Aspirin after completion of standard adjuvant therapy for colorectal cancer (ASCOLT): an international, multicentre, phase 3, randomised, double-blind, placebo-controlled trial.

Background: Aspirin is a simple, globally available medication that has been shown to reduce the incidence of colorectal cancer. We aimed to evaluate the safety and efficacy of aspirin in the secondary prevention of colorectal cancer.

Methods: This phase 3, randomised, double-blind, placebo-controlled trial was conducted at 66 centres across 11 countries and territories (ten in Asia-Pacific; one in the Middle East).

Spontaneous rupture of hepatic hydatid cyst into the inferior vena cava and hepatic vein.

Hydatid disease is a zoonosis caused by . Vascular complication like rupture of hepatic hydatid cyst into inferior vena cava is extremely rare and potentially life threatening. This report describes a case of a 52-year-old male with spontaneous fistulization of a hepatic hydatid cyst into the inferior vena cava and right hepatic vein.

Syncopal reactions in blood donors: Pathophysiology, clinical course, and features.

Vasovagal syncope (VVS) in donors is a transient loss of consciousness due to short-term global cerebral hypoperfusion, which has a rapid onset and has complete spontaneous recovery. VVS may be triggered by pain, fear, anxiety, or emotional upset and loss of blood perse. It is an exaggeration of an adaptive response meant to assist in reducing the amount of bleeding/loss of blood.

Impact of Surgical Mask Placement Over High-Flow Nasal Cannula on Oxygenation Parameters in COVID-19 Patients Experiencing Hypoxemic Respiratory Failure.

Background: During the COVID-19 pandemic, managing respiratory failure in critically ill patients has presented significant challenges. A high-flow nasal cannula (HFNC) has been established as an effective respiratory support modality, offering heated, humidified oxygen at high flow rates. However, concerns persist regarding the potential for aerosol dispersion and the risk of viral transmission, particularly in COVID-19.

Multicentric Cross-Sectional Survey to Assess the Variation of Fractionation Strategies Used in the Management of Head and Neck Cancers in the Asian Region (INNOCENCE-ASIA).

Purpose: Head and neck cancers (HNCs) are in general treated with conventional fractionation regimen of 1.8-2 Gy per fraction. Altered fractionation (ALFT) strategies such as hypofractionation radiotherapy (HYPO-RT), accelerated fractionation radiotherapy (AFRT), and hyperfractionation radiotherapy (HFRT) have not been practiced uniformly across centers in different parts of the world.

Effect of Characteristic Inflammatory and Structural Pelvic Magnetic Resonance Imaging Lesions on Expert Assessment of Axial Juvenile Spondyloarthritis.

Objective: To evaluate the influence of pelvic magnetic resonance imaging (MRI) findings on axial disease assessment in juvenile spondyloarthritis (JSpA).

Methods: This was a cross-sectional study of patients with JSpA with suspected axial disease. Three experts reviewed each case and rated their confidence (-3 to +3) in the presence of axial disease, first with clinical data and second with clinical and MRI data.

A Review of Emerging Evidence and Clinical Applications of Hyperbaric Oxygen Therapy.

Hyperbaric Oxygen Therapy (HBOT) is a medical treatment that involves administering 100% oxygen at increased atmospheric pressure to enhance oxygen delivery to tissues. Initially developed for decompression sickness, HBOT has since been utilized for a wide range of medical conditions, including severe infections, non-healing wounds, and, more recently, COVID-19. This review explores the historical development of HBOT, its principles, its emerging role in the management of and its outcome as treatment in COVID-19, particularly in mitigating inflammation, hypoxemia, and oxidative stress.

Exploring the Connection: Moyamoya Disease and Its Implications for Cardiovascular Health.

Moyamoya disease (MMD) is a vascular disorder characterized by steno-occlusive alterations in cerebral arteries, often resulting in ischemic or hemorrhagic events predominantly affecting the female population and more common in Asian populations. Despite its predominantly neurological manifestations, recent research suggests a potential association between MMD and cardiovascular diseases (CVDs). MMD involves various genetic and environmental factors, with mutations in the RNF213 gene being strongly implicated in disease susceptibility, with histopathological findings revealing intimal lesions and smooth muscle proliferation, contributing to vascular occlusion as well as dysregulation of circulating endothelial and smooth muscle progenitor cells further complicating MMD's pathogenesis.

PWWP2A/B: Prominent players in the proteomic landscape.

The PWWP domain is a conserved motif unique to eukaryotes, playing a critical role in various cellular processes. Proteins containing the PWWP domain are typically found in chromatin, where they bind to DNA and histones in nucleosomes, facilitating chromatin-associated functions. Among these proteins, PWWP-domain containing proteins 2A and 2B (PWWP2A and PWWP2B), identified during the H2A interactome analysis, are DNA methyltransferase-related proteins, that are structurally disordered, except for their PWWP domain.

Incremental cost of treating antimicrobial-resistant infections among hospitalised patients in India: a cohort study.

Background: Accurate estimates of incremental cost (IC) attributable to antimicrobial resistance (AMR) provide information of immense public health importance to the policy makers. Here, we present the IC from patient perspective for treating antimicrobial-resistant pathogens in India.

Methods: This cohort study was conducted in eight hospitals including government (GH), private (PH) and trust hospitals (TH), considering their ownership, geographical location and categories of cities.

Real-World Evidence of the Impact of CanAssist Breast on Physician's Decision About the Use of Adjuvant Chemotherapy in Early Breast Cancer.

Background Clinicians use prognostic biomarker/multi-gene-based tests for predicting recurrence in hormone receptor-positive/HER2-negative (HR+/HER2-) early-stage breast cancer (EBC). CanAssist Beast (CAB) uses the expression of five protein biomarkers in combination with tumor-specific parameters such as tumor size, histopathological grade, and lymph node status to predict the risk of distant recurrence within five years of diagnosis for patients with HR+/HER2-, EBC. The current study aimed to evaluate the impact of prognostic tests on adjuvant chemotherapy decisions by assessing the agreement between clinical and CAB risk stratification as low-risk (LR) or high-risk (HR) for distant recurrence.

Matrix Metalloproteinase-9 as a Predictor of Healing in Diabetic Foot Ulcers.

Background Wound healing in diabetic foot ulcers (DFUs) is hindered by several physiological and biochemical abnormalities, including prolonged inflammation, an imbalance in extracellular matrix (ECM) synthesis and degradation, insufficient neovascularization, and reduced macrophage activity. In DFUs, excessive and uncontrolled matrix metalloproteinases (MMPs) degrade the ECM and impede wound healing. Matrix metalloproteinase-9 (MMP-9) concentration plays a key role in inflammation and ECM degradation.

A Case of Primary Aldosteronism Masquerading as Bartter and Gitelman Syndromes.

Primary aldosteronism (PA) is a common cause of secondary hypertension, with familial hyperaldosteronism (FH) contributing to a lesser number of cases. FH type IV, a rare subtype, has hardly been reported as a subtype of PA cases. We present a case of a 27-year-old female who presented to the emergency department with circumoral tingling and numbness.

From Crisis to Cure: The Resilient Recovery of a Patient With Tetanus.

Tetanus is a severe neurological condition triggered by the toxin of , resulting in extreme muscle stiffness and spasms. Although vaccination can prevent it, without treatment, tetanus carries a high risk of death due to respiratory failure and autonomic disturbances. This case report describes a 24-year-old Indian male who developed tetanus after branding (a traditional procedure for jaundice in rural India) on his wrist.

Functional and Radiological Outcomes of Short-Segment Fixation With Intermediate Screws for Thoracolumbar Spine Fractures.

Introduction Thoracolumbar fractures, particularly burst fractures, represent a significant health concern due to their prevalence and functional impact. This study evaluates the efficacy of short-segment posterior fixation with intermediate screw instrumentation in treating unstable thoracolumbar fractures. Methods A prospective study was conducted from July 2022 to December 2023, including 26 patients with traumatic thoracolumbar fractures.

A Phase III, Double-Blind, Randomized, Multicenter, Clinical Trial to Evaluate the Efficacy and Safety of a Fixed-Dose Combination of Metformin Hydrochloride and Myo-Inositol Compared to Metformin in Patients With Polycystic Ovary Syndrome.

Background Polycystic ovary syndrome (PCOS) poses a significant health concern among reproductive-aged women and is characterized by ovarian dysfunction, hyperandrogenism, and insulin resistance. This study aims to assess the efficacy and safety of metformin and myo-inositol combination therapy compared to metformin monotherapy in patients with PCOS. Materials and methods This was a phase III, double-blind, randomized controlled clinical trial.

Multidrug resistant : A study on its pathogenesis and therapeutics.

The overuse of antibiotics has led to the global dissemination of , an increasingly challenging nosocomial pathogen. This review explores the medical significance along with the diverse resistance ability of . Intensive care units (ICUs) serve as a breeding ground for , as these settings harbour vulnerable patients and facilitate the spread of opportunistic microorganisms.

Low-Grade Myofibroblastic Sarcoma of the Acetabulum - A Rare Case with Review of Literature.

Introduction: Low-grade myofibroblastic sarcoma (LGMS) is an atypical and extremely infrequent type of tumor, primary mass being usually present in subcutaneous and soft tissue. Bony involvement is very rare. It has a very high chance of recurrence locally due to its aggressive biological behavior, metastasis in other parts of body is rarely seen.

Exploring the regulatory role of small RNAs in modulating host-pathogen interactions: implications for bacterial and viral infections.

MicroRNAs (miRNAs) and transfer RNA-derived stress-induced RNAs (tiRNAs) have emerged as crucial players in the post-transcriptional regulation of gene expression in various cellular processes, including immunity and host defense against infections. In recent years, increasing evidence has highlighted their complex role in influencing the host response during viral and bacterial infections. miRNAs have been shown to play multiple roles in host-pathogen interaction like TLR activation and altered disease virulence during bacterial infections.

The Society of Thoracic Surgeons (STS) Clinical Practice Guideline on Surgical Management of Oligometastatic Non-small Cell Lung Cancer.

Background: The use of local consolidative therapy (LCT) in patients with oligometastatic non-small cell lung cancer (NSCLC) is rapidly evolving, with a preponderance of data supporting the benefits of such therapeutic approaches incorporating pulmonary resection for appropriately selected candidates. However, practices vary widely institutionally and regionally, and evidence-based guidelines are lacking.

Methods: The Society of Thoracic Surgeons assembled a panel of thoracic surgical oncologists to evaluate and synthesize the available evidence regarding the role of pulmonary resection as LCT.

Self-Reported Delayed Adverse Events and Flare Following COVID-19 Vaccination Among Patients With Autoimmune Rheumatic Disease (AIRD) in Malaysia: Results From the COVAD-2 Study.

Objectives: To determine the prevalence of self-reported delayed adverse events (DAEs), major AEs, and flares following COVID-19 vaccinations among patients with autoimmune rheumatic diseases (AIRDs) in Malaysia.

Methodology: An electronically validated survey from the COVID-19 vaccination in autoimmune diseases (COVAD) study group was distributed in July 2021 to patients with autoimmune diseases and healthy controls (HCs). The survey collected data on DAEs (any AE that persisted or occurred after 7 days of vaccination), any early or delayed major adverse events (MAEs), and flares following COVID-19 vaccination.

Temporal pattern and effect of COVID-19 on the trend of TB, DRTB, paediatrics TB and TB with HIV Coinfection: A decadal trend analysis.

Background: India shares 2/3 of global TB burden. MDR and HIV coinfections are the main obstacle in achieving the successful TB control because it decrease the therapy effect.

Objective: To analyze the long-term trends of incidence of tuberculosis cases and identify any differences between actual and projected cases after the COVID-19 pandemic.

Association of anemia with poor housing quality among older Indian adults: Multilevel modeling analysis of nationally representative cross-sectional study in India.

Introduction: Anemia is an important public health disorder. There is a significant chunk of India's population residing in poor housing quality with inadequate sanitation and hygiene, which might lead to higher anemia prevalence. The objective was to determine the association between anemia with poor housing quality among the older Indian adult population (≥45 years) as per residence.