NRI Academy of Medical Sciences

Postpartum depression (PPD) is a debilitating complication of childbirth and is associated with significant consequences for maternal well-being and infant development. Current pharmacological treatments have many limitations, including a delayed onset of action, variable response rates, and concerns about tolerability, underscoring the need for novel therapeutic approaches. Zuranolone has recently emerged as a novel oral therapy specifically for the treatment of PPD and represents a potential turning point in the management of PPD. This narrative review outlines the evolving evidence base for zuranolone, including current understanding of its efficacy and tolerability, and explores practical considerations for its use. The potential role of zuranolone within the broader treatment landscape is discussed, alongside key uncertainties regarding duration of effect, longer-term outcomes and accessibility. By synthesising available literature and identifying key knowledge gaps, this review aims to clarify the evolving role of zuranolone in the treatment of PPD, while highlighting priorities for future research and clinical practice.

The synthesis of thiazole linked pyrimidine and chalcone derivatives 20a-j was achieved by the Claisen-condensation reaction between thiazole-aldehyde and different types of aryl ketones in the presence of piperidine in ethanol at reflux for 12 h time. These derivatives were tested for their cytotoxicity values against MCF-7, A2780, A549 and Colo-205 cell lines with Etoposide as standard drug by utilizing MTT reduction assay protocol. Among the synthesized derivatives, the derivative 20a with 3,4,5-trimethoxyaryl ring showed superior anticancer effect on all cell lines, with IC50 values from MCF-7 = 0.05 ± 0.007 µM; A549 = 0.11 ± 0.047 µM; Colo-205 = 0.66 ± 0.062 µM and A2780 = 0.96. ± 0.075 µM. Molecular docking studies targeting human Topoisomerase IIβ revealed that several synthesized compounds, 20a, 20b, 20f, 20 g, and 20j exhibited notable binding affinities (− 5.9 to − 5.5 kcal/mol) in comparison to the standard drug Etoposide (− 6.5 kcal/mol). These candidates showed favourable interactions with critical active site residues such as GLN778, ASP479, ARG503, and MET782, which are crucial for stabilizing the topoisomerase–DNA complex. The interaction patterns suggest a potential mechanism for modulation at the protein-DNA interface. Among these, compound 20a exhibited a favourable binding and interaction profile, positioning it as a promising hit for the development of novel anticancer therapeutics.

Inflammatory bowel disease (IBD), comprising ulcerative colitis (UC) and Crohn's disease (CD), is a chronic inflammatory condition of the gastrointestinal tract associated with immune dysregulation and alterations in the gut microbiota. Growing evidence suggests that intestinal microbial dysbiosis plays an important role in disease pathogenesis, prompting interest in microbiome-targeted therapies, such as fecal microbiota transplantation (FMT). This systematic review aimed to evaluate the efficacy and safety of FMT in adult patients with IBD. A comprehensive literature search was conducted in PubMed, Embase, Scopus, and the Cochrane Library for studies published between 2020 and 2025 using keywords related to "fecal microbiota transplantation" and "inflammatory bowel disease." Eligible studies included randomized controlled trials (RCTs), cohort studies, systematic reviews, and meta-analyses involving adult patients with UC or CD. Due to clinical and methodological heterogeneity, a structured narrative synthesis was performed in accordance with Synthesis Without Meta-analysis (SWiM) guidelines. Nine studies comprising 1,847 participants met the inclusion criteria, including five RCTs, two systematic reviews, and two meta-analyses. In patients with UC, clinical remission rates ranged from 32% to 40%, with response rates between 44% and 52%. In CD, remission rates ranged from 24% to 31%, although evidence remained limited and heterogeneous. Multi-donor stool preparations and repeated FMT administrations were associated with improved clinical outcomes compared with single-donor protocols or single-dose protocols. Adverse events occurred in approximately 12-15% of patients and were predominantly mild gastrointestinal symptoms, while serious adverse events were rare (<2%). Current evidence suggests that FMT may induce clinical remission in a subset of patients with UC, while evidence in CD remains less consistent. Larger randomized trials with standardized protocols and long-term follow-up are needed to determine optimal donor selection, dosing strategies, and long-term safety.

Introduction: Team-Based Learning (TBL), originally developed in business education, has emerged as an effective pedagogical strategy in the health sciences due to its structured, collaborative framework that promotes active knowledge application and teamwork. Traditional lecture-based approaches are often inadequate in fostering higher-order cognitive skills, (TL) methods such as TBL. This approach facilitates deeper understanding and enhances long-term retention, particularly in complex disciplines such as neuroanatomy. Aim: To assess the effectiveness of TBL as a TL method in neuroanatomy among Phase I Bachelor of Medicine and Bachelor of Surgery (MBBS) students and to obtain feedback following the session. Materials and Methods: A quasi-experimental study was conducted to evaluate TBL among Phase I MBBS students of the 2024-2025 batch in the Department of Anatomy at NRI Medical College, Chinakakani, Guntur, Andhra Pradesh, India, over a duration of two months (February 2025 to March 2025). The study was conducted among all 200 students using convenience sampling. The TBL process comprised three stages: self-preparation (Stage 1), Individual Readiness Assurance Tests (IRAT) and Team Readiness Assurance Tests (TRAT) (Stage 2), and team-based clinical application (Stage 3). Online anonymous feedback was collected using a pre-validated questionnaire on the usefulness of TBL through Google Forms. The responses were recorded on a 5-point Likert scale and presented as percentages in tabular form. Multiple Choice Question (MCQ)-based pre-test and post-test scores were analysed using descriptive statistics and a paired t-test with Statistical Package for the Social Sciences (SPSS) software. Results: The mean score of the pre-test, IRAT, was 3.78, while the TRAT score was 6.75. The post-test score, conducted after two weeks to assess content retention, was 8.14, demonstrating a statistically significant improvement in content retention (p < 0.001). Most students agreed that TBL enhanced engagement, team interaction, and the clinical application of knowledge. Conclusion: TBL combines the advantages of both small and large group TL formats, as it promotes active participation, critical thinking, and peer-assisted learning when students work in teams, while also facilitating interactive discussion with the instructor. Its structured approach enables in-depth understanding of complex subjects such as neuroanatomy. Therefore, its incorporation into the curriculum is recommended for Phase I MBBS students, wherever appropriate.

Background OCT improves PCI outcomes compared with angiography alone but requires contrast to displace blood for image acquisition. In patients at risk of contrast-induced nephropathy, minimizing contrast use is clinically important. Objectives The objective of the study was to compare heparinized saline and contrast as flushing media for coronary frequency domain optical coherence tomography (OCT) during percutaneous coronary intervention (PCI). Methods In this prospective, multicenter, observational study, paired contrast and heparinized saline OCT pullbacks were obtained during the same procedure from 166 patients undergoing PCI at 4 tertiary centers in India. A total of 2072 matched pairs of OCT frames (in 259 paired OCT runs) were analyzed by 2 blinded investigators. Vessel dimensions including proximal reference diameter, minimal lumen area, minimum lumen diameter, and distal reference diameter (DRD) were compared. Ethical approval was obtained at all participating institutions, and all patients provided informed consent. Results Saline and contrast-based OCT demonstrated no significant differences in proximal reference diameter (2.76 ± 0.59 vs 2.74 ± 0.60 mm; P = 0.65), minimal lumen area (5.33 ± 2.48 vs 5.36 ± 2.52 mm2; P = 0.85), minimum lumen diameter (2.55 ± 0.68 vs 2.56 ± 0.66 mm; P = 0.78), or distal reference diameter (2.54 ± 0.55 vs 2.55 ± 0.55 mm; P = 0.83). Bland-Altman analysis showed good agreement without proportional bias. Interobserver reliability for vessel measurements was moderate to good with Intraclass Correlation Coefficient ranging from 0.69 to 0.79. Sensitivity analysis for clustering confirmed the robustness without proportional bias. No adverse events were observed with saline flushes. Conclusions Heparinized saline provides vessel measurements comparable to contrast media for frequency domain OCT without safety concerns. Saline flushing is a feasible alternative for OCT-guided PCI, particularly in patients at risk of contrast-induced nephropathy.