An Unusual Case of Giant Arterio-Venous Malformation of Anterior Abdominal Wall.

Arterio-Venous Malformations (AVMs) are high flow vascular anomalies, commonly seen in head, neck and extremities. AVMs represent a direct connection between the arterial and the venous systems. They are congenital, often asymptomatic and rarely manifest before adolescence.

Predictors of adverse outcome in patients of tuberculous meningitis in a multi-centric study from India.

Introduction: This study aimed to investigate the factors which may predict mortality and neurological disability at one year follow up in patients of tuberculous meningitis (TBM) in India.

Methodology: Patients with TBM were prospectively enrolled from July 2012 to September 2014 from four tertiary care hospitals of Delhi. The demographic characteristics, clinical features and laboratory findings were collected and patients were followed up till 1 year.

Pelvic Mass Lesions in Females: Tissue Characterization Capability of MRI.

Introduction: Magnetic Resonance Imaging (MRI) of adult female pelvis is a well-established tool in the evaluation of utero-ovarian lesions and is often used to supplement ultrasonography. The need for diagnostic surgical intervention has largely been eclipsed with the advent of MRI, which has become the imaging modality of choice for characterization of pelvic masses.

Aim: To assess the role of MRI in female pelvic mass lesions and to exploit the tissue characterization capability of MRI.

An observational study on patient admission in the anaesthesia gas monitor and minimum alveolar concentration monitoring: A deficiency with huge impact.

Background And Aims: Minimum alveolar concentration (MAC) monitoring is an integral part of modern-day anaesthesia. Both MAC and MAC-awake are age dependant, and age of the patient needs to be entered in the monitor. This study was aimed to assess the practice of patient birth year entry in the anaesthesia monitor and its impact on MAC monitoring.

Gastric Varices in Cirrhosis vs. Extrahepatic Portal Venous Obstruction and Response to Endoscopic -butyl-2-cyanoacrylate Injection.

Background: Gastric varices (GV) are found in patients with portal hypertension. Incidence of bleeding from GV is relatively low, but is severe, and associated with higher mortality.

Aims And Objectives: To compare the types of GV in cirrhosis vs.

Cytomorphology of Basaloid Squamous Cell Carcinoma: A Diagnostic Dilemma.

Basaloid Squamous Cell Carcinoma (BSCC) is an unusual and high grade variant of Squamous Cell Carcinoma (SCC) with a predilection for the upper aerodigestive tract. The cytomorphologic diagnosis of this tumour is challenging as it shares common cytomorphologic features with its differential diagnoses. However, a careful examination of the cytology can help in delivering a diagnosis of BSCC.

Acute pulmonary edema and thrombocytopenia following venous air embolism during sitting position neurosurgery.

Venous air embolism (VAE) is a well-known complication of sitting position neurosurgery which most characteristically manifests as mild to severe hemodynamic alterations. Development of pulmonary edema is a known, though infrequent, manifestation of VAE. We report here the occurrence of acute pulmonary edema without accompanying hemodynamic changes in a patient undergoing retromastoid craniotomy and tumor decompression in the sitting position.

Association of Cholesteryl Ester Transfer Protein (CETP) Gene -629C/A Polymorphism with Angiographically Proven Atherosclerosis.

Association of cholesteryl ester transfer protein (CETP) Gene -629C/A Polymorphism with angiographically proven atherosclerosis CETP gene has been linked to CAD risk via its role in HDL and LDL metabolism. There is no agreement of whether CETP is atherogenic or not. Furthermore, various genotypes of CETP gene have been associated with CETP levels and thus with atherosclerosis risk.

Perioperative complications in endovascular neurosurgery: Anesthesiologist's perspective.

Background: Endovascular neurosurgery is known to be associated with potentially serious perioperative complications that can impact the course and outcome of anesthesia. We present here our institutional experience in the anesthetic management of various endovascular neurosurgical procedures and their related complications over a 10-year period.

Methods: Data was obtained in 240 patients pertaining to their preoperative status, details of anesthesia and surgery, perioperative course and surgery-related complications.

Development of predisposition, injury, response, organ failure model for predicting acute kidney injury in acute on chronic liver failure.

Background And Aim: There is limited data on predictors of acute kidney injury in acute on chronic liver failure. We developed a PIRO model (Predisposition, Injury, Response, Organ failure) for predicting acute kidney injury in a multicentric cohort of acute on chronic liver failure patients.

Patients And Methods: Data of 2360 patients from APASL-ACLF Research Consortium (AARC) was analysed.

Malignant Granular Cell Tumour Presenting as a Paravertebral Mass in an Adolescent Male- A Rare Presentation of an Uncommon Tumour.

Granular Cell Tumour (GCT), also known as Abrikossoff's tumour is a rare neural tumour, mostly benign and solitary but rare malignant and multifocal occurrence are also reported. Location of tumour varies widely within body with tongue, skin and subcutaneous tissue being the most common sites. We report a case of malignant GCT in a 17-year-old male presented with a paravertebral swelling.

Assessment of striatal & postural deformities in patients with Parkinson's disease.

Background & Objectives: Though striatal and postural deformities are known to occur commonly in atypical Parkinsonism patients, these may also be seen in patients with Parkinson's disease (PD). These are frequently misdiagnosed as joint or orthopaedic pathology leading to unnecessary investigations. This study was conducted to observe the various striatal and postural deformities among patients with PD in India.

Predictors of curative resection and long term survival of gallbladder cancer - A retrospective analysis.

Background: Gallbladder cancer (GBC) is an aggressive malignancy. We analysed factors predicting resectability and survival of patients with GBC and the impact of surgical obstructive jaundice (SOJ).

Methods: Four hundred and thirty-seven patients with suspected GBC were analysed (52 excluded: benign pathology n = 35, missed GBC n = 17).

Phytosterols as a natural anticancer agent: Current status and future perspective.

Phytosterols are naturally occurring compounds in plants, structurally similar to cholesterol. The human diet is quite abundant in sitosterol and campesterol. Phytosterols are known to have various bioactive properties including reducing intestinal cholesterol absorption which alleviates blood LDL-cholesterol and cardiovascular problems.

Vitamin D deficiency among pediatric osteoarticular tuberculosis patients.

Objectives: We prospectively investigated serum 25 hydroxy vitamin D concentrations in children suffering from osteoarticular tuberculosis. The age or sex correlation to vitamin D levels in affected subjects was also calculated.

Methods: Twenty five untreated children with osteoarticular tuberculosis were taken as cases along with equal number of age and sex matched 'healthy' controls.

Cystic Pheochromocytoma Presenting as Adrenal Cyst.

Pheochromocytomas are usually solid tumours. But it can present as cystic lesions in the adrenal gland. Cystic lesions in adrenal gland with hypertension needs attention to rule out pheochromocytoma.

Biologics for the treatment of pyoderma gangrenosum in ulcerative colitis.

Pyoderma gangrenosum (PG) is an uncommon extra-intestinal manifestation of inflammatory bowel disease (IBD). Despite limited published literature, biologics have caused a paradigm shift in the management of this difficult-to-treat skin condition. The clinical data and outcomes of three patients with active ulcerative colitis and concurrent PG treated with biologics (infliximab two and adalimumab one) are reviewed in this report.

Intercoronary communication in chronic total occlusion: In search of recognition.

Intercoronary communications (ICC) or open-ended coronary circulation is rare. We describe intercoronary communication in a case of chronic total occlusion, and discuss the pathophysiological and clinical significance of these rare entities. The present case also demonstrates the anatomical presence of ICC despite angiographic absence for the first time using CT coronary angiography.

Asian-Pacific Association for the Study of the Liver (APASL) consensus guidelines on invasive and non-invasive assessment of hepatic fibrosis: a 2016 update.

Hepatic fibrosis is a common pathway leading to liver cirrhosis, which is the end result of any injury to the liver. Accurate assessment of the degree of fibrosis is important clinically, especially when treatments aimed at reversing fibrosis are being evolved. Despite the fact that liver biopsy (LB) has been considered the "gold standard" of assessment of hepatic fibrosis, LB is not favored by patients or physicians owing to its invasiveness, limitations, sampling errors, etc.

Writer's cramp in spinocerebellar ataxia Type 1.

Dystonia can be encountered in a small subset of patients with spinocerebellar ataxia (SCA), but task specific dystonia is extremely rare. We report a case of a 48-year-old male with confirmed SCA Type 1 (SCA1) with mild progressive cerebellar ataxia and a prominent and disabling Writer's cramp. This case highlights the ever-expanding phenotypic heterogeneity of the SCA's in general and SCA1 in particular.

Role of mTOR signaling pathway in the pathogenesis of subependymal giant cell astrocytoma - A study of 28 cases.

Background: Subependymal giant cell astrocytomas (SEGA) are slow-growing benign intraventricular tumors, the pathogenesis of which is debated. Recent studies have shown that tuberous sclerosis complex (TSC) 1 and TSC2 genes are linked to the mammalian target of rapamycin (mTOR) cell signaling pathway. We aimed to analyze TSC1 and TSC2 gene mutation, hamartin and tuberin protein expression, and protein expression of mTOR signaling cascade in a series of SEGA to determine their role in pathogenesis.

Spectrum of Renal and Urinary Tract Diseases in Kashmiri Children.

Introduction: Definite paucity of data pertaining to spectrum of renal and urinary tract diseases in our state and in various parts of India forms the basis of this study. Available data has emphasized more on specific clinical syndromes and chronic renal diseases rather than over all spectrums of renal and urinary tract diseases, that too in adult population.

Aim: The present study a retrospective analysis, forms one of the basic data of paediatric nephrology and urology related disorders in our state.

Anesthetic management of a parturient with varicella presenting for cesarean delivery.

Varicella (chicken pox) infection is associated with a significant risk of maternal and fetal morbidity and mortality. The choice of anesthetic technique, either neuraxial or general anesthesia, in such patients remains controversial. Anesthetic management depends not only on the extent of disease involvement and associated complications, but also on the indication for cesarean delivery.

Carbamazepine-induced dystonia in an adolescent.

Dystonia is sustained muscle contraction, which may be primary or secondary to other causes. Drugs comprise one of the most important causes for the secondary dystonia, the usual mechanism being a dopaminergic blockade. There are very few reports describing dystonia resulting from carbamazepine (CBZ) administration.