Tag: pubmed

J Postgrad Med. 2026 Jun 15. doi: 10.4103/jpgm.jpgm_861_25. Online ahead of print.

ABSTRACT

To explore the potential of virtual reality (VR) as a training tool for basic life support (BLS) and other emergency procedures to achieve higher levels of knowledge in the cognitive, psychomotor, and affective domains. Sixty trainees, divided into two groups of thirty each, were trained first using conventional methods, followed by VR devices, and then crossed over in this randomized crossover trial. Data indicators included a pre-validated set of thirty-one mixed response questions administered via Google Forms and a checklist of twelve parameters. Assessment was performed using “Direct observation of procedural skills” at four time periods, at T0 (before training), T1 (post-completion of training with the conventional or immersive technique), T2 (post-completion of training with the immersive or conventional technique), and T3 (post-three months of last training with either the conventional or immersive technique). Inferential statistics were performed using the Chi-square test for categorical variables and analysis of variance (ANOVA) for continuous variables. Intra-group comparison revealed a significant difference from T0 to T3 for all parameters in groups I and II, except for the “compression depth” parameter in group I. Inter-group comparison at T0 and T3 revealed no statistically significant difference between the two techniques. Overall satisfaction levels from T0 to T3 in both groups revealed an increasing learning preference for the VR method (46.6%-73.3% in group I and 50%-80% in group II). Immersive teaching-learning methods using VR provided a scalable and consistent learning experience, highlighting its utility for BLS training in remote or resource-constrained environments. Trainees’ preferences and VR’s ability to foster a desired teaching-learning environment are promising signs, warranting exploration of its long-term synergistic impact with other immersive teaching-learning methods.

PMID:42301684 | DOI:10.4103/jpgm.jpgm_861_25

J Postgrad Med. 2026 Jun 11. doi: 10.4103/jpgm.jpgm_159_26. Online ahead of print.

ABSTRACT

INTRODUCTION: Adverse drug reactions (ADRs) are an important cause of morbidity, prolonged hospital stay, and increased healthcare costs. Monitoring and reporting ADRs through pharmacovigilance systems help identify drug-related risks and improve patient safety. This study aimed to describe the pattern, characteristics, and outcomes of ADRs reported at a tertiary care teaching hospital under the Pharmacovigilance Programme of India (PvPI).

MATERIALS AND METHODS: A retrospective, observational, cross-sectional study was conducted at the ADR Monitoring Center of a tertiary care teaching hospital. Individual Case Safety Reports submitted to the Vigiflow database between January 2023 and December 2024 were analyzed. This study got approval by ethics committee. Data were evaluated for patient demographics, suspected drugs, system organ class involvement, seriousness, outcomes, and causality using the World Health Organization-Uppsala (WHO-UMC) scale. Descriptive statistics were used to summarize the data.

RESULTS: A total of 299 ADRs were described and analyzed. Adults accounted for the majority of cases, with a slight male predominance. Antimicrobials (29%) were the most commonly implicated drug class. Most ADRs were non-serious. On causality assessment, the majority of reactions were classified as “probable (90.63%)”. The most common adverse event was headache (8.6%). The ADR outcome was recovered/resolved in 64.6%.

CONCLUSION: ADRs are commonly encountered in tertiary care settings, with antimicrobials being the most frequent contributors. Describing and analyzing reported ADR data, increasing awareness among medical students, healthcare professionals, and encouraging regular ADR reporting are essential steps to enhance patient safety and promote rational drug use.

PMID:42301674 | DOI:10.4103/jpgm.jpgm_159_26

Saudi J Gastroenterol. 2026 Jun 9. doi: 10.4103/sjg.sjg_91_26. Online ahead of print.

ABSTRACT

BACKGROUND: During follow-up of IPMN, attention should be paid to both IPMN-derived carcinoma and PDAC concomitant with IPMN (concomitant PDAC). Concomitant PDAC lacks clear risk factors and is often detected late. This study evaluated non-contrast MRI performance for early detection and identification of optimal imaging sequences.

METHODS: Patients histologically diagnosed with PDAC between May 2012 and March 2024 who underwent MRI at diagnosis were retrospectively included. PDAC located ≥5 mm from an IPMN was defined as concomitant PDAC. Cases of IPMC and main-duct IPMN were excluded. MRI sequences (T1WI, T2WI, MRCP, and DWI with ADC maps) were reviewed. Tumor detection was defined as (1) mass identification on T1WI/T2WI, (2) Main pancreatic duct (MPD) stricture or poor visualization with upstream dilatation on MRCP, or (3) hyperintense mass on DWI. Two radiologists independently evaluated all images.

RESULTS: Sixty-four cases (28 females; median tumor diameter, 21 mm) were analyzed. The median age at diagnosis was 74.5 years (interquartile range: 68-80 years), Blood test values showed median CA19-9 levels of 78 U/mL. The detection sensitivities by radiologists A and B were T1WI, 76.7%/68.3% (κ0.71); T2WI, 31.3%/29.7% (κ0.71); DWI, 71.4%/71.4% (κ0.87); and MRCP, 43.4%/35.8% (κ0.84). Combined sensitivities were 89.1%/82.8% for “T1WI and DWI” and 92.2%/85.9% for “T1WI, DWI and MRCP”.

CONCLUSIONS: Among single sequences, T1WI demonstrated the highest sensitivity. The combination of “T1WI, DWI, and MRCP” showed the highest sensitivity, although the differences were not statistically significant and should be interpreted cautiously for detecting PDAC concomitant with IPMN.

PMID:42301667 | DOI:10.4103/sjg.sjg_91_26

Indian Dermatol Online J. 2026 Jun 9. doi: 10.4103/idoj.idoj_80_25. Online ahead of print.

ABSTRACT

BACKGROUND: Narrowband ultraviolet B (NBUVB) phototherapy is an established treatment for vitiligo. However, real-world practices vary significantly, particularly in dosing strategies, maintenance schedules, and the use of minimal erythema dose (MED) testing, impacting treatment outcomes.

AIM AND OBJECTIVES: To assess NBUVB phototherapy practices among Indian dermatologists, evaluate patient characteristics and treatment outcomes, and identify variations in clinical protocols.

PATIENTS AND METHODS: An online, questionnaire-based survey was conducted among 80 Indian dermatologists who responded actively using NBUVB. The questionnaire was validated through expert review, pilot testing, and reliability assessment before deployment. Validation included content validation by three senior dermatologists with more than 15 years of phototherapy experience to ensure item relevance and clarity. A pilot test among 10 dermatologists confirmed internal consistency. Data were analyzed using descriptive statistics.

RESULTS: Among 80 respondents (response rate of 5%), 65% had >10 years’ experience. Most respondents (52.5%) used only NBUVB whole-body units, while others employed combination or targeted phototherapy devices. MED testing was performed by only 30%, typically using visual test dose methods; 70% used empirical starting doses. A 200 mJ/cm² starting dose was most common (60%). Maintenance therapy was administered every 1-2 weeks in 75%. Early clinical improvement was observed after 10-20 sessions, and >50% re-pigmentation in vitiligo occurred after 50-70 sessions in 85%. Acral vitiligo showed a mixed response, with poor or limited response in 60% of cases. Mild erythema (80%) and burning (60%) were the most reported side effects.

LIMITATIONS: The study is limited by self-reported data, possible recall bias, and lack of detail on MED testing procedures.

CONCLUSION: There is marked variability in NBUVB protocols among Indian dermatologists. Emphasizing standardized guidelines and MED-based personalized dosing could improve therapeutic outcomes and patient safety in vitiligo management.

PMID:42301666 | DOI:10.4103/idoj.idoj_80_25

Indian J Cancer. 2026 Jan 1;63(1):41-51. doi: 10.4103/ijc.ijc_1006_23. Epub 2026 Jun 9.

ABSTRACT

BACKGROUND: Exposure of a cell to carcinogens leads to an increase in the chromosomal aberrations, while such karyotypic anomalies and elevated deoxyribonucleic acid content have been observed in a plethora of oral precancerous lesions and conditions, and are expressed in the form of micronuclei. The aim of the present study was to correlate the frequency of these micronucleated cells (MNCs) with the severity of the disease process in oral submucous fibrosis (OSMF) and oral squamous cell carcinoma (OSCC) patients.

METHODS: The present cross-sectional, hospital-based study consisted of 150 subjects in an age range from 15 to 80 years including patients who were clinically diagnosed and histopathologically proven as OSMF and OSCC patients, along with age and sex matched, normal, healthy controls. Also, cytological analysis was carried out using the oral exfoliative cytology procedure, while the frequency of MNCs was calculated using a differential counter.

RESULTS: The mean MNC% in the control group was calculated as 0.3% ± 0.35% in the present study as against the mean MNC% of 1.22% ± 0.37% in the OSMF, and 2.0% ± 0.60% in the OSCC groups, while the difference was statistically significant ( P < 0.001). Also, the mean MNC% was calculated to be 0.71% ± 0.08% in Stage I OSMF as against 1.31% ± 0.18% and 1.59% ± 0.17% in Stage II and Stage III OSMF, respectively, with the difference being statistically significant ( P < 0.001). Similarly, the difference in the mean MNC% when calculated between the different stages of OSCC was, also, statistically significant ( P < 0.001) with the mean MNC% in Stage I OSCC being 1.15% ± 0.11% as against 1.59% ± 0.25% in Stage II, and 2.23% ± 0.30% in Stage III and 2.68% ± 0.19% in Stage IV OSCC, respectively.

CONCLUSIONS: Based on the results obtained in the present study, it can, thus, be concluded that the mean MNC% increased significantly in OSCC patients when compared with the control and OSMF groups, and in the OSMF group in comparison with control group, thus, suggesting micronuclei assay as a useful diagnostic adjunct for screening populations which are at high risk for developing various oral precancerous lesions and conditions, and frank oral cancers.

PMID:42301658 | DOI:10.4103/ijc.ijc_1006_23

Indian J Cancer. 2026 Jan 1;63(1):9-17. doi: 10.4103/ijc.ijc_225_24. Epub 2026 Jun 9.

ABSTRACT

BACKGROUND: To assess the efficacy and safety of first-line programmed-death 1 (PD-1)/programmed-death ligand 1 (PD-L1) inhibitors + chemotherapy for driver-gene negative advanced non-squamous non-small cell lung cancer (NSCLC).

METHODS: Eligible literature was identified following a systematic search of four electronic databases (PubMed, Embase, Ovid, and Cochrane library databases) from their inception to June, 2023. Unpublished research was searched from the American Society of Clinical Oncology (ASCO), European Society for Medical Oncology (ESMO), and the World Conference on Lung Cancer (WCLC) meeting abstracts. Review Manager 5.3 software was used for analysis.

RESULTS: Nine randomized controlled trials (RCTs) were identified and included, involving 3443 driver-gene negative advanced non-squamous NSCLC patients. PD-1/PD-L1 inhibitors + chemotherapy had significantly longer progression-free survival (PFS) (hazard ratio [HR] = 0.57, 95% CI = 0.52-0.61, P < 0.00001), and overall survival (OS) (HR = 0.69, 95% confidence interval = 0.63-0.76, P < 0.00001) compared with chemotherapy alone. Analysis was performed based on PD-L1 expression levels; patients with any PD-L1 expression had PFS benefit ( P < 0.00001), while only patients with PD-L1 ≥50% ( P = 0.02) and PD-L1 ≤1% ( P = 0.0009) had OS benefit. Regarding liver metastases, there was no statistically significant benefit of PD-1/PD-L1 inhibitors + chemotherapy regimens for the liver metastases cohort in OS ( P = 0.08). In brain metastasis patients, PD-1/PD-L1 inhibitors + chemotherapy regimens demonstrated an improvement in PFS compared to chemotherapy ( P = 0.03).

CONCLUSION: Our results show that PD-1/PD-L1 inhibitors + chemotherapy showed better survival benefits than chemotherapy in driver-gene negative advanced non-squamous NSCLC patients.

PMID:42301654 | DOI:10.4103/ijc.ijc_225_24

Water Sci Technol. 2026 Jun;93(11):1674-1690. doi: 10.2166/wst.2026.291. Epub 2026 May 28.

ABSTRACT

Extraneous water intrusion and sewage exfiltration due to sewer defects are difficult to detect. This study presents a potentially effective sewer defect diagnosis method, namely, the distributed acoustic sensing (DAS) framework. Firstly, a proof-of-principle study was performed using a 5-m sewer model for DAS signal analysis. Controlled intrusions were applied with defined flow rate and fall height, under defined static and dynamic background flows. Under laboratory conditions, pouring-induced intrusion events generated localized transient strain impacts with clear time- and frequency-domain fingerprints, enabling DAS to localize the impact region and distinguish between inflow-side and manhole-side responses. For exfiltration, time-domain responses of the DAS signals were too weak, but upon amplification of the power spectral density (PSD) between 20 and 30 Hz, leakages were detected by consistent and localized amplified signals under experimental scenarios. Secondly, a field test was conducted on an 800-m sanitary sewer in operation. Despite urban noise interference, statistical screening of amplified PSD signals between 20 and 30 Hz identified recurrent mid-level events to be associated with two candidate defective segments, which were later confirmed. These results provide an initial proof-of-principle field demonstration, but the field evidence remains limited and further validation is still required before broader engineering applicability.

PMID:42301646 | DOI:10.2166/wst.2026.291

Water Sci Technol. 2026 Jun;93(11):1550-1562. doi: 10.2166/wst.2026.279. Epub 2026 May 11.

ABSTRACT

The development of microbial communities within granular-activated carbon (GAC) transforms it into a highly effective biofilter, integrating adsorption and biodegradation processes for contaminant removal. This study evaluated the performance of an O₃-biological-activated carbon (BAC)-O₃ system for removal of inorganic contaminants and secondary effluents disinfection. The BAC column was packed with 50 cm of commercial GAC, reaching biological stability after approximately 45 days of operation. System efficiency was assessed based on the removal of sodium (Na), calcium (Ca), magnesium (Mg), chloride (Cl^–), and boron (B). A central composite design (CCD) was employed to the treatment process, generating mathematical models, statistically validated, to determine optimal treatment conditions, leading to the selection of an O₃ dosage of 4 mg L^-1 before and after the BAC stage. The system effectiveness was further tested through the removal of nine metals and microbial disinfection. Results confirmed that the O₃-BAC process efficiently removed inorganic contaminants, while the additional post-BAC ozonation step was essential for achieving effluent disinfection. The final treated effluent achieved quality standards suitable for non-potable restricted reuse, and its successful application in hydroponic lettuce cultivation demonstrates a promising avenue for sustainable water reuse in controlled agricultural environments.

PMID:42301638 | DOI:10.2166/wst.2026.279

Recenti Prog Med. 2026 Jun;117(6):288-294. doi: 10.1701/4716.47323.

ABSTRACT

BACKGROUND: In the Italian Region Friuli-Venezia Giulia, Herpes Zoster (HZ) vaccination of actively offered free of charge to the population at age 65. Vaccination uptake is below the goal of coverage ≥50% set in the national vaccination plan.

OBJECTIVE: We set up a pilot project with a small number of General Practitioners (GPs) of the Health Authority of Udine, to assess whether GPs can catch-up patients invited for vaccination the previous year but not attending the appointment.

METHODS: Twelve GPs voluntarily adhering to the project were provided from the Vaccination Center with 10 doses of vaccine each, corresponding to the immunization of 5 individuals. They contacted patients born in 1959 not adhering to the previous invitation and proposed to immunize them. We assessed whether vaccination coverages increased among patients followed by those GPs and the feasibility of contacting the patient and handling the vaccine.

RESULTS: Among participating GPs, from July to December 2025, coverage of patients in the cohort of interest increased from 42.9% to 63.4%. Although some physicians had difficulties in managing the vaccine and some reported that contacting patients is extremely time-consuming, the overall judgment of feasibility of both the contact and information of patients and of the actual vaccine administration was excellent.

CONCLUSION: This pilot project suggests that the collaboration with GPs can strongly contribute to improve HZ vaccine uptake. Since such collaboration was considered feasible, more GPs from the same Health Authority may be involved.

PMID:42301627 | DOI:10.1701/4716.47323

Recenti Prog Med. 2026 Jun;117(6):279-287. doi: 10.1701/4716.47322.

ABSTRACT

INTRODUCTION: Heart Failure (HF) represents a critical challenge for the National Health Service (SSN) in terms of mortality and costs, often fueled by fragmented management between hospital and community care. The objective of this study is to analyze the current care pathway and related direct costs (hospitalizations, medications, outpatient services) to identify inefficiencies and propose an improvement model based on Lean and Value-Based Healthcare (VBHC) methodologies.

MATERIALS AND METHODS: A retrospective analysis was conducted from January 2022 to December 2023 on a sample of 689 patients with heart failure, utilizing administrative data flows (SDO, SPA, SPF, and SIAD). Lean tools, specifically “As-Is” and “To-Be” Swim Lane maps, were applied to map processes and evaluate hospital-community integration.

RESULTS: The total costs generated by the 689 monitored patients amounted to €2,451,475.60. This is broken down as follows: €1,312,227.66 from hospital discharge records (SDO), €169,716.38 from Emergency Department (PS) services, €82,908.64 from outpatient services (SPA), €114,472.92 from pharmaceutical records (SPF), and €772,150 from home care services (SIAD). Significant critical issues emerged in the “As-Is” pathway, revealing analysis biases such as 32.5% of patients not undergoing outpatient visits and 4.7% not receiving specific medications. The “To-Be” model proposes value-centered management through the activation of the Territorial Operations Center (COT), the assignment of a lead physician (tutor), the use of telemedicine, and the integration of the Electronic Health Record (FSE) to overcome the observed biases.

CONCLUSIONS: Shifting to an integrated and digitalized model is essential to ensure continuity of care and therapeutic adherence, thereby reducing exacerbations and optimizing the use of public resources.

PMID:42301626 | DOI:10.1701/4716.47322