001) independently. For the APGAR score, the yoga group showed a significant increase from baseline compared to the control group (U:76.0, p<0.001). Conclusion Our study suggests that both regular yoga and guided meditation interventions are effective in reducing anxiety and stress levels while improving the well-being of emergency medicine residents. Signifi-cantly, the yoga group showed even greater improvement, underscoring the efficacy of this approach.
Parikh M, Bhagat P, Sutaria AH
… +5 more, Bharwad S, Vaja H, Banker A, Shah K, Goswami HM
Natl Med J India
· 2026 · PMID 42325034
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Background Introduction to medical research early in the undergraduate years contributes to building a robust foundation for students in their medical education. In India, due to the lack of a structured curriculum incor...Background Introduction to medical research early in the undergraduate years contributes to building a robust foundation for students in their medical education. In India, due to the lack of a structured curriculum incorporating research in medical under-graduation, a window opens for many unsuitable practices - predatory journals, unguided exposure to research, no checkpoint for unethical practices and reduced productivity of the student and the system alike and during the course of study, undergraduates tend to prioritize only their core subjects, with research not being acknowledged. Thus, practical applications to encourage early involvement in research during the initial stages need to be provided. Further, mentoring is a key element in professional growth, and functional mentoring is a pragmatic approach that produces measurable outcomes across several levels. Methods We designed a programme that incorporates a tangible outcome, using a functional mentorship model and experiential learning. We further evaluated the implementation of a structured, mentored clinical research programme targeting the undergraduate medical students at the institute. Results We present our experience with the first batch of this 4 month mentorship programme using the context, input, process and product model of evaluation. Conclusion Through this programme, we could create a drive for productive, ethical research at a grass root level and help students appreciate the symbiotic relationship between research and clinical care.
Natl Med J India
· 2026 · PMID 42325033
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Background Diabetic foot ulcers are an important problem for people with diabetes mellitus. We aimed to determine the mortality rate in patients with diabetic foot ulcers and assess the relationship between mortality, th...Background Diabetic foot ulcers are an important problem for people with diabetes mellitus. We aimed to determine the mortality rate in patients with diabetic foot ulcers and assess the relationship between mortality, the Wagner classification of diabetic foot, and biochemical parameters, such as glucose, haemoglobin A1c (HbA1c), and lipid profile. Methods We included patients with diabetic foot ulcers treated at a training and research hospital from April 2019 to June 2022. We compared patients who died during this period and those who were alive to determine the mortality rate and assess predictive factors for mortality. Results We included 170 patients in the study; their mortality rate was 29.4%. The Wagner classification did not reveal a statistically significant difference in mortality (p=0.334). However, a statistically significant association was found between mortality and the duration of diabetes (p=0.036), uric acid levels and creatinine values (p<0.05). Although the median HbA1c levels were higher in those who were alive compared with the deceased, this did not affect mortality. Conclusion The Wagner classification for diabetic foot ulcers did not show any correlation with mortality. Instead, blood glucose, creatinine, and aspartate aminotransferase values predicted mortality in people with diabetic foot.
Manolasya V, Prasanth P, Reddy BVR
… +3 more, Manasa CVS, Mohan A, Vishnubhotla S
Natl Med J India
· 2026 · PMID 42325031
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A 32-year-old male presented with a history of decreased urine output following an alleged history of deliberate self-harm by consuming glufosinate ammonium 13.5% w/w SL herbicide (Synkill®) two days earlier. General phy...A 32-year-old male presented with a history of decreased urine output following an alleged history of deliberate self-harm by consuming glufosinate ammonium 13.5% w/w SL herbicide (Synkill®) two days earlier. General physical examination revealed pulse 86 beats/minute, blood pressure 140/90 mmHg, and respiratory rate 20/minute. Laboratory investigations revealed elevated serum creatinine (5.96 mg/dl), creatinine phosphokinase (340 i.u./L), and elevated serum hepatic transaminases. On day 6 of hospitalization, he developed right-sided lower motor neuron facial palsy and was started on oral prednisolone. The following day, the weakness progressed, and bilateral lower motor neuron facial palsy developed. During the next few days, a descending type of flaccid paralysis developed, including involvement of respiratory muscles, requiring assisted mechanical ventilatory support. Magnetic resonance imaging (MRI) of the brain showed a normal study. The electroneuromyography test showed prolonged latency with reduced amplitude and conduction velocity. The sensorium of the patient also worsened with a Glasgow Coma Scale (GCS) of E1VTM1 by day 11 of hospital stay. A computed tomography scan of the brain done after a fall in GCS showed no abnormality of the brain parenchyma. The blood and urine samples sent for toxicological analysis revealed the presence of glufosinate in urine alone. The patient was discharged against medical advice from the hospital. Our patients highlights a very rare manifestation of glufosinate ammonium herbicide poisoning.
Kumar A, Sharma G, Singh A
… +5 more, Venkataraman S, Kumar U, Khan MA, Deepak KK, Bhatia R
Natl Med J India
· 2026 · PMID 42325028
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Background Fibromyalgia (FM) is a widespread chronic musculoskeletal pain condition which affects approximately 1%-2% of the world's population predominantly females (female:male ratio, 9:1). The most common symptoms inc...Background Fibromyalgia (FM) is a widespread chronic musculoskeletal pain condition which affects approximately 1%-2% of the world's population predominantly females (female:male ratio, 9:1). The most common symptoms include musculoskeletal pain at 18 paired tender points along with morning stiffness, brain fogging, sleep disturbances, anxiety, depression and fatigue. We studied explores the demographic and clinical characteristics of the Indian FM population. Methods We screened 118 FM patients, aged 18-65 years; with moderate to high pain scores. Demographic attributes such as age and body mass index (BMI); and clinical attributes such as pain, flexibility, tender point counts, origin and duration of pain along with its clinical manifestations were recorded and analyzed. Correlation analysis was also performed between the clinical parameters. Results The mean age, weight, height and BMI of the FM patients (n=107) were 35.9 (10.1) years, 62.3 (9.9) kg, 1.56 (0.08) m and 25.6 (3.9) kg/m2, respectively. Patients felt an average pain of 6.9 (0.9) on the Visual Analog Scale (VAS); that was distributed on 15.9 (2.4) mean tender point counts (TPCs) for an average duration of 7.3 (6.2) years. We found a significant correlation between VAS and TPCs. No correlation was seen between lumbar flexion, BMI and VAS. Conclusion Indian patients with FM have a wide range of demographic and social attributes which significantly affect their clinical outcomes. So, while planning treatment strategies especially in developing countries the demographic and socioeconomic characteristics should be considered before administering any treatment strategy.
Chakraborty S, Goyal M, Goyal P
… +1 more, Mishra P
Natl Med J India
· 2026 · PMID 42325027
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Background Some artificial intelligence models use heart rate variability (HRV) features to classify sleep stages. Estimation of HRV indices requires the removal of outliers and correction of ectopic beats from the elect...Background Some artificial intelligence models use heart rate variability (HRV) features to classify sleep stages. Estimation of HRV indices requires the removal of outliers and correction of ectopic beats from the electrocardiography (ECG) data. In addition, sleep epochs bear a temporal relationship to each other, while classifiers treat epochs as independent entities. To address this, we propose a bidirectional long short-term (BLSTM) architecture and a random forest classifier (RFC) for the classification of 5 sleep stages, using HRV features and sleep epoch index. Methods Polysomnography data of 645 subjects from the 'You Snooze You Win: The PhysioNet/Computing in Cardiology Challenge 2018' dataset were selected. ECG data were corrected for outliers and ectopic beats using linear interpolation. Time, frequency, and non-linear domains' HRV indices were determined and fed into the models. Results The RFC and BLSTM models obtained validation classification accuracy of 79.6 (1.6) and 74.70 (1.05), respectively, with RFC outperforming BLSTM. Further, the RFC model was validated with polysomnography data of 43 subjects from the Haaglanden Medisch Centrum dataset and obtained an accuracy of 78.9% with Cohen's kappa of 0.70 and macro F1 score of 0.789. We also demonstrated the importance of a proper pre-processing pipeline and incorporating the epoch index as a temporal feature for training the classification model. Conclusion Automated analysis of sleep data from diverse centres has potential to provide insights into population-wide sleep patterns and disease stratification, enabling targeted interventions and public health education.