MSD (India)

ABSTRACTBackground:Gestational diabetes mellitus (GDM) significantly affects maternal and fetal health by altering placental structure and function, critical for fetal growth. Understanding the histomorphological changes in GDM-affected placentas can offer insight into how these adaptations impact pregnancy outcomes.Materials and Methods:This cross-sectional study examined 220 placental samples (110 from normal pregnancies and 110 from GDM-complicated pregnancies) collected from Index Medical College and Hospital. Morphological characteristics (shape, cotyledon count, cord insertion type), morphometric measurements (diameter, thickness, circumference, weight), and histological markers (syncytial knots, fibrinoid necrosis, villous fibrosis, and perivillous fibrin deposition) were assessed. Neonatal outcomes, including birth weight, APGAR scores, and fetoplacental weight ratio, were recorded and statistically analyzed.Results:Placentas from GDM pregnancies showed significantly higher weight (556.1 g vs. 498.8 g, P < 0.05), thickness, and cotyledon count (13 vs. 9, P < 0.05). GDM was associated with a predominance of eccentric cord insertions (71.8% vs. 27.3% in normal, P < 0.05) and diverse placental shapes. Histologically, GDM placentas had elevated syncytial knots (100%), fibrinoid necrosis (83.6%), and villous fibrosis (70.9%), suggesting placental stress and reduced efficiency. Neonates from GDM pregnancies had higher birth weights (3.68 kg vs. 3.2 kg, P < 0.001) and a lower fetoplacental weight ratio, highlighting the risks of fetal macrosomia.Conclusion:The observed histomorphological changes in GDM placentas suggest compensatory mechanisms in response to the hyperglycemic environment but may also contribute to neonatal complications.

Introduction: The Cannabis sativa Linn plant is an excellent source of fiber, containing important phytochemical constituents, such as Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD), which have been found to be effective in the treatment of various ailments, such as neurodegenerative diseases, epilepsy, pain, inflammation, insomnia, etc. As a result, various drug dosage forms, such as tablets, capsules, transdermal patches, and liquid formulations, have been developed, and many are under clinical investigation, while many formulations are still in development to benefit human health. Method: This review was conducted by analyzing articles on Cannabis sativa published in the last ten years from ScienceDirect, Scopus, PubMed, Web of Science, and SciFinder. Recent papers explore patents on different Cannabis sativa formulations and their diverse applications. Result: The existing literature underscores the pivotal role played by Cannabis sativa within the realm of pharmaceuticals. It has emerged as a promising candidate in various domains, including neurodegenerative diseases, diabetes management, antimicrobial resistance, antidepressant treatments, antiviral therapies, cancer treatment, hypertension management, inflammation reduction, and antioxidant applications. Conclusion: This review discusses the origin of the species, its history, marketed formulations, clinically investigated drugs, updated patents, and the various therapeutic applications of cannabis in different diseases. It also highlights its efficacy and safe use for human health.

Journalists from India-administered Kashmir have endured the psycho-social brunt of living in a militarized zone. Restrictions imposed on the media by the governing class in a neoliberal milieu function to regulate the narrative on the conflict with the help of agenda setting. This analysis identifies themes of direct, indirect and structural violence, and shows how psychological symptoms such as anxiety, alienation, hypervigilance, helplessness, depression and trauma emerge from them. Employing thematic analysis coupled with a deductive approach, the author highlights how working conditions of the journalists shape their psycho-social wellbeing. In-depth interviews with Kashmiri photojournalists, journalists and editors (print and digital) and secondary sources, such as local and international studies on the psychological wellbeing of the population in general, demonstrate the psycho-social wellbeing of journalists in the Kashmir Valley.

Abstract: Interactive entertainments using AI have become possible due to merging AI with games. The paper explores in-depth multi-dimensional relations among AI in gaming, including Game AI, Adaptive Gameplay, and ML in VE. The study intends to investigate how the current AI in games landscape impacts gameplay dynamics and customer experience. The paper discusses the latest approaches such as AI-driven NPCs and procedural generation of content that transforms gameplay experience. Secondly, it analyzes how machine-learning can help in designing adaptable gaming situations to satisfy different tastes and skills players. Further, this study identifies trends and envisages future breakthroughs in AI in gaming. This work aims at addressing challenges and ethical issues associated with artificial intelligence and virtual environment domain in order to understand where is future heading for gaming experience.

Political parties are crucial to the "representative democratic forms of government" that the majority of democracies have adopted in the modern era and act as a "link between the electorate and the elected. " Comparing India to other nearby countries, one could say that its democracy has succeeded. Given that West Bengal is a state in India, it is safe to say that West Bengal is also a success story for democracy. In a democracy, the party system plays a crucial role. Democratic political systems are developed and remain stable as a result of party systems. West Bengal activists paved the way for India's freedom movement during the British era; in the postindependence era of the Indian party system, the people of West Bengal have maintained their own diversity with an agitation spirit, social reform, and contemporary thinking. In the 21st century, the role of the party system in West Bengal is changing in a variety of ways, and different variables play a role.

An equity analyst’s opinion of stocks summarizes how a variety of different forces (such as geopolitical, macroeconomic, country, industry, and company-specific) and their interaction may affect the future performance of a company. In this article, we constructed an analyst-sentiment factor that tracks changes in analyst expectations, and then examined its relationship with global equity performance. We also sought to define the analyst-sentiment factor and learn about its stability and performance. Our analysis revealed that analyst sentiment has been a robust and differentiated investment factor with strong associated risk premiums. It exhibited unique characteristics and information relative to traditional equity style factors such as value, quality, and momentum.

BackgroundPeople with Advanced HIV Disease (AHD) are at higher risk of TB coinfection and mortality. However, there are challenges in TB diagnosis with the currently recommended diagnostic tools. WHO recommends lateral flow urine lipoarabinomannan (LF-LAM) assay to assist TB diagnosis among AHD patients. We assessed the utility and acceptability of using urine LF-LAM assay for TB diagnosis among patients at public Antiretroviral Therapy (ART) Centres in Mumbai.MethodsThe cross-sectional study was conducted among adult AHD patients accessing care from 17 ART centres during November,2020-June, 2021. Urine LF-LAM was offered as routine care for eligible patients in combination with standard diagnostic tests. We calculated the proportion of positive LF-LAM results by CD4 categories and TB symptoms and performed multivariable logistic regression to determine the factors associated with LF-LAM positivity.ResultsAmong 2,390 patients, the majority (74.5%) had CD4 between 101–200 cells/mm3. The mean age was 43.7 years (SD:10.6), 68.6% were male, 8.4% had TB symptoms and 88.0% were on ART. The overall proportion of patients with urine LF-LAM positive results was 6.4%. Among PLHIV with CD4≤100 cells/mm3, the positivity was 43.0% and 7.7% in symptomatic and asymptomatic patients, respectively. Among PLHIV with a CD4>100 cells/mm3, the positivity was 26.7% and 2.7% in symptomatic and asymptomatic patients respectively. Urine LF-LAM positivity was higher among inpatients, ART naïve, patients on treatment for <6 months, symptomatic and in WHO clinical stage III/IV of HIV disease as compared to the reference categories. We detected an additional 131 TB cases with urine LF-LAM in combination with the standard diagnostic tests.ConclusionThe study demonstrated the utility of urine LF-LAM for TB diagnosis among AHD patients and the simple, user-friendly test was acceptable as part of routine care. Inclusion of urine LF-LAM test in the current diagnostic algorithm may facilitate early TB diagnosis among AHD patients.

A 30-year-old woman presented with an acute-onset high-grade fever (103°F), multiple episodes of throbbing abdominal pain in the right quadrant, and pustular red lesions on the left leg. The radiological findings were suggestive of autoimmune cholangitis and pancreatitis. The skin lesions recurred on different portions of the body, and histopathological findings showed lobular and septal lymphohistiocytic infiltrate without vasculitis. The epidermis had focal ulcerations, and the dermis showed the presence of subcutaneous fat and an infiltrate of lymphocytes, histiocytes, and neutrophils (described as lobular and septal panniculitis without vasculitis). Based on the clinical and histopathological features, a diagnosis of migratory panniculitis was made. The patient was managed with analgesics, antibiotics, and a long course of steroids; the patient responded well to these medications. To the best of our knowledge, this is one of the first case reports of migratory panniculitis associated with IgG4-related disease. Patients with migratory panniculitis should be investigated for the presence of IgG4-related autoimmune disease. However, steroids remain the drug of choice when these conditions occur together.

A key recommendation of the National AIDS Control Programme-IV of India was to develop new strategies for geo-prioritization of the human immunodeficiency virus (HIV) epidemic. We conducted this study to categorize the districts in Maharashtra (India) based on a multidimensional framework for geo-prioritization of services. Programmatic data on trends of HIV prevalence, coverage of marginalized populations and vulnerability factors were included. A composite indicator based on these was developed, and the cumulative score was calculated for each district. HIV prevalence among general population has declined steadily from 0.60% in 2007 to 0.33% in 2017. The programme coverage was stable but inadequate for men who have sex with men (MSM). The coverage for female sex workers (FSWs) was inadequate and reduced over time. Nine districts were categorized as high priority, 13 as moderate priority and 11 were classified as low-priority districts based on burden and vulnerability for HIV. The high-priority districts were Pune, Solapur and Yavatmal for FSW interventions and Pune, Thane and Latur for MSM interventions. This multidimensional indicator is based on existing programmatic data, dynamic and can be made state-specific. It is useful to categorize and prioritize districts for allocation of resources and geo-prioritization of services in resource limited settings.