Placenta accreta spectrum (PAS) has emerged as one of the most consequential complications in contemporary obstetrics, yet the biological mechanisms underlying abnormal placental attachment remain incompletely resolved. Much of the existing literature has focused on surgical management and imaging diagnosis, while the genomic and molecular architecture of PAS has received comparatively less integrative attention. Over the past decade, however, rapid advances in high-resolution molecular technologies – including single-cell transcriptomics, spatial transcriptomics, proteomics, and circulating biomarker profiling – have begun to reveal a far more complex biological landscape than previously appreciated. The present systematic review was therefore undertaken to synthesize current evidence on the genomic, epigenetic, and multi-omics determinants of pathological trophoblast invasion that characterize PAS. A comprehensive literature search was conducted across major biomedical databases, with study identification, screening, and eligibility assessment performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidance. After sequential filtering of records through predefined inclusion criteria and risk-of-bias evaluation, forty-three studies were included in the final qualitative synthesis. Across these studies, converging lines of evidence suggest that PAS reflects a convergence of several molecular disturbances rather than a single pathway defect. Altered trophoblast differentiation programs, dysregulated signaling networks – including Wingless-related Integration Site, NOTCH, Phosphoinositide 3-Kinase/AKT, and transforming growth factor-β – and disruption of the decidual immune microenvironment consistently appear as central elements. In parallel, emerging biomarker research highlights the potential clinical relevance of circulating proteins, exosomal microRNAs, and cell-free placental DNA as early indicators of abnormal placentation. Taken together, the literature indicates that PAS may be better understood as a systems-level disorder of placental invasion governed by interconnected genomic and microenvironmental processes. Integrating multi-omics discovery with translational biomarker development may ultimately enable earlier risk prediction and more individualized clinical management of PAS.
Background: Malnutrition and muscle wasting are common in critically ill patients and contribute to functional decline. Multidisciplinary nutrition support teams (NSTs) are recommended to improve nutritional delivery; however, data from Indian intensive care units (ICUs) using functional endpoints are limited. Objectives: To evaluate the effect of NST implementation on handgrip strength (HGS) (primary endpoint) and nutritional outcomes in critically ill adults. Materials and Methods: Single-center pre–post observational study including 100 adult ICU patients (>18 years; ICU stay >48 h). Phase 1 (n = 50) received standard nutrition care and Phase 2 (n = 50) received structured NST-led care (intensivist, dietitian, nurse, pharmacist, and respiratory therapist). Nutrition targets were prescribed based on body mass index and measured resting energy expenditure (indirect calorimetry). Dominant HGS and weight were recorded on day 1, at discharge, and at day 28 postdischarge. Results: Baseline age, sex distribution, and acute physiology and chronic health evaluation II (APACHE II) were similar between groups; Nutrition risk in critically ill (NUTRIC) score was higher in Phase 1. Calorie and protein delivery improved in Phase 2 with lower deficits (all P < 0.01). The primary endpoint change in dominant HGS from Day 1 to Day 28 was − 1.02 ± 1.48 kg in Phase 1 versus + 1.99 ± 2.88 kg in Phase 2 (mean difference 3.01 kg; 95% confidence interval [CI] 2.11 to 3.91; P < 0.001). Effect size was large (Cohen’s d = 1.31). In an adjusted linear model (age, sex, APACHE II, and NUTRIC), NST remained independently associated with improved grip change (adjusted mean difference 3.01 kg; 95% CI 2.02 to 3.99; P < 0.001). Conclusion: Implementation of a multidisciplinary NST improved nutritional adequacy and was associated with clinically meaningful improvement in muscle strength recovery. Structured team-based nutritional care may improve the functional outcomes in critically ill patients in Indian tertiary care settings.
Background: Hypertension is a significant risk factor for cognitive decline, yet the roles of systemic inflammation and autonomic dysfunction in this progression remain poorly understood. This study aimed to evaluate the associations between the neutrophil-to-lymphocyte ratio (NLR), heart rate variability (HRV), and cognitive impairment in hypertensive patients. Methods: A cross-sectional study was conducted among 161 subjects (88 hypertensive and 73 normotensive). Cognitive function was assessed using the Hindi mini-mental state examination and the Hindi Montreal Cognitive Assessment (MoCA). Autonomic function was measured via HRV parameters, including standard deviation of normal to normal intervals (SDNN) and low-frequency power. Systemic inflammation was evaluated using the NLR. Independent predictors were identified using multivariate regression analysis. Results: Hypertensive subjects demonstrated significantly lower cognitive scores (MoCA: 24.89 ± 2.67 vs. 26.90 ± 1.78; P < 0.001) and higher NLR (2.89 ± 1.18 vs. 1.01 ± 0.24; P = 0.034) compared to normotensives. Within the hypertensive group, 19.3% exhibited cognitive impairment. These individuals had significantly higher NLR (3.01 ± 0.78 vs. 2.23 ± 0.49; P = 0.02) and lower SDNN (31.78 ± 19.38 vs. 36.12 ± 22.81 ms; P = 0.023). Multivariate analysis identified age (β = −0.312), elevated systolic blood pressure (SBP) (β = −0.245), NLR (β = −0.198), and SDNN (β = 0.186) as independent predictors of cognitive status. Adjusting for confounders, the risk of cognitive impairment was 4.12 times higher with SBP > 140 mmHg (P < 0.001), 2.84 times higher with NLR >2.5 (P = 0.003), and 2.31 times higher with SDNN <30 ms (P = 0.014). Conclusion: Elevated systemic inflammation (NLR) and reduced autonomic flexibility (SDNN) are independent predictors of cognitive decline in hypertensive patients. These markers, alongside SBP, provide critical prognostic value for identifying patients at high risk of cognitive impairment.
Background: Transfusion-dependent hemoglobinopathies such as sickle cell disease (SCD) and thalassemia require lifelong blood support, but transfusion services in India remain largely designed for episodic care, creating systemic barriers. Aim: To assess administrative gaps in blood transfusion services in a hemoglobinopathy-endemic district and their impact on transfusion-dependent patients. Materials and Methods: A multi-phase administrative audit was conducted in Raigarh, Chhattisgarh (June–October 2022), evaluating four blood banks across different administrative models. Patient experience mapping included 220 transfusion recipients. Administrative assessment, triangulation of findings, and limited pilot corrective interventions were performed. Results: Significant inter-bank variability existed despite uniform regulatory standards. Major gaps included fragmented workflows, poor hemovigilance, inadequate counseling, donor dependency, and weak continuity of care. Patients with SCD and thalassemia faced recurrent delays, repeated donor burden, cumulative financial strain, and poor recognition of chronic transfusion needs. Most deficiencies were process-related rather than resource-related, and selected administrative reforms were operationally feasible. Conclusion: Transfusion-dependent hemoglobinopathies represent a chronic care systems challenge requiring continuity-oriented transfusion services. Substantial improvements may be achieved through workflow redesign and better coordination without major additional resources, while targeted financial protection remains necessary.
Background: Animal bite represents a significant public health concern globally, particularly in developing countries. Previous studies have highlighted the widespread presence of cultural beliefs and misconceptions related to wound management and food restrictions in dog bite victims. The objectives of the study were to assess wound management practices and identify the sociocultural beliefs among animal bite victims before attending a health care facility. Materials and Methods: A cross-sectional study was conducted among animal bite victims attending the Rabies Immunization Clinic, Sir Ronald Ross Institute of Tropical and Communicable Diseases, Hyderabad. A total of 230 study participants were recruited using the consecutive sampling technique and were administered a pretested, semi-structured questionnaire for data collection. The Chi-square test of association was applied to determine the relationships between categorical variables and delay in vaccination. Results: A total of 156 (67.8%) participants out of 230 performed wound management at home. Among those practicing home-based wound care, 33.9% washed the wound with water alone, 20.5% used soap and water, and 28.2% used antiseptic solution. Traditional applications such as turmeric (11.5%), neem leaves paste (3.2%), lime (1.9%), and bitter gourd leaves paste (0.64%) were also reported. 29.13% of participants experienced a delay in initiation of postexposure vaccination. Conclusion: Program managers and policymakers to strengthen community awareness and myth-busting education on immediate wound care and the importance of timely postexposure vaccination.
The growth of smartphones and social networking services in the 21st century has had an enormous impact on the development of childhood and adolescence in India. Digital technologies provide a wide range of opportunities for education, communication, and creativity, but growing evidence indicates that excessive and uncontrolled smartphone and social media use has negative impacts on children’s and adolescents’ mental, physical, and social well-being. Reports of digital literacy challenges, problematic social media use, cyberbullying, sleep disturbances, anxiety, depression, and academic distraction are much higher in some countries. The vulnerability of adolescents is particularly unsettling as a young person enters a pivotal period in both his or her neurodevelopment and psychosocial profile. But in some countries, those responses include limiting social media, prohibiting it in schools, and cracking down on age-verification laws. Australia, for example, has passed one of the harshest world regulations by prohibiting anyone under 16 from using social media, and some European countries are currently grappling with similar measures. India has no strict regulatory controls on children’s use of social media, despite having one of the highest shares of young smartphone users worldwide. This editorial explores global evidence on digital technology and youth, its implications for youth well-being and new regulations, and calls on India to formulate a coherent policy framework to safeguard the welfare of children and adolescents in the digital age.
Objective: The study aimed to phenotypically and genotypically characterize colistin resistance in carbapenem-resistant Klebsiella pneumoniae. Materials and Methods: Isolates of K. pneumoniae obtained in 1 year period from various clinical samples were assessed for Carbapenem resistance using Kirby–Bauer disk diffusion method, and those found resistant were further analyzed for Colistin susceptibility using Broth microdilution method and interpreted as per European Committee on Antimicrobial susceptibility testing guidelines. The colistin-resistant isolates were subjected to molecular detection of mcr-1 gene using gel-based polymerase chain reaction. Statistical Analysis: Odds ratios and 95% confidence intervals were calculated using appropriate statistical software. P values were calculated using the comparison of proportions, with a significant value being <0.05. Results: The study was conducted on 243 isolates of K. pneumoniae obtained from urine (41.6%), respiratory samples (25.9%), pus (16.4%), blood (10.3%), and sterile body fluids (5.8%). Out of these, around 35% were carbapenem-resistant. The carbapenem-resistant K. pneumoniae were isolated more from respiratory samples (44.4%) and least in urine (29.7%). Almost 55% of carbapenem-resistant K. pneumoniae were resistant to colistin, with almost 37% having a minimum inhibitory concentration of 8 μg/mL. Both the resistant isolates were maximally obtained from intensive care unit samples. None of the colistin-resistant isolates were found to harbor mcr-1 gene. Conclusions: The colistin resistance remains under-detected due to a lack of proper infrastructure, especially in developing countries, and its ever-increasing resistance requires an evidence-based administration of the drug, especially to patients harboring known multidrug-resistant pathogens such as K. pneumoniae.
Background: The impact of Anti-Tuberculosis treatment on Visual acuity and on retina using optical coherence tomography. Methods: All patients aged 15 to 45 years, referred to Ophthalmology OPD with tuberculosis prior to the start of antitubercular treatment (AKT), were included between 2022 and 2024. Data like visual acuity and retinal nerve fiber layer thickness were collected at baseline, prior to the start of AKT, and at 1 and 3 months after initiating AKT. Results: Ethambutol had the largest percentage of patients with abnormal vision, while individuals treated with linezolid, levofloxacin, cyclosporine, bedaquiline, pyrazinamide, and clofazimine had a high prevalence of normal eyesight. All patients had normal fundus findings at the initial visit and the 1-month follow-up. However, aberrant fundus abnormalities, including bilateral disc edema and flame-shaped hemorrhages, appeared by the 3-month follow-up in patients on linezolid (1.9%), levofloxacin (3.4%), cyclosporine (2.5%), bedaquiline (2.9%), pyrazinamide (2.0%), and clofazimine (2.0%). All patients on all medications showed normal color vision (CV) at the initial appointment. However, individuals started exhibiting aberrant CV results at the 1-month follow-up when taking bedaquiline, levofloxacin, and linezolid. At the 3-month mark, delanamide also showed a higher percentage of CV anomalies (14.3%). Conclusions: In our study, majority of patients on AKT maintained normal vision throughout the treatment, experienced mild visual impairments, with ethambutol showing the highest incidence of abnormal vision outcomes, though not statistically significant. Overall, AKT demonstrated a minimal impact on both visual acuity and on the retina in most patients.
Background: Weaning from mechanical ventilation is a critical phase in the care of intensive care unit (ICU) patients. Accurate prediction of weaning success is essential for patient outcomes. Ultrasound evaluation of diaphragm function and lung aeration has gained attention as a potential predictor. This study aimed to assess the role of ultrasound in predicting weaning outcomes, comparing diaphragm thickening fraction (DTF) and lung ultrasound score (LUS). Methodology: This study was conducted in a tertiary care ICU from November 2019 to December 2021, involving 80 mechanically ventilated patients. The study assessed age, sex, ICU stay duration, and mechanical ventilation duration in two groups: those successfully extubated and those who failed weaning. Ultrasound measurements of DTF and lung aeration (LUS) were obtained and analyzed. Results: Age and sex did not significantly differ between the groups, but the duration of ICU stay and mechanical ventilation differed markedly, with patients who failed weaning having longer stays in both. DTF emerged as a significant predictor of weaning success, with a cutoff value of 32.5% showing high sensitivity (92.9%) and specificity (86.8%). LUS also demonstrated predictive power, with a sensitivity of 83.3% and specificity of 86.8% when using a cutoff value of 8.5. DTF outperformed LUS with a slightly higher AUC (0.978 vs. 0.943) and greater sensitivity. Conclusion: This study highlights the value of ultrasound assessment in predicting weaning outcomes for mechanically ventilated patients. Both DTF and LUS proved to be significant predictors of weaning success. These noninvasive, bedside ultrasound techniques can assist clinicians in making informed decisions during the weaning process. Ultimately, the results suggest that early identification of patients at risk of weaning failure can reduce mechanical ventilation duration and improve ICU patient outcomes.
Artificial intelligence (AI) is increasingly being explored as a means to extend the analytical and clinical scope of prenatal genomic screening, yet reported performance and implementation remain heterogeneous across applications. This systematic review synthesizes current evidence on AI-assisted methods in cell-free DNA (cfDNA) screening, noninvasive detection of monogenic and copy-number variants, and AI-supported interpretation of fetal exome and genome sequencing. In accordance with PRISMA 2020 guidelines, structured searches of major biomedical databases and registries were conducted through January 2025. Of 1,284 records identified, 38 studies met the inclusion criteria and were included in a qualitative synthesis. The reviewed literature encompassed machine learning models leveraging cfDNA fragmentomic features, deep-learning architectures for fetal variant inference, automated noninvasive prenatal testing (NIPT) pipelines, and AI-enabled prioritization of variants in fetal exome and genome sequencing. Across studies, AI-based approaches were reported to improve defined analytic tasks compared with conventional workflows. For trisomy risk prediction, several models demonstrated high discriminative performance, with reported area under the receiver operating characteristic curve values commonly ranging from approximately 0.90 to 0.97. In genome-wide copy-number variation and monogenic variant detection, selected AI frameworks reported sensitivities and specificities frequently exceeding 90% under controlled study conditions, alongside high overall accuracy. AI-assisted fetal-fraction estimation models showed improved robustness in low fetal fraction samples, and multiple studies described recovery of clinically relevant information from borderline or noninformative NIPT results. Integration of AI-derived genomic outputs with prenatal ultrasound phenotyping was also associated with higher diagnostic yields in cohorts with fetal structural anomalies. Nevertheless, the evidence base is constrained by retrospective study designs, population bias, limited external validation, and inconsistent reporting of model development. Ethical and implementation challenges, including explainability, equity, and communication of probabilistic results, remain prominent. Overall, current evidence suggests that AI-enhanced prenatal genomics is progressing toward early clinical integration, while underscoring the need for standardized validation frameworks, diverse population datasets, and robust governance to support responsible use in perinatal care.
Background: Hepatitis B virus (HBV) induces both acute and chronic hepatitis in humans. Although a safe and effective vaccine exists, HBV infection continues to pose a major global health challenge. Chronic HBV affects approximately 240–300 million individuals worldwide. Annually, about 600,000 fatalities occur due to liver diseases associated with HBV. Aims: This study aims to detect prevalent genotypes in cases of hepatitis B attending a tertiary care hospital. Settings and Design: A hospital-based prospective study was conducted in the viral research and diagnostic laboratory from January 1, 2023, to June 30, 2024. Materials and Methods: A 5 ml blood sample was collected from each patient and tested for hepatitis B surface antigen (HBsAg) using chemi enzyme-linked immunosorbent assay on the Abbott ARCHITECT i1000SR (Abbott Diagnostics, Chicago, IL, USA) platform. A total of 76,896 patients screened, 759 tested positive. Among them, 588 patients had detectable viral load using the Truenat® assay. Deoxyribonucleic acid was extracted from 100 samples with high viral loads using QIAamp® kit. Real-time polymerase chain reaction was used for genotype analysis using Sacace™ HBV Genotype kit. Results: A total of 76,896 patients were screened for HBsAg, revealing 759 positive cases (0.98% seroprevalence). Genotype D was found to be more prevalent, comprising 68% compared to 32% for Genotype A, with the highest number in 20–29 years of age group (29%), where 69% were Genotype D. The youngest age group (10–19) showed a contrasting trend, with 75% being Genotype A. Conclusions: Genotype D is prevalent in our region. To reduce HBV transmission, vaccination and public health interventions should target predominant genotypes.
Beginning latter part of the twentieth century, a paradigmatic transformation in scientific thought: a shift from reductionist models toward an understanding of complexity and systemic interdependence is being witnessed. Disciplines such as the chaos theory, systems biology, network science, and ecology have revealed that the behavior of wholes cannot be entirely deduced from the properties of their parts. This paper explores resonances between this modern scientific orientation and classical Indian philosophical traditions, particularly Vedic, Upanishadic, Sāṃkhya, Buddhist, and Tantric thought. While historically and culturally distinct, these systems share a vision of reality as a dynamic, self-organizing web of interrelations rather than a mechanistic assemblage. By examining the Indian concepts of Ṛta, dharma, Brahman, Prakṛti, pratītya-samutpāda, and spanda, the attempt is to identify a philosophical convergence with contemporary theories of complexity, emergence, and nonlinearity. Rather than suggesting a direct anticipation of modern science by ancient thinkers, the analysis highlights a dialogical correspondence that may contribute to an integrative epistemology – one that unites scientific and contemplative modes of knowing within a framework of relational ontology.
Background: Medical education in India has been revamped and restructured. Among the various new inclusions are a structured competence-based curriculum. The gazette notification also outlines the required activities of an intern in all disciplines, including community medicine. However, despite structured guidelines developed by experts, the confidence of an Indian Medical graduate depends on unknown factors. Objective: This study aims to find out the constructs governing intern’s confidence based on competencies from each domain of learning in the subject of community medicine. Methodology: A cross-sectional study was done among 62 interns completing posting in community medicine in the government medical college from October 2024 to November 2024. Tools: A valid, reliable scale was developed based on components of three domain knowledge as per the CBME curriculum and the gazette notification of internship guidelines. Results: Two factors emerged from a 12-item, valid, reliable tool, namely “primary healthcare program-based activities” and “institute-based activities.” Both the factors are mutually discriminent with the second factor only being convergent. Thirty-four percent of data variation was explained. Conclusion: Constructs (of confidence) identified in training for community medicine are site dependent, with activity either at college/institute as one and the other being program-based activities in the first and second tier of primary health care.
Background: Autism spectrum disorder (ASD) and other neurodevelopmental disorder among children have an increasing prevalence globally. Measuring the severity of such condition is of great value for parents and clinicians. There are limited validated tool to assess the severity of ASD in the regional language. Aims: This study aims to evaluate validity and reliability of a questionnaire on the assessment of severity of ASD and neurodevelopmental disorder in the Bengali language. Methods: After obtaining ethical approval, this psychometric study was conducted among 104 children attending district Early Intervention Center in Darjeeling district. Results: Items were generated by literature review. Kaiser-Meyer-Olkin measure of sampling adequacy of 0.67 and significant Bartlett’s test of sphericity (P < 0.05) indicates that the sample size is adequate for factor analysis. Confirmatory factor analysis (CFA) revealed that 27 items out of 29 items were suitable for the Bengali version of modified questionnaire. The factorial analysis revealed five domains such as language, communication, cognitive awareness, socialization, and behavior that explain 54.2% estimated variance providing reasonable representation of underlying constructs in the questionnaire. The values of the fit indices in CFA were acceptable. Overall reliability was measured by Cronbach’s alpha (0.934) and McDonald’s omega (0.902). Conclusions: The questionnaire is suitable for use in Bengali population as it shows acceptable validity and reliability. However, more research should be done in different parts of the country to evaluate its effectiveness in various cultural and medical settings.
Background: This retrospective observational study examines the effectiveness of new safety protocols that address psychiatric crises and substance abuse cases within emergency departments (EDs). Methods: The research examined 500 patient records spanning from 2020 to 2023 to evaluate treatment results between 278 patients who received new safety protocols and 222 patients who received standard care. The new protocols consisted of physical and pharmacological restraints together with enhanced security measures and psychiatric counseling. Descriptive and multivariate statistical analyses were conducted. The primary outcome was the patient discharge rate. The study measured secondary outcomes by evaluating ED stay duration, along with safety requirements, hospital admission, readmission frequencies, and treatment stability. Results: The discharge rate showed a substantial improvement in patients who received the protocol-based treatment, reaching 51% compared to 45% in patients without the protocol (P < 0.05). The primary outcome measurement demonstrated improved results. The average duration of ED visit remained unchanged between groups (mean: 7.05 h, standard deviation: 3.42). Patients who were older in age and widowed needed fewer supplemental security interventions during their stay (P < 0.05). The research showed that patients who graduated from university needed less hospitalization than other patients (P = 0.034). Conclusion: The research shows that individualized safety protocols alongside interdisciplinary care can boost discharge rates for patients without extending their time in the ED. The research evidence supports implementing these protocols as standard emergency care procedures to improve both staff and patient safety and maximize resource effectiveness.
Osteopetrosis, also known as “marble bone disease,” is a group of rare genetic disorders caused by osteoclast failure, which ranges widely in severity. Osteopetrosis presents with a varied spectrum ranging from craniofacial abnormalities such as frontal bossing and nerve compression, visual defects to organomegaly and anemia attributed to extramedullary hematopoiesis due to bone marrow failure, which can be life-threatening. Similarly, hypercalcemia can trigger acute pancreatitis, with primary hyperparathyroidism being the most common cause. While rare, hypercalcemia from multiple myeloma can also lead to this condition. Herein, we present two interesting cases with unusual presenting complaints pertaining to these respective disorders, where timely diagnosis and intervention were lifesaving.
Introduction: Hepatitis B virus (HBV) is a DNA virus that causes liver fibrosis (FIB), inflammation, and cancer. Accurate FIB assessment is the key to managing chronic liver disease. Noninvasive biomarkers like FIB-4 (based on age, aspartate aminotransferase [AST], alanine aminotransferase, and platelets) and AST/platelet ratio index (APRI) (AST to platelet ratio) are widely used. This study assessed the accuracy of APRI, FIB-4, and HBV DNA in detecting advanced FIB in human immunodeficiency virus (HIV)–HBV coinfected patients on antiretroviral therapy (ART), as well as in HBV mono-infected patients. Materials and Methods: 100 HIV–HBV coinfected and 50 HBV mono infected patients were recruited in this study after taking informed consent, presenting to ART center and medicine outpatient departments of our tertiary care center, respectively. Results: A total of 100 patients, divided into two groups: 50 mono-infected with HBV and 50 coinfected with HIV and HBV were included. FIB-4 score were F0–F1, n = 19; F2, n = 9; F3, n = 22 in HIV–HBV coinfected patients whereas HBV mono-infected patients had F0–F1, n = 17; F2, n = 7 and F3, n = 26. APRI score were > 0.7, n = 88%; <0.7 and ≤ 1.5, n = 8%; <2, n = 4% in HIV–HBV coinfected patients and > 0.7, n = 44%; <0.7 and ≤ 1.5, n = 42%; <2, n = 14% in HBV mono-infected patients. High HBV viral load was seen in patients having elevated FIB-4. Also, patients with mono-infected HBV were having symptomatic hepatic disease as compared to HIV–HBV coinfected patients who were generally asymptomatic. Conclusions: FIB-4 and APRI are feasible tools for managing HIV–HBV coinfected patients in resource-limited settings. Routine HBV screening, liver enzyme checks, and FIB assessment using APRI and FIB-4 should be integrated into ART initiation and ongoing care for HIV-positive individuals.
Publications make scientific data accessible to the general public and enable the academic community to assess new information for other academicians to evaluate the quality of research and utilization of results. Some factors help young researchers select quality journals for selection journal for publication. Impact factors (IFs), indexing agencies, and predatory journals are some major elements that affect researchers, academicians, and scholars worldwide before they publish their work. Although IF is widely used by educational institutions and practitioners, there are still misconceptions about calculating IF, why it is important, and how it is used. What are predatory journals? In India, nowadays, IF has given importance to the performance evaluation and promotion of teaching faculty in medical colleges, nursing colleges, and other faculty under the University Grant Commission and other research institutions. The objective of this study is to develop insights for young researchers about IF, indexing agencies, predatory journals, writing articles, and other metrics for evaluating and selecting journals for publication and enhancing author visibility.
Introduction: Pleural effusion is a common diagnostic problem associated with significant morbidity. Its management mainly depends on the correct diagnosis of underlying disease. The present study is being done to evaluate the efficacy of pleural fluid-to-serum bilirubin ratio versus Light’s criteria in differentiating exudates from transudates. Materials and Methods: The present observational study was conducted in 60 patients with pleural effusion in the Department of Respiratory Medicine, Gandhi Medical College and Hospital, Secunderabad, TG, after obtaining clearance from the Institutional Ethics Committee over a period of 18 months. On the basis of underlying disease, the pleural effusions are grouped into transudate and exudate. Pleural fluid and serum samples of the study groups were collected and analyzed for bilirubin ratio, protein, lactate dehydrogenase, and Light’s criteria, and the results were compared. Results: In our study, out of total 60 patients with pleural effusion, 33 were exudates (55%) and 27 were transudates (45%). In the present study, it was observed that the sensitivity of Light’s criteria appears to be similar to pleural fluid/serum bilirubin ratio (96.97%) for classifying exudates, whereas in terms of specificity, the pleural fluid/serum bilirubin ratio (96.30%) was superior when compared to Light’s criteria (92.59%). The number of false-positive cases was minimum with pleural fluid/serum bilirubin ratio (positive predictive value [PPV] – 96.3%) when compared to Light’s criteria (PPV – 94.12%), whereas the negative predictive value for both Light’s criteria and bilirubin ratio was similar (96.1% and 96.3%). Conclusions: In the evaluation of pleural effusions in low-resource settings, to differentiate transudative and exudative pleural effusions, the pleural fluid-to-serum bilirubin ratio can be used as an easy and cost-effective alternative diagnostic tool.
A profound transformation is underway, driven by the emergence of artificial intelligence (AI) as a powerful catalyst for interdisciplinary collaboration. AI is not merely a tool for data processing; it is an integrative force, dismantling traditional boundaries and enabling a new era of research that is more holistic, efficient, and ultimately, more effective. For a journal dedicated to the fusion of applied sciences and clinical practice, the advent of AI represents a pivotal moment, demanding a re-evaluation of how we discover, diagnose, and deliver healthcare.
