Sepsis-Associated Acute Kidney Injury: Pathophysiology and Treatment Modalities.

Sepsis-associated acute kidney injury (S-AKI) is a critical complication that significantly contributes to the morbidity and mortality of sepsis patients. This narrative review explores the complex and multifactorial pathophysiology of S-AKI, which involves hemodynamic alterations, microcirculatory dysfunction, endothelial damage, inflammatory responses, oxidative stress, and direct tubular injury. Conventional perspectives linking S-AKI primarily to reduced renal blood flow are now being reconsidered, with growing insights highlighting the significance of microcirculatory dysfunction and endothelial activation as key contributors.

The diagnostic accuracy of point-of-care nucleic acid-based isothermal amplification assays for scrub typhus: a systematic review and meta-analysis.

Introduction: The diagnosis and detection of pathogens such as and is a cause of major concern among the public health community. Unavailability of rapid, cost-effective diagnostic assays contributes to delayed diagnosis and timely treatment. Using the methodology of systematic reviewing and meta-analysis, the study aimed to synthesize and compare the diagnostic performances of all the available isothermal assays for the detection of classical rickettsial diseases.

Perceptions and barriers to the use and training of point-of-care ultrasound among Finnish emergency physicians - a nationwide survey.

Background: Point-of-Care Ultrasound (POCUS) has become integral to emergency medicine (EM) as a critical diagnostic support tool. In Finland, where EM was formally recognised as a specialty as recently as in 2013, a historical lack of systematic training for POCUS has existed. Such training has largely depended on individual initiative rather than a standardised program while many other areas of EM training have already seen the introduction of structured education.

Elastographic evaluation for fatty liver disease in north Indian children and adolescents with type 1 diabetes.

Objectives: The prevalence and predisposing factors to metabolic dysfunction-associated fatty liver disease (MAFLD) in children with type 1 Diabetes (T1D) living in developing countries are unknown.

Methods: A cross-sectional study was conducted in children with T1D. The presence of liver fat and tissue stiffness were assessed by ultrasonography and shear-wave elastography (SWE), respectively.

Efficacy of shared decision making in tobacco cessation among health facilities of Haryana, India - A double blinded, parallel group Randomized Controlled trial Protocol.

Background: Shared decision-making (SDM) incorporates evidence, patient values, and preferences into medical decision-making. SDM and decision aids might promote health professional engagement and patient knowledge of tobacco cessation therapy, improving usage and results. The SDM facilitates talks that lead to better-informed judgements that align with patients' priorities, unlike individual decision-making.

Development and Preliminary Validation of a Novel Instrument to Assess Re-Injury Associated Anxiety Following Traumatic Orofacial and Dental Injury in Young Boxers.

Background/aim: An injury sustained during sports activity can lead to the development of reinjury anxiety and hamper performance. Although tools exist to assess re-injury anxiety, a domain of interest in the field of sports medicine, research in the psychological impact of an orofacial injury is rudimentary. The present study envisaged to develop an instrument to assess the presence of reinjury anxiety following orofacial and dental injury in boxers aged between 10 and 16 years.

Identification of Critical Signature in Post-Traumatic Stress Disorder Using Bioinformatics Analysis and in Vitro Analyses.

Background: Post-traumatic stress disorder (PTSD) is a complex psychiatric condition that emerges following exposure to trauma and significantly affects daily functioning. Current research is focused on identifying effective treatments for PTSD. Advances in bioinformatics provide opportunities to elucidate the underlying mechanisms of PTSD.

Comparison of Intraoperative Propofol-Dexmedetomidine and Ketofol-Dexmedetomidine Infusions on Recovery from Anesthesia in Patients Undergoing Endoscopic Trans-Sphenoidal Pituitary Surgeries: A Randomised Controlled Trial.

Background: A rapid and smooth emergence is essential in patients undergoing trans-sphenoidal pituitary surgeries. Ketofol has been used as an anesthetic agent with good recovery characteristics. We conducted this study to compare the recovery profile of the patients receiving propofol-dexmedetomidine or ketofol-dexmedetomidine infusions for trans-sphenoidal excision of pituitary tumours.

Using Zebrafish Models to Study Epitranscriptomic Regulation of CNS Functions.

Epitranscriptomic regulation of cell functions involves multiple post-transcriptional chemical modifications of coding and non-coding RNA that are increasingly recognized in studying human brain disorders. Although rodent models are presently widely used in neuroepitranscriptomic research, the zebrafish (Danio rerio) has emerged as a useful and promising alternative model species. Mounting evidence supports the importance of RNA modifications in zebrafish CNS function, providing additional insights into epitranscriptomic mechanisms underlying a wide range of brain disorders.

Role of stereotactic radiosurgery for intracranial epidermoid tumors: a systematic review to assess its safety, efficacy, and complication profile.

Background: Even a gross total resection of a benign epidermoid tumor (ET) carries a high risk of recurrence. The management strategy mostly involves redo surgical excision but at a significant cost of morbidity and mortality. The role of adjuvant radiation therapies in this scenario is still undefined.

Clinical characteristics affecting weight loss in an East Asian population receiving semaglutide: A STEP 6 subgroup analysis.

Objective: To explore the effects of semaglutide versus placebo on body weight (BW) by subgroups of baseline characteristics.

Methods: In STEP 6, Japanese and Korean adults with overweight or obesity were randomized to subcutaneous semaglutide 2.4 mg, semaglutide 1.

Outcomes after medical treatment for primary aldosteronism: an international consensus and analysis of treatment response in an international cohort.

Background: Primary aldosteronism can be treated medically but there is no standardised method to evaluate treatment outcomes. We aimed to develop criteria for assessing the outcomes of targeted medical treatment of primary aldosteronism, analyse outcomes across an international cohort, and identify factors associated with a complete treatment response.

Methods: An international panel of 31 primary aldosteronism experts used the Delphi method to reach consensus on the definition of complete, partial, or absent biochemical and clinical outcomes of medical treatment of primary aldosteronism.

Targeting FABP4/UCP2 axis to overcome cetuximab resistance in obesity-driven CRC with drug-tolerant persister cells.

Colorectal cancer (CRC) is closely linked to obesity, a condition that significantly impacts tumor progression and therapeutic resistance. Although cetuximab, an EGFR-targeting monoclonal antibody, is a cornerstone in metastatic CRC treatment, resistance often emerges, leading to poor outcomes. This study investigated the role of drug-tolerant persister (DTP) cells and their metabolic interactions within the tumor microenvironment (TME) in cetuximab resistance.

Unhealthy behaviours associated with uncontrolled hypertension among adults in India- Insights from a national survey.

Background: Non-communicable diseases (NCDs) are governed by a cluster of unhealthy behaviours and their determinants, like tobacco and alcohol, unhealthy diet, lack of physical activity, overweight and obesity, pollution (air, water, and soil), and stress. Regulation of these unhealthy behaviours plays a crucial role in blood pressure control among individuals on hypertensive treatment, especially those suffering from uncontrolled hypertension. Hence, the present study aims at identifying the unhealthy behaviours associated with uncontrolled hypertension.

Effects of the Affordable Care Act on Contraception, Pregnancy, and Pregnancy Termination Rates.

Objective: To investigate the effects of the Affordable Care Act (ACA) and its elimination of cost sharing on contraception utilization, pregnancy rates, and abortion rates.

Methods: We conducted a retrospective cohort study within a health care system serving more than 4.5 million insured members across 21 medical centers and 250 clinics.

Multipronged strategy for protection and motivation of healthcare workers during the COVID-19 pandemic: a real-life study.

Objective: We aimed to assess risk of COVID-19 infection & seroprotection status in healthcare workers (HCWs) in both hospital and community settings following an intensive vaccination drive in India.

Setting: Tertiary Care Hospital.

Methods: We surveyed COVID-19 exposure risk, personal protective equipment (PPE) compliance, vaccination status, mental health & COVID-19 infection rate across different HCW cadres.

Effect of plateletpheresis on donor variables and platelet yield using three different cell separators: Experience from tertiary care hospital.

Introduction: Platelet collection by apheresis is common nowadays. Many cell separators are available in the market for the same. This study was conducted to study the effect of various donor factors on platelet yield and the effect of different cell separator variables on platelet yield.

Serological characteristics and immunohematological difficulties in autoimmune hemolytic anemia patients: A retrospective analytical study from South India.

Introduction: Autoimmune hemolytic anemia (AIHA) is a condition in which there is decreased survival of red blood cells (RBC) due to the destruction of RBC by autoantibodies. AIHA is classified into warm, cold, and mixed according to temperature sensitivity. The antibodies may be immunoglobulin G, immunoglobulin M, immunoglobulin A, or complement proteins, and hemolysis may be intravascular or extravascular.

Resource Utilization and Cost in Management of Febrile Infants After the 2021 Clinical Guideline.

Objective: The 2021 American Academy of Pediatrics clinical practice guideline (CPG) for well-appearing febrile infants aims to promote evidence-based care, reduce practice variability, enhance care quality, and optimize cost. We aimed to examine the trends in resource utilization and cost associated with the evaluation and management of febrile infants aged 8 to 60 days before and after the CPG's publication.

Methods: We performed a retrospective cross-sectional study using the Pediatric Health Information Systems Database, covering the periods of August 2019 to July 2021 (pre-CPG) and August 2021 to July 2023 (post-CPG).

Advancing pain education: a cross-sectional study in the Portuguese medical schools.

Introduction: Chronic pain negatively impacts on quality of life and is often underreported and undertreated. Therefore, it is essential for medical schools to provide education in pain management for students. This study evaluated the current state of pain education in the Portuguese medical schools, focusing on integrating pain-related topics into the curriculum.

A Mixed Reality-Based Telesupervised Ultrasound Education Platform on 5G Network Compared to Direct Supervision: Prospective Randomized Pilot Trial.

Background: Ultrasound education is transitioning from in-person training to remote methods using mixed reality (MR) and 5G networks. Previous studies are mainly experimental, lacking randomized controlled trials in direct training scenarios.

Objective: This study aimed to compare an MR-based telesupervised ultrasound education platform on private 5G networks with traditional in-person training for novice doctors.

Instruments for Evaluating Undergraduate Medical Education in Complementary and Integrative Medicine: A Systematic Review.

The provision of courses in complementary and integrative medicine (CIM) varies widely between medical schools. To effectively improve CIM education, it is essential to use robust evaluation instruments that measure the impact of different educational interventions. This review aimed to identify and critically appraise qualitative and quantitative instruments used to evaluate CIM courses in undergraduate medical education.

Custom ocular prostheses incorporating braille for a patient with bilateral anophthalmia: A clinical report.

Bilateral anophthalmia, a clinical condition characterized by the absence of globe and ocular tissues from both the orbits, presents considerable challenges to a patient's daily routine and use of prostheses. The patient's inability to orientate custom ocular prostheses (COPs) 3-dimensionally is understandable, and they typically rely on caregivers to manage the prostheses and prevent inadvertent injury to the socket. This clinical report describes the successful integration of braille script into COPs as a solution to these challenges by improving prosthesis management, decreasing caregiver dependence, and encouraging independence.