Introduction: This study aimed to evaluate the relationship between lumbar vertebral bone mineral density and body mass index among postmenopausal women attending a tertiary care center. Methods: A cross-sectional study was conducted involving 194 postmenopausal women presenting to the department of PMR. Bone mineral density (BMD) of the lumbar spine (L1–L4) was measured using dual-energy X-ray absorptiometry (DEXA). BMI was calculated using the standard formula based on height and weight. Participants were categorized by BMI (underweight, normal, overweight, and obese), and their BMD values were compared across groups. Statistical analysis was performed to assess the correlation between BMI and lumbar spine BMD. Results: Approximately one-third of participants had a normal BMI, while nearly two-thirds were overweight or obese. The mean BMI in the normal BMD group was 28.71kg/m², whereas it was 24.88 kg/m² in the osteoporosis group. This difference was statistically significant (p < 0.001). A moderate positive correlation (r 0.379, p < 0.01) was observed between BMI and lumbar BMD. Conclusions: A significant, moderately positive correlation was observed between BMI and lumbar BMD, suggesting that lower BMI is associated with increased risk of low bone mass. Higher BMI may have a protective effect on bone health in this population. These findings underscore the importance of BMI as a modifiable factor in the assessment and management of postmenopausal osteoporosis.
Introduction: Due to high prevalence and morbidity, cervical cancer screening programme is essential. HPV mRNA (messenger RNA) assay test is a newer test that detects the overexpression of E6 and E7 mRNA. The aim of this study was to determine the performance of HPV E6/E7 mRNA assay test as the screening of high-grade cervical intraepithelial neoplasia (CIN). Methodology: 100 sexually active women, aged 30-59 years with persistent vaginal discharge of more than 6 months, post coital bleeding, intermenstrual bleeding or dyspareunia and unhealthy cervix were recruited for the study. Current pregnancy or 3 months postpartum or previous history of cervical cancer or procedure or pelvic irradiation were exclusion criteria. All participants underwent five screening methods (HPV E6/E7 mRNA test, liquid-based cytology, HPV DNA testing, Visual inspection with acetic acid and Lugols iodine (VIA and VILI, respectively) and followed by histopathology. Diagnostic performance of screening tests was calculated to identifying CIN 2 lesions. Results: 57% of the women belonged to 30-39 years age group. 62% of the women presented with only persistent vaginal discharge while 24% presented with mixed symptoms. Four patients were found to have CIN 2 lesions. Sensitivity and specificity were as follows: HPV mRNA (25%, 82.29%), HPV DNA (75%, 77.08%), liquid-based cytology (25%, 93.83%), VIA (100%, 27.08%), and VILI (100%, 29.17%), respectively. Conclusion: HPV E6/E7 mRNA assay test has high specificity but low sensitivity in detection of cervical cancer.
Introduction: Breast cancer is the most commonly diagnosed cancer in women. Following a diagnosis, womens quality of life (QoL) is significantly impacted by the appearance of physical, psychological, and social repercussions that alter their expectations and attitudes toward life. This study aimed to assess the quality of life in breast cancer patients with post-modified radical mastectomy (Post-MRM). Methodology: This was a cross-sectional study that included about 120 participants who had undergone the post-modified radical mastectomy. The FACT-G version four questionnaire was used to evaluate participants QoL. The participants were divided into three groups based on the duration of follow-up: group 1 (more than three years), group 2 (two years), and group 3 (one year). Results: There were 27 participants in group 1, 42, and 51 in group 2 and 3, respectively. Spearman analysis revealed significant correlations between demographic/clinical variables and QoL. Negative correlations were found between tumor stage and physical well-being (PWB) and emotional well-being (EWB). Positive correlations were found between social well-being (SWB) and education level as well as occupation of patients. Additionally, 23% of patients expressed concerns about their body image and reconstructive surgery, while 37% patients in groups 2 and 3 faced difficulties in seeking treatment due to the COVID-19 pandemic. Conclusion: Tumor stage, education level, occupation, and marital status had an impact on the QoL in breast cancer survivors. QoL was affected due to surgical wound-related problems and difficulties in seeking adjuvant treatment during the first year of treatment. During the consequent period, it was affected due to local and systemic recurrence, lymphoedema, and body image concerns.
Introduction: Streptococcus pneumoniae, is a gram-positive, lancet-shaped bacteria that causes otitis media, meningitis, and pneumonia, among other ailments. It is a major contributor to bacterial pneumonia, particularly in young children. Precise identification of S pneumoniae infection is necessary for the best possible treatment of patients, appropriate use of antibiotics, and public health initiatives. The organism is fastidious in nature and may fail to grow in culture and miss detection. Molecular methods are reported to be more sensitive and rapid to identify the bacteria. Present work was done to identify presence of S pneumoniae in pediatric patients presenting with acute respiratory infections attending tertiary care hospital at Jaipur, Rajasthan. Methodology: A total of 50 throat swab samples were collected from pediatric patients attending JK Lon Hospital, Jaipur aged 0-15 years. Total nucleic acid was extracted using an automated extraction system (NucliSENSEEasyMAG, Biomerieux), 5 µl of which was used to detect S pneumoniae by real-time PCR. Results: Among 50 samples tested, in the present study 17 (34%) were from female patients and 33 (66%) were from male patients. 0-5 years was the most common age group, with fever and cough being the most common symptoms among 48 (96%) Indoor Patient Department (IPD) and 2 (4%) Outdoor Patient Department (OPD) samples. The positivity for S pneumoniae was found to be (22, 44%), real-time PCR was found to be a rapid and effective tool for the detection. Conclusion: High positivity was found for S pneumoniae by Real-time PCR which helped in the rapid detection of the bacteria. Rapid identification helps in treating patients, however further large-scale studies are required to know the true prevalence of the pathogen and also identify serotypes responsible for the infection.
Introduction: Radiation-based technologies are integral to modern healthcare, significantly advancing diagnostic, therapeutic, and research capabilities. Despite their undeniable benefits, the use of ionizing radiation carries potential risks to patients and healthcare workers, underscoring the need for comprehensive radiation protection awareness across all health.. professions. This review article examines the critical need to strengthen radiation protection awareness among diverse healthcare professionals and emphasises prioritising safety within the medical and health community. Methodology: A narrative review of the published literature, international guidelines, and professional practice documents was conducted to analyse radiation exposure risks, existing safety practices, and strategies to enhance awareness among radiation professionals; non-radiation professionals who use radiation; healthcare professionals assisting during radiation procedures; and those prescribing radiological examinations. Results: Radiation professionals, including radiologists, radiotherapists, radiologic technologists, nuclear medicine physicians and technologists, and medical physicists, require continuous education and strict adherence to safety protocols. Non-radiation professionals involved in radiation use or procedural assistance must understand radiation risks and apply appropriate protective measures, while referring clinicians need the skills for informed decision-making to avoid unnecessary exposure. Medical physicists play a pivotal role in curriculum development, clinical supervision, quality assurance, continuing education, research, and innovation across multiple medical specialities. Conclusion: Integrating radiation protection education into healthcare curricula, fostering interdisciplinary collaboration, and promoting a strong safety culture are essential to ensure responsible use of radiation and safeguard both patient welfare and professional well-being.
Dental implants are frequently utilized to restore both parţial and total dentures. Dental implant failure is not unusual, despite the fact that numerous studies on the subjects have documented a long-term success rate. An inflammatory response in the tissues is a hallmark of peri-implant disease around an implant. Early diagnosis and timely treatment are essential to prevent the progression of the condition and reduce the risk of implant failure. Over time, the rate of dental implant failure tends to increase due to both biological and technical factors. As a result, clinicians are increasingly required to devote more attention to the management of ailing and failing implants. To avoid implant failure, peri-implant illness should be identified and treated as soon as feasible. Numerous facts of peri-implant illness and its treatment are included in this overview of the literature.
Tele-periodontics leverages modern tele-communications to deliver specialized periodontal care including diagnosis, treatment planning, monitoring, and patient education—from a distance. This approach is particularly transformative for patients in remote or underserved regions, such as many parts of India, who otherwise face significant barriers to accessing specialist care. This review article explores the evolution, current applications, and future potential of tele-periodontics, based on a systematic review of the literature from 2010 to 2024. It examines the integration of key technologies like artificial intelligence (AI) for radiographic analysis, cloud-based electronic health records (EHRs), and remote monitoring systems. While tele-periodontics offers immense promise in improving accessibility, reducing costs, and enhancing patient engagement, it confronts significant challenges: namely, a lack of standardized clinical protocols, regulatory complexities, and the need for high-quality evidence to validate its effectiveness. The COVID-19 pandemic acted as a significant catalyst, accelerating its adoption for maintaining continuity of care. The article concludes that tele-periodontics is poised to become an integral component of modern periodontal practice, requiring focused research to develop robust, standardized clinical and ethical frameworks.
Introduction: Tuberculosis (TB) remains a significant public health challenge, particularly with the emergence of Drug-resistant Tuberculosis (DRTB). Assessing the ‘quality of life’ (QoL) of DRTB patients is essential for addressing not only the medical but also the psychosocial impacts of the disease. This study aimed to assess the QoL of DRTB patients attending the DRTB centre in Gwalior, Madhya Pradesh, and to identify socio-demographic factors that influence QoL across various domains. Methodology: This cross-sectional study included 150 DRTB patients aged 15-70 years. Data were collected using the WHO-QoL BREF questionnaire, assessing four domains: physical health, psychological health, social relationships, and environment. Statistical analysis was performed using t-tests, ANOVA, and regression models. Results: The study found that the social domain had the highest mean score (56.20 ± 16.89), while the physical (50.74 ± 13.71) and environmental domains (50.08 ± 15.56) had the lowest scores. Age, gender, education, marital status, and socioeconomic class were significantly associated with QoL scores. Married patients, those with higher education, and individuals from higher socioeconomic classes showed better QoL. Females scored higher in social and environmental domains, while younger patients had better psychological well-being. Conclusion: Socio-demographic factors play a critical role in influencing the QoL of DRTB patients. A holistic care approach, incorporating medical, psychological, and social support, is essential to improve outcomes. Targeted interventions are needed to address the physical and environmental challenges faced by these patients.
Objectives: Point-of-care cranial ultrasound (POCUS) has emerged as a critical diagnostic modality in neonates with perinatal risk factors, allowing bedside assessment of central nervous system abnormalities. Neonates with maternal, per partum, or neonatal risk factors such as prematurity, low birth weight, and respiratory distress syndrome (RDS) are at high risk for neurodevelopmental complications. This study aims to evaluate point-of-care cranial ultrasound findings in neonates with perinatal risk factors, correlating these findings with risk factors and assessing their association with neurodevelopmental outcomes. Methodology: This prospective observational study was conducted over 12 months at a tertiary care hospital, involving 115 neonates with perinatal risk factors. Cranial ultrasounds were performed between days 3–7 of life and neonates with abnormal findings were followed up at 9 months using Trivandrum Developmental Screening Charts to assess neurodevelopmental delays. Results: Abnormal cranial ultrasounds findings were observed in 26% of neonates, with periventricular flares (80%) being the most common, followed by germinal matrix hemorrhage (6.66%), focal cystic lesions (6.66%), and cystic periventricular leukomalacia (3.33%). Significant correlations (p<0.05) were found between abnormal findings and very low birth weight, RDS, sepsis, and birth asphyxia. Among neonates with abnormal findings, 26.7% exhibited delayed milestones. Conclusion: POCUS is an effective, non-invasive, and cost-efficient tool for detecting and monitoring cranial abnormalities in neonates with perinatal risk factors. Its integration into neonatal care protocols facilitates early diagnosis, timely interventions, and better neurodevelopmental outcomes, emphasizing its role in modern neonatal care.
Introduction: Surveillance of Japanese Encephalitis (JE) is important as the presence of the vector has been reported earlier from Western Rajasthan, due to which, a large population remains at risk of getting the disease. Therefore, identifying the pathogen among patients is important for managing and formulating public health policies. Hence, this study was planned to detect the presence of JE in pediatric patients attending tertiary centers in Rajasthan and the clinical-epidemiological profile in positive cases. Methodology: This prospective, cross-sectional study included suspected pediatric patients of meningoencephalitis up to the age of 18 years. A cerebrospinal fluid (CSF) sample was obtained using aseptic procedures, and JE IgM ELISA was done using the NIV IgM antibody capture ELISA or JE Detect™ IgM Antibody Capture ELISA (Inbios). Results: Seven (0.63%) samples were positive for JE out of 1097 patients. Among participants, 63.6% were males, of which 0.57% were positive, while 36.3% were females, with 0.75% positivity. Higher positivity was observed in the age group of 12-18 years (2.08%). All were having fever and seizures with altered sensorium (70%), neck rigidity (40.1%), headache (35%), vomiting (29.9%), Brudzinski sign (29.9%), and abdominal pain (16.9%). Out of seven positive cases, three (42.86%) were discharged without any neurological sequelae, two (28.5%) were discharged with neurological sequelae, two (28.5%) died. Conclusion: This study documented the emergence of JE in Rajasthan. Regular surveillance is needed to test the presence of JE in cases of meningoencephalitis, and steps should be taken to control the vector. Moreover, other pathogens should also be tested regularly.
Introduction: HIV infection is primarily caused by Human Immunodeficiency Virus type 1 (HIV-1), and has become a chronic condition with the advent of multi-drug antiretroviral therapy (ART). ART can also lead to adverse effects, including renal dysfunction, especially in patients receiving Tenofovir-based regimens. The objective of this study is to estimate the prevalence of renal dysfunction in HIV-infected patients on ART for ≥6 months; identify factors associated with renal dysfunction and assess the impact of Tenofovir duration on renal function. Methodology: The study included 300 HIV-positive patients on Tenofovir-based ART for at least six months. Renal dysfunction was defined based on estimated glomerular filtration rate (eGFR): mildly decreased renal function as eGFR 60–89 mL/min/1.73 m², and kidney failure as eGFR <15 mL/min/1.73 m². Demographic, clinical, and biochemical data were collected using a pre-validated, structured questionnaire with convenience sampling. Data were analyzed using SPSS version 25. Results: Among 300 HIV-positive patients on Tenofovir-based ART for ≥6 months, 45% had mildly decreased renal function, while 0.3% experienced kidney failure. Mean age was 37.97 years (SD 11.15), with age showing a significant association with renal function (p <0.001); younger participants predominantly had normal renal function, whereas older age groups had higher impairment rates. Conclusion: Prevalence of renal dysfunction among HIV patients on Tenofovir-based ART was notable at 45.3%. Age, body weight, serum potassium, and albumin levels were significant predictors of renal function. These findings emphasize the importance of routine renal monitoring in HIV positive patients receiving Tenofovir based ART, to ensure early detection and intervention.
Introduction: Spinal cord injury causes extensive musculoskeletal insult, which results in temporary or permanent dysfunction in motor, sensory, and autonomic functions. This study aimed to assess neurogenic bowel dysfunction in spinal cord injury patients and its impact on quality of life. Methodology: A total of 100 patients with spinal cord injury presenting after six months of injury were clinically evaluated for level, extent, and severity according to ASIA scale. International spinal cord injury bowel function basic data set version-2 regarding bowel functions of the last month was filled and neurogenic bowel dysfunction score was calculated. Overall impact of neurogenic bowel dysfunction on quality of life in the last week was assessed using Likert-type questionnare. Results: Upper motor neuron neurogenic bowel was present in majority of patients (81%). 88% of study patients had history of two to six times per week frequency of defecation, defecation duration of 78% patients were 31 to 60 minutes. Around 48% study patients were suffered from moderate neurogenic bowel dysfunction. There was statistically significant association between neurogenic bowel dysfunction grade with age groups, ASIA grade and types of neurogenic bowel. 58% patients’ quality of life was impacted due to neurogenic bowel dysfunction. Conclusions: SCI has a significant effect on neurogenic bowel in term of faecal incontinence, defecation time, constipation, method of bowel management. Association of NBD with age group, type of neurological bowel, ASIA grading was found statistically significant. During the early stage of rehabilitation, an appropriate bowel program should be carefully designed to prevent bowel dysfunction, and to improve quality of life.
To obviate external influences and stringency that is being increasingly imposed upon medical professionals, the commentary underscores the importance of earnest self-appraisal and genuine course correction by healthcare professionals where blamed, instead of blind and blatant denial, and suggests some remedies to restore public trust, and lost glory and grandeur that were enviable in the days gone by.
