International Journal of Research in Medical Sciences
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A retrospective drug utilization study in chemotherapy-induced nausea and vomiting
Full text linkBackground: Chemotherapy-induced nausea and vomiting (CINV) significantly impacts patients' quality of life. Despite advancements in therapy, optimal management of CINV remains crucial. This study evaluates drug utilization patterns in CINV management in patients attending the government cancer hospital, Chhatrapati Sambhajinagar (Maharashtra). Objective were to evaluate the drug utilization patterns in CINV management amongst cancer patients.
Methods: Retrospective, cross-sectional observational study in 242 cancer patients attending the outpatient department in a government cancer hospital, Chhatrapati Sambhajinagar. The prescriptions were taken from the record section after the necessary approval of IEC and permissions. Prescriptions were evaluated as per WHO drug prescribing indicators.
Results: The 484 drugs were prescribed for CINV in 242 patients. Most patients were aged between 51-60 years (31.82%), followed by 41-50 years (26.86%). All drugs are prescribed under generic names. Three classes of drugs were identified as monotherapy or combination therapy. 5-HT3 receptor antagonists and corticosteroids were the two most frequently used classes, followed by NK1 receptor antagonists. In prescribing patterns, dual combination regimens of 5-HT3 receptor antagonists and corticosteroids were the most common (99.17%), followed by triple combination and monotherapy (0.41% each). Out of the total, 483 (99.79%) drugs were given by parenteral route and 1 (0.21%) by oral route.
Conclusions: Following standard protocols for CINV was noted. The use of 5-HT3 receptor antagonists (Granisetron) and corticosteroids (dexamethasone) in combination was common, suggesting a pattern of adherence to guidelines and improving patient care
Comparison of aerobic training versus relaxation therapy on anxiety and depression in children with asthma: a pilot study
Full text linkBackground: Asthma in growing children affects their emotional, intellectual, and physical development. Aerobic training has been advised for asthmatics to increase fitness and cardio-respiratory endurance, decrease dyspnoea, and improve quality of life. However, studies regarding aerobic training and its effect on anxiety and depression in the paediatric population are limited. Psychological treatments can decrease emotional distress as a result of symptoms, but does not improve their physical capacity. Thus, the aim of our study was to study the effects of eight weeks of aerobic training versus Jacobson’s relaxation technique on anxiety and depression in asthmatic children with mild to moderate severity.
Methods: It was a single centre prospective comparative study. 45 asthmatic children satisfying the inclusion criteria were screened for anxiety and depression by using revised children's anxiety and depression scale (RCADS) scale. They were divided into 3 groups. Group A received diagrammatic breathing exercises, group B children received aerobic training, and group C received Jacobson’s relaxation. Pre- and post-8-week effects training effects were assessed.
Results: Study results showed there was a significant difference between aerobic and relaxation on anxiety score with p value of 0.004. There was no significant difference on depression score between aerobic and relaxation with p value of 0.086.
Conclusion: The study results showed that an aerobic training program reduces anxiety and depression levels in asthmatic children aged 6-11 years
Conservative surgical management of large bilateral mandibular odontogenic keratocyst: a case report and literature review
Full text linkOdontogenic keratocyst (OKC) have a been a controversial topic within the medical, research and taxonomy community. It is because of these controversies this requires our special attention. From a clinician’s view, its varied presentation and high recurrence rate makes it special. One possible explanation for such high recurrence is the presence of anti-apoptotic gene; BCL-2 in high concentration in the epithelial lining of OKCs. Even rarer is its presentation bilaterally, we present one such case of a young male. After facing multiple misdiagnosis and any significant improvement, he was finally diagnosed on the basis of biopsy and underwent serial marsupialization followed by enucleation. We present this case to stress on the fact that conservative surgical management by marsupialization under local anaesthesia itself is enough without the need of costly reconstruction in cases with unilocular cyst involving the mandible bilaterally with review of relevant literature.
Double column fixation for type C fractures of the distal humerus by precontoured bi-condylar plating in a 90-90 pattern
Full text linkIntroduction: Distal humerus fractures, particularly Type C fractures, present significant challenges in orthopaedic trauma management due to their complexity and the intricacies involved in surgical repair. This study aimed to assess double-column fixation for type C fractures of the distal humerus by pre-contoured bi-condylar plating in a 90-90 pattern.
Methods: This retrospective study was conducted in the Department of Orthopedics, Upazilla Health Complex, Munshigonj, Bangladesh, from January 2014 to January 2018. A total of 38 patients were evaluated based on set criteria. Functional outcomes were assessed using the Mayo Elbow Performance Score (MEPS) at six months. Data were analyzed using SPSS version 20.0, with descriptive statistics applied to demographics, surgical methods, and outcomes.
Result: This study of 38 patients with Type C distal humerus fractures found most were aged ≤47 (71.1%) and male (55.7%). C2 fractures were most common (65.8%). Time to surgery and hospital stay increased with fracture complexity. MEPS results showed 26.7% had excellent and 57.8% good outcomes. Complications included elbow stiffness (21.1%), arthritis (13.2%), heterotopic bone (10.5%), fixation failure (7.9%), and infection (5.3%).
Conclusion: Most patients had good to excellent outcomes based on MEPS. Though some experienced complications like stiffness and heterotopic ossification, overall results support the technique's effectiveness in restoring elbow function
A scintillating tale of the early stages of self-directed learning for future doctors in a growing medical college
Full text linkBackground: Self-directed learning (SDL) is a pivotal element in modern medical education, encouraging learners to take ownership of their learning process. In response to the National Medical Commission (NMC)'s mandate, this study aimed to assess the influence of SDL among preclinical and paraclinical students at AMCH (Arunai Medical College and Hospital) Tiruvannamalai, Tamilnadu, India.
Methods: Through mixed research methods, we evaluated the awareness of SDL, faculty perceptions, and student learning outcomes. The study involved the implementation of an innovative assessment tool, AMAI (Arunai Metacognitive Assessment Instrument), to track progress in the SDL process and eliminate bias.
Results: The study revealed increased student engagement, reflective practices, and improvements in analytical thinking at the metacognitive level. The AMAI assessment tool played a crucial role in ensuring consistency and tracking student development.
Conclusions: This research highlights the effectiveness of SDL in medical education, demonstrating its impact on student performance and faculty involvement. The AMAI tool serves as a structured framework for evaluating SDL implementation
A cross-sectional analytical survey on ACL depressive syndrome at a tertiary care hospital
Full text linkBackground: One of the most prevalent and incapacitating injuries affecting active people is an anterior cruciate ligament (ACL) injury. There is evidence of the physical effects of ACL injuries, but there is now growing evidence of the psychological toll, which is referred to as ACL depressive syndrome. The purpose was to evaluate the relationship between pain functional activities (WOMAC) and depression and overall health in individuals with ACL injuries.
Methods: 50 Patients diagnosed with ACL injury, aged 15-45, were screened who fulfilled the inclusion criteria and were enrolled in the study after giving consent to the Department of Orthopaedics. The patients were asked questions related to their activities of daily life and mental health, including depression.
Results: The study found a statistically significant moderate positive correlation between WOMAC scores and the Pain subdomain of the SF-36 (R=0.30, p=0.034). All other correlations, including WOMAC with PHQ-9 and other SF-36 dimensions, were weak and not statistically significant.
Conclusions: The study indicates substantial differences in emotional (p=0.03) and general health (p=0.00) as critical emphasis areas, whereas other indicators had a minor effect on quality of life
Knowledge, attitude and practice regarding human papillomavirus vaccination among medical students
Full text linkBackground: Cervical cancer is a leading cause of cancer-related deaths among women, especially in developing countries like India. Human papillomavirus (HPV) types 16 and 18 are primary causative agents, and the HPV vaccine is a key preventive tool. However, uptake remains low due to limited awareness, safety concerns, and cultural misconceptions. This study aimed to evaluate knowledge, attitudes, and practices (KAP) regarding HPV vaccination among medical students and to identify barriers and facilitators to vaccine uptake.
Methods: A cross-sectional study was carried out at a tertiary care teaching hospital in Amritsar India. Undergraduate students aged 18-22 years, from 1st, 2nd, 3rd and 4th year professional MBBS students were included in the study.
Results: Out of 300 participants, 229 (76.33%) were aware of the HPV vaccine, while only 21 (7%) had received it. Common barriers included limited access, concerns over safety and efficacy, and cost. Demographic factors like age, gender, maternal education, and family history of malignancy showed no significant association with knowledge levels. A majority expressed willingness to get vaccinated in the future.
Conclusions: Medical students in India demonstrate moderate knowledge of HPV vaccination. Improving education on vaccine safety and efficacy, incorporating it into the curriculum, increasing awareness programs, reducing costs, and introducing supportive government policies may enhance vaccine acceptance
Prediction of post-surgical complications in hand reconstruction using machine learning
Full text linkBackground: Hand reconstruction is a complex surgical procedure in which various postoperative complications may arise, such as infections, flap necrosis, and joint stiffness. The prediction of these complications has traditionally relied on the surgeon’s experience and conventional clinical models. However, artificial intelligence (AI), particularly machine learning, has proven to be an effective tool for analyzing large volumes of clinical data and enhancing predictive capabilities in various medical fields.
Methods: A retrospective study was conducted with a sample of 200 patients who underwent hand reconstruction, using exclusively clinical record data. Three machine learning models were evaluated: XGBoost, Random Forest, and an artificial neural network. A data preprocessing pipeline, feature selection, and cross-validation were applied to optimize model performance. Predictive capability was assessed using the ROC curve and the area under the curve (AUC).
Results: XGBoost achieved the best performance with an AUC of 0.88, followed by Random Forest (AUC = 0.88) and the artificial neural network (AUC = 0.86). The most relevant variables for predicting complications included patient age, comorbidities such as diabetes mellitus, type of injury, and surgery duration.
Conclusions: AI models proved to be useful tools for predicting postoperative complications in hand reconstruction, surpassing the accuracy of conventional methods. In particular, XGBoost demonstrated the highest predictive capacity. These findings suggest that machine learning could optimize surgical planning and clinical decision-making, although further studies are needed to validate its applicability across different populations
Heart failure with reduced ejection fraction: differences between atrial fibrillation and sinus rhythm
Full text linkBackground: Atrial fibrillation (AF) is a common comorbidity in heart failure with reduced ejection fraction (HFrEF), with prevalence ranging from 10% to 60%. While AF is generally associated with increased mortality in HF, its impact on HFrEF outcomes remains uncertain. This study evaluates clinical, laboratory and echocardiographic differences between HFrEF patients with and without AF.
Methods: This study included 91 patients (Left ventricular ejection fraction<50%) admitted to Grodno State Cardiological Centre from January to November 2024. Patients were divided into two groups: 57 (63%) with AF (paroxysmal or persistent) and 34 (37%) with sinus rhythm (SR). Clinical, laboratory and echocardiographic data were analysed using STATISTICA 12.0.
Results: AF patients had higher BMI (p=0.005) and obesity prevalence (62% vs 26%, p=0.001). Hypertension and diabetes rates were similar, but SR patients had more stable angina (53% vs 34%, p=0.03) and prior myocardial infarction (44% vs 26%, p=0.048). AF patients showed worse renal function (higher urea, creatinine and lower eGFR). Echocardiography revealed larger left (p=0.03) and right atria (p=0.017) in AF, while SR patients had a higher contractility index (p=0.032).
Conclusions: HFrEF patients with SR more often had ischemic cardiomyopathy, while those with AF had a dilated or mixed origin, as reflected in atrial size and contractility differences
Maternal and fetal outcome in pregnancy associated with malignancy: a case series at a tertiary care centre in India
Full text linkMalignancy in pregnancy is rare presentation with an estimated incidence of 1 per 1000. Pregnancy with malignancy poses a unique challenge for treating physician because of the safety concerns for the unborn child. The aim of the study was describing the maternal and infant outcomes of malignancy in pregnancy and to describe the various treatment options according to tumour type and gestational age. A prospective observational study was done at tertiary care centre for 6 months from December 2020 to June 2021. A case series of pregnancy associated malignancy were observed and followed up till postpartum period. Three cases were of ovarian tumors with good maternal and fetal outcomes as they were in early stages of the disease. Fourth case was of metastatic lung carcinoma with adverse maternal outcome due to advanced malignancy. The conclusion was that a multidisciplinary approach of obstetrician, pathologist, radiologist, oncologist, onco-surgeon, neonatologist is necessary in managing these cases. The treatment strategy should be discussed and structured on an individual basis. A combined approach of surgery and chemotherapy is advocated depending on the stage of the disease and gestation. Neonatal outcomes like prematurity, low birth weight are anticipated and good overall maternal and fetal outcome can be achieved