International Journal of Research in Medical Sciences
Not a member yet
9900 research outputs found
Sort by
Cannabis-induced cardiac arrhythmias: mechanistic insights, epidemiologic patterns, and clinical implications
Get PDFAs legalization and therapeutic interest expand, the global use of cannabis has significantly increased. Nonetheless, its cardiovascular impacts-particularly the risk of heart arrhythmias-are still not well acknowledged. Recent findings suggest that cannabis, especially its psychoactive element Δ9-tetrahydrocannabinol (THC), could have a mechanistic influence in triggering both atrial and ventricular dysrhythmias. A narrative review was performed utilizing pertinent literature released from January 2000 to May 2024. Databases explored encompassed PubMed, Scopus, and Web of Science. Studies were chosen for their relevance to cannabis-related arrhythmias, encompassing experimental, observational, and clinical findings. Focus was directed towards mechanistic understanding, epidemiological patterns, and clinical results. Cannabis use has been linked to a range of arrhythmias, from harmless palpitations to severe ventricular tachyarrhythmias and sudden cardiac arrest. THC affects cardiomyocyte ion channels, extends repolarization, and modifies autonomic control, establishing a basis for arrhythmogenesis. Long-term exposure could lead to myocardial fibrosis and oxidative stress. Increased risk is observed in young adults, regular users, and those with psychiatric or pre-existing heart issues. Even with these results, awareness and screening continue to be restricted in regular clinical practice. Cannabis presents a clinically important yet overlooked danger for cardiac arrhythmias. Healthcare professionals ought to take into account recent cannabis consumption in patients who show unexplained arrhythmias. There is a critical requirement for longitudinal research and revised clinical guidelines to guide risk evaluation, patient education, and monitoring approaches.
Study of etiologies of postmenopausal bleeding by cytology and histopathological examination
Get PDFBackground: Postmenopausal bleeding (PMB) is a common gynecologic complaint with a wide range of benign and malignant etiologies. While atrophic changes are the most frequent benign causes, PMB may also be the earliest sign of gynecological malignancies such as cervical and endometrial cancer, particularly in low-resource settings where screening uptake is low. Aim lies to determine the etiologies of PMB using cytological and histopathological evaluation and identify the most common associated factors, particularly those indicating malignant potential.
Methods: A hospital-based cross-sectional study was conducted at Rajendra institute of medical sciences (RIMS), Ranchi, from April 2021 to August 2022. A total of 76 postmenopausal women presenting with vaginal bleeding were included. Detailed histories, clinical examinations, pap smear, transvaginal ultrasonography (TVS), and endometrial or cervical biopsies were performed. Histopathological findings were considered the definitive diagnosis. Data were analyzed using SPSS version 23.0, and associations were tested using chi square test and odds ratios (ORs) with 95% confidence intervals (CIs); a p<0.05 was considered significant.
Results: The most common age group affected was 51-60 years (47.4%). Histopathological diagnoses revealed cervical cancer in 30.3% of cases, followed by atrophic endometrium (23.7%), cervical intraepithelial neoplasia (CIN) (23.7%), endometrial hyperplasia (10.5%), and endometrial cancer (6.6%). A significant association was found between low socioeconomic status and cervical cancer (p=0.03, OR=4.33). Early childbirth (≤19 years) was significantly associated with CIN (p=0.03, OR=3.14). Parity of 0-4 was associated with endometrial hyperplasia (p=0.03). Pap smear results correlated well with histopathological findings in high-grade lesions and malignancies.
Conclusions: Cervical cancer remains the leading malignant cause of PMB, especially among women of low socioeconomic background. Atrophy and endometrial hyperplasia are significant benign causes. Cytology and histopathological examination remain essential tools for evaluating PMB, particularly in resource-limited settings.
Post-traumatic stress disorder following implantable cardioverter defibrillator shocks: a hidden cost of life-saving therapy
Get PDFAlthough implantable cardioverter-defibrillators (ICDs) play a critical role in preventing sudden cardiac death, the very shocks that preserve life can paradoxically become a source of long-term psychological harm. PTSD following ICD shocks remains an underrecognized diagnosis, despite mounting evidence linking it to declines in mental health, quality of life, and even cardiovascular prognosis itself. Patients may experience intrusive re-experiencing of trauma, persistent hypervigilance, avoidance behaviors, and anticipatory anxiety: symptoms that not only disrupt daily functioning but can also interfere with treatment adherence and long-term treatment outcomes. A review was conducted of literature published between January 2008 and May 2024 using PubMed, Scopus, and Web of Science databases. Emphasis was placed on patient-reported outcomes, intervention efficacy, and gaps in clinical practice. ICD shocks, particularly when inappropriate or clustered, have been linked to clinically significant PTSD symptoms in as many as 38% of recipients. Proposed mechanisms span heightened sympathetic arousal, maladaptive fear conditioning, and neurobiological changes involving key limbic structures. Risk appears to be elevated among younger patients, women, individuals with preexisting trauma histories, and those with comorbid anxiety or depressive disorders. Validated tools like the PCL-5 and Florida shock anxiety scale (FSAS) offer practical means of detecting distress, and growing evidence supports the benefit of interventions such as trauma-focused cognitive-behavioral therapy, SSRIs, EMDR, and tailored device programming. Routine screening, shock-minimization strategies, and integration of psychological services into device clinics are essential. Future studies should address long-term outcomes, standardized interventions, and guideline development for multidisciplinary management
Evaluation and treatment of post-renal transplant cytomegalovirus disease in children
Get PDFCytomegalovirus (CMV) infection typically presents as viremia, a clinical syndrome, or tissue-invasive disease. Identifying risk factors and conducting initial blood investigations, followed by invasive tests when appropriate, are crucial steps to rule out serious tissue-invasive disease. Ganciclovir is the cornerstone of CMV disease treatment, with oral valganciclovir used subsequently based on treatment response. For patients with UL-97 mutant ganciclovir-resistant CMV, foscarnet may be administered, often alongside intravenous immunoglobulin (IVIG), particularly in cases of life-threatening conditions such as CMV pneumonitis. Despite the significance of CMV in this population, there is currently a lack of comprehensive clinical reviews or guidelines specifically addressing the management of post-renal transplant CMV disease in children. This article aims to fill that gap by discussing the various modalities for treating post-renal transplant CMV in children, along with its clinical manifestations and necessary investigations
Metal toxicity and its correlation with endoplasmic reticulum stress, mitochondria functioning and gene expression analysis in occupationally exposed workers
Get PDFBackground: Owing to the widespread presence of lead in the environment the possibility of endogenous exposure remains a serious health hazard. Lead enters in the body through inhalation and ingestion and adversely affects cells and targets the cell organelles.
Methods: Aim of this study was to examine the correlation of lead toxicity with the gene expression of endoplasmic reticulum (ER) (GRP78 and PERK), mitochondrial functioning (PINK1 and PARK7), apoptosis (Pro apoptosis (BAX and p53) and anti-apoptosis (Bcl-2 and c-Myc)) in occupationally exposed painters and battery workers compared with age matched control subjects. Lead levels were measured in the whole blood by using inductively coupled plasma mass spectrometry (ICP-MS) that allow very low-level detection limit of the elements. Gene expression analysis was performed by quantitative real time PCR (qPCR).
Results: Results of the study showed that the lead levels were significantly high in the painters and battery workers when compared with controls (41.37±20.71 µg/dl, 56.25±17.66 µg/dl and 6.55±2.02 µg/dl, respectively, p<0.001). Results of the gene expression analysis of ER stress, mitochondrial functioning and pro-apoptotic genes like GRP78, PERK, PINK1, PARK7, Bax and p53 were found significantly up-regulated in painters and battery workers, respectively. The Anti-apoptotic genes like Bcl-2 and c-Myc were found significantly down regulated in painters and battery workers.
Conclusions: Results of the study showed that increased level of Lead alter the gene expression of ER, mitochondrial functioning and apoptosis in occupationally exposed painters and battery workers
The interplay between cognitive impairment and mental health in women with PCOS: a systematic review
Get PDFPolycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. While its physical symptoms such as irregular menstruation, acne and infertility receive considerable attention, the cognitive and psychological burdens associated with PCOS often go unnoticed. This study conducted a systematic narrative review to synthesize the existing literature on the cognitive and mental health implications of PCOS. A comprehensive search across PubMed, Scopus and Web of Science was performed for studies published between 2015 and 2025. Using PRISMA guidelines, we identified 52 initial records, from which 12 high-quality studies were included. Both subjective tools (like psychological inventories) and objective assessments (e.g., MoCA, EEG, ERP) were analyzed to understand the interplay between PCOS and cognitive or emotional well-being. Findings revealed consistent patterns of cognitive impairments in attention, memory and executive functioning among women with PCOS. Neurophysiological data, such as reduced P300 amplitudes and abnormal EEG rhythms, supported these clinical symptoms. Simultaneously, a high prevalence of anxiety (up to 42%) and depression (around 37%) was reported, often aggravated by body image issues, infertility and sociocultural stigma. Notably, cognitive decline and psychological distress appeared interlinked, forming a feedback loop that intensifies suffering over time. A person's emotional and mental well-being are intricately related to polycystic ovary syndrome (PCOS). A multidisciplinary strategy is urgently needed to treat polycystic ovary syndrome (PCOS), which includes cognitive screening and psychological assistance as part of standard treatment
HbA1c test awareness, sociodemographic characteristics and lifestyle behaviour among type 2 diabetes mellitus patients
Get PDFBackground: Glycated hemoglobin (HbA1c) is a key biomarker for long-term glycemic control. The studies have shown that patients having an understanding of HbA1c values in diabetic patients is associated with better glycemic control and self-care practices. This study aims to assess HbA1c test awareness among type 2 diabetes mellitus (T2DM) patients and examine its association with sociodemographic and lifestyle factors.
Methods: This cross-sectional study was conducted among 230 type 2 diabetes mellitus patients using purposive sampling and the participants were recruited from outpatient and laboratory department of a hospital in Mangaluru, Karnataka, India. Awareness of HbA1c test was assessed using a structured questionnaire and analyzed in relation to demographic and lifestyle variables. Chi-square test were used for the analysis of data using statistical package for the social sciences (SPSS) software, and p<0.05 was considered statistically significant.
Results: Out of 230 participants, 56.5% were male and 43.5% were aged 50–69 years. Only a minority of participants (16.1%) were aware of the HbA1c test. The HbA1c test awareness was not significantly associated with age, gender, education, employment, income, smoking, alcohol use, medication adherence, or diet adherence.
Conclusions: Awareness of HbA1c test among T2DM patients was limited. Structured patient education and counseling programs focusing on HbA1c monitoring may empower patients to achieve better glycemic control and reduce the risk of diabetes-related complications
Evaluation of causes of acute onset paraparesis in a tertiary care centre in South India
Get PDFBackground: Paraparesis is a complex condition that presents with unique challenges and people living with paraparesis can lead fulfilling lives with the right support and rehabilitation. This study aimed to determine the causes of acute onset paraparesis presenting to emergency department.
Methods: A hospital-based cross-sectional study done for a period of 12 months in 90 people attending a tertiary care hospital in Siddipet, Telangana. Patients aged less than 14 years, pregnant and lactating mothers and patients who were not willing to participate in the study were excluded. Preliminary data was recorded, followed by clinical examination and necessary relevant laboratory and radiological investigations were done.
Results: After complete evaluation, 33% of the people were found to have hypokalemic periodic paralysis, 30% were having Guillain Barre syndrome, 4% people were diagnosed with traumatic vertebral fractures and 3% of the people were found to have polymyositis. Rest of the people were having extramedullary Tumors, intervertebral disc prolapses, cauda equina syndrome, conus medullaris, paraneoplastic syndromes, neuromyelitis optica, transverse myelitis and multiple sclerosis.
Conclusions: Acute onset paraparesis must be evaluated swiftly starting with metabolic abnormalities which seem to be the most commonly encountered cause followed by imaging modalities, keeping in mind a few conditions related to spinal cord. Early detection and treatment are important to avoid grave consequences. It is imperative that atraumatic causes must also be taken into account besides the traumatic etiology, as there can be a significant improvement in their quality of life with timely medical attention and prompt treatment
Integration of artificial intelligence and robotics in rehabilitation therapy: enhancing motor recovery after injury or stroke
Get PDFBackground: Artificial intelligence (AI) and robots are revolutionizing healthcare by delivering intelligent, adaptable, and patient-centric solutions. These technologies restore motor function, improve therapeutic precision, and adapt patient treatment regimens, making them vital for rehabilitation therapy. Recent advances in neuroscience, motor control, robotics, and AI-based algorithms have opened new doors in brain and motor rehabilitation. Invasive and non-invasive human-machine interfaces can reduce the long-term effects of strokes and spinal cord injuries. This research examines how AI and robotics can improve motor recovery after injury or stroke in rehabilitation therapy.
Methods: This study utilizes the quantitative research methodology. Data were gathered from different clinical trials and studies that specifically examined AI-assisted robotic rehabilitation therapy. Important indicators consist of the enhancement in motor function, rates of patient adherence, and the overall efficacy of therapy. A total of 19 participants were selected for this investigation. The standard of care group had ten participants and the robotic therapy group nine.
Results: The study showed that robotic therapy improved all evaluations more than the control group, proving that AI and robotic technology work in rehabilitation therapy.
Conclusions: The findings demonstrate that AI-integrated robotic therapy outperforms normal care in rehabilitation. Subsequent research endeavours may delve deeper into the enduring advantages and enhance the treatment regimens to optimize patient recuperation
Osseointegration in dental implants
Get PDFOsseointegration refers to the direct structural and functional connection between living, organized bone and the surface of a load-bearing implant. It plays a vital role in implant stability and is regarded as essential for both implants loading and the long-term clinical success of endosseous dental implants. The implant–tissue interface represents a highly dynamic zone of interaction, involving not only issues related to biomaterials and biocompatibility but also changes in the mechanical environment. The process of osseointegration begins with an initial mechanical interlock between the implant and the surrounding alveolar bone, followed by biological fixation through ongoing bone growth and remodeling at the implant surface. Given its complexity, numerous factors affect both the formation and maintenance of bone at the implant interface. This review aims to evaluate the current understanding of clinical assessment methods and the key factors influencing the success and failure of osseointegrated dental implants.