K.S. Hegde Medical Academy

The increasing incorporation of multiple sweeteners into processed foods underscores the need to evaluate their combined genotoxicity. Epidemiological studies associate high intake of sweeteners with elevated risks of cardiovascular, cerebrovascular, and metabolic disorders, yet the genetic consequences of their combined consumption remain largely unexplored, highlighting the necessity of assessing their interactive genotoxic risks. This study therefore aimed to investigate the genotoxic and developmental toxicity of the widely used artificial sweeteners, acesulfame potassium (ACE K), aspartame (ASP), and stevia (S), individually and in relevant binary and ternary combinations (ACE K + ASP, ACE K + S, ASP + S, and ACE K + ASP + S) at 10, 30, and 50 mM. Genotoxicity was assessed using the Drosophila SMART assay, complemented by molecular docking and 100-ns dynamic simulations with the developmental regulators Engrailed (En) and Hedgehog (Hh), and toxicity prediction via ProTox-3.0. All sweeteners produced dose-dependent genotoxic effects, with ACE K–containing mixtures showing higher spot frequencies at 10 mM, while ASP + S exhibited stronger genotoxicity at 30 and 50 mM; the triple combination consistently mirrored the 10 mM trend. In silico analyses revealed higher binding affinities of ACE K toward En and Hh, aligning with in vivo observations. Collectively, these findings demonstrate concentration-dependent genotoxic risks associated with sweetener mixtures and indicate that formulations incorporating stevia may offer relatively safer alternatives for food applications.

Myoepitheliomas are rare benign salivary gland tumours, representing less than 1

Summary: Background: Data of Central Nervous System (CNS) demyelinating disorders from India has been published from limited centres. The Indian Multiple Sclerosis And Allied Demyelinating Disorders Registry and Research Network (IMSRN) is a multicentric database for multiple sclerosis and allied demyelinating disorders in the Indian subcontinent. This study aimed to describe the demographic, clinical, laboratory, treatment, and follow-up details of patients in the IMSRN and summarise the distribution of major disease phenotypes in a real-world cohort. Methods: This was a prospective, observational, registry-based analysis of patients with CNS demyelinating disorders enrolled in the IMSRN between 16 August 2021 and 25 October 2025. Data were collected in a predefined case record form at recruitment and periodically every six months on a secure database. We performed descriptive and comparative analyses, including temporal trends, treatment patterns, and longitudinal follow-up. Findings: As of 25th October, 2025, 4976 patients have been recruited including radiologically isolated syndrome (RIS), 15 (0.30%); clinically isolated syndrome (CIS), 200 (4.02%); multiple sclerosis (MS), 2479 (49.82%); neuromyelitis optica spectrum disorder (NMOSD), 793 (15.94%); myelin oligodendrocyte antibody associated disease (MOGAD), 698 (14.03%); acute disseminated encephalomyelitis (ADEM), 76 (1.53%); chronic relapsing inflammatory optic neuritis (CRION), 34 (0.68%); chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS), three (0.06%), and others, 562 (11.29%). The mean (SD) age of the entire cohort at enrolment is 34.62 (12.16) years, at disease onset was 29.12 (11.80) years and median (IQR) disease duration at recruitment is 2.79 (0.51–7.22) years; longest for MS. There were 65.33% females and 34.67% males, with a female-to-male ratio of 1.9:1; highest in NMOSD (3.58:1). Most patients are from urban areas and educated. Optic nerve and spinal cord involvement were the dominant areas at first presentation. The median (IQR) number of relapses per patient over follow-up was 2 (1–3) highest in the NMOSD population; dominated by optic nerve and spinal cord symptoms. The median (IQR) EDSS was 2 (1–4.5). Rituximab was the commonest disease modifying therapy (DMT) used. Longitudinal trends reflect improvement in time-to-diagnosis and significant shift in the pattern of DMT use in MS towards oral DMTs and B-cell inhibitors. Interpretation: The paper describes a cohort of patients with MS and allied disorders. The key disease characteristics of the MS population seem similar to those reported in international MS registries. The data adds to the existing literature to ascertain disease patterns, response to treatment, and long-term outcome. Funding: The IMSRN registry is funded by the Indian Council of Medical Research (ICMR) vide Grant number 5/4-5/192/NeuroTF/2019-NCD-1.

Ovarian germ cell tumors (OGCTs) arise from primordial germ cells and are the second most common ovarian neoplasms after surface epithelial tumors. While the majority are benign, approximately 5

Background Daily oral iron supplementation has been a standard for treating iron-deficiency anemia, but is often limited by gastrointestinal side effects and poor adherence. Alternate-day dosing has been proposed to improve tolerability and absorption based on hepcidin-mediated iron regulation. The objective of the study was to compare the effect of daily versus alternate-day oral iron supplementation on hemoglobin and serum ferritin levels, gastrointestinal side effects, and compliance among anemic women aged 18–49 years over 12 weeks. Methods This randomized, double-blind, placebo-controlled trial was conducted in the Dakshina Kannada district, Karnataka, India. Seventy-four anemic women (hemoglobin 8–12 g/dL) were randomized to receive 60 mg elemental iron daily (n = 37) or on alternate days with placebo on off-days (n = 37). The primary outcome was hemoglobin change; secondary outcomes included ferritin change, gastrointestinal symptoms, and compliance. An intention-to-treat analysis was conducted to reflect real-world supplementation priorities. Continuous variables (mean ± SD, median) were tested for normality (Shapiro–Wilk); between-group comparisons used chi-square, t-test, and Mann–Whitney U; within-group comparisons used paired t-test/Wilcoxon. Ferritin trajectories used Friedman testing. Side effects were compared using Fisher's exact test (categorical) and the Mann–Whitney U test (ordinal severity). Correlations: Pearson's r/Spearman's ρ; effect sizes: Cohen's d; Absolute risk increase / Numbers needed to harm were reported. Results Both groups showed significant within-group improvement in hemoglobin and ferritin (p < 0.001). Hemoglobin gain was comparable between groups (+ 1.49 vs + 1.17 g/dL, p = 0.249), but the daily group showed significantly greater ferritin rise (+ 8.08 vs + 4.88 ng/mL, p = 0.039). The daily group experienced markedly higher gastrointestinal side effects (94.6% vs 40.5%, p < 0.001; number needed to harm = 1.8) and significantly lower compliance (84.1% vs 92.7%, p = 0.005). Compliance correlated positively with both hemoglobin and ferritin gains. Subgroup analysis showed the daily regimen's ferritin advantage was concentrated among women with moderate anemia, menstrual disturbances, and older age. Conclusion Both regimens effectively improved hemoglobin, with comparable efficacy overall. Daily supplementation offered superior ferritin repletion, particularly in higher-risk subgroups, but at the cost of substantially greater gastrointestinal burden and reduced adherence, supporting a stratified, patient-centered approach to dosing. Trial registration Central Trial Registry of India on 6th March 2025 (CTRI/2025/03/081855).