Medical University of the Americas (MUA) is a private for-profit offshore medical school in Charlestown, Nevis. It is owned by R3 Education, Inc. which also owns St. Matthew's University and Saba University School of Medicine MUA confers upon its graduates the Doctor of Medicine (MD) degree. Students at MUA are primarily from the US and Canada and return to those countries to practice medicine. A typical incoming class at MUA is about 150 students.
OBJECTIVES:This study aims to present a comprehensive maternal genetic perspective on the population history of coastal northwestern India, especially Gujarat. The region is important due to its paleoanthropological significance, its role in the Indus Valley civilization, and its location within routes of Indo-European and Dravidian speaking populations. Previous studies have often used limited samples, underscoring the need for more extensive mitochondrial DNA analyses. MATERIALS AND METHODS:We sequenced and analyzed complete mitochondrial genomes from 168 individuals in Gujarat. To place these within a broader phylogenetic framework, we included an additional 529 complete mitogenomes representing East-West Eurasian and South Asian lineages. Phylogenetic relationships and chronological expansions were examined, and Bayesian analysis was used to assess changes in maternal effective population size over time. RESULTS:Our findings show that the majority of (76%) of maternal lineages in Gujarat are from South Asia. East Eurasian and West Eurasian contributions are comparatively low, at 0.6% and 21%, respectively. Looking at the events of the last few millennia, we note that only 19% of West Eurasian lineages appear to have entered the region within the last 5000 years. Most Eurasian haplogroups represent early founding lineages, while 81% of West Eurasian lineages predate the Steppe migration. DISCUSSION:The data suggest that western India retains largely indigenous maternal ancestry, with little evidence for major maternal migration or replacement over the last 40,000 years. West Eurasian lineages entered in several small waves rather than a single large influx, challenging the classic Indo-Aryan migration model.
Chikungunya virus (CHIKV) is an arthropod-borne viral disease which spreads to humans by mosquito bites, inducing musculoskeletal pain and fever. CHIKV was endemic to the Indian Ocean region till 2004 that affected millions. It has been expanding its existence to non-endemic regions in Europe, the Middle East and the Pacific regions since 2004. Current fast CHIKV transmission scenario highlights the necessity of innovating control methods and devising novel diagnostic techniques. Conventional vector control measures lack efficacy as CHIKV vector evolves. Also, the existing assays used to detect CHIKV vary on sensitivity and specificity. This leads to mis-reporting or under-reporting of CHIKV cases especially in the endemic regions. This review discusses the CHIKV pathogenesis, an overview of various existing detection and the mitigation measures. Later, the challenges and limitations posed by these and how they can be subjugated by employing various simple and sustainable measures are emphasised. This review also suggests strategies to deploy novel systems in resource-limited settings to effectively address the infection and transmission of CHIKV disease.
Abstract Introduction Hypermagnesemia is an electrolyte derangement which has the propensity to become life-threatening. Severe hypermagnesemia can cause stark side effects, including neuromuscular paralysis, respiratory failure and shock. This is a case of magnesium toxicity, presumably secondary to laxative misuse, leading to cardiorespiratory failure and eventually death. Case The patient is a 73-year-old female with a past medical history of hypertension, gastroesophageal reflux disease, and irritable bowel syndrome-consitpation. She had been experiencing significant constipation and abdominal pain for one week, prompting her to contact her primary physician. She was given two enemas, MiraLAX and took over-the-counter magnesium-containing laxatives. While passing a bowel movement, she had a syncopal episode, and emergency services were contacted. She was taken to an outside hospital, where she was noted to be hypotensive, refractory to IV fluids and requiring two pressors. Laboratory tests revealed a lactate level of 13 mmol/L and a magnesium level of 9.5 mg/dL. Unfortunately, her condition worsened, and due to decreased respiratory effort, she was intubated and sedated before being transferred to our facility for a higher level of care.Upon arrival, she was transferred to the ICU and required additional vasopressor support with a third pressor. Repeat laboratory tests showed a lactate level of 11.7 mmol/L, and magnesium was greater than 20 mg/dL. Repeat imaging identified concern for ischemic colitis; however, was not a surgical candidate. Despite aggressive resuscitation efforts including IV antibiotics, stress dose steroids, and calcium infusions, her condition did not improve. Repeat magnesium did not improve, and given her profound hypotension and hypoxia, she was not a candidate for dialysis.Due to hypermagnesemia from laxative overuse and the patient experienced worsening refractory shock and multiorgan failure. Given her prognosis, the family decided to pursue comfort measures, and the patient expired shortly afterward. Discussion Severe hypermagnesemia, albeit rare, has the propensity to precipitate profound cardiovascular and respiratory failure. This occurs due to calcium channel blockade in cardiac tissue and smooth muscle, resulting in decreased contractility and vascular tone, as well as interference with calcium-dependent acetylcholine release at the neuromuscular junction, which reduces respiratory effort. Treatment includes intravenous calcium and fluids, diuretics and dialysis; however, the latter becomes less feasible if hemodynamic instability arises, as in this patient. This case report identifies that clinicians must exercise caution and educate patients about the use of magnesium-containing agents in bowel dysmotility. Furthermore, it demonstrates that hypermagnesemia requires early identification and aggressive treatment. This abstract is funded by: NONE
Stroke is an increasing cause of death and disability across Africa, driven by rising vascular risk factors and persistent health-system limitations. Transient ischemic attack (TIA) is a strong predictor of early ischemic stroke and represents a critical window for secondary prevention. However, TIA recognition and management pathways across Africa remain poorly defined and frequently fragmented. This narrative review examines the burden of stroke and available TIA data in Africa, outlines key challenges in TIA recognition and management, and highlights opportunities for context-specific pathway development. Major barriers include low public awareness, delayed presentation, limited access to neuroimaging, workforce shortages, absence of standardized protocols, and financial constraints that undermine continuity of care. Key opportunities include task-sharing, digital health and telemedicine, electronic decision support, strengthened referral systems, lifestyle-based risk-factor reduction, workforce development, and integration of TIA care into broader non-communicable disease strategies. Strengthening structured TIA pathways offers a feasible and high-impact strategy to reduce preventable stroke morbidity and mortality across Africa.
This structured narrative literature review examined current evidence on the identification and management of post-traumatic stress disorder (PTSD) and trauma-related symptoms in children and adolescents with autism spectrum disorder (ASD). Literature was identified through searches of PubMed, PsycINFO, and Google Scholar, focusing on peer-reviewed English-language studies published between 2010 and 2025. Studies were included if they examined PTSD, trauma-related symptoms, assessment, diagnosis, or interventions in autistic children and adolescents, or provided an ASD-specific or broader neurodevelopmental context relevant to trauma. Findings were organized thematically due to heterogeneity in study designs, participant characteristics, diagnostic instruments, and outcome measures. The reviewed literature suggests that PTSD and trauma-related symptoms may be frequently unrecognized in autistic youth due to assessment complexities related to symptom overlap, communication differences, sensory sensitivities, and diagnostic overshadowing. Adapted screening approaches, caregiver and educator input, and developmentally appropriate assessment strategies may improve recognition of trauma-related distress. Evidence for treatment remains limited, but modified trauma-focused interventions, including adapted cognitive behavioral therapy (CBT), eye movement desensitization and reprocessing, caregiver-assisted approaches, and trauma-informed care settings, may support more individualized management. Overall, current evidence supports the importance of early, ASD-sensitive recognition of trauma-related symptoms while highlighting the need for larger pediatric studies, validated screening tools, longitudinal follow-up, and greater diversity in study populations.
