Assessing neoadjuvant chemotherapy's impact on complications following radical cystectomy.

Introduction: Despite level 1 evidence supporting neoadjuvant chemotherapy (NACT) followed by radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC), its adoption is hindered by concerns about toxicity and detrimental impact on post-RC complications. We retrospectively reviewed post-RC complications at a tertiary care hospital, particularly assessing impact of NACT.

Methods: Data from the institutional bladder cancer database were retrieved for patients aged ≥18 with MIBC (≥American Joint Committee on Cancer Clinical Stage T2), treated with RC between May 2013 and July 2023.

Percutaneous Intervention of Aortic Pseudoaneurysm and Severe Bioprosthetic Valve Regurgitation Following a Bentall Procedure.

A 77-year-old man with a history of a Bentall procedure presented with acute decompensated heart failure. Investigations revealed severe bioprosthetic aortic valve regurgitation and a large pseudoaneurysm eroding the sternum. We describe the multimodal imaging and heart team planning to stent the pseudoaneurysm with an endograft followed by transcatheter valve-in-valve implantation.

Oral Versus Injectable Vitamin D Therapy for Treating Nutritional Rickets in Indian Children: A Comparative Study.

Background: Rickets is a common metabolic bone disease in children, primarily caused by vitamin D deficiency. This study aimed to compare the efficacy of oral weekly vitamin D supplementation and injectable stoss therapy in treating nutritional rickets in Indian children.

Methods: This prospective, randomized, controlled trial was conducted over 18 months at a tertiary care center.

Under-representation of older Indian persons with cancer in clinical trials.

Objective: Older patients with cancer have traditionally been under-represented in global clinical trials. There are no data from India regarding this issue.

Methods And Analysis: This was a retrospective analysis done at our institute on interventional studies conducted between 2003 and 2023 in adult patients with malignancies.

Glucagon, rather than Glucagon-Like Peptide 1, Mediates Higher Post-Lunch Glucose Excursions during Breakfast Skipping in Asian Indian Patients with Uncontrolled Type 2 Diabetes Mellitus.

Introduction: The effect and mechanism of skipping breakfast on glycemic control in type 2 diabetes mellitus (T2DM) in Asian-Indians is unknown.

Methods: Cross-over, within-group study recruiting 5 habitual breakfast eaters (BE) and 5 habitual breakfast skippers (BS) with uncontrolled T2DM (HbA1c 7-9%). Patients underwent testing after three days of following their usual breakfast habits and after seven days of crossing over to the other arm.

Efficacy of oral irrigators compared to other interdental aids for managing peri-implant diseases: a systematic review.

Objective: Peri-implant diseases (peri-implant mucositis and peri-implantitis) are inflammatory conditions that affect the peri-implant tissues and are induced by microbial biofilms (dental plaque) formed around the implant. Removal of biofilm is the fundamental step in managing peri-implant diseases. Interdental cleaning aids such as interdental brush, unitufted brush, or oral irrigation along with regular toothbrushing are recommended for effective plaque control around implants.

The impact of preoperative venous thromboembolism on patients undergoing TURBT: Perioperative outcomes and healthcare costs from US insurance claims data.

Objectives: To assess the impact of a positive history of venous thromboembolism (VTE) on perioperative outcomes, including length of in-hospital stay, readmission rates, 90-day postoperative complications, and healthcare costs in bladder cancer (BCa) patients undergoing transurethral resection of bladder tumour (TURBT) in the United States.

Patients And Methods: Patients aged ≥18 years with a BCa diagnosis undergoing TURBT were identified in the Merative® Marketscan® Research de-identified databases between 2007 and 2021. Multivariable logistic regression adjusted by relevant perioperative confounders was used to investigate the association between diagnosis of VTE before TURBT and 90-day complication rates, new postoperative VTE events, re-hospitalization, and total hospital expenditures (2021 US dollars).

Efficacy and Safety of Boswellia serrata and Apium graveolens L. Extract Against Knee Osteoarthritis and Cartilage Degeneration: A Randomized, Double-blind, Multicenter, Placebo-Controlled Clinical Trial.

Background: Osteoarthritis is the prevailing form of inflammatory condition in joints of adults and the aging population, leading to long-term disability and chronic pain. Current therapeutic options have variable therapeutic efficacy and/or several side effects.

Methods: A randomized, placebo-controlled, double-blind clinical trial was conducted in 62 participants using a nutraceutical [standardized Boswellia serrata Roxb.

Net Benefit of Early Anticoagulation for Stroke With Atrial Fibrillation: Post Hoc Analysis of the ELAN Randomized Clinical Trial.

Importance: The net clinical effect of early vs later direct oral anticoagulant (DOAC) initiation after atrial fibrillation-associated ischemic stroke is unclear.

Objective: To investigate whether early DOAC treatment is associated with a net clinical benefit (NCB).

Design, Setting, And Participants: This was a post hoc analysis of the Early Versus Late Initiation of Direct Oral Anticoagulants in Post-Ischaemic Stroke Patients With Atrial Fibrillation (ELAN) open-label randomized clinical trial conducted across 103 sites in 15 countries in Europe, the Middle East, and Asia between November 6, 2017, and September 12, 2022, with a 90-day follow-up.

Nebulized aminoglycosides for ventilator-associated pneumonia: Methodological considerations and lessons from experimental studies.

Aminoglycosides are concentration-dependent antibiotics exerting a bactericidal effect when concentrations at the site of infection are equal to or greater than 5 times the minimum inhibitory concentrations (MIC). When administered intravenously, they exhibit poor lung penetration and high systemic renal and ototoxicity, imposing to restrict their administration to 5 days. Experimental studies conducted in anesthetized and mechanically ventilated sheep and pigs provide evidence that high doses of nebulized aminoglycosides induce a rapid and potent bacterial killing in the infected lung parenchyma.

Real world experience on patterns of usage and toxicity profile of immunotherapy drugs in Indian patients: A prospective observational study.

Background: Immune checkpoint inhibitors (ICIs) are now considered revolutionary agents in the treatment of various cancers. Prospective data are limited on the patterns of usage and toxicity profile of these drugs. We planned this study for addressing the same in Indian patients.

Patients with neurological or psychiatric complications of COVID-19 have worse long-term functional outcomes: COVID-CNS-A multicentre case-control study.

It is established that patients hospitalised with COVID-19 often have ongoing morbidity affecting activity of daily living (ADL), employment, and mental health. However, little is known about the relative outcomes in patients with COVID-19 neurological or psychiatric complications. We conducted a UK multicentre case-control study of patients hospitalised with COVID-19 (controls) and those who developed COVID-19 associated acute neurological or psychiatric complications (cases).

Patterns, timing and predictors of recurrence following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: an international multicentre retrospective cohort study.

Background: Most patients undergoing pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC) develop recurrence. No previous studies have investigated predictors of local-only recurrence following PD for PDAC. Our study aimed to determine timing, pattern and predictors of any-site and local-only recurrence following PD for PDAC.

Negative Pressure Dressings to Prevent Surgical Site Infection After Emergency Laparotomy: The SUNRRISE Randomized Clinical Trial.

Importance: Patients undergoing unplanned abdominal surgical procedures are at increased risk of surgical site infection (SSI). It is not known if incisional negative pressure wound therapy (iNPWT) can reduce SSI rates in this setting.

Objective: To evaluate the effectiveness of iNPWT in reducing the rate of SSI in adults undergoing emergency laparotomy with primary skin closure.

Correlating the Optical Coherence Tomography Patterns and Biomarkers of Diabetic Macular Edema with Hemoglobin Level in Diabetic Kidney Disease.

Purpose: To correlate the optical coherence tomography (OCT) based morphological patterns of diabetic macular edema (DME) and prognostic biomarkers with severity of anaemia in patients with diabetic kidney disease (DKD).

Patients And Methods: Single centre, observational cross sectional study of 42 eyes of 42 patients with DME and DKD. Eyes were divided into 2 groups: Group A (Haemoglobin level above 10 g% and group B with haemoglobin less than 10 g%).

Protocol for a systematic review and individual participant data meta-analysis for risk factors for lung cancer in individuals with lung nodules identified by low-dose CT screening.

Background: Worldwide, lung cancer (LC) is the second most frequent cancer and the leading cause of cancer related mortality. Low-dose CT (LDCT) screening reduced LC mortality by 20-24% in randomised trials of high-risk populations. A significant proportion of those screened have nodules detected that are found to be benign.

Effects of Therapeutic Hypothermia and Minimal Enteral Nutrition on Short-Term Outcomes in Neonates with Hypoxic-Ischemic Encephalopathy: A 10-Year Experience from Oman.

Background: Therapeutic hypothermia (TH) is the standard treatment for moderate to severe hypoxic-ischemic encephalopathy (HIE) in developed countries, but data on its safety and efficacy in low-middle-income countries are limited and often conflicting. The impact of enteral feeding during TH remains inadequately explored. We aimed to examine TH's effects on mortality and brain injury and evaluate the safety and effectiveness of minimal enteral feeding during TH.

A case report of long-latency evoked diaphragm potentials after exposure to acute intermittent hypoxia in post-West Nile virus meningoencephalitis.

We present a case report of a 42-year-old female with post-West Nile virus meningoencephalitis who exhibited unique, long-latency diaphragm potentials evoked by transcranial and cervical magnetic stimulation after exposure to acute intermittent hypoxia (AIH). The subject was recruited for a study investigating AIH effects on respiratory motor function in healthy individuals. She had contracted West Nile virus infection 5 years before assessment that resulted in hospitalization and persistent allodynia but was not reported to the research team.

Advanced In Vitro Models for Preclinical Drug Safety: Recent Progress and Prospects.

The majority of drugs are typically orally administered. The journey from drug discovery to approval is often long and expensive, involving multiple stages. A major challenge in the drug development process is drug-induced liver injury (DILI), a condition that affects the liver, the organ responsible for metabolizing most drugs.

Results of ICE-Guided Isolation of the Superior Vena Cava With Pulsed Field Ablation.

Background: Earlier studies have documented the risk for sinoatrial node injury and phrenic nerve paralysis as complications following radiofrequency catheter ablation for electrical isolation of the superior vena cava (SVCI).

Objectives: The aim of this study was to assess the safety and feasibility of SVCI in patients with atrial fibrillation undergoing pulsed field ablation (PFA) METHODS: Six hundred sixteen consecutive patients undergoing PFA for pulmonary vein isolation plus SVCI were included in this multicenter analysis. Superior vena cava (SVC) ablation was performed under the continuous guidance of intracardiac echocardiography.

Sex Differences in Long COVID.

Importance: A substantial number of individuals worldwide experience long COVID, or post-COVID condition. Other postviral and autoimmune conditions have a female predominance, but whether the same is true for long COVID, especially within different subgroups, is uncertain.

Objective: To evaluate sex differences in the risk of developing long COVID among adults with SARS-CoV-2 infection.

Demand side financing for promoting institutional delivery: experiences of Janani Suraksha Yojana in Indian states.

Public expenditure for the improvement of maternal health is crucial in addressing the major social and demographic challenges in developing countries like India. Accordingly, the Government of India initiated the Janani Suraksha Yojana (JSY) in 2005 as a flagship conditional cash transfer scheme to encourage institutional delivery in the country. While the provisions under the JSY remain uniform throughout the country, there are apprehensions that the impact would differ across the states as well as between the rural and urban setups depending on varied socio-economic conditions and local level dynamics.

Romiplostim Reduces Platelet Transfusion Needs in Multiple Myeloma Patients Undergoing Autologous Stem Cell Transplantation.

Background: There is no standard treatment to accelerate recovery from melphalan-induced thrombocytopenia in multiple myeloma (MM) patients undergoing autologous stem cell transplantation (ASCT). Romiplostim, a thrombopoietin receptor agonist, has been developed to upregulate platelet production.

Objective: This study aimed to assess the efficacy and safety of romiplostim in reducing platelet transfusions post-ASCT in MM patients.

Vitronectin regulates lung tissue remodeling and emphysema in chronic obstructive pulmonary disease.

Vitronectin (VTN) is an important extracellular matrix protein in tissue remodeling, but its role in COPD is unknown. We show that VTN regulates tissue remodeling through urokinase plasminogen activator (uPA) signaling pathway in COPD. In human COPD airways and bronchoepithelial cells and the airways of mice with cigarette smoke (CS)-induced experimental COPD, VTN protein was not changed, but downstream uPA signaling was altered (increased plasminogen activator inhibitor-1, uPAR) that induced collagen and airway remodeling.