International Journal of Research in Medical Sciences
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Relation between stress and gastrointestinal disorders
Get PDFBackground: This study investigated psychological influences in gastrointestinal (GI) disorders by analyzing relationships among stress, depression, anxiety, and somatization. Standardized scales were applied with 73 participants, revealing notable associations between stress and physical complaints. Findings highlight the significance of the brain-gut connection and recommend integrative therapeutic approaches. Aim was to evaluate the association between stress levels and general health, somatization, depression, anxiety, and illness perception among patients with gastrointestinal disorders.
Methods: This cross-sectional survey-based research distributed offline questionnaires to patients experiencing gastrointestinal symptoms to assess stress and its associations with general health, somatization, depression, anxiety, and illness perception. Data collection employed four standardized instruments: GHQ-12, SDC, DASS-42, and IPQ-R. Data were processed with Microsoft Excel and SPSS version 23, emphasizing descriptive and inferential methods. Descriptive analysis involved calculating mean and standard deviation for GHQ-12, SDC, DASS-42, and IPQ-R.
Results: Of 73 respondents, SDC showed 6.8% had marked somatic concerns. These findings emphasize the overlap between psychological stress and physical outcomes, as patients with GI symptoms often present emotional struggles through somatic complaints.
Conclusions: Stress was significantly correlated with the somatization disorder checklist (GI)
Biopsy proven cerebral toxoplasmosis presenting as an initial manifestation of HIV infection
Get PDFWe present an unusual case of a 45 years male patient presenting with subacute onset of headache, persistent nausea and seizure episodes. He was initially started on anti-tubercular (ATT) drugs empirically at outside hospital based on Magnetic resonance imaging (MRI) findings of brain stem lesions. Patient presented at our institute with progressive worsening of neurological symptoms and radiological findings. He did not have risk factors for immunosuppression or human immunodeficiency virus (HIV) infection. Stereotactic biopsy from the occipital lesion was performed in view of diagnostic uncertainty and worsening clinical condition which revealed the diagnosis of cerebral toxoplasmosis. Patient subsequently tested positive for HIV via fourth generation combination immunoassay. Our case highlights the observation that cerebral toxoplasmosis can rarely present as an initial manifestation of HIV infection and stereotactic brain biopsy, if feasible, can guide in making a clinical decision in patients who have diagnostic uncertainty regarding focal brain lesions
A review on probiotics and mental health: exploring the gut-brain axis and its therapeutic potential
Get PDFThe relationship deemed with the axis of gut-brain has come to be a major area of interest in the pathophysiology of mental health disorders. At the centre of this interaction is the gut microbiota, which communicates with the brain through neural, endocrine, immune, and metabolic pathways. Probiotics, which has led to the term "psychobiotics" being coined. This article is meant to bring out the elements and mechanisms of the gut-brain axis concerning microbiota's role in neurodevelopment and behaviour, and its probiotics' therapeutic potential in psychopathologies such as depression, anxiety, stress response disorders, and other psychiatric disorders. Both preclinical and clinical studies have been reviewed for their evidence on the efficacy and safety of probiotics in strengthening mental health outcomes. Challenges such as strain and dosage variance, by understanding and possibly using the gut-brain-microbiota interaction via selective probiotic treatments could open up new ways of adjunctive treatment for mental health disorders
Amyand’s hernia: case report and literature review
Get PDFAmyand's hernia is the eponym for a cecal appendix-whether inflamed or not-incarcerated within the sac of an inguinal hernia. This type of hernia is uncommon, occurring in approximately 0.5-1% of all inguinal hernias, and most cases are found in children
Atypical megaloblastic anemia: mimicking myelodysplastic syndrome and presenting as heart failure
Get PDFMegaloblastic anemia is a reversible hematological disorder caused by impaired DNA synthesis, most commonly due to vitamin B12 or folate deficiency. Mostly it presents with anemia, neuropathy but severe cases can mimic bone marrow failure syndrome or even heart failure-like symptoms. We report a case of a 57-year-old male who presented with progressive fatigue, tingling sensations, and exertional breathlessness. Examination revealed pallor, glossitis, knuckle hyperpigmentation, and peripheral neuropathy. Laboratory investigations showed pancytopenia with a dimorphic blood picture and hypersegmented neutrophils. A positive direct coombs test (DCT) and persistent anemia even after packed red blood cell transfusion initially raised possibility of myelodysplastic syndrome (MDS). However, a markedly low serum vitamin B12 level and megaloblastic changes in peripheral smear and normal bone marrow finding confirmed the diagnosis of vitamin B12 deficiency. Our patient responded dramatically to parenteral vitamin B12 therapy, with rapid improvement. This case highlights the importance of considering nutritional deficiencies in patients with pancytopenia and atypical systemic features. Early recognition and treatment can prevent misdiagnosis, avoid unnecessary interventions, and prevent irreversible neurological complications
Evaluation of cardiac autonomic dysfunction using electrocardiography in type 2 diabetes mellitus patients: a case-control study
Get PDFBackground: Type 2 diabetes mellitus (T2DM) is associated with a high risk of cardiovascular complications, including cardiac autonomic neuropathy (CAN), which significantly increases morbidity and mortality. Electrocardiography (ECG) offers a non-invasive method to detect cardiac dysautonomia early. This study aimed to evaluate ECG changes in T2DM patients and correlate them with cardiac autonomic dysfunction.
Methods: A cross-sectional observational study was conducted on 50 T2DM patients and 50 age- and gender-matched healthy controls. Standard 12-lead ECG was performed to assess heart rate, RR interval, PR interval, QRS duration, QRS axis, and QTc interval. Cardiac autonomic function was evaluated using heart rate variability (HRV) parameters and clinical autonomic tests. Statistical analysis was performed to compare ECG parameters and prevalence of ischemic and conduction abnormalities between groups.
Results: T2DM patients exhibited significantly higher mean heart rates (86.9±10.81 versus 78.78±11.26 beats/minute; p=0.001), prolonged PR interval (162.40±31.72 versus 138.20±16.98 msec; p=0.001), increased QRS duration (70.98±12.72 versus 65±8.63 msec; p=0.007), and prolonged QTc interval (410.63±43.80 versus 329.20±29.74 msec; p=0.001) compared to controls. Additionally, ischemia (20% versus 4%; p=0.01), infarction (22% versus 6%; p=0.02), and conduction blocks (14% versus 2%; p=0.02) were significantly more prevalent in T2DM patients. HRV analysis indicated reduced autonomic function in the diabetic group.
Conclusions: T2DM is associated with significant ECG abnormalities reflecting cardiac dysautonomia and increased cardiovascular risk. ECG can serve as a valuable tool for early detection of CAN in diabetic patients, enabling timely intervention to reduce adverse outcomes
The spectrum of exudative pleural effusion: clinical and etiological insight
Get PDFBackground: Pleural effusion, an abnormal accumulation of fluid in the pleural space, is classified as transudative or exudative using Light’s criteria. This study aimed to evaluate the clinical and etiological profile of exudative pleural effusion in a tertiary care center in a high-tuberculosis-prevalence region.
Methods: This prospective study at Acharya Shri Chander college of medical sciences, Jammu (February 2024–January 2025), included 70 patients (14-85 years) with exudative pleural effusion. Demographics, clinical history, and investigations (X-ray, pleural/sputum analysis, CT) were recorded. Data were analyzed using excel and SPSS v20.0 with chi-square and Fisher’s exact tests.
Results: The cohort was predominantly male (94.3%, p<0.001) with a mean age of 71.6±5.6 years. Common symptoms included cough (87.1%), dyspnea (77.1%), and fever (75.7%), with cough significantly associated with tuberculosis (p=0.02). Mean symptom duration was 2.7±1.2 weeks. Right-sided pleural effusion was most frequent (47.1%), followed by left-sided (27.1%) and bilateral (25.7%). Consolidation (22.9%) was significantly associated with pneumonia (p=0.01). Pleural fluid was exudative in 98.57% of cases, with malignant cells in 1.4%. Sputum analysis (n=53) showed AFB growth (35.84%) or CBNAAT positivity (50.94%), strongly associated with tuberculosis (p<0.001). Pulmonary tuberculosis was the leading etiology (74.3%), followed by pneumonia (8.6%), lung malignancy (1.4%), and undetermined causes (15.7%).
Conclusions: Pulmonary tuberculosis is the leading cause of exudative pleural effusion in this cohort, with symptoms and imaging consistent with infection. The low malignancy rate, unlike Western data, highlights the need for region-specific diagnostics
A morphometric study of variation in dens of second cervical vertebrae: corona dentis and its clinical implication
Get PDFBackground: Type-II odontoid fractures are often managed by anterior screw fixation, a technique that requires precise morphometric knowledge of the dens. The corona dentis, a bony spur at the odontoid apex, may artificially elongate measurements, leading to potential surgical complications if unrecognized.
Methods: Thirty dry human C2 vertebrae were studied using a digital vernier caliper. Morphometric parameters of the dens and vertebral body were recorded, including height, anteroposterior (AP) and mediolateral (ML) diameters, and dimensions of the corona dentis. Non-metric features such as dens tip shape, orientation, and transverse ligament groove morphology were assessed independently by two observers. Measurements were repeated to minimize intra-observer variability.
Results: Corona dentis was observed in 8 of 30 specimens (26.7%). The mean height of the dens without corona was 15.35±1.84 mm anteriorly and 15.65±1.70 mm posteriorly, whereas combined heights with corona averaged 18.95 mm and 19.25 mm, respectively. The corona itself measured 3.60±0.79 mm in height and 9.80±0.99 mm in width. The dens averaged 10.1±0.91 mm (AP) and 9.8±0.99 mm (ML). Non-metric analysis showed tapering tips in 40%, retroverted axes in 56.7%, and transverse-type ligament grooves in 60% of specimens.
Conclusions: The corona dentis is a relatively common anatomical variation that significantly increases apparent dens height. Failure to recognize this structure may result in overestimation of screw length during anterior odontoid fixation. Preoperative CT evaluation and careful apex identification are essential for safe surgical planning
Five-year survival rate from triple-negative breast cancer varies on follow up, platin agents and multidisciplinary team: a prospective analysis at tertiary level hospitals in Bangladesh
Get PDFBackground: Triple-Negative Breast Cancer (TNBC) is an aggressive subtype of breast cancer lacking ER, PR, and HER2, with high recurrence and mortality. This study evaluates survival outcomes and treatment impact in Bangladesh. The objective of this study was to assess the five-year survival rate of TNBC patients in Bangladesh, evaluate the impact of platin-based chemotherapy and MDT, and compare the outcomes of neoadjuvant and adjuvant treatments.
Methods: This prospective analysis was conducted on 165 TNBC patients from a cohort of 1672 breast cancer patients treated at two tertiary hospitals in Dhaka between January and December 2018. Patient data were collected prospectively, and follow-up was conducted every six months via phone or departmental database. Data on demographic characteristics, co-morbidities, treatment regimens, and survival outcomes were analyzed.
Results: Among the 165 TNBC patients, 37 (22.42%) died within the five-year follow-up period, with 52 (58.43%) surviving. Disease-Free Survival (DFS) was observed in 47 (52.81%) patients, and recurrence was recorded in 5 (5.62%). The survival rate varied significantly across different age groups: 59.62% survival in the 40-63 years age group, 32.69% in the 39 and younger group, and 7.70% in the 64 and above group. Notably, 91 (55.15%) patients received neoadjuvant chemotherapy (NACT), and 74.74% of them survived five years. The overall survival (OS) rate was highest in those treated with platinum-based agents, with a survival rate of 70.97%. The median survival time for those receiving MDT was 61.07%, compared to 19.79% for those treated without MDT. A significant correlation was found between treatment completion (p<0.05), chemotherapy regimen (p<0.01), and follow-up adherence (p<0.05) on survival outcomes.
Conclusions: This study highlights the importance of early detection, treatment completion, and MDT management in improving TNBC survival, particularly for those under 63 years
Epidemiology of lung cancer in a central India population: a single tertiary cancer centre 5-year prospective study
Get PDFBackground: Globally, there have been varied changes in trends of lung cancer epidemiology depending on the geographic region, gender, histological subtype, and incidence. Also, there is a dearth in our current understanding of the changing epidemiological trends of lung cancer among Indian patients. Indian epidemiological data on lung cancer are limited, particularly in the central region.
Methods: We conducted a 5-year prospective study (January 2020-December 2024) at the Department of State Cancer Institute, Jabalpur (Madhya Pradesh), to evaluate the demographic and clinico-radiological profiles of primary lung cancer in Central India. Cases with confirmed histological or cytological diagnoses were reviewed, collecting data on demographics, risk factors, residence, histological subtype, and stage at presentation.
Results: A total of 546 patients (median age: 58.4 years; male-to-female ratio: 3.9:1) were included, with 60% smokers and 68.5% from rural areas. Most of the patients presented with non-small-cell carcinoma (NSCLC), with squamous cell carcinoma being the most common histological subtype (49.6%), followed by adenocarcinoma (34.6%), undifferentiated carcinoma (2.5%), and large-cell carcinoma (1.8%). Small-cell lung carcinoma accounted for 9.5% of cases. Over half of the patients (57.4%) presented with stage IV disease at diagnosis. Common metastatic sites included the pleura, liver, brain, bone, and adrenal glands, with bone metastases more commonly observed in smokers.
Conclusions: A significantly high proportion of lung cancer patients in Central India are smokers. Passive smoking is also a risk factor in our region. Squamous cell carcinoma remains the predominant subtype