Pratyush Kumar

Background: Obstructive sleep apnea (OSA) is linked to arrhythmia and cardiovascular morbidity, but the cardiac response to individual obstructive events is incompletely characterised at minute‐scale resolution. We aimed to determine whether ECG‐derived autonomic features distinguish apnea from nonapnea minutes and whether these features change before scored event onset. Methods: We performed a secondary analysis of the PhysioNet Apnea‐ECG learning set (34 subjects after exclusion of one duplicated recording; 30 male, 4 female; mean age 47.0 ± 9.7 years; AHI 0–82.4 events/h). For each 1‐min segment, we computed mean heart rate, SDNN, RMSSD, pNN50 and RR irregularity rate from QRS‐derived RR intervals. Minutes were classified as baseline, preapnea, apnea, or post‐apnea and associations tested using mixed‐effects regression with subject random intercepts. Results: The analytic dataset comprised 17,004 min; 38.2% were apnea minutes. Apnea minutes showed a heart rate reduction of −2.66 bpm (95% CI: −2.92 to −2.41, p < 0.001) and an RMSSD increase of +19 ms (95% CI: 15–23, p < 0.001) versus baseline. In multivariable modelling, SDNN was the dominant feature ( β = +0.472); RMSSD showed a sign reversal ( β = −0.416) and reciprocal logistic odds ratios (SDNN OR 134.9 vs. RMSSD OR 0.034) consistent with substantial collinearity. Preapnea minutes showed directionally similar but smaller changes; post‐apnea minutes showed partial normalisation. Conclusion: Obstructive apnea is associated with a reproducible minute‐level autonomic signature of bradycardia and increased RR variability, with detectable shifts preceding scored event onset. Variability metrics, particularly SDNN, contribute more than mean heart rate. Findings require validation in cohorts with linked cardiovascular outcomes.

Introduction Medicaleducation in India is transitioning to a competency-based curriculum, necessitating effective teaching methodologies and resources. This study compares the effectiveness of Peer-Assisted Jigsaw Teaching Strategy (JTS) versus conventional didactic teaching, supplemented with either ScholarRx Bricks or traditional textbooks, in enhancing the academic performance and perceptions of first-year medical students. Materials and Methods Afour-armed randomized trial was conducted with 92 first-year medical students. Participants were divided into two main groups: JTS (Group A) and conventional didactic teaching (Group B). Each group was further divided into subgroups using either ScholarRx Bricks (Rx) or traditional textbooks (C). Pre, post, and final theoretical and clinical assessments, as well as motivation, confidence, and academic perception scores, were collected. Data were analyzed using mixed effects ordinal regression and other statistical methods. Results Post-intervention, significant improvements in motivation (p=0.009) and confidence (p=0.013) were observed, particularly in the J.Rx group. Theory scores showed remarkable increases in the J.Rx group (pp=0.004) and J.C (p<0.05) groups. Academic perception scores also showed significant enhancements, especially in the J.Rx group. Conclusion The Jigsaw Teaching Strategy, particularly when paired with ScholarRx Bricks, significantly improved motivation, confidence, and academic performance compared to conventional didactic methods. The collaborative nature of JTS and the engaging ScholarRx modules contributed to these positive outcomes. Future research should explore the long-term impacts and involve larger, more diverse cohorts to validate these findings.

Background: Global healthcare research suffers from inequalities, favouring high-income countries, which hampers fair healthcare access. Low and lower-middle-income nations face limited participation and editorial bias, posing concerns for research integrity. Potential reasons for this pattern might be the overrepresentation of researchers from the Global North on editorial boards, disparities in the quality of scientific research, lack of support for local research initiatives, and challenges posed by language barriers. The aim of this study was to assess data transparency and representation patterns of low- and lower-middle-income nations on Editorial Boards of prominent Internal Medicine journals. Methods: The top 50 journals in the "Internal medicine including allied super specialities" subject category were selected based on SCImago journal ranking, journal impact factor, literature research and journal citation report. We examined the editorial boards of these journals using the World Bank Income Criteria. Results: Out of 2406 editorial board members of leading journals, only 5(0.21%) were from low-income countries (LICs), while lower-middle-income countries (LMICs) and upper-middle- income countries (UMICs) constituted 64(2.67%) and 176(7.31%), respectively. High-income countries (HICs) dominated editorial boards, with 2161(89.8%) representation. Conclusion: Editorial boards of top Internal Medicine and allied super-specialty journals lack adequate representation from low and lower-middle-income countries. This deficiency has significant implications, affecting knowledge production, policy development, and the overall progress of science and research on a global scale. Urgent measures are required to establish a fair and inclusive scholarly publishing system that caters to researchers from all regions.

A BSTRACT: The COVID-19 pandemic has had significant psychological effects on individuals and communities around the world. Studies have found that the prevalence of anxiety and depression symptoms increased significantly during the pandemic. The goal of the study is to understand how the emerging new virus variants keep the world in a state of fear and how mental health measures can be implemented and adopted to alleviate anxiety. A broad search for observational studies was carried out in Pubmed, Google Scholar, Clinical Key, and World Medical Library. Studies that reported and/or related the existence of anxiety generated by suffering or not from diseases caused by the new emerging COVID-19 viruses and that for which the full text of the article was accessible were included in the study, while systematic review and meta-analysis and studies in groups were excluded. However, 22 studies were included in the review. The deleterious psychosocial effects were the restructuring of life, establishment of unhealthy habits, emergence of “ corona phobia ”, fear and stigma of being afflicted with the disease and spreading it to loved ones, and lack of contact with others. Increased rates of depression and anxiety were also seen. The circulating variants responsible for these main psychosocial repercussions were Epsilon, Zeta, Eta, Iota, Kappa, Alpha, Beta, Gamma, and Delta . Social support was found to be protective. There is a critical need for a comprehensive approach addressing not only the physiological well-being of an individual but also their mental well-being to pave the way for a society that is resilient in the face of current as well as future pandemics.

Pranic Healing (PH) is an ancient energy healing method focusing on the body's energy fields. The study explores its potential positive impact on the well-being of medical students. Existing research supports the transformative effects of PH on molecular structures and overall well-being. Spiritual well-being has been linked to mental health, and the study aims to evaluate the connection between Basic Pranic Healing workshops and students' mental health in a stressful medical school environment.This retrospective observational pilot study recruited 50 medical students through purposive sampling. Participants from Dr. Baba Saheb Ambedkar Medical College, Delhi, India, completed pre and post-workshop questionnaires, assessing knowledge, attitude, interest, motivation, and impact on well-being. Data were analyzed using SPSS, employing descriptive statistics and relevant tests.45 interested students participated, with a mean age of 20.78±2.09, 68.8% female. Significant improvements were observed in pre and post-workshop scores for knowledge (p = 0.00), interest (p = 0.00), and confidence (p = 0.00). Beliefs shifted positively with a final favorable perception . Participants reported a positive impact on various life domains with 56% practicing learned techniques weekly. Efficacy in healing (73.4%) and self-healing (84.4%) was notable The Basic Pranic Healing workshop effectively enhanced participants' knowledge, interest, confidence, beliefs, and overall perceptions. Positive impacts on various life domains and high success rates in healing demonstrate the practical relevance of Pranic Healing in promoting well-being. Findings support the integration of holistic healing practices in healthcare training and personal development programs.

Introduction: The COVID-19 pandemic has significantly impacted global healthcare systems. Vaccination is an effective strategy to battle the disease. Policies and distribution frameworks have varied widely across countries. The paper aims to highlight the global vaccination trends in these nations, based on their economic classification, which will illuminate key takeaways that will allow for better pandemic management policies. Methods: A list of the most populated countries across each income slab was drawn up, and information on their vaccination campaigns was collected from national government portals and official health department websites of these countries in a structured manner. Data collected for the attributes was qualitatively described and converted into binary responses for quantitative analysis. ANOVA test, Chi-square test, and regression models were employed. Results: A consistent decreasing trend was noted in the percentage of the population vaccinated as the spectrum from higher-income countries to lower-income countries was traversed for all dose statuses. Fewer types of vaccines were available in the lower-income countries. Though compliance with the CDC vaccination strategies guide was largely noted, a linear regression univariate analysis of vaccination drive parameters carried out for single-dose vaccination yielded statistically significant results for medical provider vaccine standardization (P-value = 0.002), vaccination requirements (P-values P-values <0.001) Vaccine hesitancy was not dependent on economic status. Conclusion: Concerted global initiatives like vaccine donation would assist efforts in mitigating disease spread. Prompt busting of baseless anti-vaccine narratives and strengthening healthcare infrastructure to meet national requirements should be given due importance.

Introduction: Femoral head fractures are uncommon injuries where patient outcomes depend on immediate surgical workup and postoperative rehabilitation. This study aimed to evaluate the functional outcomes of patients treated by open reduction and internal fixation (ORIF) using the screw fixation technique for the fracture head of the femur. Materials and Methods: Fourteen patients with femoral head fractures were treated by ORIF using the screw fixation technique in the Department of Orthopedics at a tertiary care hospital in Coimbatore, India for a period of 2 years. They were followed up for a minimum of 1 year to assess postoperative fracture union, postoperative complications, and functional and radiological outcomes by using relevant scoring systems such as Harris Hip Score, Oxford Hip Score, and Thompson-Epstein Hip Score. Results: Femoral head fracture patients in the age group of 36 ± 12.5 years (M: F = 1.8:1), classified as per Pipkins and Thompson-Epstein system were operated using the ORIF technique and followed up for 3.3 ± 1.8 years; the mean range of motion at the operated hip joints achieved were flexion 115.5°, extension 24.4°, abduction 35.5°, adduction 26.5°, internal rotation 34.4°, and external rotation 36.6°. Harris’s hip score was excellent in 57%, good in 14%, fair in 7%, and poor in 21% of the subjects. Oxford’s hip scores were satisfactory in 93% of the subjects. Osteoarthritis (28.9%) and avascular necrosis (7.14%) were seen as complications. Conclusion: According to our Indian population and cost constraints prevailing, we extrapolate these results obtained to our community population and thereby recommend ORIF of fracture femoral head by the screw fixation technique and postoperative non-weight-bearing protocol as a safe treatment schedule.

Gender representation in academic and professional settings is crucial for diversity and inclusivity. Editorial boards of scholarly journals shape research priorities, influencing global knowledge flow. In obstetrics and gynecology, with a focus on women’s health, board composition is of particular significance. This paper explores gender representation in international obstetrics and gynecology journal editorial boards, addressing potential disparities. The study adopts a cross-sectional design, analyzing the gender composition of editorial boards in global obstetrics and gynecology journals. A comprehensive search strategy identified relevant journals, using databases and manual searches. Inclusion criteria ensured journals’ language of use and disciplinary scope within obstetrics and gynecology. Ethical considerations prioritized privacy and confidentiality, with data extracted systematically. Genderize.io aided in gender determination of the board members. At the time of writing, among 1175 editorial members from 20 journals, 44.8% are females. Representation varies across roles: editor-in-chief (27.27% female), deputy/executive positions (43.33% female), senior/specialized positions (50.66% female), wider/general positions (45.89% female), nonacademic positions (36% female), external academic positions (19.56% female), honorary/founding positions (33.33% female), and administrative positions (31.03% female). This study contributes a comprehensive analysis of gender representation in obstetrics and gynecology journal editorial boards. Persistent disparities across roles underscore the need for targeted interventions to foster diversity and equity. Ethical considerations emphasize the importance of addressing these disparities for social justice and research integrity. Recommendations to guide journals in fostering inclusive editorial practices, contributing to a more equitable landscape in obstetrics and gynecology research.

Leptin is a peptide hormone synthesized by white adipose tissue. Its principal site of action is in the brainstem and hypothalamus, where it acts to modulate satiety and control of reward and aversion. Leptin deficiency or resistance is associated with dysregulation of cytokine production, increased susceptibility to infections, autoimmune disorders, malnutrition, and inflammatory responses. Studies have shown variation in leptin levels between males and females, and in different phases of the menstrual cycle as well. Our study aims to explain the variation in leptin levels and their physiological role in the menstrual cycle. A total of 1887 records were identified from PubMed, Google Scholar, and Cochrane. We included studies where females were 18-40 years of age, who had achieved menarche, and were on regular menstrual cycles. We excluded studies which were cross-section, pre-prints, or studies where inadequate information was provided. Seven studies were included in the study. We used the standardized mean difference as the outcome measure. Leptin levels varied significantly in the phases of the menstrual cycle as well as during prepubertal, pubertal, and postpubertal phases. The standardized mean difference in leptin levels between the follicular phase and the luteal phase was 2.67 ng/mL (95% CI: 0.16 to 5.19 ng/mL). Fluctuations in leptin levels can cause weight changes and reproductive cycle disturbances. Hence, in cases of infertility with abnormal menstrual cycles, measurement of the physiologic variability in leptin levels may help to diagnose the cause of infertility and appropriate interventions can be started.