Neuromyelitis optica is also known as Devic disease Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Neuromyelitis optica – how is it different to multiple sclerosis? 13/06/26, 15:59 Last updated: Published: 13/07/24, 11:56 Neuromyelitis optica is also known as Devic disease This is article no. 6 in a series on Rare Diseases. Next article: Apocrine carcinoma . Previous article: Unfolding prion diseases . If you have never heard of neuromyelitis optica (NMO), you’re not alone! NMO is a rare disease affecting the spinal cord and optic nerve. A disease is determined as rare when it affects less than 1 in 2000 people. NMO, Devic’s disease in layman’s term, is an autoimmune disease, which means the immune system fails and attacks healthy self-cells, and can be one-off or recurrent. When patients experience a NMO attack, symptoms like eye pain and weakness in limbs, caused by inflammation of the spinal cord (transverse myelitis) and optic nerve (optic myelitis), commonly occur. There is a much higher prevalence of females with NMO than males. The exact reasons are still being researched, but some suggest it could be due to hormonal, genetic, and epigenetic factors, including the gut microbiome. New, highly effective, FDA-approved preventive treatments (eculizumab, inebilizumab, satralizumab, ravulizumab) and the investigation of daratumumab, which recently showed a 74% reduction in relapse risk. The field is shifting towards early, targeted therapy to prevent severe relapses. So the question arises – what causes NMO? In short, we don’t know yet. However, we do understand that 90% of NMO cases are caused by NMO-specific antibodies against Aquaporin4 (AQP4), an intrinsic membranes protein highly concentrated in the spinal cord and the brain, specifically in astrocytes and ependymal cells lining in the ventricles. AQP4 are water-selective channels in many plasma membranes and are responsible for maintaining brain-water homeostasis. Did you know NMO is often mistaken as Multiple Sclerosis (MS)? MS is also an autoimmune system and has similar symptoms as NMO, such as vision and mobility difficulties. However, there are important differences between the two. NMO specifically targets the optic nerves and spinal cord, leading to more severe attacks that can cause blindness and paralysis if not treated promptly. On the other hand, MS affects the brain and spinal cord more diffusely. Diagnosis and treatment for NMO and MS can be quite different, making it crucial to correctly distinguish between the two conditions. Advanced techniques like MRI scans, blood tests for specific antibodies (like AQP4-IgG for NMO), and careful clinical evaluation help doctors make the right diagnosis and provide appropriate treatment. Understanding these distinctions is vital for effective management and improving the quality of life for those affected by these diseases. Written by Chloe Kam Related article: Neuroimaging REFERENCES Hor, J.Y., Asgari, N., Nakashima, I., Broadley, S.A., Leite, M.I., Kissani, N., Jacob, A., Marignier, R., Weinshenker, B.G., Paul, F., Pittock, S.J., Palace, J., Wingerchuk, D.M., Behne, J.M., Yeaman, M.R. and Fujihara, K. (2020). Epidemiology of Neuromyelitis Optica Spectrum Disorder and Its Prevalence and Incidence Worldwide. Frontiers in Neurology , 11. doi: https://doi.org/10.3389/fneur.2020.00501 . Kim, S.-M., Kim, S.-J., Lee, H.J., Kuroda, H., Palace, J. and Fujihara, K. (2017). Differential diagnosis of neuromyelitis optica spectrum disorders. Therapeutic Advances in Neurological Disorders , 10(7), pp.265–289. doi: https://doi.org/10.1177/1756285617709723 . Mader, S. and Brimberg, L. (2019). Aquaporin-4 Water Channel in the Brain and Its Implication for Health and Disease. Cells , 8(2), p.90. doi: https://doi.org/10.3390/cells8020090 . Project Gallery

It's produced by European honeybees Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Medicinal Manuka 10/07/25, 11:21 Last updated: Published: 11/05/24, 11:57 It's produced by European honeybees Manuka honey has received considerable attention recently due to its impressive antimicrobial ability and potential for future clinical use. Manuka honey is produced by European honeybees ( Apis mellifera ) that visit the Manuka tree ( Leptospermum scoparium ) in New Zealand. It is most commonly distributed as monofloral honey (produced by bees that have visited predominantly one plant species—in this case, the Manuka bush); however, it can also be sold as multifloral. The Manuka tree, which the European honeybees visit, has a long history of use for its medicinal properties. The Māori (the indigenous Polynesian people of mainland New Zealand) valued it for its wide variety of uses, referring to the plant as ‘taonga’ (‘treasure’). The leaves from the tree were used to make infusions that could reduce fevers, and the gum produced from the tree was used to moisturise burns and soothe coughs. In the 18th century, European settlers contacted the Māori and became aware of this tree and its healing properties; they used the leaves as a medicinal tea to treat scurvy. In 1839, an English beekeeper, Mary Bumby, introduced bees to New Zealand, and by 1860, the bee population had grown extensively, and colonies were present throughout forests. The Māori learnt to harvest the honey produced by these bees and promoted the production of Manuka honey. The honey was used by the Māori for the same benefits they used the Manuka tree. In the 1980s, the biochemist Peter Molan launched the first scientific research on the antimicrobial properties of Manuka honey, evaluating its ability to kill microbes. Research has demonstrated that Manuka honey is an effective bactericidal (killer of microbes). Dr Jonathon Cox and his colleagues at Aston University showed that administering Manuka honey can be effective against Mycobacterium abscessus , which is fatal without treatment. Using a model of an artificial lung, Dr Cox found that the addition of Manuka honey reduced the dosage of the highly potent amikacin by 8-fold, which is an extremely significant difference to the quality of life of patients as a common consequence of the 13-month amikacin treatment is permanent hearing loss. Alternative remedies for bacterial infections are required to combat the growing concern of antibiotic resistance. Many molecules of Manuka honey are responsible for their antimicrobial activity, including methylglyoxal (MGO) content. MGO can interfere with the lipid bilayer structure of the bacterial membrane, leading to leakage of its cellular contents and cell death. MGO can also impair the function of enzymes involved in energy production and macromolecule synthesis within bacteria. Additionally, Manuka honey can also produce hydrogen peroxide, which generates highly reactive oxygen species (ROS) within bacterial cells. These ROS, such as hydroxyl radicals, can cause oxidative damage to biomolecules, including proteins, lipids, and DNA, leading to bacterial cellular death. Altogether, these mechanisms enable Manuka honey to disrupt bacterial growth and proliferation. Manuka honey is currently used as a medical product for professional wound care in European hospitals. The main advantage of Manuka honey is that the mechanisms behind its antibacterial activity are diverse, making it effective against resistant strains of bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) . A systematic review written by Jonathon Cox states that certain commercially available varieties of Manuka honey are effective against organisms that have a high degree of antibiotic resistance. Therefore, this leads to the promising preliminary conclusion that Manuka honey could be the answer to the investigation of finding an effective antimicrobial, an alternative to antibiotics. Written by Harvey Wilkes Related article: Natural substances as treatment to infection REFERENCES Nolan, V.C., Harrison, J. and Cox, J.A., 2022. In vitro synergy between manuka honey and amikacin against Mycobacterium abscessus complex shows potential for nebulisation therapy. Microbiology, 168(9), p.001237. Nolan, V.C., Harrison, J., Wright, J.E. and Cox, J.A., 2020. Clinical significance of manuka and medical-grade honey for antibiotic-resistant infections: a systematic review. Antibiotics , 9 (11), p.766. Project Gallery

CRISPR, regenerative medicine, vaccine development and recombinant DNA tech Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Medical Biotechnology 10/07/25, 11:21 Last updated: Published: 03/06/23, 14:57 CRISPR, regenerative medicine, vaccine development and recombinant DNA tech Introduction Throughout the course of human history, the foundation of medicine has predominantly relied upon biochemistry. Whereby, scientists utilise naturally occurring and artificially synthesised chemical compounds to elicit therapeutic responses within the body. However, during the 21st century, the field of medicine witnessed a paradigm shift towards medical biotechnology- driving major breakthroughs in healthcare. What is medical biotechnology? Medical biotechnology can be defined as the use of living organisms or their products to investigate, understand and target biological systems in order to improve healthcare outcomes. By integrating the principles of genetic engineering and biological processes, scientists are able to develop novel pharmaceuticals and create diagnostic tools for disease management. Major advancements in medical biotechnology A groundbreaking technology within this field is the CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) — Cas9 system. Which utilises CRISPR-associated protein Cas9 and guide RNA (gRNA) as a molecular tool to precisely modify genetic material. By harnessing this gene editing system, scientists can manipulate specific DNA sequences and modulate gene expression, making it an invaluable tool towards precision medicine. Its ability to correct genetic defects has shown promise in the future development of targeted therapies for genetic diseases. Regenerative medicine, another frontier in medical biotechnology aims to regenerate damaged or diseased tissues and organs. This interdisciplinary field integrates principles from tissue engineering and stem cell biology to enable tissue repair and regeneration. Stem cells possess a remarkable capacity to self-renew and differentiate into various specialised cell types. Through research biotechnologists seek to engineer functional tissues and organs for transplantation or stimulate the body's innate regenerative abilities. The development of vaccines is yet another critical aspect of medical biotechnology. Vaccines are designed to stimulate the immune system and confer immunity against specific pathogens, thereby preventing infectious diseases. Modern biotechnology techniques, such as genetic engineering and cell culture, enable cost-effective vaccine development. Recombinant DNA technology enables antigen production in non-pathogenic host cells, eliminating the need for pathogen harvesting. Ongoing advancements include RNA/DNA vaccines, allowing antigen production within recipients' bodies. Conclusion Medical biotechnology continues to play a pivotal role in advancing scientific knowledge and enhancing disease diagnostics and treatment. It holds immense promise for the future of healthcare, particularly in the field of precision medicine. However, it is crucial to acknowledge that this technology also carries inherent risks. Misuse can lead to negative consequences, such as bioterrorism and other destructive outcomes. Written by Komal Nasir Related article: Biggest innovations in the biosciences currently Project Gallery

Its toxicodynamics, and balancing benefits and risks Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Exploring Ibuprofen 05/03/26, 15:06 Last updated: Published: 17/01/24, 01:28 Its toxicodynamics, and balancing benefits and risks What is Ibuprofen? Ibuprofen is a standard over-the-counter medicine which can be bought from supermarkets and pharmacies. It is primarily used for pain relief, such as back pain, period pain, toothaches, etc. It can also be used for arthritis pain and inflammation. It is available in various forms, including tablets, capsules, gels, and sprays for the skin. The Toxicodynamics of Ibuprofen Toxicodynamics refers to the biological effects of a substance after exposure to it. Scientists look at the mechanisms by which the substance produces toxic effects and the target organs or tissues it affects. Ibuprofen works by stopping the enzymes that synthesise prostaglandins, which are a group of lipid molecules that cause inflammation, including symptoms like redness, heat, swelling and pain. Therefore, after the action of Ibuprofen, inflammatory responses and pain are reduced. Ibuprofen targets organs and tissues, including the gastrointestinal tract, the kidneys, the central nervous system, blood and more. Balancing the Benefits and Risks Ibuprofen’s method of action means it is a safe and effective pain relief medication for most people. It is also easily accessible and easy to use. However, it is able to affect the target organs and tissues negatively and, therefore, can have serious side effects, especially if taken for an extended period of time and/or in high doses. They include heartburn, abdominal pain, kidney damage (especially for people who already have kidney problems), low blood count and more. Therefore, it is important to use Ibuprofen responsibly. This can be done by understanding and being well-informed about its effects on the body, particularly its impact on organs and tissues. With caution and proper use, the side effects can be minimised. One of the easiest ways to lessen side effects is by taking the medication with food. Additionally, patients should take the lowest effective dose for the shortest possible time. If patients have a history of stomach problems, avoiding Ibuprofen and using alternatives is the best solution. Patients can also talk to their GP if they are concerned about the side effects and report any suspected side effects using the Yellow Card safety scheme on the NHS website. Written by Naoshin Haque Related articles: Synthesis of ibuprofen / Anthrax toxin / The Pain Gate Theory Project Gallery

Various people are needed to make a successful David Attenborough nature documentary Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Behind the scenes of a David Attenborough nature film Last updated: 25/05/26, 19:40 Published: 25/05/26, 19:29 Various people are needed to make a successful David Attenborough nature documentary Sir David Attenborough celebrated his 100th birthday on 8th May 2026 to much fanfare. He is the visionary and narrator of iconic BBC nature documentaries like the Planet Earth series (the first released in 2006, the sequel released in 2016, and the most recent instalment released in 2023, see Figure 1 ). Sir Attenborough’s landmark docuseries Life on Earth , released in 1979, showed the public natural beauty in a way no producer had done before. However, there are dozens of people around Sir Attenborough away from the spotlight, who carry out excruciating work to make his nature documentaries so engaging. In honour of the centenarian, the BBC released an interview with Sir Attenborough and the crew behind Life on Earth . This article explains what I learned from watching that interview, and how nature documentary filming has changed over the course of Sir Attenborough’s long, illustrious career. People behind the scenes Various people are needed to make a successful David Attenborough nature documentary. Before filming begins, there are producers responsible for planning travel, accommodation, meetings with local wildlife experts, and other logistics. Lawyers help secure filming permissions in each country, and health & safety experts help write risk assessments. Then there is the camera crew, managed by a film director. To precisely operate the heavy cameras, the crew need physical strength, dexterity, and concentration. After the camera crew returns from filming, the producers pick the best scenes and video editors stitch them together. In addition, a live orchestra is recorded playing bespoke music scores for each documentary, the audio from which is passed on to sound mixers. Depending on what needs to be filmed and where, other specialists may also be needed. For example, a camera was attached to a professional paraglider for filming a fast-flying golden eagle in the Planet Earth II documentary. As Sir Attenborough has got older, his role has shifted from presenting and directing on-site to script-writing and narrating from home, but the dedication and expertise of his team have stayed the same. Challenges of filming Everyone in a nature documentary crew faces many challenges throughout the filming process, but it is all worth it when the final documentary is released. Ensuring the wildlife are not disturbed by filming is crucial, so that they behave naturally and do not attack the crew. Behind-the-scenes footage from the Planet Earth III documentary shows the camera crew staying still, keeping a respectful distance, even putting on camouflage to discreetly film wildlife. Another challenge is the physical toll of filming in extreme habitats. In the Life on Earth interview celebrating his 100th birthday, Sir Attenborough said he did not know he was allergic to donkey fur until he had to ride one for the docuseries, and it flared up his skin exactly when he needed to be on camera. While filming Planet Earth III, the crew in Madagascar got sick from eating local food, and a producer in the Himalayas got mountain sickness from the low oxygen conditions. These health issues are made worse by the lack of medical care in some of the remote regions being filmed in. The mental challenges of wildlife filming are not to be underestimated – a cinematographer on Planet Earth II describes how difficult it was to watch an animal die because trying to save its life would risk the crew’s safety. It is also challenging to be away from loved ones for weeks, especially during holidays or important family events. Cinematographers need to be incredibly patient when filming wildlife. It could take weeks for the animals to feel comfortable enough in the presence of humans to behave naturally, or for unpredictable natural phenomena to occur, or to find a rare animal in the vast empty wilderness. Despite the patience and sacrifices, it may be that the crew does not get the footage they want in the time they have. If the country being filmed in is politically unstable, both the video footage and the crew could be at risk. In the Life on Earth interview, one of the producers recalls Saddam Hussein’s troops seizing the crew’s hotel in Iraq. Sir Attenborough describes in the same interview how the most famous moment of the documentary, where he gets close and personal with gorillas, was almost captured by armed soldiers in Rwanda. Issues with filming permits could also threaten a shoot’s success, such as if a rebel group controlling the filming area does not acknowledge permits issued by the official government. Since the filming equipment is expensive and possibly irreplaceable, it must be carefully protected. Extreme weather events and wildlife, even animals that are not being filmed, risk damaging the equipment. With all these challenges, everyone involved in a wildlife documentary needs to be resilient. How technology has evolved Nature documentaries have changed a massive amount since Life on Earth was filmed in the mid-1970s, during the advent of colour television, whereas now we can watch wildlife in 4K ultra-high definition, showing how cameras have evolved rapidly in the last 50 years. Cameras have also gotten smaller, like drones or remote camera traps, meaning parts of nature which people cannot reach can still be filmed ( Figure 2 ). Camera traps also help with discreet filming, as mentioned earlier, allowing us to get closer to wildlife than ever before. Assistant producers on Life on Earth explained in the Sir David Attenborough centenarian interview that they arranged logistics on physical paper since there were no e-mails, so it could take weeks to hear back from international colleagues. The producers also said the documentary was filmed when commercial aeroplanes were a new concept, so they could plan to film on opposite ends of the world faster than ever before. The COVID-19 pandemic helped the innovation of remote technology, making filming even faster than flying to the filming site. Local camera operators can now send footage to the UK for editing, or robot cameras can be controlled halfway across the world. Thus, while Life on Earth was the first documentary of its kind, new technology since its release has made nature documentaries more engaging. Conclusion Filming a David Attenborough nature documentary requires patience and tenacity from a wide range of skilled people, in the face of health-, safety-, and weather-related challenges. Using state-of-the-art camera equipment, the documentaries we have access to today have captured wildlife in a level of detail Sir Attenborough could not have dreamed of when he filmed Life on Earth in the 1970s. The next time you relax to the sound of Sir Attenborough’s voice, think of the years of blood, sweat, and tears it took to produce such a marvellous celebration of nature. Written by Simran Patel Project Gallery

Diving deep Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link The science and controversy of water fluoridation 03/04/26, 17:23 Last updated: Published: 17/11/23, 17:00 Diving deep In the pursuit of national strategies to improve oral health, few interventions have sparked as much debate and divided opinions as water fluoridation. Whilst some have voiced concerns about water fluoridation in recent years, viewing it as mass medicalisation and an intrusion into personal choice, researchers and dental professionals continue to champion its benefits as a cost-effective, population-wide approach that can significantly reduce tooth decay and enhance the oral health of communities across the country. The statistics from 2021-2022 paint a concerning picture, with a staggering 26,741 extractions performed on 0-19-year-olds under the NHS due to preventable tooth decay, amounting to an estimated cost of £50 million. With the NHS bearing the responsibility of providing dental care to millions of people nationwide, the introduction of water fluoridation stands out as a promising ally in the quest for more efficient healthcare and the alleviation of the burden on our already-strained healthcare system, all while improving dental health in a cost-effective manner. Fluoride is a naturally occurring chemical element found in soil, plants and groundwater, which can reduce dental decay through a dual mechanism; fluoridating water reduces dental decay by both impeding demineralisation of enamel and enhancing remineralisation of teeth following acid attacks in the mouth. When sugars from food or drinks enter the mouth, the bacteria present in plaque act to convert these sugars to acid, demineralising the outer surface of teeth and leading to the formation of cavities. The incorporation of fluoride into the structure of tooth enamel during remineralisation strengthens and hardens the outer layer of teeth, rendering teeth less susceptible to damage and more resistant to acid-induced demineralisation. Moreover, fluoride has also been proven to reverse early tooth decay by repairing and remineralising weakened enamel, thus averting the need for restorative dental procedures such as fillings. The inhibition of demineralisation and encouragement of remineralisation overall prevents cavities forming and preserves the vitality of our smiles. The main adverse effect of fluoridating water is the risk of dental fluorosis, which affects the appearance of teeth. Dental fluorosis is a cosmetic dental condition caused by excessive fluoride exposure, resulting in changes in tooth colour and texture. It presents as small opaque white spots or streaks on the tooth surface. It is important to note that these conditions generally occur at fluoride levels significantly higher than those recommended for water fluoridation. Opponents of water fluoridation also argue on ethical grounds, citing concerns about mass medication infringing on personal choice and the right to decide whether to use fluoride or dental products containing fluoride. In some cases, opposition is rooted in conspiracy theories and scepticism about government motives. Findings from the Office for Health Improvement and Disparities and the UK Health Security Agency highlight the benefits of water fluoridation. The data collected illustrates young populations in areas of England with higher fluoride concentrations are up to 63% less likely to be admitted to hospital for tooth extractions due to decay compared to their counterparts in areas of lower fluoridation levels. This disparity is most pronounced in the most deprived areas, where children and young adults benefit the most from the addition of fluoride to the water supply. These findings strongly support the evidence for the advantages of water fluoridation and highlight how this simple method can substantially improve health outcomes for our population. While fluoridation has proven beneficial for communities, especially those from deprived backgrounds, it has demonstrated successful outcomes for individuals across all demographics, irrespective of age, education, employment, or oral hygiene habits. It's essential to emphasize that water fluoridation should not replace other essential oral health practices such as regular tooth brushing, prudent sugar intake, and dental appointments. Instead, it should complement these practices, working in synergy to optimize oral health. As of now, approximately 10% of the population in England receives water from a fluoridation scheme. While the protective and beneficial effects of fluoridation are well-established, the decision to move towards a nationwide water fluoridation scheme ultimately rests with the Secretary of State for Health in the coming years. As of 2025-26, the government is actively moving to expand coverage (inc. in the North East England) to reduce NHS dental costs. Written by Isha Parmar Project Gallery

The prevalence of diverticulosis is increasing in developed countries Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Understanding diverticular disease 14/07/25, 16:08 Last updated: Published: 27/11/24, 11:31 The prevalence of diverticulosis is increasing in developed countries Diverticulosis, diverticula, diverticulum, and diverticulitis - they may sound similar, but each term describes a specific aspect of diverticular disease. Before diving into diverticular disease, let’s clarify these key terms: Diverticulum: a small, bulging pouch that forms in a weak spot in the lining of the large intestine. Diverticula: the plural form of a diverticulum, indicating multiple bulging pouches in the large intestine's lining. Diverticulosis: a condition where multiple diverticula are present in the large intestine. Diverticulitis: this occurs when one or more diverticula become inflamed or infected. What is diverticular disease? Diverticular disease can be broadly categorised into two main conditions: diverticulosis and diverticulitis. Both involve the presence of diverticula in the colon, but the key difference lies in inflammation. In diverticulitis, the diverticula become inflamed or infected, leading to symptoms. On the other hand, diverticulosis is typically asymptomatic. However, there is a third condition, referred to as symptomatic uncomplicated diverticular disease (SUDD), where diverticula are present without inflammation, but the patient still experiences symptoms. The prevalence of diverticulosis is increasing in developed countries, largely due to the typical 'Western diet', which is high in red meat and low in fibre. Additionally, lifestyle factors such as obesity, smoking, and physical inactivity contribute to this rise. Age is also a significant factor, with 85% of diverticulosis cases occurring in individuals over the age of 50. Pathophysiology The formation of diverticula in the colon is primarily due to three factors: structural abnormalities in the colonic wall, disordered intestinal motility, and a deficiency of dietary fibre. The large intestine has two layers of muscle that work together to move its contents: an inner circular layer and an outer longitudinal layer. The outer layer consists of three bands called the taeniae coli, which run longitudinally along the colon. The gaps between these muscle bands are areas of weakness, making them vulnerable to the development of diverticula. Age-related weakening of the connective tissue further increases the risk of developing diverticula in these vulnerable areas. In some patients, abnormal gut motility can lead to areas of high pressure in the bowel, causing the mucosa to bulge outward, forming diverticula. Similarly, a lack of fibre in the diet can increase bowel pressure and lead to irregular movement, which also promotes outpouching. As we've discussed, some patients with diverticula may remain asymptomatic, while others experience varying levels of discomfort. The transition from diverticulosis to diverticulitis occurs when undigested food or a fecalith becomes trapped in these pouches, causing a blockage. This leads to bacterial growth and multiplication, resulting in infection and inflammation of the pouch. Symptoms Diverticular disease comes with a range of symptoms, some of which are quite common and could be easily mistaken for other conditions. General symptoms like nausea, vomiting, diarrhoea, and fever often overlap with other digestive problems, making diagnosis tricky. However, certain symptoms can hint more strongly at diverticular disease. For instance, experiencing pain in the lower left side of the abdomen (known as the left iliac fossa) or noticing rectal bleeding are more specific indicators that may point towards this condition. Recognising these symptoms can help in getting a more accurate diagnosis and appropriate treatment. Management Managing diverticular disease depends on the individual patient and the severity of their symptoms. For some, simple, conservative treatments are enough—this might include staying hydrated, eating a high-fibre diet, and giving the bowel a short rest by temporarily avoiding food. However, if a patient is experiencing significant pain or signs of infection, medical treatment is necessary. This may involve pain relief based on the WHO pain ladder or antibiotics to tackle the infection. In more serious cases, where other treatments haven’t worked or the patient is in a life-threatening situation, surgery might be required. A common procedure for these severe cases is the Hartmann’s procedure. This surgery removes the damaged section of the large intestine, usually due to infection or blockage. The healthy end of the intestine is brought out through an opening in the abdomen, creating a temporary colostomy that allows waste to leave the body through a bag. This setup gives the intestine time to heal, and in some cases, a follow-up surgery can reconnect it for normal function. Complications There are both short-term and long-term complications associated with diverticulitis, particularly in more severe cases that require more aggressive treatment such as surgery (see Figure 4 ). Future directions Recent changes in the management of diverticulitis have shifted how clinicians approach treatment. One significant update involves the use of antibiotics. Traditionally, diverticulitis was treated with routine antibiotic prescriptions. However, newer guidelines suggest that antibiotics may not be necessary for uncomplicated cases, helping to reduce both antibiotic resistance and the potential medication side effects for patients. Another emerging trend is treating uncomplicated diverticulitis on an outpatient basis. This allows patients to be managed at home with pain relief and dietary adjustments, which in turn frees up hospital resources for those with more severe conditions. Additionally, the management of complicated diverticulitis has evolved. For instance, abscesses may now be treated with percutaneous drainage rather than resorting to emergency surgery. Conclusion In summary, diverticular disease can vary widely in its symptoms and required treatments, ranging from dietary changes to surgical interventions for severe cases. Identifying specific signs and understanding the treatment options can empower patients and help them make informed choices. Advances in treatment approaches are also helping to improve outcomes and quality of life for those affected. Written by Abbasali Gulamhussein Related articles: Crohn's disease / The gut microbiome / Interplay of hormones and microbiome REFERENCES Cater, M. (2023). Foods for Diverticulosis and Diverticulitis . [online] www.hopkinsmedicine.org . Available at: https://www.hopkinsmedicine.org/health/wellness-and-prevention/foods-for-diverticulosis-and-diverticulitis . Matrana, M.R. and Margolin, D.A. (2009a) Epidemiology and pathophysiology of diverticular disease , Clinics in colon and rectal surgery . Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC2780269/ (Accessed: 12 October 2024). Miller, A.S. et al. (2021) The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery , Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland . Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC9291558/ (Accessed: 12 October 2024). NHS (2019). Diverticular disease and diverticulitis . [online] NHS. Available at: https://www.nhs.uk/conditions/diverticular-disease-and-diverticulitis/ . Sciencedirect.com . (2019). Hartmann Procedure - an overview | ScienceDirect Topics . [online] Available at: https://www.sciencedirect.com/topics/medicine-and-dentistry/hartmann-procedure . Singh, B., May, K., Coltart, I., Moore, N. and Cunningham, C. (2008). The Long-Term Results of Percutaneous Drainage of Diverticular Abscess. The Annals of The Royal College of Surgeons of England , [online] 90(4), pp.297–301. doi: https://doi.org/10.1308/003588408x285928 . Ubhi, L. (2023). Prescribing Analgesia and the WHO Analgesic Ladder | Geeky Medics . [online] geekymedics.com . Available at: https://geekymedics.com/prescribing-analgesia-and-the-who-analgesic-ladder/ . Project Gallery

It's in the diet Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link How epigenetic modification gives the queen bee her crown 23/01/25, 11:52 Last updated: Published: 26/11/23, 10:46 It's in the diet Honey bee colonies are comprised of three kinds of adult bees: workers, drones and a single queen. While all drones are male, the queen and the worker bees are female. Within the female population, only the queen bee is fertile and is thus responsible for laying eggs which are fertilised by drones. Additionally, a queen bee is larger than worker bees and produces pheromones to allow the colony to function. However, worker and queen bees are genetically identical, so how is it possible that they are so fundamentally different? ( Figure 1 ) The answer lies in epigenetic modification , defined as the alteration in gene function without a change in the DNA sequence. Types of epigenetic regulation include histone modification, DNA methylation and action of noncoding RNA. The honey bee Apis mellifera is amongst the many species that can produce different characteristics of organisms using the same genome. The mechanism by which honey bees do this derives from epigenetic modification resulting from the difference in diet during larval development. All larvae feed on royal jelly during the first three days of their development ( Figure 2 ). However, worker larvae will then feed on a diet of honey and pollen, which constitutes worker jelly. In comparison, the queen larva maintains a diet of royal jelly; this is a complex mixture produced by nurse bees and contains water, crude protein, monosaccharides, and fatty acids. Subsequently, the difference in dietary intake provides information to facilitate the correct epigenome which in turn allows correct transcription. Thus, key studies have taken place to investigate the effect of epigenetic marks on the development of bees. DNA methyltransferase DNMT3 is responsible for the methylation of DNA and is a repressive mark; a study found that the silencing of DNMT3 resulted in worker larvae developing into queens that had developed ovaries. Consequently, this shows that royal jelly gives information to larvae destined to be queens that can be interpreted to apply the correct epigenome. Additionally, certain histone deacetylase inhibitors have been observed in royal jelly including the compound 10 HDA and phenylbutyrate. Histone acetylation within regions of the genome results in chromatin opening; acetylation is associated with active regions. HDACi activity will inhibit the removal of such acetylation and maintain open regions of DNA. However, note that worker bees are not just a repressed version of queen bees, as they have overexpressed genes of their own to facilitate their specific behaviours. On examination of the methylome (see Figure 3 ), different genes were identified as being hypo- or hyper- methylated within worker vs queen bees. See the table below for a detailed analysis of worker and queen bees on days 3-5 of development. How exactly the specificity of epigenetic modifications is accomplished is not completely realised. To exemplify this, DNMTs do not have specificity, and thus, there must be an interplay between chromatin modifiers and cellular components to accomplish the correct recruitment of enzymes involved in epigenetic modification. However, it is clear that the epigenomes of workers vs queen bees are decidedly different and thus are the cause of different physiological and behavioural characteristics. Written by Isobel Cunningham Related articles: An introduction to epigenetics / Famine-induced epigenetic changes Project Gallery

And can we overcome them? Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link The Challenges in Modern Day Chemistry 04/04/26, 17:39 Last updated: Published: 24/02/24, 22:09 And can we overcome them? Chemistry is often called the "central science" because it connects everything in the natural world. It is the foundation for how we understand life and is essential for solving the massive problems facing humanity today. In recent years, chemistry has changed significantly as top researchers push the boundaries of technology. However, this progress is met with a series of complex, overlapping challenges that require creative and completely new solutions. This article explores the most difficult hurdles currently facing the world of modern chemistry. Sustainability and the Imperative of Green Chemistry The biggest challenge for modern chemistry is the urgent need for environmental sustainability. For a long time, the chemical industry has been a major contributor to pollution and the loss of natural resources. Because of this, there is a desperate need to create "greener" and safer chemical processes. Green chemistry is a leading movement focused on designing products that avoid using or creating hazardous materials. Researchers in this field are working hard to find non-toxic alternatives and energy-efficient methods to reduce the damage caused by chemical work. Energy Storage and Conversion at the Frontier As the world demands more renewable energy, like solar and wind power, the need for better ways to store and convert that energy has become incredibly urgent. Chemistry is at the heart of developing advanced batteries, fuel cells, and supercapacitors. However, scientists are still struggling with how to make batteries hold more power, last longer, and cost less to produce. To solve this, a massive effort is underway to find brand-new materials and invent better ways to manage the chemical reactions that store electricity. Drug Resistance as a Crescendoing Predicament The rise of "superbugs"—bacteria that antibiotics can no longer kill—is a growing crisis in medicine. As germs continue to evolve, chemists face the massive task of constantly inventing new antibiotics and antiviral drugs. At the same time, the move toward "personalized medicine" requires new ways to design drugs that are tailored to a specific person’s body. The ultimate goal is to find a way to stop drug resistance while also getting rid of dangerous side effects, which is one of the most difficult puzzles in chemistry today. Ethical Conundrums and the Regulatory Labyrinth As chemistry continues to move forward, the ethical and legal questions surrounding it become more complicated. Issues like who owns a discovery, how to innovate responsibly, and how to prevent chemical knowledge from being used for harm require careful thought and strict ethical rules. Finding the right balance between pushing for scientific breakthroughs and being a responsible protector of those discoveries is a constant challenge for the chemistry community. In conclusion... Modern chemistry is a fast-moving field that drives innovation in almost every industry while tackling global problems. However, it must overcome its own obstacles, from environmental responsibility and drug resistance to complex ethical dilemmas. Success will require experts from different fields to work together, use their imaginations, and commit to using their power for good. As we continue to learn more about the world of atoms and molecules, solving these problems is the only way to ensure a sustainable and successful future for everyone. Written by Navnidhi Sharma Related article: Green Chemistry Project Gallery

The web of geopolitics surrounding the Rohingyas, and how this impacts their health Facebook X (Twitter) WhatsApp LinkedIn Pinterest Copy link Addressing the health landscape of Bangladesh’s Rohingya community Last updated: 05/03/26, 15:04 Published: 18/09/25, 08:00 The web of geopolitics surrounding the Rohingyas, and how this impacts their health This is article no. 6 in a series about global health injustices. Previous article: Health gaps in conflict-affected Kashmir. Next article: A deep, critical reflection . Introduction Welcome to the sixth article of the Global Health Injustices Series, a collaboration with Nasif Mahmood . This article focuses on the ongoing injustices and health issues affecting the Rohingya refugees in Bangladesh. This community leads a vulnerable life and suffering that it is becoming one of the most significant South Asian crises in the 21st century. Due to Bangladesh's inadequate resources and geopolitical situation, the overall health and well-being of the country and the migratory population are severely hampered. A brief history of Bangladesh and the Rohingya population Bangladesh's history is intricate and has been influenced by many cultures. After India was divided in 1947, the area, previously part of ancient Bengal, was ruled by the British and became East Pakistan. Demands for autonomy resulted from tensions between West and East Pakistan. The Bangladesh Liberation War in 1971, culminating in these tensions, led to the country's independence. Bangladesh has made great strides in education, health, and economic growth since gaining its autonomy, despite facing economic hardship, political turmoil, and natural disasters. Rohingya, the Muslim ethnic minority from the state of Rakhine, were denied citizenship by the Myanmar Government, leaving them homeless. They endured years of persecution, discrimination, and violence. In 2017, an inhuman, violent crackdown by the military of the Myanmar government forced over 70,000 Rohingya to flee to Bangladesh. Over 1 million refugees live in Bangladesh, primarily in the Cox Bazar area. A lot of refugees cause overcrowding situations, and limited resources lead to a high rate of nutritional problems and spread of disease, specifically infectious diseases and mental health disorders in the refugee camp. Connecting geopolitics and health: impacts on the Rohingya population The Rohingya crisis is more than just a humanitarian issue; it is a tangled web of geopolitical challenges. The Myanmar government’s ongoing refusal to grant citizenship and fundamental rights to the Rohingya people not only deepens their suffering but also fuels instability in the region. They have not taken the necessary steps to ensure their safety, leaving the crisis unresolved. As refugees continue to pour into neighbouring countries, tensions have escalated, placing a heavy burden on host nations like Bangladesh. This crisis worsens existing socio-economic problems and stretches resources thin in areas struggling to care for their citizens. The international community has responded in various ways; some countries are pushing for tougher sanctions against Myanmar, while others are focused on delivering aid to those affected. However, the underlying issues driving this crisis will unlikely be resolved without a coordinated and sustained political effort ( Table 1, Figure 1 ). Addressing them can lead to improved outcomes for the Rohinyga population. On top of that, the health challenges faced by the Rohingya people go beyond just infectious diseases. The lack of access to essential health services has not only worsened physical health problems but has also led to a growing mental health crisis. Many Rohingya individuals are grappling with post-traumatic stress disorder (PTSD), anxiety, and depression stemming from their traumatic experiences of violence, loss, trauma, isolation, and forced displacement. Yet, mental health services in the refugee camps are severely lacking. A study showed that the prevalence of emotional and behavioural disorders is high among forcefully migrated refugee children, because of traumatic exposure like the unexpected death of parents, forceful displacement, and the witnessing of family violence and abuse. The stigma surrounding mental health in many cultures, including in the Rohingya community, creates additional hurdles for those seeking help. Enhancing access to mental health support is crucial, not just for the immediate well-being of the refugees, but also for their long-term healing and successful integration into the societies that host them. Moreover, providing humanitarian aid and hosting such a large population in Bangladesh is becoming difficult. The national and international NGOs maintain healthcare for the Rohingya population. However, the funding shortage and inadequate infrastructure hinder the provision of adequate medical services. For this reason, the refugee camps have reported significant outbreaks of diphtheria, cholera, and COVID-19. Given the challenges, developing innovative solutions and working collaboratively on a global or regional scale is needed. By empowering local health workers and training them to offer basic healthcare and mental health support, to close the service delivery gaps. Additionally, building partnerships among NGOs, governments, and international organisations can help ensure that resources are allocated more effectively and that comprehensive health programs are created to meet the unique needs of the Rohingya population. It's crucial to engage the community; by listening to the voices and experiences of the Rohingya, we can develop interventions that truly respect their dignity and cultural context. Additionally, raising global awareness about the struggles faced by the Rohingya can lead to stronger advocacy efforts. Involving the media, educational institutions, and civil society can foster a deeper understanding of the interconnected issues of geopolitics and health. Initiatives that share personal stories and experiences can rally public support and drive meaningful change. Ultimately, tackling the Rohingya crisis calls for a multifaceted approach that blends immediate humanitarian aid with long-term strategies aimed at ending their statelessness and ensuring their rights as human beings are upheld and protected. Recommendations from NGOs National NGOs: Several national NGOs play an essential role in supporting the healthcare needs of the Rohingya population: Bangladesh Rural Advancement Committee (BRAC), one of the world's largest NGOs, provides comprehensive health care services, including maternal and child health, immunisation programmes, disease prevention initiatives, and arranges many health campaigns for refugees. Gonoshasthaya Kendra established a field hospital and free clinic in the Cox Bazar area near the refugee camp, focusing on primary health care and emergency medical support. International NGOs MedGlobal, an international NGO, responds to this global crisis by delivering medical assistance within the refugee camp. Support hospitals and clinics for affected refugees between 2017 and 2019. This organisation's volunteers contributed over 17,000 hours of aid, assisting more than 80,000 individuals. Medair is another international NGO offering health and nutritional support to the Rohingya refugees. Migrant Offshore Aid focuses on sea rescue operations and delivering medical aid and assistance to surfers. Together, these national and international organisations make meaningful contributions to the healthcare needs of the Rohingya population, handling both immediate medical concerns and long-term health support in a challenging environment. Their collaborative efforts help ensure that essential services reach those in critical need, facilitating better health outcomes for refugees. Although they address the healthcare needs of the Rohingya, several challenges can limit their effectiveness. For example, coordination issues may lead to overlapping efforts or service gaps, resulting in inequitable and unequal healthcare access. Also, limited resources and funding can slow extensive long-term support, leaving specific medical needs unaddressed. Additionally, the intricate political and social conditions restrict these organisations' capacity to operate effectively, impacting immediate care and sustainable health initiatives for the Rohingya population. Moving forward, it is crucial for host countries to: finance extra healthcare facilities in refugee camps to enhance access and reduce diseases, launch culturally appropriate mental health initiatives with locally trained workers to decrease stigma and provide community-based support, integrate nutrition programmes to address different forms of malnutrition in vulnerable communities and encourage further international support to maintain health initiatives among the Rohingya population. Conclusion The Rohingya crisis is an example of global health injustice exacerbated by geopolitical and humanitarian challenges. At the same time, Bangladesh is trying to provide temporary shelter for the refugees to minimise the crisis. However, this crisis also requires international cooperation, policy support, and increased funding. Solving this issue is essential for global public health and human rights. Notably, finding sustainable solutions will help the Rohingya people recover and thrive, and enhance stability and security in the region. Their future goes beyond humanitarian aid; it is about upholding inclusion, justice, and respect for human dignity, which should guide all efforts to link geopolitics with health outcomes. To truly tackle the health issues faced by the Rohingya community, we need to take a comprehensive approach that looks at the political, social, and economic factors at play. By adopting such all-encompassing systems, we can work towards a brighter and fairer future for the Rohingya community and other vulnerable groups around the globe who are facing similar challenges. The next article will be the final one reflecting on everything discussed in this series. Written by Nasif Mahmood and Sam Jarada Related articles: Health and well-being in- Palestine , Kashmir / South Asian famine / South Asian mental health / Ethnic health inequalities REFERENCES Tinker HR. History of Bangladesh | Events, People, Dates, & Facts [Internet]. Encyclopedia Britannica. 2023 [cited 2025 Jul 15]. Available from: https://www.britannica.com/topic/history-of-Bangladesh Rahman MM, Bhuiyan MR, Ali MZ, Rahman MS, Hossain MA. Insecurity feelings and mental health status of Rohingya orphan children in BangladeshResearchGate; 2021 https://www.researchgate.net/publication/348521935_Insecurity_Feelings_and_Mental_Health_Status_of_Rohingya_Orphan_Children_in_Bangladesh UNHCR. Rohingya refugee crisis – Bangladesh. 2023. https://www.unhcr.org International Crisis Group (ICG). The health crisis in Rohingya refugee camps. 2022. https://www.crisisgroup.org Tay AK, Riley A, Islam R, Welton-Mitchell C, Duchesne B, Waters V, et al. The culture, mental health and psychosocial wellbeing of Rohingya refugees: a systematic review. Epidemiology and Psychiatric Sciences [Internet]. 2019 Apr 22 [cited 2025 Sep 10];28(5):489–94. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6998923/ Human Rights Watch. The plight of Rohingya refugees in Bangladesh. 2023. https://www.hrw.org . Nivedita Sudheer, Banerjee D. The Rohingya refugees: a conceptual framework of their psychosocial adversities, cultural idioms of distress and social suffering. Cambridge Prisms Global Mental Health [Internet]. 2021 Jan 1 [cited 2025 Sep 10];8. Available from: https://www.cambridge.org/core/journals/global-mental-health/article/rohingya-refugees-a-conceptual-framework-of-their-psychosocial-adversities-cultural-idioms-of-distress-and-social-suffering/F4D229807D4ED7667EA16195FDF5C787 World Health Organization (WHO). Health challenges in Rohingya refugee camps. 2022. https://www.who.int Médecins Sans Frontières (MSF). Medical response in Rohingya refugee settlements. 2022. https://www.msf.org Project Gallery