Implant for Augmentation of Cerebral Blood Flow Trial-1 (ImpACT-1). A single-arm feasibility study evaluating the safety and potential benefit of the Ischemic Stroke System for treatment of acute ischemic stroke.

Background: The Ischemic Stroke System is a novel device designed to deliver stimulation to the sphenopalatine ganglion(SPG).The SPG sends parasympathetic innervations to the anterior cerebral circulation. In rat stroke models, SPG stimulation results in increased cerebral blood flow, reduced infarct volume, protects the blood brain barrier, and improved neurological outcome.

Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update.

The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set up in 2004 on acute-on-chronic liver failure (ACLF) was published in 2009. With international groups volunteering to join, the "APASL ACLF Research Consortium (AARC)" was formed in 2012, which continued to collect prospective ACLF patient data. Based on the prospective data analysis of nearly 1400 patients, the AARC consensus was published in 2014.

Infection in a Pediatric ICU: A Hospital Based Prospective Observational Study.

Introduction: Admission to a pediatric intensive care unit (PICU) with a (SA) infection is associated with considerable mortality and morbidity. There is paucity of data about epidemiology of SA infection in a PICU. This study was aimed at elucidating the clinicoepidemiological profile and outcome of children admitted to ICU with infection.

Prevalence of Epilepsy and Inter-Ictal Epileptiform Discharges in Children with Autism and Attention-Deficit Hyperactivity Disorder.

Objective: To study the prevalence of epilepsy and Inter-ictal epileptiform discharges (IED) in children with Autism spectrum disorder (ASD) and Attention-deficit hyperactivity disorder (ADHD), and the factors associated with occurrence of epilepsy in these children.

Methods: Children between 6 and 12 y attending the Child Development Centre of a tertiary-care institute in India were evaluated for ASD and ADHD as per Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Childhood Autism Rating Scale was used to assess ASD severity, and Conner's Rating Scales were used to sub-classify children with ADHD.

Clinical Importance of () Gene Polymorphisms and Their Expression Patterns in Coronary Artery Disease Patients: A Study from India.

The influence of Estrogen Receptor 1 (ESR1) gene -397T>C (PvuII) and -351A>G (XbaI) polymorphisms on the risk of development of coronary artery disease (CAD) in the north Indian population was analysed. We hypothesized that ESR1 gene polymorphisms may influence the susceptibility to CAD through variation in Estrogen Receptor α (ERα) expression. To assess this concept, we evaluated ERα mRNA expression in blood plasma of CAD patients.

Perioperative management of a patient with double orifice mitral valve with supramitral ring with subaortic membrane with ventricular septal defect and severe pulmonary hypertension: Report of a rare case.

Double-orifice mitral valve (DOMV) is an unusual congenital anomaly characterized by a mitral valve with a single fibrous annulus with two orifices or rarely two orifices with two separate mitral annuli opening into the left ventricle. We present a first report of a patient with a DOMV with supramitral ring (SMR), subaortic membrane (SAM), a large ventricular septal defect (VSD) with more than 50% aortic override, and severe pulmonary arterial hypertrophy (PAH). This patient underwent excision of the SAM, and SMR, with closure of the VSD together under cardiopulmonary bypass (CPB).

Endoscopic Retrograde Cholangiopancreaticography in Children: A Single-center Experience From Northern India.

Objective: To evaluate spectrum, efficacy and safety of Endoscopic retrograde cholangiopancreatography (ERCP) in pediatric population.

Methods: Retrospective case record review of pediatric patients (age ≤15 y) undergoing ERCP between January 2011 to June 2015 at a tertiary care referral hospital in New Delhi, India. The Indications for ERCP, cannulation success rate, procedure success rate and complications were recorded.

Esophageal tuberculosis: Uncommon of common.

Background And Aim: Esophageal involvement in tuberculosis (TB) is rare and is usually secondary. Data on esophageal TB are scarce. We aimed to analyze clinical and endoscopic features and outcomes of treatment in esophageal TB.

Genetic landscape of gallbladder cancer: Global overview.

Gallbladder cancer (GBC) is a rare malignancy of biliary tract cancer (BTC), characterized by late presentation and poor prognosis. It exhibits wide geographical as well as ethnical variations. So, diverse epidemiology along with etiological factors have been discussed in the current article.

A case of liver cirrhosis and Chilaiditi syndrome with atypical pneumonitis.

Respiratory distress is very uncommon as a presenting symptom of Chilaiditi syndrome. Furthermore, pneumonia is not documented with the syndrome, compromising further to the distress. We describe a middle-aged man, chronic alcoholic, recently diagnosed with liver cirrhosis, presented with a 1-year history of slowly progressive breathlessness.

Prevalence and impact of abnormal routine pre-operative test results among elective surgical patients with or without co-morbidity: An observational comparative study.

Background: At present, selective and clinical assessment-based pre-operative investigations are advocated, but it is yet far from routine practice.

Aim: This study aims to assess the prevalence and impact of abnormal routine pre-operative test results among co-morbid and non-co-morbid elective surgical patients.

Methods: Data for this prospective study were collected by reviewing the medical charts of the patients attending pre-anaesthetic clinic from December 2016 to April 2017.

Correlation of different parity and school education with acceptance of labor analgesia among antenatal women: A questionnaire-based study.

Background And Aim: Pain relief is nearly regarded as the right of patients in modern day health care. Women undergo excruciating pain during normal vaginal delivery (NVD). However, the acceptance of labor analgesia (LA) has remained very poor.

Role of radiological imaging and interventions in management of Budd-Chiari syndrome.

Budd-Chiari syndrome (BCS) is a clinical condition resulting from impaired hepatic venous drainage, in which there is obstruction to the hepatic venous outflow at any level from the small hepatic veins to the junction of the inferior vena cava and the right atrium leading to hepatic congestion. The diagnosis of BCS is based on imaging, which can be gathered from non-invasive investigations such as ultrasonography coupled with venous Doppler, triphasic computed tomography (CT) and magnetic resonance imaging (MRI). Apart from diagnosis, various interventional radiology procedures aid in the successful management of this syndrome.

Diabetic Painful Neuropathy and Restless Legs Syndrome in Diabetes.

Restless legs syndrome (RLS) and diabetic painful neuropathy (DPN) are two distinct neurological conditions, which share many similarities. As RLS occurs frequently in persons with diabetes, the differential diagnosis and management of RLS and DPN may pose a clinical challenge. This communication describes the etiopathogenesis, clinical features, investigations, and treatment of both conditions.

Abnormal routine pre-operative test results and their impact on anaesthetic management: An observational study.

Background And Aims: One of the reasons for continued routine pre-operative testing practice is the identification of hidden problems which may affect perioperative management. This study was aimed to assess the prevalence of abnormal test results, their impact on perioperative management and cost-effectiveness for detecting such abnormalities.

Methods: This observational study was conducted by screening the files of the patients attending pre-anaesthetic check-up during December 2016-January 2017.

Laparoscopic Surgery for Gallbladder Cancer: An Expert Consensus Statement.

Background: Despite the increasing number of reports on the favorable outcomes of laparoscopic surgery for gallbladder cancer (GBC), there is no consensus regarding this surgical procedure.

Objective: The study aimed to develop a consensus statement on the application of laparoscopic surgery for GBC based on expert opinions.

Methods: A consensus meeting among experts was held on September 10, 2016, in Seoul, Korea.

Survey Results of the Expert Meeting on Laparoscopic Surgery for Gallbladder Cancer and a Review of Relevant Literature.

Background: Favorable outcomes of laparoscopic surgery for gallbladder cancer (GBC) have been reported; yet consensus on the indications and surgical techniques for laparoscopic surgery for GBC is lacking.

Objective: To evaluate the current status of laparoscopic surgery for GBC by analyzing the results of a survey of experts and by reviewing the relevant published literature.

Methods: Before an expert meeting was held on September 10, 2016 in Seoul, Korea, an international survey was undertaken of expert surgeons in the field of GBC surgery.

Isoniazid and rifampicin heteroresistant Mycobacterium tuberculosis isolated from tuberculous meningitis patients in India.

Background: Heteroresistant Mycobacterium tuberculosis (mixture of susceptible and resistant subpopulations) is thought to be a preliminary stage to full resistance and timely detection, initiation of correct treatment is vital for successful anti tubercular therapy. The aim of this study was to detect multi drug resistant (MDR) and heteroresistant M. tuberculosis with the associated gene mutations from patients of tuberculous meningitis.

Lhermitte-Duclos Disease: A Rare Cause of Cerebellar Ataxia.

The aim of this study is to describe a case of Lhermitte-Duclos disease (LDD), which is an extremely rare cause of cerebellar ataxia. LDD is an extremely rare type of benign cerebellar mass and usually manifest as features of raised intracranial pressure and cerebellar dysfunction. Patients may remain asymptomatic for many years, and detection of tumor may be by chance on routine magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS).