Significance of sentinel lymph node biopsy in low- and intermediate- risk endometrial cancer: a study at tertiary care centre, India.

Objective: To evaluate the incidence of sentinel lymph node (SLN) metastasis observed in patients with presumed low- and intermediate-risk endometrial cancer (EC) and change in stage and adjuvant therapy resulting from SLN analysis. Secondary objectives include assessing the rates of detection of SLN using indocyanine green (ICG) dye and complication rates.

Methods: Between March 2017 and December 2023, 210 patients were included in the study.

Total Hip Replacement in a Patient with Erdheim-Chester's Disease: A Case Report.

Case: Erdheim-Chester's disease (ECD) is a rare multisystem disorder considered as a neoplasm of non-Langerhans cell histiocytes. We report a case of uncemented total hip arthroplasty in a 74-year-old patient with ECD for femoral neck fracture with pathological involvement of distal metaphysis and diaphysis. We reviewed the literature on bony involvement.

Fundic gland adenocarcinoma.

Gastric malignancy is one of the most common malignancies diagnosed worldwide. Over the past many decades, extensive research has been made into the risk factors, pathogenesis and prognosis of gastric adenocarcinoma. However, gastric adenocarcinoma of the fundic gland (GA-FG) has been recently defined, and not much is known about its risk factors and pathogenesis.

Endovascular Treatment of Ruptured Broad-Necked Intracranial Aneurysms with Double Microcatheter Technique: Case Series with Brief Review of Literature.

 Treatment of ruptured broad-necked intracranial aneurysms by endovascular therapy is technically burdensome. It is commonly treated with stent- and balloon-assisted coils embolization. The aim of this study was to evaluate clinical and radiological outcomes following double micro-catheter (MC) technique.

Anesthetic challenges in pediatric robot-assisted surgeries.

With the advent of minimally invasive surgeries, robot-assisted techniques have gained popularity because they overcome various shortcomings of standard laparoscopic surgeries. Despite the associated costs and limitations among the pediatric population, surgeon comfort due to the ergonomic design, in combination with enhanced three-dimensional high-fidelity imaging and tissue handling, may offer better surgical and postoperative outcomes. However, robotic surgeries require innovations with regard to patient positioning and the overall arrangement of operative equipment and personnel.

Sublingual Administration of Tacrolimus is Safe and Provides Similar Drug Exposure to Per-oral Route in Liver Transplant Recipients During Early Postoperative Period-A Large, Retrospective, Observational Study.

Background/aims: Per-oral (PO) administration of tacrolimus (TAC) results in inadequate trough levels in the early postoperative period in liver-transplant (LT) recipients who undergo Roux-en-Y hepaticojejunostomy for biliary reconstruction. Sublingual administration (SL) of tacrolimus provides an alternative route in such patients.The objectives of this study were to assess the feasibility and safety of SL tacrolimus in adult LT-recipients in the early postoperative period and to compare therapeutic efficacy of SL administration of tacrolimus versus PO route.

A multicentre prospective registry of one thousand sepsis patients admitted in Indian ICUs: (SEPSIS INDIA) study.

Background: Sepsis is a global health problem with high morbidity and mortality. Low- and middle-income countries have a higher incidence and poorer outcome with sepsis. Large epidemiological studies in sepsis using Sepsis-3 criteria, addressing the process of care and deriving predictors of mortality are scarce in India.

Adrenal Hemorrhage as a Complication of Plug-assisted Retrograde Transvenous Obliteration of Gastrorenal Shunt Managed by Adrenal Artery Embolization: A Case Report.

We describe a patient who underwent plug-assisted retrograde transvenous obliteration for gastric varices. After the procedure, the patient developed hypotension and tachycardia. Contrast-enhanced computed tomography showed a left adrenal hematoma.

C3 glomerulopathy: a kidney disease mediated by alternative pathway deregulation.

C3 glomerulopathy (C3G) is an ultra-rare complement-mediated kidney disease caused by to the deregulation of the alternative pathway (AP) of proximal complement. Consequently, all effector loops of the complement are active and can lead to pathologies, such as C3a- and C5a-mediated inflammation, C3b opsonization, surface C3b-mediated AP C3 convertase assembly, C3 cleavage product deposition in the glomerulus, and lytic C5b-9/MAC cell damage. The most common pathologic mechanisms are defective chronic alternative pathway deregulation, mostly occurring in the plasma, often causing C3 consumption, and chronic complement-mediated glomerular damage.

A Study on Radiation Level at the Treatment Plane Due to Induced Activity in Linear Accelerator Head.

Background: The induced activity is produced in the target, monitor chamber, flattening filter (FF), collimating jaws, etc., when a high-energy photon beam is utilized for radiation therapy. This may result in add-on exposure to radiation professionals.

Breaking boundaries: Ticagrelor monotherapy in high-risk patients.

Atherosclerotic plaque formation is a leading cause of arterial thrombosis that significantly impacts global health by instigating major adverse cardiovascular events (MACE) like myocardial infarction (MI) and stroke. Platelets are central to this process, leading to the development of antiplatelet therapies, to mitigate MACE risks. The combination of aspirin with a potent P2Y inhibitor known as dual antiplatelet therapy (DAPT) is the standard for post-percutaneous coronary intervention (PCI) aimed at reducing ischemic events.

Paraneoplastic Proliferative Myositis on 18 F-FDG PET/CT.

We present a rare and never-before-reported case of paraneoplastic proliferative myositis that was incidentally detected in a 42-year-old man who had been receiving systemic cytotoxic chemotherapy for classic Hodgkin lymphoma. We highlight his 18 F-FDG PET/CT findings and its utility in helping to diagnose this condition, avoiding unnecessary surgical resection and the added costs associated with it.

Comparative Efficacy and Safety of Low-Dose Versus Standard-Dose Rabbit Antithymocyte Globulin Induction Strategy in Kidney Transplant Recipients: Insights From a Single-Center Experience in North India.

Background Rabbit antithymocyte globulin (rATG) is frequently utilized as an induction therapy in kidney transplant recipients (KTRs). Full-dose rATG induction therapy (7-10 mg/kg) has been associated with increased morbidity. However, definitive data on the appropriate rATG dosage remains scarce.

Therapeutic Plasma Exchange in Hepatology: Indications, Techniques, and Practical Application.

It is sobering that many liver failure patients die in the absence of liver transplantation (LT), and reducing its morbidity and mortality urgently needs more non-transplant treatment options. Among the several artificial liver support devices available, therapeutic plasma exchange (TPE) is the only one that improves survival in acute liver failure (ALF) patients. In many other disorders, data on survival benefits and successful bridging to transplant is encouraging.

Metatranscriptomic insights into the dengue patient blood microbiome: Enhanced microbial diversity and metabolic activity in severe patients.

Background: Dengue is the most re-emergent infection, with approximately 100 million new cases reported annually, yet no effective treatment or vaccine exists. Here, we aim to define the microbial community structure and their functional profiles in the dengue positive patients with varying disease severity.

Methodology/principal Findings: Hospital admitted 112 dengue-positive patients blood samples were analyzed by dual RNA-sequencing to simultaneously identify the transcriptionally active microbes (TAMs), their expressed genes and associated pathways.

The Sepsis Score Dilemma: Balancing Precision and Utility.

Pande R, Pandey M. The Sepsis Score Dilemma: Balancing Precision and Utility. Indian J Crit Care Med 2024;28(10):906-907.