Odd Sites of Parathyroid Adenomas: 18F-fluorocholine PET/CT Pointing to the Right Place.

Primary hyperparathyroidism is mostly caused by parathyroid adenoma(s) which are generally localized using routine imaging modalities such as neck ultrasonography and Tc-SestaMIBI scintigraphy. However, these can miss ectopic parathyroid adenomas due to their limited sensitivities. These ectopic lesions can later lead to failure of surgical excision and necessitate the need for a re-exploration.

Comparison of inflammatory markers in low-pressure pneumoperitoneum with deep neuromuscular block versus standard pressure pneumoperitoneum among patients undergoing laparoscopic cholecystectomy for gallstone disease: a randomized control trial.

Background: Low-pressure pneumoperitoneum (LPP) is an attempt to improve laparoscopic surgery. Lower pressure causes lesser inflammation and better hemodynamics. There is a lack of literature comparing inflammatory markers in LPP with deep NMB to standard pressure pneumoperitoneum (SPP) with moderate NMB in laparoscopic cholecystectomy.

Combined endovascular and percutaneous approach to the management of spontaneous splenic arteriovenous fistula.

A splenic arteriovenous fistula (AVF) is an uncommon splenic vascular disease which can be congenital or acquired. A 40yr old woman, without any history of chronic liver disease, presented with non-specific pain abdomen, underwent contrast-enhanced CT and was diagnosed to have a splenic AVF with multiple intervening venous aneurysms and early filling of the portal vein. The vascular abnormality was successfully treated with a combined percutaneous glue embolisation and endovascular balloon-assisted coil embolisation.

Perioperative complications of laparoscopic inguinal hernia repair in India: a prospective observational study.

Purpose: These days laparoscopic inguinal hernia surgery, both totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP), is a commonly performed procedure due to advancements in laparoscopic instruments and the availability of skilled laparoscopic surgeons. The purpose of this study was to compare the perioperative complications of these two procedures.

Methods: This was a prospective observational study between July 2019 and December 2020.

Role of Fluorocholine Positron Emission Tomography/Computed Tomography in the Localization of Culprit Lesions in Patients of Persistent/Recurrent Primary Hyperparathyroidism: A Prospective Study in COVID Times.

Introduction: Recurrent/persistent primary hyperparathyroidism in patients who have undergone previous parathyroidectomy is a challenging condition. Imaging is important for localizing the parathyroid adenoma for re-exploration and F-Fluorocholine (F-FCH) positron emission tomography/computed tomography (PET/CT) seems ideal for this purpose.

Aim: This prospective study attempted to ascertain the utility of F-FCH PET/CT as an investigation in preoperative localization of abnormal parathyroid tissue in recurrent/persistent primary hyperparathyroidism while comparing it with Tc-Sestamibi dual-phase scintigraphy with early single-photon emission CT (SPECT)/CT and neck ultrasonography (USG).

Low-pressure pneumoperitoneum with deep neuromuscular blockade versus standard pressure pneumoperitoneum in patients undergoing laparoscopic cholecystectomy for gallstone disease: a non-inferiority randomized control trial.

Background: Low-pressure pneumoperitoneum (LPP) is an attempt at improving laparoscopic surgery. However, it has the issue of poor working space for which deep neuromuscular blockade (NMB) may be a solution. There is a lack of literature comparing LPP with deep NMB to standard pressure pneumoperitoneum (SPP) with moderate NMB.

Macrofollicular Architecture in Invasive Encapsulated Follicular Variant of Papillary Thyroid Carcinoma: A Pitfall in Thyroid Practice.

Background: Predominantly macrofollicular architecture in invasive encapsulated follicular variant of papillary thyroid carcinoma (IEFVPTC-MF) is rare and often a cause of misinterpretation during pre-operative work-up and histopathology evaluation. We comprehensively evaluated the radiological, cytological, gross, microscopic, molecular and follow-up characteristics of four such cases, intending to increase its recognition and add our experience to the limited literature available.

Methods: All such histopathologically-proven cases of IEFVPTC-MF were retrieved from the departmental archives.

Recurrent Desmoid Fibromatosis of the Thyroid Gland: A Diagnostic Challenge.

A 31-year-old Indian female with a history of near-total thyroidectomy 2.5 years prior presented with recurrent neck swelling. Magnetic resonance imaging (MRI) of the neck revealed an infiltrating mass involving the thyroid bed.

Multi-modality parathyroid imaging: A shifting paradigm.

The goal of parathyroid imaging in hyperparathyroidism is not diagnosis, rather it is the localization of the cause of hyperparathyroidism for planning the best therapeutic approach. Hence, the role of imaging to accurately and precisely localize the abnormal parathyroid tissue is more important than ever to facilitate minimally invasive parathyroidectomy over bilateral neck exploration. The common causes include solitary parathyroid adenoma, multiple parathyroid adenomas, parathyroid hyperplasia and parathyroid carcinoma.

Endoscopic totally extraperitoneal repair for groin hernia: Experience from a tertiary care centre.

Background: Totally extra-peritoneal (TEP) and transabdominal preperitoneal (TAPP) repair are two established minimal access techniques of groin hernia surgery. TEP offers the advantage of avoiding violation of the peritoneal cavity.

Aim: This study aims to describe the decade-long experience of TEP in groin hernia repair in a tertiary care teaching institute and the feasibility of the same in difficult scenarios.

Impact of Fluoro-Choline PET/CT in Reduction in Failed Parathyroid Localization in Primary Hyperparathyroidism.

Introduction: Accurate localization of the pathological parathyroid gland is a prerequisite for minimally invasive surgical management of hyperparathyroidism (HPT). Poor imaging or discordance in odd situations like ectopic adenomas, parathyroid hyperplasia, syndromic HPT results in localization dilemma thus causing failed parathyroidectomy. We studied the impact of Fluoro-Choline (FCH) PET/CT imaging in reduction in localization failure of parathyroid adenoma.

Illness wellness scale: novel grading system for performance status of patients under surgical care.

Background: Grading the illness using clinical parameters is essential for the daily progress of inpatients. Existing systems do not incorporate these parameters holistically. The study was designed to internally validate the illness wellness scale, based upon clinical assessment of the patients requiring surgical care, for their risk stratification and uniformity of communication between health care providers.

Intramedullary Teratoma of Spine in an Adult Patient.

Spinal teratomas are rare spinal tumors. Most of these present in children. We present the imaging findings of a spinal teratoma that was not symptomatic until adulthood.

Gastric Outlet Obstruction Following Recurrent Pancreatitis Uncovers a Giant Parathyroid Adenoma: A Case Report.

A 35-year-old female presented with abdominal pain, fever, projectile vomiting, and a diffuse tender epigastric mass. She was diagnosed to have acute persistent pancreatitis with a pancreatic pseudocyst. Elevated serum calcium levels provided an etiologic link between hypercalcemia and pancreatitis.

Analysis of the Variations in the Colic Branching Pattern of the Superior Mesenteric Artery: A Cadaveric Study With Proposal to Modify Its Current Anatomical Classification.

Background: Vascular anatomy of the ascending colon is more complex and variable as compared to the left. Variations range from the mode of origin, branching to territorial supply. The present study was undertaken to learn the anatomical variations of the superior mesenteric artery (SMA) and its colic branches in detail.

Comparison of Non-Operative Mesotherapy and Surgery in the Management of Superficial Lipomas.

Background: Lipomas are benign adipocytic tumours. Surgical excision is the gold standard for treating such lipomas, but it results in unaesthetic scarring.

Methods: A total of 126 patients were randomised into two groups.

CT-Guided Lumbar Sympathectomy as a Last Option for Chronic Limb-Threatening Ischemia of the Lower Limbs: Evaluation of Technical Factors and Long-Term Outcomes.

The purpose of this study was to assess the effects of anatomic and technical factors on the long-term outcome of CT-guided lumbar sympathectomy in patients with chronic limb-threatening ischemia. Thirty patients (28 men, two women; mean age, 45.8 years) with chronic limb-threatening ischemia and diffuse tibial arterial disease not amenable to revascularization were included.

Evaluation of MR Visual Rating Scales in Major Forms of Dementia.

 The aim of the study is to visually rate major forms of dementia using global cortical atrophy (GCA), medial temporal lobe atrophy (MTA), and Fazeka's scales and Koedam's score using magnetic resonance imaging (MRI). The purpose is to correlate the visual rating scales (VRS) with severity of dementia.  Thirty patients fulfilling DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) criteria for Alzheimer's dementia (AD), vascular dementia (VaD), and frontotemporal dementia (FTD) underwent MRI brain.

Giant secretory multifocal adrenal myelolipoma: a diagnostic dilemma.

A 38-yearr-old man presented with erectile dysfunction and infertility. On examination, he was hypertensive and detected to have a left flank mass. Blood investigations were unremarkable except raised serum noradrenaline levels.

An Analysis of the Economic Burden of the Trauma Services at a Level 1 Public Sector Trauma Center in South Asia.

Background: Incidence of road traffic injuries (RTIs) is increasing and accounting for country's 3% gross domestic product. It is crucial to perform a cost analysis of trauma systems to allocate resources judiciously.

Aim And Objectives: To study the economic burden of trauma care on the patient attending a level I trauma center including stratification of costs according to injury.

Dengue fever in a south Asian metropolis: a report on 219 cases.

Background And Objectives: Yearly epidemics of Dengue fever occur post-monsoon in India's capital, Delhi. A prospective observational study was conducted during the outbreak months to understand the epidemiology and outcome of this infection and its economic impact.

Materials And Methods: Febrile hospitalized (n=219) patients with dengue fever diagnosed by a combination of MAC-ELISA, GAC-ELISA and NS1Antigen-ELISA were enrolled.

Familial Occurrence of Thyroglossal Duct Cyst.

Thyroglossal duct cysts are one of the commonest benign midline neck swellings. These are the remnants of the embryologic duct that fails to regress by the 10th week of fetal development. Generally, these are sporadic, slowly enlarging midline neck lumps, with half of them presenting before the age of 30.