Jenner's Legacy: How Edward Jenner's Smallpox Vaccine Changed Public Health.

Edward Jenner who discovered immunology and the smallpox vaccine conducted a smallpox vaccination test in 1796, which is considered a landmark in the history of modern immunization. This review focuses on describing Jenner and his accomplishments highlighting his discovery as a shift in the approaches toward disease control and prevention as well as the basis for further eradicating smallpox globally. Jenner's use of cowpox to protect people from smallpox was a revolution from other essential procedures such as variolation. His vaccine demonstrated how immunization could be used to combat diseases, and over the years the idea began to be deployed to other vaccines and other diseases. Besides the given medical profession, the work of Jenner was relevant to the changes or even enhancements of health policies and health systems globally. His vaccine provided not only the means to arrest a wide disease that could easily eliminate many human beings but also initiated procedures of disease prevention and control. Another important type of immunity, herd immunity, which determines an approach to managing specific diseases in the present, as well as knowledge of the degree of protection provided by the antigen in terms of the overall immune status of a population, was also achieved based on the actions taken after Jenner's procedure. As our society searches for vaccines for emergent diseases to date, this review reveals that Jenner's accomplishments are still relevant. In this article, analyzing Jenner's approach and the role of society and science at the time, along with the consequences of his work, the reader sees how Jenner changed the world of public health and laid a foundation for today's vaccination. Such an approach allows considering the changes and evolution of the topic that Jenner studied and contributed to and how people fight infections today.

Factors affecting early initiation of breastfeeding among mothers of urban area of Jabalpur district, Madhya Pradesh, India: A community-based cross-sectional study.

Background: Early initiation of breastfeeding reduces infant mortality and morbidity and prolongs the duration of breastfeeding. Objective: The present study was conducted to assess the prevalence of early initiation of breastfeeding and factors associated with early initiation of breastfeeding in the urban area of Jabalpur district of Madhya Pradesh. Methodology: The present community-based cross-sectional study was conducted in an urban area of Jabalpur district of Madhya Pradesh from March 2017 to July 2018 on 370 recently delivered mothers. Data were collected by interview, using the pretested structured questionnaire and analyzed using SPSS, version 20. Significance was set at the value of P < 0.05. Results: The prevalence of early initiation of breastfeeding was found to be 45.4%. The percentage of mothers initiating breastfeeding earlier increased when they belonged to the higher age group, nuclear family, were educated, employed, counseled during antenatal visits, non-primigravida and delivered in health institutions. It was also observed that type of delivery, socioeconomic status of mothers, birth weight of baby and occupation of husband are not significantly associated with the early initiation of breastfeeding. Conclusion: Increasing literacy amongst the population, promoting marriages at an appropriate age, counseling pregnant women regarding early initiation of breastfeeding during antenatal care visits and institutional deliveries can significantly increase the prevalence of early initiation of breastfeeding in the mothers of urban areas of Jabalpur district, Madhya Pradesh.

Use of Technology to Promote Road Safety: Public Health Perspective.

Road safety has been acknowledged as a public health concern of global significance owing to its direct association with human lives and their well-being. Road safety is a much broader concept than measures that are aimed to just prevent accidents, but it extends to improving the quality of life of members of the community, safeguarding environmental health, and improving the economy of the nation. With the passage of time, several technologies in road safety have surfaced, and their collective employment can aid in the establishment of a smart, safe, and efficient transportation system in nations. In fact, these technologies will account for a significant reduction in the number of accidents, better management of traffic, and improved road safety. In conclusion, ensuring road safety can save lives, promote responsible behavior, and create secure transportation system. There is an immense need to create awareness, engage the community, and embrace technology to minimize the possibility of road accidents and ensure safe journeys for all.

Escape Rooms in Medical Education: Unlocking Realistic Simulated Clinical Scenarios Using Interprofessional Education.

The delivery of medical education is a complex process, considering the vast nature of the syllabus, and multiple competencies are needed to be attained by medical students. Escape rooms are an innovative approach to delivering medical education and provide an enriching learning experience for students. These rooms are designed to replicate clinical scenarios, and they provide a platform for students to apply their theoretical knowledge to clinical practice. The employment of escape rooms in medical education has been linked with multiple merits for the students and helps them to attain multiple competencies. The participants in escape rooms are generally from different disciplines, and as mentioned above, it gives a chance to students from varied disciplines to acknowledge the role of each specialty and understand the need that for successful healthcare delivery, all professionals have to work as a team. In other words, these room offers a wonderful opportunity for students to come out of discipline-level segregation and work together to ensure the delivery of comprehensive healthcare services. In conclusion, escape rooms have the potential to deliver experiential and contextual learning for students from different disciplines. As healthcare delivery is a multidisciplinary approach, there is an immense need to explore the possibility of running escape rooms along with students from other disciplines and together move forward across the complexities of clinical practice.

Diagnostic accuracy of mean corpuscular volume in detecting coexisting iron deficiency in patients of sickle cell disorders: A hospital-based study.

Background: Co-existing iron deficiency in patients of sickle cell disease (SCD) and trait may worsen anemia, and adversely affect neuro-cognitive development and growth. Determining a cut-off below which Mean corpuscular Volume (MCV) can predict iron deficiency in SCD patients can preclude use of more expensive test serum ferritin. Aims: This study was conducted to determine the diagnostic accuracy of low MCV in detecting iron deficiency compared to serum ferritin levels in patients with SCD. Methods: 60 consecutive patients with SS or AS pattern on hemoglobin electrophoresis were enrolled. The index test (MCV) and the reference standard test (serum ferritin) were performed in a blind and independent manner. The measures of diagnostic accuracy were calculated and the precision of the point estimates were expressed by 95% confidence intervals. As MCV is a continuous variable, we also used multi-level likelihood ratios to compute diagnostic accuracy of MCV at several cut-points. Results: The sensitivity of low MCV in detecting iron deficiency was 40.0% (95% CI-20.0-63.6), the specificity was 78.4% (95% CI-61.3-89.6) using serum ferritin as a reference standard. The sensitivity and specificity of predicting coexisting iron deficiency at this point was 60.9% (CI-38.6-80.3%) and 75.7% (CI-58.8-88.2%) respectively. Conclusions: The low sensitivity (40%) of microcytosis in detecting iron deficiency indicates that many cases will be missed if MCV alone is used to detect co-existing iron deficiency anemia in SCD patients. No single test is good enough to detect co-existing iron deficiency and a combination of tests might be useful.

Pembrolizumab Plus Carboplatin and Paclitaxel as First-Line Therapy for Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma (KEYNOTE-B10): A Single-Arm Phase IV Trial.

PURPOSE: Standard-of-care first-line treatment for recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) is pembrolizumab plus platinum and fluorouracil (FU). However, FU is associated with potential challenges (continuous 4-day infusion, high administration costs, and cardiovascular and gastrointestinal toxicities), creating a clinical need for alternative chemotherapy combinations. We evaluated the efficacy and safety of first-line pembrolizumab plus carboplatin and paclitaxel for R/M HNSCC in the open-label, single-arm, phase IV KEYNOTE-B10 study (ClinicalTrials.gov identifier: NCT04489888). METHODS: Eligible adults had previously untreated, histologically or cytologically confirmed R/M HNSCC regardless of PD-L1 status, measurable disease per RECIST v1.1 by blinded independent central review (BICR), and an Eastern Cooperative Oncology Group performance status of 0 or 1. Patients received pembrolizumab 200 mg intravenously once every 3 weeks for ≤35 cycles and carboplatin AUC 5 mg/mL/min intravenously once every 3 weeks for ≤6 cycles and investigator's choice of paclitaxel 100 mg/m2 on days 1 and 8 or 175 mg/m2 on day 1, intravenously once every 3 weeks. The primary end point was objective response rate per RECIST v1.1 by BICR. RESULTS: Between October 27, 2020, and April 29, 2022, 149 patients were screened and 101 received treatment. As of February 20, 2023, the median follow-up was 18.9 months (range, 9.1-27.0). At this final analysis, 49 (49%) of 101 patients had an objective response (95% CI, 38.4 to 58.7), including seven patients (7%) with a confirmed complete response. Of the 101 treated patients, grade 3-5 and serious treatment-related adverse events occurred in 76 (75%) and 27 (27%), respectively. There were no new safety signals. CONCLUSION: Pembrolizumab plus carboplatin and paclitaxel showed promising antitumor activity and a manageable safety profile in first-line R/M HNSCC, suggesting this combination may be an alternative option for this patient population.

Understanding Preventive Health Behavior: A Mixed-Methods Study to Explore Factors Influencing the Practice of Breast Self-Examination Among Indian Medical Students.

INTRODUCTION: Breast cancer (BC) is among the most prevalent oncological cases in the world, and the global burden of the disease is expected to rise further in the coming years. Strategies aiming at early diagnosis, backed by research and a well-trained healthcare cadre, can aid low- and middle-income countries (LMIC) in tackling the possible cancer-caused strain on healthcare systems. Our study aimed to evaluate the level of knowledge of medical students concerning BC and explore barriers and facilitators of breast self-examination (BSE). METHODS: A sequential explanatory mixed-methods study approach to better understand factors and beliefs influencing preventive health practice in BSE was conducted among students at a medical college in rural Maharashtra, India. One hundred and two female medical students completed the quantitative phase, and 15 of them gave in-depth interviews (IDIs) for the qualitative aspect. RESULTS: Among the participants, 67.6% had good knowledge of risk factors, but only 10% knew the recommendations for BSE, clinical breast examination (CBE), and mammography. We found that being taught BSE by a trusted source and knowing a BC patient were significant facilitators. In contrast, lack of self-efficacy and two fear factors were found to be acting as barriers for BSE, one being the absence of fear of ever getting BC and the other fear of detecting a lump. CONCLUSION: This study reveals a gap between knowledge of risk factors and their translation to disease prevention practice. The barriers elicited are modifiable by planning and implementing an appropriate training program covering risk factors and recommending all available screening and preventative modalities. A well-trained medical staff will be instrumental in improving the health status of our community and country.

Regulatory mechanisms of plant rhizobacteria on plants to the adaptation of adverse agroclimatic variables.

The mutualistic plant rhizobacteria which improve plant development and productivity are known as plant growth-promoting rhizobacteria (PGPR). It is more significant due to their ability to help the plants in different ways. The main physiological responses, such as malondialdehyde, membrane stability index, relative leaf water content, photosynthetic leaf gas exchange, chlorophyll fluorescence efficiency of photosystem-II, and photosynthetic pigments are observed in plants during unfavorable environmental conditions. Plant rhizobacteria are one of the more crucial chemical messengers that mediate plant development in response to stressed conditions. The interaction of plant rhizobacteria with essential plant nutrition can enhance the agricultural sustainability of various plant genotypes or cultivars. Rhizobacterial inoculated plants induce biochemical variations resulting in increased stress resistance efficiency, defined as induced systemic resistance. Omic strategies revealed plant rhizobacteria inoculation caused the upregulation of stress-responsive genes-numerous recent approaches have been developed to protect plants from unfavorable environmental threats. The plant microbes and compounds they secrete constitute valuable biostimulants and play significant roles in regulating plant stress mechanisms. The present review summarized the recent developments in the functional characteristics and action mechanisms of plant rhizobacteria in sustaining the development and production of plants under unfavorable environmental conditions, with special attention on plant rhizobacteria-mediated physiological and molecular responses associated with stress-induced responses.

Integrating Psychological Care Training in Trauma Care for Medical Students: the Need and the Strategies.

Trauma, whether arising from accidents, violence, or medical emergencies, generally has a substantial impact on the lives of victims, their family members, the society, and the healthcare delivery system. The purpose of the article is to justify the need to train medical students in trauma-related psychological care, explore the significance of simulation-based training, and identify coping strategies to augment the resilience of medical students. As healthcare professionals are the ones who are executing trauma care-related interventions, it is essential that medical students are trained to offer psychological care to the victims and family members of trauma to enable healing of both the body and the mind. If medical students learn about psychological care pertaining to trauma, they will be well equipped to handle sudden traumatic events by being more adaptable and resilient. Medical students can be trained in multiple ways to improve their psychological preparedness while delivering trauma care. As a part of the psychological training related to the management of trauma victims, medical students must be trained in developing coping strategies and resilience. In conclusion, facilitating learning among medical students in the psychological aspects of trauma care is a crucial domain for developing competent healthcare professionals. It is a priority to integrate into medical education a comprehensive learning about psychological care that will empower medical students to respond effectively to the complexities of trauma with empathy, resilience, and effective communication.

Practice makes perfect: The learner-doctor blueprint for proficient physicians.

In the process of producing competent and efficient medical graduates, clinical teaching is an integral component of undergraduate training. Even though clinical training has been linked with multiple benefits and plays a defining role in transforming a medical student into a competent doctor, it has some inherent challenges. The learner-doctor method emphasizes learning by doing and has the potential to counter the identified challenges in the traditional mode of clinical training. The learner-doctor method places emphasis on collaborative learning, wherein students learn by experiential learning and active participation in patient care. This method not only fosters the development of clinical skills but also cultivates critical thinking, teamwork, empathy, and effective communication. A number of activities or strategies must be planned and implemented to ensure that the set objectives of the learner-doctor method are accomplished by the medical institutions. In conclusion, as medical education continues to evolve, the learner-doctor method of clinical training is a dynamic approach to bridging the gap between theoretical knowledge and practical skills. As this method enables medical students to actively engage in patient care and improve their critical thinking, it becomes the need of the hour that every medical institution should explore the opportunity to effectively implement the same in their settings.

Synergistic interactions of nanoparticles and plant growth promoting rhizobacteria enhancing soil-plant systems: a multigenerational perspective.

Sustainable food security and safety are major concerns on a global scale, especially in developed nations. Adverse agroclimatic conditions affect the largest agricultural-producing areas, which reduces the production of crops. Achieving sustainable food safety is challenging because of several factors, such as soil flooding/waterlogging, ultraviolet (UV) rays, acidic/sodic soil, hazardous ions, low and high temperatures, and nutritional imbalances. Plant growth-promoting rhizobacteria (PGPR) are widely employed in in-vitro conditions because they are widely recognized as a more environmentally and sustainably friendly approach to increasing crop yield in contaminated and fertile soil. Conversely, the use of nanoparticles (NPs) as an amendment in the soil has recently been proposed as an economical way to enhance the texture of the soil and improving agricultural yields. Nowadays, various research experiments have combined or individually applied with the PGPR and NPs for balancing soil elements and crop yield in response to control and adverse situations, with the expectation that both additives might perform well together. According to several research findings, interactive applications significantly increase sustainable crop yields more than PGPR or NPs alone. The present review summarized the functional and mechanistic basis of the interactive role of PGPR and NPs. However, this article focused on the potential of the research direction to realize the possible interaction of PGPR and NPs at a large scale in the upcoming years.

Unlocking the Potential: Millets and Their Impact on Diabetes Management.

Many studies, including case studies, meta-analyses, and randomized trials, have demonstrated the benefits of a low-carb diet in the management of obesity, diabetes, and pre-diabetes. Numerous studies suggest that diets low in carbohydrates are safe and can greatly enhance the management of both forms of diabetes as well as the general health of those who have the disease. When used in conjunction with effective therapy, this diet can result in weight loss, decreased prescription dosages, and in certain cases, remission from type 2 diabetes. Globally, there has been a notable surge in the prevalence of diabetes cases as a result of factors such as population growth, aging, urbanization, rising obesity rates, and declining physical activity. Diabetes can be controlled in large part by diet, and millets having low-glycemic index (GI) have become more significant as they release glucose into the bloodstream at a very slow rate. Creating a low-glycemic meal mix with locally sourced ingredients is crucial for daily diet plans. Dietary changes, particularly the addition of millet, can help prevent and manage diabetes mellitus. Eating practices have long been acknowledged for their important role in promoting health and wellness through the consumption of nutrient-dense meals. The health benefits of millet, an underappreciated food crop, are numerous and include low GI, high-fiber content, non-acid-forming potential, polyunsaturated fatty acids (PUFAs), and gluten-free status. Apart from staple crops like wheat and rice, millets are also very healthy and useful, and they have an immense amount of opportunity to aid in the global fight against food insecurity, which is a problem that many countries now confront. Millets are high on the list of recommended foods because of their many health advantages and antioxidant characteristics. Diets that are low in carbohydrates, low in GI, Mediterranean, and very low in calories are now popular. Diabetes can be managed with a nutritious diet, regular exercise, cessation of smoking, and maintenance of a healthy body weight. Furthermore, calorie restriction, the use of low-GI meals, and an increase in fiber content are all possible nutritional strategies in the management of diabetes.

NF-κB pathway as a molecular target for curcumin in diabetes mellitus treatment: Focusing on oxidative stress and inflammation.

Diabetes mellitus (DM) is a collection of metabolic disorder that is characterized by chronic hyperglycemia. Recent studies have demonstrated the crucial involvement of oxidative stress (OS) and inflammatory reactions in the development of DM. Curcumin (CUR), a natural compound derived from turmeric, exerts beneficial effects on diabetes mellitus through its interaction with the nuclear factor kappa B (NF-κB) pathway. Research indicates that CUR targets inflammatory mediators in diabetes, including tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6), by modulating the NF-κB signaling pathway. By reducing the expression of these inflammatory factors, CUR demonstrates protective effects in DM by improving pancreatic ß-cells function, normalizing inflammatory cytokines, reducing OS and enhancing insulin sensitivity. The findings reveal that CUR administration effectively lowered blood glucose elevation, reinstated diminished serum insulin levels, and enhanced body weight in Streptozotocin -induced diabetic rats. CUR exerts its beneficial effects in management of diabetic complications through regulation of signaling pathways, such as calcium-calmodulin (CaM)-dependent protein kinase II (CaMKII), peroxisome proliferator-activated receptor gamma (PPAR-γ), NF-κB, and transforming growth factor ß1 (TGFB1). Moreover, CUR reversed the heightened expression of inflammatory cytokines (TNF-α, Interleukin-1 beta (IL-1ß), IL-6) and chemokines like MCP-1 in diabetic specimens, vindicating its anti-inflammatory potency in counteracting hyperglycemia-induced alterations. CUR diminishes OS, avert structural kidney damage linked to diabetic nephropathy, and suppress NF-κB activity. Furthermore, CUR exhibited a protective effect against diabetic cardiomyopathy, lung injury, and diabetic gastroparesis. Conclusively, the study posits that CUR could potentially offer therapeutic benefits in relieving diabetic complications through its influence on the NF-κB pathway.

Addressing the Challenge: A Review of Effective Prevention Strategies for Childhood Obesity in India.

Childhood obesity is a growing public health concern in India, with rising prevalence rates and associated health risks. This review examines effective prevention strategies for addressing this issue. Through a comprehensive analysis of research findings, policy initiatives, and community-based interventions, the review identifies critical components of successful prevention efforts. These include multi-sectoral collaborations, tailored interventions addressing socioeconomic and cultural factors, and the involvement of families and healthcare professionals. The importance of addressing childhood obesity in India is underscored, given its significant impact on health outcomes, healthcare costs, and quality of life. The review concludes with a call to action for stakeholders and policymakers to prioritise prevention efforts, allocate resources, and implement evidence-based interventions to combat childhood obesity effectively. By working together, India can mitigate the adverse effects of childhood obesity and promote a healthier future for its children.

Health-Related Challenges and Programs Among Agriculture Workers: A Narrative Review.

Agriculture is one of the most hazardous occupations, with many workers experiencing occupational accidents and ill health. The misuse of toxic substances, often due to inadequate protective measures, raises concerns about both individual and nature safety. However, the strenuous tasks done by the agricultural workers, especially those related to pesticide exposure and some challenges affect the farmer's health and well-being. This review paper used databases like PubMed and Google Scholar to elaborate this. English language studies are included and other languages are excluded. The health system for agricultural labour in India sheds light on the neglected status of agricultural workers and emphasizes the need for health promotion programs. For that, training and interventions are important as crucial elements in reducing pesticide exposure, with a call for the enforcement of existing laws and regulations. Agriculture workers have a proper knowledge and attitude towards the safety and program to overcome the health-related conditions they face. This paper also addresses the practices of personal protective equipment (PPE) and the challenges faced by farmers in adopting adequate safety measures.

Obesity and Preventive Intervention Among Children: A Narrative Review.

Childhood obesity has become a major public health concern around the world, with a rise in prevalence over the last few decades. This abstract provides an overview of pediatric obesity, including its causes, implications, and potential treatments. Childhood obesity is caused by a complex combination of environmental, genetic, and behavioral variables. A child's likelihood of developing obesity is influenced by factors, such as socioeconomic status, family dynamics, and cultural norms. Childhood obesity leads to extensive repercussions, elevating the risk of chronic conditions, such as diabetes, cardiovascular diseases, and mental health challenges. Furthermore, children dealing with obesity often face social stigmatization, diminished self-esteem, and academic struggles. Efforts to prevent and manage childhood obesity should employ a comprehensive and multi-tiered approach. This involves enacting policies geared toward enhancing nutrition in schools and communities, advocating for increased physical activity (PA), and curbing sedentary behaviors.

Combined polygenic scores for ischemic stroke risk factors aid risk assessment of ischemic stroke.

BACKGROUND: Current risk assessment for ischemic stroke (IS) is limited to clinical variables. We hypothesize that polygenic scores (PGS) of IS (PGSIS) and IS-associated diseases such as atrial fibrillation (AF), venous thromboembolism (VTE), coronary artery disease (CAD), hypertension (HTN), and Type 2 diabetes (T2D) may improve the performance of IS risk assessment. METHODS: Incident IS was followed for 479,476 participants in the UK Biobank who did not have an IS diagnosis prior to the recruitment. Lifestyle variables (obesity, smoking and alcohol) at the time of study recruitment, clinical diagnoses of IS-associated diseases, PGSIS, and five PGSs for IS-associated diseases were tested using the Cox proportional-hazards model. Predictive performance was assessed using the C-statistic and net reclassification index (NRI). RESULTS: During a median average 12.5-year follow-up, 8374 subjects were diagnosed with IS. Known clinical variables (age, gender, clinical diagnoses of IS-associated diseases, obesity, and smoking) and PGSIS were all independently associated with IS (P < 0.001). In addition, PGSIS and each PGS for IS-associated diseases was also independently associated with IS (P < 0.001). Compared to the clinical model, a joint clinical/PGS model improved the C-statistic for predicting IS from 0.71 to 0.73 (P < 0.001) and significantly reclassified IS risk (NRI = 0.017, P < 0.001), and 6.48% of subjects were upgraded from low to high risk. CONCLUSIONS: Adding PGSs of IS and IS-associated diseases to known clinical risk factors statistically improved risk assessment for IS, demonstrating the supplementary value of inherited susceptibility measurement . However, its clinical utility is likely limited due to modest improvements in predictive values.