The GC-MS Study of the Ayurvedic Formulation "Dhanwantharam Thailam" Used for Rheumatism.

Background: The scientific validity of contemporary and alternative medicinal practices, such as Ayurveda and Siddha, holds significant importance in today's context. Aim and Objective: The present study employs gas chromatography-mass spectrometry (GC-MS) analysis to investigate a pain-relieving Ayurvedic oil, Dhanwantharam Thailam, aiming to establish correlations between its medicinal activity and the biomolecules it contains. Materials and Methods: Procured sample from a reputable Ayurvedic vendor in Chennai, Dhanwantharam Thailam underwent GC-MS analysis using standard procedures. Results and Discussion: The resulting profile revealed the presence of crucial molecules like oleic acid, dodecanoic acid, 1,2,3-propanetriyl ester, ethenyl ester, and 9,12-octadecadienoyl chloride (Z, Z), aligning with the medicinal properties attributed to Dhanwantharam Thailam. Conclusion: The identification of these biomolecules supports the role of Dhanwantharam Thailamas an effective pain-relieving oil.

Prediction Performance of Deep Learning for Colon Cancer Survival Prediction on SEER Data.

Colon and rectal cancers are the most common kinds of cancer globally. Colon cancer is more prevalent in men than in women. Early detection increases the likelihood of survival, and treatment significantly increases the likelihood of eradicating the disease. The Surveillance, Epidemiology, and End Results (SEER) programme is an excellent source of domestic cancer statistics. SEER includes nearly 30% of the United States population, covering various races and geographic locations. The data are made public via the SEER website when a SEER limited-use data agreement form is submitted and approved. We investigate data from the SEER programme, specifically colon cancer statistics, in this study. Our objective is to create reliable colon cancer survival and conditional survival prediction algorithms. In this study, we have presented an overview of cancer diagnosis methods and the treatments used to cure cancer. This paper presents an analysis of prediction performance of multiple deep learning approaches. The performance of multiple deep learning models is thoroughly examined to discover which algorithm surpasses the others, followed by an investigation of the network's prediction accuracy. The simulation outcomes indicate that automated prediction models can predict colon cancer patient survival. Deep autoencoders displayed the best performance outcomes attaining 97% accuracy and 95% area under curve-receiver operating characteristic (AUC-ROC).

Revisit of Polyomavirus Nephropathy Grading in Renal Allograft Recipients According to the Banff 2019 Working Group Classification: A Study From a Large Transplant Center in South India.

Background In renal transplant patients, the biopsy-proven incidence of polyomavirus nephropathy (PVN) is approximately 5%. There is no consensus in the morphologic classification of definitive PVN, which is attempted in the Banff 2019 Working Group classification, which groups histologic changes, reflects clinical presentation, and facilitates comparative outcome analyses. This study aims to analyze the clinical and histopathological findings and outcomes among the three classes in the recent classification. Materials and methods The study was conducted in the department of pathology and nephrology over a period of six years. All cases diagnosed as PVN on renal allograft biopsies were included. The clinical and biochemical findings were obtained from hospital records. Histopathology slides were reviewed and classified according to Banff 2019 criteria and were analyzed with clinical, laboratory, histopathological parameters along with the clinical outcome. Results Out of 205 renal transplants performed during the study period, 14 patients (6.8%) were diagnosed with PVN. The mean age of diagnosis was 38 years, with a Male: Female ratio of 1.8:1. The median period of diagnosis of the viral infection after transplant was 10 months. Histomorphology grading according to Banff 2019 revealed four cases (28.5%) in PVN class 1, eight cases (57.2%) in PVN class 2, and two cases (14.3%) in PVN class 3. Cases in PVN class 1 presented early. PVN class 1 was associated with a single type of inclusion, and multiple type inclusions were observed in higher classes. Associated diseases were thrombotic microangiopathy (TMA), borderline cellular rejection, antibody-mediated rejection (ABMR), and concomitant infections. PVN class 1 had a better outcome compared to PVN class 2 and class 3. Conclusion PVN1 was observed to have better clinical presentation and outcomes than PVN2 and 3; however, this could not be statistically concluded due to the low sample size and other associated diseases.

Myeloma Cast Nephropathy an Unusual Association with HIV Infection Presenting with Renal Dysfunction.

Human immunodeficiency virus (HIV)-associated renal disease is a pan-nephropathy, causing glomerular, tubular, and interstitial changes. The common lesion is the collapsing variant of focal segmental glomerulosclerosis. Multiple myeloma presenting as light chain cast nephropathy in an HIV-positive patient is very rare. A 45-year-old female retropositive patient presented with one episode of hematuria. Kidney biopsy was performed with a clinical diagnosis of acute interstitial nephritis (AIN). Biopsy showed unremarkable glomeruli. Tubules were dilated and showed a few periodic acid-Schiff (PAS) positive and many PAS-negative fractured casts surrounded by histiocytic reaction. Immunofluorescence and immunohistochemistry (IHC) showed lambda restriction by the casts. Bone marrow aspirate showed an increase in plasma cells, and the biopsy showed nodular aggregates of atypical plasma cells, which showed lambda restriction by IHC. PAS-negative fractured tubular casts are known to be associated with HIV-related nephropathy and need detailed hematological workup to rule out an associated plasma cell dyscrasia.

Effect of alternate nostril breathing exercise on blood pressure, heart rate, and rate pressure product among patients with hypertension in JIPMER, Puducherry.

INTRODUCTION: Hypertension has a direct relationship with the circulation, respiration, and function of vital organs. Similarly, complementary therapy such as alternate nostril breathing exercise has a direct effect on mental and physical health. MATERIALS AND METHODS: This is a quantitative experimental research with randomized controlled trial design. A total of 170 and 85 individuals were allotted to each group. Patients in the study group were instructed alternate nostril breathing exercise two times a day (10 min duration of exercise each time) for 5 days along with routine treatment, and patients in the control group underwent routine treatment. RESULTS: There was a marked reduction in systolic blood pressure (BP), diastolic BP, heart rate, and rate pressure product after the continuous 5-day alternate nostril breathing exercise in the study group. P < 0.0001 demonstrated a statistically significant difference in systolic BP, diastolic BP, heart rate, and rate pressure product that existed pre- and post-assessment on 1st day and 5th day. CONCLUSION: It can be concluded that regular simple alternate nostril breathing exercise effectively reduces hypertension.

Collective substitutions of selective rare earths (Yb3+, Dy3+, Tb3+, Gd3+, Eu3+, Nd3+) in ZrO2: an exciting prospect for biomedical applications.

The study aims to understand the significance of collective rare earth (RE3+) substitutions in ZrO2 structures for biomedical applications. The RE3+ ions namely Yb3+, Dy3+, Tb3+, Gd3+, Eu3+, and Nd3+ were selected and their concentrations were adjusted to obtain three different combinations. The influence of RE3+ on the crystal structure of ZrO2 alongside the absorption, luminescence, mechanical, magnetic, computed tomography (CT), magnetic resonance imaging (MRI) properties was explored. The concomitant effect of the average ionic size and RE3+ concentration determines the crystallization behavior of ZrO2 at elevated temperatures. The collective RE3+ substitutions exhibit both up-conversion and down-conversion emissions with their respective excitation at 793 and 350 nm. Nevertheless, increment in the concentration of RE3+ is found to be detrimental to the mechanical stability of ZrO2. The collective characteristics of multiple RE3+ demonstrate the potential of the investigated system in multimodal imaging applications. The unique luminescence characteristics of Eu3+ and Tb3+ are promising for fluorescence imaging while the presence of Dy3+, Tb3+, Gd3+ and Nd3+ unveils a paramagnetic response required for MRI. In addition, Dy3+ and Yb3+ contribute to the high X-ray absorption coefficient values suitable for X-ray CT imaging.

Retrospective correction of intensity inhomogeneity with sparsity constraints in transform-domain: Application to brain MRI.

An effective retrospective correction method is introduced in this paper for intensity inhomogeneity which is an inherent artifact in MR images. Intensity inhomogeneity problem is formulated as the decomposition of acquired image into true image and bias field which are expected to have sparse approximation in suitable transform domains based on their known properties. Piecewise constant nature of the true image lends itself to have a sparse approximation in framelet domain. While spatially smooth property of the bias field supports a sparse representation in Fourier domain. The algorithm attains optimal results by seeking the sparsest solutions for the unknown variables in the search space through L1 norm minimization. The objective function associated with defined problem is convex and is efficiently solved by the linearized alternating direction method. Thus, the method estimates the optimal true image and bias field simultaneously in an L1 norm minimization framework by promoting sparsity of the solutions in suitable transform domains. Furthermore, the methodology doesn't require any preprocessing, any predefined specifications or parametric models that are critically controlled by user-defined parameters. The qualitative and quantitative validation of the proposed methodology in simulated and real human brain MR images demonstrates the efficacy and superiority in performance compared to some of the distinguished algorithms for intensity inhomogeneity correction.

Microbiological Profile of Chronic Tonsillitis in the Pediatric Age Group.

Introduction Tonsillitis is a very common disease in children. Understanding the microbiology and pathology of chronic tonsillitis is an important step in its management. The aim of the study was to describe the microbiological profile of core tonsillar tissue in chronic tonsillitis in children. Materials and methods Children under 16 years of age with chronic tonsillitis were recruited in the descriptive study. Children with recurrent tonsillitis and recurrent tonsillitis with obstructive symptoms were included. Children who underwent tonsillectomy for obstructive symptoms alone and those who received antibiotics for at least one month prior to surgery were excluded from the study. Dissection and the snare method of tonsillectomy were done on all children. The operated specimen was cut into two halves in a sterile container. The core of the tonsillar tissue was swabbed with two sterile cotton-tipped swabs and sent for the microbiological evaluation of aerobes and anaerobes. The tonsillar tissue was sent for a histopathological examination. Results A total of 106 children were operated for chronic tonsillitis in one year. The mean age of children included in this study was 9.4 years. The duration of symptoms due to tonsillar disease ranged from four weeks to 28 months. There were 48 males and 58 females. Recurrent tonsillitis was the most common indication for tonsillectomy in all children. A total of 301 aerobes and 171 anaerobic microorganisms were isolated from 106 children with chronic tonsillitis. The aerobic bacterial species most often isolated was Streptococcus viridans, which was present in 83 children followed by Group A, ß-hemolytic Streptococci in 67 children. The anaerobic bacterial most often isolated was Peptococcus species in 49 children. Polymicrobial aerobic and anaerobic flora were present in all tonsillar specimens, yielding an average of 4.1 isolates per specimen. The histopathological examination revealed chronic tonsillitis with reactive follicular hyperplasia in all (100%) children. Actinomycosis was associated with non-specific reactive follicular hyperplasia in four specimens. Conclusion Polymicrobial aerobic and anaerobic flora are identified in deep tonsillar tissue in children with tonsillitis. The identification of bacterial isolates from the core tissue in recurrent tonsillitis could dictate the management of chronic tonsillitis. The histopathological examination of the core tissues of the tonsils helps in an accurate identification of organisms that are difficult to culture.

A non-iterative multi-scale approach for intensity inhomogeneity correction in MRI.

Intensity inhomogeneity is the prime obstacle for MR image processing like automatic segmentation, registration etc. This complication has strong dependence on the associated acquisition hardware and patient anatomy which recommends retrospective correction. In this paper, a new method is developed for correcting the intensity inhomogeneity using a non-iterative multi-scale approach that doesn't necessitate segmentation and any prior knowledge on the scanner or subject. The proposed algorithm extracts bias field at different scales using a Log-Gabor filter bank followed by smoothing operation. Later, they are combined to fit a third degree polynomial to estimate the bias field. Finally, the corrected image is estimated by performing pixel-wise division of original image and bias field. The performance of the same was tested on BrainWeb simulated data, HCP dataset and is found to provide better performance than the state-of-the-art method, N4. A good agreement between the extracted and ground truth bias field is observed through correlation coefficient on different MR modality images that include T1w, T2w and PD. Significant reduction in coefficient variation and coefficient of joint variation ratios in real data indicate an improved inter-class separation and reduced intra-class intensity variations across white and grey matter tissue regions.

Study of prevalence of sexually transmitted infections/human immunodeficiency virus and condom use among male-to-female transgender: A retrospective analysis from a tertiary care hospital in Chennai.

CONTEXT: A "Transgender" person is one who dresses as, desires to be, has undergone surgery to become or identifies with opposite sex. They have a higher risk of sexually transmitted infection (STI) due to a combination of biological and social reasons. They have risky sexual behaviors but low-risk perception. AIMS: The aim of this study is to determine the prevalence of STI/human immunodeficiency virus (HIV) in transgender (TG) and association with condom use. SETTINGS AND DESIGN: A retrospective study of 82 male-to-female TGs attending our sexually transmitted disease (STD) clinic from 2011 to 2014 was undertaken. SUBJECTS AND METHODS: Detailed history including sexual exposure, high-risk practices, and condom usage was obtained, and clinical examination for any evidence of STI was done. They were screened for the presence of STI/HIV and other appropriate investigations were done whenever required. STATISTICAL ANALYSIS USED: Retrospective analysis was used. RESULTS: In our study, the total prevalence of STI/HIV in the studied population was 48.8% which was considerably higher than the prevalence in the general population which was 5.4%. Promiscuity rate of TGs studied was 45%, 33% of them were male sex workers. Syphilis was the most common STD, followed by HIV, genital warts, and gonorrhea. The prevalence of condom use was 45.1%, and the prevalence of STI/HIV in the condom used TGs was 14.6%. CONCLUSION: Based on the above findings, the TG group is found to have a higher prevalence of HIV/STI despite the higher use of condoms which is mostly attributable to the lack of correct and consistent use of condoms. This stresses upon the importance of promoting the condom usage and knowledge, and also this group should be the focus of intensive intervention programs aimed at STI screening and treatment, reduction of risky sexual behavior, and promotion of HIV counseling and testing.

Pattern of sexual behavior in adolescents and young adults attending STD clinic in a tertiary care center in South India.

BACKGROUND AND OBJECTIVES: There is an alarming increase in the prevalence of sexually transmitted infections (STIs) among adolescents and young adults of our country. The aim of our study is to depict the current pattern of sexual behavior in this vulnerable sector of population. MATERIALS AND METHODS: The study was performed by reviewing the medical records of 1140 adolescents and young adults from January 2015 to June 2015. Demographic and sexual behavior data were collected in a predesigned format. The outcome variables such as age of coital debut, sexual promiscuity, and knowledge about condom usage were statistically analyzed among the study population. RESULTS: The male: female ratio was 1.6:1. Nearly 78.2% were unmarried and 60% have completed their high school level education. Mean age of coital debut was 21.1 years in males and 18.6 years in females and 201 (17.6%) were practicing risky sexual behavior. Homosexuality was observed in 109 (33.4%) men. Furthermore, 149 (13.1%) had exposure to commercial sex workers. Prevalence of STIs was 99 (8.7%). The overall condom usage at least once was reported only by eighty (23.5%) adolescents. Complete knowledge about condom usage was found to be very low (8%). CONCLUSION: Our study reports a high incidence of risky sexual behavior as well as a lack of complete knowledge about safe sex practices in the study population. The need of the hour is to implement sex education program at high school level to prevent STIs in this vulnerable population.

Prevalence of asymptomatic infections in sexually transmitted diseases attendees diagnosed with bacterial vaginosis, vaginal candidiasis, and trichomoniasis.

BACKGROUND: Sexually transmitted diseases (STD) are a major health problem affecting mostly young people in both developing and developed countries. STD in women causes both acute morbidity and complications such as infertility, ectopic pregnancy, low-birth weight, and prematurity. AIMS: The aim of the study is to assess the prevalence of bacterial vaginosis, vaginal candidiasis, and trichomoniasis among asymptomatic females attending STD outpatient department in a tertiary care hospital in South India. MATERIALS AND METHODS: A retrospective analysis of data collected from clinical records of 3000 female patients of age 18 to 49 over a period of 12 months (July 2014 to June 2015) was carried out at the Institute of Venereology, Madras Medical College. Complete epidemiological, clinical, and investigational data were recorded and analyzed for the prevalence of bacterial vaginosis, vaginal candidiasis, and trichomoniasis among asymptomatic patients. RESULTS: About 48.37% (228/470) of bacterial vaginosis patients were asymptomatic. Nearly 45.38% (116/235) of vaginal candidiasis patients were asymptomatic and 30.35% (26/87) of trichomoniasis patients were asymptomatic. The above infections were common in the age group 25-35. CONCLUSION: Holistic screening protocol was incorporated for all female patients attending STD clinic even if asymptomatic and should be treated accordingly to prevent the acquisition of other serious sexually transmitted infections.

Cardiovascular syphilis complicated by Lower thoracic and upper abdominal aneurysm - A rare case report.

A 50-year-old male presented with left lower abdominal pain, visible pulsation below xiphoid process, and tenderness in the left iliac fossa for the past 10 days. Chest X-ray revealed blunting of left cardiophrenic angle. Echocardiogram revealed descending thoracic aortic pseudoaneurysm. Contrast-enhanced computed tomography of the chest and abdomen revealed dissecting aneurysm of lower thoracic and upper abdominal aorta. Thoracoabdominal aortogram revealed erosion of D12 vertebra and infected aneurysm of adjacent thoracoabdominal aorta. Serum venereal disease research laboratory assay was positive in 1:4 dilution Treponema pallidum hemagglutination assay was positive. The patient was treated with Injection procaine penicillin for 20 days undercover of steroids. Cerebrospinal fluid analysis was normal. Aortic aneurysm repair with reconstruction was done. Histopathology was in favor of syphilitic etiology. This case is being presented as descending thoracic and upper abdominal aortic aneurysm due to syphilis complicated by dissection and erosion of vertebral body is rare and has not been reported nowadays to the best of our knowledge.

Estimation and comparison of serum cortisol levels in periodontally diseased patients and periodontally healthy individuals: A clinical-biochemical study.

INTRODUCTION: Psychological conditions, particularly psychosocial stress have been implicated as risk indicators of periodontal disease. Stress increases cortisol production from the adrenal cortex by stimulating an increase in the release of ACTH from the pituitary gland. Increased cortisol production suppresses the immune response and increases the potential of periodontal tissue destruction. AIM: The aim of the present study was to estimate and compare the serum cortisol levels in periodontally diseased patients and periodontally healthy individuals. MATERIALS AND METHODS: Total of 45 subjects were recruited for this study and were categorized into three groups. Group I - Comprised of aggressive periodontitis patients (n = 15), Group II - Chronic periodontitis patients (n = 15), and Group III - Healthy controls (n = 15). Serum samples were collected from each of the groups and cortisol levels were determined using cortisol immunoassay kit. Clinical examination covered probing depth, gingival index (GI), gingival recession, plaque index, and clinical attachment level. The statistical analysis was done using nonparameteric t-test and Spearman's rank correlation coefficient. RESULTS: With respect to cortisol, the levels were higher in Group-I compared to the other groups. On comparison of mean cortisol levels among the groups, the values were statistically significant between Group-I and Group-III. Group-I showed a significant negative correlation between cortisol levels and GI. CONCLUSION: Within the limits of the study serum cortisol levels was higher in the chronic periodontitis group compared to the other groups. Positive correlation was found between the cortisol levels and other clinical parameters except for the GI.

Evaluation of transcription factor that regulates T helper 17 and regulatory T cells function in periodontal health and disease.

BACKGROUND: The differentiation of naοve T helper (Th) cells towards Th17 and regulatory T cells (Treg) is regulated by the transcription factors retinoic acid related orphan receptor gamma transcription (RORYt) and Forkhead box p3 (Foxp3), respectively. An imbalance in the activity of these transcription factors could result in the dysregulation of Th17/Treg response. MATERIALS AND METHODS: Total RNA was isolated from gingival tissue obtained from 10 patients, each from periodontally healthy and diseased groups. The gene expression of RORYt and Foxp3 was measured by real-time reverse transcription polymerization chain reaction using total RNA isolates from gingival tissues group when compared to the healthy group, while Foxp3 demonstrated a 6.68 ± 0.03 fold decrease of expression in diseased group when compared to healthy group. CONCLUSION: Our results indicate a functional imbalance in the Th17/Treg response in periodontal disease group when compared to the periodontally healthy group.

Stevens-Johnson syndrome induced by a combination of lamotrigine and valproic acid.

Lamotrigine and valproic acid are well-tolerated anticonvulsants, but frequently associated with severe cutaneous reactions, such as the Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis, when used in combination. We report a case of SJS likely induced by the use of a lamotrigine and valproic acid regimen and as a dental surgeon it is important to identify such lesion and report to pharmacovigilance.

Crown lengthening procedure in the management of amelogenesis imperfecta.

Full mouth rehabilitation includes a promising treatment planning and execution thus fulfilling esthetic, occlusal, and functional parameters maintaining the harmony of the stomatognathic system. Crown lengthening procedures have become an integral component of the esthetic armamentarium and are utilized with increasing frequency to enhance the appearance of restorations placed in the esthetic zone. Crown lengthening plays a role to create healthy relationship of the gingiva and bone levels so as to gain access to more of the tooth which can be restored, if it is badly worn, decayed or fractured, below the gum line. This paper highlights the full mouth crown lengthening procedure performed on a patient with amelogenesis imperfecta.

Comparison of genomic DNA methylation pattern among septic and non-septic newborns - An epigenome wide association study.

DNA methylation is the current strategy in the field of biomarker discovery due to its prognostic efficiency. Its role in prognosis and early diagnosis has been recognized in various types of cancer. Sepsis still remains one of the major causes of neonatal mortality. Delay in diagnosis of sepsis leads to treatment difficulties and poor outcome. In this study, we have done an epigenome wide search to identify potential markers for prognosis of neonatal sepsis which may improve the treatment strategies. We analyzed the CpG methylation status in the epigenome of three septic and non-septic babies using Illumina Infinium HumanMethylation450K methylation microarray. The microarray data was analyzed with Illumina GenomeStudio v2011.1. After screening for biological and clinical significance, we found 81 differentially methylated CpGs located in 64 genes. Bioinformatic analysis using DAVID and GeneMania revealed a panel of differentially methylated protocadherin beta (PCDHB) genes that play vital role in leukocyte cell adhesion and Wnt signaling pathway. Apart, genes like CCS, DNAJA3, and DEGS2 were potentially hyper/hypo methylated which can be utilized in the development of novel biomarkers. This study will be helpful in exploring the role of DNA methylation in the pathophysiology of neonatal sepsis. The complete microarray data can be accessed from the public domain, Gene Expression Omnibus of NCBI (http://www.ncbi.nlm.nih.gov/geo/). The accession number is GSE58651.

Effect of copper (Cu2+) inclusion on the bioactivity and antibacterial behavior of calcium silicate coatings on titanium metal.

The present study is an investigation of the effect of copper (Cu2+) inclusion on the bioactivity, antibacterial behavior, corrosion resistivity and leaching characteristics of calcium silicate coatings on titanium metal. The synthesis of stoichiometric CaSiO3 and five different concentrations of Cu2+ substitutions in CaSiO3 was carried out. The incorporation of Cu2+ in the crystal lattice of CaSiO3 was investigated by means of the Rietveld refinement technique. The results from the structural investigation have shown that stoichiometric CaSiO3 crystallizes in the monoclinic system (space group = P121/a1 and unit cell parameters a = 15.4241 (5) Å, b = 7.3276 (7) Å and c = 7.0620 (8) Å with α = 90°, ß = 95.404° and γ = 90°) and are in good agreement with the literature data for crystalline CaSiO3. The substitution limit of Cu2+ in the crystal lattice of CaSiO3 was determined as 4.399 wt% of Cu2+ and the increased level of Cu2+ substitution resulted in the formation of an additional phase in the form of tenorite (CuO). The fabrication of stoichiometric CaSiO3 and Cu2+ substitutions in CaSiO3 coatings on Ti metal was achieved through an electrophoretic deposition technique and no change in the phase behavior of the coatings was noted until the heat treatment temperature reached 800 °C. Immersion tests of CaSiO3 coatings in simulated body fluid solution resulted in the formation of an apatite layer within 3 days of immersion. Antibacterial tests showed that pure CaSiO3 powders did not exhibited any antibacterial activity whereas the presence of Cu2+ in CaSiO3 resulted in good activity against E. coli and S. aureus. Potentiodynamic polarization tests performed on the Cu2+ doped CaSiO3 coatings resulted in its better corrosion resistivity when compared to the pure metal and dissolution tests performed on coatings resulted in the leaching of Cu2+ at low levels.