Total Knee Arthroplasty in Paget's Disease using 3D-Printed Patient-Specific Femoral Jig - A Case Report.

Introduction: Patients with Paget's disease develop abnormal bony anatomy which can result in significantly altered lower limb alignment predisposing them to early secondary osteoarthritis. Due to the severe extra-articular deformity, total knee arthroplasty (TKA) in these patients is challenging. Conventional knee arthroplasty using intramedullary guides is not an option and can lead to erroneous limb alignment postoperatively.

A Multicenter Retrospective Cohort Study on Management Protocols and Clinical Outcomes After ABO-incompatible Kidney Transplantation in India.

Background: There is no robust evidence-based data for ABO-incompatible kidney transplantation (ABOiKT) from emerging countries.

Methods: Data from 1759 living donor ABOiKT and 33 157 ABO-compatible kidney transplantations (ABOcKT) performed in India between March 5, 2011, and July 2, 2022, were included in this retrospective, multicenter (n = 25) study. The primary outcomes included management protocols, mortality, graft loss, and biopsy-proven acute rejection (BPAR).

"External Iliac Artery Injury After Total Hip Arthroplasty in an Infected Intrapelvic Hemiarthroplasty": A Case Report.

Case: We report a patient with intrapelvic prosthetic protrusion associated with infection after hemiarthroplasty for a fracture neck of the femur. We discuss the challenges involved in the management of this complex case with recommendations to manage a vascular injury.

Conclusion: In patients with an intrapelvic prosthesis, thorough preoperative vascular evaluation and vigilant postoperative check are required to prevent a vascular injury.

Multi-center prospective survey of hepatocellular carcinoma in Kerala: More than 1,200 cases.

Background: Hepatocellular carcinoma (HCC) is considered uncommon in India. The aim of this study was to document the demographic characteristics and clinical aspects of HCC in Kerala, India.

Methods: A survey of HCC in Kerala was performed.

Histopathological spectrum of adult renal tumours: A single center experience and review of literature.

Background: Renal tumors constitute approximately 3% of all malignancies in adults. They form a heterogenous group with variable morphological, immunohistochemical, and molecular features.

Aim: The objective of this study was to analyze the spectrum of adult renal tumors at a tertiary care center and study the demographic and histomorphological features.

Are Semiquantitative Methods Superior to Deauville Scoring in the Monitoring Therapy Response for Pediatric Hodgkin Lymphoma?

Tailoring treatment in patients with Hodgkin lymphoma (HL) is paramount to maximize outcomes while avoiding unnecessary toxicity. We aimed to compare the performance of SUV reduction (ΔSUV) and the PET ratio (rPET) versus the Deauville score (DS) for assessing the chemotherapy response in pediatric HL patients undergoing F-FDG PET-CT. Fifty-two patients with biopsy-proven HL (aged 8-16 years) were enrolled at baseline, interim (after the second or third chemotherapy round) and post-therapy (on completion of first-line chemotherapy).

ISCCM Guidelines on Acute Kidney Injury and Renal Replacement Therapy.

Unlabelled: Acute kidney injury (AKI) is a complex syndrome with a high incidence and considerable morbidity in critically ill patients. Renal replacement therapy (RRT) remains the mainstay of treatment for AKI. There are at present multiple disparities in uniform definition, diagnosis, and prevention of AKI and timing of initiation, mode, optimal dose, and discontinuation of RRT that need to be addressed.

Isolated Cricoid Fracture and Thyroid Hematoma in Blunt Injury of the Neck.

Blunt trauma to the neck may result in life threatening injuries due to airway compromise. Thyroid Injury in a previously normal gland is rare, so is Isolated Cricoid Fracture. The expanding thyroid hematoma and an unstable larynx compound the effects of compression and lead to sudden deterioration of the patient.

The Popliteal Artery is Safe in Medial Meniscal Repair Using All Inside Devices in Adults: An MRI-Based Simulation Study.

Introduction: This simulation study on MRI of the knee was performed to assess the risk of injury to the popliteal artery (PA) and common peroneal nerve (CPN) during all-inside meniscal repairs in adults.

Methods: We simulated repair of the posterior horn of both medial (PHMM) and lateral menisci (PHLM) through anteromedial (AM) and anterolateral (AL) portals, using straight and curved devices, on 200 magnetic resonance imaging (MRI) scans taken with the knee in extension. For simulation using straight devices, the shortest distance from the menisco-capsular junction (MCJ) and the free edge of the meniscus to PA and CPN in vectors of AM and AL portals was measured.

Spectrum of drug-induced liver injury in a tertiary hospital in southern India.

Background Anti-tuberculosis drugs are thought to account for about 50% of drugs that cause liver injury in India. We show that the spectrum of drugs is much wider than previously reported. Methods We evaluated all patients with unexplained acute liver injury presenting during 2006-2016 using a structured proforma for drug-induced liver injury (DILI).

Trends in Primary Anatomical Single-Bundle Anterior Cruciate Ligament Reconstruction Practice in Adult Patients Prevalent Among Arthroscopy Surgeons of Six Southern States of India.

Background: Although guidelines from multiple scientific studies decide the general trend in ACLR practice, there is often a variation between scientific guidelines and actual practice.

Methods: A 17-member committee comprised of sports surgeons with experience of a minimum of 10 years of arthroscopy surgery finalized a survey questionnaire consisting of concepts in ACL tear management and perioperative trends, intraoperative and post-operative practices regarding single-bundle anatomic ACLR. The survey questionnaire was mailed to 584 registered sports surgeons in six states of south India.

Impact of Covid-19 on gastrointestinal cancer surgery: A National Survey.

Purpose: To understand the actual impact of the Covid-19 pandemic and frame the future strategies, we conducted a pan India survey to study the impact on the surgical management of gastrointestinal cancers.

Methods: A national multicentre survey in the form of a questionnaire from 16 tertiary care gastrointestinal oncology centres across India was conducted from January 2019 to June 2021 that was divided into a 15-month pre-Covid era and a similar period of active Covid pandemic era.

Results: There was significant disruption of services; 13 (81%) centres worked as dedicated Covid care centres and 43% reported suspension of essential care for more than 6 months.

Evaluation of photoneutron dose equivalent in 10 MV and 15 MV beams for wedge and open fields in the Elekta Versa HD linac.

In a high-energy medical linear accelerator (linac), if the interaction of photon energy is higher than the neutron binding energy of high atomic material, it emits a neutron field through a photonuclear reaction. The objective of this current study is to measure the photoneutron dose equivalent produces in a motorized wedge field and open field of 10 MV and 15 MV photon beams in Elekta Versa HD™ linac. The PNDE values were recorded at various positions along the patient plane using the Bubble Detector-Personal Neutron Dosimeter (BD-PND).

One-Year Outcomes with Use of Anti-T-Lymphocyte Globulin in Patients Undergoing Kidney Transplantation: Results from a Prospective, Multicentric, Observational Study from India.

Introduction: Large-scale Indian data on the use of anti-T-lymphocyte globulin (ATLG) (Grafalon) as induction therapy in kidney transplantation (KT) patients is lacking. The aim of this study was to determine the 1-year patient and graft survival outcomes with the use of ATLG as induction regimen in KT.

Methods: In a prospective, multicentric, observational study, adult patients who underwent ABO-compatible KT and had received ATLG as a part of induction were included in the study.

An Unusual Case of Posterior Knee Dislocation Following Total Knee Arthroplasty: A Case Report.

Introduction: We propose a possible mechanism of dislocation in a posterior stabilized (PS) total knee arthroplasty (TKA) and suggest that it can be treated like a stable posteriorly dislocated hip replacement if stable throughout the range on examination under anesthesia.

Case Report: A 71-year-old female presented with the right posterior knee dislocation following 1 year of TKA. Following the successful relocation, the knee was found to be stable throughout the range of movement and an uneventful recovery at 3 years follow-up.

Outcomes of retrograde intrarenal surgery in renal calculi of varying size.

Introduction: Technological advancements have made it possible to attempt retrograde intrarenal surgery (RIRS) in patients with large renal calculi. The objective of this study was to compare the intraoperative adverse events, postoperative complications and stone free rates (SFR) of RIRS in patients with renal calculi of varying sizes.

Methods: Patients who underwent RIRS for renal calculi between January 2016 and June 2020 were categorized into six size groups according to the longest dimension or cumulative measurement of the longest dimension of calculi as follows: Group 1 (1-9 mm), Group 2 (10-19 mm), Group 3 (20-29 mm), Group 4 (30-39 mm), Group 5 (40-49 mm) and Group 6 (≥50 mm).

Management strategies and outcomes in renal transplant recipients recovering from COVID-19: A retrospective, multicentre, cohort study.

Background: There is an enormous knowledge gap on management strategies, clinical outcomes, and follow-up after kidney transplantation (KT) in recipients that have recovered from coronavirus disease (COVID-19).

Methods: We conducted a multi-center, retrospective analysis in 23 Indian transplant centres between June 26, 2020 to December 1, 2021 on KT recipients who recovered after COVID-19 infections. We analyzed clinical and biopsy-confirmed acute rejection (AR) incidence and used cox-proportional modeling to estimate multivariate-adjusted hazard ratios (HR) for predictors of AR.

Double Level Osteotomy in an Overcorrected Distal Femoral Varisation Osteotomy: A Case Report.

Case: We report a patient who was diagnosed with idiopathic genu valgum at the age of 11 years and underwent bilateral distal femur osteotomies. At age 30 years, she presented with pain around her right knee with a varus deformity. Although the corrective osteotomy was at the distal femur, she was noticed to have a bifocal deformity in both femur and tibia.

A rare case of collision tumour of the ovary complicated by torsion.

Collision tumour is the coexistence of two adjacent, but histologically distinct tumours without histologic admixture. Collision tumours are rare in the ovary. It is mostly a histopathological diagnosis often missed in preoperative imaging.