Robot-Assisted Minimally Invasive Coronary Artery Bypass Grafting: Total Arterial Revascularization Using the Double-Docking Technique.

Objective: The right internal mammary artery is considered to be the second choice for arterial conduits for coronary artery bypass grafting (CABG). However, the widespread use of bilateral internal mammary artery (BIMA) grafting is limited owing to increased technical demands, lengthy procedure, and high incidence of sternal wound complications. We compared the early clinical outcomes of a novel robot-assisted double-docking technique (DDT) with an open sternotomy technique for total arterial revascularization using BIMA.

Functional Outcomes of Gap Non-Union Humerus Fractures Treated with Fibular Strut Graft, Iliac Crest Graft, and Locking Compression Plate.

Introduction: The humeral shaft gap non-union treatment surgically after unsuccessful fixation is difficult. In this study, the functional outcome of unsuccessful fixation of humeral shaft gap non-unions using a locking compression plate (LCP), fibular strut graft, and iliac bone graft was evaluated.

Case Report: After taking ethical approval, we studied 10 patients with humeral shaft gap non-unions with unsuccessful surgical fixation treated with open reduction and internal fixation using LCP with fibular strut graft and iliac cancellous bone graft.

Extraovarian Fibroma with Minor Sex Cord Elements-a Rare Tumour at Rare Site.

Sex cord stromal tumour (SCST) of ovary account for 5-8% of all ovarian malignancies. These include fibroma, thecoma, fibro-thecoma, Leydig cell tumour, granulosa cell tumour, and Sertoli cell tumour. Although considered primary ovarian malignancy, SCST has been described in extraovarian location also.

ISCCM Position Statement on the Management of Severe Malaria in Intensive Care Unit.

Unlabelled: Malaria is a worldwide health concern, but a great majority of cases occur in tropical countries like India. With almost 95% of Indian population living in malaria endemic regions, India contributes to most of the global malaria cases and deaths, outside of African countries. Despite significant advances towards malaria control and eradication, mortality associated with severe malaria remains particularly high.

Diagnosis and management of pediatric acute liver failure: consensus recommendations of the Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ISPGHAN).

Timely diagnosis and management of pediatric acute liver failure (PALF) is of paramount importance to improve survival. The Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition invited national and international experts to identify and review important management and research questions. These covered the definition, age appropriate stepwise workup for the etiology, non-invasive diagnosis and management of cerebral edema, prognostic scores, criteria for listing for liver transplantation (LT) and bridging therapies in PALF.

Heterogeneity in nomenclature and abbreviation usage for anti-synthetase syndrome: a scoping review.

Anti-synthetase syndrome constitutes a dynamically evolving subset of Idiopathic Inflammatory Myopathy, however, the nomenclature and abbreviations for this syndrome are plagued by heterogeneity, leading to lack of consistency in literature. The objective of this study is to evaluate existing diversity in disease names and abbreviations, with a future goal to develop consensus on the nomenclature. A scoping review format was used for analysis.

Intraoperative Reverse Takotsubo Cardiomyopathy in Liver Transplantation: An Anesthesiologist's Nightmare.

Background: Reverse Takotsubo cardiomyopathy (TTC) is a rare variant of stress cardiomyopathy, characterized by basal akinesia with apical sparing. To our knowledge, this case is the first reported in the literature of intraoperative reverse TTC (rTTC) in liver transplantation.

Case: After a thorough workup, a 19-year-old man, diagnosed with extrahepatic biliary atresia, was taken up for living-related donor liver transplantation.

Navigating Cardiovascular Risk and Lipid Management in Indian Patients: Key Messages from the Lipid Association of India 2024 Consensus Statement IV.

Effective lipid management is crucial for preventing atherosclerotic cardiovascular disease (ASCVD). The Western lipid guidelines may not apply to Indian subjects because of the vast differences in cardiovascular (CV) disease epidemiology. To overcome this challenge, the Lipid Association of India (LAI) in 2016 proposed an ASCVD risk stratification algorithm.

A rare case of A endocarditis.

Unlabelled: Non-typhoid endocarditis is uncommon. Non-typhoid A endocarditis is even more rare. Although the spectrum of available antibiotics is adequate for treatment, the importance of this condition stresses its rarity of occurrence and presentation.

Takayasu arteritis with recurrent coronary artery disease.

Takayasu arteritis is a rare type of large vessel vasculitis that commonly affects individuals of Asian descent. Coronary artery involvement is rare. We report the case of a young female with history of Takayasu arteritis who underwent stenting and reported with in-stent restenosis.

Global burden of metabolic diseases, 1990-2021.

Background: Common metabolic diseases, such as type 2 diabetes mellitus (T2DM), hypertension, obesity, hypercholesterolemia, and metabolic dysfunction-associated steatotic liver disease (MASLD), have become a global health burden in the last three decades. The Global Burden of Disease, Injuries, and Risk Factors Study (GBD) data enables the first insights into the trends and burdens of these metabolic diseases from 1990 to 2021, highlighting regional, temporal and differences by sex.

Methods: Global estimates of disability-adjusted life years (DALYs) and deaths from GBD 2021 were analyzed for common metabolic diseases (T2DM, hypertension, obesity, hypercholesterolemia, and MASLD).

Evaluation of Safe Margins Using Immunohistochemistry in Oral Squamous Cell Carcinoma.

Background: Hematoxylin & Eosin (H & E) stains have been conventionally used to establish the status of safe margins following resection of primary Oral Squamous Cell Carcinoma. Due to non-specificity of this stain, there is a possibility of false negative results. In this study, we have assessed the role of Immunohistochemistry (IHC) in establishing the status of safe margins.

Spontaneous Hypoglycaemia due to Insulin Autoimmune Syndrome in Six Cases, Response to Steroid Therapy and Rituximab.

Introduction: Dr. Hirata of Japan first described insulin autoimmune syndrome (IAS) in 1970. Seven hundred ninety-five cases of this rare syndrome have been reported from Japan and China and 29 from India.

Efficacy and Safety of Osilodrostat in Managing Cushing's Syndrome: A Systematic Review and Meta-Analysis.

No meta-analysis has holistically analysed and summarized the efficacy and safety of osilodrostat, a novel dual 11β-hydroxylase (cytochrome P450 family 11 subfamily B member 1 [CYP11B1]) and 18-hydroxylase (aldosterone synthase, CYP11B2) inhibitor in managing Cushing's syndrome (CS). We undertook this meta-analysis to address this knowledge gap. Electronic databases were searched for randomized controlled trials (RCTs) involving patients with CS receiving osilodrostat in the intervention arm.

Short- and Medium-Term Outcomes Comparison of Native- and Valve-in-Valve TAVI Procedures.

Background: In high-risk patients with degenerated aortic bioprostheses, valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) has emerged as a less invasive alternative to surgical valve replacement. To compare outcomes of ViV and native valve (NV) TAVI procedures.

Methods: 34 aortic ViV-TAVI performed between 2012 and 2022 using self-expanding valves, were included in this retrospective analysis.

Electromyographic Analysis of Large Muscle Activity in Progressive Collapsing Foot Deformity.

Background: There are various deformities described in the spectrum of Progressive Collapsing Foot Deformity (PCFD) which not only have adverse effects on the foot but also on the entire lower limb. Early lower limb muscular fatigue and pain during exertion is the most common complaint of patients with PCFD. Surface electromyography (sEMG) provides an accurate assessment of muscle activity.

Multidisciplinary Consensus for Rationalizing the Use of Acid Suppressants in Children and Adults: CONFOR.

Unlabelled: The use of acid suppression therapy (AST) is a common approach for managing a wide spectrum of acid peptic disorders. Histamine type 2-receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) are the most widely prescribed AST in routine clinical practice. However, an exponential surge in the prescriptions of PPIs, such as Omeprazole, Esomeprazole, Pantoprazole, Lansoprazole in recent years and their associated adverse effects have raised concern about their inappropriate and overuse, both in children and adults.