Nimbolide, a Neem Limonoid, Inhibits Angiogenesis in Breast Cancer by Abrogating Aldose Reductase Mediated IGF-1/PI3K/Akt Signalling.

Background & Objective: The insulin/IGF-1R/PI3K/Akt signalling cascade is increasingly being linked to breast cancer development, with aldose reductase (AR) playing a key role in mediating the crosstalk between this pathway and angiogenesis. The current study was designed to investigate whether nimbolide, a neem limonoid, targets the oncogenic signaling network to prevent angiogenesis in breast cancer.

Methods: Breast cancer cells (MCF-7, MDA-MB-231), EAhy926 endothelial cells, MDA-MB-231 xenografted nude mice, and tumour tissues from breast cancer patients were used for the study.

Organ-specific Adverse Events of Immune Checkpoint Inhibitor Therapy, with Special Reference to Endocrinopathies.

Immune checkpoint inhibitors are potent and promising immunotherapeutic agents that are increasingly used for the management of various types of advanced cancers. The widespread approval of this group of drugs simultaneously revealed immune-related adverse events as unique side-effects. Endocrinopathies are one of the most common immune-related adverse events.

Artificial Intelligence in hepatology, liver surgery and transplantation: Emerging applications and frontiers of research.

The integration of artificial intelligence (AI) and augmented realities into the medical field is being attempted by various researchers across the globe. As a matter of fact, most of the advanced technologies utilized by medical providers today have been borrowed and extrapolated from other industries. The introduction of AI into the field of hepatology and liver surgery is relatively a recent phenomenon.

A Comparative Analysis of Transcranial and Endoscopic Repair for Traumatic CSF Rhinorrhea.

Background:  Surgical treatment of anterior cranial base traumatic cerebrospinal fluid (CSF) rhinorrhea is challenging and is fraught with complications. Whether a person should be offered open craniotomy or endoscopic endonasal repair is a dilemma faced by most surgeons. This study is one of the few to directly compare the two forms of management.

Hepatobiliary and Gastrointestinal Involvement in Langerhans Cell Histiocytosis-Spectrum of Three Cases.

Langerhans cell histiocytosis (LCH) is a rare group of disorder, due to clonal neoplastic proliferation of dendritic cells in the bone marrow expressing a Langerhans cell phenotype. 1 This disease particularly affects the pediatric age group and young adults and often presents with skin rashes, lung infiltrates, and bone lesions. It can also manifest with endocrine dysfunction and hematopoietic disorders.

Effect of Coronavirus Disease 2019 on Transplantation and Nephrology in India: A Nationwide Report From India.

Background: The effect of coronavirus disease 2019 (COVID-19) on a developing nation is sparsely reported and, more importantly, the discrepancies in public and private sectors are underexplored.

Methods: We retrospectively investigated the data on the effect of COVID-19 on renal transplantation between 2019 and 2020 in a nationwide analysis from 8 public and 10 private sector hospitals of India.

Results: On comparing the yearly data, the number of living-related transplants and deceased donor transplants declined by 48% (2610 vs 1370) and 49% (194 vs 99), respectively.

A study of femoral offset in the South Indian population and its clinical implications in hip arthroplasty.

Background: Recreation of the normal proximal femoral anatomy is paramount for a successful total hip arthroplasty. The study aims to look at whether the range of offset options available in the femoral stems available locally, would be adequate to restore the native femoral horizontal offset (FHO) of the South Indian population.

Method: This is a prospective single-center study of 1-year duration, where we study the FHO on radiographs and CT scans in 100 patients.

Utility of MRCP in surveillance of primary sclerosing cholangitis associated hepatobiliary malignancy: 15 year experience at a single institution in Ontario, Canada.

Objective: Magnetic resonance cholangiopancreatography (MRCP) is used for the surveillance of primary sclerosing cholangitis (PSC) and its associated complications. The time interval gap for subsequent follow-up MRCP is variable depending on clinical practice patterns, therefore this study was done to assess the MRCP follow-up strategy used in our institution for screening PSC-associated hepatobiliary malignancies.

Materials And Methods: This retrospective observational cohort included MRCP studies in adult patients, with clinical and radiological diagnosis of PSC over the past 15-year period between January 1, 2003 to December 31, 2018.

Impact of COVID-19 pandemic on bariatric surgery in India: An obesity and metabolic surgery society of India survey of 1307 patients.

Background: Although safe practice guidelines were issued by the Obesity and Metabolic Surgery Society of India (OSSI) in the end of May 2020, surgeons have been in a dilemma about risk of subjecting patients to hospitalisation and bariatric surgery. This survey was conducted with the objective to evaluate the risk of coronavirus disease-19 (COVID-19) infection in peri- and post-operative period after bariatric and metabolic surgery (BMS).

Methods: A survey with OSSI members was conducted from 20 July 2020 to 31 August 2020 in accordance with EQUATOR guidelines.

Role of Imaging in a Case of Toxoplasmosis Presenting as Generalized Lymphadenopathy.

Toxoplasmosis is caused by an obligate protozoan intracellular parasite. The disease has variable prevalence globally and is usually asymptomatic. Pregnant and immunocompromised people are at risk of getting infected.

F-Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography Detected Inguinal Lymph Nodal Metastasis from Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) usually metastasizes to the regional abdominal lymph node, lungs, and bones. Nonregional lymph node involvement by HCC in the absence of regional lymph nodes is rare. We describe the F-fluorodeoxyglucose positron-emission tomography-computed tomography findings of an HCC patient with histopathologically proven inguinal lymph nodal metastasis in the absence of regional lymph nodal metastases.

Manual extraction is superior to power tools when removing stripped titanium locking screws.

Introduction: Removal of screws from a titanium locking plate is often difficult once the screw has seized and the head is damaged. Such stripped screws are removed with an extraction screw, which can be used manually or on power. We aim to compare the extraction rates using both these methods.

Tobacco use and clinical leukoplakia lesions among south Indian tribes.

Objectives: Leukoplakia is a white mucosal thickening and perhaps undermining change in the oral mucosa transcendently found in tobacco users. Since the tobacco utilization is extensively higher with the indigenous groups in the Asia Pacific locale, the current examination implicated the prevalence of tobacco consumption and leukoplakial lesions and the relationship between the two.

Methods: This cross-sectional study was conducted through six tribal hamlets of Chithalayath Forest range at Wayanad district of Kerala, South India.

Total Hip Arthroplasty in Post-traumatic Acetabular Nonunion with Symphysis Pubis Diastasis: A Case Report.

Case: We report a patient with a long-standing post-traumatic pubic diastasis along with acetabular nonunion who developed painful hip arthritis that needed a total hip arthroplasty. We discuss the unique challenges in the acetabular component positioning.

Conclusion: In patients with symphysis pubis diastasis, the surgeon should be prepared to place the cup in less than normal anteversion.

Pubic Diastasis in Polytrauma Patients: Traumatic or Congenital?: A Report of 2 Cases.

Case: We report 2 patients who were involved in high-velocity road traffic accidents. Both these patients had congenital pubic diastasis with very subtle clinical and radiological signs that were misdiagnosed as posttraumatic diastasis on initial radiographic evaluation.

Conclusion: Trauma surgeons should be aware of this anomaly because congenital pubic diastasis could present without any major clinical signs and could easily be mistaken for a traumatic diastasis.

Brodie's Abscess Following Radiofrequency Ablation of an Atypical Osteoid Osteoma.

A 15 years old boy presented with an atypical osteoid osteoma (OO) in distal femur. He underwent radiofrequency ablation (RFA) elsewhere. He presented to our centre a year later with persisting pain.

Laparoscopic appendicular interposition ureteroplasty for mid-ureteral defect.

Patients with ureteral defects and salvageable renal units present a challenge in reconstructive urology. Vermiform appendix interposition is an option in the management of mid-ureteral defects that can not be managed by primary ureteroureterostomy. Laparoscopic appendicular interposition ureteroplasty is a technically demanding and an infrequently attempted procedure.

Epidemiological link between obesity, type 2 diabetes mellitus and cancer.

There exists a complex interaction between obesity, type 2 diabetes mellitus (T2DM) and cancer, and an increase in the incidence of cancer is expected with the growing obesity-diabetes pandemic. The association of cancer with diabetes mellitus and obesity appears to be site-specific, the highest risk being for post-menopausal breast cancer, endometrial cancer, and colorectal cancer. Moreover, there is worsening of hyperglycaemia with the onset of cancer, evidencing a bi-directional link between cancer and diabetes mellitus and the need for monitoring for diabetes in cancer survivors.

The Indian Network of Drug-Induced Liver Injury: Etiology, Clinical Features, Outcome and Prognostic Markers in 1288 Patients.

Background: Etiology of and outcomes following idiosyncratic drug-induced liver injury (DILI) vary geographically. We conducted a prospective study of DILI in India, from 2013 to 2018 and summarize the causes, clinical features, outcomes and predictors of mortality.

Methods: We enrolled patients with DILI using international DILI expert working group criteria and Roussel Uclaf causality assessment method.