SRMS JOURNAL OF MEDICAL SCIENCE

Toxicities Profile of Bevacizumab in Cancer Patients Treated in a Tertiary Care Cancer Institute

2025-06-17T16:12:58+0530

Introduction: Bevacizumab, a recombinant humanized monoclonal antibody against vascular endothelial growth factor (VEGF), inhibits tumor growth by blocking angiogenesis. Bevacizumab was approved in common solid tumors with high therapeutic need. Overall, bevacizumab is generally well tolerated. Some side effects can be fatal, its critical to determine risk factors, toxicity profile and set up treatment plans to reduce treatment related morbidity and death. The present study aims to assess side effects of bevacizumab mainly hypertension,proteinuria and hepatotoxicity. Material and Methods: About 25 patients treated with bevacizumab for a time period of 3 months from January 25th to March 25th in the year 2025 were recruited between age group of 18 to 60 years. People unwilling to sign the informed consent form and people who are not showing up on time for therapy or evaluation were excluded in this study. Urine sample were collected for the evaluation of proteinuria, blood sample for checking transaminitis and regular mesearement of blood pressure for hypertension evaluation. All the toxicity were assessed according to CTCAE. Results: The study shows that bevacizumab is associated with a significantly increased risk of proteinuria and hypertension in patients who received treatment for metastatic cancers of the lung, hepatocellular, gastroesophageal, colorectal, and ovarian. Over 40% of patients show hypertension either as a new onset (20%) or exacerbation of previous hypertension (80%). About 28% of patients had mild or moderate proteinuria, high grade proteinuria was found in only 4% of patients and none of our patient had advanced to nephrotic syndrome. No liver toxicity as all the alanine aminotransferase and aspartate aminotransferase levels were within normal range. Conclusion: The administration of bevacizumab requires disclosure of the risks and the benefits and alternative therapies to patients in an informed consent-like process. With evolving precision oncology the role of bevacizumab continuous to grow and care givers should be aware of the toxicities of the drug.

Fertility Issues in Cancer Patients: An Observational Survey-Based Study

2025-06-17T16:12:58+0530

Background: Advances in cancer therapy have increased survival rates, particularly among adolescents and young adults. However, cancer treatments such as chemotherapy, radiotherapy, and surgery can significantly impair fertility, posing long-term psychosocial and reproductive challenges. Despite clinical guidelines recommending fertility counseling, awareness and uptake of fertility preservation methods remain limited. This study aimed to assess awareness, attitudes, and practices regarding fertility preservation among cancer patients of reproductive age using a structured, self-validated questionnaire. Material and Methods: A cross-sectional observational study was conducted at a tertiary care cancer center over a six-month period. Patients aged 15 to 45 years undergoing or recently completing cancer treatment were recruited. Data were collected using a self-validated questionnaire that assessed knowledge of fertility risks, prior counseling, preservation actions taken, and the psychological impact. Descriptive and inferential statistics were used for analysis. Results: A total of 44 patients completed the questionnaire. Only 9% were aware that cancer treatments could impair fertility, and just 5% reported receiving counseling prior to treatment. Fertility preservation was pursued by a minority of 2%, with sperm cryopreservation being the most commonly utilized method. Female patients were significantly less likely to be informed or offered preservation options. Emotional distress related to potential infertility was reported by over half of the participants. Barriers identified included lack of awareness, financial constraints, urgency of treatment, and limited access to services. Conclusion: Fertility preservation remains an underutilized aspect of cancer care. There is a critical need to enhance patient education, improve provider training, and implement structured fertility counseling protocols at an early stage in the cancer care pathway.

Perceptions and Knowledge of Anaesthesiology Among Medical Undergraduates: A Survey of Career Pathways and Influences

2025-06-17T16:12:58+0530

Introduction: Anaesthesiology is a critical yet often underrecognized medical specialty, playing a vital role in patient safety, perioperative care, and pain management. Despite its importance, many medical students lack awareness of its scope, leading to low interest in pursuing it as a career. This study aimed to evaluate the perceptions and knowledge of anaesthesiology among undergraduate medical students in India and identify factors influencing their career choices.

Material and Methods: A cross-sectional online survey was conducted among 137 medical students and interns from various institutions across India. The questionnaire assessed demographic details, knowledge of anaesthesiology, career preferences, and factors affecting specialty selection.

Results: Results revealed that while 81.6% of respondents acknowledged anaesthesiology as a life-saving specialty, only 34.3% considered it as a career option. Key deterrents included limited patient interaction (31.3%), lack of recognition (20.4%), and insufficient exposure during training (18.9%). Conversely, motivators such as work-life balance (25%), growing demand (39%), and diverse clinical roles (20%) were cited by those interested in the field. Exposure to anaesthesiology significantly influenced perceptions, with 45.3% of students who had clinical postings expressing greater interest. Gender differences were observed, with female students prioritizing work-life balance while male students emphasized income and recognition. Early clinical exposure and mentorship were identified as crucial factors in shaping career decisions.

Conclusion: The study highlights the need for curriculum reforms, increased visibility of anaesthesiology in undergraduate training, and targeted awareness campaigns to address misconceptions. Enhancing early exposure and mentorship could attract more students to this essential specialty, addressing global workforce shortages and improving healthcare delivery.

Assessing Cancer Awareness and Knowledge Among Healthcare Professionals in a Tertiary Care Teaching Hospital, Bareilly

2025-06-17T16:12:58+0530

Introduction: Cancer has long been one of the most feared diseases, widely regarded to be synonymous with death. Lack of awareness fuels many myths and misconceptions related to cancer, which perpetuates the stigma associated with it. Moreover, a considerable number of different cancer types may be preventable by using primary intervention techniques, such as health education, cancer awareness, behaviors, and lifestyle modifications. Therefore, this study aimed to assess the current levels of awareness and perceptions about cancer among healthcare professionals with various socio-economic statuses and diverse backgrounds in the tertiary care teaching hospital in Bareilly, India.

Methods and Material: We conducted a population-based interview survey of healthcare professionals aged 18 years or older using the awareness and beliefs about cancer questionnaire in a tertiary care teaching hospital in Bareilly, India. A total of 72 healthcare professionals were interviewed using a semi-targeted sampling method. A questionnaire was designed by compiling two major international tools in literature, i.e., Cancer Awareness Measure (CAM) and a survey on cancer awareness and attitudes (by NCCP). For the data analysis, questions were coded and entered. Quantitative variables were summarized using measures of central tendency as mean, while categorical variables were depicted using frequencies and percentages.

Result: The study included 37 males and 35 females, with the majority (59.7%, n = 43) falling within the 18 to 33 years age group and being relatively well-educated, as 43% (n = 31) were graduates. Despite more than half of the participants (70.6%) being aware of the most common cancer in females, their knowledge about screening programs for major female cancers like breast and cervical cancer was limited, with only 43.2 and 41.6% aware of them, respectively. Participants recognized an average of 5.2 out of 13 early cancer warning signs and cancer risk factors. While 62.4% of participants believed that cancer is not a death sentence, 43% still did not want to know if they had cancer.

Conclusion: The findings highlight a relatively young and educated population with a moderate level of awareness about the most common cancer. However, significant gaps remain in knowledge about cancer screening programs and early warning signs. Misconceptions—such as the belief that cancer is a death sentence—and reluctance to know one’s diagnosis further underscore the need for targeted health education. Strengthening awareness campaigns and promoting routine screening could play a crucial role in enhancing early detection and improved outcomes.

Mental Health Status in Patients Who has Undergone Cancer Treatment

2025-06-17T16:12:58+0530

Introduction: Psychological distress, including anxiety and depression, is common among cancer patients and can impact treatment outcomes and quality of life. This study aimed to evaluate anxiety and depression levels in post-treatment cancer patients using the GAD-7 and PHQ-9 screening tools.

Material and Methods: 42 patients with various carcinoma types undergoing radiotherapy were assessed. Demographic data, cancer type, treatment details, and responses to GAD-7 and PHQ-9 questionnaires were collected. A descriptive analysis of anxiety and depression symptoms was performed.

Results: The cohort had a mean age of 56 years and was predominantly female, with breast carcinoma being the most frequent diagnosis. Most patients reported minimal anxiety and depressive symptoms. Total PHQ-9 scores ranged from 0 to 8, with the majority scoring in the minimal depression range. GAD-7 responses similarly indicated low anxiety levels. These findings suggest that the post-treatment group exhibits psychological resilience.

Conclusion: Despite the known psychological burden of cancer, most patients in this cohort exhibited low anxiety and depression levels post-radiotherapy. Routine use of brief screening tools like GAD-7 and PHQ-9 can facilitate early identification of psychological distress and guide timely interventions to improve survivorship care.

A Comparative Morphometric Analysis of Diaphyseal Nutrient Foramina in the Long Bones of the Forearm and Leg in the North Indian Population

2025-06-17T16:12:58+0530

Introduction: The nutrient foramen (NF) is the opening in the shaft or diaphysis of a long bone that allows the nutrient artery to enter the medullary cavity, ensuring adequate blood supply to inner parts of the bone, which is critical for bone growth, remodeling, and healing. Knowledge of the location and number of nutrient foramina is essential during bone transplants, resections, or fixations, as in orthopedic surgeries. Ethnic and population variability is observed in the number and size of nutrient foramina among different populations. The study aims to find significant clinical-anatomical correlations of nutrient foramen between the bones of the forearm and leg in the North Indian population by comparative morphometric analysis.

Material and Methods: The present study was conducted on 240 adult long bones of the forearm and leg, 60 each of radius, ulna, tibia, and fibula of unknown sex and age, from the North Indian population, available in the Department of Anatomy, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh.

Results: The study showed the location of NF in the upper third in 75% of the radius, 70% in the ulna, while in the lower third in 76.6% of the tibia and 66.6% in the fibula. In all radius and ulna, nutrient foramina is directed towards the upper end, while in all tibia and fibula, it is towards the lower end. 91.6% of radius, 86.6% of ulna, 81.6% of tibia, and 91.6% of fibula accepted 26G of needle.

Conclusion: The present study confirms and expands upon existing knowledge of nutrient foramina anatomy by providing population-specific data from North India. This knowledge is crucial not only for academic anatomy but also for clinical applications such as fracture repair and reconstructive surgeries.

The Role of AI in Shaping Medical Education: Evaluating Usage Trends Among Students and Teachers

2025-06-17T16:12:58+0530

Introduction: Artificial intelligence (AI) is revolutionizing medical education by enhancing personalization, interactive learning, and clinical simulation. While AI supports improved accessibility, efficiency, and assessment, barriers such as high costs, ethical concerns, and insufficient faculty training persist. The present study was done to assess the knowledge & attitude of medical students and teachers towards AI in medical education.

Material and Methods: A descriptive cross-sectional survey was carried out over a 3-month period among MBBS students, postgraduate residents, and faculty members at SRMS IMS Bareilly. Data were collected using a structured online questionnaire via Google Forms, comprising three sections: demographic information, awareness of AI, and attitudes toward its application in medical education.

Results: A total of 150 participants responded to the online survey, with the majority being first-year MBBS students. Most MBBS students (48%) aged 20 to 30 years use AI tools for education, chatbots (67.4%) being the most popular. A large proportion (56.7%) reported no prior AI training but expressed interest in learning. Quick response (30%) and personalized learning (22%) were reported as key benefits, while concerns included reduced human interaction (47.3%) and AI potentially replacing doctors (26.7%). Most of the respondents believe that AI will revolutionize medical education (57.3%).

Conclusion: AI tools are increasingly utilized by medical students, particularly early-year learners. Despite limited formal training, both students and faculty display a positive outlook toward AI integration. Addressing ethical concerns and enhancing training infrastructure is essential to optimize AI’s role in medical education

A Study of Quality Control in Pap Smear Cytology in a Tertiary Care Centre Using ASC:SIL Ratio

2025-06-17T16:12:58+0530

Introduction: Internal quality indicators used in gynecological cytopathology include determining the rate of atypical squamous cells (ASC), calculation of ASC: SIL ratio, cytologyhistology correlation, and high-risk HPV-positivity rates in ASC-US. These indicators help in quality control measures. Bethesda suggests that the ASC: SIL ratio should be less than 3:1. this study aims to determine the ASC: SIL ratio as an internal quality control indicator in gynecological cytological smears.

Material and Methods: The present study was conducted in the Department of Pathology SRMS Institute of Medical Sciences, Bareilly, UP. Archived cases of the preceding 2 years, from January 1, 2023, to December 31, 2024, were taken. The clinical details were retrieved from records. The study included conventional pap-stained smears of ASC-US, ASC-H, LSIL, HSIL, and SCC. ASC: SIL ratio was calculated by dividing the Sum of all ASC cases by the Sum of all SIL cases.

Results: About 5231 cervical Pap smears were received during the study period, of which 5061 (97%) were satisfactory. There were 39 cases with squamous cell abnormality, of which 13 were ASCUS, 9 were ASC-H, 8 were HSIL, 3 were LSIL, 6 were SCC cases, and the ratio ASC: SIL was 1.28, which was below the upper benchmark of 3:1.

Conclusion: The ASC: SIL ratio is a simple method for calculating internal quality indicators in cervical cytopathology. Keeping it below 3:1 reduces diagnostic uncertainty and supports WHO’s goal to eliminate cervical cancer. Regular feedback and periodic training programs can help reduce the ASC: SIL ratio, which exceeds the benchmark of 3:1.

Assessment of Delay in Treatment of Breast Cancer: Trend and Determinants

2025-06-17T16:12:58+0530

Introduction: In developing countries, most breast cancer patients with advanced stage. Stage at diagnosis is the most important prognostic factor, but delay in diagnosis and treatment of breast cancer is not uncommon, especially in developing countries. This study was conducted to analyze the barriers in the early detection of cancers and to address the obstacles, which could be reciprocated in improvement.

Material and methods: This hospital-based, cross-sectional study was conducted in the Department of Radiation Oncology at Shri Ram Murti Smarak Institute of Medical Sciences, located in Bareilly, Uttar Pradesh. All the patients of breast cancer who had presented first time in OPD, from 01.01.2025 till 31.03.2025, as well as those who have recently started treatment, were taken in this study, considering they were able to recall the details required, have been enrolled in this study. Data from the questionnaire were entered in Excel sheets and given proper codes for calculation. Frequencies and proportions were calculated, majorly in the form of mean or median values.

Results: A total of 41 patients has been enrolled. The median age of presentation for breast cancer was 50 years (range 31-67 years), 41.4% were illiterate, 63.4% belonged to rural areas, and 85.4% were financially dependent. The median time interval between noticing symptom first time and seeking first consultation (T1) was 30 days (10–60 days); first consultations to reaching tertiary cancer center (T2) 20 days (10–40 days); to make diagnosis was 7 days (4–9 days); from diagnosis to start treatment was 6 days (3–10 days) while overall median delay was 50 days (10–60 days).

xConclusion: There was insufficient knowledge and awareness of breast cancer, its risk factors, symptoms, treatment, or available healthcare facilities in close proximities, especially in rural areas that too delay in treatment of breast cancer patients. Cancer screening and awareness may lead to early presentation in the hospital for treatment.

Awareness, Attitudes, and Barriers Towards Cancer Screening: A Cross-Sectional Survey

2025-06-17T16:12:58+0530

Introduction: Cancer screening is an essential tool in the early detection and prevention of malignancies. It improves survival outcomes and reduces the treatment burden by identifying cancer in its early stages. Despite its benefits, participation in cancer screening remains low in many populations. This study aimed to assess the awareness, attitudes, and barriers to cancer screening among patients attending a tertiary care hospital.

Material and Methods: A cross-sectional survey was conducted over a three-month period in the outpatient department of a tertiary care hospital. About 50 adult participants were recruited using convenience sampling. Data were collected using a structured, pre-validated questionnaire that included demographic details, awareness of cancer screening, and barriers to participation. Descriptive statistics were used to analyze the data.

Results: Only 6% of participants had undergone cancer screening despite 82 to 86% acknowledging the importance of early detection. Head and neck cancer was the most reported type (40%). Knowledge about specific screening procedures was low (6%). Major barriers included the belief of being healthy (74%), fear of diagnosis (28%), and distance to the screening center (28%).

Conclusion: Although general awareness of the benefits of cancer screening was high, actual screening rates were significantly low. The findings suggest that psychological barriers and accessibility issues are the primary obstacles to progress. Efforts to increase screening uptake should focus on education, community-based services, and reducing systemic barriers.