Vivekananda Memorial Hospital

Social support is known to influence pregnancy outcomes. We explored the sources of social support available to pregnant women in a rural setting in south India. We conducted 13 focus group discussions (FGDs) among women of child-bearing age, husbands, mothers/ mothers-in-law, community health workers, and community leaders. FGDs were transcribed and analysed using thematic analysis. Support received during pregnancy were mainly in three domains; tangible, informational and emotional support. Tangible support refers to providing practical support such as cooking nutritious food for the pregnant women, helping them with household chores, and accompanying pregnant women for hospital visits. Informational support refers to measures aimed at improving awareness during pregnancy and promoting informed decision making such as advice on dietary practices and remedies for common ailments. Emotional support refers to the support provided by family members and CHWs in fulfilling women’s desires during pregnancy and allowing them a safe space to share their problems. Sources of support identified include husbands, elders in the family, friends, the local community, and health service providers. In general, perceptions were similar across participant groups, age and gender. While tribal participants sought elders’ advice and relied on traditional remedies compared to non-tribal participants, they were more likely to access nutritional aids offered by the government. CHWs provide additional support to tribal communities in identifying pregnant women, closely monitoring them and extending informal support during pregnancy and delivery by taking them to the hospital. Members of the joint family including mothers-in-law and sisters-in-law actively helped in chores, nutrition and newborn care compared to the nuclear family. In general, women felt that they received valuable support from family and community. Participants felt that support from husbands, families and neighbours had an influence on women’s health and behaviour during pregnancy. The findings were used to develop intervention modules to promote maternal health and the health of their offspring.

Spleen tyrosine kinase (SYK) plays a pivotal role in immunoreceptor signalling pathways implicated in various cancers and autoimmune diseases. Inhibition of SYK has shown therapeutic potential by attenuating immune-mediated damage and suppressing tumour growth. This study reports the synthesis, characterization, and evaluation of a novel series of aminopyrimidin-4-yl-1H-pyrazole derivatives (31, 35, 36, 37, 39, 41, 44, 47 and 49) as selective SYK inhibitors. The chemically synthesized molecules were structurally confirmed using 1H, 13C NMR and mass spectrometry techniques. Further, molecular docking studies revealed differential binding affinities with the SYK active site, highlighting molecule 44 as the lead candidate, displaying the lowest docking score and strongest interactions. Subsequent 200 ns molecular dynamics simulations confirmed the enhanced stability of 44 in complex with SYK, evidenced by consistent hydrogen bonding, minimal root-mean square deviation (RMSD), and compact protein folding relative to other ligands. Furthermore, binding free energy calculations corroborated the favourable energetic profile of 44. Also, principal component and free energy landscape analyses showed that 44 maintained a single, stable conformational state with limited flexibility. On the other hand, in vitro enzyme inhibition assays employing a luminescence-based kinase activity system demonstrated that several compounds, particularly 44, exhibited potent concentration and time-dependent inhibition of SYK inhibition activity. Kinetic characterization revealed that 44 functions via a non-competitive inhibition mechanism, suggesting allosteric binding outside the ATP substrate site. These integrative in silico and in vitro findings establish 44 as a promising lead molecule for SYK-targeted therapies, combining potent binding affinity, conformational stability, and effective enzyme inhibition. This work advances the design of novel small-molecule SYK inhibitors with potential applications in cancer and autoimmune disease treatment.

Human gut microbiomes respond to lifestyle transitions, yet the extent to which these responses are conserved across spatio-cultural contexts remains undercharacterized. We present the South Asian MicroBiome ARray (SAMBAR), a population-scale 16S gut microbiome study of 575 adults from ten geographically and socio-culturally diverse South Asian communities. Each community was sampled in ancestral villages and urban centers, enabling controlled comparisons of geography and lifestyle. Relative to global cohorts, SAMBAR microbiomes occupy a distinct compositional space with stronger correlation to geography and community membership than lifestyle. Although urbanization is consistently associated with increased abundance of disease-linked taxa, microbiome responses to lifestyle transitions are largely community-driven, including the acquisition of wheat- and dairying-associated microbial modules in some communities that may facilitate non-genetic adaptation to lactase non-persistence. Microbiome responses to urbanization are heterogeneous even at regional scales, reflecting local culture and geography and underscoring the need for community-specific investigations of health impacts.

Abstract BackgroundThe COVID‐19 pandemic has renewed attention to the conflicting demands placed on caregivers worldwide. Nowhere is this more evident than in South Asia, where cultural norms and a scarcity of long‐term care facilities have made the home the locus of caregiving for individuals with brain health conditions and disabilities. A hidden cost of this informal arrangement is the burden experienced by the primary caregiver. This may be exacerbated when traditional caregiving expectations clash with personal aspirations outside the family.MethodThis paper investigates the determinants of burden among 494 informal caregivers in India, Pakistan, and Bangladesh during the COVID‐19 pandemic. The variables, obtained from the Coping with Loneliness, Isolation, and COVID‐19 (CLIC) Global Caregiver study, include caregiver demographic characteristics, features of the caregiving arrangement, and subjective measures of the caregiving experience. The dependent variable in our analysis, the perceived frequency of burden, is rated by respondents on a five‐level scale. Role strain is expected to be greatest among young, educated women living with the care recipient in their own homes. Therefore, burden should exhibit a positive association with female gender, education, and cohabitation, and a negative association with age.ResultOut of the 494 caregivers included in the study, 33.8% experienced increasing burden and 58% experienced loneliness some of the time during Covid‐19. The ordinal logistic marginal effects are consistent with all four hypotheses. Caregiver Burden is found to be positively correlated with female gender (OR,1.92; 95%CI, 0.35,1,03; P=<0.001), the 18‐39 age range (OR,1.71; 95%CI, 0.114, 0,963; P=0.01), poor finances (OR,2.192; 95%CI,0.22,1.34; P=0.006), poor physical health (OR, 2.24, 95%CI, 0.29,1.32, P=0.002), poor mental health (OR,1.86; 95%CI, 0.14,1.10, P=0.011), and care recipients with dementia/Alzheimer's (OR,2.76; 95%CI, 0.52,1.51, P=<0.001) and/or mental health conditions (OR,1.61; 95%CI, 0.02,0.94, P=0.039).ConclusionRole strain may be a significant driver of burden when the caretaker’s educational and professional potential collide with traditional South Asian family obligations. The burden reported by our respondents suggests that role strain may elevate stress among young, educated caregivers. Our results, therefore, provide indirect evidence concerning the changing economic and socio‐cultural context of caregiving in South Asian households.

Context: Geriatric mental health is an emerging public health concern of paramount importance. There is a dearth of community studies on the mental health status of the elderly tribal population. Objectives: The objective of the study is to estimate the prevalence of anxiety and depression among the elderly tribal population and assess the sociodemographic factors associated with it. Materials and Methods: This is a cross-sectional study conducted among elderly tribes of HD Kote, Mysuru, with a sample size of 339 by multistage sampling method. A house-to-house interview was conducted using a predesigned, pretested questionnaire, and anxiety was assessed using Generalized Anxiety Disorder-7 and depression using Kannada Geriatric Depression Scale-15. Data were analyzed using SPSS version 25 (licensed to the institution). Descriptive representation was done using proportions, mean, standard deviation, median, and interquartile range. Inferential statistics such as Chi-square analysis/Fisher's exact analysis were used. P <0.05 was considered to be statistically significant. Results: The overall prevalence of anxiety was 8.2% of which 4.7%, 2.9%, and 0.6% had mild, moderate, and severe anxiety, respectively. Occupation, financial dependency, and comorbid status were significantly associated with anxiety. The overall prevalence of depression was 22.4%, of which 18.9% and 3.5% had moderate and severe depression, respectively. Gender, occupation, marital status, living status, financial dependency, personal habits, comorbid status, and functional disability were significantly associated with depression. Conclusion: Anxiety and depression deserve the same consideration and remedy as any other illness among the elderly. A concerted effort from the public and private sectors is essential to promote mental health in this vulnerable population.

As very limited clinical data is available in Indian patients with Zonisamide initial monotherapy, a subgroup analysis of data from a prospective, post-marketing. A surveillance study was conducted to evaluate the efficacy and safety of Zonisamide as initial monotherapy in Indian adult patients.

BackgroundHypertension (HTN) is one of the major causes of cardiovascular morbidity and mortality. The objective of the study was to investigate the burden and predictors of HTN in India.Methods6120 subjects participated in the Screening and Early Evaluation of Kidney disease (SEEK), a community-based screening program in 53 camps in 13 representative geographic locations in India. Of these, 5929 had recorded blood pressure (BP) measurements. Potential predictors of HTN were collected using a structured questionnaire for SEEK study.ResultsHTN was observed in 43.5% of our cohort. After adjusting for center variation (p < 0.0001), predictors of a higher prevalence of HTN were older age ≥40 years (p < 0.0001), BMI of ≥ 23 Kg/M2 (p < 0.0004), larger waist circumference (p < 0.0001), working in sedentary occupation (p < 0.0001), having diabetes mellitus (p < 0.0001), having proteinuria (p < 0.0016), and increased serum creatinine (p < 0.0001). High school/some college education (p = 0.0016), versus less than 9th grade education, was related with lower prevalence of HTN. Of note, proteinuria and CKD were observed in 19% and 23.5% of HTN subjects. About half (54%) of the hypertensive subjects were aware of their hypertension status.ConclusionsHTN was common in this cohort from India. Older age, BMI ≥ 23 Kg/M2, waist circumference, sedentary occupation, education less, diabetes mellitus, presence of proteinuria, and raised serum creatinine were significant predictors of hypertension. Our data suggest that HTN is a major public health problem in India with low awareness, and requires aggressive community-based screening and education to improve health.