Fundic gland adenocarcinoma.

Gastric malignancy is one of the most common malignancies diagnosed worldwide. Over the past many decades, extensive research has been made into the risk factors, pathogenesis and prognosis of gastric adenocarcinoma. However, gastric adenocarcinoma of the fundic gland (GA-FG) has been recently defined, and not much is known about its risk factors and pathogenesis.

Hypertension in Young Adults: Treat It Before It's Too Late.

Hypertension affects a major part of the world population and is one of the leading modifiable risk factors for cardiovascular disease. Its prevalence is increasing in all age groups due to various factors, which include poor lifestyle. Among young people, it poses a special challenge and needs critical reappraisal.

Endovascular Treatment of Ruptured Broad-Necked Intracranial Aneurysms with Double Microcatheter Technique: Case Series with Brief Review of Literature.

 Treatment of ruptured broad-necked intracranial aneurysms by endovascular therapy is technically burdensome. It is commonly treated with stent- and balloon-assisted coils embolization. The aim of this study was to evaluate clinical and radiological outcomes following double micro-catheter (MC) technique.

Brachytherapy With Modified Rotte-y Applicator for Inoperable Endometrial Cancer: A Case Report.

The preferred treatment for medically inoperable early-stage endometrial cancer (EC) is definitive radiation therapy (RT), either in the form of brachytherapy (BT) alone or in combination with external beam radiotherapy (EBRT). This case report details a modified brachytherapy approach for a 59-year-old female patient who was known to have multiple comorbidities, poor performance status, and progressive slowness in activities of daily living. She presented with a complaint of post-menopausal bleeding per vaginum, for which she underwent investigations and was diagnosed with a case of endometrial adenocarcinoma, International Federation of Gynecology and Obstetrics (FIGO) stage IA and grade I.

Anesthetic challenges in pediatric robot-assisted surgeries.

With the advent of minimally invasive surgeries, robot-assisted techniques have gained popularity because they overcome various shortcomings of standard laparoscopic surgeries. Despite the associated costs and limitations among the pediatric population, surgeon comfort due to the ergonomic design, in combination with enhanced three-dimensional high-fidelity imaging and tissue handling, may offer better surgical and postoperative outcomes. However, robotic surgeries require innovations with regard to patient positioning and the overall arrangement of operative equipment and personnel.

Cytomegalovirus Infections in Hematopoietic Stem Cell Transplant: Moving Beyond Molecular Diagnostics to Immunodiagnostics.

Human CMV, regularly reactivated by simple triggers, results in asymptomatic viral shedding, powerful cellular immune responses, and memory inflation. Immunocompetent individuals benefit from a robust immune response, which aids in viral management without causing clinically significant illness; however, immunodeficient individuals are always at a higher risk of CMV reactivation and disease. Hematopoietic stem cell transplant (HSCT) recipients are consistently at higher risk of CMV reactivation and clinically significant CMV illness due to primary disease, immunosuppression, and graft vs.

Sublingual Administration of Tacrolimus is Safe and Provides Similar Drug Exposure to Per-oral Route in Liver Transplant Recipients During Early Postoperative Period-A Large, Retrospective, Observational Study.

Background/aims: Per-oral (PO) administration of tacrolimus (TAC) results in inadequate trough levels in the early postoperative period in liver-transplant (LT) recipients who undergo Roux-en-Y hepaticojejunostomy for biliary reconstruction. Sublingual administration (SL) of tacrolimus provides an alternative route in such patients.The objectives of this study were to assess the feasibility and safety of SL tacrolimus in adult LT-recipients in the early postoperative period and to compare therapeutic efficacy of SL administration of tacrolimus versus PO route.

An Interesting Case of Hypogammaglobulinemia Caused by the Combined Effect of Rituximab Infusion and Common Variable Immunodeficiency (CVID).

This case report is about a patient who presented with bilateral fungal pneumonia. He had a background of viral hepatitis-E infection five years ago, non-Hodgkin lymphoma in remission for four years, and a severe COVID-19 infection three years ago. He was found to have a common variable immune deficiency (CVID) in the background of long-standing hypoglobulinemia, which had never been evaluated.

Need for Advocacy Around Eating Right: A Call for Reducing the Burden of Malnutrition-A Pilot Study.

Background: Adequate nutrition status is imperative for overall health and well-being, although numerous challenges impede its attainment. Various sociodemographic determinants significantly influence an individual's nutrition status, particularly those of women.

Methods: In this pilot study, the dietary patterns of 105 women were collected using the modified version of the FIGO nutrition checklist, along with their sociodemographic details to determine the enablers and barriers to their right nutrition.

A multicentre prospective registry of one thousand sepsis patients admitted in Indian ICUs: (SEPSIS INDIA) study.

Background: Sepsis is a global health problem with high morbidity and mortality. Low- and middle-income countries have a higher incidence and poorer outcome with sepsis. Large epidemiological studies in sepsis using Sepsis-3 criteria, addressing the process of care and deriving predictors of mortality are scarce in India.

Sympathetic Overdrive and Role of Beta-blockers in Various Forms of Heart Failure: A Consensus Statement from India.

In heart failure, sympathetic overdrive is evidenced by norepinephrine spillover, receptor level changes, etc. Beta-blockers continue to be the cornerstone of treatment in patients with chronic heart failure due to their ability to counteract sympathetic overdrive. Extensive clinical research has demonstrated that long-term beta-blocker treatment with metoprolol succinate, carvedilol, or bisoprolol enhances left ventricular function and reverses left ventricular remodeling, decreases hospitalization risk, and increases survival.

Management of Spinal Langerhans Cell Histiocytosis in Children: A Systematic Review.

Background: Spinal Langerhans cell histiocytosis can manifest as solitary site unifocal form or as systemic form in children. The management options for solitary spinal site unifocal form are many. They include spontaneous resolution of the lesion and supervised treatment, steroid injection of the lesion, systemic chemotherapy, radiation therapy and surgery.

Adrenal Hemorrhage as a Complication of Plug-assisted Retrograde Transvenous Obliteration of Gastrorenal Shunt Managed by Adrenal Artery Embolization: A Case Report.

We describe a patient who underwent plug-assisted retrograde transvenous obliteration for gastric varices. After the procedure, the patient developed hypotension and tachycardia. Contrast-enhanced computed tomography showed a left adrenal hematoma.

Treatment optimisation for blood pressure with single-pill combinations in India (TOPSPIN) - Protocol design and baseline characteristics.

Background: The burden of over 300 million individuals living with hypertension in India is increasing steadily. Most current guidelines recommend initial combination therapy for effective blood pressure (BP) control. However, there is no randomised evidence to inform which combinations to use in the South Asian population, who account for over one-quarter of the world's population.

Incidence and Prognostic Significance of Arrhythmia in Acute Myocardial Infarction Presentation: An Observational Study.

Background Arrhythmias are well-recognized complications of acute myocardial infarction (AMI) and are an important risk factor for mortality in both men and women across a wide age range. Aim This study aims to analyze the incidence of arrhythmia in patients with AMI with respect to age, gender distribution, and location of AMI and also to evaluate the prognostic factors of mortality in patients with AMI. Methods This prospective, observational, and cross-sectional study included 300 patients admitted within an hour of the presentation of AMI at a Super Speciality Hospital, MGMMC (Mahatma Gandhi Memorial Medical College), Indore, after fulfilling the inclusion criteria.

In a cohort of 961 clinically suspected Duchenne muscular dystrophy patients, 105 were diagnosed to have other muscular dystrophies (OMDs), with LGMD2E (variant SGCB c.544A>C) being the most common.

Background: Targeted next generation sequence analyses in a cohort of 961 previously described patients with clinically suspected Duchene muscular dystrophy (DMD) revealed that 145/961 (15%) had variants in genes associated with other muscular dystrophies (OMDs).

Methods: NGS was carried out in DMD negative patients after deletion/duplication analysis followed by WES for No variant cases.

Results: The majority of patients with OMDs had autosomal recessive diseases that included Limb-Girdle Muscular Dystrophies (LGMDs), Bethlem, Ullrich congenital Myopathies and Emery-Driefuss muscular dystrophy.

Comparative Efficacy of Dexlansoprazole, Pantoprazole, Esomeprazole, and Rabeprazole in Achieving Optimal 24-Hour Intragastric pH Control: A Randomized Crossover Study Using Ambulatory pH Monitoring.

Introduction: Proton pump inhibitors (PPIs) regulate gastric acid reflux. Dexlansoprazole's efficacy in prolonging acid suppression compared to conventional PPIs and placebo requires evaluation.

Methods: A prospective, randomized, placebo-controlled, five-way crossover pilot study was conducted on healthy volunteers comparing the potency of dexlansoprazole to conventional PPIs in which five patients were randomized into five treatment cohorts, including dexlansoprazole 60 mg, pantoprazole 40 mg, esomeprazole 40 mg, rabeprazole 20 mg, and placebo, assessing 24-hour intragastric pH using Z/pH Recorder (ZepHr®, Diversatek, Inc.

C3 glomerulopathy: a kidney disease mediated by alternative pathway deregulation.

C3 glomerulopathy (C3G) is an ultra-rare complement-mediated kidney disease caused by to the deregulation of the alternative pathway (AP) of proximal complement. Consequently, all effector loops of the complement are active and can lead to pathologies, such as C3a- and C5a-mediated inflammation, C3b opsonization, surface C3b-mediated AP C3 convertase assembly, C3 cleavage product deposition in the glomerulus, and lytic C5b-9/MAC cell damage. The most common pathologic mechanisms are defective chronic alternative pathway deregulation, mostly occurring in the plasma, often causing C3 consumption, and chronic complement-mediated glomerular damage.

A Study on Radiation Level at the Treatment Plane Due to Induced Activity in Linear Accelerator Head.

Background: The induced activity is produced in the target, monitor chamber, flattening filter (FF), collimating jaws, etc., when a high-energy photon beam is utilized for radiation therapy. This may result in add-on exposure to radiation professionals.

Ki-67 With MRI in Predicting the Complete Pathological Response Post-neoadjuvant Chemotherapy.

Neoadjuvant chemotherapy (NAC) is increasingly used for high-risk breast cancer to achieve pathologic complete response (pCR), an indicator of event-free survival and favorable survival outcomes. Integrating MRI and Ki-67 biomarker analysis into predictive models offers a promising approach to optimize NAC response assessment and guide personalized treatment strategies. This study evaluates the validity of combined MRI and Ki-67 metrics for predicting pCR.

Promising role of Voxelotor in managing sickle cell disease in children: a narrative review.

Sickle cell disease (SCD) is characterized by chronic hemolytic anemia and intermittent vaso-occlusive crises. To date, four disease-modifying drugs have been approved for the treatment of SCD: hydroxyurea (an S-phase inhibitor), L-glutamine (an amino acid), crizanlizumab (a P-selectin inhibitor), and voxelotor (a hemoglobin S polymerization inhibitor). Preclinical studies suggested that voxelotor effectively treats SCD and sickle cell anemia (SCA).