MGM Journal of Medical Sciences

Permanent URI for this collection

https://imsear.searo.who.int/handle/123456789/152473

Editor-in-Chief: Dr Chander P Puri
ISSN: 2347-7946

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.mgmjms.com/

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Now showing 1 - 20 of 421

Variant configuration of the arterial circle of Willis
(Wolters Kluwer – Medknow, 2025-06) Ominde, Beryl S.; Enaohwo, Mamerhi T.; Ikubor, Joice E.; Chukwujindu, Sonia U.; Jeremiah, Ogheneyole; Omoro, Orovwoghene F.; Igbigbi, Patrick S.
Background: A clear understanding of the anatomical variations in the circle of Willis (CoW) is crucial for the effective surgical management of intracranial emergencies such as hemorrhage, infarction, and aneurysms. This study aims to evaluate the configuration of the CoW and provide data on the regional pattern of vascular variations among Nigerian residents in Delta State. Materials and Methods: Using a cross-sectional design, we analyzed 200 archived computed tomographic brain images (104 males and 96 females) from the imaging department of a hospital in Delta State, Nigeria. This retrospective study was conducted following ethical approval from the hospital’s review board. The prevalence of CoW variants was calculated using the Statistical Package for the Social Sciences (version 27.0), with comparisons made based on gender and laterality. Statistical significance was set at P < 0.05 with a 95% confidence interval. Results: A complete CoW was observed in 86 patients (43%), while 114 patients (57%) had an incomplete configuration. Variants in the anterior and posterior circulations were found in 50 (25%) and 55 (27.5%) patients, respectively, with both circulations affected in nine patients (4.5%). The most common variations were absence of the anterior communicating artery (18, 9%) and hypoplasia of the posterior communicating artery (58, 29%). CoW variations were significantly associated with laterality (P < 0.05), but no significant differences were found based on gender. Conclusion: The study revealed that hypoplasia of the posterior communicating artery and absence of the anterior communicating artery were the most frequent vascular variations in this population. These findings contribute important regional data on the anatomical variability of the CoW and can serve as a reference for future radiological and clinical evaluations.
A cross-sectional study on factors contributing to health anxiety among healthcare workers in Nigeria due to the COVID-19 pandemic experience
(Wolters Kluwer – Medknow, 2025-06) Mwoltu, Nanribet; Njor, Samuel; Sanni, Olaniyi Felix; Okposin, Ndom; Ugege, Ose; Peter, Nweke; Michael, Akanji; Ugwuike, Joseph; Amechi, Paul; Abang, Roger; Umoh, Paul; Emmanuel, Godwin; Ochonye, Bartholom`ew; Kalaiwo, Abiye
Background: The COVID-19 pandemic has had a profound effect on healthcare workers (HCWs) worldwide, where it intensified preexisting weaknesses in the healthcare system. Health anxiety (HA) among HCWs emerged as a significant concern, fueled by factors such as extended work hours, limited access to personal protective equipment, and fear of contracting or spreading the virus. This study aimed to estimate the prevalence of HA among facility-based and community-based HCWs in Nigeria during the pandemic, examine the socio-demographic factors associated with HA, and explore their coping mechanisms, challenges, and concerns. Materials and Methods: A cross-sectional study used a purposive sampling technique and an online Google Form to collect data from 327 HCWs across Akwa Ibom, Cross River, and Lagos states during the COVID-19 lockdown. Descriptive statistics and binary logistic regression were employed to analyze the data and identify associations between sociodemographic variables and HA symptoms. Results: The findings revealed that 42.2% of HCWs reported experiencing HA, with 35.5% showing clinically elevated symptoms. Younger workers aged 18–29 were significantly more likely to exhibit heightened anxiety. Gender identity and location were also influential, with transgender and gender non-conforming individuals, along with HCWs in Lagos, experiencing higher levels of HA. Major challenges included restricted access to clients and heightened concerns about personal safety. Coping strategies reported by HCWs included participating in online learning and maintaining social connections. Conclusion: The study underscores a notably high prevalence of HA among HCWs in Nigeria during the COVID-19 crisis, pointing to the urgent need for targeted mental health support and interventions to alleviate the psychological burden on these essential workers.
Community-based active case detection of hidden visceral leishmaniasis and post-kala-azar dermal leishmaniasis cases to support the elimination of visceral leishmaniasis in Bihar, India
(Wolters Kluwer – Medknow, 2025-06) Deepak, Kuldeep Singh; Trisal, Monal; Mishra, Jyoti; Sinha, Ashish
Background: Visceral leishmaniasis (VL), commonly known as kala azar, remains a serious parasitic disease and a critical public health concern in India. Bihar alone accounts for nearly 70% of the global VL burden. Despite sustained elimination efforts, the disease persists, primarily due to underreporting and undiagnosed cases, particularly post-kala-azar dermal leishmaniasis (PKDL), which serves as a concealed reservoir for continued transmission. Methods: Between February 2016 and February 2019, the Government of Bihar, in collaboration with multiple partners, implemented a proactive active case detection (ACD) strategy. This multifaceted approach included door-to-door screening, training of private healthcare providers, diagnostic camps, community mobilization, and vector control interventions such as Indoor Residual Spraying and single-dose ambisome therapy. Findings: Under this initiative, healthcare workers screened 2,493,778 individuals across 960 villages, identifying 7504 suspected cases—5786 of VL and 1718 of PKDL. Diagnostic confirmation led to the detection of 959 positive cases, with PKDL accounting for 40.2%. As a result of the ACD program, the number of reported VL cases in Bihar sharply declined from over 14,000 in 2012 to just 335 by 2023. Interpretation: The ACD strategy played a pivotal role in reducing VL incidence by actively identifying and treating hidden cases of VL and PKDL, thereby breaking the chain of transmission. Its integrated approach— encompassing vector control, accurate diagnostics, and active community participation—demonstrates a replicable model for eliminating other neglected tropical diseases (NTDs). Conclusion: The ACD initiative in Bihar has led to a substantial decline in VL burden, offering a scalable and effective strategy for disease elimination. By closing critical gaps in surveillance, diagnosis, treatment, and PKDL management, this community-based model provides a robust framework for addressing NTDs on a national and global level.
Comparative clinical profile of herpes zoster in immunocompromised and immunocompetent patients: insights from a tertiary care center
(Wolters Kluwer – Medknow, 2025-06) Chatterjee, Rupak; Sarkar, Subhajit D.; Mukherjee, Shatavisa; Pramanik, Ipsita; Pramanik, Netai; Anuradha, Subramanian; Chakravarty, Jaya
Background: Herpes zoster (shingles) results from reactivating the latent varicella-zoster virus in sensory nerve ganglia. While incidence increases with age due to declining immunity, immunosuppression from human immunodeficiency virus (HIV) infection has led to a rising occurrence of shingles in younger populations. Objectives: This study compared the clinical profile of herpes zoster in immunocompromised and immunocompetent patients in a tertiary care setting in eastern India. Materials and Methods: Detailed clinical and demographic information was collected from all eligible patients. Each patient underwent a comprehensive examination to identify the affected dermatome(s) and assess disease severity, including vesiculation, crusting, pain, keloid formation, and systemic symptoms. HIV testing was conducted after obtaining informed consent. Patients were monitored weekly until full resolution of symptoms was achieved. Results: The thoracic dermatome was the most frequently involved, followed by the trigeminal, in both HIV-positive and HIV-negative groups. Multiple dermatome involvement was observed in 48.15% of HIV- positive patients but in none of the HIV-negative cases. Systemic symptoms were present in 22 (81.48%) HIV-positive patients, a significantly higher proportion compared with the HIV-negative group (P = 0.0476). The duration for cessation of new vesicle formation and complete healing of lesions was notably longer in HIV-positive individuals than in HIV-negative ones. Conclusion: Herpes zoster shows distinct clinical differences in HIV-positive compared with HIV-negative individuals. The HIV-positive group exhibited prolonged lesion progression and healing. Since herpes zoster is classified as clinical stage 2 of HIV infection, its occurrence should prompt careful evaluation and management in HIV-positive patients.
A comparative study on the knowledge, attitudes, and practices of self-medication in rural and urban regions of Tumkur, Karnataka, India
(Wolters Kluwer – Medknow, 2025-06) Supriya, Challa K.; Prakash, Chaitanyaa; Nandini, Thimmegowda; Reddy, Pesala Pavan Kumar
Background: Self-medication (SM), defined as using medicines without professional medical advice, is an increasing public health concern, particularly in developing countries like India. This study aimed to evaluate and compare SM practices among residents of rural and urban areas of Tumkur, Karnataka, India. Materials and Methods: A cross-sectional survey was conducted to assess and compare the knowledge, attitudes, and practices regarding SM among rural and urban populations in Tumkur. Two hundred individuals participated, equally divided between 100 from rural areas and 100 from urban areas. Data were gathered using a structured and pre-tested questionnaire that included sections on demographic details, medication usage patterns, and perceptions about SM. The collected data were analyzed using Jeffreys’s Amazing Statistics Program. Results: SM was prevalent in both rural and urban areas. Urban residents (28.5%) demonstrated higher awareness, with 32.5% frequently reading package inserts, and reported slightly more adverse effects (9%). Both groups commonly used SM for conditions such as headaches (31.5%), fever (26.5%), and cough (20.5%). Rural participants (24.5%) showed a higher acceptance of SM. Pharmacies were the primary source of medication for both groups, with 48.5% of rural participants and 39% of urban participants obtaining their medicines from pharmacies. Conclusion: This study uniquely compares SM practices in rural and urban areas, highlighting regional differences. The findings indicate the necessity of strengthening the role of pharmacists, enforcing stricter regulations on over-the-counter medications, and improving healthcare access, especially in rural areas.
Giant malignant melanoma: report of a rare case
(Wolters Kluwer – Medknow, 2025-06) Singh, Iqbal; Vaghela, Kalpesh; Dangi, Jignesh; Bhuva, Vidhi
Background: Malignant melanomas generally carry a poor prognosis, an amplified concern in cases of neglected melanomas that progress to substantial sizes. The term giant melanoma typically refers to tumors measuring over 5–10 cm, which are of rare incidence and often associated with an especially unfavorable outcome. Clinical Case: A 45-year-old woman presented with an 18-month history of swelling on the sole of her right foot. The mass had grown rapidly over the preceding 3–4 months. On examination, a large, fungating lesion with satellitosis was observed over the plantar aspect of her right foot. Surgical excision of the mass was performed, and subsequent histopathological analysis confirmed the diagnosis of giant nodular melanoma (NM). Conclusion: This case illustrates a rare instance of giant NM with satellitosis, emphasizing the aggressive nature and poor prognosis associated with delayed presentation and advanced tumor size.
Portfolios in competency-based medical education: a roadmap to holistic MBBS training
(Wolters Kluwer – Medknow, 2025-06) Puri, Sarandeep Singh; Goel, Neha; Garg, Pradeep
This review article highlights the essential role of portfolios in Competency-Based Medical Education (CBME). Once simple tools for record-keeping, portfolios have evolved into crucial instruments for assessment and learning. They support reflective practice and offer a comprehensive way to monitor students’ development throughout their medical training. The article examines various types of portfolios, their integration into the CBME framework, and the experiences of both students and educators in utilizing them. It also compares portfolios with traditional assessment methods and addresses common challenges such as time constraints, technological barriers, and anxiety related to evaluation. To enhance the effectiveness of portfolios, the review discusses supportive strategies, including mentorship, the use of digital platforms, and innovative approaches like artificial intelligence and gamification. When implemented thoughtfully, portfolios can greatly contribute to developing competent, confident, and reflective medical professionals.
Mapping the clinico-pathological landscape of CNS neoplasms: an observational study from a tertiary care cohort
(Wolters Kluwer – Medknow, 2025-06) Mohapatro, Meenakshi; Mishra, Pratiksha; Munda, Fakir C.; Mohanty, Lity
Background: Central nervous system (CNS) tumors encompass a wide spectrum of neoplastic and non-neoplastic conditions. Materials and Methods: This retrospective cross-sectional study was conducted in the histopathology section of the Department of Pathology at S.C.B. Medical College and Hospital, Cuttack, India. The study spanned from June 2023 to June 2024. Clinical parameters, including patient age, sex, tumor grade, radiological findings, and immunohistochemical profiles, were reviewed to establish a final diagnosis. Results: A total of 183 CNS tumor cases were analyzed, comprising 89 males (49%) and 94 females (51%). The highest incidence was observed in the sixth decade of life, with 45 cases. The oldest patient was 76, while the youngest was a 1-month-old female infant. Gliomas, glioneuronal, and neuronal tumors were the most frequently diagnosed categories, accounting for 76 cases (39.53%). Meningeal tumors followed, with 42 cases (22.95%), of which meningothelial meningioma was the most common subtype, with 25 cases (59.52%). Astrocytic tumors represented 66 cases (36%), with astrocytoma, IDH mutant, World Health Organization (WHO) Grade 2 being the most prevalent subtype (21 cases, 31.8%), followed by Grade 4 (13 cases, 19.69%) and Grade 3 (nine cases, 13.6%). Among pediatric patients, pilocytic astrocytoma emerged as the most common. Conclusion: This study highlights the distribution and burden of CNS tumors in our region and provides a detailed classification based on the 2022 WHO guidelines. Accurate categorization of CNS neoplasms is crucial for effective diagnosis, prognostication, and therapeutic planning, offering vital insights into patient outcomes and disease behavior.
Diagnostic confusion caused by excess beta-carotene: a case of primary carotenemia
(Wolters Kluwer – Medknow, 2025-06) Palaha, Harvinder K.; Priya, P.S. Meghana; Puranik, Preeti; Reddy, Vindya S.; Bhadran, Arya; Majjagi, Vinay K.
Carotenemia is a benign condition characterized by yellow-orange skin discoloration, typically sparing the sclera, that results from excessive consumption of carotenoid-rich foods. Although it is benign, it is often misdiagnosed as jaundice, leading to unnecessary diagnostic procedures. We present a case of carotenemia arising from a high intake of carotene-rich foods.
Gastrointestinal stromal tumor presenting as an ovarian malignancy: an unusual report of a case diagnosed on histopathology and immunohistochemistry
(Wolters Kluwer – Medknow, 2025-06) Bushra; Khan, Sabina; Khetrapal, Shaan; Aden, Durre; Tiwari, Soumya; Jetley, Sujata
Gastrointestinal stromal tumors (GISTs) are the most prevalent malignant tumors of mesenchymal origin. They typically express the KIT receptor tyrosine kinase, which plays a key role in their pathogenesis. Mutations in the KIT gene often result in continuous activation of this receptor, leading to uncontrolled cell proliferation and resistance to apoptosis. Clinically, GISTs may imitate gynecological tumors during physical examination and pelvic ultrasound, making diagnosis challenging due to their nonspecific features and similarity to gynecologic malignancies. A 44-year-old female patient presenting with features of perforation peritonitis and a free-floating large pelvic mass mimicking gynecologic origin highlights the diagnostic difficulty posed by such cases. Ongoing research is needed to assess the diagnostic value of CD117-negative but DOG1-positive immunomarkers in identifying these tumors. Accurate diagnosis of GISTs, especially when they occur alongside other malignancies, requires a thorough clinical assessment, detailed immunophenotypic profiling, and advanced imaging techniques.
Medical students’ knowledge and competence in fundamental communication skills
(Wolters Kluwer – Medknow, 2025-06) Singh, Gurjeet; Singh, Raksha; Sethuraman, K. R.
Effective communication is a fundamental component of high-quality medical care, enabling healthcare providers to establish therapeutic relationships that foster patient-centered outcomes. In clinical settings, clear communication between the provider and patient plays a vital role in shared decision-making and the development of self- management strategies, particularly for elderly patients. This rapid review aims to synthesize the impact of communication quality and effectiveness on patient-centered outcomes in geriatric care. Despite its importance, communication skills are often not formally taught in many medical schools, presenting significant challenges in clinical practice. The National Medical Commission emphasizes the importance of essential communication skills, including active listening, empathy, delivering clear explanations, asking open-ended questions, and acknowledging cultural diversity. Practicing these skills across various clinical scenarios can lead to more accurate diagnoses, improved treatment outcomes, quicker recovery, and greater patient satisfaction. To ensure effective communication, reliable performance assessment tools, such as the objective structured clinical examination, are crucial. These tools help identify gaps in communication skills and provide guidance for targeted improvements.
Low platelet count during pregnancy
(Wolters Kluwer – Medknow, 2025-06) Agrawal, Trupti; Kaundinya, Aditi; Pawde, Anuya
Thrombocytopenia, a platelet count below 150,000/mm3 , is the second most common hematological disorder during pregnancy, following anemia. It affects approximately 7–10% of pregnant women and may result from physiological changes or underlying pathological conditions, some of which can have serious maternal and fetal consequences. This study was conducted at a tertiary care center in Navi Mumbai to assess the causes, management, and maternal outcomes associated with thrombocytopenia in pregnancy. Over one year, 12 cases were examined. Among these, 50% were diagnosed with gestational thrombocytopenia (GT), 16% with immune thrombocytopenic purpura (ITP), another 16% with dengue-related thrombocytopenia, 10% with hypertensive disorders of pregnancy, and 8% with hereditary thrombocytopenia. Treatment strategies varied based on the underlying cause, including platelet transfusions, corticosteroids, and intravenous immunoglobulin. While GT was typically mild with favorable outcomes, more severe conditions such as ITP and hypertensive disorders required coordinated, multidisciplinary care. Prompt diagnosis, targeted treatment, and planned institutional deliveries were crucial in minimizing complications and achieving positive maternal and fetal outcomes.
Insights from platelet donors in tertiary care hospitals
(Wolters Kluwer – Medknow, 2025-06) Yalamanchili, Swapna; Raghavan, Vijayashree; Muniraj, Femela; Mythily, V.
Background: Blood and platelet transfusions play a vital, life-saving role in modern medicine. Materials and Methods: This cross-sectional descriptive study utilized a structured questionnaire administered to platelet donors via a convenience sampling method from February 2023 to October 2023. After excluding incomplete and outlier responses, 352 completed forms were analyzed. Platelet donations were performed using Terumo Accel, Spectra Optia, and MCS+ apheresis machines. Statistical Analysis: Data were analyzed using descriptive statistics and percentage analysis with SPSS version 23. Results: The mean age was 30.81 (SD = 8.29) years. Only 1.98% of donors experienced hematomas as well as fainting, 263/352 (74.71%) expressed that they felt appreciated, and 293/352 (83.23%) believed that a lab test on the donated blood would serve as a motivator. Most (95.17%) donors were fully satisfied with the donation process, and 91.76% appreciated the staff ’s efforts. Also, 321/352 (91.19%) indicated a desire to donate in the future based on a suitable time, 302/352 (85.79%) felt adequate privacy at the center, 329/352 (93.46%) found the environment clean and hygienic, and 288/352 (81.81%) expressed a wish to donate voluntarily twice or more in a year. The majority of the donors had the “O Positive” blood group. Conclusion: Donor retention is essential for ensuring a positive and satisfying donation experience. Strategies such as showing appreciation for donors and offering laboratory tests on donated blood can be effective motivators. Although the incidence of adverse reactions was low and mild, additional measures can be implemented to minimize them further.
Impact of high-intensity exercises on elderly male patients with osteosarcopenia: a systematic review
(Wolters Kluwer – Medknow, 2025-06) Aman, Ifra; Saifi, Shaima; Singh, Sucheta; Aryal, Pratiksha; Zutshi, Kalpana; Khan, Huma
Background: Osteosarcopenia is a degenerative metabolic syndrome characterized by the concurrent presence of osteoporosis and sarcopenia. It results from age-related processes and lifestyle factors. Among non-pharmacological interventions, exercise has shown promise in enhancing bone mineral density in individuals with osteoporosis. This review aims to evaluate the effectiveness of high-intensity exercise interventions in older men diagnosed with osteosarcopenia. Materials and Methods: A comprehensive literature search was conducted from January 2019 to September 2024 using the Web of Science, Google Scholar, and PubMed databases. The population, intervention, comparison, outcomes, and study framework guided the selection process. The basic search strategy was used to search articles, and the following keywords were used: osteosarcopenia, high-intensity exercises, resistance training, elderly, and randomized controlled trial (RCT). The preferred reporting item for systematic review and meta analysis guideline was used to screen the studies based on predefined inclusion and exclusion criteria, and methodological quality was assessed using the PEDro scale. Results: A total of 111 articles were initially identified. After the first screening phase, 85 articles were excluded due to duplication. An additional 15 articles were excluded during the abstract screening phase: three were unrelated to physiotherapy, seven involved different interventions, four did not focus on osteosarcopenia, and one was not an RCT. Four articles were included in the final review. Conclusion: This systematic review concludes that high-intensity exercise training offers significant benefits for elderly male patients with osteosarcopenia, supporting its role as an effective non-pharmacological intervention in clinical management.
Maternal risk factors and microbiological profile of urinary tract infections in pregnancy: a cross-sectional study at a tertiary care center
(Wolters Kluwer – Medknow, 2025-06) Goyal, Akansha; Chauhan, Sapna
Introduction: Urinary tract infections (UTIs) in pregnancy are a significant cause of maternal and fetal morbidity, necessitating early detection and targeted management. Despite extensive research, gaps remain in understanding the interplay of demographic, obstetric, and clinical risk factors influencing UTI susceptibility. This study aims to assess the prevalence of symptomatic and asymptomatic bacteriuria (ASB), identify associated risk factors, and analyze the distribution of bacterial uropathogens in pregnant women. By refining risk stratification, the findings contribute to enhancing antenatal screening protocols and guiding evidence-based preventive strategies to reduce UTI-related complications during pregnancy. Aim: To assess the prevalence, risk factors, and bacterial distribution of UTIs in pregnancy. Objectives: 1.Determine the prevalence of symptomatic and ASB. 2.Analyze maternal demographic, obstetric, and clinical risk factors. 3.Identify bacterial uropathogens and their distribution. 4.Provide insights for improved antenatal screening and prevention. Materials and Methods: A cross-sectional study was conducted among 600 pregnant women and categorized into symptomatic (n = 400) and asymptomatic (n = 200) groups. Sociodemographic characteristics, obstetric risk factors, and clinical parameters were assessed. Midstream urine samples were collected for culture, and bacterial isolates were identified using standard microbiological methods. Data were analyzed using the chi-square test, and statistical significance was set at P < 0.05. Results: The overall prevalence of UTI was 17.3% (104/600), with a significantly higher occurrence in the symptomatic group (66.3%) compared to the asymptomatic group (33.7%) (P < 0.001). The highest prevalence was observed among multigravida women (56%). Significant risk factors for UTI included lower socioeconomic status, rural residence, history of previous UTI, diabetes, and anemia (P < 0.05). Among bacterial isolates, Escherichia coli (56%) was the most common uropathogen, followed by Enterococcus spp. (15%), Klebsiella pneumoniae (11.5%), and Pseudomonas spp. (11.5%). Conclusion: This study highlights the significant burden of UTIs in pregnancy and their association with key demographic and clinical risk factors. The findings emphasize the need for routine screening and early management, particularly in high-risk groups, to prevent adverse maternal and neonatal outcomes. Integrating targeted preventive strategies into antenatal care can help mitigate the impact of UTIs, improving maternal health outcomes.
A comparative study of the association between childhood trauma and depression disorder among first-year MBBS and physiotherapy students
(Wolters Kluwer – Medknow, 2025-06) Jadhav, Shraddha; Jodhani, Bhoomi; Dase, Rajesh
Background: Depressive disorders are a major public health concern and are often linked to childhood trauma (CT), which includes various forms of abuse and neglect. CT can interfere with emotional and psychological development, increasing susceptibility to depression and anxiety later in life. Early exposure to trauma affects brain development and stress regulation systems, contributing to chronic stress and mood disorders. Materials and Methods: This cross-sectional study was conducted at MGM Medical College and Hospital, Chhatrapati Sambhajinagar (Aurangabad), Maharashtra, India, and included 176 first-year MBBS and physiotherapy students, with 88 participants from each group. Data on participants’ backgrounds and health information were collected using a structured form. The Childhood Trauma Questionnaire-Short Form (CTQ-SF) was employed to assess childhood abuse experiences, while the Hamilton Depression Rating Scale (HAM-D) was used to evaluate depression levels. Results: Among the 176 students, CTQ-SF results indicated that 91 reported no history of trauma, whereas 85 had experienced some form of CT. Of those with a history of trauma, 28 students (P = 0.68) exhibited depressive symptoms according to the HAM-D scale, suggesting a potential association between CT and depression. Conclusion: The study highlights a significant prevalence of CT among students, with a possible link to depressive symptoms. These findings emphasize the need to address CT to promote mental well-being in young adults. Educational institutions should implement support programs and workshops on trauma awareness and coping strategies. Creating safe spaces for students to share their experiences and ensuring access to counseling services can help mitigate the effects of trauma and foster better mental health outcomes.
A comparative assessment of efficacy for pain relief and quality of life between dienogest and combined oral contraceptive pills in endometriosis patients in Eastern India
(Wolters Kluwer – Medknow, 2025-06) Kumari, Priyanka; Ray, Rathindra Nath; Sarkar, Sandip; Dastidar, Sohini Ghosh; Munde, Yogesh
Background: This study aimed to compare the effectiveness of dienogest (DNG) and combined oral contraceptive (COC) pills in alleviating pain among patients with endometriosis in Eastern India. Materials and Methods: A prospective, hospital-based, observational comparative study was conducted at R. G. Kar Medical College and Hospital in Kolkata, India, from March 2021 to August 2022. The study included two groups: Group A (dienogest 2 mg/day, n = 115) and Group B (combined oral contraceptive pills, Mala-N, n = 115). Pain levels were assessed using the Visual Analog Scale (VAS), and the quality of life (QoL) was evaluated with the Endometriosis Health Profile Questionnaire (EHP-5 PRO) after 3 and 6 months of treatment. Results: The mean age ± standard deviation was 32.57 ± 8.02 years in Group A and 32.89 ± 7.92 years in Group B. After 6 months, Group A showed a significant reduction in pelvic pain (P = 0.001), whereas Group B did not experience a significant improvement (P = 0.55). A significant difference in pain reduction was observed between the two groups after 6 months (P = 0.0001). Both treatments resulted in slight improvements in the quality of life, but the difference between the groups was not statistically significant. Conclusion: Both dienogest and COC pills may assist in managing endometriosis-related pain and enhancing the quality of life, with dienogest showing superior pain relief. These medications appear to be safe and effective options for managing endometriosis.
Generic giants to biotech frontiers: mapping India’s pharma trajectory—part I
(Wolters Kluwer – Medknow, 2025-06) Ghosh, Prasanta Kumar
The Indian pharmaceutical industry is a large, mature, stable, and expansive global leader, recognized as the “pharmacy of the world.” The industry turns out high-quality, low-cost generic medicines, catering to domestic and international markets. The government of India promotes the development of the industry with a sharp focus on the availability of quality medicines at affordable prices to its people. To maintain and excel from the present performance state, the industry needs to improve its manufacturing base and use and add more generic active pharmaceutical ingredients (APIs) and biotech drugs, including vaccines and biosimilar molecules, in its formulation kitty. In this review, efforts have been made to identify the more vibrant individual manufacturing companies in the country that contribute to more than 90% of the turnover of the production of the Indian pharmaceutical industry. Identifying the key pharma companies can facilitate providing targeted support by the government through policies, thereby strengthening the industry to increase their turnover, supplying quality drugs at affordable prices, and conducting more research and development. Another aspect of the review was to identify the APIs that are being produced in the country, as well as those that are imported, and the need to list the quantum of imports of the APIs so that steps can be explored to get some of them to be manufactured locally by imbibing suitable policy supports.
Assessment of chronic liver disease using two-dimensional shear wave elastography in a tertiary care hospital in North India
(Wolters Kluwer – Medknow, 2025-06) Rishu, Raunak; Wahab, Shagufta; Zafar, Khwaja S.; Khan, Rizwan A.
Background: Chronic liver disease (CLD) presents a significant public health challenge, often leading to cirrhosis and severe fibrosis. Common causes include viral hepatitis, excessive alcohol consumption, and non-alcoholic fatty liver disease, among others. This study evaluated liver stiffness using two-dimensional shear wave elastography (2D-SWE) in patients with CLD at a tertiary care center in northern India. Materials and Methods: This prospective study was conducted in the Department of Radiodiagnosis at Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India, from July 2022 to June 2024. One hundred patients diagnosed with CLD, and 100 age-matched healthy controls were included. Liver stiffness was measured using a Samsung V8 ultrasound system with 2D-SWE techniques, and the liver stiffness values were expressed in kilopascals (kPa) and graded accordingly. Results: Liver stiffness was significantly elevated in the CLD group, with a mean value of 14.09 kPa compared to 4.95 kPa in the control group. The median and interquartile range values also indicated statistically significant differences (P < 0.001). Among the CLD patients, 41% exhibited Grade 2 fibrosis, 41% exhibited Grade 3, and 18% showed Grade 4 fibrosis. In contrast, 83% of the control group displayed no fibrosis, while 17% had Grade 1 fibrosis. Conclusion: Two-dimensional SWE is a reliable, non-invasive tool for assessing liver stiffness and staging fibrosis in CLD. It evaluates a larger liver volume than a conventional biopsy without the risk of hemorrhage or infection. This technique holds promise for the routine assessment and monitoring of liver fibrosis.
A histopathological study of vesiculobullous skin lesions in a tertiary care hospital in Chhattisgarh, India
(Wolters Kluwer – Medknow, 2025-06) Siddiqui, Rabia Parveen; Sharma, Riti; Biswas, Aishik; Singh, Mrityunjay Kumar; Varma, Ruchi; Bhaskar, Vanita
Background: Vesiculobullous skin lesions (VBLs) encompass a heterogeneous group of dermatological disorders, each with distinct clinical and pathological characteristics. Skin punch biopsy remains a fundamental diagnostic tool in evaluating these lesions. Histopathological examination is vital in confirming the diagnosis, guiding targeted therapy, and improving clinical outcomes. Aims and Objectives: To analyze the histopathological features, distribution patterns, and clinicopathological correlations of VBLs over 2 years. Materials and Methods: This study was conducted in the Department of Pathology between June 2022 and May 2024. It included all skin punch biopsies received from patients of all age groups presenting with vesiculobullous lesions during the study period. Results: A total of 84 cases were examined, comprising 32 males and 52 females, with a male-to-female ratio of 1:1.6. Patients were aged 22 to 73 years, with the highest incidence observed in the 31–40-year age group (42 cases). The mean patient age was 38 years. Pemphigus vulgaris (PV) was the most frequently diagnosed condition, accounting for 42 cases, followed by pemphigus foliaceus accounting for 24 cases. Bullous pemphigoid was seen in seven cases, while erythema multiforme accounted for three cases. Rare conditions such as epidermolysis bullosa acquisita, subepidermal bullous lesions, lichen planus pemphigoid, and Darier disease were identified in two cases. Conclusion: The study highlighted a slight female predominance among patients with VBLs, with the 31–40- year age group most commonly affected. The extremities were the most frequent site of involvement. PV emerged as the predominant vesiculobullous disorder in this cohort. The limitation of our study includes the lack of immunofluorescence in our center and single-institute data.

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