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Abstract Glioblastoma multiforme (GBM), a WHO grade IV diffuse glioma, is a highly aggressive brain tumor with a median survival of less than a year. Characterized by robust proliferation and invasion, recent studies spotlight glioma stem cells (GSCs) within GBM tumors, pivotal in tumor development, progression, and treatment resistance. This review aims to shed light on the critical role of GSCs in the initiation and progression of GBM, emphasizing their contribution to tumor development and resistance to existing treatments. Unlike normal stem cells, GSCs play a pivotal role in GBM pathogenesis. The review delves into the unique characteristics of GSCs, marked by heightened metabolic activities and distinct epigenetic and transcriptional programming. Recognizing the significance of GSCs in recent years, the review examines how their presence amplifies the lethal nature of GBM. The review also critically evaluates recent advancements in glioma and GBM diagnostic methods and treatment therapies, which also include targeting GSCs. Providing a concise yet comprehensive overview, the review contributes insights into GBM's intricate dynamics, offering potential directions for future research and therapeutic strategies.

ABSTRACT: Background: The health and nutritional status of young children is an index of national investment within the development of its future manpower. There is a limited data available on health profile among adolescents in India. Thus, this study was undertaken with the target of assessing the nutritional status and morbidity pattern of school children Jodhpur district of Rajasthan. The objectives of this study were to assess the health profile including general physical examination, anthropometric measurements, morbidity pattern and addiction among school-going children of Jodhpur. Material and Methods: A school-based observational cross-sectional study was carried out among the nearby schools pertaining to our urban and rural health centres associated with the Department of Community Medicine and Family Medicine, AIIMS Jodhpur. Result: A total of 525 school children participated in the study. On general physical examination, it was observed that the majority (4.1%) of the school children from rural area were seen with 'flag sign' in comparison with those in urban region. Fluorosis was observed in the majority (60.2%) in rural schools in comparison with urban and this was found to be statistically significant (P = 0.000). The majority (21, 0.04%) of them were suffering from hearing loss, among them (13,61.9%) were from rural area in comparison with (08, 38.1%) in urban and this difference was found to be statistically significant. (0.000*). Anaemia was observed in (210, 40.0%) of the school children. Conclusion: The study brings out the need for intensified and targeted school health awareness programmes for school-going children and utilization of various services. [ABSTRACT FROM AUTHOR]

Integrating Ayurveda, Yoga, Unani, Siddha, and Homoeopathy (AYUSH) into preventive medicine enhances holistic health care by addressing lifestyle, mental well-being, and disease prevention. This integration is vital for addressing India's quadruple burden of non-communicable diseases (NCDs), communicable diseases, poor maternal and child health (MCH) outcomes, and an aging population. The National Health Policy 2017 promotes this integration through "Pluralism," aligning with the World Health Organization (WHO)'s Sustainable Development Goal (SDG) 3 and global traditional medicine priorities. Essential actions include adopting integrative care models, standardizing treatment protocols, training healthcare professionals, and advancing research. Despite its promise, challenges persist, such as limited awareness among modern physicians, minimal interaction between practitioners, lack of standardized protocols, and insufficient research on AYUSH's synergistic effects. The Indian Association of Preventive and Social Medicine (IAPSM) can play a pivotal role in overcoming these barriers. By advocating for policy development, adopting integrative care frameworks, and fostering educational and research collaborations with AYUSH institutes, IAPSM can advance the integration of AYUSH into preventive medicine. Promoting research and increasing public awareness of AYUSH's role in disease prevention and health promotion is essential for achieving a comprehensive healthcare system. [ABSTRACT FROM AUTHOR]

BackgroundIndian Diabetic Risk Score (IDRS) and Community Based Assessment Checklist (CBAC) are easy, inexpensive, and non-invasive tools that can be used to screen people for Metabolic Syndrome (Met S). The study aimed to explore the prediction abilities of IDRS and CBAC tools for Met S.MethodsAll the people of age ≥30 years attending the selected rural health centers were screened for Met S. We used the International Diabetes Federation (IDF) criteria to diagnose the Met S. ROC curves were plotted by taking Met S as dependent variables, and IDRS and CBAC scores as independent/prediction variables. Sensitivity (SN), specificity (SP), Positive and Negative Predictive Value (PPV and NPV), Likelihood Ratio for positive and negative tests (LR+ and LR-), Accuracy, and Youden's index were calculated for different IDRS and CBAC scores cut-offs. Data were analyzed using SPSS v.23 and MedCalc v.20.111.ResultsA total of 942 participants underwent the screening process. Out of them, 59 (6.4%, 95% CI: 4.90-8.12) were found to have Met S. Area Under the Curve (AUC) for IDRS in predicting Met S was 0.73 (95%CI: 0.67-0.79), with 76.3% (64.0%-85.3%) sensitivity and 54.6% (51.2%-57.8%) specificity at the cut-off of ≥60. For the CBAC score, AUC was 0.73 (95%CI: 0.66-0.79), with 84.7% (73.5%-91.7%) sensitivity and 48.8% (45.5%-52.1%) specificity at the cut-off of ≥4 (Youden's Index, 2.1). The AUCs of both parameters (IDRS and CBAC scores) were statistically significant. There was no significant difference (p = 0.833) in the AUCs of IDRS and CBAC [Difference between AUC = 0.00571].ConclusionThe current study provides scientific evidence that both IDRS and CBAC have almost 73% prediction ability for Met S. Though CBAC holds relatively greater sensitivity (84.7%) than IDRS (76.3%), the difference in prediction abilities is not statistically significant. The prediction abilities of IDRS and CBAC found in this study are inadequate to qualify as Met S screening tools.

Background: The aim of the present study was to recalibrate the effectiveness of Indian Diabetes Risk Score (IDRS) and Community-Based Assessment Checklist (CBAC) by opportunistic screening of Diabetes Mellitus (DM) and Hypertension (HT) among the people attending health centres, and estimating the risk of fatal and non-fatal Cardio-Vascular Diseases (CVDs) among them using WHO/ISH charts.Methods: All the people aged ≥ 30 years attending the health centers were screened for DM and HT. Weight, height, waist circumference, and hip circumferences were measured, and BMI and Waist-Hip Ratio (WHR) were calculated. Risk categorization of all participants was done using IDRS, CBAC, and WHO/ISH risk prediction charts. Individuals diagnosed with DM or HT were started on treatment. The data was recorded using Epicollect5 and was analyzed using SPSS v.23 and MedCalc v.19.8. ROC curves were plotted for DM and HT with the IDRS, CBAC score, and anthropometric parameters. Sensitivity (SN), specificity (SP), Positive Predictive Value (PPV), Negative Predictive Value (NPV), Accuracy and Youden's index were calculated for different cut-offs of IDRS and CBAC scores.Results: A total of 942 participants were included for the screening, out of them, 9.2% (95% CI: 7.45-11.31) were diagnosed with DM for the first time. Hypertension was detected among 25.7% (95% CI: 22.9-28.5) of the participants. A total of 447 (47.3%) participants were found with IDRS score ≥ 60, and 276 (29.3%) with CBAC score > 4. As much as 26.1% were at moderate to higher risk (≥ 10%) of developing CVDs. Area Under the Curve (AUC) for IDRS in predicting DM was 0.64 (0.58-0.70), with 67.1% SN and 55.2% SP (Youden's Index 0.22). While the AUC for CBAC was 0.59 (0.53-0.65). For hypertension both the AUCs were 0.66 (0.62-0.71) and 0.63 (0.59-0.67), respectively.Conclusions: IDRS was found to have the maximum AUC and sensitivity thereby demonstrating its usefulness as compared to other tools for screening of both diabetes and hypertension. It thus has the potential to expose the hidden NCD iceberg. Hence, we propose IDRS as a useful tool in screening of Diabetes and Hypertension in rural India. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic overburdened the healthcare system and affected the mental health of healthcare workers. Yoga has proven to improve mental health correlates, within diverse population groups, including healthcare workers. Considering the pandemic-imposed restrictions, this trial was designed to study the feasibility and effect of tele-yoga intervention on burnout, sleep quality, depression, anxiety, stress, mindfulness, and immune markers of healthcare workers on COVID-19 duty., Methods: This randomized controlled trial was conducted in a tertiary care hospital. Tele-yoga intervention was delivered five days a week for 8 weeks. Stanford Professional Fulfilment Index (SPFI), Pittsburg Sleep Quality Index (PSQI), Depression Anxiety and Stress Scale (DASS-21), Mindfulness Attention Awareness Scale (MAAS) were used to assess the burnout, sleep quality, depression, anxiety, stress and mindfulness. Blood samples were assessed for TNF-α, IL-6 and serum cortisol levels., Results: A total of 147 healthcare workers were screened to achieve a sample size of 90 (45 each in tele-yoga intervention and control group). Of the 45 subjects in the intervention group, 35 attended at least 50 % of sessions over 8 weeks, at the rate of 3.35 sessions per week. Nearly 37.14 % of subjects among 35 were able to attend more than 70 % of the tele-yoga sessions. At the endline, 35 in the intervention and 37 in the control group completed the outcome questionnaires. On both per protocol (PPA) and intention to treat analyses (ITT) the burnout index, PSQI, anxiety and stress scores and IL-6 and serum cortisol level were significantly lower among the tele-yoga group compared to control group participants (p<0.05) at the endline. The effect size was medium (r=0.3-0.5) favoring intervention group for most of the parameters., Conclusions: Tele-yoga is a feasible and accessible intervention for improving burnout, sleep quality, and reducing anxiety, stress, IL-6, and serum cortisol among healthcare workers in tertiary care hospitals during the COVID-19 pandemic. Being a single-center pilot study in India and with other methodological limitations, the generalizability of the study findings is restricted., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

While mitotic spindle inhibitors specifically kill proliferating tumor cells without the toxicities of microtubule poisons, resistance has limited their clinical utility. Treating glioblastomas with the spindle inhibitors ispinesib, alisertib, or volasertib creates a subpopulation of therapy induced senescent cells that resist these drugs by relying upon the anti-apoptotic and metabolic effects of activated STAT3. Furthermore, these senescent cells expand the repertoire of cells resistant to these drugs by secreting an array of factors, including TGFβ, which induce proliferating cells to exit mitosis and become quiescent-a state that also resists spindle inhibitors. Targeting STAT3 restores sensitivity to each of these drugs by depleting the senescent subpopulation and inducing quiescent cells to enter the mitotic cycle. These results support a therapeutic strategy of targeting STAT3-dependent therapy-induced senescence to enhance the efficacy of spindle inhibitors for the treatment of glioblastoma., Competing Interests: Christian T. Meyer is a co-founder and part equity holder in Duet BioSystems. Steven S. Rosenfeld is a member of the External Advisory Board of Myosin Therapeutics and is part equity holder in this company. The authors declare no competing interests., (© 2024 The Author(s).)

Background: Medicines in indigenous systems such as Ayurveda have strong antimicrobial activity but double-blind randomized control trials are infrequent in this system of medicine. The efficacy of a new ayurvedic formulation was evaluated during the pandemic., Methods: 150 mild-moderate COVID-19 patients were enrolled and randomized in 1:1 to NAOQ19 and placebo group. RT-PCR was done on Day 3, 5 and 7. CBC, CRP, LFT, and KFT were assessed at baseline and exit. Duration of hospital stay was noted and clinical assessment was also performed., Result: The results demonstrated more people turning RT-PCR negative in the NAOQ19 group compared to the placebo group on day 3 (p-value = 0.033). The mean time duration to turn RT-PCR negative was significantly lower in the NAOQ19 group (4.6 days) compared to placebo group (5.2 days) (p-value = 0.018). There was significant reduction in hospital stay among patients in the NAOQ19 arm who were discharged earlier (5.6 days) compared to placebo group (6.4 days) (p-value = 0.046). Patients in NAOQ19 arm did not show any adverse life-threatening events., Conclusion: The ayurvedic preparation given along with standard of care therapy reduced the duration of hospital stay and there was earlier conversion to RT-PCR negative.The integrated approach can help to reduce patient workload in the hospitals as well as limit the transmission of the virus in the community., Study Registration: CTRI/2021/05/033790., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: 'Frailty' has no consensual definition till date, although the term occupies a pivotal role in geriatric medicine. A bibliometric analysis of the literature serves to capture the keyword cooccurrences and linkages, co-citations, author collaborations, research trends and to present the extant research in a nutshell., Objective: To explore the usage of frailty, its domains in medical research and the evolution of the term to other disciplines through systematic mapping by bibliometric analysis., Methods: Literature search was done in the Scopus database using a pre-formed search strategy. 2629 documents were retrieved. Co-occurrence citation analysis using keywords and link strength was obtained using the VOSviewer ver.1.6.16. A three-field plot was constructed using 'biblioshiny' package of the R-studio to identify the various domains of frailty. Descriptive statistics were applied to identify the trends in frailty research, number of contributions from countries, fields of research involving frailty., Results: Total of 3739 publications were observed, with the USA having most number of contributions (740, 20%) as single country, while India has only 19 contributions (0.5%) in the past 20 years. As a region, Europe and Central Asia contributed to the maximum (1714, 46.4%), most of them being from the high-income countries. Research on frailty has steadily increased over the past two decades, with most of the researches being conducted in the fields of Medicine, Biochemistry and Genetics. Cooccurrence citations and three-field plots indicate the evolving usage of frailty in other domains, such as cognition, mental health, indicators of survival, risk assessment, mortality, and quality of life., Conclusion: Upon exploring frailty, it also makes one wonder if frailty could be the cause for what is known as death due to 'natural causes' or 'old age'. The implementation of extension codes in the ICD-11 related to 'Ageing' (XT9T) and 'Old Age' (MG2A), paves way for researchers to further explore 'frailty' as a cause of mortality., Competing Interests: None

Severe pain experienced by patients with oral submucous fibrosis (OSMF) compromises their physiotherapy and negatively affects the surgical outcome and the patient's compliance. The main aim of this study was to develop a protocol for pain control in the management of OSMF postoperatively. This was a prospective, parallel with active control, double-arm, triple-blinded, randomised control trial (RCT) with 48 OSMF patients, randomised into two groups - Group A (control, n = 25): received non-opioid analgesics (NSAIDs) and Group B (cases, n = 23): received transdermal fentanyl patches (TFP). Pain and interincisal opening were measured on postoperative days 1, 3, 5, 7, 9, and 15, and on the1 st and 3 rd postoperative months. Quality of Life (QoL) was assessed preoperatively, on the 15 th day postoperatively, and 3 rd month postoperatively, and compliance was documented postoperatively on the 9 th day. The transdermal fentanyl patch was found to have statistically significantly more effect in controlling severe pain during active mouth opening exercises, and thus significantly increased the patients' compliance. Although there was increased mouth opening and QoL in the fentanyl group, the differences were statistically insignificant. Our study recommends the use of TFP for better pain control and compliance in postoperative OSMF patients., (Copyright © 2022. Published by Elsevier Ltd.)

Competing Interests: There are no conflicts of interest.

Context: It was hypothesized that knowledge of skilled birth attendants (SBAs) about partograph and its utilization can be improved by modifying their predictors through training workshops., Aim: To upgrade the knowledge regarding partograph and its utilization by SBAs by modifying their predictors through training workshops., Settings and Design: This was an intervention study, which was conducted in a rural area of the Jodhpur district of Rajasthan state., Subjects and Methods: The SBAs were interviewed through pre and postintervention with the help of a prevalidated semi-structured interview schedule. As a part of an intervention, a series of half-day training workshops were conducted in the intervention block. Data were analyzed using SPSS version 23., Statistical Analysis Used: Descriptive statistics, univariate (Chi-square, t -test), and multivariate (logistic regression) analysis., Results: A total of 213 SBAs (105 from intervention and 108 from control block) were included in the study. SBAs who had received training related to the partograph were having significantly higher odds of knowing (AOR = 22.6[10.7-47.9]) as well as utilization (AOR = 22.5[7.05-72.1]) of partographs as compared to their counterparts. Knowledge was also a significant predictor of the utilization of partograph. Intervention could significantly improve the knowledge of SBAs about partograph as well as its utilization in the intervention block., Conclusion: Significant impact of the intervention on knowledge about partograph and its utilization was evidenced in the present study. There is a need to conduct training and refresher courses for healthcare workers on partograph use., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Family Medicine and Primary Care.)