Eosinophilic colitis (EC) is the rarest amongst the uncommon spectrum of eosinophilic gastrointestinal disorders (EGIDs). Manifestation in the elderly is rarer still. Presentation as a cecal mass mimicking malignancy is exceptional. Such an extraordinary case is presented and the quandary faced in its management is discussed. Attempt is made to discern a pattern, based on the experience and a review of similar cases in the literature, to foretell the diagnosis.
{"title":"Eosinophilic colitis mimicking colon cancer: Does clinico- radiologic discrepancy expose the mimic?","authors":"Diwakar Prasad Singh , Amit Singh , Manish Manrai , Manoj Kalpande , Ramanathan Saranga Bharathi","doi":"10.1016/j.mjafi.2024.10.008","DOIUrl":"10.1016/j.mjafi.2024.10.008","url":null,"abstract":"<div><div>Eosinophilic colitis (EC) is the rarest amongst the uncommon spectrum of eosinophilic gastrointestinal disorders (EGIDs). Manifestation in the elderly is rarer still. Presentation as a cecal mass mimicking malignancy is exceptional. Such an extraordinary case is presented and the quandary faced in its management is discussed. Attempt is made to discern a pattern, based on the experience and a review of similar cases in the literature, to foretell the diagnosis.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 1","pages":"Pages 101-105"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To compare choroidal thickness (CT) in eyes diagnosed with Pseudoexfoliation Syndrome (PXS) without evidence of glaucoma to age- and sexmatched healthy subjects using spectral domain optical coherence tomography (SD-OCT).
Methods
This study compared 30 eyes with PXS (Group A), with 30 control eyes (Group B). Key inclusion criteria: age ≥ 18 years; best-corrected visual acuity ≥ 20/40; intraocular pressure ≤ 21 mmHg. Exclusion criteria: spherical equivalent > ± 6 diopters, axial length > 25 mm, evidence of glaucoma/chronic diseases/medications likely to affect CT. CT was measured using enhanced depth imaging mode of SD-OCT. Differences in CT were analyzed using unpaired t-tests.
Results
While the average macular CT was lower in eyes with PXS compared to controls, the difference was not statistically significant (p = 0.06). However, significant thinning of the choroid was observed in specific subfields in PXS eyes, including the central subfield (p = 0.04), inferior inner subfield (p = 0.03), nasal outer subfield (p = 0.04), and the inferior outer subfield (p = 0.03). Although not statistically significant (p > 0.05), other subfields of the macula also showed a trend of thinner choroid in Group A compared to controls, except for the temporal outer macular subfield.
Conclusion
Eyes with PXS exhibit thinner choroid, particularly in the central, inferior inner, and nasal outer and inferior outer subfields of the macula, compared to controls. These findings suggest localized choroidal alterations in PXS eyes, which may have clinical implications warranting further investigation.
{"title":"Comparison of macular choroidal thickness in patients with pseudoexfoliation syndrome to healthy subjects using enhanced depth SD-OCT imaging","authors":"Ananya Chatterjee , Vikas Ambiya , Gaurav Kapoor , Srishti Khullar","doi":"10.1016/j.mjafi.2024.11.019","DOIUrl":"10.1016/j.mjafi.2024.11.019","url":null,"abstract":"<div><h3>Background</h3><div>To compare choroidal thickness (CT) in eyes diagnosed with Pseudoexfoliation Syndrome (PXS) without evidence of glaucoma to age- and sexmatched healthy subjects using spectral domain optical coherence tomography (SD-OCT).</div></div><div><h3>Methods</h3><div>This study compared 30 eyes with PXS (Group A), with 30 control eyes (Group B). Key inclusion criteria: age ≥ 18 years; best-corrected visual acuity ≥ 20/40; intraocular pressure ≤ 21 mmHg. Exclusion criteria: spherical equivalent > ± 6 diopters, axial length > 25 mm, evidence of glaucoma/chronic diseases/medications likely to affect CT. CT was measured using enhanced depth imaging mode of SD-OCT. Differences in CT were analyzed using unpaired t-tests.</div></div><div><h3>Results</h3><div>While the average macular CT was lower in eyes with PXS compared to controls, the difference was not statistically significant (p = 0.06). However, significant thinning of the choroid was observed in specific subfields in PXS eyes, including the central subfield (p = 0.04), inferior inner subfield (p = 0.03), nasal outer subfield (p = 0.04), and the inferior outer subfield (p = 0.03). Although not statistically significant (p > 0.05), other subfields of the macula also showed a trend of thinner choroid in Group A compared to controls, except for the temporal outer macular subfield.</div></div><div><h3>Conclusion</h3><div>Eyes with PXS exhibit thinner choroid, particularly in the central, inferior inner, and nasal outer and inferior outer subfields of the macula, compared to controls. These findings suggest localized choroidal alterations in PXS eyes, which may have clinical implications warranting further investigation.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 1","pages":"Pages 42-47"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.mjafi.2025.05.012
Pooja Pai , Shyamala Guruvare , Kavitha Saravu
Background
Immunocompromised women are prone to human papillomavirus (HPV) persistence and cervical cytological abnormalities. Screening them for cervical epithelial abnormalities and cancer is essential.
Method
We conducted a prospective observational study for 2 years at a tertiary care hospital. Women between 25 and 65 years of age with any of the immunocompromised conditions–human immunodeficiency virus (HIV) positive, autoimmune disorders, chronic kidney disease, diabetes, and bronchial asthma–were recruited. After informed consent, we performed cytological screening or cotesting (cytology plus HPV). Those who were screen positive were advised for further evaluation/follow-up. Sociodemographic and clinical details were collected as per the proforma.
Results
Out of the 141 immunocompromised women screened, 9 (6%) tested screen positive. Among these, two were HPV positive, 6 had positive cytology, and one tested positive for both HPV and cytology. Cytological abnormalities were highest among women with diabetes mellitus 7/91 (7%); this included atypical squamous cells of uncertain significance (ASCUS): 5 (all HPV negative), ASC-H (one), and suspicion of invasive cancer (one). Among women with diabetes, cytological abnormalities were observed in those with a longer duration of the disease and multidrug medication. HIV positive women had satisfactory CD4 count (54%), and those (45%) with count <500 had extremely low viral load; except one, all were compliant with antiretroviral therapy (ART).
Conclusion
Immunocompromised states have a higher prevalence of cervical screen positivity. The cytological abnormalities were maximum in diabetic women, which were predominantly of low grade and non-HPV related.
{"title":"Prevalence of cervicovaginal human papillomavirus and cytological abnormalities in immunocompromised women at a tertiary level setting in coastal Karnataka","authors":"Pooja Pai , Shyamala Guruvare , Kavitha Saravu","doi":"10.1016/j.mjafi.2025.05.012","DOIUrl":"10.1016/j.mjafi.2025.05.012","url":null,"abstract":"<div><h3>Background</h3><div>Immunocompromised women are prone to human papillomavirus (HPV) persistence and cervical cytological abnormalities. Screening them for cervical epithelial abnormalities and cancer is essential.</div></div><div><h3>Method</h3><div>We conducted a prospective observational study for 2 years at a tertiary care hospital. Women between 25 and 65 years of age with any of the immunocompromised conditions–human immunodeficiency virus (HIV) positive, autoimmune disorders, chronic kidney disease, diabetes, and bronchial asthma–were recruited. After informed consent, we performed cytological screening or cotesting (cytology plus HPV). Those who were screen positive were advised for further evaluation/follow-up. Sociodemographic and clinical details were collected as per the proforma.</div></div><div><h3>Results</h3><div>Out of the 141 immunocompromised women screened, 9 (6%) tested screen positive. Among these, two were HPV positive, 6 had positive cytology, and one tested positive for both HPV and cytology. Cytological abnormalities were highest among women with diabetes mellitus 7/91 (7%); this included atypical squamous cells of uncertain significance (ASCUS): 5 (all HPV negative), ASC-H (one), and suspicion of invasive cancer (one). Among women with diabetes, cytological abnormalities were observed in those with a longer duration of the disease and multidrug medication. HIV positive women had satisfactory CD4 count (54%), and those (45%) with count <500 had extremely low viral load; except one, all were compliant with antiretroviral therapy (ART).</div></div><div><h3>Conclusion</h3><div>Immunocompromised states have a higher prevalence of cervical screen positivity. The cytological abnormalities were maximum in diabetic women, which were predominantly of low grade and non-HPV related.</div></div><div><h3>Trial registration number</h3><div>CTRI/2023/03/050492.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 1","pages":"Pages 94-100"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Management of bowel dysfunction in children is expensive. Pharmacological measures (PM) are the most commonly used treatment option which has shown to have varying outcomes. The next option after failed PM involves invasive surgical procedures like the Malone Antegrade Continence Enema (MACE). Trans Anal Irrigation (TAI) is an efficacious treatment modality between failed medical therapy and invasive surgeries. As no cost analysis of TAI in children has been conducted, this study evaluated the direct costs involved with TAI in comparison to PM from the health care provider perspective.
Methods
Children >4 years with persistent bowel dysfunction despite PM, were divided into three groups: Constipation, Pseudoincontinence and Incontinence group. The costs of existing PM and number of diapers used daily were noted for each patient. In all patients, PM was stopped and TAI was initiated. Improvement in symptoms and reduction in daily diaper usage over six months was recorded. The direct costs of TAI versus the costs that would be involved had PM been continued, were compared using paired ‘t’ test.
Results
34 patients (20 male, 14 female) with an average age of 76.7 months were divided into three groups: Constipation:12, Pseudoincontinence:15 and Incontinence:7. In all groups, there was a significant reduction in direct costs with TAI in comparison to PM.
Conclusion
In children with bowel dysfunction, TAI is an effective and significantly economical treatment modality in comparison to PM and should be considered early on in the management therapy.
{"title":"Analysis of direct costs of trans anal saline irrigation to pharmacological measures for bowel dysfunction","authors":"Ravi Patcharu , Santosh Dey , Karunesh Chand , Arun Kumar Yadav","doi":"10.1016/j.mjafi.2024.08.015","DOIUrl":"10.1016/j.mjafi.2024.08.015","url":null,"abstract":"<div><h3>Background</h3><div>Management of bowel dysfunction in children is expensive. Pharmacological measures (PM) are the most commonly used treatment option which has shown to have varying outcomes. The next option after failed PM involves invasive surgical procedures like the Malone Antegrade Continence Enema (MACE). Trans Anal Irrigation (TAI) is an efficacious treatment modality between failed medical therapy and invasive surgeries. As no cost analysis of TAI in children has been conducted, this study evaluated the direct costs involved with TAI in comparison to PM from the health care provider perspective.</div></div><div><h3>Methods</h3><div>Children >4 years with persistent bowel dysfunction despite PM, were divided into three groups: Constipation, Pseudoincontinence and Incontinence group. The costs of existing PM and number of diapers used daily were noted for each patient. In all patients, PM was stopped and TAI was initiated. Improvement in symptoms and reduction in daily diaper usage over six months was recorded. The direct costs of TAI versus the costs that would be involved had PM been continued, were compared using paired ‘t’ test.</div></div><div><h3>Results</h3><div>34 patients (20 male, 14 female) with an average age of 76.7 months were divided into three groups: Constipation:12, Pseudoincontinence:15 and Incontinence:7. In all groups, there was a significant reduction in direct costs with TAI in comparison to PM.</div></div><div><h3>Conclusion</h3><div>In children with bowel dysfunction, TAI is an effective and significantly economical treatment modality in comparison to PM and should be considered early on in the management therapy.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 1","pages":"Pages 26-31"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant disorder of abnormal vessel formation. The hallmarks of this disease are vascular lesions mainly arteriovenous malformations and telangiectasia involving mucocutaneous surfaces like skin and gastrointestinal tract. Anaemia, though an important clinical manifestation, is often missed as a diagnostic clue. We report the case history of a middle aged man who presented to multiple centres with symptomatic anaemia, suffered a stroke and underwent intervention for a pulmonary arteriovenous malformation before a diagnosis of HHT was eventually established.
{"title":"Vascular whispers and anaemia: Unravelling hereditary haemorrhagic telangiectasia","authors":"Parvinder Singh , Ritwik Chakrabarti , Bharat Hosur , Partha B. Mukherjee , Sandeep Thareja , P.K. Sharma , Saurabh Dawra","doi":"10.1016/j.mjafi.2025.01.003","DOIUrl":"10.1016/j.mjafi.2025.01.003","url":null,"abstract":"<div><div>Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant disorder of abnormal vessel formation. The hallmarks of this disease are vascular lesions mainly arteriovenous malformations and telangiectasia involving mucocutaneous surfaces like skin and gastrointestinal tract. Anaemia, though an important clinical manifestation, is often missed as a diagnostic clue. We report the case history of a middle aged man who presented to multiple centres with symptomatic anaemia, suffered a stroke and underwent intervention for a pulmonary arteriovenous malformation before a diagnosis of HHT was eventually established.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 1","pages":"Pages 111-115"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.mjafi.2024.11.021
Amit Pawar , A.K. Baranwal , A.K. Biswas , Ujjwal Dimri , Deepti Mutreja , Rajat Jagani , Anoop Sharma
Background
Platelet concentrates (PCs) have been used for nearly 50 years, significantly impacting transfusion medicine. However, their 5-day shelf life leads to substantial wastage. Apheresis technology offers controlled platelet isolation, and platelet additive solutions (PAS) enhance storage and reduce activation, aiming to extend shelf life. The aim of this study was to compare the expression of platelet activation markers CD62P and Annexin V in apheresis platelet concentrates (APCs) stored in PAS versus autologous plasma from day 1 to day 5.
Methods
This prospective study was conducted at a tertiary care hospital in Maharashtra. APCs stored in autologous plasma and PAS (InterSol) were collected using a Haemonetics MCS+ cell separator. Activation markers were detected by flow cytometry.
Results
APCs in PAS showed higher baseline activation on day 1. On day 5, CD62P expression was significantly higher in PAS (49.59% vs 38.91%), but Annexin V expression showed no difference due to a rapid increase in plasma. PAS also resulted in higher platelet yield on day 5.
Conclusion
Significant differences in activation rates between platelets stored in PAS and plasma warrant further research, especially on the roles of potassium and magnesium in PAS. PAS helps manage blood group inventories, reduce ABO antibody titers, and maintain platelet quality for up to 7 days. More extensive studies, particularly in India, are needed to validate these benefits and explore extending PAS storage time.
血小板浓缩物（platelet浓缩液，PCs）已经使用了近50年，对输血医学产生了重大影响。然而，它们的5天保质期导致大量浪费。Apheresis技术提供可控的血小板分离，血小板添加剂溶液（PAS）增强储存并减少活化，旨在延长保质期。本研究的目的是比较血小板活化标志物CD62P和膜联蛋白V在PAS储存的血小板浓缩物（APCs）和自体血浆中从第1天到第5天的表达。方法本前瞻性研究在马哈拉施特拉邦的一家三级保健医院进行。使用Haemonetics MCS+细胞分离器收集储存在自体血浆和PAS （InterSol）中的APCs。流式细胞术检测活化标记物。结果PAS组apcs在第1天的基线激活水平较高。在第5天，CD62P在PAS中的表达明显升高（49.59% vs 38.91%），但由于血浆中Annexin V的表达迅速升高，因此没有差异。PAS也导致第5天血小板产量增加。结论血小板活化率与血浆活化率存在显著差异，值得进一步研究，尤其是钾和镁在血小板活化中的作用。PAS有助于管理血型清单，降低ABO抗体滴度，并维持血小板质量长达7天。需要进行更广泛的研究，特别是在印度，以证实这些好处，并探索延长PAS储存时间。
{"title":"Platelet activation markers in apheresis platelet concentrates stored in platelet additive solution versus autologous plasma","authors":"Amit Pawar , A.K. Baranwal , A.K. Biswas , Ujjwal Dimri , Deepti Mutreja , Rajat Jagani , Anoop Sharma","doi":"10.1016/j.mjafi.2024.11.021","DOIUrl":"10.1016/j.mjafi.2024.11.021","url":null,"abstract":"<div><h3>Background</h3><div>Platelet concentrates (PCs) have been used for nearly 50 years, significantly impacting transfusion medicine. However, their 5-day shelf life leads to substantial wastage. Apheresis technology offers controlled platelet isolation, and platelet additive solutions (PAS) enhance storage and reduce activation, aiming to extend shelf life. The aim of this study was to compare the expression of platelet activation markers CD62P and Annexin V in apheresis platelet concentrates (APCs) stored in PAS versus autologous plasma from day 1 to day 5.</div></div><div><h3>Methods</h3><div>This prospective study was conducted at a tertiary care hospital in Maharashtra. APCs stored in autologous plasma and PAS (InterSol) were collected using a Haemonetics MCS+ cell separator. Activation markers were detected by flow cytometry.</div></div><div><h3>Results</h3><div>APCs in PAS showed higher baseline activation on day 1. On day 5, CD62P expression was significantly higher in PAS (49.59% vs 38.91%), but Annexin V expression showed no difference due to a rapid increase in plasma. PAS also resulted in higher platelet yield on day 5.</div></div><div><h3>Conclusion</h3><div>Significant differences in activation rates between platelets stored in PAS and plasma warrant further research, especially on the roles of potassium and magnesium in PAS. PAS helps manage blood group inventories, reduce ABO antibody titers, and maintain platelet quality for up to 7 days. More extensive studies, particularly in India, are needed to validate these benefits and explore extending PAS storage time.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 1","pages":"Pages 74-78"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.mjafi.2025.03.003
Veena Nayak , Sadhana N. Holla , Smita Shenoy , Harshini H , Aditya Vinayak Raveendran
Overactive bladder (OAB) is characterized by urinary urgency, frequency, and incontinence. The primary medications used for OAB treatment include antimuscarinics and beta-3 adrenergic agonists. The objective of this review was to understand the beta-3 signaling mechanisms in OAB and analyze the results of studies comparing mirabegron either as monotherapy or in combination with antimuscarinics for OAB treatment. A literature search for comparison studies on beta-3 adrenergic drugs and antimuscarinic medications for OAB from different databases was conducted. Although the antimuscarinic class of medications has been reported to be an effective therapy for the symptomatic management of OAB, dose-limiting adverse effects continue to be the reason for discontinuation in the elderly population. Due to the high efficacy of mirabegron and the possible unavoidable side effects associated with antimuscarinic drugs, OAB can be treated with oral beta-3-agonists. In patients who are resistant to monotherapy, a combination therapy consisting of antimuscarinic agents and beta-3-agonists may be attempted. Primarily, this review emphasizes the role of beta-3 agonists in OAB in terms of their mechanism, safety, and efficacy in comparison with those of antimuscarinic drugs.
{"title":"Exploring the therapeutic potential of beta-3 adrenergic agonists in overactive bladder: A comprehensive review","authors":"Veena Nayak , Sadhana N. Holla , Smita Shenoy , Harshini H , Aditya Vinayak Raveendran","doi":"10.1016/j.mjafi.2025.03.003","DOIUrl":"10.1016/j.mjafi.2025.03.003","url":null,"abstract":"<div><div>Overactive bladder (OAB) is characterized by urinary urgency, frequency, and incontinence. The primary medications used for OAB treatment include antimuscarinics and beta-3 adrenergic agonists. The objective of this review was to understand the beta-3 signaling mechanisms in OAB and analyze the results of studies comparing mirabegron either as monotherapy or in combination with antimuscarinics for OAB treatment. A literature search for comparison studies on beta-3 adrenergic drugs and antimuscarinic medications for OAB from different databases was conducted. Although the antimuscarinic class of medications has been reported to be an effective therapy for the symptomatic management of OAB, dose-limiting adverse effects continue to be the reason for discontinuation in the elderly population. Due to the high efficacy of mirabegron and the possible unavoidable side effects associated with antimuscarinic drugs, OAB can be treated with oral beta-3-agonists. In patients who are resistant to monotherapy, a combination therapy consisting of antimuscarinic agents and beta-3-agonists may be attempted. Primarily, this review emphasizes the role of beta-3 agonists in OAB in terms of their mechanism, safety, and efficacy in comparison with those of antimuscarinic drugs.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 1","pages":"Pages 6-15"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.mjafi.2024.09.010
Rohith Bhagawath , Muralidhar M. Kulkarni , K. Eshwari , D. Akhila , Afraz Jahan , Priyanka Bantwal , Veena G. Kamath
Background
Youth smoking is a major concern as the average age at which people start smoking has been declining in recent years. Strengthening tobacco control policies at educational institutions (EI) will prevent the access to tobacco products for minors. The current study aims to assess teacher’s knowledge and compliance to tobacco-free-educational-institution (ToFEI) policy.
Methods
Four districts of a south Indian state were chosen for the study. A face-to-face interview with approximately 50 head teachers from respective districts was carried out by a trained interviewer to assess the compliance to ToFEI guidelines. The shops within 100 yards of EI were visited to confirm the sale of tobacco using geographic information system.
Results
A total of 234 EI were surveyed, of which 79 (33.8%) institutions had ‘tobacco-free institution’ board. A display board prohibiting tobacco sale within 100 yards of school was present in 175 (74.8%) institutions. A total of 733 shops were found around 195 EI and of them, 9.7% (71/733) shops were selling tobacco products.
Conclusion
Despite the existence of tobacco-free school guidelines in India, there was a lacunae in compliance with provisions of guidelines among various EIs across Karnataka state. With nearly one-fifth of institutions having shops that sell tobacco within 100-yard of institutions, further laxity in implementation of tobacco control activities can be a threat and can lead to easy availability of tobacco products and attract more students to use the lethal products.
{"title":"Compliance to the tobacco-free educational institution policy (ToFEI study) in urban areas of selected districts of Karnataka: A situational analysis","authors":"Rohith Bhagawath , Muralidhar M. Kulkarni , K. Eshwari , D. Akhila , Afraz Jahan , Priyanka Bantwal , Veena G. Kamath","doi":"10.1016/j.mjafi.2024.09.010","DOIUrl":"10.1016/j.mjafi.2024.09.010","url":null,"abstract":"<div><h3>Background</h3><div>Youth smoking is a major concern as the average age at which people start smoking has been declining in recent years. Strengthening tobacco control policies at educational institutions (EI) will prevent the access to tobacco products for minors. The current study aims to assess teacher’s knowledge and compliance to tobacco-free-educational-institution (ToFEI) policy.</div></div><div><h3>Methods</h3><div>Four districts of a south Indian state were chosen for the study. A face-to-face interview with approximately 50 head teachers from respective districts was carried out by a trained interviewer to assess the compliance to ToFEI guidelines. The shops within 100 yards of EI were visited to confirm the sale of tobacco using geographic information system.</div></div><div><h3>Results</h3><div>A total of 234 EI were surveyed, of which 79 (33.8%) institutions had ‘tobacco-free institution’ board. A display board prohibiting tobacco sale within 100 yards of school was present in 175 (74.8%) institutions. A total of 733 shops were found around 195 EI and of them, 9.7% (71/733) shops were selling tobacco products.</div></div><div><h3>Conclusion</h3><div>Despite the existence of tobacco-free school guidelines in India, there was a lacunae in compliance with provisions of guidelines among various EIs across Karnataka state. With nearly one-fifth of institutions having shops that sell tobacco within 100-yard of institutions, further laxity in implementation of tobacco control activities can be a threat and can lead to easy availability of tobacco products and attract more students to use the lethal products.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 1","pages":"Pages 48-54"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.mjafi.2025.01.001
Padmaprakash KV , Sandeep Thareja , Ravi Kanth K , Nishant Raman , PK Sharma , AS Prasad , D.K. Jha
Background
Acute pancreatitis (AP) can lead to severe complications like pancreatic/peripancreatic necrosis and sepsis. Existing scoring systems for predicting severity and mortality have limitations. This study aimed to characterize the demographic and etiological aspects of AP and compare the predictive accuracy of the Acute Physiology and Chronic Health Evaluation II (APACHE-II), modified computed tomography severity index (mCTSI), and Modified Marshall Score (MMS) for assessing severity and mortality in a large cohort from India.
Methods
This retrospective observational study included consecutive AP patients admitted to a tertiary care hospital in northern India between January 2020 and December 2023. Patients aged ≥15 years were enrolled based on established criteria. Data on demographics, clinical outcomes, and scoring systems (APACHE-II, mCTSI, MMS) were analyzed using Chi-square tests and receiver operating characteristic (ROC) curve analysis for predictive accuracy. Statistical significance was defined as p < 0.05.
Results
Among 645 patients, 77% (n=501) were male, with a median age of 36 years. Mild and moderate disease occurred in 30.7% (n=198) and 42% (n=271) of cases, respectively, while severe AP was present in 27.3% (n=176). An APACHE-II score ≥8 (AUC: 0.941) at admission had higher diagnostic accuracy (91%) for severe AP compared to mCTSI ≥8 (AUC: 0.787), which had a diagnostic accuracy of 73.7%. APACHE-II (AUC: 0.857) was the most accurate for predicting infected necrosis, while mCTSI (AUC: 0.742) was better for predicting the need for intervention. Seventy-seven patients died (case fatality rate: 11.9%). The APACHE-II score (AUC:0.947) was a superior predictor of mortality compared to mCTSI (AUC: 0.790), with diagnostic accuracies of 83.1% vs. 67.6%, respectively.
Conclusion
The APACHE-II score more accurately predicts the severity, infected necrosis, and mortality of acute pancreatitis, while mCTSI is better for assessing intervention needs, and both scoring systems are complementary in clinical management.
{"title":"Chasing clarity in acute pancreatitis: Comparing computed tomography severity index and APACHE-II score in predicting severity in Indian patients","authors":"Padmaprakash KV , Sandeep Thareja , Ravi Kanth K , Nishant Raman , PK Sharma , AS Prasad , D.K. Jha","doi":"10.1016/j.mjafi.2025.01.001","DOIUrl":"10.1016/j.mjafi.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Acute pancreatitis (AP) can lead to severe complications like pancreatic/peripancreatic necrosis and sepsis. Existing scoring systems for predicting severity and mortality have limitations. This study aimed to characterize the demographic and etiological aspects of AP and compare the predictive accuracy of the Acute Physiology and Chronic Health Evaluation II (APACHE-II), modified computed tomography severity index (mCTSI), and Modified Marshall Score (MMS) for assessing severity and mortality in a large cohort from India.</div></div><div><h3>Methods</h3><div>This retrospective observational study included consecutive AP patients admitted to a tertiary care hospital in northern India between January 2020 and December 2023. Patients aged ≥15 years were enrolled based on established criteria. Data on demographics, clinical outcomes, and scoring systems (APACHE-II, mCTSI, MMS) were analyzed using Chi-square tests and receiver operating characteristic (ROC) curve analysis for predictive accuracy. Statistical significance was defined as p < 0.05.</div></div><div><h3>Results</h3><div>Among 645 patients, 77% (n=501) were male, with a median age of 36 years. Mild and moderate disease occurred in 30.7% (n=198) and 42% (n=271) of cases, respectively, while severe AP was present in 27.3% (n=176). An APACHE-II score ≥8 (AUC: 0.941) at admission had higher diagnostic accuracy (91%) for severe AP compared to mCTSI ≥8 (AUC: 0.787), which had a diagnostic accuracy of 73.7%. APACHE-II (AUC: 0.857) was the most accurate for predicting infected necrosis, while mCTSI (AUC: 0.742) was better for predicting the need for intervention. Seventy-seven patients died (case fatality rate: 11.9%). The APACHE-II score (AUC:0.947) was a superior predictor of mortality compared to mCTSI (AUC: 0.790), with diagnostic accuracies of 83.1% vs. 67.6%, respectively.</div></div><div><h3>Conclusion</h3><div>The APACHE-II score more accurately predicts the severity, infected necrosis, and mortality of acute pancreatitis, while mCTSI is better for assessing intervention needs, and both scoring systems are complementary in clinical management.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"82 1","pages":"Pages 79-87"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号