International Journal of Research in Medical Sciences
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A study to identify the risk factors associated with infertility among women attending infertility clinics
Full text linkBackground: Infertility is not a newly emerging issue; it has its crux from the olden days. It is a preexisting problem and a threat to the social integration of families. The impact of this problem contributes a lot to the disharmony among young couples.
Methods: Present study is a quantitative approach and descriptive design. It consists of the demographic variables, gynecological factors, psychological factors, lifestyle factors, physical measures, diagnosed cause of infertility and hormonal values.
Results: A total of 400 women participated in the study, in that 100 cases randomly selected. It was observed that women with infertility (76%) were within the age group of 21-30 years of age, (85%) of them had a primary education and (89%) of them were home makers (77%) them were living in a nuclear family, Hindus (77%) and also reside at urban region (52%). Experience marital conflicts (70%) It was inferred that a higher proportion of women (93%) are non-vegetarians, more than half them (63%) have a meal pattern of 2 meals,
Conclusions: The study concluded that irregular menstrual cycle, marital and familial conflicts, overweight, more of non-vegetarian foods, lack of exercise etc. were some common risk factors associated with infertility. The study thus also had a conclusion that with certain awareness on the modifiable factors and ways to modify them will always contribute towards betterment of women’s health in terms of fertility
Evaluation of myotoxicity and neuropathy in hemotoxic snake bite envenomation in a tertiary care center
Full text linkBackground: Snakebite is a significant health problem in India, particularly in rural areas. Hemotoxic snakebites can cause myotoxicity, leading to acute kidney injury and other complications due to extensive muscle injury. This study aimed to investigate the clinical severity of myotoxicity in hemotoxic snakebite patients and its effect on AKI.
Methods: A prospective observational study was conducted among 50 patients with hemotoxic snakebite admitted to a tertiary care center in Odisha. Clinical manifestations, serum creatine phosphokinase levels and nerve conduction studies were evaluated.
Results: The majority of patients were males (74%) in the 30-39 age group. Russell's viper was the most common species responsible for envenoming (60%). Elevated serum CPK levels were found in 80% of patients, indicating muscle damage. Local necrosis was associated with significantly higher mean CPK levels (555.78±353.51 U/l). AKI was observed in 46% of patients, with serum creatinine levels correlating with AKI severity. Nerve conduction studies revealed abnormalities in two-thirds of cases, including axonal neuropathy and motor-sensory deficits.
Conclusions: Myotoxicity is a significant complication of hemotoxic snakebite, contributing to AKI and other systemic manifestations. Serum CPK levels may serve as a useful biomarker for predicting tissue damage severity. Early identification, continuous monitoring and supportive care are crucial in managing snakebite victims. Further research is needed to validate these findings and refine the use of serum CPK in clinical decision-making
The role of primary health care collaborative care models in mental health management: a narrative review
Full text linkCollaborative care models (CCMs), which embed behavioral-health screening, care management, and psychiatric consultation in routine primary-care workflows, consistently outperform usual care. A narrative synthesis of randomized trials, systematic reviews, implementation studies, and policy documents published from January 2010 to April 2024 shows that CCMs reduce depression and anxiety symptoms, boost remission and adherence, and raise patient satisfaction. Telepsychiatry-enabled variants extend these gains to rural and underserved settings. Economic analyses reveal lower total costs driven by fewer hospitalizations and emergency visits. Persistent barriers, fragmented reimbursement, incompatible IT systems, workforce shortages, and stigma limit scale-up. Targeted policy reforms, integrated health-IT, and expanded training are therefore essential to realize CCMs’ full potential in primary care
Primary immune complex membranoproliferative glomerulonephritis and C3 glomerulonephritis: experience of two rare diseases from a single centre
Full text linkBackground: This study has been conducted to evaluate and compare the clinicopathological profile and treatment outcome of primary immune complex membranoproliferative glomerulonephritis (IC-MPGN) and C3 glomerulonephritis (C3 GN), two rare glomerular diseases and to find any predictive factors for renal and patient outcome.
Methods: A retrospective observational cross-sectional study, conducted at a tertiary care hospital. Patients with biopsy-proven MPGN were included after satisfying the inclusion and exclusion criteria. Detailed history, clinical examinations, laboratory investigations and kidney biopsy were noted. Outcome was recorded at months 3, 6, 12 and at the last available follow-up.
Results: Of the 24 subjects enrolled, 11 (45.8%) had primary IC-MPGN and 13 (54.2%) had C3 GN. Nephrotic syndrome is the prevalent presentation. No statistically significant difference was found in respect to clinical and biochemical parameters between two groups. Complement mediated group had more crescent and features of chronicity in renal biopsy. Renal and patient outcome was significantly better in immune mediated group compared to complement mediated group (log rank p=0.015); including complete remission (p=0.003), proteinuria reduction at 3 months (p=0.009), at the last known follow-up (p=0.005). During follow up, hematuria, higher serum creatinine and low median serum albumin were significantly more common in complement mediated group. No significant predictors were found for renal outcome and outcome was not influenced by treatment modality.
Conclusions: IC-MPGN and C3 GN are rare glomerular diseases. Although phenotypically similar, C3 GN showed poor outcome. Further multicentric study may help to better understand these diseases to find cost effective treatment
Comparative study between sequential chemoradiotherapy with concurrent chemoradiotherapy for unresectable locally advanced esophageal cancer
Full text linkBackground: Esophageal squamous cell carcinoma (ESCC) is a prevalent malignancy in South Asia with a high burden of unresectable cases at presentation. Chemoradiotherapy remains the mainstay of treatment, with concurrent chemoradiotherapy (CCRT) offering improved tumor control but at the cost of higher toxicity. The study aimed to compare the clinical efficacy and treatment-related toxicities of sequential chemoradiotherapy (SCRT) versus concurrent chemoradiotherapy (CCRT) in patients with unresectable locally advanced ESCC.
Methods: This quasi-experimental study was conducted at Khwaja Yunus Ali Medical College and Hospital, Sirajganj, from January 2020 to June 2021. A total of 62 patients with histologically confirmed unresectable ESCC were randomly assigned to two groups: Arm A (CCRT) and Arm B (SCRT), with 31 patients in each group.
Results: The baseline characteristics were comparable between the two arms. At 24 weeks, complete response rates were slightly higher in Arm A (51.61%) than in Arm B (41.93%), though not statistically significant (p>0.05). Toxicity analysis revealed a significantly higher incidence of Grade III esophagitis in the CCRT group (22.58% vs 3.23%; p=0.001). Hematologic and late radiation-related toxicities were also more frequent in Arm A. Weight loss and need for nutritional support (e.g., NG tube) were more common in the CCRT group, although not statistically significant.
Conclusions: While both treatment strategies showed similar tumor response rates, SCRT was associated with a more favorable toxicity profile. Thus, SCRT may serve as an effective and safer alternative for patients with unresectable locally advanced ESCC, especially in resource-constrained settings or among patients with borderline performance status
PD-1 expression on peripheral blood CD4+ T lymphocytes in treatment-naïve HNSCC patients: a flow cytometry analysis
Full text linkBackground: Head and neck squamous cell carcinoma (HNSCC) is a globally prevalent malignancy with a high burden in India. Programmed death protein-1 (PD-1), an immune checkpoint receptor, is a potential biomarker in several cancers. However, its prognostic relevance on circulating CD4+ T cells in HNSCC remains uncertain. To evaluate PD-1 expression on peripheral blood CD4+ T lymphocytes in treatment-naïve HNSCC patients and determine its association with clinicopathological features.
Methods: This prospective, cross-sectional study included 32 histopathologically confirmed, treatment-naïve HNSCC patients at a tertiary care center over 18 months. Peripheral blood mononuclear cells were analyzed using flow cytometry (Cytomics FC 500, Beckman Coulter) with antibodies against CD3, CD4 and PD-1 (CD279). PD-1 expression was quantified on gated CD4+ T cells. Statistical analysis was performed using SPSS v25.0, with significance set at p<0.05.
Results: The mean age was 49.94±10.5 years; all patients were male. The most common tumor sites were palate (40.63%), tongue (31.25%) and oral mucosa (28.13%). The mean PD-1 expression on CD4+ T lymphocytes was 5.51±2.06%. PD-1 expression showed no statistically significant association with tumor site (p=0.843), histological differentiation (p=0.363), lymph node metastasis (p=0.930) or tumor stage (p=0.930).
Conclusions: PD-1 expression on peripheral CD4+ T cells does not correlate with tumor site, grade, stage or metastatic status in HNSCC patients. While flow cytometric quantification of PD-1 may offer non-invasive insights, its standalone utility as a prognostic marker in peripheral blood appears limited. Larger studies incorporating tumor microenvironment analysis and longitudinal follow-up are warranted
Extracorporeal shockwave therapy for tendinopathies: a comprehensive literature review
Full text linkTendinopathies, including Achilles, patellar, lateral epicondylitis, and plantar fasciitis, are chronic musculoskeletal disorders with limited responsiveness to conventional therapies. Extracorporeal shockwave therapy (ESWT), a non-invasive intervention, has emerged as a promising modality targeting both symptomatic relief and structural regeneration. To synthesize high-level evidence on the efficacy and mechanisms of ESWT in managing tendinopathies, emphasizing randomized controlled trials (RCTs), treatment protocols, patient outcomes, and methodological quality. Following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, a comprehensive search of four databases was conducted for English-language RCTs published between 2000 to 2024. Inclusion criteria focused on ESWT interventions for tendinopathies with reported clinical outcomes. Quality was assessed using the PEDro scale and Cochrane Risk of Bias 2.0 tool. Four RCTs involving 432 participants were included, addressing plantar fasciitis, Achilles tendinopathy, lateral epicondylitis, and patellar tendinopathy. ESWT demonstrated significant reductions in pain (VAS), improved functional scores (VISA-A, RM, AOFAS), and structural recovery. Focused ESWT showed deeper penetration and neovascularization benefits, while radial ESWT was more effective for superficial lesions. Variability in energy flux densities and session protocols influenced therapeutic response. PEDro scores ranged from 6 to 9, with low-to-moderate risk of bias. ESWT offers effective, non-invasive treatment for various tendinopathies, especially when conventional options fall short. Future research should emphasize protocol standardization, long-term outcome evaluation, and comparative efficacy with other regenerative modalities.
Emergency department visits by older adults in India: a comprehensive review
Full text linkIndia's aging population is rapidly growing, necessitating urgent attention to the healthcare needs of older adults (≥60 years). Emergency departments (EDs) often serve as the primary access point for acute care, accommodating both critical emergencies and preventable, non-urgent visits. This comprehensive review examines the contributing factors to ED utilization by older adults in India, highlighting acute exacerbations of chronic illnesses, gaps in outpatient services, and social determinants of health. It also explores systemic challenges, including ED overcrowding and the lack of geriatric-specific services, and draws insights from international studies to contextualize these issues. Recommendations include strengthening primary care, leveraging telemedicine, establishing geriatric emergency departments (GEDs), and implementing policy reforms to optimize healthcare delivery for older adults. Addressing these challenges can improve healthcare outcomes, alleviate ED overcrowding, and ensure age-sensitive care for India’s growing elderly population
Post-pandemic assessment of knowledge, attitude and practices of healthcare professionals regarding telemedicine: a pilot study
Full text linkBackground: The COVID-19 pandemic has accelerated the adoption of telemedicine as an alternative method of healthcare delivery, enabling patient care while minimising physical contact. In India, its use is growing, yet understanding healthcare professionals’ perspectives remains essential for effective integration.
Methods: A cross-sectional survey was conducted among healthcare professionals working in India. Data were collected using an online questionnaire comprising 15 structured, self-administered, and closed-ended questions. The survey captured demographic details such as age, gender, and profession. Responses were tabulated and manually analysed to assess knowledge, attitudes, and practices regarding telemedicine.
Results: Most participants (86.23%, n=238) reported being familiar with the concept of telemedicine, including knowledge of relevant applications, platforms, and professional training. A large majority (84.43%, n=233) agreed that telemedicine could reduce patient travel costs, thereby improving accessibility to healthcare services.
Conclusion: The study indicates that telemedicine is perceived positively by healthcare professionals in India and has strong potential as a complementary tool in healthcare delivery. Its integration could enhance access, reduce costs, and improve patient convenience, particularly in underserved areas
Facial reconstruction following basal cell carcinoma: repair using a paramedian forehead flap-a case report
Full text linkBasal cell carcinoma (BCC) is the most common malignant cutaneous neoplasm, primarily affecting sun-exposed areas, with the nasal region being one of the most frequently involved sites. Here this report presents the case of a 68-year-old male presenting with an ulcerated lesion on the nasal tip, clinically consistent with nodular ulcerative BCC. A wide local excision was performed, and intraoperative frozen section analysis confirmed tumor-free margins. Reconstruction of the resulting full-thickness nasal defect was accomplished using a two-stage interpolated paramedian forehead flap. The postoperative course was uneventful, yielding an outcome that was both aesthetically satisfactory and functionally robust, with no evidence of recurrence during short-term follow-up. This case highlights the importance of meticulous oncologic resection and tailored reconstructive planning in managing complex nasal defects caused by skin cancer