The magnitude of the problem of sickle cell disease (SCD) in India is very large and diverse. For people living with SCD there are several unmet health care needs making it pertinent to focus on recognizing the important public health burden of SCD in the country. In a bid to achieve this goal, the Indian College of Hematology (ICH) of the Indian Society of Hematology and Blood Transfusion (ISHBT) in collaboration with Indian Council of Medical Research (ICMR) has formulated a Guideline on Management and Control of Sickle Cell Disease in India. This was achieved by a national taskforce comprising top experts from the field who held multiple sessions to deliberate on different aspects and form consensus on preparing a comprehensive document on SCD care in India. The taskforce has presented its recommendations on various aspects of SCD in India, all of which have been evaluated based on the best evidence. Where the evidence was weak, the recommendations have been based on consensus among the experts. This review which is adapted from the comprehensive guideline document gives a concise treatise on various aspects of sickle cell disease in India along with specific recommendations. The section on screening and diagnosis provides an evidence-based background to scientifically select the most appropriate and feasible test option(s) in various Indian practice settings. The other aspects covered in this review are management of SCD in stable condition, iron overload and chelation therapy, vaso-occlusive crisis, management of other complications of SCD, blood transfusion in SCD, haematopoietic stem cell transplant and gene therapy in SCD, immunization and antibiotic prophylaxis in SCD and monitoring of patients with SCD. It also gives guidance on special circumstances such as pregnancy and surgery in SCD. It concludes with a note on prevention and control of SCD in India with an outline of a defined roadmap to make this possible.
A concise three‐step strategy provides enantioenriched, densely functionalized cycloheptannulated heteroarenes bearing a spirolactone motif adjacent to a tertiary stereocenter. The sequence begins with racemic α‐heteroaromatic γ‐butyrolactones, which undergo a microwave‐assisted Aromatic Cope rearrangement to afford key α‐(allyl)heteroaryl lactone intermediates. A subsequent organocatalytic Allylic Alkylation, leveraging a readily accessible Lewis base, enables the efficient synthesis of chiral lactones with excellent stereoselectivity (dr up to >99:1, er up to 99 :1) and good to very good yields (up to 94%). The final ring‐closing metathesis step seamlessly constructs the target polycyclic frameworks, demonstrating broad structural versatility.
Fruit processing industries generate by-products rich in polyphenols and antioxidants, but they decay due to short lifespans and inadequate management. This study aims to evaluate the impact of In-vitro digestion (IVD) on polyphenols, antioxidant potential, and polyphenolic profiles (free and bound) using HPLC–DAD in apples and pomegranate by-products. Predominant phenolic compounds in each sample found were myricetin, protocatechuic acid, and catechin. Most of the individual phenolic compounds reduced upon digestion except for gallic acid, protocatechuic acid, sinapic acid, and ferulic acid. The order of phenolic compounds and antioxidants among the fruit by-products was pomegranate peel (PPe) > pomegranate pomace (PPo) > apple pomace (AP) based on the phenolic compositions studied and antioxidant properties (DPPH, ABTS⋅+, FRAP, and reducing power activity). These by-products are high in polyphenols, and post-IVD revealed their retention and remained bioaccessible; therefore, they can be used to develop functional foods.
Background: Undernutrition among children under five remains a critical global health challenge, contributing to higher mortality. Traditional therapeutic foods often overlook the gut microbial derangements, critical for nutrient assimilation, growth, and long – term recovery. Finger millet, with its exceptional nutritional profile, stands as a sustainable alternative to cereal – based foods to address this nutritional gap while supporting gut health and inflammation. Objectives: The aim of this study is to evaluate a Finger Millet – based Complementary Food (FMCF) as a nutrient – dense, safe, and acceptable intervention for moderately acute malnourished (MAM) children. Methods: Finger millet (GPU–28) was germinated, roasted, and gamma – irradiated to improve nutrient bioavailability, reduce antinutrients, and ensure microbial –safety. We enrolled 200 children (100 MAM, 100 Healthy controls) aged 18 – 59 months from Anganwadi Centres. Participants have been randomized to receive either FMCF or an equicaloric wheat-based control (Balamrutham+) for 8 –weeks. Anthropometry, dietary intake, gut – microbiota composition, and inflammation marker estimation and correlation will be performed at different timepoints. Results: Product analysis revealed superior protein – energy ratio, fibre, calcium, and micronutrient content in FMCF compared to Balamrutham+. Microbiological and aflatoxin testing confirmed safety and shelf-life stability. Pilot feeding trial showed higher consumption (81 –98%) and shorter eating times (53 – 71%, p <0.001). Conclusion: FMCF is promising, cost-effective, and scalable intervention for nutritional-recovery in MAM, with potential to modulate the gut – microbiome and alleviate inflammation. The product aligns with SDG 2 (Zero Hunger) and SDG 3 (Good Health and Well-being), reinforcing its relevance as a public-health intervention. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial CTRI/2023/06/053590 ### Funding Statement This study has been funded by Indian council of medical research (ICMR) ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee of ICMR NIN gave ethical approval for this work I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes the data supporting this study's findings will be made available on reasonable request
