Laparoscopic Management of Esophageal Epiphrenic Diverticulum.

A 45-year-old man who presented with progressive dysphagia of five months duration was diagnosed as a case of oesophageal epiphrenic diverticulum after endoscopic and imaging investigations. He underwent laparoscopic cardiomyotomy with Dor's fundoplication. Myotomy was done from the base of the diverticulum up to 2 cm distal to the gastroesophageal junction.

A Case of Parathyroid Adenoma with Bilateral Subtrochanteric Pathological Femur Fracture - A Rare Case Report.

Introduction: Primary hyperparathyroidism is a commonly occurring endocrine disorder that is characterized by elevated calcium levels, decreased phosphate levels, and high levels of parathyroid hormone (PTH). The condition can lead to significant bone resorption and pathological fractures.

Case Report: We report a case of a 44-year-old female who presented with bilateral thigh pain after a trivial fall at home.

Integrated viral and immune monitoring in a prospective COVID-19 cohort from India.

In this study, we report on longitudinal kinetics of cellular immune subsets following SARS-CoV-2 infection in a cohort of hospitalized individuals and evaluate the interplay of these profiles with infecting viral variants, humoral immunity including neutralizing responses, vaccination history, and clinical outcomes. A cohort of 121 SARS-CoV-2-infected individuals exhibiting varying disease states were prospectively evaluated for lymphopenic profiles, antiviral humoral responses and infecting viral variants for a period of up to 90 d spanning the period of February 2021 to January 2022 (second and third waves of infection). A total of 51 participants received at least 1 vaccine dose of indigenous vaccines (Covishield or Covaxin) prior to recruitment.

Revisiting Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) and Portsmouth-POSSUM (P-POSSUM) Scores: Are They Valid in Cases of Ileal Perforation?

Introduction Ileal perforation due to typhoid is common in tropical countries, and the ensuing secondary peritonitis is treated by resuscitation and surgery. The Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) was developed to predict postoperative outcomes to overcome systemic obstacles in any healthcare setup and is considered fairly accurate. The Portsmouth-POSSUM (P-POSSUM) score was developed as a corrective scoring system for overestimations made by the POSSUM score vis-à-vis mortality.

Late-Onset Angioedema With Olanzapine in a Tertiary Hospital.

A medical condition known as angioedema is characterized by sudden swelling of the mucosa, subcutaneous tissue, dermis, and submucosal tissues. If airway obstruction results in respiratory distress, this condition may be fatal. Histamine, bradykinin, and leukotrienes are just a few of the complex chemotactic mediators that play a role in the pathophysiology of angioedema and can lead to fluid buildup in deeper skin layers.

Max Delbruck: Founder of Molecular Genetics.

Max Delbrück (1906-1981) attended the University of Gottingen, where he studied astrophysics initially, switching later to theoretical physics. He earned his PhD in physics from Gottingen in 1930. Delbruck then moved to England and Denmark.

Atypical Presentation of Multiple Myeloma Affecting Appendicular Skeleton Associated with Pathological Neck of Femur and Proximal Humerus Fractures - A Case Report.

Introduction: The increasing incidence of atraumatic neck of femur (NOF) fractures, often linked to age-related bone weakening, is a notable clinical trend. This case report highlights a 72-year-old male presenting with NOF and proximal humerus fractures post-trivial fall, revealing lytic lesions suggestive of multiple myeloma (MM). Despite inconclusive skeletal and metabolic evaluations, a comprehensive surgical approach confirmed MM, emphasizing the importance of thorough diagnostic and therapeutic management in complex cases.

Use of Hartshill Rectangle with Sublaminar Wiring in Spinal Stabilization of D4-D5 Fracture Dislocation with Acute Spinal Cord Injury - A Cost-Effective Treatment.

Introduction: Fractures in the upper thoracic spine pose technical challenges due to the transition from cervical to thoracic spine, often resulting in complete spinal cord injuries necessitating stabilization. Various posterior fixation techniques include Harrington rods, wired distraction rods, L-rods with sub-laminar wiring, and pedicle screw fixation. Luque pioneered sublaminar wiring (SLW), later enhanced by Dove's Hartshill system for superior biomechanical stability.

Atypical Presentation of Primary Greater Trochanter Tuberculosis - A Case Report.

Introduction: Tuberculosis (TB) of the greater trochanter constitutes about 2% of musculoskeletal TB cases, often presenting with non-specific symptoms of localized pain, tenderness, and swelling, necessitating differentiation from other conditions like tumors. Bursal involvement results in the formation of a fluctuating mass. This case emphasizes the need for meticulous diagnostic evaluation in these cases due to their uncommon presentation and potential for inadequate assessment.

Role of GeneXpert in the diagnosis of extrapulmonary tuberculosis.

The World Health Organization endorsed the cartridge-based nucleic acid amplification test Xpert MTB/RIF (GXP) for the diagnosis of tuberculosis (TB). Studies about GXP efficiency in extrapulmonary TB (EPTB) are scarce. Hence, we decided to study the role of GXP in EPTB.

Uncommon Effect of Phenytoin on Fracture Union: Report of Two Cases.

Introduction: Prolonged phenytoin (PHD) therapy in epileptics predisposes patients to deleterious effects on bone health causing osteoporosis; however, despite its known effect on wound healing, collagen and fibroblast proliferation, and osteogenic differentiation, its impact on fracture healing remains poorly researched, we, report two cases of early exuberant callus formation in long bone fractures in patients undergoing long-term PHD therapy.

Case Report: Two female patients with known seizure disorder on long-term PHD therapy experienced proximal humerus fractures after trivial trauma. Metabolic work-up revealed low serum calcium and Vitamin D3 levels with elevated ALP, serum osteocalcin, and iPTH.

'PRUT' - A cadaveric study to understand the mechanism of this rare paediatric elbow injury with a comprehensive review of literature.

Introduction: Proximal radio-ulnar translocation (PRUT) with elbow dislocation, without a fracture, is an extremely unusual injury.

Case: A 6-year-old female child presented to us with posterior elbow dislocation, PRUT and incomplete ulnar nerve palsy. A hematoma aspiration and reduction of the elbow joint were done with a hyper-supination manoeuvre to reverse the translocation.

Effectiveness of Supramaximal Angiotensin-converting Enzyme Inhibition in Controlling Proteinuria in Congenital Nephrotic Syndrome with Cytomegalovirus Infection and an NPHS1 Mutation.

Congenital nephrotic syndrome (NS) is characterized by early-onset heavy proteinuria. Most cases of congenital NS are associated with genetic mutations in the podocyte proteins. The causal relationship of perinatal infections with congenital NS has not yet been proven.

An audit of prescribing pattern of anti-epileptic drugs with its effect on therapeutic drug levels and seizure control at a tertiary care public hospital.

Objective: The study objective was to evaluate the prescription pattern and use of anti-seizure medications (ASMs) in patients with a seizure disorder and to evaluate if a change in the ASM dose had a beneficial effect on seizure control, observed through Therapeutic Drug Monitoring [TDM] level of ASMs.

Methods: Details of anti-seizure medications with their therapeutic levels in the blood of patients with seizure disorder were analysed.

Design: Hospital-based retrospective analysis of patient case records.

Neutrophil-to-lymphocyte Ratio as a Marker for Diagnosis and Prognostication of Sepsis.

Purpose: Exploring the ideal marker for early diagnosis and prognosis of sepsis is crucial due to limitations of available sepsis indicators. Hence, we aimed to evaluate the neutrophil-to-lymphocyte ratio (NLR) as a diagnostic and prognostic marker of sepsis.

Materials And Methods: This prospective case-control study was conducted at a tertiary care teaching public hospital.

Immunoglobulin A Nephropathy Presenting in Young Adults as Advanced Chronic Kidney Disease and Posttransplant Early Recurrence: A Case Series.

Immunoglobulin A nephropathy (IgAN) is the most common glomerular disease, leading to chronic kidney disease. The disease is characterized by microscopic hematuria, gross episodic hematuria, hypertension, and subnephrotic proteinuria with or without renal function impairment. It affects individuals of all age groups, commonly seen in 10-40 years of age.

Early Dinner Improves the Glycemic Profile in Habitual Late Eaters With Uncontrolled Type 2 Diabetes Mellitus in the Short Term.

Background Late dinner (LD) can worsen the glucose profile in type 2 diabetes (T2D). We assessed the short-term effect of early dinner (ED) on glycemic control in habitual late eaters with uncontrolled T2D. Methodology This interventional, single-arm, within-group trial recruited 10 habitual late eaters with uncontrolled T2D (glycosylated hemoglobin: 7-9% and either fasting plasma glucose (FPG): ≥140 mg/dl or post-prandial plasma glucose: ≥200 mg/dl).