International Journal of Medical Research & Review (IJMRR)
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Engaging the Next Generation: A Review of Youth-Focused Anti-Tobacco Awareness Campaign: In association with National Health Mission, National Tobacco Control Programme and National Oral Health Programme
No full textTobacco use, primarily through smoking / chewing , is one of the preventable morbidity and mortality factors worldwide. The combustion of tobacco releases thousands of chemical compounds, carcinogens and toxins, which initiate and promote systemic pathophysiological processes. The clinical manifestations are extensive, including a high burden of Cardiovascular diseases, a spectrum of Respiratory conditions and association with at least 17 different types of Cancer. Nicotine, the psychoactive component, causes a potent neurobiological dependence making it impossible to avoid smoking / chewing habit. Public health programs focused on effective cessation, a combination of behavioural counselling and pharmacotherapy, can substantially reduce the global health burden. This review provides the extensive evidence on the health consequences of tobacco consumption and exposure to environmental tobacco smoke.
The Ministry of Health and Family Welfare in collaboration with Ministry of Education, Ministry of Social Justice and Empowerment has launched the Tobacco Free Youth Campaign (TFYC) in 2023. The first campaign saw over 1.42 lakh educational institutions and 12,000 villages declared tobacco-free. TFYC 2.0 in 2024 expanded the reach to 1.67 lakh institutions and 27,000 villages. The ongoing TFYC 3.0 is a 60-day drive to prevent youth tobacco use and support cessation through six key strategies: Awareness generation, Enforcement of COTPA 2003 and PECA 2019, compliance with Tobacco-Free Educational Institution guidelines, Expansion of Tobacco-Free Villages, Social media engagement, and Capacity building. The campaign adopts a whole-of-government approach to inspire a healthier, tobacco-free young generation across India
Hypoalbuminemia as A Predictor of Adverse Outcomes in Exacerbation of Chronic Obstructive Pulmonary Disease – A Prospective Cohort Study
Full text linkBackground: COPD involves systemic inflammation, with exacerbations worsening health, increasing hospitalisations, and accelerating disease progression. Hypoalbuminemia, linked to inflammation and poor nutrition, reflects disease severity and is associated with worse clinical outcomes. This study assesses serum albumin as a cost-effective predictor of adverse outcomes during COPD exacerbation.
Materials and Methods: A 12-month prospective cohort study was conducted in the Department of Pulmonary Medicine, Government Medical College, Thiruvananthapuram, involving patients admitted with acute COPD exacerbations. Data included serum albumin, ABG, routine labs, oxygen/NIV needs, ICU admissions, hospital stay duration, and mortality. Patients were followed for 3 months post-discharge to assess exacerbation frequency.
Results: 108 patients were divided into two groups: Group 1 (hypoalbuminemia) and Group 2 (normal albumin), with 54 participants each. Hypoalbuminemia was significantly associated with low BMI, lower socioeconomic status, reduced FEV₁, increased ICU admissions, greater oxygen and NIV requirements, need for invasive ventilation, longer hospital stay, and a higher number of exacerbations both in the past year and within 3 months post-discharge. Additional analysis showed that frequent exacerbations were also associated with lower socioeconomic status, reduced FEV₁, oxygen and NIV requirements, ICU admission, and steroid use.
Conclusion: Serum albumin can be used as a useful predictor of adverse outcomes in the exacerbation of COPD
Challenges and Opportunities in Normothermic Liver Perfusion: A Standard Research Review from an Indian Perspective
Full text linkLiver transplantation is the only definitive treatment for end-stage liver disease and acute liver failure; however, the shortage of viable donor organs remains a critical challenge. Conventional static cold storage (SCS), while widely used, is associated with ischemia-reperfusion injury, leading to suboptimal graft function. Normothermic liver perfusion (NLP) has emerged as an advanced preservation technique that mimics physiological conditions, thereby reducing cellular injury, extending preservation times, and improving organ viability. Studies have demonstrated that NLP enhances graft recovery, facilitates viability assessment, and increases the utilization of marginal donor livers. Despite these advantages, the implementation of NLP in India is hindered by high costs, infrastructure limitations, and the need for specialized expertise. However, with increased investment in healthcare, research collaborations, and regulatory support, NLP could revolutionize liver transplantation in India by improving transplant outcomes and expanding the donor pool. This review explores the clinical benefits, challenges, and potential pathways for integrating NLP into India’s organ transplantation framework, highlighting the need for strategic policy interventions, cost-effective solutions, and workforce training to enable widespread adoption
Clinical and Ultrasonographic Correlates of Mastalgia: A Prospective Study from a Tertiary Hospital in Bangladesh
Full text linkBackground: Mastalgia is a common breast complaint that often prompts imaging evaluation despite a low likelihood of malignancy. Limited data exist on the clinical and ultrasonographic (USG) patterns of mastalgia in Bangladeshi women.
Objectives: To evaluate the clinical characteristics and USG findings among women presenting with breast pain at Popular Diagnostic Centre, Barishal, Bangladesh in 2024, and to explore associations between clinical features and imaging outcomes.
Methods: This prospective observational study enrolled 70 consecutive female patients presenting with breast pain. Bilateral breast USG was performed using standardized protocols. Of these 62 patients, valid USG data were available for 57, with findings categorized as normal, simple cyst, fibroadenoma, fibrocystic change, mastitis, or suspicious lesion (BI-RADS 4/5). Descriptive statistics summarized data, and Chi-square or Fisher’s Exact tests examined categorical associations. Independent t-tests compared continuous variables. Effect sizes (Cramer’s V, Cohen’s d) were calculated.
Results: Common associated symptoms included nipple discharge (27.3%) and swelling (25.5%). Across 57 patients with valid USG data, a total of 65 findings were recorded: normal scans (21.5%), simple cysts (21.5%), fibroadenomas (18.5%), fibrocystic changes (15.4%), mastitis (10.8%), and duct ectasia (4.6%). Suspicious lesions accounted for 7.7% of findings and were present in 8.8% of patients. No statistically significant associations were found between pain type and USG findings (χ² = 5.72, p = 0.455, Cramer’s V = 0.058) or between laterality and USG findings (Fisher’s exact p = 0.706, Cramer’s V = 0.033). The difference in mean age between cyclical and non-cyclical pain groups was not significant (t = –0.48, p = 0.636, Cohen’s d = –0.134).
Conclusion: In this cohort, most women with breast pain had benign USG findings, and no significant associations were observed between pain characteristics and imaging outcomes. USG remains a valuable, accessible, and reassuring first-line tool for evaluating mastalgia, particularly in younger and low-risk women, while maintaining vigilance for atypical presentations
A Case Report on Treatment of Pancreatoblastoma in a 55-year-old female: Treatment of Pancreatoblastoma
No full textBackground: Pancreatoblastoma is a rare, malignant tumor develops in the pancreas and is distinguished by lobular structures which contain acinar cells and squamoid corpuscles. The most common site was head of the pancreas and most common symptom is abdominal pain and vomiting.
Case Presentation: A 55-year-old female presented with complaints of abdominal pain and vomiting’s with vitals in normal range. However, her serum amylase and lipase levels were found to be elevated. A contrast-enhanced computed tomography (CECT) revealed a large exophytic mass lesion in her pancreas, measuring 6.5 x 9.3 x 8.5 cm and causes distortion of the SMV medially and stretching of the anterior superior pancreaticoduodenal vein. The main pancreatic duct is severely compressed. Our patient underwent a Whipple procedure and exhibited an unremarkable recovery.
Conclusion: Pancreatoblastoma is a curable tumor that requires early diagnosis through a multi-disciplinary approach. The tumor is removed completely by surgery and pathology; Immunohistochemistry confirms the diagnosis. Following surgery, the patient is closely monitored to look for any residual disease, metastases, or recurrences.
Keywords: Pancreatoblastoma, amylase, lipase, Whipple procedure, immuno histochemistr
Clinical Outcomes Of Patients On Non-Invasive Ventilation In Severe Exacerbation Of Chronic Obstructive Pulmonary Disease
Full text linkBackground: Acute exacerbations of chronic obstructive pulmonary disease (COPD) lead to worsening clinical outcomes. Non-invasive ventilation (NIV) is increasingly applied, reducing intubation rates, in-hospital mortality, and healthcare costs. This study evaluated the role of NIV in improving clinical outcomes during severe COPD exacerbations.
Objectives: To assess outcomes of NIV in severe COPD exacerbations, and to identify predictors of hospital mortality, need for intubation, NIV duration, and ICU stay.
Materials and Methods: A prospective cohort study was conducted in the Department of Pulmonary Medicine, Government Medical College, Thiruvananthapuram, over one year. Consecutively selected patients with severe COPD exacerbations admitted to ICU and initiated on NIV were analysed. Clinical outcomes, arterial blood gas (ABG) values, and hospital course were recorded.
Results: Among 85 patients, 65 were above 60 years, 68 were male, 42.4% had COPD for over 10 years, and 45.9% reported irregular drug intake. NIV failure requiring mechanical ventilation occurred in 11.8%, while in-hospital mortality was 2.4%. At 3-month follow-up, 75.9% had at least one exacerbation, and mortality was 30.1%. Predictors of NIV failure included low initial Glasgow Coma Scale, abnormal pH at baseline and subsequent intervals (4, 24, 48 hours), irregular drug adherence, and severe obstruction on pulmonary function testing.
Conclusion: NIV significantly reduced in-hospital mortality and ICU stay in severe COPD exacerbations. Early recognition of predictors of NIV failure is crucial for timely escalation to mechanical ventilation
Understanding Generation Z nursing students and Role of Nursing Faculty and Educators :A Narrative review
Full text linkThe nursing education landscape is undergoing a significant transformation due to generational shifts. A widening gap exists between Generation Y educators and Generation Z and Alpha students, impacting teaching methodologies and curriculum design. Students\u27 readily available access to online information contrasts sharply with educators\u27 past experiences of in-depth research. This necessitates a paradigm shift in teaching approaches to accommodate the unique learning styles and technological proficiency of younger generations. Understanding the sociocultural influences shaping Gen Z students\u27 worldviews, and embracing technology in the classroom, are crucial for effective nursing education and preparing the future nursing workforce. Faculty development focusing on technology integration is essential to bridge the generational divide and ensure successful student learning
Communication barriers encountered by the undergraduate nursing students and the newly admitted patients while interacting with each other in the tertiary care hospital of Bhopal
Full text linkIntroduction: Communication is a lifelong learning process. Clear communication means the information is conveyed effectively between people. As a part of training for nursing service, nursing students have to communicate with patients focusing on the patient\u27s needs and problems. Many nursing students face communication difficulties with their facilitators and patients during their clinical learning. This study aims to determine the communication barriers encountered by the undergraduate nursing students and the newly admitted patients in tertiary care hospital of Bhopal and to find out the association of the communication barriers with the selected socio- demographic variables. Methods: A descriptive, cross sectional study was conducted among 138 undergraduate nursing students and 73 newly admitted patients. The barriers were assessed with the help of a self structured questionnaire and the association was analyzed with frequency, percentage, distribution and fischer’s exact test. Results: Among nursing students, 68.8% reported moderate communication barriers, and 21% faced severe barriers. Among patients, 36% experienced moderate communication barriers and 24.7% of them faced severe communication barriers. This study also concludes that there is significant association between the level of communication barrier with the course and year of study of the undergraduate nursing students and with the highest level of education of the patients. Conclusion: Furthermore, it was also concluded that the most significant barrier among the nursing students and the admitted patients was psychological barrier with those patients who did not neither maintain eye contact nor show interest and with those nursing students who did not maintain a good eye contact nor let them express their ideas, respectively
Clinical and histopathological profile of patients with exudative pleural effusion of unknown cause who undergo medical thoracoscopy
No full textBackground: Exudative lymphocytic effusions form a significant proportion of undiagnosed pleural pathologies. This study explores the clinical and histopathological profile of exudative pleural effusion of unknown cause who undergo medical thoracoscopy.
Materials And Methods: This cross-sectional study enrolled 37 patients with exudative pleural effusion. Ultrasound-guided thoracentesis was conducted and samples were sent for pleural fluid cytology. Thoracoscopic pleural biopsy was kept as the gold standard.
Results: A total of 37 patients were included in the study. 14 (37.83%) were smokers. 19 (51.35%) were exposed to firewood smoke. Only 1 participant (2.7%) reported exposure to passive smoke.5 patients had STEMI/ recent CABG in the last 1 year.1 participant reported a history of Ayurvedic drug intake. There was no asbestos occupational exposure in any of our subjects but 5 of our subjects had mesothelioma. It can be related to an indirect exposure which is absent due to a recall bias. 2 participants reported a history of recent trauma or RTA, but it was unrelated to the final diagnosis. Histopathological profile showed adenocarcinoma in 19(51.35%), tuberculosis in 7(18.9%).Thoracoscopy pleural findings include nodules in 26(70.27%).
Conclusion: Our study concluded that pleural nodules on thoracoscopy were suggestive of malignant aetiology with good cytology yield. Pleural metastasis from lung adenocarcinoma has a good yield of cytology and is the most common cause of exudative pleural effusions that underwent medical thoracoscopy
Profile and Outcome of Fibrotic Interstitial Lung Diseases: A Prospective Cohort Study
Full text linkBackground: Interstitial lung disease (ILD) encompasses a range of disorders marked by lung inflammation and fibrosis. Progressive fibrosing ILDs (PF-ILDs) notably affect patient prognosis and quality of life. This study evaluates the clinical profile, outcomes, and progression risk factors in fibrotic ILD patients at a tertiary center in Kerala.
Methods: A prospective cohort study included patients over 18 years diagnosed with fibrotic ILD via high-resolution computed tomography (HRCT). Demographic, clinical, and radiological data were collected, with a 6-month follow-up assessing disease progression and adverse outcomes.
Results: The study included 78 patients, with a median age of 60 years; 55.1% were female. Dyspnea on exertion (97.4%) was the most common symptom, followed by cough (71.7%). HRCT findings revealed reticulations (98.7%), traction bronchiectasis (84.6%), and honeycombing (42.3%). Nonspecific interstitial pneumonia (NSIP) was the predominant pattern (60.3%), with connective tissue disease-associated ILD (CTD-ILD) being the most common diagnosis (38.5%). At 6 months, 34.6% of patients remained stable, while 65.4% experienced disease progression or mortality. Significant associations were found between age, smoking, firewood smoke exposure, and clinical outcomes, while vaccination correlated with better outcomes. Chest X-ray and HRCT findings, particularly UIP patterns, were linked to disease progression.
Conclusion: A substantial proportion of fibrotic ILD patients experience progression within six months. Key predictors include age, smoking, and specific HRCT findings. Recognizing these factors is crucial for improving management strategies in PF-ILD