Understanding Preventive Health Behavior: A Mixed-Methods Study to Explore Factors Influencing the Practice of Breast Self-Examination Among Indian Medical Students.

INTRODUCTION: Breast cancer (BC) is among the most prevalent oncological cases in the world, and the global burden of the disease is expected to rise further in the coming years. Strategies aiming at early diagnosis, backed by research and a well-trained healthcare cadre, can aid low- and middle-income countries (LMIC) in tackling the possible cancer-caused strain on healthcare systems. Our study aimed to evaluate the level of knowledge of medical students concerning BC and explore barriers and facilitators of breast self-examination (BSE). METHODS: A sequential explanatory mixed-methods study approach to better understand factors and beliefs influencing preventive health practice in BSE was conducted among students at a medical college in rural Maharashtra, India. One hundred and two female medical students completed the quantitative phase, and 15 of them gave in-depth interviews (IDIs) for the qualitative aspect. RESULTS: Among the participants, 67.6% had good knowledge of risk factors, but only 10% knew the recommendations for BSE, clinical breast examination (CBE), and mammography. We found that being taught BSE by a trusted source and knowing a BC patient were significant facilitators. In contrast, lack of self-efficacy and two fear factors were found to be acting as barriers for BSE, one being the absence of fear of ever getting BC and the other fear of detecting a lump. CONCLUSION: This study reveals a gap between knowledge of risk factors and their translation to disease prevention practice. The barriers elicited are modifiable by planning and implementing an appropriate training program covering risk factors and recommending all available screening and preventative modalities. A well-trained medical staff will be instrumental in improving the health status of our community and country.

The Rarity of Maxillary Osteomyelitis: Insights From a Unique Case Report.

Maxillary osteomyelitis is a rare bone infection and is rarer to come across with the advent of advanced antibiotic therapies. It is often linked to immunocompromised conditions, namely diabetes mellitus, cancer, and chronic alcoholism, as they increase the chances of developing osteomyelitis. We present a rare case of maxillary osteomyelitis along with an infraorbital abscess in a 32-year-old male patient with uncontrolled diabetes. The patient complained of dental pain, facial swelling, and visual disturbances. The patient was managed with sequestrectomy along with curettage, incision, and drainage of orbital abscess. The patient responded well to surgery and had no complications post-surgery. As radiographic signs may present late, the authors aim to highlight the significance of thorough clinical examination and good patient history. Prompt radical treatment is necessary to avoid any severe consequences.

A Case of Marfan Syndrome With Congenital Hip Dysplasia and Spine Abnormality.

Marfan syndrome, a hereditary disorder of connective tissue marked by FBN1 gene mutations, presents a clinical tapestry requiring a multidisciplinary approach for optimal management. This case report details the presentation of an 11-year-old male exhibiting musculoskeletal deformities, notably an abnormally curved spine and congenital hip dysplasia, indicative of Marfan syndrome. The absence of cardiovascular abnormalities and family history challenges the diagnostic process. Clinical evaluation revealed classical signs, including positive wrist and thumb signs, pectus carinatum, a loose skin fold, and scapular winging. Laboratory investigations, including imaging studies, confirmed the diagnosis. The patient's management involves a multifaceted strategy, addressing cardiovascular risks through beta-blockers and potential surgical interventions, orthopedic measures for musculoskeletal complications, and ophthalmologic interventions for ocular manifestations. Genetic counseling facilitates informed decision-making, and psychosocial support ensures holistic care. This case underscores the necessity of recognizing atypical presentations and employing a holistic, collaborative approach for early diagnosis and effective management of Marfan syndrome, thereby emphasizing the importance of ongoing research and heightened clinical awareness in enhancing outcomes for individuals living with this intricate genetic disorder.

An Interesting Case of Macular Amyloidosis With No Significant Etiology.

Macular amyloidosis is primary localized cutaneous amyloidosis (PLCA). It is described by the extracellular accumulation of heterogenic amyloid proteins in the skin that does not affect the systemic immune system, causing hyperpigmented patches. It is a prevalent skin disorder of young female adults, especially in India, since it affects the population with darker skin. History of frictional rub on the skin is typically present, such as using loofah or bathing scrubs or stones. The case presented below is of a 23-year-old female who presented with a hyperpigmented patch on the upper back of both sides and extensor surface of arms and did not have any history of usage of loofah on those areas, compelling us to research more on the other causative factors (genetic predisposition, infectious agents, and UV radiation are probable causative factors) for macular amyloidosis. This condition is not entirely cured; it is managed symptomatically only to improve cosmetic outcomes.

A Comprehensive Case Study of a Hyperlaxity Dilemma: An Injury-Prone Young Athlete.

A prevalent condition that is frequently linked to joint trauma is joint hyper-laxity. The knee joint is one of the most complex and injury-prone joints in sports. The most commonly injured is the anterior cruciate ligament (ACL). The case presented below is of a 24-year-old athlete with a past history of many sports-related injuries who is now presented with a complete tear of the ACL with hyper-laxity as a risk factor. The patient has a Beighton score of six out of nine without any other symptoms, which is suggestive of benign hyper-laxity of the joints and not hyper-laxity syndrome. Here, we emphasize that medical professionals must know the fundamental connection between hyper-laxity and musculoskeletal injuries and their proper management and rehabilitation for future prevention.

Factors Associated With Low Birth Weight Among the Tribal Population in India: A Narrative Review.

Low birth weight (LBW) is defined by the WHO as a birth weighing less than 2500 g (5.5 lb). The highest burden of any nation is LBW infants. In countries where the frequency of neonate babies is high, short gestation is a major cause. LBW babies have an 11-13 times greater risk of delayed developmental milestones and other medical diagnoses. Greater than the global incidence, LBW prevalence is a severe public health problem in India. A comprehensive literature search was conducted using internet sources like PubMed, Web of Science, Cochrane Library, and Google Scholar. The words "birth weight," "abnormal birth weight," "LBWs," "neonates," "premature birth," "risks factors," "causes," "factors," "prevalence," and "frequency" were searched. In this review, we examine the causes of LBW, implementation of pre-birth prevention strategies, and post-birth multifaceted health promotion interventions. The mother's knowledge, dietary requirements, and prenatal services need to be addressed to decrease the prevalence of LBWs among tribal districts of India.

Malunion of a Clavicle Fracture in a Young Adult: A Case Report and Surgical Intervention.

This case study examines the medical complexity of managing a neglected clavicle in a young patient, resulting in a complicated interstitial non-union. Despite initial therapeutic efforts, the fracture was not treated, resulting in significant pain as well as functional and aesthetic disabilities. This case outlines accurate clinical presentation and diagnostic methods. In addition, malunion clavicle fractures require multifaceted therapeutic approaches including surgical interventions, rehabilitation programs, and psychological support. Through comprehensive research and long-term follow-up, this report reveals the complexity of traumatic fractures, highlighting the importance of early recognition and intervention. To address the issue effectively, it is essential to follow a multidisciplinary approach that includes physical assessment, pharmacotherapy, and physiotherapy. This case report aims to highlight the critical role of comprehensive individual care in improving the patient's condition and emphasizes the importance of vigilant healthcare practices.

Effects of Periodontitis on Major Organ Systems.

This review focuses on the fact that oral disorders are not merely localized to the mouth; in a broader sense, they also have a more significant impact on systemic health. In this review, we tried to bring to the notice various complications of periodontitis on the body's major organ systems. It has also been suggested that there is a potential connection between periodontitis and certain systemic disorders. Reviewing this fascinating topic is necessary. The objective is to create a thorough body of knowledge on the subject that is simple to access, alert medical professionals to the connection between dental health and systemic health, and highlight the necessity of a more thorough incorporation of medical and dental training. Periodontitis is a probable risk factor for various problems connected to the cardiovascular, pulmonary, endocrine, musculoskeletal, central nervous, and reproductive systems. It is a continual likely source of infection. Oral health affects overall health, and if extensive healthcare is ever accomplished, dental health should never be considered a distinct, remote, and lower significant part of health wholly disconnected from quality of life. One should never underestimate oral disorders as being acute and always curable. People should take utmost care and take the condition seriously to prevent significant complications.

Novel Chemotherapy Modalities for Different Cancers.

Even though many of the approved drugs still have high systemic toxicity due to a lack of tumor selectivity and present pharmacokinetic drawbacks, like low water solubility, that negatively influence the drug circulation time and bioavailability, the anti-cancer study has produced commendable results in recent years. The stability tests carried out under stressful exposure to high temperatures, hydrolytic media, or light sources during their development or under moderate settings have shown the vulnerability of anti-cancer medications to various factors. Because of this, the development of degradation products is considered hospital waste in pharmaceutical formulations and the environment. Until now, various formulations have been created for attaining tissue-specific therapeutic targeting, lowering harmful side effects, and enhancing drug stability. To boost the specificity, efficiency, and durability of active molecules that are targeted in cancer therapy the invention of prodrugs is the potential approach. The latest study illustrates that the solubility, pharmacokinetics, cellular uptake, and stability of chemotherapy drugs can be improved through the incorporation of them into vesicular systems, such as polymeric micelles or cyclodextrins, or via nanocarriers containing chemotherapeutics linked to monoclonal antibodies. In this review article, we provide an overview of the most recent advances in the field of designing very stable prodrugs or nanosystems that are powerful anti-cancer medications and their actions on the body.

A Phenomenal Depiction of Paranoid Schizophrenia With Auditory Hallucinations: A Case Report.

This case report provides a vivid illustration of a schizophrenic case in a 59-year-old man with auditory hallucinations, illuminating the nature of his symptoms. Auditory hallucinations were prominent, and the patient received voices urging him to perform actions that clearly corresponded to his paranoid thoughts. Through comprehensive research and long-term follow-up, this report reveals the complexity of traumatic schizophrenia, highlighting the importance of early recognition and intervention. One must emphasize a multidisciplinary approach, including psychiatric assessment, pharmacotherapy, and psychotherapy. This case report aims to highlight the critical role of comprehensive individual care in improving the patient's condition and emphasizes the importance of compassionate healthcare practices.

The Past, Present, and Future of One Health in India: A Narrative Review.

Humans have experienced a long-lasting pandemic of COVID-19 going on since the year 2020. Such events have recently increased the demand for a competent disease outbreak response system, more precisely, a One Health platform. The interaction between humans, animals, and ecosystems is inevitable. It is a known fact that the interface between these three entities is important for survival. In rural areas, especially in developing countries, it is a common practice to keep the animal shed in close proximity to their homes. Further, this intricate relationship itself plays a role in the spread and transmission of the disease. The involvement of the human-animal interface in emerging and re-emerging diseases has caused havoc in recent times and might prove challenging to overcome. Over the years, many efforts have been made on international and national platforms to adopt and implement a transdisciplinary, collaborative, intersectoral approach in India. This review highlights the major initiatives taken for the implementation of one health and the challenges faced over the years in our country.

Public Health Importance of Emporiatrics: A Review.

People travel all around the world to explore, trade, sojourn, etc. Millions of individuals cross national and international borders. Travel medicine services are offered by general practitioners, specialized travel clinics, or immunization centers. Epidemiology, illness prevention, and travel-related self-treatment are all included in the interdisciplinary field of travel medicine. The main objective is to keep travelers alive and in good health, by reducing the effects of illness and accidents through preventative measures and self-care. The danger to a traveler's health and well-being must be understood, and the travel medicine practitioner's job is to help their patient or client recognize and manage those risks. The absence of any disease or symptom does not always indicate good health. Chronic illness sufferers, including those with cancer, diabetes, and hypertension, can maintain a reasonable level of health and mobility. Travel medicine is a rapidly developing, extremely dynamic, multidisciplinary field that calls for knowledge of a range of travel-related illnesses as well as current information on the global epidemiology of infectious and non-infectious health risks, immunization laws and requirements around the world, and the shifting trends in drug-resistant infections. Pre-travel consultation aims to reduce the traveler's risk of disease and harm while on the road through preventive counseling, education, recommended drugs, and essential vaccines. Specialized medical guidance can help reduce the potential health risks of travel. Emporiatrics is not only used for traveling advice or things to be done during the period of the journey but it also creates room in implementing the interdisciplinary subject with new methods or development of new policies, technologies, and various programs to reduce unnecessary problems of the travelers, which will boost tourism.

A Comprehensive Review on Non-Alcoholic Fatty Liver Disease.

Non-alcoholic fatty liver disease (NAFLD), now known as metabolic dysfunction-associated liver disease (MASLD), is a spectrum of liver disease. It can be identified by the fact that considerable amount of hepatocytes with minimal or no alcohol use have steatosis. Because of its rising incidence along with increasing rates of obesity, metabolic syndromes, and diabetes mellitus type 2, NAFLD is expected to overtake all other causes of cirrhosis over the next decade, necessitating liver transplantation. Nevertheless, heart disease persists as the most prevalent manifestation of mortality, with only a small percentage experiencing fibrosis and complications associated with the liver. Pathologically, NAFLD is linked to lipid toxicity, oxidative stress, lipid deposits, and endoplasmic reticulum stress. A healthy diet, physical exercise, and a decrease in weight are advised by current international guidelines for the treatment of NAFLD, along with a limited number of medicinal therapies, including vitamin E and pioglitazone. Various natural substances have also been identified as NAFLD in vivo and in vitro regulators. The frequency, complexity of the pathophysiology, lack of authorised medications, and difficulty in interpretation of NAFLD have made it a major problem. This article assesses MASLD's pathophysiology, diagnosis, treatment, and epidemiology. This study also reviews a few natural substances that have been shown to have therapeutic advantages for NAFLD.

Risk Factors of Postpartum Depression.

Postpartum depression (PPD) is a widespread mental health problem and one of the prime causes of maternal suffering and ill health. On a global level, the prevalence of the disorder is about 10 to 15%. Symptoms generally appear within the first four to six weeks, which is the high-risk period. However, it may develop up to one year post-delivery. PPD presents with symptoms of classical depression, including mood fluctuations, bouts of crying, lack of interest in the child, and even thoughts of suicide. PPD not only has adverse effects on the mother's health but also hampers the growth and development of the child. It hampers the formation of a healthy mother-child bond, which in turn may impact feeding practices. The social environment of the infant during the first few months is primarily provided by the mother, and PPD may thus impact the child's development. It also increases the child's susceptibility to malnutrition. Research on postpartum depression has garnered momentum within the last few years. However, the masses are still largely unaware of the disorder and its implications. There is also an inadequacy of awareness of the risk factors of PPD. The cross-cultural differences in manifestations and appropriate preventive measures have not been extensively studied. Some risk factors for PPD are similar to those for classic depression; however, obstetrical and pediatric factors are also involved. This literature review aims to assess the currently known risk factors for PPD, their strength of association, and probable mechanisms to help identify the high-risk group and enable the implementation of preventive measures or facilitate early diagnosis. The factors identified spanned sociodemographic, biological, psychological, and obstetric domains. These included socioeconomic standing, marital relationship, history of psychiatric illness, social support, gestational diabetes, vitamin D deficiency, immigration status, delivery method, violence and abuse, birth experience, and biological and epigenetic markers. The risk factors for postpartum depression are numerous and may have strong to weak associations with the development of PPD. A previous history of depression or psychiatric illness, depressive symptoms during pregnancy, gestational diabetes, and a lack of spousal and social support were the most powerful risk factors. Other significant factors include complications during pregnancy, low socioeconomic status, and stressful life events. Studies on maternal age and chronic illness as risk factors were inconclusive. The roles of genetic and epigenetic markers, cultural factors, and vitamin D insufficiency require further investigation.

The Purpose of Time-Motion Studies (TMSs) in Healthcare: A Literature Review.

By utilizing time study methodologies, one can ascertain how long it takes a skilled person to complete a task with a specific level of quality. Time study aids in the selection of different job execution options as well as in the determination of the workforce required for a certain task, and thus assist in increasing manpower efficiency. It also aids in the acquisition of plants and machinery. By elaborating on the definition of "time-motion studies" (TMSs) as it is used in the biomedical literature and presenting justification based on full knowledge of that definition, this work aims to contribute to the standardization of TMSs. In TMSs, which is a type of quantitative data gathering, an outside observer records the motions and time necessary to complete an activity, together with an analysis aimed at increasing productivity. This paper suggests that, according to the researchers, the term is used to designate a range of investigations, the gathering and/or analysis of the length of one or more occurrences. A detailed analysis of all the available literature is done in this paper to get knowledge about TMS and its use in healthcare. Also, a comprehensive overview of many methodologies applied in works that are classed or referred to as TMSs is provided in this paper. Time motion investigations were first introduced in industrial engineering at the beginning of the twentieth century. Since then, they have been extensively employed by biological researchers, and because there is currently interest in parts of clinical workflow, they have attracted attention. However, combining the findings from different studies has proven challenging because there is a lot of variation in how techniques are used and reported. Although efforts have been made to uniformly publish these data and outcomes, there is still confusion about what TMSs are. A shared understanding of time and motion (TAM) research, as well as a proper acknowledgment of the various approaches it comprises, is a critical step toward standardization and validation. In this review paper literature analysis is done to discover what is known as TMSs to achieve the mentioned purpose.

A Review on the Use of Metformin in Pregnancy and Its Associated Fetal Outcomes.

A commonly used first-line anti-diabetic medication, metformin, has been used in pregnancy. The drug is known to have specific effects on different organs around the body. One of these organs includes the ovaries. Therefore, for more than 40 years, it has often been prescribed for maternal obesity along with gestational diabetes mellitus. Untreated pregnancies like these frequently result in complications for both the mother and the fetus, like macrosomia, pregnancy-induced hypertension, obstructed labor, stillbirths, and perinatal deaths. In addition, there is also evidence that these mothers tend to develop type II diabetes mellitus during their pregnancy and even a few years post-delivery. These complications can be controlled or even reduced with the help of metformin, sometimes combining it with insulin or clomiphene citrate if required. There is still a need to cautiously prescribe the drug by outweighing its benefits against the risk associated with it. The current research on the subject leans more towards the benefits offered to the mother during pregnancy. Only a few randomized, controlled trials have been conducted on the fetal condition after the mother has been administered metformin. Furthermore, these studies lack the appropriate sample size and long-term follow-up on these metformin-exposed offspring. As a result, there are no reliable data available to clinicians and physicians about the drug. Owing to its benefits in certain pregnancies, it is less likely that the drug will cease to be prescribed. Therefore, it becomes increasingly imperative to conduct more research on this topic to ensure the drug is safe for the mother and the offspring.

Young-Onset Dementia and Neurodegenerative Disorders of the Young With an Emphasis on Clinical Manifestations.

Young-onset dementia (YOD) refers to a neurological ailment primarily affecting people below 65 years of age in roughly about 8% of cases found through various researches. The high rate of prevalence of secondary dementias among older patients proves that younger people show a better prognosis of the conditions causing dementia than older people. However, effective interventions have to be usually provided early in the course of cognitive decline to help facilitate cognitive improvement. The risk of development of prodromal dementia is high if there is a development of psychoses in middle-aged or older people. When there is a development of psychoses in middle to late life, the likelihood of this indicates prodromal dementia is high. The clinical presentation is quite variable and often subtle in frontotemporal dementia (FTD) but may be dominated by personality change, behavioral disturbances, motivation, or the loss of empathy. There is great heterogeneity in the probable causes of dementia in young age as compared to dementia in old age, and some observed differences also exist in the course and characteristics of the disease. These causes may range from the most probable cause such as Alzheimer's disease (AD) to causes with low probability, such as metabolic disorders and prion diseases. The symptoms of young-onset dementia include a gradual development of personality and behavioral changes over a period of years. However, in the initial stages of young-onset dementia, this change can be attributed to various issues, such as depression, marital problems, and menopause. Other neurodegenerative diseases such as Huntington's disease show presentations such as changes in personality, chorea, and depression that can be observed in patients in their early adulthood. A few other neurodegenerative disorders are myoclonic epilepsy with ragged red fibers (MERRF) and mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) with presentations such as characterized muscle weakness, poor growth, problems with vision and hearing, and the involvement of the multi-organ system, including the central nervous system to name a few. There is also the prevalence of juvenile parkinsonism in the community, which represents a group of clinicopathological entities present before the age of 21. Young-onset Parkinson's disease (PD) (YOPD) appears to have the same pathological presentation as late-onset Parkinson's disease (LOPD). Recent researches have proved that "gene therapy" can be useful in the treatment and in preventing the progression of symptoms in cases of neurodegenerative diseases.

A Review of Proteins Associated With Neuroprotection and Regeneration in Alzheimer's Disease.

One of the most prevailing conditions of dementia is the illness known as Alzheimer's disease. The diagnostic signs of Alzheimer's disease progressively get worse over a long period since it is a cumulative condition. Alzheimer's disease causes modest memory loss in its initial stages, but people cannot converse or react to their surroundings in the later stages of the disease. In Alzheimer's disease, the destruction of neurons and the interconnection between them in the cortical region and the hippocampus is the beginning, after which the disease proceeds. The cerebral cortex regions are subsequently involved in thinking, linguistics, and interpersonal communication. Other parts of the brain eventually suffer harm as well. A person with Alzheimer's slowly loses the capacity to live and do daily tasks on their own over time. The illness is lethal in the end. Dementia is most commonly caused by ageing. Although dementia grows more prevalent as individuals age, this does not imply that dementia is a natural component of ageing. Up to 40% of those over 85 years who have dementia suffer from this condition. Amyloid, a beta protein that wrongly builds up and creates neurofibrillary tangles in the brain, causes Alzheimer's, a condition of protein misfolding. According to tradition, the primary cause of neuronal degeneration caused by the amyloid hypothesis is the buildup of beta-amyloid peptides. According to theory, the hazardous protein form that upsets the cell's calcium ion balance clumps amyloid fibrils, which leads to apoptotic cell death. This review article discusses the pathophysiology and biochemistry of various neuroprotective proteins to examine the potential of future anti-medications for Alzheimer's disease.

Tobacco Cessation Intervention for Young People.

Most adolescent tobacco control programs focus on preventing consumption, but teen smoking persists. It is uncertain whether adult-specific therapies can assist adolescents in quitting smoking. The rising incidence of smoking in low and middle-socioeconomic countries and the challenges of conducting tobacco cessation programs in these settings (due to increasing population, poor lifestyle, lack of awareness and education, professional stress, and non-compliance) need an emphasis on the scope of trials to conduct tobacco cessation in these settings. In the 11th Five Year Plan, the Indian government introduced a new National Tobacco Control Program, which currently spans 108 districts in 31 states across the country. The objective is to review the randomized control trials of selected individuals held in India and assess and evaluate the effectiveness of the steps taken by the government to help people quit tobacco consumption. These programs are important because of the hazards and impact they have on the public health indices of the nation. The government has taken steps like prohibiting smoking in public areas and banning sources. Several programs, particularly those that employed group counselling, included a range of approaches that proved beneficial in helping young people quit smoking. The RCTs mentioned are psychosocially followed by behavioral and pharmacological therapies. The challenges faced are not having participatory health care, motivating tobacco users to quit even in the short-term, adequate coverage; barriers at a different level of implementation (at a regional, state, or national level); and interference by the tobacco industry should be eliminated. The currently functioning programs in India are the National Tobacco Control Program, the National and three Regional Quitlines and mCessation.

A Review on Umbilical Cord Milking and Its Implications in Neonatal Health.

In India, there is an extreme lack of advancement in techniques concerning the care of infants during labor and post-pregnancy, i.e., the postnatal period. India projected an Infant Mortality Rate of 28.771 deaths per 1000 live births for the year 2021. Such a high death rate in infants arises a dire need to discover and launch new techniques and increase the application of the existing lesser-known techniques. One less well-known technique is the milking of the infant's umbilical cord. Transfusion of placental blood has recently been considered definitive in the care of newborns with the boon to the infant of declined death rate in preterm neonates and the enhanced consequences of growth in term infants. The chief goal of this descriptive review article is to examine all the studies relating to umbilical cord milking (UCM) in late-preterm and term infants and to evaluate every achievable outcome and restriction of a given process in clinical application, mainly when compared to rapid and late umbilical cord clamping. Application of milking of the umbilical cord can be seen to improve the health of hypoxic neonates, weight parameters, blood volume, hematocrit, hemoglobin, iron levels in the blood, red blood cell count, blood pressure, right ventricular output, left ventricular functions, cerebral oxygenation, urine output regulation, cognitive abilities, antioxidant levels, better outcomes in the resuscitation of infant and above all helps in lowering Infant Mortality Rates.