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Background: The accessory breast tissue is found in 6%. It is seen commonly in the axilla. It is asymptomatic or causes pain, restricts arm movement, causes cosmetic problems, or causes anxiety. We evaluated symptoms, signs, investigations, treatment, and postoperative complications of women with accessory breast tissue. Methods: Our cross-sectional study was conducted in the Surgery OPD, Nagpur, on 52 women who presented with accessory breast tissue in the period from January 2019 to October 2023. Results: In this study, of 52 patients, the majority, that is, 38 (73.07%) patients, presented with uneasiness due to the position of mass followed by 25 (48.07%) with swelling in the axilla. Twelve (23.07%) patients presented with pain in mass in premenstrual and menstrual periods, and seven (13.46%) patients with accessory nipples. Fifty (96.15%) patients had axillary swelling. One (1.92%) patient each had swelling in groin and thigh. Thirty-six (69.2%) patients had sonography findings consistent with breast-like tissue. In nine (17.30%) patients, findings suggested lipoma. Surgical excision was conducted in 52 (100%) patients. In 43 (82.69%) patients, histopathology was consistent with simple breast tissue. In six (11.53%) patients, it was fibroadenoma, and in three (6.76%) patients, histopathology was suggestive of carcinoma. Twenty-eight (53.84%) patients had no complications. Thirteen (25%) patients had an allergy to sticking, six (11.53%) patients had uneven scar, and four (7.69%) patients had hypertrophy of scar. Conclusion: In our study, in the majority of patients, the site of accessory breast tissue was axilla. It caused uneasiness. Surgical excision was conducted in all patients. Postoperative complications were the least.

Abstract Background Reducing overweight and obesity has been a longstanding focus of public health messaging and physician–patient interactions. Clinical guidelines by major public health organizations describe both overweight and obesity as risk factors for mortality and other health conditions. Accordingly, a majority of primary care physicians believe that overweight BMI (even without obesity) strongly increases mortality risk. Main points The current evidence base suggests that although both obese BMI and underweight BMI are consistently associated with increased all-cause mortality, overweight BMI (without obesity) is not meaningfully associated with increased mortality. In fact, a number of studies suggest modest protective, rather than detrimental, associations of overweight BMI with all-cause mortality. Given this current evidence base, clinical guidelines and physician perceptions substantially overstate all-cause mortality risks associated with the range of BMIs classified as “overweight” but not “obese.” Discrepancies between evidence and communication regarding mortality raise the question of whether similar discrepancies exist for other health outcomes. Conclusions Health communication that inaccurately conveys current evidence may do more harm than good; this applies to communication from health authorities to health practitioners as well as to communication from health practitioners to individual patients. We give three recommendations to better align health communication with the current evidence. First, recommendations to the public and health practitioners should distinguish overweight from obese BMI and at this time should not describe overweight BMI as a risk factor for all-cause mortality. Second, primary care physicians’ widespread misconceptions about overweight BMI should be rectified. Third, the evidence basis for other potential risks or benefits of overweight BMI should be rigorously examined and incorporated appropriately into health communication.

Introduction: Cis-atracurium has a neuromuscular blocking capacity approximately three times that of atracurium besylate. The Effective Dose (ED) 95 of cis-atracurium is 0.04 mg/kg, while that of atracurium is 0.2 mg/kg. Cis-atracurium is preferred over atracurium due to the lack of histamine release, providing better cardiovascular stability. This study compares these two drugs in terms of haemodynamic parameters, neuromuscular blocking properties, intubating conditions, and safety profiles. Aim: To assess the efficacy of atracurium and cis-atracurium from various perspectives, including neuromuscular blockade, haemodynamic stability, and safety profiles. Materials and Methods: A double-blinded, randomised clinical study was conducted from January 2019 to October 2019 in Rajkot, Gujarat, India. Sixty patients undergoing abdominal surgeries under general anaesthesia were allocated to two groups. Group A received a loading dose of atracurium 0.5 mg/kg followed by a maintenance dose of 0.1 mg/kg, while Group B received a loading dose of cis-atracurium 0.2 mg/kg followed by a maintenance dose of 0.03 mg/kg. During the surgical procedure, parameters studied included neuromuscular blockade, hemodynamic changes, intubating conditions, and safety profiles in terms of complications. Student’s t-test was used to analyse normally distributed continuous variables, and the chi-square test was used for qualitative variables. Results: The demographic profiles were comparable in both groups in terms of age (p-value=0.800), sex (p-value=0.393), weight (p-value=0.101), and American Society of Anaesthesiologists (ASA) grading (p-value=0.509). A significant increase in heart rate (99.46±8.06 (/minute) vs. 91.66±9.11 (/minute)) and mean arterial blood pressure (104.44±10.16 (mm of Hg) vs. 93.4±12.77 (mm of Hg)) was noted post-intubation in Group A compared to Group B. Patients in Group A (3.5±0.62 minutes) had a faster onset of neuromuscular blockade compared to Group B (4.6±0.49 (minutes)), while the duration of action of the first loading dose and the 25% recovery time from the last supplemental dose was longer in Group B (52.86±5.18 minutes and 41.66±3.60 minutes) than in Group A (31.2±4.82 minutes and 20.86±4.37 minutes). Fewer patients experienced complications (hypotension, erythema of the skin) in Group A compared to Group B. Conclusion: Cis-atracurium releases less histamine compared to atracurium and has a longer duration of action. Cis-atracurium can be a better alternative to atracurium as it offers better haemodynamic, neuromuscular, and safety profiles with similar intubating conditions.

Abstract Background In contemporary society, anxiety has become a widespread disorder leading to compromised well-being and heightened depressive states. Extensive literature reviews indicate the diverse biological effects of benzimidazole and piperazine derivatives, notably their impact on the central nervous system. This study aimed to design, molecularly dock, synthesize, and assess the anxiolytic potential of six derivatives of 2-(4-phenylpiperazin-1-yl)-1H-benz[d]imidazole and 2-(4-phenylpiperazin-1-methyl)-1H-benz[d]imidazole. Results In the present study, an attempt was made to synthesize benzimidazole derivatives conventionally. The benzimidazole nuclei are condensed with various substituted piperazines to obtain targeted benzimidazole–piperazine hybrids. Their anxiolytic activity is determined using the Elevated Plus Maze test and hole board test in mice. All compounds have shown good docking scores and in vivo anxiolytic activity. Conclusion Out of all the derivatives synthesized, compounds 5b, 5c, and 5f exhibited outstanding anxiolytic efficacy in both computational simulations and live subjects. Compound 5b demonstrated a remarkable docking score relative to the ligand, suggesting its potential as a promising candidate warranting further exploration.

Considering the distinctive generalization of the Gronwall-Bellman inequality, in this paper we innovates new dynamical inequalities on time scale. These inequalities will be acted a profound tools for studying qualitative properties such as uniqueness, existence, stability and asymptotic behavior of solutions of dynamic equations on time scale.

A 50-year-old man presented with a large, lobulated swelling of the scrotum that had been persisting for two years. This swelling developed slowly, increasing over time, and was accompanied by a foul-smelling discharge. Examination revealed a scrotum covered in nodules, significantly enlarged but with a soft to firm consistency. The scrotal skin was entirely affected, while the penis remained normal-sized and shaped, with no sign of inguinal lymphadenopathy [Table/Fig-1]. The patient underwent surgery to remove the lobulated mass, followed by skin grafting and covering of the testis with dartos fascia. The operation proceeded smoothly, and histopathological analysis confirmed a diagnosis of scrotal lymphatic filariasis.

BACKGROUND: Smartphones have become an indispensable part of almost everyone’s life. India has now become the leading and second-largest Smartphone market in the world. It has been noted that the purpose of Smartphone usage has exceptionally changed over the past few years, especially among students, professionals, and the common man. Smartphones have now become essential and the need of the hour, and medical students are no exception. Smartphones can make “smart students smarter”! There are now 10,275 unique applications labeled under the “Medical” and “Healthcare and Fitness” categories. The common medical applications used are MedCalc, Drug Infusion, Flashcards, Encyclopedia, Merck Manual, Medscape, PubMed, Epocrates, MedlinePlus, Lab test applications, Medical Dictionary, Eponyms etc. Despite the advantages and needs of smartphones, they have proven to be a source of potential hazard to human health, not only physical but also mental, social, and emotional well-being. There is consistent evidence for co-morbidity (such as obesity, heart diseases, neck and back pain, etc.) between excessive smartphone use and other psychiatric disorders, such as depression, anxiety, obsessive and compulsive disorder (OCD), and attention deficit hyperactivity disorder (ADHD) similar to internet addiction. The significant association of this addiction with poorer sleep quality and higher perceived stress has been a cause for concern. Hence, further investigation to explore the association between smartphone addiction and mental health, this study was undertaken. MATERIALS AND METHODS: Our study was undertaken in Dr VMGMC, Solapur, from June to August 2022, after obtaining approval from the ethical committee, approval number 172/22. Total voluntary participation for the study was 600 (from first to final year), and accordingly convenient sample size was taken. RESULTS: We found that out of the total participants, 42% of the participants had an average screen time of 4–6 h daily. A very small percentage of participants (4%) spent less than two hours in front of a screen. Alarmingly, 65% of the participants had an average screen time of more than 4 hours, which puts them at risk for the negative health impacts of prolonged screen time. Around 12% of them had symptoms of mild stress, 10.3% for mild anxiety, and 15.6% for mild depression. 10.6% had symptoms of moderate stress, 23.3% for moderate anxiety, and 16% for moderate depression. A small proportion of undergraduates, that is, 5%, 16%, and 11.6%, had symptoms of severe and extremely severe stress, anxiety, and depression, respectively. CONCLUSION: The study participants did not feel a lot of stress, anxiety, or depression symptoms when smartphones were used judiciously and mostly for non-social purposes (such as studying, listening to music, or watching videos). This investigation led us to the conclusion that there are some positive effects of smartphones on mental health. However, those who spent an excessive amount of time on their smartphones for social contact, with an average screen time of 5 h, showed signs of mild to moderate sadness, moderate anxiety, and tension, demonstrating that social media had a negative impact on the mental health of medical undergraduates. Therefore, efforts should be made to inform medical students about how using a smartphone is harming their mental health.

Globally, we are seeing a rise in non-communicable diseases such as obesity, hypertension, diabetes, metabolic syndrome, chronic respiratory diseases, cancer, etc., due to stressful lifestyle in this competitive world. Most of the non-communicable diseases are associated with lifestyle behavior. Presently, the role of lifestyle medicine is very critical and important in the management of chronic lifestyle-associated disorders. Considering the above facts, we decided to review the literature to gain a deeper insight into the implications of lifestyle medicine in medical practice. A literature search was conducted on PubMed, Scopus and Google Scholar databases. We observed that lifestyle medicine intervention is a growing and newer discipline and is being employed along with conventional management of non-communicable diseases by medical practitioners today, as they are strongly associated with lifestyle behaviors and practices. Motivation for change in lifestyle is challenging because it depends on the patient’s determination and eagerness to adapt and accommodate to the newer lifestyle pattern. The medical practitioners should spend time in coaching patients on lifestyle-related health education. Guidance and coaching by medical practitioners will help patients adapt to practices of maintaining regular physical activity, a balanced diet, good sleep hygiene, and avoid addictions of tobacco and alcohol as part of life. Introducing real and progressive evidence-based behavioral changes to reduce the risks of lifestyle-related acute and chronic diseases in medical practice will reduce the burden of non-communicable disease.

Fibrocytes are monocyte-derived cells implicated in wound healing. Here, the authors utilise single cell RNA-seq, genetic ablation and multiplexed imaging to identify a fibrocyte population in lung cancer models, and use human lung cancer coculture systems to highlight their potential to modulate microenvironmental niche and sensitivity to endothelin blockade.

Abstract Background Globally, the prevalence of chronic kidney disease (CKD) is higher in women than in men; however, women have been historically under-represented in nephrology clinical trials. Metabolic acidosis increases risk of progressive loss of kidney function, causes bone demineralization and muscle protein catabolism, and may be more consequential in women given their lower bone and muscle mass. Veverimer, an investigational, non-absorbed polymer that binds and removes gastrointestinal hydrochloric acid, is being developed as treatment for metabolic acidosis. Methods This was a Phase 3, multicenter, randomised, blinded, placebo-controlled trial in 196 patients with CKD (eGFR: 20–40 mL/min/1.73 m2) and metabolic acidosis who were treated for up to 1 year with veverimer or placebo. We present the findings from a pre-specified subgroup analysis evaluating the effects of veverimer on metabolic acidosis and physical function among women (N = 77) enrolled in this trial. Results At week 52, women treated with veverimer had a greater increase in mean (± standard error) serum bicarbonate than the placebo group (5.4 [0.5] vs. 2.2 [0.6] mmol/L; P

Aim This study was aimed to translate an updated European Organization for Research and Treatment of Cancer (EORTC) quality of life module for head and neck (EORTC QLQ-H&N43) in grammatically and conceptually acceptable Marathi language and its linguistic validation. Materials and Methods Approval was obtained from the Institutional Ethics Committee. The permission for translation was obtained from the EORTC translation unit (TU). The EORTC guidelines for the translation were followed to form a translation for pilot testing which was administered to 10 Marathi speaking head and neck squamous cell cancer (HNSCC) patients who gave informed written consent for the participation in the study. Patients were interviewed personally. The final Marathi translation was prepared and sent to EORTC TU for approval. Statistical analysis was performed using SYSTAT version 12 by Cranes software, Bengaluru, Karnataka, India. Results After getting permission, the translation files were received from EORTC TU, including Marathi EORTC QLQ-H&N35 for reference. Two forward translations, reconciled translation, back translations, first interim translation, translation for proof editing, and second interim translation (SIT) were prepared. This SIT was pilot tested in 10 Marathi-speaking HNSCC patients. Each patient was interviewed regarding difficulty in answering, confusing or offensive word, and reframing sentence. The questionnaire was well understood by patients reflecting its linguistic validity. After incorporating the changes as per the patient’s interview, updated translation was prepared and sent to EORTC TU which was accepted and approved by EORTC. The psychometric analysis of pilot testing showed that the questionnaire is acceptable. Conclusion Marathi translation of EORTC QLQ-H&N43 is well accepted and understandable. It can be used for future studies.

Intraflagellar transport (IFT) in C. elegans chemosensory cilia is an example of functional coordination and cooperation of two motor proteins with distinct motility properties operating together in large groups to transport cargoes: a fast and processive homodimeric kinesin-2, OSM-3, and a slow and less processive heterotrimeric kinesin-2, kinesin-II. To study the mechanism of the collective dynamics of kinesin-II of C. elegans cilia in an in vitro system, we used Total Internal Reflection Fluorescence microscopy to image the motility of truncated, heterodimeric kinesin-II constructs at high motor densities. Using an analysis technique based on correlation of the fluorescence intensities, we extracted quantitative motor parameters, such as motor density, velocity and average run length, from the image. Our experiments and analyses show that kinesin-II motility parameters are far less affected by (self) crowding than OSM-3. Our observations are supported by numerical calculations based on the TASEP-LK model (Totally Asymmetric Simple Exclusion Process-Langmuir Kinetics). From a comparison of data and modelling of OSM-3 and kinesin-II, a general picture emerges of the collective dynamics of the kinesin motors driving IFT in C. elegans chemosensory cilia and the way the motors deal with crowding.

Background: The aim of the study was to assess the correlation between salivary cotinine level and psychological dependence measured through Fagerstrom test for nicotine dependence (FTND) questionnaire among tobacco users. Materials and Methods: This was a cross-sectional study, conducted on tobacco users. Participants with the present habit of tobacco chewing and smoking above the age of 16 years were included in the study. A standard questionnaire form of FTND revised version for smoking and smokeless form of tobacco were given to each participant. Each participant was asked to answer the questions as per their experience of tobacco consumption and calculate the total point score or FTND score. Salivary cotinine level assessment was done using commercial available NicAlert kit. Results: When salivary cotinine level was correlated with different variables of both groups, it was observed that weak correlation between salivary cotinine level and FTND scoring in smokers group (r = 0.083) and also in smokeless group (r = 0.081). When two groups were compared for salivary cotinine level, statistically significant difference (P = 0.021) was observed, with smokeless group showing high level of salivary cotinine level as compared to smokers group. Conclusion: Salivary cotinine and psychological dependence through FTND scoring are not strongly correlating with each other. This indicates that dependence over tobacco is a separate phenomenon and cannot be assessed by salivary cotinine level. It is well accepted that salivary cotinine level is influenced by age of individual, duration of habit, and type of tobacco consumption.

Calotropis procera (commonly known as Swallow wort) is described in the Ayurvedic literature for the treatment of inflammation and arthritic disorders. Therefore, in the present work, the antiarthritic activity of potential fractions of Swallow wort leaf was evaluated and compared with standards (indomethacin and ibuprofen). This study was designed in Wistar rats for the investigation of antiarthritic activity and acute toxicity of Swallow wort. Arthritis was induced in Wistar rats by injecting 0.1 mL of Freund’s complete adjuvant (FCA) on the 1st and 7th days subcutaneously into the subplantar region of the left hind paw. Evaluation of our experimental findings suggested that antiarthritic activity of methanol fraction of Swallow wort (MFCP) was greater than ethyl acetate fraction of Swallow wort (EAFCP), equal to standard ibuprofen, and slightly lower than standard indomethacin. MFCP significantly reduced paw edema on the 17th, 21st, 24th, and 28th days. It also showed significant effect (p < 0.01) on arthritic score, paw withdrawal latency, and body weight. The inhibition of serum lysosomal enzymes and proinflammatory cytokines along with improvement of radiographic features of hind legs was also recorded with MFCP. Finally, it was concluded that MFCP can be a feasible therapeutic candidate for the treatment of inflammatory arthritis.

Background: To evaluate the relation between serum-25-hydroxy Vitamin-D levels (S25OHVDL) and concurrent chemoradiation therapy (CTRT) toxicities in patients of head and neck squamous cell cancer (HNSCC). Methods: After an institutional ethics committee approval, consecutive HNSCC patients who received radical/adjuvant CTRT were prospectively evaluated. Patients were assessed for CTRT toxicities using Common Terminology Criteria for Adverse Events version 5.0 (CTCAE-v5.0) and the response was evaluated according to Response Evaluation Criteria In Solid Tumors version 1.1 (RECIST-1.1). S25OHVDL was assessed at the time of the first follow-up. Patients were divided into group A (Optimal) and group B (suboptimal) according to S25OHVDL. The treatment toxicities were correlated with S25OHVDL. Results: Twenty-eight patients were evaluated for the study. S25OHVDL was optimal in eight (28.57%) and suboptimal in 20 patients (71.42%). Mucositis and radiation dermatitis were significantly more in subgroup B (P-value 0.0011 and 0.0505, respectively). Relatively lower but nonsignificant hemoglobin and peripheral white blood cell counts were observed in subgroup B. Conclusion: Suboptimal S25OHVDL was associated with significantly more skin and mucosal toxicities in HNSCC patients treated with CTRT. Keywords: 25-hydroxy vitamin-D, head and neck squamous cell cancer, radiation toxicities, Author(s): Arya Bhanu [1]; Chaitali M. Waghmare (corresponding author) [1]; Vandana S. Jain [1]; Hemant J. Pawar [2] Introduction Head and neck squamous cell cancers (HNSCC) account for a major [...]

Well-type ionization chamber is often used to measure strength of brachytherapy sources. This study aims to check long term response stability of High Dose Rate (HDR) -1000 Plus well-type ionization chamber in terms of reference air kerma rate (RAKR) of a reference 137 Cs brachytherapy source and recommend an optimum frequency of recalibration. An HDR-1000 Plus well-type ionization chamber, a reference 137 Cs brachytherapy source (CDCSJ5), and a MAX-4000 electrometer were used in this study. The HDR-1000 Plus well-type chamber was calibrated in terms of reference air kerma rate by the Standards Laboratory of the International Atomic Energy Agency (IAEA), Vienna. The response of the chamber was verified at regular intervals over a period of eight years using the reference 137 Cs source. All required correction factors were applied in the calculation of the RAKR of the 137 Cs source. This study reveals that the response of the HDR-1000 Plus well-type chamber was well within ±0.5% for about three years after calibration/recalibration. However, it shows deviations larger than ±0.5% after three years of calibration/recalibration and the maximum variation in response of the chamber during an eight year period was 1.71%. The optimum frequency of recalibration of a high dose rate well-type chamber should be three years.

Molecular motor proteins fulfill the critical function of transporting organelles and other building blocks along the biopolymer network of the cell’s cytoskeleton, but crowding effects are believed to crucially affect this motor-driven transport due to motor interactions. Physical transport models, like the paradigmatic, totally asymmetric simple exclusion process (TASEP), have been used to predict these crowding effects based on simple exclusion interactions, but verifying them in experiments remains challenging. Here, we introduce a correlation imaging technique to precisely measure the motor density, velocity, and run length along filaments under crowding conditions, enabling us to elucidate the physical nature of crowding and test TASEP model predictions. Using the kinesin motor proteins kinesin-1 and OSM-3, we identify crowding effects in qualitative agreement with TASEP predictions, and we achieve excellent quantitative agreement by extending the model with motor-specific interaction ranges and crowding-dependent detachment probabilities. These results confirm the applicability of basic nonequilibrium models to the intracellular transport and highlight motor-specific strategies to deal with crowding.