Padmashree Dr. D.Y. Patil University

Introduction: Gouty arthritis is a common inflammatory condition caused by the deposition of uric acid crystals in the joints, leading to intense pain, swelling, and functional impairment. Thermal therapies, including hot and cold fomentation, are often used as adjunctive treatments for managing inflammation and pain in various musculoskeletal conditions. However, the efficacy of these therapies in acute gout remains underexplored. This study aims to compare the effects of hot fomentation versus cold fomentation in patients experiencing acute gout flares, assessing pain reduction, swelling, joint mobility, and overall patient satisfaction. Materials and Methods: A randomized controlled trial was conducted with 2,400 patients diagnosed with acute gouty arthritis, divided into two equal groups: Group A received hot fomentation (38°C-42°C) and Group B received cold fomentation (5°C-10°C). Both interventions were applied twice daily for 20 min over 5 days, alongside standard gout care. Pain intensity was measured using the visual analog scale (VAS), while joint circumference, range of motion, and patient satisfaction were recorded at baseline, day 3, and day 5. Statistical analyses compared outcomes between the two groups. Results: Cold fomentation significantly reduced pain intensity (VAS score reduction of 68% by day 5) compared to hot fomentation (26% reduction, P < 0.001). Joint swelling decreased by 25% in the cold group versus 5% in the hot group, with cold therapy also leading to greater improvements in joint mobility (average increase of 15° vs. 5°, P < 0.01). Notably, 35% of patients in the hot fomentation group experienced flare-ups, compared to only 2% in the cold fomentation group (P < 0.001). Patient satisfaction was also higher in the cold group, with 85% of participants reporting satisfaction versus 30% in the hot group. Conclusion: This study demonstrates that cold fomentation is significantly more effective than hot fomentation in managing acute gouty arthritis. Cold therapy provided superior pain relief, reduced swelling, improved joint mobility, and minimized the risk of symptom exacerbation. In contrast, hot fomentation often worsened symptoms, making it unsuitable for acute gout management. These findings suggest that cold fomentation should be the preferred thermal therapy for gout flare-ups, while heat applications should be avoided.

In this study, we introduce Bacillus enclensis AGM_Cr8, a gram-positive marine bacterium isolated from the chronically polluted Versova Creek in Mumbai, India. AGM_Cr8 exhibits robust tolerance to chromate stress, thriving in marine agar media containing up to 3200 mg/l of hexavalent chromium [Cr(VI)], with the Minimum Inhibitory Concentration (MIC) established at 5000 mg/l. Notably, AGM_Cr8 also displays tolerance to other heavy metals, including Lead [Pb (II)] (1200 mg/l), Arsenic [As (III)] (400 mg/l), Cadmium [Cd(II)] (100 mg/l), and Nickel [Ni(II)] (100 mg/l). Scanning Electron Microscopy (SEM) reveals the presence of Cr(VI) on the bacterial surface, accompanied by the secretion of extracellular polymeric substances (EPSs) facilitating Cr(VI) sequestration. This observation is validated through Energy Dispersive Spectroscopy (EDS). Transmission Electron Microscopy (TEM) and Scanning Transmission Electron Microscopy–Energy Dispersive Spectroscopy (STEM-EDS) confirm internal bioaccumulation of Cr(VI). X-ray photoelectron spectroscopy (XPS) identifies distinct peaks around 579 and 576 eV, indicating the coexistence of Cr(VI) and Cr(III), implying a bioreduction mechanism. De novo genome sequencing identifies twenty-two chromate-responsive genes, including putative chromate transporters (srpC1 and srpC2), suggesting an efflux mechanism. Other identified genes encode NAD(P)H-dependent FMN-containing oxidoreductase, NADH quinone reductase, ornithine aminotransferase, transporter genes (natA, natB, ytrB), and genes related to DNA replication and repair (recF), DNA mismatch repair (mutH), and superoxide dismutase. We therefore, propose a chromate detoxification pathway that involves an interplay of chromate transporters, enzymatic reduction of Cr(VI) to Cr(III), DNA repair and role of antioxidants in response to chromate stress. We have highlighted the potential of AGM_Cr8 for bioremediation in chromium-contaminated environments, given its robust tolerance and elucidated molecular mechanisms for detoxification.

The global oral healthcare system faces significant challenges, including disparities in access to services and facilities along with a widespread lack of awareness about different preventive measures. The phrase “social media” describes a wide range of online platforms and software that let users interact, share, communicate, and explore. A sizable number of people now use social media applications. It has long been used to increase public awareness of general health issues. It has also gained acceptance in the dental sector in the last few years. It has been widely used as a tool for teledentistry and to disseminate oral health knowledge and information. This study emphasizes different digital media tools that can raise comprehensive oral health knowledge and the benefits and drawbacks of doing so along with discussing the significance of social media in endorsing oral health awareness among the population.

Objective This retrospective observational study aims to evaluate cases of adenomatoid odontogenic tumors (AOTs) from 1990 to 2023, including unique environmental scanning electron microscopy (ESEM) features. Study Design Cases of AOT were retrieved from the Oral Pathology department archives and evaluated retrospectively over a 33-year period (1990–2023). Data collected and analyzed included age, sex, occupation, location, clinical features, radiographic appearance, and histopathological characteristics. Additional analysis was performed using ESEM. Results Among the 4 cases evaluated, a majority demonstrated female occurrence and were most located in the mandibular region. ESEM analysis revealed distinctive structural features of AOT. Conclusion This long-term study confirms the female predilection of AOT and identifies the mandible as the most common site of occurrence. SEM findings provide novel insights into the tumor’s ultrastructure, potentially aiding in diagnosis and understanding of AOT pathogenesis.

The opioid crisis has emerged as a significant public health concern globally, with India facing unique challenges in preventing and managing substance abuse. This systematic review aims to analyze the current state of the opioid crisis in India, evaluate existing prevention and management strategies, and propose evidence-based recommendations for addressing this complex issue. A comprehensive literature search was conducted across multiple databases, resulting in the inclusion of 30 studies meeting the predefined criteria. The review highlights the multifaceted nature of the opioid crisis in India, influenced by factors such as socioeconomic conditions, cultural norms, and healthcare accessibility. Key findings include the need for comprehensive prevention programs, improved access to evidence-based treatments, and integration of harm reduction strategies. The review also emphasizes the importance of addressing co-occurring mental health disorders and the potential of community-based interventions in managing substance abuse. Challenges identified include stigma, limited access to treatment, inadequate healthcare infrastructure, regulatory barriers, and lack of comprehensive policies. Recommendations for future directions include developing culturally appropriate prevention programs, assessing the long-term effectiveness of treatment modalities, exploring innovative approaches to reduce stigma, and investigating the role of technology in improving access to care. By implementing a multifaceted approach that considers the unique sociocultural context of India (including factors such as family structures, religious beliefs, economic disparities, and regional variations in drug use patterns), there is potential to significantly reduce the burden of opioid abuse and improve outcomes for affected individuals and communities.

This case study outlines various challenges entrepreneurs face regarding onboarding farmers, adopting technology, and funding. The case begins with the background information of Mr. Pawar, the owner of Wingrow Agritech, an overview of the Indian agricultural market, and the company’s journey since its inception. The case ends with probing questions associated with challenges in the business. The COVID-19 pandemic acted as a boon for his business for a short period. But the challenge was to survive later. The entrepreneur was aware of the huge scope and potential of the Indian Agri market. The case highlights the owner’s dilemma for survival and standing his business in adverse scenarios.

Tubular ectasia of the epididymis is a rare benign disorder that, when present, is usually seen in patients post-vasectomy. It can also be seen in patients with a prior history of trauma or local infection. Patients typically present with a palpable scrotal mass and dull-aching pain. It is important to differentiate this disease from other common disorders such as varicocele, hydrocele, spermatocele, or even testicular malignancy. We report a rare case of tubular ectasia of the epididymis in a 55-year-old patient with palpable scrotal swelling with no prior operative history of vasectomy nor any history of trauma. We share this patient's ultrasonography findings along with a literature review of this uncommon disease.

Background Atopic dermatitis (AD) has a complex etiology that includes Th2 polarization, which is accompanied by the cytokines IL4, IL-5, IL-13, and IL-31, as well as Th17 and Th22, and in chronic lesions, Th1 cells. Tofacitinib inhibits Th1-, Th2-, and Th17-associated cytokines by selectively blocking JAK1 and JAK3 receptors. We conducted a multicentric, retrospective chart analysis to study the efficacy and safety of tofacitinib in patients with moderate to severe refractory AD. Materials and Methods We included 16 adult patients (aged >18 years) with moderate to severe AD who had previously undergone systemic therapy with inadequate response. In the baseline, demographic data, previous treatment history, severity scores (eczema area and severity index [EASI] and SCORing Atopic Dermatitis [SCORAD]), and quality of life score (Dermatology Life Quality Index [DLQI]) were noted. Baseline blood investigations, including complete blood count, liver function test, renal function test, lipid profile, and interferon gamma release assay for tuberculosis, were done. Patients were followed up every month for 6 months that included documentation of severity scores, blood investigations, and DLQI. Any adverse events, if reported, were noted. Result All 16 patients completed the 6-month trial. Our patients were previously treated with cyclosporine (n = 10), methotrexate (n = 3), or both (n = 3). The mean EASI scores improved from 23.38 ± 9.56 at baseline to 8.50 ± 7.57 at the end of 6 months. The mean SCORAD score improved from 41.25 ± 8.69 at baseline to 14.93 ± 7.82 at the end of 6 months. Quality of life also improved as the mean DLQI improved from 15.18 ± 2.73 at baseline to 5.31 ± 4.11 at the end of the study period. No severe adverse reactions were noted, but 3 patients experienced dyslipidemia and 2 patients had altered bleeding time. Conclusion Tofacitinib is a safe and effective treatment option for recalcitrant moderate to severe adult AD.

Volatile oils or essential oils (EOs) were extracted from three V. sebifera samples (labeled as A, B, and C) in September 2018 and February 2019; the extraction process involved hydrodistillation of the leaves. The chemical compositions of the EOs were analyzed using gas chromatography-mass spectrometry (GC/MS). The volatile components were identified by comparing their retention indices and mass spectra with standard substances documented in the literature (ADAMS). The antioxidant activity of the EOs was evaluated using 2, 2-diphenyl-1-picrylhydrazyl (DPPH), while their toxicity was assessed using Artemia salina Leach. Molecular docking was utilized to examine the interaction between the major constituents of V. sebifera EO and acetylcholinesterase (AChE), a molecular target linked to toxicity in A. salina models. The EO obtained from specimen A, collected in September 2018, was characterized by being primarily composed of (E,E)-α-farnesene (47.57%), (E)-caryophyllene (12.26%), and α-pinene (6.93%). Conversely, the EO from specimen A, collected in February 2019, was predominantly composed of (E,E)-α-farnesene (42.82%), (E)-caryophyllene (16.02%), and bicyclogermacrene (8.85%), the EO from specimen B, collected in September 2018, primarily contained (E,E)-α-farnesene (47.65%), (E)-caryophyllene (19.67%), and α-pinene (11.95%), and the EO from the leaves collected in February 2019 was characterized by (E,E)-α-farnesene (23.57%), (E)-caryophyllene (19.34%), and germacrene D (7.33%). The EO from the leaves collected in September 2018 contained (E,E)-α-farnesene (26.65%), (E)-caryophyllene (15.7%), and germacrene D (7.72%), while the EO from the leaves collected in February 2019 was primarily characterized by (E,E)-α-farnesene (37.43%), (E)-caryophyllene (21.4%), and α-pinene (16.91%). Among these EOs, sample B collected in February 2019 demonstrated the highest potential for inhibiting free radicals, with an inhibition rate of 34.74%. Conversely, the EOs from specimen A exhibited the highest toxic potentials, with an lethal concentration 50 (LC50) value of 57.62 ± 1.53 µg/mL, while specimen B had an LC50 value of 74.72 ± 2.86 µg/mL. Molecular docking results suggested that hydrophobic interactions significantly contributed to the binding of the major compounds in the EO from sample B to the binding pocket of AChE.

Malicious traffic segregation and attack detection caused major financial loss and became one of the most serious security hazards. Moreover, cyber security attack is the major issue, which impacts network security. The network attack methods are constantly being upgraded by the technology development and it remains a major issue for detection and protection against network attacks. For this, it is required to present an effective strategy for detecting and maintaining network security. The work provides timely and accurate congestion attack detection and identification. In the Internet of Things (IoT) cloud system malicious traffic segregation and attack detection based on a hybrid optimization-enabled deep learning (DL) network is developed in this research. At first, the input log files are gathered from the simulation of IoT sensors and the superior route is selected by the proposed Fractional Hunger Jellyfish Search Optimization (FHGJO) algorithm. The FHGJO is the integration of Hunger Game Jelly Fish Optimization (HGJO) and Fractional Calculus (FC). Furthermore, the HGJO is the combination of Hunger Game Search Optimization (HGS) with Jellyfish Optimization (JSO). Then, the segregation is done based on the fitness measures and for preprocessing; the input data is fed using quantile normalization. The feature selection process is employed using the weighted Euclidian distance (WED). With the SpinalNet, the malicious segregation is categorized as malicious and non-malicious and the proposed FHJGO is used to tune the SpinalNet. Furthermore, the proposed FHGJO-trained Deep Quantum Neural Network (DQNN) is utilized to detect the attack and classifies it into a Denial-of-Service (DOS) attack, Distributed Denial of Service (DDoS) attack, and buffer overflow attack. Moreover, the proposed model is evaluated using the NSL-KDD dataset and BoT-IoT dataset. The proposed method ensures network security with 0.931 accuracy, 0.923 sensitivity, and 0.936 specificity.

Virtual reality (VR) has emerged as an innovative technology in various fields. It transforms how we experience and interact with the world, and it has also developed into physical rehabilitation. Rehabilitation has also evolved from mere exercises to using technology while giving exercises to patients. VR is a technology that can enhance treatment and improve outcomes. VR uses computer-generated three-dimensional interactive simulation models, allowing users to engage in environments resembling real-world objects and events. An extensive literature search was conducted on SCOPUS, PubMed, the Web of Science and relevant rehabilitation databases. The keywords ‘virtual reality’, ‘rehabilitation’ and ‘physical therapy’ were employed to identify pertinent studies. The inclusion criteria encompassed research investigating the use of VR in rehabilitating musculoskeletal, neurological and cardiovascular conditions. VR has been used in various rehabilitation domains. It is effectively used in balance and gait training, cognition and memory training, pain management, muscle strengthening, etc. It has also been shown to improve adherence to exercises. VR training in physical therapy represents a transformative advancement in rehabilitation. Integrating VR technology offers many benefits, including enhanced engagement, customised therapy regimens and a safe environment for patients to practice and improve their physical abilities. The evidence from various studies indicates its potential to improve outcomes for individuals with a wide range of physical impairments.

Heavy metals are essential for the survival of all living organisms in trace amounts. Industrializations and urbanisation are the two major rationale behind the massive rise in the contamination of land and water bodies including marine and freshwater. The major sources of heavy metal are coal burning, smelting operations, tanneries, waste incineration, pesticides, fungicides, metallurgy, etc. Due to the toxicity of heavy metals when living beings encounter contaminated water of sediment laden with heavy metal endure health hazards. Heavy metals and metalloids such as chromium, lead, mercury, cadmium, nickel, and cobalt are poisonous and carcinogenic even in minute amounts, posing a major threat to human life. The most sustainable approach towards remediating these heavy metals is bioremediation. It involves bacterial bioremediation, fungal, biofilms and phytoremediation, which is not only sustainable but also efficient and cost effective. This review delivers a comprehensive overview of the recent trends in bioremediation of heavy metals, their sources, toxicity, and alternative approach of using marine microbes and their pottential for remediation of heavy metals.

One of the most prevalent types of odontogenic cysts is a dentigerous cyst, which is usually connected to the crown of an immature tooth. We report the case of an 11-year-old boy, who had a swelling over his left cheek, which was determined to be a dentigerous cyst by radiological imaging and clinical examination. Over the course of two months, the peanut-sized mass grew to 3x2 cm. A massive, well-defined cystic lesion connected to an unerupted premolar tooth was found on a CT scan of the left maxillary alveolar arch and sinus floor. Under general anesthesia, the patient had a Caldwell-Luc surgery to remove the cyst. In order to avoid difficulties related to cyst formation, which can invade surrounding tissues and even result in cancer if left untreated, early detection using radiological imaging is essential. Complete excision of the cyst is the treatment, particularly for big lesions, in order to limit morbidity and lower the likelihood of aggressive behavior. This case emphasizes the necessity of thorough examination and surgical intervention when necessary, underscoring the significance of early identification and adequate therapy to minimize potential problems related to dentigerous cysts. In cases of dentigerous cysts, early intervention, and appropriate surgical procedures are critical to reducing morbidity and improving patient outcomes.

Introduction Atlanto-occipital assimilation is the most common osseous anomaly of the cervical-occipital junction. The incidence rate of occipitalization has been reported 1.42.5/1000 children. Most of the patients are asymptomatic initially. Clinical features usually appear after 3rd decade depending on the level and degree of spinal cord compression with surrounding vital structures such as vertebral artery involvement. Hence, early definitive diagnosis and subsequent successful treatment are necessary in such cases to prevent life-threatening complications. Case Report A 16-year-old male presented with neck pain and progressive weakness of the bilateral lower limb since the past 2 months suffering from difficulty in walking, giddiness, and numbness of his fingertips. Hoffman’s sign was positive. Plain cervical spine radiography (AP and lateral) is falsely suggestive of the absence of an atlas. MRI revealed the tip of the dens projecting 1314 mm above the Chamberlains line suggestive of basilar invagination. Occipito-cervical fixation was planned with an occipital plate, laminar, pedicle screw, and rods. Occipital plate fixed with screws (6,8 mm). C2 vertebra fixation with pedicle screw and laminar screws and C3 vertebra with a lateral mass screw under C-arm guidance. The patient mobilized with a walker from post-operative day 2 and then he ambulated unaided. Conclusion Different types of atlanto-occipital assimilation have been reported. Treatment modality completely depends on neurological symptoms and instability.Although, different surgical options are available, occipito-cervical fixation with occipital plate, screws, and rod fixation is the most superior surgical technique for atlanto-occipital assimilation with atlanto-occipital instability.

Background: Cervical cancer is a prevalent and deadly malignancy in females, with chemotherapy often proving ineffective due to significant side effects and the development of chemo-resistance. This study investigates the medicinal potential of Clerodendrum infortunatum linn. , a genus with approximately 500 species in the Lamiaceae family. Limited research exists on the species of Clerodendrum infortunatum and its various solvent extracts. Objective: The study aims to assess the anti-cancer properties of different solvent extracts from this plant on human cervical cancer cells. Methods: The study examines the plant's phytochemical components and their potential to inhibit cancer growth. Aerial parts of the plant were extracted using the Soxhlet method, and the presence of Rutin, Quercetin, and Gallic Acid in specific solvent extracts was validated through High-Performance Thin Layer Chromatography (HPTLC). In vitro assays, including MTT, Apoptosis, Cell Cycle analysis, Intracellular Reactive Oxygen Species assessment, and Gene expression PCR, were conducted to investigate the plant's anti-cancer properties further. Results: The outcomes of the phytochemical assessment indicated that Rutin was predominantly present in the water extract, with quercetin being more concentrated in the decoction, and the hydro-alcoholic extract showing elevated levels of gallic acid. Notably, the decoction extract demonstrated the highest cytotoxic activity, primarily through early apoptosis and arrests in the S-phase and G2M phases. Clerodendrum infortunatum exhibited a reduction in Intracellular Reactive Oxygen Species. The gene expression analysis disclosed an impact on the BCL-2 gene. Conclusion: Notably, Clerodendrum infortunatum exhibited the ability to initiate early apoptosis, halt the cell cycle at the S and G2M phases, and diminish levels of reactive oxygen species significantly. The gene expression analysis revealed an influence on the BCL-2 gene. To sum up, this research underscores the encouraging cytotoxic and antioxidant attributes of Clerodendrum infortunatum, implying its potential for cervical cancer treatment.

Introduction The concept of work-life balance is a complex, multidimensional intertwinement of the roles an individual plays in their professional and personal life. Work-life balance is crucial for every profession, and doctors have no exemption not exempted from it. Medical students and young graduates face numerous challenges that potentially impact their work (study)-life balance. Objectives of the study The aim is to assess the hours spent in study and the hours spent in non-study activities by medical students and graduates in India and to assess the study-life balance among them. Methodology A cross-sectional observational study employing a predefined web-based survey to investigate the study-life balance among medical students and graduates across India. A predesigned questionnaire was designed and made accessible through Google Forms, which was distributed among doctors across India via popular social media platforms. Data management was conducted using Microsoft Excel and Data analysis was done using SPSS (IBM Corp., Armonk, NY). Results A total of 416 responses were included in the study. The study participants were predominantly female (64.2%). Most of the study participants were from the State of Telangana (63.9%). The time spent studying was < 10 hours/week for 43.8% students and 10-25 hours/week for 27.2% students. Around 24% students reported spending 10-25 hours/week in hospital. While 47.4% reported spending less than one to two hours per day with their family, 26% of the participants answered “yes” to the question “Do you feel that your study-life is stressful?.” Conclusions Self-care and study-life balance is a multi-factorial focal area that is based on balancing stress and happiness, with completing the tasks of the medical school. Medical students need to receive proper guidelines to transition into medical school for better study-life balance.

In order to remove moisture from the air, sorbent is utilized. In most of industrial areas, such as food industry, drug and cold storage industries. Sorbent-based air cooling powered by solar energy is suggested. The solar power is used for heater of 1.5 KW power. It is investigated how solar energy is used to generate power and the effects of airflow rate and increases moisture removal rate (double sorbent wheel). The study’s anticipated findings will point to energy savings. To determine the eliminated moisture as a function of air flow rate at solar noon, an empirical equation is utilized. Additionally, an empirical calculation was employed to determine how well the wheels regenerate and absorb energy. For some applications, sorbent dehumidification systems’ capacity to dry the air to any desired humidity level is advantageous. The moisture removal rate is increased by this TSSD. This technique is limited by the requirement for high-grade heat (about 180°F) to replenish the sorbent. The sorbent wheel’s design clearly reflects customer health, safety and hygiene (rotor). Depending on the project’s characteristics, techniques like sorbent dehumidification is used, depending on the particulars of the project.