International Journal of Clinical and Biomedical Research

Oxidative Puzzle of Female Infertility: A Systematic Narrative Review

Dr Shaily Sengar — 2026-01-10

Oxidative stress, characterized by an imbalance between the production of the reactive oxygen species (ROS) and the ability of the antioxidant defense systems. It is crucial to the pathophysiology of infertile women, deleterious impacts through the oocyte maturation, ovulatory functions, associated with reproductive disorders as polycystic ovary syndrome (PCOS) and endometriosis. Mitochondria of oocytes and granulosa cells are the leading sources of ROS whose generation is further worsened by ageing, obesity, as well as environmental assaults. Although physiological levels of ROS are necessary to normal follicular growth and ovulation, excessive levels of ROS cause oocyte DNA breakage, meiotic spindle deregulation, and embryonic in survival. The inherent antioxidant enzymes which as superoxide dismutase (SOD) and glutathione, give the cellular systems partial protection against oxidative damage, however significant and the exogenous antioxidant supplementation such as vitamins C and E, coenzyme Q10, N-acetyl cysteine as well as Melatonin have shown an encouraging result in randomized controlled trials (RCTs) and meta-analyses. Clinical evidence shows that there are better ovarian responsiveness and better oocyte yield and better pregnancy rates in assisted reproductive technologies (ART) especially in women with advanced ovarian age or PCOS. A Cochrane systematic review found a moderate relationship between antioxidant use and increased rates of live births, but the evidence quality was overall low because of the study heterogeneity. Notably, antioxidant interventions were generally well-tolerated and portable with minimal side effects. Future studies ought to focus on more rigorously constructed, high quality, RCTs that are targeted at clinically meaningful end point outcomes like live birth rates as well as consider adjunct parameters of sperm DNA fragmentation, which modifies female reproductive outcomes indirectly. Combination of personalized antioxidant treatment and specific lifestyle changes has a significant therapeutic potential for the female reproductive health and optimizing fertility.

ASSESSMENT OF MITOCHONDRIAL DNA CONTENT AND OXIDATIVE STRESS BIOMARKERS IN CUTANEOUS LICHEN PLANUS

Dr Mohd Qamar — 2026-02-21

Cutaneous lichen planus (CLP) is a chronic immune-mediated inflammatory dermatosis in which oxidative stress and mitochondrial dysfunction are increasingly implicated, yet integrated biomarker evidence remains limited. Methods: In this cross-sectional pilot study, 30 histopathologically confirmed CLP patients and 30 age- and sex-matched healthy controls were enrolled. Relative mtDNA copy number and telomere length were measured using quantitative real-time PCR, while serum TOS was estimated by a colorimetric assay. CLP patients had a markedly reduced mtDNA content in comparison to controls (246.95±69.95 versus 289.40±73.60; p=0.026). The relative telomere length was significantly greater in the CLP group (16279.92±2363.58 vs 14677.06±2528.51; p=0.021). TOS levels were elevated in CLP patients (32.11±14.67 vs 16.59±7.06 µmol H₂O₂ equivalents/L; p<0.0001), indicating a substantially more oxidative stress. CLP is linked to mitochondrial DNA depletion, modified telomere dynamics, and significant oxidative stress. These results support the hypothesis that mitochondrial malfunction and oxidative imbalance are pivotal in CLP development. Therapeutic approaches aimed at oxidative stress and mitochondrial well-being may provide potential advantages. Further long-term studies are needed to better understand the cause-and-effect correlations and therapeutic consequences.

EFFECT OF THREE MONTHS COURSE OF DAILY TERIPARATIDE INJECTION ON OSTEOPOROSIS IN A RURAL POPULATION: A ONE YEAR FOLLOW UP STUDY USING pDEXA

Dr.Ajinkya Surendra Girme — 2026-02-21

Osteoporosis continues to represent a significant public-health problem, especially in the rural setting, where access to the availability of sophisticated diagnosis and treatment options limited. Awareness, knowledge and long term consequences, and the importance of calcium supplementation are often inadequate among rural population. Additionally, inadequate finances are also a significant barrier towards patient compliance, which increases disease burden and the risk of fractures. The present study aim is to test the intervention on the effects of a three-month trial of daily intramuscular teriparatide (20µg) administered subcutaneously on the patients with osteoporosis in a rural community. Then treatment outcomes assessed using peripheral dual-energy X-ray absorptiometry (pDEXA; EXA 3000). The study patients with osteoporotic cracks in the spine were included people who experienced spinal fractures. Inj teriparatide intervention was administered three months daily as SC injections. Patients were followed by regular follow-up up to 3 months and pDEXA measurements at a year time. The findings of the study helped to improve the knowledge of teriparatide effectiveness for the treatment of osteoporosis in the rural population and provided evidence to support therapeutic interventions to develop feasible and effective osteoporosis management strategies.

IMPACT OF AN INTEGRATED QUIZ-BASED LEARNING APPROACH ON ACADEMIC PERFORMANCE AND STUDENT PERCEPTION IN FIRST-YEAR MBBS STUDENTS

Seema Singh — 2026-02-21

Teacher - centered approach in medical education are now a day’s being replaced by integrated, learner centered ones. Using quiz based learning, especially across curriculum areas, facilitates deeper understanding, acquisition and application of the new knowledge. However, the effectiveness of integrated quiz based learning approach for the first professional MBBS course is still insufficient. The present study therefore evaluated the effectiveness of an integrated quiz based learning and learners perception regarding its efficacy. This was an educational interventional study on 150 phase one MBBS students. However, final participation across all rounds along with completed feedback was obtained from 141 students only, and their responses were included in statistical analysis. Participants were randomly assigned to five teams with 30 in each team. An integrated quiz on preclinical disciplinary was conducted in four rounds: MCQ, visual, case-based and rapid fire. Descriptive statistics were used to analyze baseline data, performance scores, perceived difficulty, and student’s feedback. The rapid fire round was perceived as most difficult format by 49% students, followed by case based (26%) and visual rounds (16%). The physiology topic was found to be the hardest by 39% of participants. Student perception were highly in favor, as 96% agreed that the quiz is the support for easy learning, 96% reported for better revision and 98% endorsed a fostered positive learning environment. All the students (100%) were expressed their willing to participate in integrated quizzes in future classes. The maximum team score among the teams was 49/60 and minimum of 38/60 - showing variability in group performance. Quiz based teaching effectively enhanced engagement, motivated students, deeper understanding, and created positive learning environment in the undergraduate medical curriculum. Positive learner feedback supports the incorporation of this active learning method within a first professional MBBS programme.

PREVALENCE OF STRESS AND ITS CORRELATION WITH COGNITION AMONG MEDICAL STUDENTS

Subhashri Soundirarajan — 2026-02-21

Stress is highly prevalent among medical students due to academic demands, clinical responsibilities, and psychosocial factors. Persistent stress has been linked to impaired cognitive performance and long-term neuropsychological consequences. However, objective assessment of cognition in relation to stress among medical undergraduates remains limited. Stress was assessed using MSSQ-40 which evaluates six stressor domains, and categorized as mild, moderate, high, and severe. For correlation analysis, 125 students were recruited and subjected to cognitive assessment using auditory P300 event-related potentials recorded at the Cz electrode placement. The overall prevalence of stress (high + severe categories) was 53.37%. Academic-related stressors (72.8%) and teaching-learning related stressors (69.0%) were the most predominant domains. Statically significant differences in mean stress scores across phases were observed for academic related, teaching learning, Social related and group activities related stressor (p <0.05). P300 latency showed a significant positive correlation with academic related (r=0.28, p=0.04), teaching learning (r=0.31, p=0.02), Drive related (r=0.527, p<0.001), and group activities related stressor (r=0.39, p<0.001). More than half of the medical students experienced significant stress, predominantly academic related factors. Higher stress levels were associated with prolonged P300 latency, suggesting stress-related cognitive slowing. Early identification and targeted interventions may help improve both mental well-being and cognitive performance among medical undergraduates.

MATERNAL MORTALITY IN A TERTIARY CARE HOSPITAL: A 3-YEAR REVIEW

Dr Shaily Sengar — 2026-02-21

Motherhood is associated with multiple health risks, including maternal mortality remaining a major global public health concern, particularly in Empowered Action Group states of India, which continue to report higher levels of maternal mortality ratio. The present study aimed to analyze the clinical etiology, and systemic factors contributing in maternal deaths at a tertiary referral center of Madhya Pradesh, a state persistently elevated MMR. All recorded and reported maternal deaths (n=35) over a 3-years period were subjected to retrospective descriptive analysis. Data was extracted from institutional maternal death review registers and clinical records, including demographic features, antenatal care exposure and the immediate causes of deaths. Most of the maternal deaths (82.8%) were seen in the age group 20–29 years, and 91.4% belonged to rural backgrounds. Only 37.1% of cases were booked for antenatal care, thus highlighting the apparent deficiency in antenatal coverage. The postpartum period emerged as the highest risk phase, accounting for 60% of maternal deaths. Hypertensive diseases of pregnancy (Eclampsia) were the most common direct cause of death (42.9%), followed by obstetric haemorrhage (22.8%) and sepsis (20%). Severe anaemia was a ubiquitous indirect contributing factor, present in 68.6% of cases. The high institutional MMR is representative of role of the study centre as a tertiary "safety net" center for critically ill, unbooked rural referrals from rural and peripheral health facilities. The reduction of the "Three Delays" especially delays in receiving appropriate care, and alongside strengthening community based detection and management of anemia and eclampsia, is essential for reducing maternal mortality in this setting.