B. J. Medical College & Sassoon Hospital

Aerosol therapy is widely used in intensive care units (ICUs) for managing respiratory conditions. However, non-adherence to evidence-based guidelines can compromise outcomes and increase healthcare costs. This study evaluated the compliance of aerosol therapy with the "Indian Guidelines on Nebulization Therapy" and the cost incurred in critically ill patients. A prospective observational study was conducted in 307 adult patients across the ICUs of a tertiary care hospital during a six-month study period. Analysis was performed using the chi-square test and the Wilcoxon rank-sum test in RStudio (version 4-4.3, 2024). Multivariate logistic regression identified independent predictors of compliance. Of the 307 ICU patients analyzed, 64.5% were male, with an average age of 57±16 years. Jet nebulizers were used in 91.5% of cases. Bronchodilators (47.13%) and corticosteroids (35%) were widely used classes of drugs. Compliance of drug therapy with evidence-based guidelines varied significantly by duration of ICU stay (P = 0.0062) and by ICU category (P = 0.0005). Drug compliance was higher in critical care and neurology ICUs [odds ratio (OR): 6.500, P = 0.0001; OR: 4.574, P = 0.005]. Administration compliance was significantly associated with the diagnosis category (P = 0.00186) and was higher among patients with non-respiratory diagnoses (OR: 4.96, P =0.0068). Adherence to guidelines for drug therapy significantly lowered costs (P = 0.0103). Targeted interventions, protocol standardization, and staff training are needed to enhance compliance, optimize patient care, and control aerosol-related expenditures. Clinically, these findings highlight that adherence to evidence-based aerosol therapy not only enhances patient outcomes but also reduces ICU expenditure, thereby supporting integration into routine clinical practice.

Background: Severe trauma and acute fluid loss are major causes of hypovolemia, linked to high morbidity and mortality if untreated. Intravenous fluid resuscitation, including plasma volume expanders (PVEs), is essential for restoring intravascular volume and perfusion. Polygeline, a gelatine-based colloid, is widely used; however, Indian real-world safety and effectiveness data remain limited. Objectives were to describe the demographic and clinico-epidemiological profile of Indian patients with hypovolemia and to evaluate the effectiveness and safety of Polygeline 3.5% intravenous infusion in routine clinical practice. Methods: This prospective, multicentre, open-label, post-marketing observational study enrolled 154 patients aged 18-65 years who received polygeline 3.5% IV infusion. Demographic and clinical characteristics were documented. Effectiveness was assessed by changes in hemodynamic parameters, urine output, respiratory rate, metabolic markers, pallor, and skin condition over 24 hours. Safety and tolerability were monitored throughout the study. Results: Hypovolemia was equally attributed to traumatic and non-traumatic causes. Among traumatic cases, 46% were classified as class II hypovolemia and 4.7% as class III, while non-traumatic cases showed fewer moderate to severe presentations. Over 24 hours, significant improvements were observed in hemodynamic parameters: mean systolic blood pressure increased from 99.99 to 119.11 mmHg, diastolic pressure from 61.68 to 74.43 mmHg, pulse rate declined from 104.60 to 85.53 bpm, respiratory rate from 21.57 to 18.82 breaths/min, and urine output increased from 21.08 to 218.90 mL (p<0.0001). One non-serious adverse drug reaction (0.6%) was reported and resolved without intervention. Conclusions: Polygeline 3.5% IV infusion demonstrated effective hemodynamic stabilization with a favourable safety profile in patients with hypovolemia of traumatic and non-traumatic origin.

Traditional Learning Management Systems (LMS) and unverified peer-to-peer sharing networks often suffer from isolated learning experiences, outdated materials, and the proliferation of low-quality or plagiarized academic content. Out-of-the-box Large Language Models (LLMs) offer personalized tutoring, but frequently generate confident academic

Objective. Electrical burns constitute a severe multisystem trauma associated with significant morbidity and mortality, particularly in high-tension injuries involving the upper extremities. This study aimed to analyze the clinical profile, management strategies, and outcomes of patients with high-voltage electrical burns. Materials and Methods. A prospective observational study was conducted at the Department of Burns and Plastic Surgery, Civil Hospital, Ahmedabad, from July 2021 to March 2024. A total of 104 patients with high-voltage electrical burns were included. Demographic data, burn characteristics, treatment modalities, complications, and outcomes were systematically recorded and analyzed. Statistical correlation between burn surface area and hospital stay was evaluated using Pearson’s correlation coefficient. Results. The majority of patients were young males (mean age 30.7 years), with 83.6% belonging to rural areas. The mean total body surface area (TBSA) involved was 18.7%. A strong positive correlation was observed between TBSA and hospital stay (r = 0.78, p < 0.001). A total of 181 surgical procedures were performed, with fasciotomy and amputation being the most frequent interventions. Septicemia was the leading cause of death (77.8%), while 95% of amputees were successfully rehabilitated with prosthetic support. Conclusion. High-voltage electrical burns predominantly affect young, working-age males and often result in severe functional loss and prolonged hospitalization. Early surgical intervention, aggressive infection control, and structured rehabilitation significantly improve outcomes. Enhanced occupational safety measures and community education are essential to prevent such injuries in developing regions like India.

Massive ovarian edema (MOE) is a rare, tumor-like, benign condition characterized by diffuse ovarian enlargement. It is mostly associated with partial/intermittent adnexal torsion, resulting in impaired venous and lymphatic drainage of the ovaries. Owing to its nonspecific clinical presentation and tumor-like imaging appearance, MOE is often misdiagnosed as an ovarian neoplasm, leading to unnecessary oophorectomies. We report a case of MOE in a young nulligravid woman who presented with abnormal uterine bleeding. Following an initial inconclusive clinical evaluation and ultrasonography, the diagnosis was eventually confirmed by magnetic resonance imaging (MRI) of the pelvis, and appropriate treatment could be undertaken. Due to the rarity ofincidence and atypical presentation, we would like to add this case to the existing scientific literature.

"Give a Man a Fish and you feed him for a day; teach a Man to Fish and you feed him for Life" The age old adage holds value in an age which is rife with cut throat competition, insecurity, the desire for more and an emptiness in human beings like never before. Empowering the young and old with education, life skills, spiritual philosophies is the need of humanity. The present paper seeks to understand how taking refuge in a philosophy Empowers people and brings Absolute Happiness amidst their struggles of daily life. All of us seek Happiness. Fulfilment of desires for wealth, fame, social status which constitute relative happiness. Happiness that is indestructible even in the face of windfalls and blows that life brings, is Absolute Happiness. It leads to complete fulfilment in life. It's a life marked by compassion, courage, joy and wisdom. In the compilation of essays by SGI President Daisaku Ikeda, he offers six concrete conditions for Happiness: Fulfilment, a Profound Philosophy, Conviction, Cheer & Vibrancy, Courage, and Tolerance. All these conditions are encompassed in the single word "FAITH". The paper seeks to differentiate relative happiness from absolute happiness and examine if these conditions make people absolutely happy.

The present study investigates the dual impact of microbial biofertilizers on the phenotypic performance and rhizosphere microbiome composition in an onion crop. A pot experiment was conducted with seven treatments of microbial inoculants, such as Azotobacter, Azospirillum, Piriformospora indica, phosphate solubilizing bacteria (PSB), and control treatments with and without chemical fertilizers. The growth, physiological, and biochemical traits of onion were assessed alongside rhizospheric soil microbiome profiling using 16S rRNA metagenomic sequencing. Significant enhancement in plant height, leaf number, leaf area, chlorophyll content, photosynthetic rate, and antioxidant enzyme activity with low leaf temperature was observed in plants inoculated with Azotobacter and Azospirillum. Notably, the Azotobacter treatment yielded a significant enhancement in the bulb phenol content. Rhizosphere metagenomic analysis revealed 17 dominant phyla, with Actinobacteria (25.3%), Proteobacteria (22.2%), Firmicutes (12.8%), and Chloroflexi (11.02%) comprising over 70% of the total microbiome. Alpha and beta diversity metrics indicated that microbial inoculation, especially with Azospirillum and PSB, enriched the soil microbial community structure. Distinct clustering and correlations with specific microbial taxa such as Candidatus Nitrososphaera and Pseudomonas were observed in response to individual biofertilizer treatments. This study highlights the potential of biofertilizers not only in enhancing onion growth and development but also in modulating beneficial rhizosphere microbial communities. Integrating biofertilizers into onion production systems could reduce the dependency on chemical fertilizers and promote sustainable crop management.

Art therapyis a therapeutic form which uses drawing, painting, clay as a form of expression as well as therapy which helps boost self-esteem and has been effective for children, adolescents, adults, and older adults alike. As people age, both physical changes and changes in their social lives put them at a higher risk of developing multiple physical and psychological health problems. Therefore, fostering an individual's social and emotional well-being is crucial for building positive self-esteem and helps to lead a healthy, quality and productive lifestyle. This study tries to understand the outcome of art therapy on self-esteem among older adults in Pune using the pretest and posttest research design. The results of the research showed that there is a significant increase in self-esteem due to art therapy (p value< 0.01). From the resultsit can be inferred that art therapy has a significant impact in boosting self-esteem in older adults and such modules must be recommended for all older adults for a better well-being.

Quinone compounds are versatile molecules with significant biological importance and have therapeutic potential in medicine. This chapter provides a comprehensive overview of quinones, beginning with their definition, historical background, and chemical structure. It explores their diverse roles in biological systems, including their involvement in cellular respiration, enzymatic reactions as cofactors, and their function as endogenous compounds. Mechanistically, quinones employ their effects through redox properties, electron transfer processes, and interactions with cellular components such as proteins, lipids, and DNA. Therapeutically, quinones are pragmatic for their anti-cancer, antimicrobial, antiinflammatory, and antioxidant properties. Key drugs like doxorubicin and mitomycin C exemplify their efficacy in cancer treatment, while other quinones serve as antimicrobial agents against bacteria, fungi, and viruses. Challenges in drug development, including toxicity and stability issues, are addressed alongside strategies to mitigate these concerns. Case studies and clinical trial data underscore the clinical relevance of quinone-based therapies. Looking forward, future research opportunities include exploring novel quinone derivatives, integrating quinones in combination therapies, and advancing drug delivery systems to enhance their efficacy and safety profiles. The chapter concludes by emphasizing the significant role of quinone compounds in modern medicine and outlining potential breakthroughs that may further expand their therapeutic applications.