SRMS JOURNAL OF MEDICAL SCIENCE

Long-Term Physical Well-Being Among Cancer Survivors: A Retrospective Study in District Bareilly

Mohammad Arif Zia — 2026-09-02

Introduction: Cancer survivorship is increasingly recognized
as a critical phase of the cancer care continuum. Although
advancements in diagnosis and treatment have improved
survival rates, many survivors experience persistent physical
symptoms such as fatigue, pain, appetite changes, and sleep
disturbances. These long-term effects significantly impact
quality of life (QoL), especially in low-resource settings where
follow-up care is limited.
Objective: To assess the long-term physical well-being of
cancer survivors five years post-treatment and examine its
association with socio-demographic factors in District Bareilly,
Uttar Pradesh.
Material and Methods: A retrospective cohort study was
conducted among cancer survivors who completed treatment
in 2018 at a tertiary care hospital. Of 144 identified individuals,
90 survivors participated. Physical well-being was assessed
using a pretested interview schedule adapted from the quality
of life-cancer survivor version (QoL-CSV), focusing only on
the physical domain. Data were analyzed using SPSS version
25 with descriptive statistics and non-parametric tests (Mann-
Whitney U and Kruskal-Wallis).
Result: The mean total physical well-being score was 26.8 ±
10.7 out of 80. Fatigue and appetite changes were the most
prevalent symptoms. Socioeconomic status was significantly
associated with physical well-being scores (p < 0.05),
with higher scores among the upper class. No significant
associations were found with age, gender, or occupation.
Conclusion: Five years post-treatment, cancer survivors
face notable physical challenges. Socioeconomic disparities
influence physical recovery, underscoring the need for targeted
survivorship interventions in resource-limited settings.

Analysis of Adverse Drug Reactions Reported at the Adverse Drug Monitoring Centre of the Tertiary Care Hospital

Meenakshi Jindal — 2026-09-02

Introduction: The drugs developed during the recent
years lead to incredible benefits for the patients but causes
increased incidence of adverse drug reaction (ADR). ADR is an
undesirable, unintended consequence of drug administration.2
It is well known that “No drug is absolutely void of side effects”,
so to monitor such ADR, we have AMC at the tertiary care
hospital. Aim of our studywas to analyzeADRs reported at the
AMC centre of the tertiary care hospital.
Material & Methods: This retrospective study was carried
out at the AMC of Shri Ram Murti Smarak Institute of Medical
Sciences, Bareilly, for a period of 3 years. Patients of all ages
and either sex were included. Adverse drug reactions were
reported by the healthcare professionals and patients were
included in our study. The reported ADRs were analyzed
according to the demographic profile, department-wise, class
of drug and system organ class involved. Data collected was
analyzed and expressed in percentages.
Results: Total 197 ADRs were reported from various
departments. Most of the adverse drug reactions were observed
in females in the age group of 18 to 65 years. A maximum number
(29) of ADR’s were reported from the oncology department,
followed by Orthopedic, paediatric and voluntary reporting by
the patients. Most of the ADRs were reported from antibiotics
72 (36.54%). The causality assessment of ADRs were assessed
according WHO-UMC causality assessment scale, according
to which the maximum were probable,116 (58.8%) followed by
possible, 75 (38.07%) and certain, 6 (3.04%).
Conclusion: The study concluded that the spontaneous
reporting of ADR’s is satisfactory. Reporting from HCP’s
needs to be enhanced by sensitization and creating
awareness by imparting training and conducting workshops
on pharmacovigilance.

Comparative Evaluation of Height-to-Thyromental Distance Ratio, Modified Mallampati Score, and Upper Lip Bite Test as Predictors of Difficult Laryngoscopy

Upasana Sharma — 2026-09-02

Introduction: Predicting difficult laryngoscopy is essential
to prevent serious anaesthesia-related complications.
Conventional tests like the Modified Mallampati score (MMS)
and upper lip bite test (ULBT) have limitations, while the ratio
of height to thyromental distance (RHTMD) offers a more
objective, anthropometric approach. The aim of the study is
to to compare the predictive accuracy of RHTMD, MMS, and
ULBT in identifying difficult laryngoscopy in patients undergoing
elective surgery.
Material and Methods: This prospective observational study
included 80 ASA I–III adult patients scheduled for elective
surgeries under general anaesthesia. Preoperative airway
assessments included MMS, ULBT, and RHTMD, with a cut-off
value of ≥26 for RHTMD. After induction, direct laryngoscopy
was performed, and the view was graded using the Cormack-
Lehane (CL) system. Grades III and IV were classified as difficult
laryngoscopy. Sensitivity, specificity, positive predictive value
(PPV), negative predictive value (NPV), accuracy, and area
under the curve (AUC) were calculated for each parameter
using SPSS v28.
Results: The incidence of difficult laryngoscopy was 8.75%.
MMS and ULBT both demonstrated 57.14% sensitivity, 97.26%
specificity, 66.67% PPV, 95.95% NPV, and 93.75% accuracy.
RHTMD ≥26 showed 71.43% sensitivity, 69.86% specificity,
18.52% PPV, 96.23% NPV, and 70% accuracy. The ROC-AUC
for the composite predictive model was 0.737 (p = 0.039). CL
grading achieved 100% diagnostic accuracy.
Conclusion: While MMS and ULBT offer high specificity,
RHTMD provides better sensitivity. A combined approach
improves preoperative prediction of difficult laryngoscopy and
enhances airway safety.

Impact of Educational Intervention to Mothers or Caregivers on the Stunting Status of their Under-Five Children in the Adopted Villages of a Teaching Hospital in the District of Bareilly

Pankaj Garg — 2026-09-02

Introduction: Infant and young child feeding (IYCF) guidelines
ensure healthy growth, development, and long-term well-being
during the most critical period of a child’s life. The prevalence
of stunting in Bareilly, Uttar Pradesh, is 45.9%.
Material and methods: A community-based intervention
study was conducted with mothers or caregivers of under-five
children in five villages of Bareilly District, and the villages were
randomly assigned to intervention (290 mothers/caregivers)
and control (280 mothers/caregivers) groups. Data were
collected using a pre-tested interview schedule on IYCF
practices based on WHO guidelines. Statistical analysis was
performed using SPSS version 25.
Results: Breastfeeding was done by 260 (89.66%) of
children under 5 years in the intervention group, and 250
(89.66%) under 5 children in the control group (p = 0.890), but
exclusive breastfeeding was carried out by 126 (43.45%) of
the intervention group and 116 (41.43%) of the control group
mothers (p = 0.630). The prevalence of stunting was 570
(100%), and after the intervention, this rate improved to 245
(42.98%) for stunting (p = 0.000).
Conclusion: The current study concludes that the prevalence
of malnutrition in the selected population was very high. The
awareness and educational interventions brought about
success in reducing malnutrition in children under 5.

Expression of OCT3/4 in Urinary Bladder Tumors and Its Correlation with Clinicopathological and Prognostic Parameters

Swasti Garg — 2026-09-02

Introduction: Urinary bladder carcinoma is a common
malignancy with significant recurrence and progression risk.
Cancer stem cell markers such as OCT3/4, a pluripotency
transcription factor, are implicated in tumor aggressiveness
and therapeutic resistance. Assessing OCT3/4 expression may
improve prognostic accuracy and aid in risk stratification. The
aim of the study is to evaluate OCT3/4 expression in urinary
bladder tumors and correlate it with histological type, grade,
and prognostic parameters, including lymphovascular invasion
and perineural invasion.
Material and Methods: A cross-sectional study was
conducted on 40 histologically confirmed urinary bladder
tumors in the Department of Pathology, SRMS IMS, Bareilly.
Immunohistochemistry for OCT3/4 was performed, and
results were analyzed statistically for associations with
clinicopathological parameters.
Results: The mean patient age was 61.7 ± 11.1 years, and males
constituted 95%. Invasive urothelial carcinoma accounted for
85% of cases, with 65% being high grade and 50% showing
muscle invasion. OCT3/4 expression was +1 in 57.5%, +2 in
30%, and +3 in 5% of specimens. No significant association
was found with age, sex, or histological type (p >0.05). However,
higher OCT3/4 expression correlated significantly with tumor
grade (p <0.05), muscular invasion (p <0.05), and perineural
invasion, indicating increased expression in aggressive tumors.
Conclusion: OCT3/4 expression is demographically neutral
yet biologically informative, enriching risk stratification beyond
morphology by associating with high-grade, muscularis propria
invasion, and perineural invasion. The predominance of mild
positivity with selective enrichment of moderate–strong staining
in aggressive phenotypes supports OCT3/4 as a practical
adjunct immunomarker for prognostic assessment in urothelial
carcinoma.

Dosimetric Analysis and Clinical Correlation of Brachial Plexus Toxicity in Head and Neck Cancer Patients Treated with Chemoradiotherapy by IMRT Technique

Himanshi Khattar — 2026-09-02

Introduction: Radiation-induced brachial plexopathy (RIBP)
is an uncommon but potentially disabling late complication of
radiotherapy in head and neck cancer. Despite the increasing
use of intensity-modulated radiotherapy (IMRT), the brachial
plexus is not routinely contoured as an organ at risk (OAR), and
its dose–toxicity relationship remains inadequately studied. The
aim is to evaluate the dosimetric parameters of the brachial
plexus in head and neck cancer patients treated with IMRTbased
concurrent chemoradiotherapy and to correlate these
parameters with clinical, radiological, and neurophysiological
evidence of brachial plexus toxicity.
Materials and Methods: This prospective observational study
included 38 patients with stage II–IVA histologically proven
squamous cell carcinoma of the head and neck treated between
November 2019 and April 2021. Patients received definitive
radiotherapy (70 Gy/35 fractions) or adjuvant radiotherapy
(60 Gy/30 fractions), with concurrent weekly cisplatin when
indicated. The brachial plexus was retrospectively delineated
according to RTOG guidelines, and dosimetric parameters
including Dmax, Dmean, V40–V70, D50, and D80 were
analyzed. Clinical assessment was performed using
CTCAE v5.0, an 18-item brachial plexopathy questionnaire,
neurological examination, MRI, and nerve conduction velocity
(NCV) studies. The median follow-up was 39 months (range:
12–54 months).
Results: The mean maximum dose (Dmax) to the brachial
plexus was 65.15 Gy, exceeding recommended tolerance limits
in many patients. Clinically, 22 of 38 patients (57.9%) developed
symptoms suggestive of brachial plexopathy, most commonly
sensory disturbances (65.7%), proximal arm weakness (63.1%),
impaired hand function (42.1%), and limitation of daily activities
(42.1%). Over 20 patients underwent MRI and NCV evaluation;
among them, 14 (70%) demonstrated clinical evidence of
brachial plexopathy, while 10 (50%) showed concordant clinical,
MRI, and NCV abnormalities. MRI findings included nerve
root thickening, T1/T2 hyperintensity, edema, and contrast
enhancement. Significant deterioration in NCV parameters was
observed in the median, radial, axillary, musculocutaneous,
and left ulnar nerves. Patients receiving 70 and 60 Gy had
comparable brachial plexus Dmax values (66.9 vs. 66.5 Gy),
with RIBP observed in 41 and 52.3% of patients, respectively.
Conclusion: The brachial plexus frequently receives doses
exceeding recommended tolerance during IMRT for head and
neck cancer when no specific dose constraints are applied.
A substantial proportion of patients developed clinical,
radiological, and neurophysiological features of RIBP during
follow-up. Routine contouring of the brachial plexus as an OAR,
implementation of dose constraints (maximum dose ≤60–66 Gy),
and long-term surveillance are recommended to minimize
the risk of radiation-induced brachial plexopathy and improve
functional outcomes.

Maternal and Neonatal Outcome of Delayed Cord Clamping vs Early Cord Clamping in Term-Delivered Newborns

Manjari Kumari — 2026-09-02

Introduction: During the first minutes after birth, the newborn
infant receives a substantial blood transfusion from the
placenta. Delayed cord clamping [DCC] is associated with
decrease incidence of anemia in childhood, less intraventricular
hemorrhage and a lower risk of necrotizing enterocolitis as
compared to early cord clamping. The present study was
conducted to study the maternal and neonatal outcome of
DCC vs early cord clamping [ECC] in term-delivered newborns
Material & Methods: This prospective study was conducted in
term low-risk pregnant women admitted for safe confinement
in the labour room of SRMS IMS Bareilly, between August
2022 to January 2024. A total of 60 patients, who fulfilled
inclusion-exclusion criteria, were subjected to the study and
divided into two groups of 30 each: Group A with ECC and
group B with DCC. Mothers and their newborns were evaluated
with reference to maternal and neonatal outcomes. Statistical
analysis was carried out using Microsoft Excel and Epi Info
7.1 software.
Results: In this study, ECC was performed on 30 (Group A) and
DCC was performed on 30 (Group B). A significant increase in
haemoglobin level without any significant increase in neonatal
serum bilirubin level in the case of DCC as compared to ECC.
On the basis of this study, delayed cord clamping shows
significant positive effects on infants’ health.
Conclusion: Delayed cord clamping improves haemoglobin
levels and iron stores in term infants, which have major positive
effects on infants’ health and development and decrease the
incidence of childhood anaemia.

Evaluation of Brain Infection on Magnetic Resonance Imaging & Its Correlation with CSF Findings

Satish Kumar — 2026-09-02

Introduction: Brain infections represent a complex diagnostic
challenge in clinical neurology, requiring sophisticated
diagnostic approaches. This study aimed to evaluate the
correlation between magnetic resonance imaging (MRI)
findings and cerebrospinal fluid (CSF) parameters in diagnosing
brain infections.
Material and Methods: A prospective observational study
was conducted on 64 patients suspected of brain infections.
Participants underwent comprehensive MRI examinations
using Siemens Magnetom Skyra 3 Tesla and Sempra 1.5 Tesla
machines, along with detailed CSF analysis. Multiple diagnostic
parameters were evaluated, including clinical presentation,
imaging characteristics, and laboratory findings.
Results: The study population was predominantly male
(54.7%), with most patients aged 20 to 40 years. Tubercular
meningitis emerged as the most common diagnosis across
diagnostic methods. MRI demonstrated high diagnostic
accuracy, with 97.8% sensitivity for tubercular meningitis
and 90.9% for viral infections. Clinical presentations were
predominantly characterized by fever (84.4%) and headache
(68.8%). Imaging revealed single lesions in 50% of patients,
with the temporal region and basal ganglia as the most frequent
infection sites. Significant variations in CSF parameters were
observed across different infection types.
Conclusion: The study highlights the complementary nature of
MRI and CSF analysis in diagnosing brain infections. The multimodal
approach proved crucial in accurately characterizing
different types of neurological infections, emphasizing the
importance of comprehensive clinical, imaging, and laboratory
assessments.

MDCT Imaging in Non-Traumatic Acute Abdomen with Its Ultrasound Correlation

Kintali Kavyasree — 2026-09-02

Introduction: Non-traumatic acute abdomen is a common
clinical emergency with diverse etiologies requiring prompt and
accurate diagnosis. Imaging plays a critical role in evaluation,
with ultrasound (USG) often used as the first-line modality
and multidetector computed tomography (MDCT) offering
higher diagnostic accuracy, particularly when USG findings are
inconclusive. The aim of the study is to evaluate the spectrum
of MDCT findings in non-traumatic acute abdomen, analyze
their correlation with USG results, and assess the diagnostic
performance of both modalities.
Material and Methods: This prospective observational study
was conducted over 1.5 years in the Department of Radiodiagnosis
at Shri Ram Murti Smarak Institute of Medical
Sciences, Bareilly. A total of 151 patients presenting with acute
abdomen (excluding trauma cases) underwent both USG and
MDCT. Data were analyzed using SPSS v20 to determine
diagnostic accuracy, sensitivity, specificity, and correlation with
surgical, histopathological and clinical outcomes.
Results: MDCT identified abnormalities in 100% of cases,
whereas USG failed to detect pathology in 27.8%. Concordance
between USG and MDCT was observed in 60.3% of cases.
The most common diagnoses were acute pancreatitis (21.2%),
acute appendicitis (15.2%), bowel obstruction (11.9%), ureteric
calculi (11.3%), and liver abscess (11.3%). MDCT demonstrated
high sensitivity and specificity across all major conditions:
pancreatitis (100, 95.6%), appendicitis (96.3, 95.8%), bowel
obstruction (88.8, 99.3%), ureterolithiasis (100, 97.1%) and liver
abscess (100, 98.7%).
Conclusion: MDCT proved superior to USG in evaluating nontraumatic
acute abdomen, offering higher diagnostic accuracy,
better anatomical detail, and aiding in early and precise clinical
decision-making. The study supports the use of MDCT as the
imaging modality of choice in emergency abdominal settings.

Epidemiological Determinants of Common and Rare Cancers: A Hospital-Based Study in North India

Arjun Yadav — 2026-09-02

Background: Cancer remains a significant public health burden
in India, with its incidence influenced by a complex interplay
of sociodemographic and behavioral factors. Understanding
these determinants is essential to tailor prevention and control
strategies. The aim of the study is to identify the epidemiological
determinants associated with common and rare cancers in
patients attending a tertiary care center in North India.
Material and Methods: This hospital-based cross-sectional
study was conducted among 400 histologically confirmed
cancer patients between May 2023 and October 2024 at
a tertiary care hospital in Bareilly, Uttar Pradesh. Data on
sociodemographic variables, behavioral factors, and clinical
history were collected using a pre-tested semi-structured
schedule. Statistical analysis was performed using SPSS
version 25. Chi-square test was applied to explore associations
between independent variables and cancer type, with p <0.05
considered statistically significant.
Results: Significant associations were observed between
cancer type and age (p = 0.000), gender (p = 0.000), occupation
(p = 0.000), and socioeconomic status (p = 0.000). Common
cancers were more prevalent in the 41 to 60 years age group
and among females, while rare cancers were frequent in older
males and individuals from lower socioeconomic classes.
Behavioral factors such as tobacco smoking (p = 0.019),
smokeless tobacco use (p = 0.007), and alcohol consumption
(p = 0.019) were significantly associated with rare cancers.
Although 73% of tobacco users noticed health warnings,
58.7% showed indifference, and only 15.7% reported quitting.
Conclusion: The study concludes that age, gender, occupation,
and substance abuse are major determinants of cancer type.
Awareness initiatives alone are insufficient; comprehensive
prevention strategies must also address behavioral change,
socioeconomic disparities, and targeted screening efforts.