International Journal of Research in Medical Sciences
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Penile calciphylaxis: a case report and literature review
Get PDFCalciphylaxis is a rare and severe vascular disorder characterized by calcification of small vessels, leading to tissue ischemia and necrosis. It predominantly affects patients with end-stage renal disease (ESRD) and is associated with high mortality. This case report describes a 54-year-old male with ESRD on haemodialysis, diabetes mellitus, hypertension, and secondary hyperparathyroidism, who presented with intense penile pain and whitish discoloration of the glans. Despite initial supportive measures, the patient progressed to wet necrosis of the penis and prepuce, accompanied by acute testicular pain and signs of incipient necrotizing fasciitis. Empirical antibiotic therapy and analgesia were initiated, but the condition worsened, necessitating total penectomy with cystostomy due to extensive necrosis. Postoperative complications included surgical site infection, gastric ulcers, and acral necrosis, culminating in refractory septic shock and multiorgan failure, leading to death. In conjunction with this case, we review the existing literature to contextualize its findings, summarize diagnostic and therapeutic challenges, and highlight gaps in evidence. This case underscores the aggressive nature of penile calciphylaxis, its diagnostic dilemmas, and the limited therapeutic options available. Early recognition and multidisciplinary management are crucial, though prognosis remains poor
Sleep quality as a predictor of sexual dysfunction in men with type 2 diabetes
Get PDFBackground: Sexual dysfunction and hypogonadism are common yet under‐recognized complications of type 2 diabetes mellitus (T2DM). Sleep disturbances—particularly clinical insomnia—may exacerbate neuroendocrine and metabolic dysregulation, but their role as predictors of sexual dysfunction and testosterone deficiency in diabetic men remains unclear.
Methods: In this cross‐sectional study, 54 men with T2DM (age 35–60 years) attending our outpatient clinic were evaluated for insomnia (insomnia severity index, ISI), hypogonadal symptoms (androgen deficiency in ageing male, ADAM questionnaire), morning serum total testosterone (TT), and sexual dysfunction (self‐reported clinical interview). Clinical insomnia was defined as ISI >15; biochemical hypogonadism as TT <3 ng/ml; confirmed hypogonadism as ADAM‐positive plus TT <3 ng/ml. Participants were stratified by insomnia status (n=18 versus 36) and compared using t–tests and χ² tests. Logistic regression adjusted for age, body mass index (BMI), glycated haemoglobin (HbA1c), and diabetes duration identified independent predictors of confirmed hypogonadism.
Results: Clinical insomnia was present in 33.3% of the cohort. Overall, 37.0% of men reported sexual dysfunction. Insomniac participants had higher rates of sexual dysfunction (66.7% versus 22.2%; p<0.001), ADAM‐positivity (83.3% versus 36.1%; p=0.001), biochemical hypogonadism (44.4% versus 11.1%; p=0.006), and confirmed hypogonadism (38.9% versus 8.3%; p=0.014) compared to non‐insomniacs. In multivariable analysis, clinical insomnia remained the only independent predictor of confirmed hypogonadism (OR 12.14; 95% CI 1.16–126.60; p=0.037).
Conclusions: Clinical insomnia in men with T2DM is strongly associated with both sexual dysfunction and testosterone deficiency, and independently predicts confirmed hypogonadism. These findings support integrating sleep‐quality assessment into diabetic care pathways and targeting insomnia as a modifiable factor to improve sexual and endocrine health
Knowledge and attitude toward glaucoma among relatives of patients with established disease: a cross-sectional study at a tertiary eye care center
Get PDFBackground: Glaucoma is a leading cause of irreversible blindness worldwide. Relatives of glaucoma patients are at higher risk, yet their awareness and attitude toward the disease are often insufficient. The aim of the study was to assess the knowledge and attitude regarding glaucoma among first-degree relatives of patients attending a tertiary eye care center in India.
Methods: A cross-sectional study was conducted over six months at (tertiary eye care center). Two hundred fifty first-degree relatives of patients diagnosed with primary glaucoma were recruited. A structured, validated questionnaire assessed knowledge of glaucoma, risk factors, symptoms, and attitudes toward screening. Descriptive statistics and Chi-square tests were applied.
Results: Among 250 participants, 38% knew that glaucoma could cause irreversible blindness, and 45% recognized family history as a risk factor. Only 28% had previously undergone eye screening. Positive attitudes toward regular screening were observed in 52%. Higher education and prior exposure to glaucoma information were significantly associated with better knowledge and attitudes (p<0.05). Siblings of glaucoma patients showed higher awareness and more positive attitudes than parents or children. Younger participants (<40 years) demonstrated slightly better knowledge, though differences were not statistically significant.
Conclusions: Despite increased risk, knowledge and screening behavior among relatives remain suboptimal. Structured educational programs and targeted interventions in tertiary centers are essential to enhance awareness and early detection of glaucoma
Assessment of knowledge and perception about LGBTQ+ community in Indian medical students
Get PDFBackground: The LGBTQ+ community in India is underrepresented and face significant social challenges. The medical students and graduates in the country have limited educational material and training on the community’s healthcare needs. This can lead to bias in treatment and substandard patient care. The objective of this study was to assess the knowledge, education, and training, and perception of the LGBTQ+ community among Indian medical students and graduates.
Methods: A three-month cross-sectional survey-based study was conducted among Indian medical students and graduates using a Google form questionnaire to assess their knowledge, training, and perceptions about the LGBTQ+ community. The data were collected using Google sheets and analysed using Microsoft excel.
Results: Only 43% of the 546 participants had read about LGBTQ+ health in their medical school; however, 90% had used online platforms for learning. The majority agreed that more educational material was necessary, and nearly 90% perceived a need to bridge the knowledge gap on LGBTQ+ health concerns in the medical curriculum. Additionally, almost 90% of participants also felt that social support groups for the LGBTQ+ community were necessary, and educational institutions should provide sexual education for all orientations. Participants who had poor self-perceived knowledge about LGBTQ+ health had a significantly lower mean score on the knowledge assessment questionnaire than those who perceived their knowledge to be good.
Conclusions: Medical students and graduates in India need to receive adequate training and educational material on LGBTQ+ related health to improve their confidence in addressing healthcare issues and reduce bias towards the healthcare needs of the LGBTQ+ community
Inflamed and unrewarded: a narrative review exploring neuroinflammation and its impact on the brain’s reward mechanisms
Get PDFDepression is associated with dysfunction in the brain’s reward system, contributing to symptoms like anhedonia. Emerging evidence suggests that neuroinflammation plays a key role in disrupting dopaminergic pathways. This review explores how pro-inflammatory cytokines affect reward circuitry and assesses the potential of anti-inflammatory treatments. A narrative review was conducted using studies from 2000 to 2025. Databases searched included PubMed and Google Scholar. Keywords focused on depression, neuroinflammation, reward systems, cytokines, and treatment strategies. Studies in adults examining neural and behavioural outcomes were included. Pro-inflammatory cytokines (e.g., IL-6, TNF-α) impair dopamine function and alter connectivity in the mesolimbic pathway. These changes are linked to core depressive symptoms. Anti-inflammatory agents—such as TNF inhibitors, NSAIDs, and probiotics—have shown promise in alleviating symptoms, particularly in patients with high inflammation. Neuroinflammation plays a critical role in the pathophysiology of depression through its detrimental impact on dopaminergic reward pathways. Targeting inflammation presents a promising strategy for treating depression, particularly subtypes characterised by elevated immune activation. Future research should aim for biomarker-driven stratification to optimise individualised therapeutic approaches
Predictive value of hemostatic markers for complicated acute appendicitis in children: a key role for international normalized ratio
Get PDFBackground: Acute appendicitis (AA) is a common surgical emergency worldwide. The primary adverse event in patients with AA is the progression to complicated appendicitis. Although various scoring systems exist to improve diagnostic accuracy, there remains a need for simple, inexpensive, and readily available biomarkers. This study aims to identify the value of coagulation tests as a predictor of complicated acute appendicitis in pediatric patients.
Methods: We conducted a retrospective, cross-sectional study to evaluate the diagnostic performance of hemostatic markers. The study included medical records from pediatric patients who underwent an emergency appendectomy at our general surgery department between January 2022 and July 2022.
Results: A total of 84 patients were included, with an incidence of complicated acute appendicitis (CAA) of 35.71%. Receiver operating characteristic (ROC) curve analysis revealed good diagnostic performance for INR (AUC=0.803; 95% CI 0.697-0.908; p<0.001) and acceptable performance for PT (AUC=0.774; 95% CI 0.667-0.881; p<0.001) and fibrinogen (AUC=0.769; 95% CI 0.666-0.872; p<0.001). Partial thromboplastin time (PTT) did not show significant predictive value.
Conclusions: International normalized ratio (INR) is a valuable and readily available biomarker for predicting complicated AA in the pediatric population. Fibrinogen and PT also demonstrate significant, albeit lower, predictive utility. These hemostatic markers can serve as objective tools to aid in early risk stratification and optimize clinical management
An observational study examining the correlation between finger dexterity and attention in the dominant hand among young adults
Get PDFBackground: Finger dexterity and attention are essential components of cognitive-motor functioning, influencing daily activities such as writing, grasping objects and executing precise movements. While previous research has examined cognitive-motor relationships in older adults, studies focusing on young adults remain limited. Given the increasing demands on attention and manual coordination in academic, professional and sports-related domains, understanding their interdependence is crucial. To assess finger dexterity using the Nine-Hole Peg Board Test (NHPT), to evaluate attention regulation using the Attention Control Scale (ACS) and to determine the correlation between attention control and manual dexterity in the dominant hand.
Methods: A cross-sectional observational study was conducted with 100 healthy young adults aged 18–25 years at educational Institution, Mangalore. Participants’ dominant hand was identified using the Hit-the-Dot Test, followed by assessments of attention (ACS) and dexterity (NHPT). Data were analysed using Pearson’s correlation, with statistical significance set at p<0.05.
Results: Among participants, 38% were males and 62% were females, with a mean age of 19.04±1.46 years. Pearson’s correlation analysis revealed a strong positive association between attention scores and dexterity performance (r=0.878, p=0.001), indicating that individuals with higher attention control exhibited superior finger dexterity.
Conclusions: This study establishes a significant correlation between attention and finger dexterity, reinforcing the cognitive-motor connection in young adults. The findings highlight the importance of attentional regulation in executing fine motor tasks, with potential applications in fields such as surgery, sports and rehabilitation field
The role of childhood trauma in the development of psychopathology via neurocognitive pathways
Get PDFChildhood trauma is a potent risk factor for a wide range of psychopathological outcomes. This review synthesizes evidence on how trauma experienced in childhood (before age 12) impacts neurocognitive development and in turn elevates risk for later psychopathology. A comprehensive literature search was conducted focusing on cognitive, behavioral, and neurobiological effects of early trauma, with special emphasis on Indian research alongside international findings. Childhood trauma is associated with broad cognitive difficulties, including attentional bias toward threat, memory processing impairments (e.g., fragmented or overgeneral memories), executive function deficits, and emotion regulation problems. These trauma-induced neurocognitive alterations often mediate the link between early adversity and diverse psychopathological outcomes such as posttraumatic stress, anxiety, depression, and dissociation. Neurobiologically, trauma-exposed children show dysregulation of stress response systems (e.g., HPA axis) and structural and functional brain changes in regions subserving emotion and cognition (e.g., amygdala, hippocampus, prefrontal cortex). Indian studies mirror global findings, with high prevalence of child trauma and evidence of similar neurocognitive sequelae. Childhood trauma can derail neurocognitive development in ways that confer transdiagnostic psychopathology risk. These findings underscore the need for early identification and intervention for trauma-exposed children, culturally informed research (particularly in India), and dimensional frameworks (e.g., RDoC) to understand trauma-related cognitive profiles. Early interventions targeting cognitive and emotional regulation skills may mitigate the progression from childhood trauma to later mental health disorders.
Impact of kangaroo mother care on phototherapy duration and hospital stay in term neonates with neonatal jaundice: a cross-sectional study from South India
Get PDFBackground: Neonatal jaundice affects about 60% of term and 80% of preterm infants, primarily due to immature bilirubin metabolism. Phototherapy is the standard treatment, but prolonged exposure can cause complications such as dehydration, hypocalcemia, and disrupted maternal-infant bonding. Kangaroo mother care (KMC), involving skin-to-skin contact, has emerged as a supportive intervention that may enhance bilirubin excretion and reduce phototherapy duration. Objective was to assess the effect of KMC on phototherapy duration and hospital stay in term neonates with hyperbilirubinemia.
Methods: A cross-sectional observational study was conducted from July 2023 to August 2024 at Sree Balaji Medical College and Hospital. A total of 120 term neonates (gestational age 37-42 weeks, birth weight >2500 gm) with jaundice requiring phototherapy were enrolled. Exclusion criteria included preterm birth, low birth weight, early-onset jaundice, hemolytic disease, or congenital anomalies. Infants were divided into two groups: group A (phototherapy only) and group B (phototherapy + KMC). Data were analyzed using SPSS v27.
Results: The mean phototherapy duration was significantly lower in the KMC group (46.22±2.56 hours) than in the phototherapy-only group (65.13±6.88 hours) (p=0.02). Hospital stays were also significantly shorter in the KMC group (p<0.05). No adverse events related to KMC were reported. Higher gestational age and maternal education were associated with better outcomes.
Conclusions: KMC is a safe, effective adjunct to phototherapy, reducing treatment duration and hospital stay while supporting mother-infant bonding
Awareness of ceramic workers on occupational health hazard and related preventive practice
Get PDFBackground: The ceramic industry is one of the significant manufacturing sectors in Bangladesh, where workers are often exposed to various occupational health hazards. This study aimed to assess the awareness of ceramic workers regarding these hazards and the associated preventive practices in Dhaka's Mirpur Ceramics Works Ltd., the largest structural clay products manufacturer in Bangladesh.
Methods: A cross-sectional survey was conducted from 1st January to 31st December, 2022, involving 267 workers. Data were collected through face-to-face interviews using a semi-structured questionnaire that assessed socio-demographic characteristics, work-related factors, and awareness of occupational hazards, hazard identification, and preventive practices.
Results: The study found that most workers were aware of general health hazards 88.4% and hazardous materials 95%. However, awareness regarding safety regulations and hazard management was low, with only 34% and 33.3% aware, respectively. Specific physical hazards, such as noise, heat, and poor ventilation, were recognized by a significant proportion of workers 81-82%, but awareness of chemical hazards was minimal 1.9%. Ergonomic hazards were also poorly understood, with only 43.8% aware of risks related to awkward sitting and manual product handling. The study revealed that 60.7% of workers had low awareness levels, with a statistically significant association between gender and awareness, particularly among male workers.
Conclusions: The study highlights a significant gap in the awareness of occupational health hazards among ceramic workers in Bangladesh. The findings emphasize the need for targeted occupational safety training and awareness programs, especially focusing on chemical and ergonomic risks