International Journal of Research in Medical Sciences
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Integration of nursing professionals, education and healthcare services: a strategic model to empower nurses and shape healthcare policy in India
Get PDFNurses form the backbone of India’s healthcare system, yet their contributions to health policy, education, and service integration remain underutilized. Effective integration of nursing professionals, education, and healthcare services is essential for advancing universal health coverage (UHC), reducing health disparities, and optimizing the quality of care. This review explores how aligning nursing education with service delivery and policy frameworks can empower nurses to lead reforms and shape healthcare policy in India. A comprehensive search of PubMed, BMJ Open, CINAHL, and PKP-indexed journals was conducted for studies published between 2005 and 2025. Inclusion criteria targeted empirical studies, national health reports, and review articles focused on the nursing profession’s involvement in health policy, service delivery, and education integration. Thematic analysis and narrative synthesis were applied using the IMRAD framework. Out of 2,341 records, 46 studies were included. Five central themes emerged: fragmentation between nursing education and practice; insufficient policy representation of nurses; gaps in clinical leadership development; potential of nursing integration models in public health; and global best practices adaptable for India. A nurse-led strategic model emphasizing vertical integration of academic curricula with national health priorities, community engagement, and digital health innovation showed promise in improving both workforce satisfaction and patient care quality. Reforming nursing education and embedding nurses in policymaking and service delivery is vital to strengthening India’s healthcare system. Strategic integration can empower nurses as key agents in shaping equitable, patient-centered health reforms
Efficacy and safety of upadacitinib in the treatment of recalcitrant vitiligo
Get PDFBackground: Vitiligo is an acquired autoimmune disease resulting in depigmented patches of the skin, often leading to a significant psychosocial burden on patients. Building on recent advancements in understanding the immunological mechanisms in vitiligo pathogenesis, various potential treatment options such as JAK inhibitors are being clinically researched for vitiligo. In this study, upadacitinib was evaluated for its effectiveness and safety in treating recalcitrant vitiligo patients.
Methods: This study was a prospective randomized clinical trial, thirty patients of group A were treated with Upadacitinib, a dose of 15 mg once daily for 16 weeks. Thirty patients of group B were treated with low dose oral prednisolone (0.3 mg/kg body weight) daily for 16 weeks and the severity of vitiligo was measured using the Vitiligo Area Severity Index (VASI).
Results: The study shows that in Group A, the mean reduction of VASI score was lower in segmental vitiligo (1.24±0.43) and higher in acrofacial vitiligo (4.21±1.30). On the other hand, in Group B, the mean reduction of VASI score was almost similar in acrofacial vitiligo (2.17±0.35) and generalized vitiligo (2.23±0.44). The association between type of vitiligo and change in VASI score in Group A was statistically significant (0.002). At month 4, the VASI score was lower in group A (5.70±3.61) compared to group B (8.61±3.43), which was statistically significant (p=0.006).
Conclusions: The observed repigmentation with minor adverse effects in all vitiligo patients with upadacitinib suggests that upadacitinib could be a promising therapeutic option for this challenging condition
A rare case of membranous nephropathy with crescent who responded to intravenous cyclophosphamide
Get PDFCrescent formation is a rare complication of primary membranous nephropathy. It is a sign of severe glomerular injury and can lead to rapid deterioration of renal function. Primary membranous nephropathy and crescents have a lower remission rate and poor prognosis. Crescentic transformation can be associated with ANCAs or anti-GBM antibodies. Early detection and prompt management reduces the chances of progression to end stage kidney disease. Authors hereby report a case of primary membranous nephropathy with crescent who had negative ANCA and anti-GBM antibodies who responded to cyclophosphamide and achieved stabilization of GFR
Nutrient deficiencies in patients with psychiatric disorders – investigating how low levels of omega-3s, B vitamins and magnesium affect mental health conditions like depression, schizophrenia and bipolar disorder
Get PDFBackground: Psychiatric disorders such as depression, schizophrenia and bipolar disorder are complex mental health conditions that significantly affect individuals' quality of life and functional ability. While their etiology is multifactorial, growing evidence suggests that nutritional factors play an important role in the onset and progression of these disorders. This study aims to explore the relationship between deficiencies in omega-3 fatty acids, B vitamins and magnesium and common psychiatric disorders, namely depression, schizophrenia and bipolar disorder.
Methods: This cross-sectional study was conducted from January 2022 to December 2022 at two tertiary care centers in Chattogram, Bangladesh: Chattogram Ma O Shishu Hospital Medical College and BGC Trust Medical College and Hospital. A total of 100 patients diagnosed with psychiatric disorders, including depression, schizophrenia and bipolar disorder, were enrolled from the outpatient and inpatient departments of psychiatry at both institutions. Data were analyzed using SPSS version 25.
Results: In this study, omega-3, B vitamin and magnesium deficiencies were observed in 61%, 58% and 47% of psychiatric patients, respectively. Deficiencies were most common among those with depression (72.9% omega-3, 66.7% B vitamins, 50% magnesium). Patients with longer illness duration (>5 years) showed higher deficiency rates, with 70.8% for omega-3, 79.2% for B vitamins and 62.5% for magnesium. Symptom severity was significantly higher in deficient patients, with mean scores of 26.5, 27.2 and 25.8 for omega-3, B vitamin and magnesium deficiencies, respectively (p<0.05).
Conclusions: This study demonstrates a high prevalence of omega-3 fatty acid, B vitamin and magnesium deficiencies among patients with psychiatric disorders, particularly those with depression and longer illness duration. These deficiencies were significantly associated with greater symptom severity, underscoring the critical role of nutritional status in mental health
Brucella abortus and Brucella melitensis infections in humans: a case series highlighting diagnostic and epidemiological profile
Get PDFBrucellosis is a major zoonotic infection caused by Brucella species, commonly acquired through contact with infected animals or ingestion of unpasteurized dairy products. Its varied clinical manifestations and nonspecific symptoms often delay diagnosis, complicating patient management. This case series describes the clinical, diagnostic, and epidemiological features of eight confirmed brucellosis cases from a tertiary care centre. Diagnosis was established using rose Bengal plate test (RBPT), serum agglutination test (SAT), enzyme-linked immunosorbent assay (ELISA) IgM antibody detection, and real-time PCR. Species identification was performed through conventional PCR targeting the IS711 gene, followed by Sanger sequencing. Clinical data, laboratory findings, risk factors, co-infections, and treatment outcomes were systematically documented. Of the eight cases, five were infected with B. abortus and three with B. melitensis. Joint pain was universal, with sacroiliitis in two patients and rheumatoid arthritis in another two. Most patients had normal haematological parameters, with mildly elevated inflammatory markers (CRP, ESR). Rural exposure, livestock contact, and consumption of animal products were the predominant risk factors in B. abortus cases. In contrast, B. melitensis cases occurred in urban residents with no direct animal exposure, suggesting foodborne transmission. Three patients presented with co-infections (Leptospira, dengue, malaria and salmonella), while two patients with underlying malignancies succumbed. All were treated with doxycycline and rifampicin for six weeks, as per WHO guidelines. This series emphasizes the persistence of brucellosis in rural India and the emergence of B. melitensis in urban settings. Early diagnosis, molecular species identification, and integrated one health interventions are critical to reducing disease burden
A case report on fetal acrania
Get PDFFetal acrania is a rare but lethal congenital malformation within the acrania-exencephaly-anencephaly spectrum, characterized by complete absence of the cranial vault, meninges, and overlying scalp. The reported incidence is 1.4-2 per 1000 births in India, making it one of the most common neural tube defects after cardiac anomalies. Early detection through ultrasonography is crucial for counselling, prevention of maternal complications, and guiding reproductive planning. A 21-year-old primigravida presented at 16 weeks of gestation for routine antenatal care. She was unbooked case. Diagnosis of acrania was established by ultrasound, and the patient was managed with medical termination of pregnancy following counselling. Early sonographic diagnosis is vital for appropriate counselling and decision-making. Pre-conceptional folic acid supplementation remains the most effective preventive measure against neural tube defects
Stent-free Endo-DCR: success of the posterior based mucosal flap technique
Get PDFBackground: Endoscopic Dacryocystorhinostomy (Endo-DCR) is an established surgical procedure for nasolacrimal duct obstruction (NLDO). While silicone stenting is frequently employed to maintain ostial patency, concerns regarding associated complications and costs have spurred interest in stent-free techniques. This study evaluates the efficacy of the posterior-based mucosal flap technique for stent-free Endo-DCR.
Methods: This prospective observational study was conducted at Nandkumar Singh Chouhan Government Medical College, Khandwa, Madhya Pradesh, between July 2023 and July 2025. One hundred and fifty adult patients (165 eyes) diagnosed with primary acquired NLDO were included after obtaining institutional ethics committee approval and informed consent. All participants underwent stent-free Endo-DCR utilizing the posterior-based mucosal flap technique. Primary outcome measures were anatomical success (patent syringing and endoscopic visualization) and functional success (resolution of epiphora and dacryocystitis) assessed at 1, 3, 6 and 12 months post-operatively. Intraoperative and postoperative complications were also meticulously recorded.
Results: The mean age of the cohort was 51.2±11.8 years (range: 23-82 years), with a female preponderance (72.0% females). The overall anatomical success rate was 87.9% and the functional success rate was 85.5% at 12 months follow-up. Minor postoperative complications, predominantly mild synechiae formation (8.5%), were observed, none of which necessitated surgical revision during the study period. The symptomatic re-obstruction rate requiring revision surgery was 2.4%.
Conclusions: The posterior-based mucosal flap technique for stent-free Endo-DCR demonstrates robust anatomical and functional success rates with a low complication profile in the patient population of Madhya Pradesh. This approach offers a safe, effective and potentially more economical alternative to stented DCR, particularly relevant for improving access to care in resource-constrained regions
Association of angiographic severity of coronary artery disease and erectile dysfunction based on IIEF-5 score
Get PDFBackground: Erectile dysfunction (ED) is common in patients with coronary artery disease (CAD). Atherosclerosis is a shared mechanism for vasculogenic ED and CAD, suggesting a potential correlation. The objective was to evaluate the association of angiographic severity of coronary artery disease & erectile dysfunction based on IIEF-5 score.
Methods: This cross-sectional study was conducted at NICVD, Dhaka, on 60 patients with CAD and ED. Patients were divided into Group I (Gensini <20, n=30) and Group II (Gensini ≥20, n=30). ED was assessed using the IIEF-5 questionnaire, and IPA angiography was performed in the same setting.
Results: Mean IIEF-5 score was lower in severe CAD (Group II: 13.67±4.17 vs Group I: 15.93±3.14, p=0.021). Significant IPA stenosis (>50%) was more common in Group II (43.3% vs 20%, p=0.042). Spearman’s correlation showed a negative correlation between Gensini and IIEF-5 scores (ρ=-0.475, p=0.01) and a positive correlation with IPA stenosis (ρ=0.410, p=0.03). Logistic regression identified severe CAD (OR 9.13, 95% CI 1.37–60.99) and diabetes mellitus (OR 4.75, 95% CI 1.29–46.33) as predictors of IPA stenosis.
Conclusion: Severity of CAD is inversely associated with erectile function and positively correlated with IPA stenosis
Zinc supplementation for reducing duration and severity of acute diarrhoea in children: a meta-analysis
Get PDFAcute diarrhoea remains a major cause of morbidity and mortality among children under five years, particularly in low- and middle-income countries, despite widespread use of oral rehydration therapy. Zinc supplementation has been endorsed by international health authorities as an adjunct therapy, yet variations in its reported efficacy necessitate an updated synthesis of available evidence. This meta-analysis evaluated the impact of zinc supplementation on the duration and severity of acute diarrhoea in children aged 0–59 months. A systematic literature search was conducted in PubMed, Embase, and Web of Science databases for randomized controlled trials published between January 2000 and June 2025 comparing zinc supplementation with placebo or standard treatment. Fifteen eligible trials comprising 8,423 participants were included, and pooled estimates were calculated using a random-effects model. Zinc supplementation significantly reduced the mean duration of diarrhoea by 0.72 days (95% CI: −1.04 to −0.40) and decreased the risk of diarrhoea persisting beyond seven days (RR=0.65; 95% CI: 0.50–0.85). Furthermore, the risk of diarrhoea-related hospitalization was lower in the zinc group (RR=0.74; 95% CI: 0.60–0.92). Moderate heterogeneity (I²=62%) was observed across studies, likely reflecting variations in population characteristics, zinc formulations, and baseline nutritional status. These findings confirm that zinc supplementation effectively reduces both the duration and severity of acute diarrhoea in young children and supports existing World Health Organisation (WHO) recommendations for its routine use in diarrhoeal disease management. Broader integration of zinc supplementation into national child health programs, especially in resource-limited settings, could substantially reduce the global burden of childhood diarrhoeal disease
A narrative review of digital screen time and sleep quality among young adults in India
Get PDFIn India, the digital revolution has transformed daily life patterns, with smartphone penetration and internet usage reaching historic levels. However, this digital transformation has raised significant concerns about adverse health effects, particularly regarding sleep quality. This narrative review synthesizes evidence from 30 studies published between 2010 and 2025 to explore the complex relationship between digital screen time and sleep quality among young adults aged 18–35 years in India. A comprehensive literature search was conducted across multiple databases including PubMed, Scopus, and Web of Science, and this review was synthesised. The findings reveal that young adults in India spend an average of 4–6 hours daily on digital devices, with smartphones accounting for the majority of screen exposure. Excessive screen time was consistently and significantly associated with multiple dimensions of sleep impairment, including delayed sleep onset, reduced sleep duration, poor overall sleep quality, and irregular sleep schedules. Notable gender differences emerged, with men more likely to engage in prolonged gaming sessions and women spending more time on social media, leading to distinct patterns of sleep disturbances. India-specific cultural and social factors, including academic pressure, professional demands, late-night entertainment consumption patterns, and social connectivity norms, further exacerbated the problem. The review concludes that excessive screen time represents a growing public health concern in India with implications extending beyond sleep to encompass mental health, academic and professional performance, and overall well-being