Institutional Experience of Microsurgical Management in Posterior Circulation Aneurysm.

Introduction: Posterior circulation aneurysm constitutes 15%-20% of all intracerebral aneurysms. With the advancement of endovascular techniques, the microsurgery for posterior circulation aneurysms has been pushed back a little. Even the International Subarachnoid Aneurysmal Trial gave support to the concepts of endovascular procedures, but microsurgical modality should not be discouraged.

Integrated genomic analysis reveals mutated ELF3 as a potential gallbladder cancer vaccine candidate.

Gallbladder cancer (GBC) is an aggressive gastrointestinal malignancy with no approved targeted therapy. Here, we analyze exomes (n = 160), transcriptomes (n = 115), and low pass whole genomes (n = 146) from 167 gallbladder cancers (GBCs) from patients in Korea, India and Chile. In addition, we also sequence samples from 39 GBC high-risk patients and detect evidence of early cancer-related genomic lesions.

Effect of Exercise on NAFLD and Its Risk Factors: Comparison of Moderate versus Low Intensity Exercise.

Lifestyle (exercise and dietary) modification is the mainstay of treatment for non-alcoholic fatty liver disease (NAFLD). However, there is paucity of data on effect of intensity of exercise in management of NAFLD, and we aimed to study the effect of variable intensities of exercise on NAFLD. The study was performed in the Department of Gastroenterology of the SCB Medical College, Cuttack and the Biju Patnaik State Police Academy, Bhubaneswar.

Clinical features and evolution of bacterial infection-related acute-on-chronic liver failure.

Background & Aims: Bacterial infections can trigger the development of organ failure(s) and acute-on-chronic liver failure (ACLF). Geographic variations in bacteriology and clinical practice could lead to worldwide differences in ACLF epidemiology, phenotypes and associated outcomes. Herein, we aimed to evaluate regional differences in bacterial infection-related ACLF in patients with cirrhosis admitted to hospital.

To Study Relationship of Serum hsCRP with Type 2 Diabetes Mellitus, its Vascular Complications and Non-Diabetics - Case Control Study.

Objective: To find the serum hsCRP (high sensitive C reactive protein) levels in type 2 Diabetes Mellitus (DM) patients and compare its level between type 2 DM patients and healthy control subjects. To find the relationship of hsCRP levels in type 2 DM with and without vascular complications. To find the correlation of hsCRP with HbA1c and duration of type 2 DM among cases and to find the optimum cut-off value for hsCRP among type 2 DM patients.

Association of Factor V Leiden With Subsequent Atherothrombotic Events: A GENIUS-CHD Study of Individual Participant Data.

Background: Studies examining the role of factor V Leiden among patients at higher risk of atherothrombotic events, such as those with established coronary heart disease (CHD), are lacking. Given that coagulation is involved in the thrombus formation stage on atherosclerotic plaque rupture, we hypothesized that factor V Leiden may be a stronger risk factor for atherothrombotic events in patients with established CHD.

Methods: We performed an individual-level meta-analysis including 25 prospective studies (18 cohorts, 3 case-cohorts, 4 randomized trials) from the GENIUS-CHD (Genetics of Subsequent Coronary Heart Disease) consortium involving patients with established CHD at baseline.

Role of Video Laryngostroboscopy in Benign Disease of Larynx.

Benign disease of larynx frequently present with voice disorder. Observing the larynx with high resolution stroboscope and its mucosal wave pattern with greater precision aids in the better understanding of normal/abnormal anatomy and function, which forms the basis of designing treatment strategies.Videolaryngostroboscopy now a days is considered routinely used method of vocal fold examination and evaluation of patients with voice disorders.

Annular Pattern of Pustular Vasculitis: A Case Report of Unusual Morphological Presentation.

Pustular cutaneous vasculitis is a rare entity. Only handful cases are reported from all over the world. They typically present with painful pustules mainly over dorsum of hands and rarely on lower legs.

Clear cell lesions in pathology: Histomorphologic approach to diagnosis.

There has been remarkable progress in the field of surgical pathology; however, histomorphology has remained the most important and essential tool of the surgical pathologist in everyday practice till now. It is surprising that the hematoxylin-eosin (H and E) stain, introduced more than a century ago, has still remained the gold standard stain for histological examination and diagnosis of human diseases. Besides different findings or clues observed in histopathology sections like inclusions, granules, grooving, globules, halo, or clearing, which would enable the pathologist to provide a precise and accurate diagnosis; observation of clear cells is one of the important findings and clue for reporting.

NonInvasive Biomarkers in Nonalcoholic Fatty Liver Disease: Are We There Yet?

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. NAFLD encompasses a spectrum of disease ranging from simple steatosis (NAFL) to nonalcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma. However, despite the growing recognition of this important disease burden, there are significant challenges to accurately and noninvasively diagnose the various forms of NAFLD, especially to differentiate benign steatosis from the progressive NASH.

Hemichorea Secondary to Non-Ketotic Hyperglycemia as the Presenting Manifestation of Diabetes Mellitus.

Nonketotic hyperglycemia is an unusual and rare cause of hemichorea. Hemichorea though rare may be the initial manifestation of diabetes mellitus. Correction of the hyperglycemia usually results in total resolution of the signs and symptoms.

Trial of Anifrolumab in Active Systemic Lupus Erythematosus.

Background: Anifrolumab, a human monoclonal antibody to type I interferon receptor subunit 1 investigated for the treatment of systemic lupus erythematosus (SLE), did not have a significant effect on the primary end point in a previous phase 3 trial. The current phase 3 trial used a secondary end point from that trial as the primary end point.

Methods: We randomly assigned patients in a 1:1 ratio to receive intravenous anifrolumab (300 mg) or placebo every 4 weeks for 48 weeks.

Indian consensus on gastroesophageal reflux disease in adults: A position statement of the Indian Society of Gastroenterology.

The Indian Society of Gastroenterology developed this evidence-based practice guideline for management of gastroesophageal reflux disease (GERD) in adults. A modified Delphi process was used to develop this consensus containing 58 statements, which were generated by electronic voting iteration as well as face-to-face meeting and review of the supporting literature primarily from India. These statements include 10 on epidemiology, 8 on clinical presentation, 10 on investigations, 23 on treatment (including medical, endoscopic, and surgical modalities), and 7 on complications of GERD.

Hematological, Biochemical and Renal Changes in Patients of Multiple Myeloma Treated with Bortezomib Based Triple Drug Chemotherapy.

Introduction: Multiple myeloma (MM) is a neoplastic clonal plasma cell disorder. Approximately 30% of newly diagnosed MM present with baseline renal dysfunction adversely affecting prognosis and survival. But its outcome has improved with the advent of novel agents.

TNF-α promoter polymorphisms (G-238A and G-308A) are associated with susceptibility to Systemic Lupus Erythematosus (SLE) and P. falciparum malaria: a study in malaria endemic area.

Tumor necrosis factor-α (TNF-α) is a proinflammatory cytokine associated with autoimmune and infectious diseases. Importance of TNF-α in P. falciparum malaria and systemic lupus erythematosus (SLE) have been demonstrated.

Penile Horn: A Rare Presentation of Pseudoepitheliomatous, Keratotic, and Micaceous Balanitis Successfully Treated with Oral Acitretin.

Glans penis is an unusual site for horn. Only few cases are reported worldwide in English literature. Pseudoepitheliomatous, keratotic, and micaceous balanitis (PKMB) is a pyodermatitis with pseudoepitheliomatous response to chronic inflammation or infection.

Early Syringomyelia in Tubercular Meningitis.

Tubercular meningitis (TBM) can have various complications. Sometimes syringomyelia can also occur as a late complication of tubercular meningitis. Although syrinx formation in early stage of TBM is very rare.

Organophosphorus-Induced Toxic Myeloneuropathy: Series of Three Adolescent Patients with Short Review.

Organophosphate (OP) poisoning is the most common poisoning in India, accounting for almost half of the hospital admissions due to poisoning. Delayed neuropathy is initiated by an attack on a nervous tissue esterase. Although uncommon, delayed neurotoxicity has been consistently reported in literature.

Muscle-specific changes in protein synthesis with aging and reloading after disuse atrophy.

Background: Successful strategies to halt or reverse sarcopenia require a basic understanding of the factors that cause muscle loss with age. Acute periods of muscle loss in older individuals have an incomplete recovery of muscle mass and strength, thus accelerating sarcopenic progression. The purpose of the current study was to further understand the mechanisms underlying the failure of old animals to completely recover muscle mass and function after a period of hindlimb unloading.