International Journal of Applied and Basic Medical Research最新文献

Background: Current American College of Rheumatology/European League Against Rheumatism (ACR-EULAR) guidelines indicate a positive biopsy with a score of ≥1 using focus scores (FS) to quantify lymphocytic foci presence. Accurate labial minor salivary gland biopsy (LMSGB) diagnosis depends on proper biopsy sampling, observer interpretation, and FS. There are fewer studies that evaluate the sensitivity and specificity of histology and serological testing. There was a substantial association between FS and the serological test, according to one study, but not in another.

Aim: To determine the diagnostic sensitivity and specificity of LMSGB following the current ACR/EULAR diagnostic recommendations used for patients with suspected Sjögren's disease (SjD).

Materials and methods: Patients who had the symptoms of either dry mouth/eyes or both or suspected SjD with extraglandular symptoms and underwent minor salivary gland biopsies were included in this study. The study analyzed the variables of adequate amount of biopsy samples, focal scores, interpretations among pathologists with demographical data, and biochemical analysis for SjD diagnosis.

Results: The positive predictive and negative predictive values were low, indicating limited effectiveness in predicting biopsy results. The overall accuracy was 40.54%, indicating ineffectiveness in distinguishing between those with and without the condition.

Conclusion: The present study highlights the diagnostic limitations of minor salivary gland biopsy, indicating that a negative result does not rule out SjD but can rule out other infiltrative causes of xerostomia.

Three Chlamydia trachomatis biovars are recognized-trachoma (serovars A-C), urogenital (serovars D-K), and lymphogranuloma venereum (LGV) (serovars L1-L3). Only serovars L1-L3 cause invasive infection with bubo formation. Here, we present an atypical case of C. trachomatis serotype D with clinical presentation of LVG-unilateral inguinal lymph edema plus bubo formation. A 35-year-old male who have sex with men presented to the clinic with unilateral swollen painful right inguinal lymph nodes forming bubo, accompanied by fever up to 39°C and malaise. Complete blood count was tested. Urethral sample for DNA extraction and polymerase chain reaction (PCR) was taken. Ultrasonography and proctoscopy were performed. Fine-needle aspiration from lymph node was tested for malignant cells and PCR diagnostics. A full STI screen was performed. PCR positive for C. trachomatis was detected. The exact classification of C. trachomatis species needed additional genovar-specific C. trachomatis PCR. Surprisingly genotype D instead of LVG L1-L3 was discovered. Co-infection with Mycoplasma genitalium was detected. HIV, Neisseria gonorrhoeae, HSV, and Ureaplasma spp. were negative. Serology excluded syphilis, HBV, HCV, infectious mononucleosis, toxoplasmosis, and cat scratch disease. Malignant cell formation was ruled out. This case highlights the importance for clinicians to consider atypical and invasive presentations of nonLGV C. trachomatis genotypes, as reliance on clinical features alone may lead to misclassification, inappropriate management, and delayed targeted therapy.

Pigmented purpuric dermatoses (PPDs) comprise a collection of disorders characterized by many petechial hemorrhages due to underlying capillaritis. Specific clinical characteristics facilitate the categorization of PPD into different variants, with Schamberg's disease being the most frequently encountered. Treatment may not always yield positive results, and recurrences are common. We report the case of a 38-year-old male patient who presented with numerous reddish lesions on his lower and upper limbs, as well as his trunk. He exhibited purpuric eruptions and brownish discolorations that were diffusely spread across these areas. A biopsy indicated Schamberg's disease. The patient was treated with oral anti-inflammatory drugs. After 3 months of follow-up, there was significant improvement in the existing lesions, and no new lesions had developed.

The global incidence of placenta accreta spectrum is increasing rapidly, mirroring the trend of increased cesarean delivery. We report a case series of four patients diagnosed with placenta percreta who presented to a single unit of the department of obstetrics and gynecology at a tertiary care center in North India from March 2024 to May 2024 with a pathologically proven diagnosis. In all cases, a hysterectomy was the outcome. We have included cases with prenatal diagnoses in this case series. For appropriate planning, a prenatal diagnosis of placenta percreta is necessary, as the multidisciplinary team's approach is particularly beneficial. After DJ stenting, elective surgery was scheduled in one of the four instances.

Introduction: Human Milk Banking (HMB) has emerged as an effective strategy to provide pasteurized Donor Human Milk (DHM) when a mother's own milk is unavailable or insufficient. This study assessed newborn feeding practices and awareness and attitude toward human milk donation among postnatal mothers.

Materials and methods: A cross-sectional study was conducted for 3 months among 206 mothers admitted to postnatal wards under a tertiary care institute of Kolkata. The mothers were selected by systematic random sampling, and face-to-face interviews were conducted using an interview schedule, which also included an observation checklist to assess the newborn feeding practices. Descriptive and inferential statistics were employed as applicable.

Results: The mean age of study participants was 25.1 (±2.9) years. Almost 92.1% of mothers fed their newborns with breast milk. Around 63% were unaware that DHM is the best alternative for preterm infants when mothers' own milk is unavailable. Nearly half (49%) reportedly had low awareness, while 42% had unfavorable attitude toward human milk donation. Only 32% were aware of an established HMB in the study setting. Mothers' education had statistically significant associations with newborn feeding practices and awareness of human milk donation, respectively.

Conclusion: Almost half of the mothers had low awareness and unfavorable attitude toward human milk donation. Increased awareness campaigns, workshops are needed to be conducted to generate more awareness regarding milk donation and HMB.

Introduction: More than half of Indian rural women (pregnant and non-pregnant) are anemic. Limited evidence exists on the effectiveness and tolerability of ferric carboxymaltose (FCM) in Indian rural and tribal women.

Aims and objectives: The primary objective was to assess the effectiveness of intravenous (IV) infusion of FCM in iron deficiency anemia (IDA) in rural and tribal women. Secondary objectives included evaluating changes in hematological parameters from baseline and assessing tolerability.

Materials and methods: A prospective, open-label, observational, real-world, single-center study was conducted at Getwell Multispecialty Hospital, Manchar, Pune. Female patients with IDA (Pregnant: Hb 6 to <11 g/dL, non-pregnant: Hb: 6 to <12 g/dl) were recruited. FCM was administered as an IV infusion, and patients were followed up at 6 weeks. Change in Hb, other haematological parameters from baseline were assessed. Adverse effects related to FCM were monitored.

Results: Fifty-five patients completed the study; 7.27% were pregnant and 92.73% were nonpregnant. A significant increase in Hb of 3.64 g/dL was recorded at 6 weeks. All pregnant women achieved the target Hb of 11 g/dL, whereas 58.82% of nonpregnant women reached 12 g/dL; there was a significant increase in hematocrit, mean corpuscular volume, mean corpuscular hemoglobin (MCH), and MCH concentration (P < 0.05 for all) as compared to baseline. FCM infusion was well tolerated.

Conclusions: FCM IV infusion significantly increased Hb levels and other hematological parameters at 6 weeks. FCM appears to be an effective and well-tolerated treatment for IDA in pregnant and non-pregnant women in rural and tribal area.

Background: With the adoption of competency-based medical education (CBME) by the National Medical Commission of India in 2019, assessment methods such as objective structured clinical/practical examination (OSCE/OSPE) have gained importance for objectively evaluating clinical and practical competencies. However, the success of such methods largely depends on effective faculty training and subsequent transfer of training (TOT) to the workplace.

Aim and objectives: This study aimed to evaluate the immediate and long-term TOT among medical faculty following a structured OSCE/OSPE workshop and subsequent implementation in respective departments. The objectives included to design and conduct the training workshop on OSCE/OSPE and to assess knowledge retention, skill application, and impact on student learning using Kirkpatrick's four-level evaluation model.

Materials and methods: A prospective, interventional study was conducted over 3 years at a medical college with an annual intake of 150 MBBS students. The first phase involved training 29 faculty members across 16 departments through a 1-day OSCE/OSPE workshop. The second phase involved implementation in respective departments. Data were collected from trained faculty, peer faculty and students using reflective writing, self-efficacy questionnaires, Likert-scale feedback, and open-ended responses. Quantitative data were analyzed in terms of medians, percentages and satisfaction indices and represented in graphs, whereas qualitative data were transcribed and thematic analysis was conducted.

Results: A total of 29 trained faculty, 53 peer faculty, and 410 students participated in the study. Following the OSCE/OSPE workshop, 94% of departments implemented it in their workplace. Faculty showed significant improvement in knowledge, confidence, and self-efficacy, with satisfaction indices ranging from 80% to 90%. Peer faculty validated the effective application and teamwork of trained faculty. Students found OSCE/OSPE more structured, equitable, and less stressful, with improved confidence and skill retention. The study demonstrated successful TOT at all levels of Kirkpatrick's model, with sustained implementation across 3 years and regular practice thereafter, indicating strong institutional integration and impact.

Conclusions: OSCE/OSPE-based assessment was perceived positively by faculty, peers, and students, reinforcing its value in CBME. Continuous follow-up and institutional commitment are essential for long-term success. The study provides strong evidence that well-structured faculty training, followed by support and evaluation, facilitates effective and sustainable TOT.

Introduction: Vitamin D (VD) deficiency has become a global epidemic in the past 2 decades. Cardiac troponin is a specific biomarker for detecting myocardial injury, particularly in the context of myocardial infarction (MI), where elevated levels are indicative of myocardial necrosis. This study aimed to investigate the relationship between VD levels and troponin values in patients admitted to the Intensive Care Unit under suspicion of acute coronary syndrome, including comparisons with patients ultimately not diagnosed with ACS.

Materials and methods: This cross-sectional study included a group of 69 patients who were hospitalized in the Intensive Care Unit of the Hospital under suspicion of acute coronary syndrome. The control consisted of patients without ACS. The content of VD-(25[OH]D) in blood plasma was measured by enzyme-linked immunosorbent assay during June-August 2024. Blood samples were taken in tubes with ethylenediaminetetraacetic acid anticoagulant. The tubes without anticoagulant were used for collecting blood for VD, fibrinogen, D-dimer, and lipid parameter measurement.

Results: A statistically significant difference in total cholesterol levels was observed between patients with angina pectoris and those with MI (P < 0.05). Pearson correlation analysis also demonstrated a moderate negative correlation between VD levels and troponin values in patients diagnosed with MI (P < 0.05), indicating that lower VD concentrations may be associated with greater myocardial injury.

Conclusions: Based on the data obtained, the medical community is inclined to believe that correction of VD deficiency has great prognostic significance. Further clinical and experimental studies are needed to study in more detail the mechanisms of the negative effects of VD deficiency on the cardiovascular system.