109 results match your criteria: "VPS Lakeshore Hospital[Affiliation]"

Since the Asian Pacific Association for the Study of the Liver (APASL) published guidelines on non-cirrhotic portal fibrosis/idiopathic portal hypertension in 2007, there has been a surge in new information, especially with the introduction of the term porto-sinusoidal vascular disorder (PSVD). Non-cirrhotic intra-hepatic causes of portal hypertension include disorders with a clearly identifiable etiology, such as schistosomiasis, as well as disorders with an unclear etiology such as non-cirrhotic portal fibrosis (NCPF), also termed idiopathic portal hypertension (IPH). This entity is being increasingly recognized as being associated with systemic disease and drug therapy, especially cancer therapy.

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  • The study aimed to find out how common chronic liver disease is among adult Asian Indians using ultrasound shear wave elastography (SWE) in preventive radiology clinics.
  • Researchers measured liver stiffness in 1,145 participants and found that about 10.65% had advanced chronic liver disease, with 22.79% showing signs suggestive of this condition.
  • The findings highlight that chronic liver disease is linked to various comorbidities and risk factors, indicating a need for preventative strategies based on liver stiffness measurements.
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Evolving Global Etiology of Hepatocellular Carcinoma (HCC): Insights and Trends for 2024.

J Clin Exp Hepatol

August 2024

Departments of Gastroenterology, VPS Lakeshore Hospital, Kochi, 682040, India.

The epidemiology of HCC is changing all over the world and the incidence of HCC is expected to continue increasing over the next 30 years. The changes are in the predisposing factors. Hepatitis B and hepatitis C as predisposing etiologies are decreasing while NAFLD/MAFLD is increasing.

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 The aim of this study was to determine the normative percentiles for liver stiffness measurement (LSM) using shear wave elastography in an adult Asian Indian population as part of the preventive radiology initiative of the Indian Radiological and Imaging Association (IRIA).  LSMs were ascertained by two-dimensional (2D) shear wave elastography using the Mindray Resona series of ultrasound machines. The image quality was assessed using the motion stability index (M-STB) and reliability (RLB) map.

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Unlabelled: This position statement is documented based on the input from all contributing coauthors from the Indian Society of Critical Care Medicine (ISCCM), following a comprehensive literature review and summary of current scientific evidence. Its objective is to provide the standard perspective for the management of potential organ/tissue donors after brain death (BD) in adults only, regardless of the availability of technology. This document should only be used for guidance only and is not a substitute for proper clinical decision making in particular circumstances of any case.

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ISCCM Position Statement for Improving Gender Balance in Critical Care Medicine.

Indian J Crit Care Med

August 2024

Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.

Unlabelled: Gender disparity in Critical Care Medicine (CCM) persists globally, with women being underrepresented. Female Intensivists remain a minority, facing challenges in academic and leadership positions at the workplace and within academic societies. The Indian Society of Critical Care Medicine (ISCCM) recognized the need for addressing issues related to gender parity and constituted its first Diversity Equity and Inclusion (DEI) Committee in 2023.

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Timely diagnosis and management of pediatric acute liver failure (PALF) is of paramount importance to improve survival. The Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition invited national and international experts to identify and review important management and research questions. These covered the definition, age appropriate stepwise workup for the etiology, non-invasive diagnosis and management of cerebral edema, prognostic scores, criteria for listing for liver transplantation (LT) and bridging therapies in PALF.

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  • MAFLD (Metabolic Dysfunction-Associated Fatty Liver Disease) is becoming more common, and it can lead to serious liver problems called MAFLD-ACLF, but what affects patient recovery isn't fully known yet.
  • In a study, researchers looked at data from patients with MAFLD-ACLF to understand their health conditions and see who survived after 90 days, finding that about 51% of patients did survive.
  • They discovered new scoring systems to better predict survival, which included factors like diabetes and the causes of liver damage, and these new scores worked better than older ones.
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Background: Recently the peroneus longus tendon (PLT) gained popularity in anterior cruciate ligament (ACL) reconstruction and has been utilized with satisfactory outcomes. However, there are concerns regarding donor site morbidity. This study aims to compare the functional outcome of ACL reconstruction using hamstring (HT) and PLT autografts and evaluate the donor site morbidity.

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Peptide receptor radionuclide therapy (PRRT) is an established therapy for metastatic neuroendocrine neoplasms (NEN). The role of PRRT as a neoadjuvant treatment prior to surgery or other local therapies is uncertain. This scoping review aimed to define the landscape of evidence available detailing the utility of PRRT in the neo-adjuvant setting, including the clinical contexts, efficacy, and levels of evidence.

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  • * A total of 107 patients showed significant improvements in knee function, measured by the Lysholm Knee Scoring Scale and Knee Outcome Sports Activity Scale, with most patients returning to sports activities after treatment.
  • * GACI demonstrated low complication and revision rates, indicating it is a viable option for addressing large cartilage defects in the knee.
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Background: Primary type 2 hyperoxaluria is a very rare genetic disorder, where in the progression to renal failure was assumed to be insidious and not very common. PH2 is due to deficient glyoxylate reductase/hydroxypyruvate reductase (GRHPR), which was thought to have extra-hepatic production also. The progression to renal failure in these patient subgroups is well documented in the Literature and the role of SLK (simultaneous liver and kidney transplantation) has not been clearly established.

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Primary hyperparathyroidism (PHPT) is a common endocrine disease with a variable presentation. There is a recent increase in the number of asymptomatic cases due to the use of multichannel automated analyzers.

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Background: Testicular tumors have many different manifestations. The majority of these cases are presented as an incidental finding during hydrocelectomy. Malignant mesotheliomas are uncommon tumours that can arise from the coelomic epithelium of the pleura, peritoneum, pericardium, and tunica vaginalis.

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Background: In a high-energy medical linear accelerator (linac), if the interaction of photon energy is higher than the neutron binding energy of high atomic material, it emits a neutron field through photonuclear (γ, n) reaction.

Aim: The current study, evaluates the photoneutron dose equivalent (PNDE) produced between the 10 MV flattened and unflattened beams as a function of field sizes in the Elekta Versa HD™ linac.

Materials And Methods: The PNDE produced from Versa linac was recorded along the patient plane using the bubble detector personal neutron dosimeter and from the measured PNDE values, the theoretical PNDE values were simulated for various field sizes using nonlinear least-squares curve-fitting as a function of a polynomial.

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Arthroscopic Arthrolysis of Knee: Timing, Technique and Results.

Indian J Orthop

February 2024

Division of Joint Replacement and Sports Medicine, VPS Lakeshore Hospital, Ernakulam, India.

Aim: To evaluate the functional outcomes of patients undergoing arthroscopic arthrolysis of the knee and find the ideal timing for arthrolysis to achieve maximum range of motion (ROM) of the knee.

Methods: All patients who underwent arthroscopic arthrolysis for post-operative joint stiffness following surgery for injuries around knee joint at a tertiary care centre from 2009 to 2023 were included in this study. The patients' details such as primary injury, time interval between the index surgery and arthrolysis, improvement in knee range of ROM and Lysholm score from prior to arthrolysis to last follow-up post arthrolysis were retrieved from hospital database and analysed.

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Aims And Background: To describe the prevalence of IgA deposits (IgAD) in renal allografts in a cohort of renal transplant recipients and to analyze their management strategies and histopathology. To assess graft function and proteinuria after 1 year of follow-up.

Materials And Methods: A prospective longitudinal follow-up study was carried out in VPS Lakeshore Hospital and Research Centre, Kochi, Kerala, over a period of 5 years (July 2015 to June 2020).

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BK polyoma virus (BKV) belongs to Polyomaviridae family. It is a double-stranded DNA virus. Only a few cases of BKV-associated neurological disease in renal transplant recipients have been reported.

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Introduction: Total hip arthroplasty (THA) has revolutionized the treatment of hip joint arthritis. With the increased popularity and success of the procedure, research has focused on improving implant survival and reducing surgical complications. Optimal component orientation has been a constant focus with various philosophies proposed.

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Introduction: Patients with Paget's disease develop abnormal bony anatomy which can result in significantly altered lower limb alignment predisposing them to early secondary osteoarthritis. Due to the severe extra-articular deformity, total knee arthroplasty (TKA) in these patients is challenging. Conventional knee arthroplasty using intramedullary guides is not an option and can lead to erroneous limb alignment postoperatively.

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Background: There is no robust evidence-based data for ABO-incompatible kidney transplantation (ABOiKT) from emerging countries.

Methods: Data from 1759 living donor ABOiKT and 33 157 ABO-compatible kidney transplantations (ABOcKT) performed in India between March 5, 2011, and July 2, 2022, were included in this retrospective, multicenter (n = 25) study. The primary outcomes included management protocols, mortality, graft loss, and biopsy-proven acute rejection (BPAR).

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Case: We report a patient with intrapelvic prosthetic protrusion associated with infection after hemiarthroplasty for a fracture neck of the femur. We discuss the challenges involved in the management of this complex case with recommendations to manage a vascular injury.

Conclusion: In patients with an intrapelvic prosthesis, thorough preoperative vascular evaluation and vigilant postoperative check are required to prevent a vascular injury.

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Article Synopsis
  • Human small extracellular vesicles (sEVs) from adipose-derived mesenchymal stromal cells show potential in reducing osteoarthritis progression, but must be free from culture medium contaminants for clinical use.
  • A study evaluated the impact of different chemically-defined media (CDMs) on the quantity and purity of sEVs, noting that only CDM4 produced contamination-free sEVs with the best yield.
  • The sEVs derived from CDM4 not only enhanced important cellular functions in human articular chondrocytes but also significantly reduced osteochondral degeneration in a mouse model of osteoarthritis.
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Background: Hepatocellular carcinoma (HCC) is considered uncommon in India. The aim of this study was to document the demographic characteristics and clinical aspects of HCC in Kerala, India.

Methods: A survey of HCC in Kerala was performed.

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Background: Renal tumors constitute approximately 3% of all malignancies in adults. They form a heterogenous group with variable morphological, immunohistochemical, and molecular features.

Aim: The objective of this study was to analyze the spectrum of adult renal tumors at a tertiary care center and study the demographic and histomorphological features.

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