Current Issue
Volume 1, Issue 2 - 2025 (July-December)
Issue Details:
Volume 1 Issue 2 (July-December)Issue Description:
Welcome to the 2025 issue of The Spectrum Journal. This issue showcases the remarkable breadth and depth of contemporary research across multiple disciplines. From cutting-edge applications of machine learning in climate science to the revolutionary potential of quantum computing in drug discovery, our featured articles demonstrate the power of interdisciplinary collaboration in addressing global challenges.
We are particularly excited to present research that bridges traditional academic boundaries, reflecting our journal's commitment to fostering innovation through cross-disciplinary dialogue. The integration of artificial intelligence with environmental science, the application of blockchain technology to supply chain management, and the convergence of urban planning with smart city technologies exemplify the transformative potential of collaborative research.
As we continue to navigate an era of rapid technological advancement and global challenges, the research presented in this issue offers both insights and solutions that will shape our future. We thank our authors, reviewers, and editorial board members for their continued dedication to advancing knowledge and promoting scientific excellence.
Mayur Wanjari
Editor-in-Chief
The Spectrum Journal
Articles in This Issue
Role of the CVTS Nurse in Modern Cardiac and Thoracic Surgical Care: A Narrative Review
Cardiothoracic surgery (CVTS) has evolved significantly over the past decades, with advances in surgical techniques, technology, and perioperative care. The role of the CVTS nurse has become increasingly vital, encompassing preoperative, intraoperative, and postoperative patient management. This narrative review examines the evolving responsibilities, competencies, and challenges faced by CVTS nurses in modern cardiac and thoracic surgical care. A structured literature search was conducted across PubMed, Scopus, and Google Scholar, focusing on studies published between 2010 and 2025. Inclusion criteria comprised articles describing the roles, training, and impact of CVTS nurses, while studies unrelated to surgical nursing or non-English publications were excluded. The review highlights key functions including patient assessment, hemodynamic monitoring, surgical assistance, pain management, patient education, and coordination of multidisciplinary care. Challenges such as workload, stress, and need for advanced training are discussed. The findings suggest that CVTS nurses are central to improving patient outcomes, optimizing recovery, and supporting surgical teams. Future directions emphasize formalized training programs, competency-based assessments, and recognition of CVTS nursing as a specialized profession.
Contributors:
To compare short term visual and anatomical outcomes of single intravitreal injection of triamcinolone acetonide (4 mg/0.1 ml) versus single intravitreal injection of bevacizumab (1.25 mg/0.05 ml) in diabetic macular edema at the end of one month
Purpose: To compare the short-term efficacy and safety of intravitreal bevacizumab (IVB) versus intravitreal triamcinolone acetonide (IVTA) in the management of diabetic macular edema (DME). Methods: A randomized, comparative, interventional study was conducted on 40 eyes of patients with DME, divided equally into two groups (n=20 each). Group 1 received 1.25 mg/0.05 mL IVB, while Group 2 received 4 mg/0.1 mL IVTA. Baseline characteristics, including age, sex, duration of diabetes, best corrected visual acuity (BCVA), and central macular thickness (CMT), were comparable between the groups. BCVA (logMAR) and CMT were assessed at baseline and at 1 month post-injection. Results: At 1 month, both groups demonstrated statistically significant improvement in BCVA and CMT compared to baseline (p Conclusion: A single intravitreal injection of triamcinolone acetonide produces superior short-term improvements in visual acuity and macular thickness compared to bevacizumab in patients with DME. However, the associated risk of IOP elevation with IVTA requires careful post-injection monitoring.
Contributors:
Assess the Effectiveness of Self-Instructional Module on Knowledge and Attitude of Parents Regarding Preparation of First Child on Arrival of Sibling
Background: The arrival of a sibling is a major transition for the first child and may result in behavioral and emotional challenges. Parental knowledge and attitude play a crucial role in preparing the older child and minimizing sibling rivalry. Objectives: To assess the effectiveness of a self-instructional module on knowledge and attitude of parents regarding preparation of the first child for the arrival of a sibling. Methods: A pre-experimental one-group pre-test and post-test design was adopted among 100 parents at Pooja Nursing College, Bhandara, Maharashtra, from March 2024 to March 2025. Convenience sampling was used. Data were collected using a structured knowledge questionnaire and an attitude scale. A pre-test was conducted, followed by administration of the self-instructional module, and post-test data were collected after one week. Statistical analysis included descriptive and paired t-test for comparison. Results: In the pre-test, most parents had poor to average knowledge and neutral attitudes. Post-test findings showed significant improvement, with 68% achieving good knowledge and 63% demonstrating favorable attitudes. Paired t-test revealed a highly significant difference in mean knowledge and attitude scores (p Conclusion: The self-instructional module was effective in enhancing both knowledge and attitudes of parents, suggesting its potential utility in maternal and child health education programs to ease sibling transition.
Contributors:
Evolving Role of Biomarkers in Early Diagnosis and Prognosis of Alzheimer’s Disease
Alzheimer's disease (AD) is the leading cause of dementia globally, typified by insidious cognitive impairment underlain by amyloid-β plaques, neurofibrillary tangles, and neurodegeneration. Accumulating evidence shows these pathophysiological changes start years to decades before symptom onset, highlighting an urgent need for preclinical detection and prognostication. Biomarkers have revolutionized the field with the ability to measure amyloid deposition, tau pathology, and neuronal damage in vivo. The AT(N) framework has reconceptualized AD as a biologically based continuum, merging biomarkers across modalities. Cerebrospinal fluid and imaging assessments, including amyloid/tau PET and MRI-based volumetry, are still gold standards but are constrained by invasiveness and expense. New developments in blood-based biomarkers, particularly plasma phosphorylated tau (p-tau217, p-tau231), Aβ42/Aβ40 ratio, neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP), have proved to be highly accurate in identifying preclinical disease and forecasting cognitive decline. Head-to-head comparisons show that plasma p-tau217 is equally effective as tau PET in forecasting progression in cognitively unimpaired individuals, and repeated testing enhances prognostic precision. Multimodal biomarker integration provides greater predictive power, but standardization, diversity of populations, and preclinical diagnosis ethical issues persist. Potential future advances involve validation in large and heterogeneous cohorts, longitudinal follow-up, and incorporation of new markers like synaptic and inflammatory proteins. In summary, biomarkers are revolutionizing early diagnosis and prognosis of AD, making possible earlier intervention and therapeutic customization.
Contributors:
Comparative Efficacy of the Psycho-Nutritional Intervention Approach (PNIA) With and Without Ayurvedic Integration in Mild-to-Moderate Depression and Anxiety: A Biomarker-Driven Randomized Controlled Trial
Depression and anxiety remain major mental health challenges worldwide and are on the rise in India. While many individuals benefit from medication, a significant number report only partial relief or discontinue treatment due to adverse effects. This has led to the development of integrative models of care. One such approach is the Psycho-Nutritional Intervention Approach (PNIA), which combines diet, yoga, mindfulness, and counselling. Ayurveda adds another dimension by emphasizing daily routines, rejuvenating herbs, and healing therapies such as Shirodhara. Our trial evaluated whether PNIA would demonstrate enhanced efficacy when augmented with Ayurvedic interventions. We conducted a randomized study involving 120 participants aged 18–55 years who reported mild to moderate symptoms of anxiety and depression. All participants followed PNIA. Those in the integrative arm additionally received standardized Ashwagandha and Brahmi tablets, a seven-day course of Shirodhara, and lifestyle counselling. The program lasted twelve weeks. Outcomes were assessed using international scales, Indian instruments measuring disability and self-efficacy, and specific biological markers. Results revealed a clear trend: the PNIA-plus-Ayurveda group reported greater improvements in depression and anxiety symptoms, along with enhanced quality of life and daily functioning. Biological markers supported these findings, showing reduced stress levels and increased neurotrophic support. Importantly, both programs were safe and well received. These findings suggest that PNIA’s efficacy is enhanced when supplemented with Ayurvedic treatments. This combined model represents a culturally sensitive and potentially scalable approach to community-based mental health care.
Contributors:
Comparison of Postoperative Analgesic Outcomes with Intravenous Midazolam and Dexmedetomidine in Patients Undergoing Abdominal Hysterectomy Under Spinal Anaesthesia
Background: Effective postoperative pain control remains a major challenge following abdominal hysterectomy performed under spinal anaesthesia. Sedative adjuvants such as dexmedetomidine and midazolam are commonly used to prolong analgesia, provide sedation, and stabilize hemo dynamics, but their comparative postoperative efficacy remains underexplored. Objective: To compare the postoperative analgesic efficacy and sedation profile of intravenous dexmedetomidine versus midazolam in patients undergoing abdominal hysterectomy under spinal anaesthesia. Methods: A prospective, randomized, single-blind study was conducted on 150 ASA I–II patients undergoing abdominal hysterectomy. Participants were randomly divided into two equal groups: Group D received intravenous dexmedetomidine 1 µg/kg, and Group M received intravenous midazolam 0.05 mg/kg, both diluted in 10 ml normal saline. Hemodynamic parameters, Ramsay sedation scores, onset and duration of sensory and motor block, duration of postoperative analgesia, and total tramadol consumption within 24 hours were recorded. Statistical analysis was done using unpaired t-test and Chi-square test, with p Results: The groups were demographically comparable. Dexmedetomidine significantly shortened the onset and extended the duration of sensory block (343.4 ± 43.0 vs 171.5 ± 31.2 min, p Conclusion: Intravenous dexmedetomidine provides superior postoperative analgesia and sedation compared to midazolam without significant hemodynamic instability, making it a preferable adjuvant for abdominal hysterectomy under spinal anaesthesia.
Contributors:
Delayed Detection of ACTH-Secreting Pituitary Microadenoma: A Case for Serial Imaging in Refractory Cushing’s Disease
Cushing’s disease (CD), a subtype of Cushing syndrome caused by pituitary ACTH-secreting adenomas, can be challenging to diagnose, especially in the presence of adrenal incidentalomas which can suggest adrenal cause shifting the focus away from the possibility of true pituitary disease in ACTH-dependent hypercortisolism. Case Presentation This case is presented as a 61-year-old female with an initial presentation of hypercortisolism who was diagnosed with adrenal Cushing syndrome after an MRI revealed a unilateral adrenal incidentaloma. She was gonadotrophically deprived and her adrenal gland was removed and she briefly improved. The symptoms reoccurred several years later and repeat imaging and inferior petrosal sinus sampling (IPSS) showed that she had an ACTH-secreting pituitary microadenoma. After transsphenoidal resection, the IGF-I of the patient was slightly elevated that created the suspicion of GH co-secretion even though there was no clinical sign of acromegaly. The patient has attained biochemical remission and she is under close follow up. Conclusion This case highlights the diagnostic complexity of CD in the presence of adrenal incidentalomas and emphasizes the importance of thorough hormonal workup, repeat imaging, and the use of IPSS. The deviation from the diagnostic guidelines for biochemistry and failure to recognize the initial normal levels of ACTH could have eliminated the delayed diagnosis. Keywords: Cushing’s Disease, ACTH-secreting adenoma, GH co-secretion, pituitary tumor, adrenal incidentaloma, diagnostic delay
Contributors:
Clinical Outcomes of Cardiorenal Syndrome in Heart Failure Patients: A Six-Month Observational Follow
Background: Cardiorenal Syndrome (CRS) represents a bidirectional interplay between cardiac and renal dysfunction, where impairment of one organ precipitates or exacerbates dysfunction in the other. It is commonly encountered in heart failure (HF) patients and is associated with poor prognosis. Despite increasing awareness, data on the clinical outcomes and prognostic predictors of CRS in Indian populations remain limited. Objective: To evaluate the prevalence, risk factors, and six-month clinical outcomes of CRS in patients with heart failure admitted to a tertiary care hospital, and to identify predictors of mortality Methods: This prospective observational study included 70 patients with heart failure (≥12 years) admitted to D. Y. Patil Hospital, Navi Mumbai (2023–2024). Patients were classified into CRS and non-CRS groups based on consensus diagnostic criteria. Demographic, clinical, biochemical, and echocardiographic parameters were recorded. Patients were followed for six months to assess survival and rehospitalization. Statistical analyses were performed using SPSS version 26.0, with logistic regression to identify independent mortality predictors. Results: Among 70 HF patients, 48 (68.5%) had CRS. The mean age was 60.53 ± 15.55 years, with a male predominance (62.5%). The most common comorbidities were hypertension (63.9%) and diabetes mellitus (50%). Type I CRS was the most frequent subtype (54.1%). Six-month mortality was significantly higher in CRS patients (29.2%) compared to non-CRS patients (0%) (p 2000 pg/mL) (OR 3.8, p=0.008), reduced LVEF (2 mg/dL (OR 2.5, p=0.046), and eGFR Conclusion: CRS was highly prevalent among heart failure patients and strongly associated with increased mortality and poor outcomes. Reduced ejection fraction, elevated NT-proBNP, and renal dysfunction were key predictors of death. Early detection, vigilant monitoring of renal and cardiac function, and timely interventions are vital to improving prognosis in this high-risk group.
Contributors:
Comparative Evaluation of SOFA and SAPS-3 Scores for Predicting ICU Mortality in Sepsis Patients: A Prospective Observational Study from South India
Background Sepsis is a life-threatening state resulting from an ineffective biological host response to infection resulting in organ dysfunction with high mortality, especially in intensive care unit (ICU) settings. Despite progress in its management, early prognosis of sepsis remains difficult. Severity scoring systems have been developed to assess disease severity and predict outcomes, including the Sequential Organ Failure Assessment (SOFA) score and the Simplified Acute Physiology Score-3 (SAPS-3). This study sought to evaluate and compare the prognostic utility of SOFA and SAPS-3 scores in predicting ICU mortality in patients with sepsis at a tertiary care center in South India. Methods A prospective observational study was performed on 316 adult patients who were admitted to the medical intensive care unit with a confirmed or probable diagnosis of sepsis based on the criteria of Sepsis-3 definition. SOFA and SAPS-3 scores were determined using the relevant worst clinical and laboratory parameters recorded within the first 24 hours of ICU admission. Follow-up continued through discharge or death. Statistical analysis included chi-square tests, binomial logistic regression for predictor variables, and Receiver Operating Characteristic (ROC) curve to ascertain the predictive accuracy of each scoring system. Results Of the 316 sepsis patients enrolled, ICU mortality was 56%, with non-survivors being significantly older and having higher rates of ventilation and inotrope use (p Conclusion The prognostic value of SOFA and SAPS-3 scores for predicting ICU mortality among patients with sepsis was excellent. SOFA also had slightly more discriminative ability than SAPS-3, making it a useful and trusted tool for predicting outcomes early and guiding clinical decisions in critical care.