Conference report: Dhara - Vision Ayurveda 2047.

The Dhara-Ayurveda 2047 conference was organized at the University of Trans-Disciplinary Health Sciences and Technology (TDU), Bengaluru on 23rd and September 24, 2022. This was a pioneering initiative of Ministry of Culture and Ministry of Ayush to raise public awareness about the contemporary relevance of India's medical heritage. The theme of the conference was to offer innovative approaches to strengthen and globalize Ayurveda by the year 2047 to commemorate 100th year of independence of India. More than 2000 delegates from academia and industries attended this event. This conference featured a range of components including insightful vision talks, educational exhibition, interactive practical sessions, innovation-focused competition, cultural programs, and health assessment program. Distinguished speakers shared their forward-looking perspectives on the future of Ayurveda in the year 2047 with respect to personalized nutrition, Ayurvedic healthcare, interdisciplinary medicine, AYUSH integration, Ayurvedic industry, and other related topics. The conference provided a platform for students to learn innovative approaches in Ayurveda and also awarded deserving winners for their ideas. Thus, Dhara-Ayurveda 2047 conference served as a valuable platform for sharing knowledge and exploring the future of Ayurveda in India across different disciplines related to Ayurveda like biomedical sciences and engineering, information technology, pharmaceutical sciences and folk healers to visualize Ayurveda in the year 2047.

How social norms and values shape household healthcare expenditures and resource allocation: Insights from India.

We present a novel perspective on thinking about and studying healthcare spending in contexts where few health-related financial risk protection mechanisms exist and where out-of-pocket spending by households is the norm. Drawing on interviews conducted across 20 villages in two states of India, we illustrate and problematize how a complex interplay of social norms and cultural factors underpin spending decisions within households in such contexts. While our analysis draws on the fieldwork at large, we present our findings through selected narratives - stories of patients suffering from chronic breathlessness. We engage with and reveal the various ways in which social norms dynamically drive this household economy, and shape resource allocation-related decisions. We conclude that in health system contexts where out-of-pocket spending by households is the norm, it is essential to recognise the pragmatic and calculative nature of intra-household allocation of resources, and how it involves bargaining and negotiations at the intersection of social norms, economic class, caste, gender, age, and productive status. And at the same time, how all of this occurs within the economy of the family, and how it plays out differently for different members of a family is also important to recognise. Such recognition can not only help one better appreciate how this household level economy may sometimes maintain and perpetuate entrenched hierarchies and gender inequities, crucially, it can help target health related social protection policies and strategies and make them more responsive to the needs of the most vulnerable in the society and within households.

Vitamin D Deficiency in Chronic Childhood Disorders: Importance of Screening and Prevention.

Vitamin D plays a vital role in regulating calcium and phosphate metabolism and maintaining bone health. A state of prolonged or profound vitamin D deficiency (VDD) can result in rickets in children and osteomalacia in children and adults. Recent studies have demonstrated the pleiotropic action of vitamin D and identified its effects on multiple biological processes in addition to bone health. VDD is more prevalent in chronic childhood conditions such as long-standing systemic illnesses affecting the renal, liver, gastrointestinal, skin, neurologic and musculoskeletal systems. VDD superimposed on the underlying disease process and treatments that can adversely affect bone turnover can all add to the disease burden in these groups of children. The current review outlines the causes and mechanisms underlying poor bone health in certain groups of children and young people with chronic diseases with an emphasis on the proactive screening and treatment of VDD.

Outlandish pancreatic pseudocyst: A case report.

Pseudocysts in the perinephric region are rare and pose a diagnostic dilemma. We present the case of a 54-year-old male with left perirenal pancreatic pseudocyst. The diagnosis was enabled via proper clinical history taking and imaging investigations. The patient was successfully managed with definitive primary surgical treatment. This report highlights difficulties in diagnosis and treatment.

Cirrhosis of the Liver: A Case Report and Literature Review of a Rare Case Presentation of Autoimmune Hepatitis With Systemic Sclerosis.

Systemic sclerosis (SSc) is a chronic systemic disease that affects the skin, heart, lungs, kidneys, gastrointestinal tract, and musculoskeletal system. Although gastrointestinal involvement has been reported in approximately 90% of scleroderma patients, liver involvement is uncommon. A 51-year-old female was admitted to the hospital due to abdominal distension and pedal edema. She had a history of Raynaud's syndrome and multiple hypopigmented and hyperpigmented patches over her body for the last year. Her ascetic fluid analysis was transudative with a serum ascites albumin gradient >1.1, and the abdomen and pelvis ultrasonography reported liver cirrhosis with splenomegaly with perisplenic varices. Her antinuclear antibody and anti-centromere antibody were positive. Skin thickening was visible. Her alanine aminotransferase (ALT), aspartate aminotransferase (AST), and serum globulin were raised. Viral serology was negative. We managed her with diuretics, beta-blockers, prednisolone (30 mg/day administered orally), angiotensin-converting enzyme inhibitors, and calcium channel blockers. Edema and abdominal distension decreased with this management, and no Raynaud's phenomenon was observed during the hospital stay.

People's care seeking journey for a chronic illness in rural India: Implications for policy and practice.

Drawing on interviews conducted in 2019-2020, across twenty villages in India, this paper unpacks how people with chronic illness navigate complex care-seeking terrain. We show how the act of seeking care involves navigating through personal, family, social, economic, cultural, and most importantly, difficult health systems spaces-and entails making difficult social, moral, and financial choices. We show how the absence of reliable and accessible points of first contact for primary care results in people running from pillar to post, taking wrong turns, and becoming disappointed, frustrated, and, sometimes, impoverished. We reveal the complex individual and social dynamics of hope and misplaced and misguided expectations, as well as social obligations and their performance that animate the act of navigating care in rural India. We shine light on how a health system with weak primary care and poor regulation amplifies the medical, social, and financial consequences of an otherwise manageable chronic illness, and how these consequences are the worst for those with the least social, network and economic capital. Crucially we highlight the problematic normalisation of the absence of reliable primary care services for chronic illness in India, in rural India specifically. We signpost implications for research, and for policy and practice in India and similar health system contexts, i.e. those with weak primary care and poor regulation of the private sector. We argue that in India, having in place accessible, good quality, and trustworthy sources of advice and care for chronic illness at the first point of call, for all, is critical. We contend that this first point of call should be quality, public primary care services. We conclude that if such arrangements are in place in public services, people will use them.

Association of Physical Activity with Lipid Profile in Healthy Subjects: A Cross Sectional Study in Tertiary Care Hospital from Central Rural India.

Context: Physical activity is an important factor for healthy aging, and lack of it has been associated with chronic noncommunicable diseases (NCDs). Research in sedentary behavior has indicated that it is an independent risk factor of morbidity and mortality, separate from lack of physical activity. Methods: This cross-sectional study was conducted in the department of medicine in a tertiary care hospital on apparently healthy relatives of patients without chronic NCDs. Metabolic equivalents of tasks (METs) were calculated by the global physical activity questionnaire (GPAQ). Statistical Analysis: We correlated the various parameters [age, sex, body mass index (BMI), waist-hip ratio (WHR), and lipid panel with METs] by Pearson correlation coefficient. Observations and Results: Total of 750 patients with a mean age of 42.55 ± 10.93 years were included, and 389 (51.9%) were male in the present study. In our study, a strong negative correlation was found between physical activity and BMI, moderate negative correlation between physical activity with triglycerides (TG), total cholesterol (TC), and WHR. There was a high degree of positive correlation between sedentary lifestyle (SLS) duration with BMI and TC. A moderate degree positive correlation was found between SLS duration and WHR, TG, and low-density lipoproteins (LDL). Conclusion: The clinician should be aware of various obesity indices, and it was found that lipid profile is inversely correlated with physical activity and directly correlated with SLS in healthy individuals. Lifestyle changes and exercise may reduce obesity and lipid disorders and thereby reduce further development of complications in those patients.

Combining fluorescent cell barcoding and flow cytometry-based phospho-ERK1/2 detection at short time scales in adherent cells.

Detection of levels of intracellular phospho-proteins is key to analyzing the dynamics of signal transduction in cellular systems. Cell-to-cell variability in the form of differences in protein level in each cell affects signaling and is implicated in prognosis of many diseases. Quantitative analysis of such variability necessitate measuring the protein levels at single-cell resolution. Single-cell intracellular protein abundance detection in statistically significant number of adherent cells for short time sampling points post stimulation using classical flow cytometry (FCM) technique has thus far been a challenge due to the detrimental effects of cell detachment methods on the cellular machinery. We systematically show that cell suspension obtained by noninvasive temperature-sensitive detachment of adherent cells is amenable to high-throughput phospho-ERK1/2 protein detection at single-cell level using FCM in these short time sampling points. We demonstrate this on three adherent cell lines, viz., HeLa, A549, and MCF7, from distinct lineages having characteristically different elasticity at 37 °C. In particular, we use a right combination of multiplexing via fluorescent cell barcoding (FCB) and intracellular antibody staining for simultaneous detection of phospho-ERK1/2 (pERK) stimulated by epidermal growth factor (EGF) in multiple samples. Based on systematic characterization using Alexa 350 dye, we arrive at two conditions that must be satisfied for correct implementation of FCB. Our study reveals that the temperature-sensitive detachment of HeLa cells correctly captures the expected pronounced bimodal pERK distribution as an early response to EGF, which the enzymatic treatment methods fail to detect. © 2018 International Society for Advancement of Cytometry.

Magnesium single crystals for biomedical applications grown in vertical Bridgman apparatus.

This paper describes successful efforts to design, build, test, and utilize a single crystal apparatus using the Bridgman approach for directional solidification. The created instrument has been successfully tested to grow magnesium single crystals from melt. Preliminary mechanical tests carried out on these single crystals indicate unique and promising properties, which can be harnessed for biomedical applications.

In vivo monitoring the biodegradation of magnesium alloys with an electrochemical H2 sensor.

UNLABELLED: Monitoring the biodegradation process of magnesium and its alloys in vivo is challenging. Currently, this process is monitored by micro-CT and X-ray imaging in vivo, which require large and costly instrumentation. Here we report a simple and effective methodology to monitor the biodegradation process in vivo by sensing H2 transdermally above a magnesium sample implanted subcutaneously in a mouse. An electrochemical H2 microsensor was used to measure the biodegradation product H2 at the surface of the skin for two magnesium alloys (ZK40 and AZ31) and one high purity magnesium single crystal (Mg8H). The sensor was able to easily detect low levels of H2 (30-400µM) permeating through the skin with a response time of about 30s. H2 levels were correlated with the biodegradation rate as determined from weight loss measurements of the implants. This new method is noninvasive, fast and requires no major equipment. STATEMENT OF SIGNIFICANCE: Biomedical devices such as plates and screws used for broken bone repair are being developed out of biodegradable magnesium alloys that gradually dissolve when no longer needed. This avoids subsequent removal by surgery, which may be necessary if complications arise. A rapid, non-invasive means for monitoring the biodegradation process in vivo is needed for animal testing and point of care (POC) evaluation of patients. Here we report a novel, simple, fast, and noninvasive method to monitor the biodegradation of magnesium in vivo by measuring the biodegradation product H2 with an electrochemical H2 sensor. Since H2 rapidly permeates through biological tissue, measurements are made by simply pressing the sensor tip against the skin above the implant; the response is within 30s.

Biodistribution of P-selectin targeted microbubbles.

PURPOSE: To evaluate binding of P-selectin targeted microbubbles (MB) in tumor vasculature; a whole-body imaging and biodistribution study was performed in a tumor bearing mouse model. METHODS: Antibodies were radiolabeled with Tc-99 m using the HYNIC method. Tc-99 m labeled anti-P-selectin antibodies were avidin-bound to lipid-shelled, perfluorocarbon gas-filled MB and intravenously injected into mice bearing MDA-MB-231 breast tumors. Whole-body biodistribution was performed at 5 min (n = 12) and 60 min (n = 4) using a gamma counter. Tc-99 m-labeled IgG bound IgG-control-MB group (n = 12 at 5 min; n = 4 at 60 min), Tc-99 m-labeled IgG-control-Ab group (n = 5 at 5 min; n = 3 at 60 min) and Tc-99 m-labeled anti P-selectin-Ab group (n = 5 at 5 min; n = 3 at 60 min) were also evaluated. Planar gamma camera imaging was also performed at each time point. RESULTS: Targeted-MB retention in tumor (60 min: 1.8 ± 0.3% ID/g) was significantly greater (p = 0.01) than targeted-MB levels in adjacent skeletal muscle at both time points (5 min: 0.7 ± 0.2% ID/g; 60 min: 0.2 ± 0.1% ID/g) while there was no significant difference (p = 0.17) between muscle and tumor retention for the IgG-control-MB group at 5 min. CONCLUSIONS: P-selectin targeted MBs were significantly higher in tumor tissue, as compared with adjacent skeletal tissue or tumor retention of IgG-control-MB.