International Journal of Medical and Biomedical Studies

Serum ghrelin levels in PCOS and its relation with HOMA-IR

2025-07-09T13:30:58+00:00

Background: To investigate the level of Ghrelin in PCOS patients and compare with controls and also see the correlations between the serum Ghrelin levels and HOMA-IR.

Patients and methods: We analyzed 35 patients with PCOS and 35 normal women as controls. Serum Ghrelin levels and Insulin Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) were determined and compared with controls.

Results: Serum Ghrelin levels were significantly lower in PCOS group than controls.

Biomarkers in the Early Detection of Surgical Complications

2025-07-17T12:00:27+00:00

Background: Postoperative complications such as surgical site infections, wound dehiscence, and sepsis continue to be major contributors to morbidity, extended hospital stays, and increased healthcare costs. Early detection remains a clinical challenge, often leading to delayed treatment. Biomarkers like C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) have shown potential in identifying complications before clinical signs become evident.

Aim: To evaluate the role of CRP, PCT, and IL-6 as early diagnostic biomarkers for detecting postoperative complications in patients undergoing major surgery.

Methods: A prospective observational study was conducted at Narayan Medical College and Hospital (NMCH), Jamuhar, involving 200 patients who underwent major surgical procedures. Blood samples were collected preoperatively and at 24 and 72 hours postoperatively to measure CRP, PCT, and IL-6 levels. Patients were monitored for postoperative complications. Data were analyzed using SPSS version 23.0, applying appropriate statistical tests including chi-square, t-test, and ROC curve analysis.

Results: Out of 200 patients, 48 (24%) developed complications, most commonly surgical site infections. Biomarker levels at 72 hours post-op were significantly higher in the complication group: CRP (>70 mg/L), PCT (>1.5 ng/mL), and IL-6 (>120 pg/mL) with p < 0.001 for all. ROC analysis showed that IL-6 had the highest diagnostic accuracy (AUC 0.928), followed by PCT (AUC 0.914) and CRP (AUC 0.871).

Conclusion: CRP, PCT, and IL-6 are effective early biomarkers for detecting postoperative complications, with IL-6 demonstrating the highest predictive value. These markers can aid in timely diagnosis and intervention, improving surgical outcomes.

Recommendations: Routine postoperative monitoring of IL-6 and PCT should be considered, especially in high-risk surgical patients. Further multicentric studies with larger samples are recommended to validate biomarker thresholds across diverse surgical populations.

Keywords: Biomarkers, Postoperative complications, IL-6, Procalcitonin, C-reactive protein

A Study of Polypharmacy in Elderly Diabetics

2025-07-23T11:38:35+00:00

Background: Polypharmacy is increasingly common among elderly individuals with type 2 diabetes mellitus (T2DM) due to multiple comorbidities requiring complex pharmacotherapy. It poses risks such as adverse drug reactions, drug interactions, and functional decline.

Objective: To assess the prevalence, patterns, and associated factors of polypharmacy in elderly patients with T2DM.

Methods: This prospective observational study was conducted over one year in a tertiary care hospital and included 180 elderly diabetic patients (aged ?60 years). Data on demographics, comorbidities, medications, and functional status were collected and analyzed using descriptive and inferential statistics.

Results: Polypharmacy (?5 medications) was observed in 70% of patients, and excessive polypharmacy (?10 medications) in 15.6%. Common drug classes included oral hypoglycemics, antihypertensives, and statins. Significant associations were found between polypharmacy and older age, ?2 comorbidities, chronic kidney disease, and low ADL scores (p < 0.05). Potentially inappropriate medications were noted in 23.3% of cases.

Conclusion: Polypharmacy is highly prevalent among elderly diabetics and is associated with clinical and functional burden. Regular medication reviews and individualized treatment plans are crucial to reduce associated risks.

Keywords: Polypharmacy, Elderly, Type 2 Diabetes, Comorbidities

Incidence of conversion of AKI to CKD: A retrospective study in a tertiary care hospital

2025-07-26T04:58:45+00:00

Background: Acute Kidney Injury (AKI) is characterized by an abrupt decrease in kidney function, posing a substantial clinical challenge worldwide. AKI often results in adverse outcomes including progression to chronic kidney disease (CKD), which increases long-term morbidity, healthcare costs, and mortality. Understanding factors influencing this progression is critical to improving patient care and preventing chronic renal impairment.

Aim: This study aimed to determine the incidence of progression from AKI to CKD among hospitalized patients and identify key risk factors, emphasizing the role of appropriate and timely antibiotic use in AKI caused by infections.

Methods: A retrospective cohort study was performed at a tertiary care hospital, enrolling 200 patients diagnosed with AKI. Data on demographics, AKI severity, etiologies, and outcomes were collected. CKD conversion was defined as sustained reduction of GFR below 60 mL/min/1.73 m² beyond 3 months post-AKI. Statistical analyses included Kaplan-Meier survival curves and Cox regression to evaluate progression risks.

Results: Out of 200 patients, 40 (20%) progressed to CKD. CKD incidence correlated with AKI severity: 8.2% in Stage 1, 20.6% in Stage 2, and 52.9% in Stage 3 (p < 0.001). Intrinsic renal AKI showed the highest progression (39.5%). Timely interventions, particularly appropriate antibiotic administration in infection-related AKI, significantly reduced progression to 13.2%.

Conclusion: AKI severity and cause strongly influence CKD development. Early, cause-specific treatment—especially judicious antibiotic use—is vital to prevent long-term renal damage and improve prognosis.

Keywords: Acute Kidney Injury, Chronic Kidney Disease, Antibiotic Therapy, Renal Outcomes, AKI Progression

Emerging Role of GLP-1 in Insulin Resistance and Metabolic Dysfunction in PCOS

2025-08-01T03:36:45+00:00

Background: Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder characterized by insulin resistance, hyperinsulinemia, and metabolic dysfunction. Glucagon-like peptide-1 (GLP-1), an incretin hormone, plays a pivotal role in glucose homeostasis and insulin sensitivity. Recent research suggests an association between impaired GLP-1 secretion and the metabolic disturbances observed in PCOS.

Objective: To evaluate fasting and postprandial GLP-1 levels and their correlation with insulin resistance in women with PCOS compared to healthy controls.

Methods: This comparative cross-sectional study included 30 women diagnosed with PCOS based on Rotterdam criteria and 20 age- and BMI-matched healthy controls. Fasting and postprandial GLP-1 levels, insulin, glucose, and HOMA-IR were measured and statistically analyzed.

Results: Women with PCOS exhibited significantly lower fasting and postprandial GLP-1 levels (p < 0.01) and higher HOMA-IR values (p < 0.001) compared to the control group. A strong inverse correlation was found between GLP-1 levels and insulin resistance markers, suggesting that reduced GLP-1 secretion contributes to metabolic dysfunction in PCOS.

Conclusion: The study highlights the emerging role of GLP-1 in the pathophysiology of insulin resistance in PCOS. Diminished GLP-1 levels may exacerbate metabolic disturbances and offer a novel therapeutic target. GLP-1–based treatments could potentially address both metabolic and reproductive aspects of PCOS.

Management of a Pyogenic Granuloma Patient in The Anterior Maxillary Gingiva: A case study

2025-07-30T06:36:59+00:00

Background : Pyogenic granuloma (PG) is a non-cancerous lesion often resulting from an exaggerated tissue response to local irritation or trauma. This condition usually manifests in the oral cavity and grows rapidly, often mistaken for more serious pathology.

Study Objective: To present the clinical management of a patient diagnosed with PG located on the anterior maxillary gingiva
Case Presentation : A 13-year-old girl visited the Public Health Center with a complaint of gingival growth in the front upper teeth region. The lesion, which initially appeared six months prior, increased in size and caused both functional and esthetic discomfort. Clinical inspection revealed an inflammatory mass between teeth 11 and 21, measuring approximately 14x8 mm. Result and discussion: The patient is diagnosed as pyogenic granuloma. The main treatment modalities of pyogenic granuloma is surgical excision. Excision of the pyogenic granuloma was a conventional surgical procedure by scalpel 15 under local anaesthesia with adrenaline. The tissue was placed into solution od 10% formaldehyde and the trauma was sutured. Hemostasis was achieved using pressure pack. The soft tissue sample was sent for histopathology which suggested it be pyogenic granuloma.
Conclusion : Pyogenic granuloma, although benign can lead to considerable patient concern. Proper identification and surgical management typically result in favorable outcomes

Keyword : Pyogenic granuloma, excision, a conventional surgical procedure

Early Breast Cancer - Recent Advances in Imaging and Management

2025-08-21T12:18:26+00:00

Recent advances in the imaging and management of early breast cancer have substantially improved detection rates and patient outcomes, marking a significant evolution in clinical practice. Innovations in imaging modalities, including digital breast tomosynthesis (DBT), contrast-enhanced mammography (CEM) and molecular imaging, have enhanced the accuracy and sensitivity of screening, allowing for earlier and more precise identification of breast tumours. The integration of artificial intelligence (AI) and machine learning further augments diagnostic capabilities by automating image analysis and enabling personalized risk assessments. In management, personalized treatment strategies guided by genomic profiling tools, such as Oncotype DX and MammaPrint, have optimized therapeutic approaches, reducing overtreatment and associated side effects.

Advances in minimally invasive surgical techniques, such as sentinel lymph node biopsy (SLNB), oncoplastic surgery and nipple-sparing mastectomy, have improved surgical outcomes by minimizing morbidity and preserving cosmetic results. Meanwhile, innovative radiotherapy approaches, including hypofractionated radiotherapy and intraoperative radiotherapy (IORT), have reduced treatment duration and side effects without compromising efficacy. The development of targeted therapies and immunotherapy has provided new, effective options for specific breast cancer subtypes, enhancing progression-free survival and overall patient care.

Future trends in imaging and management such as the expanded use of AI, new molecular imaging techniques and advances in personalized medicine are expected to further transform early breast cancer care. These innovations hold the potential to improve precision, reduce the treatment burden and enhance patient outcomes. This paper discusses the recent advances, their impact on clinical outcomes and the future directions that may shape the continued evolution of early breast cancer management.

Keywords: Early breast cancer, imaging techniques, digital breast tomosynthesis (DBT), contrast-enhanced mammography (CEM), molecular imaging, artificial intelligence (AI), personalized treatment, genomic profiling, Oncotype DX, MammaPrint, minimally invasive surgery, sentinel lymph node biopsy (SLNB), oncoplastic surgery, nipple-sparing mastectomy, hypofractionated radiotherapy, intraoperative radiotherapy (IORT), targeted therapies, immunotherapy, breast cancer management.

Risk Stratification and Intervention Planning Using the Indian Academy of Pediatrics Malnutrition Proactive Assessment

2025-09-03T03:36:57+00:00

Background: Childhood malnutrition continues to be a major health concern in India, significantly contributing to morbidity and mortality among children under five years of age. Despite various national nutritional programs, a large proportion of children remain undiagnosed or inadequately managed. The Indian Academy of Pediatrics (IAP) Malnutrition Proactive Assessment tool offers a structured approach to identify, stratify, and guide interventions in malnourished children.

Aim: To evaluate the effectiveness of the IAP Malnutrition Proactive Assessment tool in stratifying nutritional risk and guiding intervention planning among pediatric patients in a tertiary care setting.

Methods: A retrospective observational study was conducted at a tertiary care hospital in Katihar from February 2024 to January 2025. Medical records of 100 children aged 6 months to 5 years were reviewed. Risk stratification was done using the IAP Malnutrition Proactive Assessment tool, and corresponding interventions were documented. Statistical analysis was performed using SPSS version 23.0. Associations between risk categories and intervention types were assessed using the Chi-square test.

Results: Out of 100 participants, 56 were male and 44 females, with a mean age of 2.1 ± 1.1 years. Risk stratification identified 27% of children as high risk, 42% as moderate risk, and 31% as low risk. High-risk children predominantly received therapeutic nutrition (88.9%), while most moderate-risk cases were managed with dietary counseling and supplementation. A significant association was found between risk category and intervention type (p < 0.001).

Conclusion: The IAP Malnutrition Proactive Assessment tool proved effective in categorizing children by nutritional risk and guiding appropriate, evidence-based interventions. Its application in clinical settings can improve early detection and management of pediatric malnutrition.

Recommendations: Routine implementation of the IAP Malnutrition Proactive Assessment in pediatric outpatient and inpatient settings is recommended. Training healthcare workers on its use can enhance early diagnosis and resource-appropriate interventions, ultimately improving child health outcomes.

Keywords: Malnutrition, Pediatrics, Risk Stratification, IAP Assessment, Nutritional Intervention