Challenges in understanding the epidemiology of acquired brain injury in India.

An acquired brain injury (ABI) is an injury to the brain, which is not hereditary, congenital, degenerative, or induced by birth trauma. In India, rapid urbanization, economic growth and changes in lifestyle have led to a tremendous increase in the incidence of ABI, so much so that it is being referred to as a 'silent epidemic'. Unlike developed countries, there is no well-established system for collecting and managing information on various diseases in India. Thus it is a daunting task to obtain reliable information about acquired brain injury. In the course of conducting a systematic review on the epidemiology of ABI in India, we recognized several challenges which hampered our effort. Inadequate case definition, lack of centralized reporting mechanisms, lack of population based studies, absence of standardized survey protocols and inadequate mortality statistics are some of the major obstacles. Following a standard case definition, linking multiple hospital-based registries, initiating a state or nationwide population-based registry, conducting population-based studies that are methodologically robust and introducing centralized, standard reporting mechanisms for ABI, are some of the strategies that could help facilitate a thorough investigation into the epidemiology and understanding of ABI. This may help improve policies on prevention and management of acquired brain injury in India

Phytochemical screening and antimicrobial activity of leaf extracts of Crossandra infundibuliformis (L.) nees on common bacterial and fungal pathogens

Abstract The medicinally active substances were isolated from leaves of Crossandra infundibuliformis by Soxhlet extractor and identified by phytochemical tests. The soxhlet extraction in powdered form was performed using aqueou

Evaluating the Effectiveness of Interventions to Improve the Follow-up Rate for Children With Visual Disabilities in an Eye Hospital in Nepal: Nonrandomized Study

Background: Monitoring ocular morbidity among pediatric patients requires regular follow-up visits. We found that the follow-up rate was poor among children in our setting. Therefore, we intended to assess the effectiveness of 2 interventions—(1) counseling and (2) SMS text messaging and phone calls—to improve the follow-up rates. Objective: This study aimed to evaluate the effectiveness of 2 interventions, counseling and SMS and phone calls group, as well as a routine standard care for improving the follow-up rate of pediatric patients. Methods: A Nonrandomized, quasiexperimental design was used. Children (aged 0-16 years) with ocular conditions requiring at least 3 follow-up visits during the study period were included. A total of 264 participants were equally allocated to the 3 intervention groups of (1) counseling, (2) SMS and phone calls, and (3) routine standard care group. A 20-minute counseling session by a trained counselor with the provision of disease-specific leaflets were given to those in the counseling group. For the second intervention group, parents of children received an SMS text 3 days before and a phone call 1 day before their scheduled follow-up visits. Participants allocated for the routine standard care group were provided with the existing services with no additional counseling and reminders. Participants attending 3 follow-ups within 2 days of the scheduled visit date were considered compliant. The difference in and among the proportion of participants completing all 3 follow-up visits in each group was assessed. Results: The demographic characteristics of the participants were similar across the study groups. Only 3% (8/264) of participants completed all 3 follow-up visits, but overall compliance with the follow-up, as defined by the investigators, was found to be only 0.76% (2/264). There was no statistically significant difference in the proportion of follow-up between the intervention groups. However, the proportion of participants attending the first and second follow-ups, as well as the overall total number of follow-ups, was more in the SMS and phone-call group followed by the counseling group. Conclusions: We did not find any evidence on the effectiveness of our interventions to improve the follow-up rate. The primary reason could be that this study was conducted during the COVID-19 pandemic. It could also be possible that the intensity of the interventions may have influenced the outcomes. A rigorously designed study during the absence of any lockdown restrictions is warranted to evaluate intervention effectiveness. The study also provides useful insights and highlights the importance of designing and systematically developing interventions for improving the follow-up rate and ensuring a continuum of care to children with visual disabilities in Nepal and similar contexts. Trial Registration: ClinicalTrials.gov NCT04837534; https://clinicaltrials.gov/ct2/show/NCT04837534 International Registered Report Identifier (IRRID): RR2-10.2196/3157

Challenges in understanding the epidemiology of acquired brain injury in India

An acquired brain injury (ABI) is an injury to the brain, which is not hereditary, congenital, degenerative, or induced by birth trauma. In India, rapid urbanization, economic growth and changes in lifestyle have led to a tremendous increase in the incidence of ABI, so much so that it is being referred to as a ′silent epidemic′. Unlike developed countries, there is no well-established system for collecting and managing information on various diseases in India. Thus it is a daunting task to obtain reliable information about acquired brain injury. In the course of conducting a systematic review on the epidemiology of ABI in India, we recognized several challenges which hampered our effort. Inadequate case definition, lack of centralized reporting mechanisms, lack of population based studies, absence of standardized survey protocols and inadequate mortality statistics are some of the major obstacles. Following a standard case definition, linking multiple hospital-based registries, initiating a state or nationwide population-based registry, conducting population-based studies that are methodologically robust and introducing centralized, standard reporting mechanisms for ABI, are some of the strategies that could help facilitate a thorough investigation into the epidemiology and understanding of ABI. This may help improve policies on prevention and management of acquired brain injury in India

Unraveling the Multi-Target Pharmacological Mechanism of Brassica rapa in Diabetes Treatment: Integration of Network Pharmacology and Molecular Docking Approaches

Brassica rapa has been widely reported as an anti-diabetic plant and is widely used in traditional medicine for the treatment of various disorders. However, the molecular mechanism underlying the plant's anti-diabetic activity has not been elucidated. Therefore, the present study aimed to investigate the possible molecular mechanism of B.rapa for managing diabetes mellitus through network pharmacology and molecular docking studies. The active ingredients and associated target proteins were obtained from a literature review and the Swiss Target Prediction platform and validated using the PubChem database. The disease-associated genes were retrieved from the Genecard database. The B. rapa-DM target network was analyzed using the STRING database, and the results were integrated and visualized using Cytoscape software. The molecular mechanism and therapeutic effect of B.rapa for the treatment of DM were determined by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses using the Enrichr Platform. Fifty-two active ingredients were screened from B. rapa, and 1528 putative target genes were identified from these ingredients. Four hundred and fifty-four overlapping targets matched with DM were considered potential therapeutic targets. First, ten key targets (ALB, AKT1, TNF, GAPDH, MAPK3, EGFR, VEGFA, CTNNB1, CASP3, and STAT3) were found by topological analysis. Then, the results of GO and KEGG suggested that the anti-diabetes effect of B. rapa was strongly associated with the AGE-RAGE signaling pathway in diabetic complications, Neuroactive ligand-receptor interaction, Lipid and atherosclerosis, PI3K-Akt signaling pathway, and Calcium signaling pathway. The AKT1 (Serine/Threonine Protein Kinase) enzyme is targeted by major bioactive constituents of B.rapa. Molecular Docking studies revealed that Liquiritin (docking score -6.1 Kcal/mol) showed the highest binding affinity with AKT1. These results suggest that Brassica rapa may play a role in regulating several pathways that are involved in the development of Diabetes Mellitus. Keywords: Network pharmacology, molecular mechanisms, Brassica rapa, Diabetes Mellitus (DM)       &nbsp