Dr. Ratan Chandra Kar: The Journey of the Jarawa Doctor.

 A distinguished physician Dr. Ratan Chandra Kar, born in 1954 in West Bengal, India, is known for his pivotal role in providing healthcare to the Jarawa tribe of the Andaman Islands. He began his service toward the Jarawa tribes in 1998, notably combating a devastating measles outbreak in 1999 that threatened the tribe's existence. Overcoming initial distrust, Dr. Kar earned the tribe's confidence through cultural respect and medical expertise, treating over a hundred patients at the peak of the epidemic. He had established a dedicated Jarawa Ward at Kadamtala Hospital, integrating their traditional practices with modern medicine. For his dedication, Dr. Kar received the Padma Shri in 2023, for contributing significantly to the tribe's growth from 255 to 260 individuals in 1998 to over 560 today. His work stands as a testament to the importance of culturally sensitive healthcare in preserving vulnerable indigenous communities.

Leprosy Presenting With Scleroderma and Cataract: A Clinical Conundrum.

Leprosy, a chronic infectious disease caused by Mycobacterium leprae, even though treatable, remains a significant public health problem. It mainly impacts the skin, peripheral nerves, mucosa of the upper respiratory tract, and the eyes. In this case report, we present the case of a 64-year-old female with numerous hypopigmented patches with loss of sensations, madarosis, resorption of toes and digits, skin tightening, and diminution of vision. The skin over the hands exhibited thickening, leading to functional impairments that influenced both manual dexterity and mobility. The diagnosis of this unique case, showing a complex triad of lepromatous leprosy, scleroderma, and sclerotic cataract, was confirmed by clinical evaluation, skin biopsies, serological tests, and ophthalmic examination. Following this, the patient underwent dexamethasone-cyclophosphamide pulse therapy and multidrug treatment to halt the disease progression, prevent further disability, and reduce transmission. The case management addressed the issue of overlapping symptoms and conditions to provide appropriate care and cure to the patient. Public health initiatives under the National Leprosy Eradication Programme play an important role in promoting early diagnosis, effective treatment, and community empowerment, working toward a future where leprosy is no longer a threat to public health by preventing disability, reducing transmission, and combating the social stigma associated with it.

Delivering non-communicable disease services through primary health care in selected south Asian countries: are health systems prepared?

In the south Asian region, delivering non-communicable disease (NCD) prevention and control services through existing primary health-care (PHC) facilities is urgently required yet currently challenging. As the first point of contact with the health-care system, PHC offers an ideal window for prevention and continuity of care over the life course, yet the implementation of PHC to address NCDs is insufficient. This review considers evidence from five south Asian countries to derive policy-relevant recommendations for designing integrated PHC systems that include NCD care. Findings reveal high political commitment but poor multisectoral engagement and health systems preparedness for tackling chronic diseases at the PHC level. There is a shortage of skilled human resources, requisite infrastructure, essential NCD medicines and technologies, and dedicated financing. Although innovations supporting integrated interventions exist, such as innovations focusing on community-centric approaches, scaling up remains problematic. To deliver NCD services sustainably, governments must aim for increased financing and a redesign of PHC service.

Over the Counter: Self-Care or Self-Harm? A Mixed Method Study Protocol on Prevalence and Determinants of Self-Medication Practices in Wardha.

Background Self-medication (SM), a common practice globally, possesses a dual challenge of being a self-care strategy and a potential source of harm observed across all age groups. The study is being conducted to gauge the prevalence of SM of prescription drugs with their over-the-counter access, thus addressing the delicate balance between self-care and self-harm related to SM. Material and methods This ongoing convergent parallel mixed method study with quantitative and qualitative components will be conducted on a sample size of 180 subjects aged more than 18 years from an urban community. For the quantitative component, a semi-structured questionnaire will assess the prevalence of SM, types of medications used, reasons for self-medicating, and socio-demographic factors influencing these practices. Concurrently, qualitative interviews delve deeper into the beliefs shaping SM practices. Sampling will be purposive to capture diverse perspectives, with data analyzed using statistical tools. Results This study protocol will offer a comprehensive understanding of the prevalence and determinants of SM practices. The quantitative data provide numerical insights into SM trends, while the qualitative findings elucidate the nuanced factors driving individuals' SM choices. Conclusions A multifaceted view of SM practices will be provided, aiding in developing interventions to promote safe and effective self-care while mitigating the risks of self-harm through SM. Anticipated findings can include a widespread prevalence of SM amongst the general urban populace. Significant associations can also be expected to be found with various independent variables. The results will be instrumental in informing public health policies and healthcare practices toward enhancing patient safety and well-being.

Stabilisation Splint versus Other Conservative Therapies for the Treatment of TMD: A Systematic Review.

The purpose of this systematic review was to compare the effectiveness of stabilisation splint (SS) with other conservative treatment modalities in the management of temporomandibular disorders (TMD). An electronic search in PubMed, Google Scholar, and Cochrane was conducted to find randomised control trials published on the management of temporomandibular disorders in English language from March 2000 to June 2023 along with manual search in the relevant Journal of Prosthetic Dentistry, the American Journal of Prosthodontics, and the Journal of Oral Rehabilitation. A total of 64 studies were initially considered, out of which eight studies fulfilled the inclusion criteria. Furthermore, RoB-2 analysis tool was used for checking the risk of bias in the included studies. On comparing the readings and outcomes, only one study showed that the SS was better than the comparators. The review identified that there is weak evidence of effectiveness of SS splint therapy over other conservative therapies for the treatment of TMD. Key Words: Splints, Conservative treatment, Pain measurement, Temporomandibular disorders.

Recurrent Left-Sided Hepatic Hydrothorax Leading to Liver-Mediated Dyspnea.

Cirrhosis is a common liver condition caused by several etiologies including alcohol use disorder, infectious hepatitis, and metabolic dysfunction associated with liver disease. Although common symptomatic complications of cirrhosis include malaise, gastrointestinal bleeding, and abdominal distension, shortness of breath is a less common phenomenon that may occur. Hepatic hydrothorax (HH) is an uncommon cause of shortness of breath that is believed to be caused by the accumulation of ascitic fluid in the pleural space. While most cases of HH occur with ascites and the right side, we hereby present a case of a 70-year-old female with left-sided HH without ascites.

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.

Psychometric Properties of the PANS 31-Item Symptom Rating Scale.

Objectives: Pediatric acute-onset neuropsychiatric syndrome (PANS) is characterized by sudden onset of obsessive-compulsive disorder and/or eating restriction with associated neuropsychiatric symptoms from at least two of seven categories. The PANS 31-Item Symptom Rating Scale (PANS Rating Scale) was developed to identify and measure the severity of PANS symptoms. The objective of this study was to define the psychometric properties of the PANS Rating Scale. Methods: Children with PANS (N = 135) and their parents participated. Parents completed the PANS Rating Scale and other scales on Research Electronic Data Capture. The PANS Rating Scale includes 31 items that are rated on a Likert scale from 0 = none to 4 = extreme. Pearson's correlations were run between the PANS Total score and scores on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), Yale Global Tic Severity Scale (YGTSS), Modified Overt Aggression Scale (MOAS), Columbia Impairment Scale (CIS), PANS Global Impairment Score (GIS), and Children's Global Assessment Scale (CGAS). Results: Convergent validity was supported by significant correlations between the PANS Total and scores on the CY-BOCS, YGTSS, MOAS, CIS, GIS, and CGAS. The largest correlations were with measures of functional impairment: PANS Total and CIS (r = 0.81) and PANS Total and GIS (r = 0.74). Cronbach's alpha was 0.89 which demonstrates strong internal consistency of the 31 items. PANS Total score was significantly higher in children in a flare of their neuropsychiatric symptoms compared to children who were not in a flare. Conclusions: This study provides preliminary support for the PANS Rating Scale as a valid research instrument with good internal consistency. The PANS Rating Scale appears to be a useful measure for assessing children with PANS.

Using Liver Organoids as Models to Study the Pathobiology of Rare Liver Diseases.

Liver organoids take advantage of several important features of pluripotent stem cells that self-assemble in a three-dimensional culture matrix and reproduce many aspects of the complex organization found within their native tissue or organ counterparts. Compared to other 2D or 3D in vitro models, organoids are widely believed to be genetically stable or docile structures that can be programmed to virtually recapitulate certain biological, physiological, or pathophysiological features of original tissues or organs in vitro. Therefore, organoids can be exploited as effective substitutes or miniaturized models for the study of the developmental mechanisms of rare liver diseases, drug discovery, the accurate evaluation of personalized drug responses, and regenerative medicine applications. However, the bioengineering of organoids currently faces many groundbreaking challenges, including a need for a reasonable tissue size, structured organization, vascularization, functional maturity, and reproducibility. In this review, we outlined basic methodologies and supplements to establish organoids and summarized recent technological advances for experimental liver biology. Finally, we discussed the therapeutic applications and current limitations.

Altered receptor binding, antibody evasion and retention of T cell recognition by the SARS-CoV-2 XBB.1.5 spike protein.

The XBB.1.5 variant of SARS-CoV-2 has rapidly achieved global dominance and exhibits a high growth advantage over previous variants. Preliminary reports suggest that the success of XBB.1.5 stems from mutations within its spike glycoprotein, causing immune evasion and enhanced receptor binding. We present receptor binding studies that demonstrate retention of binding contacts with the human ACE2 receptor and a striking decrease in binding to mouse ACE2 due to the revertant R493Q mutation. Despite extensive evasion of antibody binding, we highlight a region on the XBB.1.5 spike protein receptor binding domain (RBD) that is recognized by serum antibodies from a donor with hybrid immunity, collected prior to the emergence of the XBB.1.5 variant. T cell assays reveal high frequencies of XBB.1.5 spike-specific CD4+ and CD8+ T cells amongst donors with hybrid immunity, with the CD4+ T cells skewed towards a Th1 cell phenotype and having attenuated effector cytokine secretion as compared to ancestral spike protein-specific cells. Thus, while the XBB.1.5 variant has retained efficient human receptor binding and gained antigenic alterations, it remains susceptible to recognition by T cells induced via vaccination and previous infection.

Sentiment analysis of financial Twitter posts on Twitter with the machine learning classifiers.

This paper presents a sentiment analysis combining the lexicon-based and machine learning (ML)-based approaches in Turkish to investigate the public mood for the prediction of stock market behavior in BIST30, Borsa Istanbul. Our main motivation behind this study is to apply sentiment analysis to financial-related tweets in Turkish. We import 17189 tweets posted as "#Borsaistanbul, #Bist, #Bist30, #Bist100″ on Twitter between November 7, 2022, and November 15, 2022, via a MAXQDA 2020, a qualitative data analysis program. For the lexicon-based side, we use a multilingual sentiment offered by the Orange program to label the polarities of the 17189 samples as positive, negative, and neutral labels. Neutral labels are discarded for the machine learning experiments. For the machine learning side, we select 9076 data as positive and negative to implement the classification problem with six different supervised machine learning classifiers conducted in Python 3.6 with the sklearn library. In experiments, 80 % of the selected data is used for the training phase and the rest is used for the testing and validation phase. Results of the experiments show that the Support Vector Machine and Multilayer Perceptron classifier perform better than other classifiers with 0.89 and 0.88 accuracy and AUC values of 0.8729 and 0.8647 respectively. Other classifiers obtain approximately a 78,5 % accuracy rate. It is possible to increase sentiment analysis accuracy with parameter optimization on a larger, cleaner, and more balanced dataset by changing the pre-processing steps. This work can be expanded in the future to develop better sentiment analysis using deep learning approaches.

AAA ATPase protein-protein interactions as therapeutic targets in cancer.

AAA ATPases are a conserved group of enzymes that couple ATP hydrolysis to diverse activities critical for cellular homeostasis by targeted protein-protein interactions. Some of these interactions are potential therapeutic targets because of their role in cancers which rely on increased AAA ATPase activities for maintenance of genomic stability. Two well-characterized members of this family are p97/VCP and RUVBL ATPases where there is a growing understanding of their structure and function, as well as an emerging landscape of selective inhibitors. Here we highlight recent progress in this field, with particular emphasis on structural advances enabled by cryo-electron microscopy (cryo-EM).

Self-healing polymers for surface scratch regeneration.

Recently, there has been a significant increase in academic and industrial interest in self-healing polymers (SHPs) due to their remarkable ability to regenerate scratched surfaces and materials of astronomical significance. Scientists have been inspired by the magical repairing mechanism of the living world. They transformed the fiction of self-healing into reality by designing engrossing polymeric materials that could self-repair mechanical abrasions repeatedly. As a result, the durability of the materials is remarkably improved. Thus, the idea of studying SHPs passively upholds economic and environmental sustainability. However, the critical areas of self-healing (including healing efficiency, healing mechanism, and thermo-mechanical property changes during healing) are under continuous scientific improvisation. This review highlights recent notable advances of SHPs for application in regenerating scratched surfaces with various distinctive underlying mechanisms. The primary focus of the work is aimed at discussing the impact of SHPs on scratch-healing technology. Beyond that, insights regarding scratch testing, methods of investigating polymer surfaces, wound depths, the addition of healing fillers, and the environmental conditions maintained during the healing process are reviewed thoroughly. Finally, broader future perspectives on the challenges and prospects of SHPs in healing surface scratches are discussed.

Evaluation of Serial Testing After Exposure to COVID-19 in Early Care and Education Facilities, Illinois, March-May 2022.

OBJECTIVE: To understand SARS-CoV-2 transmission in early care and education (ECE) settings, we implemented a Test to Stay (TTS) strategy, which allowed children and staff who were close contacts to COVID-19 to remain in person if they agreed to test twice after exposure. We describe SARS-CoV-2 transmission, testing preferences, and the number of in-person days saved among participating ECE facilities. METHODS: From March 21 through May 27, 2022, 32 ECE facilities in Illinois implemented TTS. Unvaccinated children and staff who were not up to date with COVID-19 vaccination could participate if exposed to COVID-19. Participants received 2 tests within 7 days after exposure and were given the option to test at home or at the ECE facility. RESULTS: During the study period, 331 TTS participants were exposed to index cases (defined as people attending the ECE facility with a positive SARS-CoV-2 test result during the infectious period); 14 participants tested positive, resulting in a secondary attack rate of 4.2%. No tertiary cases (defined as a person with a positive SARS-CoV-2 test result within 10 days after exposure to a secondary case) occurred in the ECE facilities. Most participants (366 of 383; 95.6%) chose to test at home. Remaining in-person after an exposure to COVID-19 saved approximately 1915 in-person days among children and staff and approximately 1870 parent workdays. CONCLUSION: SARS-CoV-2 transmission rates were low in ECE facilities during the study period. Serial testing after COVID-19 exposure among children and staff at ECE facilities is a valuable strategy to allow children to remain in person and parents to avoid missing workdays.

Weight Loss of Over 100 lbs in a Patient of Prader-Willi Syndrome Treated With Glucagon-Like Peptide-1 (GLP-1) Agonists.

Prader-Willi syndrome (PWS) is the most common genetic obesity syndrome. The clinical features of this condition include childhood obesity, hyperphagia, infantile hypotonia, hypogonadism, short stature, and characteristic facial features. The leading cause of morbidity and mortality in PWS is hyperphagia and resultant obesity. Here, we highlight the effectiveness of glucagon-like peptide-1 (GLP-1) agonists by reporting an interesting case of successful rapid weight loss in an adult with PWS using GLP-1 agonists - exenatide and liraglutide. To the best of our knowledge, this report presents the first clinical evidence supporting the use of GLP-1 receptor agonists in the treatment of genetic obesity syndromes; our patient lost a total of 125 lbs on GLP-1 analog and continues to lose weight.

Strategic Electrochemical Determination of Nitrate over Polyaniline/Multi-Walled Carbon Nanotubes-Gum Arabic Architecture.

Significant agricultural and industrial activities necessitate the regular monitoring of nitrate (NO3-) ions levels in feed and groundwater. The current comparative study discloses an innovative user-friendly electrochemical approach for the determination of NO3- over polyaniline (PAni)-based modified electrodes. The electrochemical sensors concocted with PAni, multi-walled carbon nanotubes (CNT), and gum arabic (GA). The unique electrode material GA@PAni-CNT was synthesized by facile one-pot catalytic polymerization of aniline (Ani) with FeCl3/H2O2 in the presence of CNT and GA as integral components. As revealed by cyclic voltammetry (CV), the anchoring/retention of NO3- followed by reduction is proposed to occur when a GA@PAni-CNT electrode is immersed in phosphate buffer electrolyte containing NO3- that eventually results in a significantly higher redox activity of the GA@PAni-CNT electrode upon potential scan. The mechanism of NO3- anchoring may be associated with the non-redox transition of leucomeraldine salt (LS) into emeraldine salt (ES) and the generation of nitrite (NO2-) ions. As a result, the oxidation current produced by CV for redox transition of ES ↔ pernigraniline (PN) was ~9 times of that obtained with GA@PAni-CNT electrode and phosphate buffer electrolyte, thus achieving indirect NO3- voltammetric determination of the GA@PAni-CNT electrode. The prepared GA@PAni-CNT electrode displayed a higher charge transfer ability as compared to that of PAni-CNT and PAni electrodes. The optimum square wave voltammetric (SWV) response resulted in two linear concentration ranges of 1-10 (R2 = 0.9995) and 15-50 µM (R2 = 0.9988) with a detection limit of 0.42 µM, which is significantly lower. The GA@PAni-CNT electrode demonstrated the best detection, sensitivity, and performance among the investigated electrodes for indirect voltammetric determination of NO3- that portrayed the possibility of utilizing GA-stabilized PAni and CNT nanocomposite materials in additional electrochemical sensing applications.

Long-term health after Severe Acute Malnutrition in children and adults- the role of the Pancreas (SAMPA): Protocol.

Background: Prenatal growth retardation may increase the risk of later chronic non-communicable diseases (NCDs), including diabetes; however, long-term effects of wasting malnutrition in childhood or adulthood are less studied. Pancreatic exocrine and endocrine functions, both critical for nutrition and NCD aetiology, may not fully recover following malnutrition. However, the evidence and mechanistic information is piecemeal. We hypothesise that wasting malnutrition at any age has long-term detrimental effects on endocrine and exocrine pancreatic structure and function. Methods: The SAMPA international research programme will assess pancreatic structure and function in 3700 participants from ongoing observational nutrition cohorts, two adolescent and four adult, in Zambia, Tanzania, Philippines, and India. Pancreas size, structure, and calcification will be assessed by ultrasound and computed tomography (CT) scan; exocrine function by faecal elastase and serum lipase; and endocrine function by haemoglobin A1c (HbA1c) and blood glucose, insulin and C-peptide concentrations during an oral glucose tolerance test (OGTT). In-depth hormonal analyses of incretins, glucagon, proinsulin and trypsinogen during OGTT and intravenous glucose tolerance tests will be done in subsets of adult participants. Pancreatic size and function outcomes will be compared between people with and without prior wasting malnutrition. Analyses will investigate effect modification by sex, current age, time since malnutrition, current body mass index and dietary patterns. Mathematical modelling of OGTT data will be used to estimate the relative contribution to glucose dysregulation of decreased insulin production, changes in insulin clearance and increased insulin resistance. Proinsulin/insulin ratio will be analysed in archived samples from the Tanzanian cohort using a nested case-control design to investigate whether abnormal values precede diabetes. Conclusions: SAMPA, a large-scale multi-centre research programme using data from people with or without prior wasting malnutrition to assess several aspects of pancreatic phenotype, will provide coherent evidence for future policies and programmes for malnutrition and diabetes.

Sex and Aggression Characteristics in a Cohort of Patients with Pediatric Acute-Onset Neuropsychiatric Syndrome.

Objective: This study describes for the first time the characteristics by sex of patients with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), including clinical phenotype, treatment, and psychosocial aspects of disease. Methods: This cross-sectional study included 205 consecutive community patients evaluated between January 1, 2012 and March 30, 2019 and compared 87 females with 118 males. Our primary hypothesis was that males would display more aggression, as measured by the Modified Overt Aggression Scale (MOAS) and would be treated with immunotherapy earlier than females. The MOAS began to be administered 5 years into the study period, and 57 of the 205 families completed the MOAS for this study. Results: Our analysis revealed that males had a higher median MOAS score in the first year of clinic when compared with females (median 11, interquartile range [IQR] [4-24] vs. median 3, IQR [1-9]; p = 0.03) and a higher median subscore for physical aggression (median 4, IQR [0-12] vs. median 0, IQR [0-8]; p = 0.05). The median time from PANS symptom onset to first administration of immunotherapy, which did not include nonsteroidal anti-inflammatory drugs or short bursts of oral steroids, was 6.9 years for females and 3.7 years for males (p = 0.20). The two groups did not differ significantly in age of PANS onset, time from onset to clinic entry, other psychiatric symptom measures, or laboratory markers of inflammation. Conclusion: Among patients with PANS, males exhibit more aggressive behavior when compared with females, which may advance the decision to treat with immunotherapy. Scores that capture a more global level of functioning show that despite there being a higher level of aggression in males, female patients with PANS have similar levels of overall impairment.

Effect of national cultural dimensions and HIV prevalence rates on stigma towards people living with HIV/AIDS.

This paper examines the main and interactive effects of national culture dimensions and HIV prevalence rates on stigma towards people living with HIV/AIDS (PLHIVA). We examined these various relationships using data from a sample of 68,041 individuals from 49 countries, obtained from the World Values Survey. We used Hierarchical Linear Modeling to conduct our cross-level analyses. Our results indicated that collectivistic societies were positively associated while egalitarian and performance-oriented societies were negatively associated with stigma towards PLHIVA. Additionally, HIV prevalence rates interact with several cultural dimensions to worsen stigma towards PLHIVA. Our findings indicate the need to tailor stigma reduction strategies by taking the national culture dimensions of a given society into consideration when designing and implementing programs.