Propensity score analysis of adjuvant therapy in radically resected gallbladder cancers: a real world experience from a regional cancer center.

Backgrounds/aims: Given the high mortality associated with gallbladder cancer (GBC), the efficacy of adjuvant therapy (AT) remains controversial. We audited our data over an 11-year period to assess the impact of AT.

Methods: This study included all patients who underwent curative resection for GBC from 2007 to 2017.

Molecular Characterization of δβ Thalassemia/Hereditary Persistence of Fetal Hemoglobin and Its Correlation With Clinical and Hematological Profile; a Single Center Study in North India.

Background: δβ-thalassemia/HPFH is an uncommon hemoglobinopathy characterized by decreased or the total absence of production of δ- and β-globin and increased HbF levels. Both these disorders have variable genotype and phenotype, but significant overlap in the clinical and laboratory findings. Given the lack of literature in this regard, the study aimed to estimate the prevalence of the disease and evaluate its clinical, hematological, and molecular profile in India.

Primary cutaneous melioidosis - A rare case needing intensive care unit admission.

Background: Melioidosis cases are increasing in Southeast Asia, posing a significant challenge owing to the rising number of diabetic and immune compromised patients. Pneumonia is the most common presentation of melioidosis, while cutaneous melioidosis is rare.

Objectives: We report a case of primary cutaneous melioidosis (PCM) that eventually required intensive care unit (ICU) management.

Epidemiological Profile and Outcome of COVID-19 Patients and Its Comparison Between the First and Second Wave at a Tertiary-Level COVID Care Facility in North India.

Background: In December 2019, COVID-19 emerged in China and spread rapidly throughout the world, including India. So far, India has witnessed three spells of the disease, termed the first, second, and third waves; although the first two waves were significant in terms of severity, mortality, and need for respiratory support, the third wave had no significant impact and most people recovered without being admitted to the hospital. The present study aimed to discuss the clinical demographic characteristics and in-hospital outcomes of COVID-19 patients and their comparisons between the first and second waves.

MicroRNAs as Biomarker in Rheumatoid Arthritis: Pathogenesis to Clinical Relevance.

MicroRNAs (miRNAs) have emerged as intricate players in rheumatoid arthritis (RA), holding promise as discerning biomarkers for diagnostic and prognostic purposes. The lack of sensitivity and specificity in current diagnostic techniques, such as rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA), causes diagnosis delays in RA. The miR-146a and miR-155 act in inflammatory cascades and reduce joint deterioration, and miR-223 is paradoxical, acting differently in different illness scenarios.

Laparoscopic Management of a Rare Case of Spontaneous Biliary Perforation in an Infant.

Spontaneous biliary perforation is a rare condition, predominantly observed in infants, characterized by the leakage of bile into the peritoneal cavity without any apparent cause. This case report discusses a 3-month-old female infant who presented with symptoms of jaundice and abdominal distension. The successful management of this case with a combination of ultrasound-guided percutaneous drainage and laparoscopic cholecystostomy is detailed, highlighting the importance of minimally invasive techniques in treating this condition.

Type 1a Duodenojejunal Tubular Duplication Cyst with Complex Rotational Anomaly Masquerading as Chronic Anemia.

Enteric duplication cysts and reversed intestinal rotation (RIR) are rare congenital anomalies, with their coexistence being exceptionally uncommon. We report a 4-year-old girl who presented with chronic anemia and intermittent abdominal symptoms since infancy. Detailed workup for medical causes of anemia was inconclusive.

Liposomal Encapsulation of Chlorambucil with a Terpyridine-Based, Glutathione-Targeted Optical Probe Facilitates Cell Entry and Cancer Cell Death.

The nitrogen mustard alkylating agent chlorambucil (CBL) is a critical component of chemotherapeutic regimens used in the treatment of chronic lymphocytic leukemia. The cancer cell-killing actions of CBL are limited by glutathione (GSH) conjugation, a process catalyzed by the GSH transferase hGSTA1-1 that triggers CBL efflux from cells. In the cancer cell microenvironment, intracellular GSH levels are elevated to counterbalance oxidative stress generated due to the high glycolytic demand.

Finerenone: a breakthrough mineralocorticoid receptor antagonist for heart failure, diabetes and chronic kidney disease.

Background: Aldosterone is categorized as a mineralocorticoid hormone produced in the zona glomerulosa of the adrenal cortex. Aldosterone has considerable action in sodium and water retention along with cardiac remodeling, promoting fibrosis and these detrimental effects have been counteracted by mineralocorticoid receptors antagonists over time. Spironolactone, a non-selective steroidal MRA used extensively is potent but has serious adverse effects like gynecomastia and hyperkalemia.

The Impact of Thoracic Trauma on Morbidity and Outcomes: A Six-Year Experience From a Tertiary Care Level 1 Center.

Objective: The study aimed to summarize the impact of thoracic injury on mortality and morbidity in thoracic trauma patients.

Material And Methods: This is a retrospective observational study of all patients with thoracic injuries admitted between July 2018 and June 2024. The demographic profile, mechanism of injury, type of injury, injury severity score, duration of injury, hemodynamic status, surgical findings, concomitant injuries, hospitalization, intensive care unit stay, need for mechanical ventilation, and blood transfusions were recorded.

A Randomized Study of Consolidation Chemoradiation (CTRT) versus Observation after first line chemotherapy (CT) in Advanced Gall bladder Cancers (GBC):RACE-GB study.

Purpose: CT is the standard of care for patients presenting with unresectable advanced GBC but their prognosis remains poor. The value of consolidation CTRT after initial CT is uncertain. We therefore conducted a single centre open label randomised trial evaluating consolidation CTRT versus Observation after four cycles of CT in patients whose disease did not progress during CT (partial responders/stable disease).

Associations between Toll-like receptor 4 Asp299Gly polymorphism and susceptibility to intracranial aneurysm among male and female patients within the North Indian population.

Objectives: Intracranial aneurysms (IA), often remain asymptomatic until they get ruptured, invariably leads to subarachnoid hemorrhage (SAH), and is influenced by both genetic and environmental factors. Recent studies indicated inflammation as a key player in IA development. This study delves into genetic variations within inflammatory pathways, focusing on TLR4-mediated cytokine release as potential IA biomarkers.

Effect of Prednisolone on Clinical and Cytokine mRNA Profiling in Complex Regional Pain Syndrome.

The cardinal clinical features of complex regional pain syndrome type I (CRPS-I) are pain, edema, autonomic changes, and limitation of motoric movement, which may indicate the role of inflammation and cytokines. We report the effect of prednisolone on the clinical severity and mRNA profiling of proinflammatory (tumor necrosis factor (TNF)-α and interleukin (IL)-2) and anti-inflammatory cytokines (IL-10 and transforming growth factor (TGF)-β) in the patient with CRPS-I. Thirty-nine patients with CRPS-I of shoulder joint were enrolled.

Inflammatory myofibroblastic tumor in the intradural extramedullary space of the lumbosacral spine: a case report and review of the literature.

Inflammatory myofibroblastic tumor (IMT) is a rare, benign lesion of uncertain etiology, predominantly affecting soft tissues such as the lungs, with spinal involvement being exceedingly rare. We present the case of a 10-year-old male with a year-long history of low back pain, constipation, and difficulty in urination. MRI revealed an intradural extramedullary lesion at L5-S1, initially suspected to be a schwannoma or neurofibroma.

Laparoscopic management of variant ductal and vascular anatomy in children with choledochal cysts.

Introduction: Variations in biliary ductal and hepatic vascular anatomy increase the complexity of surgery for choledochal cysts (CDC). The laparoscopic approach for the management of paediatric CDCs with variant anatomy is underreported. This study aimed to describe anatomical variations, operative techniques and early outcomes of laparoscopic hepaticojejunostomy (HJ) in children with CDCs and variant anatomy.

A Review of The Opportunities and Challenges with Large Language Models in Radiology: The Road Ahead.

In recent years, generative artificial intelligence (AI), particularly large language models (LLMs) and their multimodal counterparts, Multi-Modal Large Language Models (MM-LLMs), including Vision Language Models (VLMs), have generated considerable interest in the global AI discourse. LLMs, or pre-trained language models (such as ChatGPT, Med-PaLM, LLaMA, etc.), are neural network architectures trained on extensive text data, excelling in language comprehension and generation.

Skin Flap Necrosis in Inguinal Lymph Node Dissection.

Inguinal skin flap necrosis (SFN) is a significant clinical problem associated with inguinal lymph node dissection (ILND). The aetiology of SFN is multifactorial, and its manifestations vary widely. Thermal damage caused by electrocautery during the elevation of the skin flap may contribute to this problem, which has not been studied previously.

Case report: exome sequencing identified mutations in the and genes in a case of osteoporosis with recurrent fractures and extraskeletal manifestations.

Background: Genetic mutations have been reported in a number of bone disorders with or without extra-skeletal manifestations. The purpose of the present study was to investigate the genetic cause in a middle-aged woman with osteoporosis, recurrent fractures and extraskeletal manifestations.

Methods: A 56-year-old Indian woman presented to the clinic with complaints of difficulty in walking, recurrent fractures, limb bending, progressive skeletal deformities, and poor overall health.

Barth syndrome: a rare cause of cardiomyopathy in neonates.

Barth syndrome (BTHS) is one of the rare X linked recessive diseases that appear in infancy with a triad of myocardial and skeletal muscle diseases, neutropenia and growth retardation. The pathogenic variant of gene leads to BTHS, which encodes the TAFAZZIN protein of the inner membrane of the mitochondria, a phosphatidyltransferase involved in cardiolipin remodelling and functional maturation. We present a case of a neonate presenting with early-onset cardiomyopathy, neutropenia and failure to thrive with no family history of cardiac diseases.

Treatment of Mycobacterium tuberculosis infected macrophages with Rifabutin loaded β-glucan microparticles induces macroautophagy mediated bacillary killing.

Tuberculosis (TB), attributable to Mycobacterium tuberculosis (M.tb.), constitutes a formidable global health challenge, particularly with the proliferation of multidrug-resistant (MDR-TB) strains.