Dr. Vasant Ramji Khanolkar: A Revolutionary Pathologist in India.

Dr. Vasant Ramji Khanolkar is known as the Father of Pathology in India. His outstanding contributions include research on the epidemiology of cancer in India, leprosy, reproduction anatomy, and family planning practices in India. He had the lion's share in medical education in India and started the subjects of Biophysics and Applied Biology at Bombay University. He recognized the importance of basic science, experimental biology, biochemistry, biophysics, and numerology in medical education. He suggested many changes in the medical education curriculum of India and strengthened the research facilities in medical education. Dr. Vasant Ramji Khanolkar was honored with Padma Bhushan, a prestigious award by the Government of India.

People's Health in People's Hands: Dr. Abhay Bang and Dr. Rani Bang's Pioneering Approach to Rural Healthcare in India.

Dr. Abhay Bang and Dr. Rani Bang, a husband-and-wife team, have dedicated their lives to reforming healthcare in rural India. Their pioneering work in Gadchiroli, Maharashtra, through the Society for Education, Action, and Research in Community Health (SEARCH), has led to revolutionary interventions such as the Home-Based Newborn Care (HBNC) model, significantly reducing infant mortality rates. Their emphasis on women's health and community empowerment has revolutionized conventional healthcare practices and influenced global health policies. This review article sheds light on the historical context and lasting impact of their contributions to community-based healthcare and public health research.

Facilitating Implementation of Shared Decision-Making in Medical Schools by Overcoming the Prevailing Challenges: A Brief Review.

The emergence of shared decision-making (SDM) in the field of medical education represents a significant shift in the way how health care is being taught to medical students and practiced by healthcare professionals. The purpose of the current review is to explore the merits of SDM to students and patients, identify the prevailing challenges in its successful implementation, and suggest appropriate solutions to overcome them. An extensive search of all materials related to the topic was performed on the PubMed search engine, and a total of 20 articles were selected. The process of implementation of SDM in medical education can turn out to be extremely challenging due to a wide range of factors. In conclusion, training medical students in the domain of SDM is crucial to cultivate the skills and attitudes that are indispensable for future healthcare professionals. The need of the hour is to identify the prevailing challenges and address them by adopting a multifaceted approach.

Exploring the Scope of Crowdsourcing in Medical Education.

In the field of medical education, crowdsourcing is the practice of obtaining views and inputs from a heterogeneous group of people using preferably digital platforms, with an aim to contribute to medical learning, creation of contents, and problem-solving and strengthen assessments. Considering the fact that medical knowledge continues to change with each day, this approach facilitates the process of continuous updation of the educational content based on recent developments. Regardless of the scope, application, and merits that can be attributed to crowdsourcing in medical education, there are some potential concerns that must be taken into account for optimizing the benefits. In summary, crowdsourcing has immense scope in medical education to create an inclusive and updated learning environment for medical students and healthcare professionals. The inputs generated through collective minds are expected to enrich the learning experience, and thus, we must look forward to exploring it for better utility.

Dr. Nitya Anand: The Visionary Behind Saheli and the Advances in Medicinal Chemistry.

Dr. Nitya Anand was a leading figure in Indian pharmaceutical research. His career spanned several decades, during which he significantly contributed to advancement in drug development and public health. His innovation of Centchroman (Saheli), the world's first non-steroidal oral contraceptive pill, changes the course of contraception use in India. He had done groundbreaking work in leprosy treatment, synthetic peptides, and antibiotics. With over 400 publications and 130 patents, he supervised over 100 PhD students. His work has been recognized with many prestigious awards, including the Padma Shri and the National Nehru Science Award, which have left a long-lasting impact on medicinal chemistry and public health.

Pioneering Community-Based Healthcare in Rural India: The Legacy of Dr. Rajnikant Arole and Dr. Mabelle Arole.

The landscape of healthcare in rural India has long been characterized by challenges that include accessibility, affordability, and cultural acceptance. Among these difficulties, the story of Dr. Rajnikant Arole and Dr. Mabelle Arole stands out as a beacon of hope and innovation. Their work in the rural areas of Maharashtra not only transformed the health outcomes of the local population but also set a precedent for community-based healthcare initiatives worldwide.

Asymptomatic Symmetric Bilateral Mandibular Tori: A Case Study.

Tori are reactive or developmental localized overgrowths of alveolar bone that are not cancerous. A thin, weakly vascularized mucosa surrounds a densely cortical, low-density mass of bone marrow known as tori or exostosis. Tori are more frequently observed in middle age. Both the maxilla (torus palatinus) and the mandible (torus mandibularis) exhibit tori. Difficulty in speaking and other issues are common obstacles associated with tori. Tori range in diameter from a few millimeters to several centimeters. Surgical excision of tori is the mainstay of treatment for large tori obstructing speech, mastication, or tongue position. The following case study includes a 36-year-old male patient with an association of mandibular canine and premolar regions with bony outgrowth.

Exploring the Interplay of Socioeconomic and Behavioral Factors: Unraveling Gender Disparities in Glycemic Control Among Adult Type 2 Diabetic Patients in Outpatient Care.

Background Diabetes mellitus (DM) presents global challenges, with optimal glycemic control being pivotal in managing complications, notably in type 2 diabetes mellitus (T2DM). Yet, achieving sustained control faces barriers stemming from socioeconomic and gender-specific disparities. This study addresses these gaps by examining socioeconomic determinants and gender disparities in diabetes management, particularly in Maharashtra, India. Methodology This cross-sectional study involved 302 T2DM patients aged 20 to 79 years. Data on sociodemographic, behavioral, and clinical factors were collected through interviews, and records were analyzed via logistic regression to identify predictors of glycemic control. Results Significant associations emerged between gender and education, occupation, and religion. Glycemic control, with a mean HbA1c of 8.45%, remained suboptimal. Logistic regression identified gender, average family income, diabetes duration, treatment nature, comorbidities, complications, and medication adherence as glycemic control predictors. Conclusions Addressing socioeconomic and gender-specific factors is paramount in diabetes management, especially in rural areas where sociocultural influences shape health behaviors. Tailored interventions, including gender-sensitive health education, are vital for improving diabetes care and outcomes. This study provides crucial insights into gender-specific influences on glycemic control among T2DM patients in Maharashtra, advocating for personalized interventions to enhance overall diabetes management.

Cobalt-Catalyzed Enantioselective Hydroboration of α-Substituted Acrylates.

Even though metal-catalyzed enantioselective hydroborations of alkenes have attracted enormous attention, few preparatively useful reactions of α-alkyl acrylic acid derivatives are known, and most use rhodium catalysts. No examples of asymmetric hydroboration of the corresponding α-arylacrylic acid esters are known. In our continuing efforts to search for new applications of earth-abundant cobalt catalysts for broadly applicable organic transformations, we have identified 2-(2-diarylphosphinophenyl)oxazoline ligands and mild reaction conditions for efficient and highly regio- and enantioselective hydroboration of α-alkyl- and α-aryl- acrylates, giving ß-borylated propionates. Since the C-B bonds in these compounds can be readily replaced by C-O, C-N, and C-C bonds, these intermediates could serve as valuable chiral synthons, some from feedstock carbon sources, for the synthesis of propionate-bearing motifs including polyketides and related molecules. Two-step syntheses of "Roche" ester from methyl methacrylate (79%; er 99:1), arguably the most widely used chiral fragment in polyketide synthesis, and tropic acid esters (∼80% yield; er ∼93:7), which are potential intermediates for several medicinally important classes of compounds, illustrate the power of the new methods. Mechanistic studies confirm the requirement of a cationic Co(I) species [(L)Co]+as the viable catalyst in these reactions and rule out the possibility of a [L]Co-H-initiated route, which has been well-established in related hydroborations of other classes of alkenes. A mechanism involving an oxidative migration of a boryl group to the ß-carbon of an η4-coordinated acrylate-cobalt complex is proposed as a plausible route.

Estimation of the Parasitic Burden of Soil-Transmitted Helminths Among Pregnant Women in the Maharashtra State of India Using qPCR: A Community-Based Study.

Background: Soil-transmitted helminth (STH) infections are widespread in developing countries with inadequate sanitation facilities. These infections can lead to malnutrition, anemia, and other complications that can negatively impact both the mother's and fetus's health during pregnancy. This study aimed to estimate the burden of STH by Kato-Katz microscopy and quantitative polymerase chain reaction (qPCR) in pregnant women from rural India. The diagnostic accuracy of these two methods was also compared. Material and Methods: A community-based cross-sectional study was conducted in rural areas of Wardha district of Maharashtra state. We randomly selected and interviewed 688 pregnant women. A total of 534 (77.61%) participants gave stool samples. Two containers (60 mL) labeled with a unique identification number were given to pregnant women to collect stool samples for Kato-Katz microscopy and qPCR. Stool specimens were transported to an accredited lab and examined within 24 hours. Suitable examinations were conducted to compare sensitivity between two tests. Results: The results are presented for 534 participants who gave stool samples. The prevalence of any STH by Kato-Katz stool microscopy was 6.55% (95%CI 4.46-12.19), and that by qPCR was 20.41 (95%CI 17.53-29.40). The sensitivity of Kato-Katz microscopy was 29.17% compared to sensitivity of 90.83% by qPCR (P = 0.001). Pregnant women with STH infection have a significantly lower weight gain during pregnancy, and the majority were either mild or moderate anemic compared to those without STH. Conclusion: The study highlighted significant differences in prevalence of STH among pregnant women by Kato-Katz microscopy and qPCR. The sensitivity of qPCR for detecting STH was higher than that of Kato-Katz microscopy.

Design-redesign, implementation, and evaluation of effectiveness of maternal nutrition and responsive parenting program on child development at 2 years of age from rural India: a cluster RCT.

Background: To promote early childhood development (ECD), we require information not only on what needs to be addressed and on what effects can be achieved but also on effective delivery methods that can be adapted to local context. We describe design, implementation, and evaluation of a complex intervention to strengthen nurturing environment for young children. Methods: Study participants were pregnant women and their children from birth to 2 years. We used design and redesign, implementation, and evaluation approaches for the study. We co-created curriculum and delivery plan with stakeholders, based on the theoretical framework, findings from formative research, and our preliminary work. We recruited 656 pregnant women and newborns, 326 (49.69%) from intervention and 330 (50.30%) from the control group. We conducted a cluster randomized controlled trial to evaluate the program's effectiveness. The outcomes of children were assessed at 12 and 24 months. Findings: At recruitment, study participants from both the study arms were similar in sociodemographic characteristics. We conducted 6,665 home visits, 25 toy-making workshops, and 65 caregiver-meetings. The initial examination of program data revealed gaps in quality and coverage of interventions. The intervention was redesigned based on feedback from stakeholders in community meetings. At recruitment, participants in both study groups had similar socio-demographics. We conducted 6,665 home visits, 25 toy workshops, and 65 caregiver meetings. Initial program data showed intervention quality and coverage gaps, leading to a redesign program based on community and stakeholder feedback. Post-re-designing, session quality improved, with program coverage rising from 32 to 98%. Male participation in home visits increased from 4.3 to 32.65%, and data errors reduced from 270 to 140 per month on average. At 24 months, program showed moderate-mild impact on ECD - cognitive (0.31, 95%CI: 0.13-0.48), language (0.2, 95%CI: 0.01-0.39), and socioemotional-development (0.19, 95%CI: 0.01-0.37), moderate effect on home-environment and mother-child interaction. 96% of women initiated breastfeed within one-hour of delivery, and exclusive-breastfeeding rate of 89.80%. Interpretations: The study provides an evidence-based community centered ECD curriculum and implementation strategies to enhance service providers, and caregivers' knowledge and skills for promoting ECD in low-resource settings with the potential to scale within existing Government Program. Funding: The trial was funded by the Saving Brains Round 5 Initiative of Grand Challenges Canada (Grant no. SB-1707-05084), and we are grateful for their ongoing support through online sessions and orientation workshops. The trial was also supported by the Indian Council of Medical Research (File No: 5/7/1693/CH/Adhoc/RBMCH-2020).

Mucous Extravasation Cyst Associated With the Lower Lip and Its Management: A Case Report.

A 15-year-old female patient was reported with swelling on the right side of the lower lip for 15 days. A provisional diagnosis of mucocele was obtained based on the patient's history and clinical examination. Under all aseptic conditions and administration of local anesthetic, surgical mucocele removal was done using a scalpel. An excised soft tissue specimen was given for histopathological examination, confirming the final diagnosis of mucous extravasation phenomena or mucocele. Recall examination after seven days reveals satisfactory lesion healing and no discomfort. This case report demonstrates that surgical excision is a simple, efficient, and affordable method for treating mucoceles and giving aesthetic and functional clearance.

Are paid tools worth the cost? A prospective cross-over study to find the right tool for plagiarism detection.

Background: The increasing pressure to publish research has led to a rise in plagiarism incidents, creating a need for effective plagiarism detection software. The importance of this study lies in the high cost variation amongst the available options for plagiarism detection. By uncovering the advantages of these low-cost or free alternatives, researchers could access the appropriate tools for plagiarism detection. This is the first study to compare four plagiarism detection tools and assess factors impacting their effectiveness in identifying plagiarism in AI-generated articles. Methodology: A prospective cross-over study was conducted with the primary objective to compare Overall Similarity Index(OSI) of four plagiarism detection software(iThenticate, Grammarly, Small SEO Tools, and DupliChecker) on AI-generated articles. ChatGPT was used to generate 100 articles, ten from each of ten general domains affecting various aspects of life. These were run through four software, recording the OSI. Flesch Reading Ease Score(FRES), Gunning Fog Index(GFI), and Flesch-Kincaid Grade Level(FKGL) were used to assess how factors, such as article length and language complexity, impact plagiarism detection. Results: The study found significant variation in OSI(p < 0.001) among the four software, with Grammarly having the highest mean rank(3.56) and Small SEO Tools having the lowest(1.67). Pairwise analyses revealed significant differences(p < 0.001) between all pairs except for Small SEO Tools-DupliChecker. Number of words showed a significant correlation with OSI for iThenticate(p < 0.05) but not for the other three. FRES had a positive correlation, and GFI had a negative correlation with OSI by DupliChecker. FKGL negatively correlated with OSI by Small SEO Tools and DupliChecker. Conclusion: Grammarly is unexpectedly most effective in detecting plagiarism in AI-generated articles compared to the other tools. This could be due to different softwares using diverse data sources. This highlights the potential for lower-cost plagiarism detection tools to be utilized by researchers.

Barriers and Facilitators of COVID-19 Vaccination Outreach Program in Rural India: A Qualitative Study.

Background Primary health centres are in charge of effectively implementing the COVID-19 vaccination program in rural areas. So, the study was planned to seek insight into the challenges faced by health personnel in the effective implementation of the COVID-19 vaccination program. Methodology The study was conducted in a rural area of Akola district which lies in the western parts of Maharashtra State and belongs to the Vidarbha region and is said to be one of the progressive districts in the region. A qualitative study was planned to understand the barriers and facilitators of the COVID-19 vaccine implementation program at rural and tribal areas. The study participants were medical officers from rural and tribal areas who actively planned and implemented COVID-19 vaccination at the primary health centre. A total of 30 medical officers were interviewed. Interview questions were focussed on the planning of COVID-19 vaccination in their area. Other questions were the problem faced during the implementation of the COVID-19 vaccination program and how it has been tackled. Results The factors identified were grouped into three groups: Health system factors, Human resource factors and Community level factors. Health system factors like shortage of vaccines and syringes, tablet paracetamol, online digital method of vaccination registration, overcrowding at the initial stage, and inadequate infrastructure were barriers to vaccination. Fear about vaccine adverse events, even in healthcare workers (HCWs), and overburdened healthcare workers were also factors affecting vaccination. At the community level, high resistance initially and misconception about the vaccine, and also the fear about post-vaccination side effects have an impact on the COVID-19 vaccination program in rural and tribal areas. Conclusion The successful vaccination rate among the population needs community leadership and a community-centred approach when conducting outreach and strengthening primary health care in terms of infrastructure, manpower, and capacity building of healthcare staff.

Rapid-cycle evaluation and learning for the effective delivery of integrated interventions in early childhood in rural India.

Background: Effective and real-time data analytics plays an essential role in understanding gaps and improving the quality and coverage of complex public health interventions. Studies of public health information systems identify problems with data quality, such as incomplete records and untimely reporting. Effective data collection and real-time analysis systems for rapid-cycle learning are necessary to monitor public health programs and take timely evidence-based decisions. Early childhood development (ECD) programs are very diverse. Rapid-cycle evaluation and learning (REAL) guides the implementation process of such complex interventions in real time. Stepping stones was one such early childhood development program implemented in Central India. Objective: The objective was to improve the delivery of complex, integrated public health interventions for early childhood development in remote areas of rural India. Methodology: The program was developed according to the principles of inclusion and community-centeredness, which can be tested quickly and iteratively. To enhance the decision-making process and improve delivery and coverage, the core team implemented an information system for rapid-cycle learning. We developed performance indicators and a performance measurement matrix after defining the specific needs. Following that, we trained staff to collect complete data using electronic data collection tools and transfer it the same day to the server for quality review and further analysis. A variety of data/information was triangulated to address the gaps in intervention delivery, and those decisions were subsequently implemented. Results: We observed that the quality of data collection improved, and errors were reduced by 50% in the third quarter. The quality of the narrative was also enhanced; it became more elaborate and reflective. Sharing their field output in meetings and improving the quality of the narrative enhanced the self-reflection skills of field staff and consequently improved the quality of the intervention delivery. Refresher training and mentoring by supervisors helped to improve the data quality over time. Conclusion: Rapid-cycle evaluation and learning (REAL) can be implemented in resource-limited settings to improve the quality and coverage of integrated intervention in early childhood. It nurtures a reinforcing ecosystem that integrates providers, community, and family perspectives and guides interactions among stakeholders by integrating data from all available sources.

Study of anaemia in pregnancy and low birth weight in fluoride endemic area of Western Rajasthan: a cohort study.

Background: Fluoride is a noxious element known to destroy gastrointestinal mucosa, leading to erythrocytes' destruction and causing anaemia. The birth weight of newborn babies is a significant indicator of a child's vulnerability to the risk of childhood diseases and chances of existence. Methods: This prospective cohort study was planned to find linkages between fluorosis and the low-birth weight of newborn babies with anaemic mothers. Antenatal mothers until the 20th week of gestation were followed up till delivery in the Antenatal Clinic of a District Hospital in one of the known fluoride-endemic districts (Nagaur) and the other not-so-endemic district (Jodhpur) of Western Rajasthan. Results: Around 19% of the newborn in Jodhpur and around 22% in Nagaur had low birth weight. Mean fluoride values in water samples were measured to be 0.57 (range from 0.0 to 2.7 PPM) in Jodhpur and 0.7 (range from 0.0 to 3.4 PPM) in Nagaur. Conclusions: Thus, in fluoride endemic areas, other factors should be included besides iron and folic acid supplementation for improving anaemia in pregnant women. This calls for assessing the effectiveness of de-fluoridation activities along with the area's most common indigenous food practices.

Dietary Determinants of Renal Calculi: A Case-Control Study From a Tertiary Care Hospital of Western Rajasthan.

Introduction Nephrolithiasis affects all countries of the world with an approximate global lifetime prevalence of 15-20%. In India, 12% of the total population is anticipated to have renal stone disease. This study was aimed at providing a relationship between various dietary factors in the formation of renal stones. Methods A case-control study was conducted among 207 patients (106 cases and 101 controls) attending the outpatient and inpatient departments of a tertiary care hospital in Jodhpur, Rajasthan. All the participants with confirmed renal stones by means of ultrasound and radiographic evaluation, aged 15-65 years were included as cases and were matched on age and gender with controls. Pearson chi-square test followed by binary logistic regression was used to assess significant associations. Results Out of all participants, 71.0% were males and 65.7% were from the age group 41-65 years. The study showed a statistically significant association between renal stones and high salt intake, reduced water intake, less consumption of milk and milk products, daily intake of tea, consumption of oxalate-rich foods and consumption of junk foods. Conclusion Dietary factors play an important role in the risk of the development of renal stones. Simple dietary modifications may significantly reduce the chances of the development of nephrolithiasis, especially in the vulnerable population.

Evaluation of Rpoß Gene and Its Various Mutants in Multidrug-Resistant Tuberculosis Cases by GeneXpert Method.

INTRODUCTION: India is one of the countries in the world which contribute to the global burden of multidrug-resistant tuberculosis (MDR-TB). GeneXpert is a method recommended by the World Health Organization (WHO) that uses five overlapping probes (Probe A to E) to detect mutation in the beta subunit of ribonucleic acid (RNA) polymerase gene (Rpoß) responsible for rifampicin resistance in Mycobacterium tuberculosis (MTB). METHOD: All the pulmonary and extrapulmonary samples received in tuberculosis (TB) laboratory for testing of MTB from January 2018 to December 2020 were analyzed for bacillary load and rifampicin resistance was identified by analyzing the number of missing probes. RESULTS: During the study period, a total of 10,021 samples were tested for MDR-TB. Out of those samples, 2674 samples were positive for MTB of which 2321 were pulmonary samples and 353 were extra-pulmonary samples. Rifampicin resistance was detected in 385 pulmonary samples and 63 extrapulmonary samples. These samples were further differentiated according to the bacillary load. The highest number of mutations was observed in Probe E followed by Probe B, Probe A, and Probe D, and the lowest was observed in Probe C. Also, mutations were associated when all probes were present or a few combinations of probes were missing. CONCLUSION: GeneXpert assay is a rapid molecular method that detected MTB and rifampicin resistance with a two-hour turnaround. It uses molecular beacons to detect mutation in the Rpoß gene. This study can be useful in analyzing the prevalence and epidemiology of MTB in a particular demographic area and also the addition of a few more probes can enhance the identification of the mutation in other codons and therefore better therapeutic interventions can be developed accordingly.

Improving the Nutritional Status of Adolescent Females in Gujarat: The Case for Targeted Investment.

Introduction Undernutrition is one of the key determinants of morbidity and mortality in adolescent females worldwide and in India. Malnutrition, particularly undernutrition, is highly prevalent among adolescent females. Although undernutrition affects the health status of adolescent females leading to poor growth and developmental problem issues among them, still, the adolescent group remains to be neglected group. The present paper particularly focuses on challenges and ways forward for improving the nutritional status of adolescent females in Gujarat. Methods and material It's a mixed method study where the secondary data analysis was conducted comparing the National Family Health Survey-5 (NFHS-5) report with the Comprehensive National Nutritional Survey (CNNS) report for the assessment of undernutrition, overweight, and anemia status among adolescent females, and the primary assessment of the nutritional status of adolescent females across Gujarat was conducted through anthropometric measurements of height and weight. Results The NFHS-5 report findings showed total thinness among adolescent females (15-19 years) in Gujarat to be 52.5%, which increased by 3% from the NFHS-4 findings. Anemia among adolescent females has also been reported to be 69%, which also increased by 12.5% from the NFHS-4 findings. Tribal regions/populations had a higher prevalence of undernutrition. Being overweight among urban adolescent females was more prevalent than in rural regions. The key findings of the CNNS report also showed that 24% of adolescent females (10-19 years) were thin while 5% of adolescent females were overweight/obese in India, while in Gujarat, 8% of adolescent females were overweight/obese. The primary data gathered suggest a prevalence of overweight in Gujarat of 8.9% in adolescent females and total thinness of 50%. Conclusion The nutritional status of adolescent females is still a major concern in many parts of India. Considering the complex set of challenges to tackle malnutrition in Gujarat and with specific attention to the adolescent group, it is vital to understand district-specific challenges and plan, program, and design district-specific strategies and implement actions to improve the existing nutritional status of adolescent females.

Pragmatic Effect of Lower Limb McKenzie in Grade One Osteoarthritis: A Novel Case Report.

Knee osteoarthritis (OA) is a usual disorder depicted as discomfort and loss of functional performance, including decreased proprioceptive acuity. Symptoms of this condition include stiffness, pain, swelling, joint disproportion, functional incompetency, and muscle atrophy, which may reduce the well-being of the patient. This report highlights the case of a 41-year-old female patient who complained of right knee pain, which was persisting for a month, and was treated with the McKenzie Technique (MT) along with electrotherapy modalities. Following 12 days protocol, there was a substantial reduction in pain, improvement in functional ability and knee muscle strength, and reduced walking time. Various other physiotherapy approaches and techniques were inculcated in the management of OA, which involved a soft tissue approach, therapeutic training, and manual method. Hence, this case report highlights the pragmatic effect of lower limb MT in grade 1 knee OA patients, which may improve the patient's well-being.