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Blog, Vol 2 Issue 3

A STUDY OF NUTRITIONAL STATUS AND KNOWLEDGE, ATTITUDE AND PRACTICES AMONG MEDICAL STUDENTS OF A COLLEGE IN KANPUR

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Dr. Abhishek Verma1, Dr. Rajesh Jain2, Dr. Anju Gahlot³, Dr. Anas Ahmad khan4, Dr. Poonam Kushwaha5 , Resident1,Professsor2, Professsor3, Associate Professsor4 , Rama Medical College Hospital and Research Centre, Kanpur Introduction / Background •Obesity is a growing public health concern in India, with rising rates among young adults.[1]•College years fundamentally shape lifelong health behaviors.•Global and national efforts (like FSSAI’s Eat Right India Movement) promote healthy eating. Yet, local evidence of impact is limited.•Recent studies show ~9–24% overweight and 2–6% obesity prevalence among Indian medical students, due to lifestyle shifts and poor nutrition.[2] Results Baseline: 28% overweight, 6% obese; Major risk factors: Frequent junk food intake (42%), Low physical activity (61%), Family history of obesity (15%)

Blog, Vol 2 Issue 3

Expert Opinion on the Positioning of Sulfonylureas in the Management of Type 2 Diabetes Mellitus: Emphasis on Gliclazide Use Across Diverse Patient Profiles

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Authors: AK Singh1, Binayak Sinha2, AG Unnikrishnan3, Sasikumar V4, Vageesh Ayyar5, R Srinivasan6, Sharvil Gadve7, AP Selvam8, Gaurav Beswal9, Abhiudayay Verma10,Bhavesh Kotak11, Deepak Bachani11, Simran Chhatwal11 Affiliations: 1GD Hospital & Diabetes Institute, Kolkata, West Bengal, India;2Fortis Hospital, Anandpur, Kolkata, West Bengal, India;3Chellaram Diabetes Institute, Pune, Maharashtra, India;4NIMS Medicity, Thiruvananthapuram, Kerala, India ;5St. John’s Medical College & Hospital, Bangaluru, Karnataka, India;6Surya Clinic and Research Centre, Coimbatore, Tamil Nadu, India;7Excel Endocrine Centre, Kolhapur, Maharashtra, India;8Aruna Diabetes Centre, Chennai, Tamil Nadu, India;9Good Hope Diabetes Thyroid Clinic, Mumbai, Maharashtra, India;10Superspeciality Endocrinology and Women’s Care Center, Indore, Madhya Pradesh, India;11Department of Medical Affairs, Dr. Reddy’s Laboratories Ltd., Hyderabad, Telangana, India Corresponding author: Dr. Simran Chhatwal, Department of Medical Affairs, Dr. Reddy’s Laboratories Ltd., Hyderabad, Telangana, India; Email: [email protected] Diabetes Mellitus, a prevalent metabolic disorder, poses a significant global health challenge. Type 2 Diabetes Mellitus (T2DM), the most common form, arises from pancreatic beta-cell dysfunction and insulin resistance. Effective management of T2DM is critical to prevent complications such as cardiovascular disease, nephropathy, neuropathy, and retinopathy. Sulfonylureas, as insulin secretagogues, play a vital role in the management of T2DM. Despite the emergence of newer antidiabetic agents, sulfonylureas remain widely used due to their efficacy, cost-effectiveness, and extensive clinical experience. This article explores the positioning of sulfonylureas in the management of T2DM, drawing on insights from recent expert discussions and advisory board meetings. The discussions underscored the benefits of intensive glycemic control, particularly in reducing microvascular complications, with sulfonylureas playing a significant role. Newer-generation sulfonylureas, such as gliclazide and glimepiride, offer improved safety profiles and reduced risk of hypoglycemia. Gliclazide, with its antioxidant properties and cardiovascular benefits, is preferred in patients with renal impairment or high hypoglycemia risk. Real-world practice indicates a preference for sustained-release formulations due to better patient adherence and more consistent blood glucose control. The article also highlights the need for personalized treatment approaches that consider patient-specific factors such as age, comorbidities, and lifestyle. Sulfonylureas, particularly gliclazide and glimepiride, remain integral to the management of T2DM. Their role is reinforced by their efficacy, affordability, and potential benefits beyond glycemic control. Ongoing research and real-world evidence continue to shape their optimal use, emphasizing individualized treatment strategies to achieve the best clinical outcomes.

Blog, Vol 2 Issue 3

Health-Seeking Behaviour among People Living with HIV/AIDS in India: A ScopingReview

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Muskan Rastogi¹ Prof Dr Sanjeev Dave 2, Dr Rashmi Pandey 3, Prof Dr Anuradha V Dave4, Dr Ridima Kamal 5 Affiliation(s):¹First Author, Master of Public Health Candidate, Indian Institute of Public Health, Odisha, India; 2 HOD Community Medicine, Autonomous State Medical College, Auraiy, Uttar Pradesh; 3 Asstt Prof Biochemistry, Govt Medical College Haridwar (Uttarakhand);4 Professor Community Medicine, Subharti Medical College, Meerut, Uttar Pradesh;5 Consultant Public Health, AIIMS New Delhi Abstract Background: Acquired Immunodeficiency Syndrome (AIDS) continues to be a major global health challenge, with India having one of the highest burdens of people living with HIV (PLHIV). Despite advances in treatment, many individuals face significant barriers to timely testing, care, and treatment adherence due to poor health-seeking behavior. Objective: This scoping review aims to synthesize existing research on the health-seeking behaviors of PLHIV in India and to identify the key factors influencing their decisions, to inform improved service delivery. Methods: We conducted a systematic search across PubMed, Scopus, and Google Scholar, following the PRISMA-ScR framework. The review included 17 peer-reviewed primary studies published in English, spanning from 2004 to May 2024. Data were synthesized using both descriptive quantitative and qualitative thematic analysis. Results: The review identified three primary barriers to health-seeking behavior: pervasive stigma, which delayed testing and treatment; social inequities, including gender and income disparities, that restricted access to care; and health system limitations, such as long travel distances and fragmented services, which contributed to poor retention. Conversely, the review found that peer and family support, as well as innovative digital health approaches, were key facilitators. The evidence base was concentrated in southern and western India, with critical gaps in central, eastern, and northeastern regions and among marginalized populations. Conclusion: Health-seeking behaviour among PLHIV in India is shaped by a complex interplay of social and systemic barriers. Based on these findings, we recommend targeted interventions to address these barriers, including stigma reduction efforts and the development of community-based, patient-centred care. Addressing evidence gaps in underrepresented populations and regions is crucial for informing scalable, equitable interventions in India. Keywords: Health-seeking behaviour, HIV, AIDS, India, Stigma, Barriers

Blog, Vol 2 Issue 2

Do Microplastics have any significant effect on Red Blood Cells? An In-depth study bySystematic Review and Meta-Analysis

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Abstract Background: Despite growing interest, there remains a critical knowledge gap regarding the toxicodynamic interactions between MPs and human erythrocytes. This study was done to consolidate emerging evidence on microplastics’ effects on red blood cells and interpret their implications for public health. Methodology: In this study, the studies were identified from multiple databases such as PubMed, Cochrane review, and Google Scholar, and all kind of data in any form of article was taken on 2 keywords: “Microplastics” and “RBC” from the last 20 years in the Literature. Results:  This systematic review of   63   articles provides consolidated evidence that MNPs interact directly with erythrocytes (RBCs), leading to oxidative damage, impaired deformability, and disruptions in oxygen transport. These effects are not isolated but form part of a broader cascade involving endothelial dysfunction, immune activation, and vascular complications. Most included studies report a statistically significant increase in haemolysis associated with the exposure under investigation, with effect sizes ranging from moderate (6%) to large (10%).   Conclusion: Given the pervasive presence of microplastics in the environment, including recent confirmation of their presence in human blood, these findings raise significant concerns about their potential haematological and systemic health effects. Regulatory bodies and public health institutions must prioritize further investigation, public. Keywords: Microplastics, Red Blood Cells, Human Blood, SystematicReview, Meta-Analysis

Blog, Vol 2 Issue 2

The Double Burden of Malnutrition and Diabetes in India: The Paradox of theThin-Fat Phenotype

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Sankalp Ghadei 1*, Deniza Patel 2, Jankhana Patel 3 1 Research Scientist, ICMR- National Institute of Virology, Pune; MPH Student, Indian Institute of Public Health, Gandhinagar; MBBS Intern, Baroda Medical College, Vadodara;2 MPH Student, Indian Institute of Public Health, Gandhinagar; 3MBBS Intern, Baroda Medical College, Vadodara Corresponding Author: 1*Sankalp Ghadei, Research Scientist, ICMR- National Institute of Virology Pune, Maharashtra, India-411021, [email protected] Abstract: Background: India faces a unique epidemiological paradox characterized by the coexistence of persistent childhood malnutrition (35.5% stunting prevalence) and an escalating diabetes epidemic affecting 77 million adults, projected to reach 134 million by 2045. This dual burden manifests through the emergence of the “thin-fat” phenotype—individuals appearing thin by conventional anthropometric standards, yet harbouring excess visceral adiposity and elevated type 2 diabetes risk. This phenomenon challenges Western paradigms linking obesity to diabetes, as Indians develop diabetes at significantly lower BMI levels than European populations. Methods: A comprehensive literature review was conducted using PubMed, Scopus, and Web of Science databases, covering publications from 1990 to 2023. Primary data sources included the National Family Health Survey-5, ICMR-INDIAB studies, and WHO reports. Studies on Indian populations, malnutrition-diabetes relationships, thin-fat phenotype characteristics, and the health system responses were systematically analysed.Results: The thin-fat phenotype affects 43.3% of India’s population, with a higher prevalence in rural areas (46%) than in urban areas (39.6%). State-level analyses reveal an inverse relationship between malnutrition and diabetes prevalence, indicating different epidemiological transition stages. Kerala demonstrates low malnutrition (19.7% underweight) but high diabetes prevalence (25.5%), while Jharkhand exhibits severe malnutrition (39.6% stunting) with emerging diabetes concerns (7.2%). The phenomenon extends to household levels, with undernourished children and diabetic adults coexisting within families. Physiological mechanisms underlying this paradox include developmental programming through Barker’s and Pedersen’s hypotheses, altered adipose tissue distributionfavouring visceral fat accumulation, sarcopenic obesity, and unique beta-cell dysfunction characteristics in Indian populations.Health System Implications: Current approaches treating malnutrition and diabetes as separate conditions through siloed programs (ICDS and National Programme for Prevention and Control of Non-Communicable Diseases) prove inadequate. BMI-based screening protocols miss 35-42% of thin diabetics, while healthcare providers lack training on dual burden complexities. The economic burden is substantial. Diabetes care costsrange from INR 5,000 to 45,000 annually, forcing 48.5% of families into distressed financing.Conclusion: India’s dual burden requires urgent, integrated health system transformation addressing both conditions simultaneously. Success demands unified screening protocols, comprehensive healthcare worker training, and coordinated policy approaches that transcend conventional disease categories to break intergenerational malnutrition and metabolic dysfunction cycles.

Blog, Vol 2 Issue 2

The Glycaemia Outcomes of Metformin with Add-on Vildagliptin orSitagliptin in T2 Diabetes Mellitus

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Introduction:T2DM is a global health concern requiring effective glycaemia management to reduce complications. While DPP-4 inhibitors like vildagliptin and sitagliptin are widely used with metformin, limited studies have compared their efficacy in lowering plasma glucose levels. This study aims to address this gap by evaluating the effectiveness of these combinations in glycemic control.Methods:A comparative observational study on 172 Patients with T2DM (≥30 years) was done with comorbidities like hypertension, dyslipidaemia, and obesity. Inclusion required lab data (FBG, PLBS, HbA1c, Cr, TG) and consent, while exclusions included T1DM, gestational diabetes, insulin therapy, alcoholuse, and emergencies. Primary (HbA1c) and secondary (Cr, TG) outcomes were assessed. Results and Conclusion: The study showed that adding vildagliptin or sitagliptin to metformin significantly improved glycaemia control in T2DM over six months. Both combinations effectively reduced FBS, PLBS, HbA1c, and TG without affecting renal function. In this cohort, patients receiving vildagliptin + metformin demonstrated a greater reduction in blood glucose levels compared to those receiving sitagliptin + metformin. Keywords: T2DM, Metformin, Vildagliptin, Sitagliptin, Glycaemia control, HbA1C, DPP-4inhibitor

Blog, Vol 2 Issue 1

An Epidemiology study of Socio-demographic-economic & Gestational Profile of Women with Early Gestational Glucose Intolerance at 8-10 weeks of Pregnancy

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Diabetes accounts for nearly 10% of global deaths among people aged 20 to 99 and is the fourteenth leading cause of Disability-Adjusted Life Years (DALYs) worldwide. The prevalence of diabetes is increasing worldwide due to factors like urbanization, nutrition, the elderly population, genetics, and lifestyle changes.1 An often-overlooked factor is gestational diabetes mellitus, which leads to glucose intolerance during pregnancy.2 Women with gestational diabetes often develop diabetes within three to six years after delivery, perpetuating a cycle of obesity, insulin resistance, diabetes, and NCDs across generations. Breaking this cycle is now more crucial than ever.3 Gestational diabetes mellitus (GDM), according to the World Health Organization, is characterized by carbohydrate intolerance leading to elevated blood sugar levels, with variable severity, first recognized during pregnancy. It is a very common metabolic disorder in pregnancy. Insulin resistance increases during pregnancy due to the development of carbohydrate intolerance.4 Adiponectin, which has antidiabetic and anti-inflammatory effects, is present in low levels in pregnant women with gestational diabetes mellitus (GDM). This decrease is associated with increased insulin resistance during pregnancy, playing a role in the onset of GDM. Insulin resistance, resulting from the β-cells’ failure to secrete insulin properly, may also be affected by maternal adiposity.5 The rising prevalence of GDM is primarily driven by modifiable risk factors like obesity, poor diet, sedentary lifestyle, and pre-existing insulin resistance, which can be reduced through early interventions. GDM has long-term effects on both the mother and offspring, influencing health outcomes across generations.

Blog, Vol 2 Issue 2

Right Ventricular Infarction Following Inferior STEMI: A Case Report and Comprehensive Review of Management Challenges

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   Siyamak Jalal Hosseini1, Mohammadreza Shoghli2*, Hermon Eyob Fesseha3, Yosan Eyob4 1Assistant Professor at Tehran University of Medical Sciences, Tehran, Iran, [email protected]; 2Ph.D. Helsinki, Department of Population Study, University of Helsinki, Helsinki, Finland, [email protected]; 3Hermon Eyob Fesseha1, Cardiology resident, Peijas Hospital District of Helsinki and Uusimaa (HUS), University of Eastern Finland; [email protected]; 4MD, general practitioner in private clinic Pihlajalinna, Finland, [email protected]  Corresponding Author: 2*Mohammadreza Shoghli, Ph.D. Helsinki, Department of Population Study, University of Helsinki, Helsinki, Finland, [email protected] Right ventricular infarction (RVI) is a life-threatening complication of inferior ST-elevation myocardial infarction (STEMI), occurring in approximately 30–50% of such cases—typically when the proximal right coronary artery (RCA) is occluded [1,2]. While left ventricular (LV) infarction receives more clinical focus, RVI significantly worsens patient outcomes and is often underdiagnosed due to nonspecific signs [3,4]. The right ventricle (RV) is anatomically distinct from the LV, with a thinner free wall, lower systolic pressure, and greater dependence on preload. These characteristics make the RV highly susceptible to ischemic damage and volume depletion. RV dysfunction can compromise left-sided output due to interventricular dependence, thereby leading to systemic hypotension and cardiogenic shock [5,6]. Although timely revascularization is the cornerstone of STEMI therapy, standard management strategies may be inadequate in dominant RVI. In such cases, mechanical support such as right ventricular assist devices (RVADs) or extracorporeal membrane oxygenation (ECMO) can be lifesaving. Unfortunately, these are not universally accessible, particularly in resource-limited settings [7]. We present a case of inferior STEMI with RVI, highlighting the limitations of current management and the impact of unavailable mechanical RV support.

Blog, Vol 2 Issue 2

Chronic Reactive Arthritis Following Bacillus Calmette-Guérin (BCG) Instillations: A Case Report and Review

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Hermon Eyob Fesseha1*, Laura sundell2, Mari Ala-Houhala3, Alexandra Häme4, Mohammadreza Shoghli5, Siyamak Jalal Hosseini6 , Yosan Eyob7 1Hermon Eyob Fesseha1, Cardiology resident, Peijas Hospital District of Helsinki and Uusimaa (HUS), University of Eastern Finland; 2MD, internal medicine and rheumatology, chief physician in Peijas Helsinki University Hospital (HUS) department of internal medicine, [email protected]; 3MD, infectious disease specialist, Peijas Helsinki University Hospital (HUS), [email protected]; 4MD, rheumatologist, Peijas Helsinki University Hospital (HUS), [email protected]; 5 Ph.D. Helsinki, Department of Population Study, University of Helsinki, Helsinki, Finland, [email protected]; 6MD, Doctor of Medicine, Professor (Assistant) at Tehran University of Medical Sciences, Tehran, Iran, [email protected]; 7MD, general practitioner in private clinic Pihlajalinna, Finland, [email protected] 1*Corresponding Author: Dr Hermon Eyob Fesseha, Cardiology resident, Peijas Hospital District of Helsinki and Uusimaa (HUS), University of Eastern Finland, Finland, Email: [email protected] Abstract Background: Reactive arthritis (ReA) is an inflammatory joint condition that typically develops days to weeks after a gastrointestinal or genitourinary infection. While it is often associated with a classic triad of arthritis, urethritis, and conjunctivitis, many patients may not exhibit all three symptoms. Previously known as “Reiter syndrome,” named after Hans Reiter, ReA is thought to result from an abnormal autoimmune response to infections caused by pathogens such as Salmonella, Shigella, Campylobacter, or Chlamydia. Recognizing this connection is essential for effective diagnosis and treatment. Case Description: A 67-year-old male developed reactive arthritis (ReA) following intravesical Bacillus Calmette-Guérin (iBCG) therapy for non-muscle invasive bladder cancer. Elevated inflammatory markers and a negative HLA-B27 result were noted. The symptoms were attributed to iBCG-related ReA, leading to the discontinuation of iBCG treatment. Outcome: Initial treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids was ineffective, necessitating disease-modifying antirheumatic drugs (DMARDs) for sustained remission and symptom control. Although chronic arthritis requiring prolonged DMARD therapy is uncommon, the patient required over 1.5 years of DMARD treatment to manage symptoms effectively. Keywords: iBCG intravesical Bacillus Calmette-Guérin, DMARD disease-modifying antirheumatic drugs, NSAIDs nonsteroidal anti-inflammatory drugs

Blog, Vol 2 Issue 2

Primary and secondary Pregnancy outcomes of Rural Women with Early Gestational Glucose Intolerance (EGGI) of a Tertiary care hospital in India

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Boddu Anuja1, Sanjev Dave2*, Prashant Dahire3, Rashmi Pandey4, Anuradha Dave 5, Ridima Kamal6 1*Dr. Boddu Anuja, Department of Community Medicine, SRTR Govt Medical College, Ambejogai, Beed, Maharashtra, India 2Sanjev Dave, HOD Community Medicine, Autonomous State Medical College, Auraiya UP-206244, India 3Associate Prof, SRTR Medical College, Community Medicine, Ambajogai, India 4Department of Community Medicine, Subharti Medical College, Meerut, Uttar Pradesh, India-250005 5Assistant Professor Biochemistry, Govt Medical College, Haridwar, Uttarakhand, India, Uttar Pradesh, India 6Public Health Consultant, Department of Community Medicine, All India Institute of Medical Sciences, New Delhi Submitted: 28 June 2025; Accepted: 10 July2025; Published: 20 July 2025 Corresponding Author: 2*Prof Dr Sanjev Dave, HOD Community Medicine, Autonomous State Medical College, Auraiya, UP206244.email: [email protected] Background: The rising prevalence of GDM is primarily driven by modifiable risk factors like obesity, poor diet, sedentary lifestyle, and pre-existing insulin resistance, which can be reduced through early interventions. Aim of study: This study aimed to determine early prediction of hyperglycemia and gestational diabetes mellitus in pregnant rural women by early screening of dysglycemia in 8-10 weeks of gestation. Methodology: This study was focused on 135 antenatal care (ANC) mothers in rural areas, given the importance of this population. It explored various parameters, including demographic factors, postprandial blood sugar (PPBS) levels, and Oral Glucose Challenge Test (OGCT) at specific times. Results: It was found that elevated early PPBS levels were linked to a greater risk of adverse pregnancy outcomes, including low birth weight, large for gestational age (LGA) babies, preterm births, increased NICU admissions, and elevated rates of pregnancy-related hypertension and gestational hypertension. Conclusion: Women with elevated early PPBS levels ≥110 mg/dl who received targeted management showed improvements in controlling blood glucose levels, potentially reducing adverse maternal and neonatal outcomes. The study advocates for early detection of elevated blood glucose levels, which enables timely interventions such as dietary education and lifestyle modifications.

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