K S Hegde Medical Academy

Purpose of the Research Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and eosinophil counts are altered in neonatal sepsis; this has not been studied in early-onset neonatal sepsis (EONS). Hence, in this cross-sectional study, we compared the blood counts and ratios of two groups of neonates: 69 each with or without EONS. Major Findings Neonates with EONS had higher median total leukocyte count, lymphocyte, and eosinophil count compared to those without sepsis. PLR was significantly lower in neonates with sepsis, with no significant difference in NLR. Hematological parameters of a subgroup of 49 preterm babies without sepsis were compared with those of 45 preterm babies with EONS. The findings were similar, with a significantly higher eosinophil count and lower PLR among preterm babies with EONS. Conclusions EONS among neonates was associated with a higher eosinophil count and a lower PLR. The differences were more pronounced among the subset of preterm babies.

Alzheimer's disease (AD) is a catastrophic neurodegenerative disorder marked by progressive decline of cognitive function, memory loss, and neuronal death. Its pathology is characterized by the formation of extracellular amyloid-beta (Aβ) plaques and intracellular neurofibrillary tangles from tau hyperphosphorylation. Despite extensive research, current treatments are limited to symptomatic relief and are associated with significant side effects. This accentuates the critical need for alternative therapeutic strategies with potent neuroprotective effects and minimal toxicity. This study investigates the neuroprotective potential of glycyrrhizic acid, as the precise molecular mechanisms by which it might improve AD pathology remain poorly understood. Using an Aβ42-induced IMR-32 cell model of AD, our research revealed that Aβ42 treatment caused significant protein alterations associated with AD pathology, mitochondrial dysfunction, cell cycle re-entry, and synaptic activity. Co-treatment with glycyrrhizic acid not only restored these protein levels, but also mitigated the hyperactivation of several key signaling pathways and rescued neurons from apoptosis. These findings suggest that glycyrrhizic acid exerts neuroprotective effects by preventing mitochondrial dysfunction and apoptosis via modulation of critical signaling pathways. This study provides strong evidence for glycyrrhizic acid's neuroprotective properties in AD, paving the way for further research into its potential as a promising therapeutic agent for Alzheimer's disease.

Abstract Gastric cancer is driven by aberrant kinase signaling that promotes uncontrolled proliferation and malignant progression. Calcium/calmodulin-dependent protein kinase kinase 2 (CAMKK2) is overexpressed in gastric cancer; however, the global phosphorylation networks downstream of CAMKK2 remain incompletely defined. In this study, we investigated the functional and signaling consequences of CAMKK2 inhibition in gastric cancer cells using an integrated phenotypic and quantitative phosphoproteomics approach. Pharmacological inhibition of CAMKK2 using STO-609 in AGS cells significantly suppressed proliferation, clonogenic growth, migration, and invasion, and induced defects in nuclear morphology indicative of impaired cell cycle progression. Tandem mass tag (TMT) based phosphoproteomic profiling identified over 10,500 phosphopeptides and revealed extensive phosphoproteome remodeling following CAMKK2 inhibition, characterized predominantly by hypophosphorylation of proteins involved in nuclear signaling, RNA processing, and cell cycle regulation. Kinase substrate enrichment and motif analyses demonstrated coordinated attenuation of CDK, MAPK, and mitotic kinase-associated signaling pathways, with convergence on E2F regulated transcriptional programs. Collectively, these findings establish CAMKK2 as a central regulator of kinase signaling networks that sustain proliferative and malignant phenotypes in gastric cancer and highlight CAMKK2 inhibition as a potential therapeutic strategy.

The complex tumor microenvironment and tumor self-protection limit the efficacy of anticancer drugs, impeding clinical translation. Designing intelligent nanomedicines that integrate diagnosis and therapy is pivotal for advancing cancer treatment. Carbon dots (CDs), with tunable fluorescence and versatile surface chemistry, have been used in diagnosis and therapy. These properties enable CD-based nanohybrids to deliver precise, image-guided tumor therapy. This review summarizes the history of CDs, the construction of CD-based nanohybrids, and their applications in tumor microenvironment–activated, image-guided cooperative tumor therapies. Finally, we discuss future research directions and clinical translation challenges. We aim to inform the rational design of CD-based nanohybrids for precise tumor treatment. • In contrary to versatile applications of CDs their small size limits their function. • Construction of CD-based nanohybrids with itself or with other materials like dendrimers, nanogels, MOF, and metal ions become popular • Nanohybrids are mostly TME responsive for varying ways of tumor treatment, including imaging-guided CDT/PDT/PTT, chemotherapy and immunotherapy. • Small size challenges to their medical applications due to quick metabolism and limited EPR-based passive tumor-targeting impact and way forward discussed. • Future outlooks proposed to enhance CD-based nanohybrids for TME responsive therapy.

Rapid Response Teams (RRTs) are designed and implemented to identify and respond to early signs of clinical deterioration, to prevent in-hospital adverse events, particularly cardiopulmonary arrests. This multidisciplinary team aims to improve patient outcomes and reduce hospital mortality. Despite their widespread adoption in high-resource settings, evidence on the efficacy of RRTs in resource-limited environments remains limited. The objective of this study was to evaluate the impact of implementing an RRT on patient outcomes in a tertiary care hospital in South India. This study compared data from six months before (November 2022 to April 2023) and six months after (November 2023 to April 2024) starting RRT. Event rates were analyzed using unadjusted and adjusted Poisson regression for all three outcomes. In-hospital mortality was additionally assessed using logistic regression and interrupted time series analysis to evaluate trends over time. Among 24,568 hospital admissions, in-hospital mortality decreased from 3.7% to 2.9% post-RRT implementation (absolute difference: 0.71%; p = 0.002). Code Blue events declined from 2.3 to 1.5 per 1,000 admissions, and unplanned MICU transfers remained stable; however, these changes were not statistically significant. Unadjusted Poisson analysis showed a significant reduction in mortality (rate ratio: 0.81; 95% CI: 0.70-0.93; p = 0.003), though adjusted models showed no significant effects. Interrupted time series analysis demonstrated a significant month-on-month decline in mortality post-intervention (OR: 0.91; 95% CI: 0.83-0.99; p = 0.021), suggesting a gradual impact over time. RRT implementation was associated with a significant reduction in in-hospital mortality, with evidence of a sustained downward trend over time. Effects on Code Blue events and MICU transfers were not statistically significant, warranting further evaluation in similar settings.

Adolescent type 2 diabetes mellitus (T2DM) is on the rise in India and is commonly attributed to co-existence of overweight and obesity in adolescents. In this line, a study by Maheshwari et al titled ‘Prevalence of obesity, determinants, and its association with hyperglycaemia among community dwelling older adolescents in India’ concluded that overweight, obesity, socioeconomic factors and higher education status were responsible for hyperglycemia in adolescents aged 15-19 years in India. We highlight that there is a significant prevalence of T2DM even in normal body mass index (BMI) and below normal BMI subjects, as mentioned in their study. There is a high prevalence of normal weight obesity in Indian adolescents which often gets missed due to a large population with normal BMI in the country. In this letter, we analyze the importance of measurement of central adiposity beyond routine BMI measurements.

Gastric ulcers are the most prevalent gastrointestinaldisorder. Bombax ceiba Linn. has beentraditionally used forthe treatment of gastric ulcers and other intestinal complications.This study aimed to evaluate the gastric antiulcerogenic potentialof the B. ceiba gum. The gum was testedorally in rats with experimentally induced gastric ulcers. The gumdemonstrated antiulcer activity by reducing the gastric juice volume,free and total acidity, ulcer index, and increasing gastric pH. LC–MS/MS-basedglobal metabolomics revealed a variety of alkaloids, flavonoids, andglycosides, among others, in the B. ceiba gum. Network pharmacology was employed to identify the human proteintargets for the B. ceiba gum metabolites.Further, the target proteins were docked against the B. ceiba gum phytoconstituents. Proteins such asEGFR, SRC, COX2, and MMPs, known for their involvement in gastriculcer healing, demonstrated tight interactions with the phytoconstituentsof B. ceiba gum. The B. ceiba gum was found to possess potent gastroprotectiveproperties, and the results supported the use of the gum of this plantin the treatment of gastric ulcers.

Integrated teaching has been introduced under the Graduate Medical Education Regulations to enhance undergraduate medical education by bridging basic and clinical sciences. This study evaluated the use of a tuberculosis “linker case” to foster interdisciplinary learning and examined its impact on student knowledge and satisfaction among Phase II MBBS students in a private medical college in Karnataka. A quasi-experimental before-and-after design was implemented with 126 participants, incorporating peer presentations, assignments, case discussions, and post-test evaluations through the institutional learning management system between July 2022 to November 2023. While the intervention did not produce significant improvements in test scores, most students (87.5%) reported positive experiences, highlighting greater understanding across disciplines and benefits from self-directed preparation and collaborative engagement. The feasibility, reusability, and strong acceptance of the linker case suggest its potential for wider application in medical curricula and its value as a model for promoting integrated learning approaches in resource-constrained settings.

Background and aims: Musculoskeletal disorders (MSDs) are the second leading cause of disability, which is measured by Years Lived with Disability (YLDs). In India, the prevalence of MSDs is not well documented. The present study aimed to study the prevalence of MSDs and their effect on the physical functional ability of patients. Methods: The present study is a community-based cross-sectional study undertaken in a village of western Maharashtra, India. A total of 330 subjects were included by systematic random sampling. The study included all adults (>18 years) who were permanent residents of the study area. The interviews with subjects were conducted through a door-to-door survey in the community using a predefined questionnaire. Functional disability was measured using the Health Assessment Questionnaire (HAQ CRD Pune version). Results were analyzed using the Chi-square and t-test. Results: The overall prevalence of MSDs was 33.03%. The development of MSD was more common in patients older than 60 years (56.2%), with female predominance (16.9%). The mean HAQ score in the study population was 13.13±4.429, indicating severe disability. The majority of them had a moderate functional disability (48.62%), and 27.52% had a severe functional disability, which highlights the significant impact of MSDs on functional ability. Among those affected by MSDs, walking was the most commonly affected activity, accounting for 27.52% of patients. Conclusion: MSDs significantly impact functional ability and interfere with daily living activities. There is an urgent need to emphasize decreasing this functional disability and improving daily living activities among those affected in rural areas.