Infections in acute liver failure - Assessment, prevention, and management.

Infections in acute liver failure (ALF) increase the associated morbidity and mortality, and often hamper the possibility of transplantation. Two-thirds of the infections in ALF are bacterial while one-third is fungal. High suspicion for infection is essential whenever there is clinical deterioration.

Novel Digital Anomalies, Hippocampal Atrophy, and Mutations Expand the Genotypic and Phenotypic Spectra of CNKSR2 in the Houge Type of X-Linked Syndromic Intellectual Development Disorder (MRXSHG).

The Houge type of X-linked syndromic intellectual developmental disorder (MRXSHG) encompasses a spectrum of neurodevelopmental disorders characterized by intellectual disability (ID), language/speech delay, attention issues, and epilepsy. These conditions arise from hemizygous or heterozygous deletions, along with point mutations, affecting CNKSR2, a gene located at Xp22.12.

Genetic and allelic heterogeneity in 248 Indians with skeletal dysplasia.

Skeletal dysplasias are a clinically and genetically heterogeneous group of rare disorders. Studies from large cohorts are essential to provide insights into the disease epidemiology, phenotypic spectrum, and mutational profiles. Here we enumerate additional 248 Indians from 197 families with a skeletal dysplasia, following a similar study earlier.

Mid-term outcomes of double-balloon technique for balloon aortic valvotomy: Experience from a tertiary care center in India.

We hypothesized that a double-balloon technique would be associated with a lower likelihood of aortic regurgitation (AR) following balloon aortic valvotomy (BAV). We present the short- and mid-term outcomes of the double-balloon technique for BAV. Fifty consecutive patients (median age: 6.

Genes of DLK1-DIO3 Locus and miR-379/656 Cluster is a Potential Diagnostic and Prognostic Marker in Patients With Hepatocellular Carcinoma: A Systems Biology Study.

Background: Hepatocellular carcinoma is the sixth most common malignancy reported globally. This highlights the need for reliable biomarkers that can be employed for diagnostic and prognostic applications. The present study aimed to classify and characterize the clinical potential of delta like non-canonical Notch ligand 1-type III iodothyronine deiodinase (DLK1-DIO3) and miR-379/656 cluster genes in hepatocellular carcinoma.

Non-communicable diseases related multimorbidity, catastrophic health expenditure, and associated factors in Ernakulam district.

Background: Multimorbidity, the coexistence of two or more chronic conditions in an individual, has emerged as a significant public health challenge with profound economic implications, exerting substantial strain on healthcare systems and economies worldwide. This study aimed to estimate the prevalence of non-communicable diseases (NCD) related multimorbidity, catastrophic health expenditure (CHE), and associated factors among adults aged ≥40 years in Ernakulam district.

Methods: A community-based cross-sectional study was conducted among 420 individuals aged ≥40 years using population probability sampling.

Clinical Manifestations of Anti-GABA-B Receptor Encephalitis: A Case Series.

Anti γ aminobutyric acid B(GABA B) receptor encephalitis is a rare form of autoimmune encephalitis. Our aim is to study the clinical characteristics and treatment outcomes of anti GABA B receptor encephalitis. This is a retrospective case series from the Neuroimmunology laboratory of Amrita Institute of Medical Sciences, Kochi, Kerala, India from 2016 to 2021.

Long-Term Follow-Up of Single-Step Free Vascularized Lymph Node Transfer for the Management of Combined Genital and Lower Extremity Lymphedema: A Case Report.

The occurrence of genital lymphedema with lower extremity involvement is rare. There is no standard approach in the management of combined genital and lower extremity lymphedema (CGLL). The limited literature available on the management of CGLL reveals the use of multiple procedures, including vascularized lymph node transfer (VLNT), lymphovenous anastomosis (LVA), and debulking.

A Case Series and Brief Review of Literature on Encapsulating Peritoneal Sclerosis: Unveiling the Cocoon.

This case series explores four distinct instances of encapsulating peritoneal sclerosis (EPS), a rare but serious condition characterized by the encapsulation of abdominal viscera, commonly referred to as abdominal cocoon. EPS is associated with severe complications, including bowel obstruction and sepsis, which can significantly impact patient outcomes. The first case involves a 41-year-old male patient who had undergone a liver transplant and ultimately succumbed to extensively drug-resistant (XDR) sepsis.

18F-FDG metabolic abnormalities precede perfusion and atrophic changes in diagnosis of early frontotemporal dementia: study from a tertiary care university hospital.

Objective: Diagnosis of early onset dementia is critical for initiating management. Although structural MRI is an established procedure for dementia evaluation, early cases may be missed. Neurodegenerative diseases lead to reductions in glucose consumption and grey matter volume loss.

Attitudes Toward Patient Safety Among Final-Year Medical Students and Interns at a Teaching Hospital in Kerala: A Cross-Sectional Study.

Background: With the advancements in medicine, medical technologies, and diagnostics, patient safety is expected to be one of the priorities of modern medicine. However, in India, several medical error-related deaths have been recorded. Medical students today are the future healthcare providers, and hence, understanding their attitudes toward patient safety is crucial.

Abscesses due to Melioidosis: A case-based review.

Melioidosis is caused by percutaneous inoculation or inhalation of , predominantly among individuals with risk factors (diabetes mellitus, immunosuppression, etc.) from endemic areas of South Asia, Southeast Asia and Northern Australia. While some patients present acutely with sepsis and multi-organ failure, others present with a subacute to chronic course characterised by abscess formation.

Robotic-arm assisted total knee replacement in an ankylosed knee.

A patient with rheumatoid arthritis in her 30s who had a left knee that had been ankylosed for 10 years was treated with robotic-arm assisted total knee replacement (RA-TKR) and surgical release of the ankyloses. For RA-TKR, accurate bony registration is essential. It was difficult to record the bone intraoperatively in an ankylosed knee with changed morphology.

Impact of exposure to extreme heat events during pregnancy on the incidence of congenital heart disease in offspring: a meta-analysis.

Background: The aetiology of congenital heart disease (CHD) is multifactorial. Environmental risk factors have emerged as an important modifiable determinant of several congenital cardiac conditions. Previous studies have shown a strong relationship between CHD and air pollution.

Thyrotoxic Periodic Paralysis With Graves' Disease: A Case Report.

One type of hypokalemic periodic paralysis that is associated with hyperthyroidism is called thyrotoxic periodic paralysis (TPP). TPP can be linked to any cause of hyperthyroidism, although Graves' disease is the most common cause. This sporadic variant of hypokalaemic periodic paralysis, thyrotoxic periodic paralysis, is characterized by rapid onset weakness in the proximal muscles.

Linguistic Validation of the Functional Assessment of Chronic Illness Therapy-Spiritual-Well-being-Expanded Version 4 Tool into Malayalam Language and its Feasibility in Advanced Cancer Patients Receiving Palliative Care.

Objective: The objective of this study was to validate the 'Functional Assessment of Chronic Illness Therapy-Spiritual-Well-being-Expanded(FACIT-SpEx) Version 4' tool in Malayalam and assess its feasibility among advanced cancer patients receiving palliative care.

Materials And Methods: The study was carried out at the outpatient Department of Cancer Palliative Medicine of Malabar Cancer Centre between November 2022 and June 2023. Initially, the FACIT-Sp-Ex version 4 tool with 23 items was translated into the Malayalam language with a forward-backward translation procedure.

Small airway involvement in severe asthma: how common is it and what are its implications?

Asthma is a prevalent chronic respiratory disease affecting all age groups globally, causing significant morbidity and mortality. Small airway involvement, often undetected by traditional spirometry, has emerged as a critical aspect of asthma pathophysiology, especially in severe cases. This retrospective observational study aimed to assess small airway dysfunction using impulse oscillometry (IOS) in 94 severe asthma patients.

Protocol for a cluster randomised controlled trial to evaluate effectiveness of a self-help group intervention to encourage smoke-free homes in slums of Kochi(Kochi Intervention for tobacco smoke free homes-KIFT).

Background: Exposure to second hand smoke (SHS) is a cause for heart disease and lung cancer among non- smokers. This cluster randomized control trial will evaluate the effectiveness of a tobacco smoke free home intervention in reducing exposure to second hand smoke.

Protocol: The intervention will be conducted among 30 clusters in urban and peri-urban areas of Kochi, India.