Sankalp Yadav

Blood donation, a fundamental act of altruism, has undergone significant evolution over the centuries. Despite medical progress, the persistent challenge lies in securing an adequate supply of blood and its derivatives. This article critically examines the proposal to introduce monetary incentives for blood donation, delving into ethical, legal, and pragmatic dimensions. India’s current framework staunchly upholds voluntary, unpaid donations. However, global practices diverge significantly. Notably, India previously permitted monetary compensation for blood donation but later prohibited it due to concerns about infection transmission. Monetary incentives offer a potential solution to address key deterrents faced by potential donors. Health anxieties, time constraints, and fear of infection often discourage voluntary donations. By providing financial motivation, we may enhance donor participation and bolster the reliability of the blood supply. While the benefits are evident, caution is essential. Implementing monetary incentives necessitates robust safeguards. Preventing the exploitation of vulnerable populations and ensuring the safety of blood products remain paramount. Striking this delicate balance requires careful consideration. By analyzing ethical, legal, and practical facets, we navigate the intricate landscape of blood supply management.

Novel investigations of how microgravity affects cellular and tissue development have recently been made possible by the multidisciplinary fusion of tissue engineering and space science. This review examines the intersection of cartilage tissue engineering (CTE) and space science, focusing on how microgravity affects cartilage development. Space microgravity induces distinct physiological changes in chondrocytes, including a 20-30% increase in cell diameter, a 1.5- to 2-fold increase in proliferation rates, and up to 3-fold increases in chondrogenic markers such as SOX9 and collagen type II. These cellular alterations impact extracellular matrix composition and tissue structure. Space-optimized bioreactors using dynamic culture methods replicate physiological conditions and enhance tissue growth, but the absence of gravity raises concerns about the mechanical properties of engineered cartilage. Key research areas include the role of growth factors in cartilage development under microgravity, biocompatibility and degradation of scaffold materials in space, and in situ experiments on space stations. This review highlights the opportunities and challenges in leveraging microgravity for CTE advancements, emphasizing the need for continued research to harness space environments for therapeutic applications in cartilage regeneration. The multidisciplinary fusion of tissue engineering and space science opens novel avenues for understanding and improving cartilage tissue engineering, with significant implications for the future of biomedical applications in space and on Earth.

Surgical training has long emphasized learning through direct observation, allowing young surgeons to gain practical insights from experienced surgeons. The advent of live surgical demonstrations has extended this learning method, providing real-time broadcasts of surgeries to wider audiences. Live surgery is a surgery that is broadcasted in real time to an audience. While live surgeries offer substantial educational benefits, enabling the rapid dissemination of advanced surgical techniques and reducing the learning curve for surgeons, they also raise critical ethical and legal questions. Concerns include potential compromises in surgical outcomes due to increased pressure on surgeons, the ethical implications of patient consent, privacy issues, and the ambiguity of accountability when complications arise. In India, these concerns have intensified following a patient's death during a live surgery, prompting legal scrutiny and a Supreme Court petition seeking to regulate the practice. This article delves into the multifaceted debate surrounding live surgeries, examining both their educational value and the ethical, legal, and practical challenges they pose. We aim to provide a comprehensive overview that will inform readers about the complexities of live surgeries, spread awareness, and stimulate further discussions on this evolving practice.

The integration of fog computing into healthcare promises significant advancements in real-time data analytics and patient care by decentralizing data processing closer to the source. This shift, however, introduces complex regulatory, privacy, and security challenges that are not adequately addressed by existing frameworks designed for centralized systems. The distributed nature of fog computing complicates the uniform application of security measures and compliance with diverse international regulations, raising concerns about data privacy, security vulnerabilities, and legal accountability. This review explores these challenges in depth, discussing the implications of fog computing's decentralized architecture for data privacy, the difficulties in achieving consistent security across dispersed nodes, and the complexities of ensuring compliance in multi-jurisdictional environments. It also examines specific regulatory frameworks, including Health Insurance Portability and Accountability (HIPAA) in the United States, General Data Protection Regulation (GDPR) in the European Union, and emerging laws in Asia and Brazil, highlighting the gaps and the need for regulatory evolution to better accommodate the nuances of fog computing. The review advocates for a proactive regulatory approach, emphasizing the development of specific guidelines, international collaboration, and public-private partnerships to enhance compliance and support innovation. By embedding privacy and security by design and leveraging advanced technologies, healthcare providers can navigate the regulatory landscape effectively, ensuring that fog computing realizes its full potential as a transformative healthcare technology without compromising patient trust or data integrity.

Tuberculous infection of the extrapulmonary sites, especially the small bones, is a seldom reported entity even in endemic countries. Moreover, simultaneous involvement of the forearm muscles is a very rare presentation with no such case reported showing concurrent involvement of the two sites. The diagnosis is challenging due to the paucibacillary nature of the disease, a lack of awareness among primary clinicians, and ambiguity in clinical features with other musculoskeletal disorders, especially when there is no pulmonary involvement. Herein, we present a first-of-its-type case of spina ventosa of the left ring finger with a tuberculous abscess in the forearm in a 15-year-old Indian male with no pulmonary seeding. The diagnosis was achieved through a detailed diagnostic workup, which resulted in the detection of Mycobacterium tuberculosis. He was initiated on antituberculous treatment with a remarkable improvement.

Extrapulmonary tuberculosis is less commonly reported, and isolated tuberculous involvement of bones such as the radius, without any pulmonary lesions, is extremely rare. Diagnosing this condition can be challenging due to ambiguous clinical features and non-specific radiological findings in the early stages. The present case describes a rare instance of isolated tuberculosis of the radius in an immunocompetent Indian male with no pulmonary involvement. The diagnosis was achieved through a high index of suspicion in an endemic region, advanced radiometric investigations, and the isolation of Mycobacterium tuberculosis using the cartridge-based nucleic acid amplification test. The patient was started on a 12-month course of appropriate chemotherapy.

The healthcare sector faces complex challenges that call for innovative solutions to improve diagnostic accuracy, treatment efficacy, and data management. Quantum computing, with its unique capabilities, holds the potential to revolutionize various aspects of healthcare. This narrative review critically examines the existing literature on the application of quantum computing in healthcare, focusing on its utility in enhancing diagnostics, data processing, and treatment planning. Quantum computing's ability to handle large, complex datasets more efficiently than classical computers can significantly impact domains such as genomics, medical imaging, and personalized medicine. Quantum algorithms can accelerate the identification of genetic markers associated with diseases, facilitate the analysis of medical images, and optimize treatment plans based on individual genetic profiles. Moreover, quantum cryptography offers a robust security solution for safeguarding sensitive patient data, a critical need as healthcare increasingly relies on digital platforms. Despite the promising outlook, the integration of quantum computing into healthcare faces technical, ethical, and regulatory challenges. The delicate nature of quantum hardware, the need for error correction, and the scalability of quantum systems pose barriers to widespread adoption. Additionally, concerns around patient privacy and data security, as well as the need for updated regulatory frameworks, must be addressed. Ongoing research and collaborative efforts involving researchers, healthcare providers, and technology developers are crucial to overcoming these hurdles and realizing the full potential of quantum computing in transforming healthcare. As quantum computing continues to evolve, its impact on the future of healthcare could be profound, leading to earlier disease detection, more personalized treatments, and improved patient outcomes. For instance, quantum computing has already been applied to enhance drug discovery processes, with companies like D-Wave Systems (Burnaby, Canada) demonstrating faster molecular simulations for pharmaceutical research and IBM's (Armonk, USA) quantum systems being used to model chemical reactions for new drug development.

Knee osteoarthritis (OA) significantly impacts global health, causing pain, disability, and socioeconomic burden. Traditional treatments often provide only temporary relief and can have adverse effects. Autologous conditioned serum (ACS) therapy, which enriches a patient's own blood with growth factors and anti-inflammatory cytokines, has emerged as a promising approach to manage knee OA, potentially offering pain reduction, improved function, and tissue regeneration. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched databases such as PubMed, Web of Science, and Cochrane using terms like "Autologous Conditioned Serum" and "knee osteoarthritis." Clinical studies were selected based on their focus on ACS's efficacy in knee OA, assessing outcomes like pain relief, functional improvement, and adverse events. Eighteen studies met the inclusion criteria, including randomized controlled trials, observational studies, and comparative analyses. The review included a wide range of study designs and outcomes, highlighting ACS's efficacy in reducing pain and enhancing knee function as evidenced by various patient-reported outcome measures Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Society Clinical Rating Score (KSCRS) with a follow-up of up to 11 years (range: 2-11 years). Comparative studies showed ACS to be as effective or superior to conventional treatments such as platelet-rich plasma, steroids, and hyaluronic acid, especially in cases of moderate synovitis. Minimal adverse effects such as peri-injection pain, rigidity, synovitis, transient sensation of redness/heat, and numbness in the knee/leg/toes were reported, underscoring ACS's safety. Some studies suggested ACS might also have disease-modifying effects, contributing to tissue repair and integrity. ACS therapy offers a promising alternative for knee OA management, demonstrating potential benefits in symptom alleviation, functional improvement, and safety. Indications of disease-modifying properties further highlight its therapeutic value. However, the need for standardized formulations and treatment protocols, long-term studies, and mechanistic understanding remain. Future research should focus on addressing these gaps to fully elucidate ACS's role in the treatment landscape of knee OA.

This article explores a timely and contentious issue within the Indian medical community: the relationship between doctors and pharmaceutical companies, particularly the sponsorship of continuing medical education (CME) events. Triggered by the National Medical Council's proposed guidelines in August 2023, which sought to ban such sponsorships, the article revisits the longstanding debate over potential conflicts of interest. While critics argue that these relationships could compromise medical ethics, the article questions whether this assumption holds up under scrutiny. It highlights the potential unintended consequences of a blanket ban, such as reduced opportunities for professional development, increased costs of healthcare services, and a slowdown in medical innovation. Furthermore, it offers a comparative analysis of global practices, revealing that no other country has imposed such a stringent ban, with other countries opting instead for regulated transparency. This one-of-a-kind article addresses a unique and underexplored topic in Indian medical literature, offering a nuanced perspective on how to balance ethical considerations with the need for continued medical advancement. Doing so calls for a more measured approach that preserves the integrity and progress of the medical profession.

Artificial intelligence (AI) is rapidly transforming the landscape of healthcare, with its applications ranging from diagnostics to robotic surgery. As India swiftly integrates AI into its healthcare system, a critical question arises: who bears the liability when AI-driven medical decisions go wrong? This article explores the complexities of assigning legal responsibility for AI in healthcare, particularly within the Indian context. While India's legal framework, including the Information Technology Act, intersects with AI usage, it lacks specific provisions addressing AI liability. The National Strategy for AI, although a step forward, does not resolve the ambiguities surrounding accountability. The article also examines how other countries, particularly the European Union and the United States, are beginning to tackle these challenges through proposed directives and regulations. However, the absence of clear, comprehensive laws worldwide reflects the inherent difficulties in legislating AI stemming from its autonomous nature, the "black box" problem, and the multifaceted roles of stakeholders. Until robust legal frameworks are established, the article cautions healthcare professionals to exercise vigilance when using AI tools, recognizing that they may still bear significant liability. This evolving legal landscape underscores the need for continued deliberations in AI regulations.