Radiofrequency ablation in the management of primary hepatic and biliary tumors.

In the United States, 80%-90% of primary hepatic tumors are hepatocellular carcinomas and 10%-15% are cholangiocarcinomas (CCA), both with high mortality rate, particularly CCA, which portends a worse prognosis. Traditional management with surgery has good outcomes in appropriately selected patients; however, novel ablative treatment options have emerged, such as radiofrequency ablation (RFA), which can improve the prognosis of both hepatic and biliary tumors. RFA is aimed to generate an area of necrosis within the targeted tissue by applying thermal therapy an electrode, with a goal to completely eradicate the tumor while preserving surrounding healthy tissue.

Utility of endoscopic ultrasound and endoscopy in diagnosis and management of hepatocellular carcinoma and its complications: What does endoscopic ultrasonography offer above and beyond conventional cross-sectional imaging?

Hepatocellular carcinoma constitutes over 90% of the primary liver tumors, the rest being cholangiocarcinoma. It has an insidious presentation, which is responsible for the delayed presentation. Hence, the management strategy relies on screening to diagnose it an early stage for curative resection and/or treatment with local ablative techniques or chemotherapy.

Spontaneous pituitary apoplexy during the second trimester of pregnancy, with sensory loss.

A 32-year-old Hispanic woman at 23 weeks gestation presented with right-sided headache, associated with photophobia and right-sided numbness. She denied visual problems, menstrual irregularities and galactorrhoea. Examination revealed visual acuity 20/40 bilaterally with some blurriness on the left side, decreased right V1-V2 facial sensation and preserved 5/5 power, but decreased sensation over the entire right upper extremity (RUE) and right lower extremity (RLE) to touch and pinprick.

Robotic assisted laparoscopic adrenalectomy: Initial experience from a tertiary care centre in India.

Introduction: Laparoscopic adrenalectomy (LA) is now considered the standard for treatment of surgically correctable adrenal disorders. Robotic adrenalectomy has been performed worldwide and has established itself as safe, feasible and effective approach. We hereby present the first study in robotic transperitoneal LA from Indian subcontinent.

Is short-term percutaneous endoscopic gastrostomy tube placement beneficial in acutely ill cognitively intact elderly patients? A proposed decision-making algorithm.

Aim: Percutaneous endoscopic gastrostomy (PEG) tube is an important method of enteral feeding for patients who require temporary or long-term artificial nutritional support to prevent or correct disease-related malnutrition. However, there is paucity of data on the utility of short-term PEG tube placements in acute illnesses in cognitively intact older adults.

Methods: We present a series of seven, cognitively intact patients (age range 72-93 years), who had PEG tubes placed for short periods.

Management of gastric variceal bleeding: Role of endoscopy and endoscopic ultrasound.

Gastric varices (GVs) are notorious to bleed massively and often difficult to manage with conventional techniques. This mini-review addresses endoscopic management principles for gastric variceal bleeding, including limitations of ligation and sclerotherapy and merits of endoscopic variceal obliteration. The article also discusses how emerging use of endoscopic ultrasound provides optimism of better diagnosis, improved classification, innovative management strategies and confirmatory tool for eradication of GVs.

Does vasculitis alone cause AVN? A review of literature.

AVN is caused by a disease, or severe trauma that affects the blood supply to the bone or in many cases may be idiopathic, with no known cause. AVN pathophysiology is most closely linked to SLE literature, and there is a strong cause and effect relationship between corticosteroid intake and AVN development in SLE patients, and AVN is extremely rare in the absence of steroid use. Apart from few anecdotal reports, there is no data on exact pathophysiologic mechanisms responsible for AVN in the setting of vasculitis.

Clinical predictors of fulminant colitis in patients with Clostridium difficile infection.

Background/aim: Clostridium difficile infection (CDI) can affect up to 8% of hospitalized patients. Twenty-five percent CDI patients may develop C. difficile associated diarrhea (CDAD) and 1-3% may progress to fulminant C.

Awareness of neurocysticercosis: A study from northwest India.

Background: Neurocysticercosis (NCC) is a common cause of epilepsy in developing countries. In order to plan and implement prevention programs, it is essential to study the awareness of NCC.

Objective: To study the awareness of NCC among patients with NCC and compare with age- and gender-matched controls without NCC.