Background/Aims: Inflammatory bowel disease (IBD) is increasing across the globe, more so in populous countries like India. We aimed to study the disease burden and epidemiological trends of IBD in India and look closer into the disease pattern across the country from 1990 to 2019. Methods: The burden of IBD was estimated in India using the data from the Global Burden of Disease estimate for 2019, which is a comprehensive worldwide project. The analysis included various parameters like incidence, prevalence, mortality, disability-adjusted life years, years lived with disability, and years of life lost as age-adjusted rates (per 100,000 population). Using modeling, the prediction was also made for 2050 in India. Results: The age-standardized incidence, prevalence, mortality, and disability rates of IBD in India for 2019 were 2.34, 20.34, 0.40, and 13.04, respectively. These are lower than the global incidence, prevalence, mortality, and disability rates of 4.97, 59.25, 0.54, and 20.15, respectively. The annual rates of change in incidence, prevalence, mortality, and disability rates in India from 1990 to 2019 were 0.05, –0.02, –0.36, and –0.35, respectively. The annual rates of change in incidence and prevalence are higher than the global rate of –0.18 and –0.19, while the annual rates of change in mortality and disability are lower than the global rate of –0.19 and –0.26. Conclusions The incidence and prevalence of IBD in India are lower compared to the global population but are increasing at a faster rate than the global population.

Early identification and management of (central) auditory processing disorder [(C)APD] necessitate a multidisciplinary approach due to its potential effects on listening, communication, and academic performance. It is crucial to assess the awareness and knowledge of the team members involved in the management of (C)APD to bridge the gap between early identification and intervention. The aim of this study was to assess the awareness and knowledge of (C)APD among pediatricians in India. Subjects and Methods: This study used a questionnaire-based cross-sectional survey. Phase I involved the development and content validation of the questionnaire. The questionnaire contained 14 closed-ended questions to assess the awareness and knowledge of the causes, symptoms, assessment, treatment, and management of (C)APD. Phase II involved the administration of the developed questionnaire to 118 pediatricians practicing in India with at least one year of experience. Results: The findings of the study indicated that the majority (94.07%) of the pediatricians were aware of (C)APD, but only a few had diagnosed a child with (C)APD (32.2%). Most pediatricians showed varying levels of accuracy in recognizing common symptoms of (C)APD. Subgroup analyses of the symptom knowledge domain using Fisher’s exact chi-square tests revealed that pediatricians with ≥11 years of experience (p=0.043) and those with postgraduate qualifications demonstrated significantly better recognition of (C)APD symptoms (p=0.009). Participants demonstrated a good understanding of the multidisciplinary team involved in the diagnosis and management of (C)APD. Conclusions: Pediatricians in India possess a good general awareness of (C)APD but limited detailed knowledge of its symptoms and management. Clinical experience and postgraduate qualifications were associated with a greater understanding of (C)APD symptomatology. The gap between knowledge and clinical practice underscores the need for targeted training, curriculum integration, and structured referral pathways to improve early identification and intervention for (C)APD.

Purpose: Down syndrome (DS) is associated with metabolic dysregulation, obesity, and increased risk of chronic inflammation. This study aimed to assess subclinical inflammation in children with DS by evaluating inflammatory biomarkers, such as high-sensitivity C-reactive protein (hs-CRP), and their association with metabolic parameters including ghrelin, lipid profiles, and vitamin D levels. Methods: A total of 49 children with DS (aged 1–18 years) and 22 age-matched healthy controls were enrolled. Anthropometric data, body fat percentage, and metabolic parameters were assessed. Inflammatory markers (hs-CRP, apolipoprotein-B [Apo B], adiponectin), metabolic hormones (ghrelin, insulin), and lipid profiles were determined from venous blood samples. Statistical analyses included bivariate correlation, analysis of variance, and multiple linear regression to identify predictors of inflammation. Results: Children with DS exhibited significantly higher hs-CRP levels than controls (p=0.03), indicative of increased systemic inflammation. Higher hs-CRP levels were associated with older age (r=0.33, p=0.006), greater obesity (body mass index: r=0.32, p=0.011), and elevated serum insulin and low-density lipoprotein levels. Ghrelin levels correlated negatively with Apo B (r=-0.41, p<0.001) and positively with hs-CRP (r=0.30, p=0.012). Predictors of inflammation (based on hs-CRP) included older age, male sex, higher gamma-glutamyl transferase level, and a diagnosis of DS (adjusted R²=0.276). Conclusion Children with DS are prone to metabolic inflammation, with increasing age and obesity exacerbating inflammatory responses. Clinicians should monitor and manage weight, dyslipidemia, and inflammation in this population to prevent long-term complications such as cardiovascular diseases and insulin resistance.

Menopause-associated estrogen deficiency has been implicated in cartilage degeneration and osteoarthritis (OA) progression. This systematic review and meta-analysis evaluates evidence from human and animal studies. Five databases were searched until March 2025. Eligible studies included postmenopausal women or ovariectomized (OVX) animal models assessing cartilage degeneration, OA severity, or related biomarkers. Human and animal studies were analyzed separately. Random-effects meta-analyses were conducted when outcomes were comparable. Eleven studies met the criteria (human, n = 6; animal, n = 5). Pooled human results for C-terminal telopeptides of type II collagen and magnetic resonance imaging-based cartilage thickness showed non-significant trends toward greater cartilage loss in estrogen-deficient women. OVX animal studies demonstrated significantly greater histological cartilage degeneration compared with controls. Hormone replacement therapy showed inconsistent but directionally protective effects. Estrogen deficiency is associated with cartilage degeneration, with strong supportive evidence from OVX models. Human evidence indicates similar trends but lacks statistical significance, highlighting the need for larger and more standardized studies.

Objectives: Health literacy (HL) is a key determinant of health behaviors and health outcomes. However, the lack of validated Hindi-language instruments limits its assessment in India. This study aimed to translate, culturally adapt, and psychometrically validate 3 internationally recognized tools—the Short Assessment of Health Literacy in English (SAHL-E), the All Aspects of Health Literacy Scale (AAHLS), and the European Health Literacy Survey Questionnaire (HLS-EU-Q47)—for Hindi-speaking adults in rural North India. Methods: A community-based cross-sectional study enrolled 250 adults from 5 villages in Uttar Pradesh. Translation followed forward–backward procedures with expert review and pretesting. Psychometric evaluation included internal consistency (Cronbach α), test–retest reliability (intraclass correlation coefficients, ICC), construct validity (exploratory factor analysis), convergent and known-groups validity, and feasibility indicators (completion rates and interview duration). Results: All instruments demonstrated strong psychometric performance. Cronbach α values were 0.84 (SAHL-E), 0.87 (AAHLS), and 0.93 (HLS-EU-Q47), and ICCs ranged from 0.86 to 0.94. Factor structures aligned with theoretical expectations. Convergent correlations ranged from 0.42 to 0.61 (p<0.001), and known-groups validity analyses showed significant differences according to education and occupation. Completion rates exceeded 98%, and the mean interview duration was approximately 32 minutes. Conclusions The Hindi-adapted SAHL-E, AAHLS, and HLS-EU-Q47 demonstrated strong reliability, validity, and feasibility for assessing HL among rural adults in India.

Replicative senescence in endothelial cells is characterized by an irreversible cell cycle arrest and impaired endothelial function, contributing to vascular aging and cardiovascular disease. Natural compounds are being actively studied for their potential to delay cellular senescence and protect vascular health. Among them, rice bran has demonstrated several vascular benefits that are mainly attributed to gamma-oryzanol (γ-Orz), a major bioactive component in rice bran. However, its role in regulating endothelial replicative senescence and the underlying molecular mechanisms remain unclear. This study aimed to explore the protective effects of rice bran extract (RBE) and γ-Orz on replicative senescence in porcine coronary artery endothelial cells (PCAECs). Replicative senescence was modeled in PCAECs by serial passaging from P1 to P3 with varying concentrations of RBE and γ-Orz.Senescence was evaluated by measuring senescence-associated β-galactosidase (SA-β-gal) activity, cell proliferation, oxidative stress, and the expression of cell cycle regulatory proteins. RBE and γ-Orz significantly reduced SA-β-gal activity, improved proliferation, and decreased oxidative stress in P3 cells, along with downregulation of senescence-related proteins p53, p21, and p16. Additionally, γ-Orz suppressed sodium-glucose co-transporter 2 expression, reduced NADPH oxidase overexpression, and restored eNOS levels. These findings indicate that RBE and γ-Orz delay endothelial senescence by alleviating oxidative stress, highlighting their potential to reduce cardiovascular disease risk associated with endothelial senescence.

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and a leading cause of cancer mortality worldwide. Its pathogenesis reflects a combination of tumour-intrinsic heterogeneity and a profoundly immunosuppressive tumour microenvironment. Growing evidence shows that tumours recapitulate developmental programs to establish an oncofetal ecosystem, characterised by the re-expression of foetal antigens and foetal-like stromal and immune subsets. These features drive immune evasion and shape therapeutic response, contributing to immunotherapy outcomes in clinic. This review outlines mechanistic insights into oncofetal reprogramming across tumour, stromal, and immune compartments and evaluates therapeutic strategies that target these dependencies. We highlight emerging vaccine platforms, cellular therapies, and biologics targeting oncofetal antigens, with particular emphasis on mRNA–lipid nanoparticle vaccines and their potential to induce robust, durable antitumour immunity. We further discuss rational combinatorial strategies that integrate vaccines with immune checkpoint inhibitors. Finally, we discuss how overcoming liver tolerance and antigenic heterogeneity will be essential for effective oncofetal-directed therapies. Collectively, targeting the oncofetal ecosystem through coordinated vaccine, cellular, and immunotherapeutic strategies offers a path toward more durable responses and broader immunotherapy benefits in HCC.

Emphysematous pyelonephritis (EPN) is a severe necrotizing kidney infection characterized by gas formation. While EPN is recognized in native kidneys and occasionally in functional renal allografts, its occurrence in nonfunctional allografts is extremely rare.We present a case of EPN in a 38-year-old female with a history of renal transplantation who developed EPN in a nonfunctional graft 1 year after returning to hemodialysis.The patient initially demonstrated excellent graft function posttransplant but later developed chronic antibody-mediated rejection and calcineurin inhibitor toxicity, which led to graft failure and resumption of hemodialysis. One year later, she presented with fever and graft site tenderness. Imaging revealed stage 3 EPN in the allograft. Empirical broad-spectrum antibiotics and percutaneous drainage were initiated, followed by graft nephrectomy due to persistent fever spikes. This case highlights the occurrence of EPN in a nonfunctional graft, even after cessation of immunosuppression. The presence of a nonfunctioning graft with impaired blood supply may have provided a nidus for infection. It underscores the importance of considering nephrectomy as a primary therapeutic approach in such cases. This case also emphasizes the need for heightened clinical suspicion and prompt intervention in transplant recipients with suspected EPN, even in the absence of a functioning graft.