Exploratory clinical subgroup clustering in systemic sclerosis: Results from the Indian Progressive Systemic Sclerosis Registry.

Objective: To conduct an exploratory cluster analysis of systemic sclerosis patients from the baseline data of the Indian systemic sclerosis registry.

Methods: Patients satisfying American College of Rheumatology-European League Against Rheumatism classification criteria for systemic sclerosis were included. The clusters formed using clinical and immunological parameters were compared.

Evaluation of Mitral-Aortic Flow Velocity Integral Ratio as a Tool to Differentiate Between Severe and Nonsevere Mitral Regurgitation.

Objectives: To evaluate mitral-aortic flow velocity integral ratio (MAVIR) as an echocardiographic tool to differentiate between severe and nonsevere mitral regurgitation (MR), compared with regurgitant volume (RVol) and effective regurgitant orifice area (EROA), with subgroup analysis in patients with calcific mitral valve, both by transthoracic (TTE) and transesophageal (TEE) echocardiography. Also, whether MAVIR can be used as a screening tool for severe MR.

Design: Prospective, cross-sectional, observational.

Comparison Among Ultrasound-Guided Thoracic Paravertebral Block, Erector Spinae Plane Block and Serratus Anterior Plane Block for Analgesia in Thoracotomy for Lung Surgery.

Background: To compare the analgesic efficacy and safety of preoperative, single-shot ultrasound-guided thoracic paravertebral block (TPVB), erector spinae plane block (ESB), and serratus anterior plane block (SAPB) in thoracotomy pain.

Design: A prospective, randomized study.

Setting: The cardiothoracic operating room and intensive care unit of a tertiary-care hospital in India.

Clinical and psychosocioeconomic impact of COVID-19 pandemic on patients of the Indian Progressive Systemic Sclerosis Registry (IPSSR).

Objectives: The aim was to determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on access to health care among patients with scleroderma and to analyse the economic and psychosocial impacts and the infection prevention measures taken by them during the pandemic.

Methods: A 25-item questionnaire designed to assess the components of the objectives was tele-administered between October 2020 and January 2021 to the patients enrolled in the Indian Progressive Systemic Sclerosis Registry.

Results: Of the 428 patients in the registry, 336 took part in the study.

Assessment of Right Ventricular Function by Newer Imaging in Echocardiography in Idiopathic Pulmonary Arterial Hypertension.

Background: The aims of the study were to assess the right ventricular (RV) functions in patients with idiopathic pulmonary arterial hypertension (IPAH) with RV longitudinal strain (RVLS) in addition to conventional parameters, as well as its correlation with severity and prognosis in IPAH.

Methods: Twenty-two IPAH patients were followed up for 1 year. ANOVA and Gabriel's pairwise comparison tests were used for comparison of RVLS with respect to WHO functional class status.

Evaluation of Percutaneous Vertebroplasty for Management of Symptomatic Osteoporotic Compression Fracture.

Introduction: Osteoporotic vertebral compression fractures are a leading cause of disability and associated morbidities among Indian population. Worldwide, approximately 20% of elderly population above 70 years and 16% of postmenopausal women are suffering from it. Vertebral compression fractures should be aggressively treated with minimally invasive techniques such as Percutaneous Vertebroplasty (PVP) or Percutaneous Kyphoplasty (PKP) to minimize pain and disability associated with it.

Laparoscopic Vesicovaginal Fistula Repair with Limited Cystotomy: A Rewarding Treatment Option.

Introduction: Vesicovaginal fistula (VVF) is the most common type of urogenital fistula. Gynecologic surgery is the most common cause associated with it. Laparoscopic approach for VVF repair gives the benefit of minimally invasive surgery with principles similar to open transabdominal approach.

Evaluation of Long Term Effect of RV Apical Pacing on Global LV Function by Echocardiography.

Introduction: We very often face pacemaker implanted patients during follow-up with shortness of breath and effort intolerance inspite of normal clinical parameters.

Aim: The aim of our study is to evaluate the cause of effort intolerance and probable cause of sub-clinical Congestive Cardiac Failure (CCF) in a case of long term Right Ventricular (RV) apical pacing on global Left Ventricular (LV) function non- invasively by echocardiography.

Materials And Methods: We studied 54 patients (Male 42, Female 12) of complete heart block (CHB) with RV apical pacing (40 VVI and 14 DCP).

Synchronous Jejunal Metastasis Presenting as Intussusception in a Case of Advanced RCC: a Rare Presentation.

Renal cell carcinoma (RCC) may metastasize to almost any organ, but metastasis to the small bowel is very rare. Factors responsible for a resistant behavior of small bowel wall are still not clear. Small bowel metastasis from RCC may cause obstruction, bleeding, and perforation.

Oxygen-18 isotope of breath CO₂ linking to erythrocytes carbonic anhydrase activity: a biomarker for pre-diabetes and type 2 diabetes.

Carbonic anhydrase (CA), a well-characterized metalloenzyme, is associated with oxygen-18 ( (18)O)-isotopic fractionations of CO₂. To investigate how CA activity links the (18)O of breath CO₂ to pre-diabetes (PD) and type 2 diabetes (T2D) during metabolism, we studied pre- and post-dose CA activities in erythrocytes with simultaneous monitoring of (18)O/ (16)O-isotope ratios of breath CO₂ and thereafter elucidated potential metabolic pathways underlying CA alteration in the pathogenesis of T2D. Here we show that the post-dose CA activity in both T2D and PD was markedly enhanced, whereas the non-diabetic controls (NDC) exhibited a considerable reduction in post-dose CA activity when compared with their basal CA activities.

Pulsatile scalp swelling.

Metastasis from follicular carcinoma is usually blood-borne. Here, we present a case of skull metastasis with intracranial extension presenting as a pulsatile scalp swelling from the follicular thyroid carcinoma.

Natriuretic peptides: Diagnostic and therapeutic use.

Natriuretic peptides (NPs) are hormones which are mainly secreted from heart and have important natriuretic and kaliuretic properties. There are four different groups NPs identified till date [atrial natriuretic peptide (ANP), B-type natriuretic peptide (BNP), C-type natriuretic peptide (CNP) and dendroaspis natriuretic peptide, a D-type natriuretic peptide (DNP)], each with its own characteristic functions. The N-terminal part of the prohormone of BNP, NT-proBNP, is secreted alongside BNP and has been documented to have important diagnostic value in heart failure.

Life-threatening haemothorax: a rare presentation of pulmonary arteriovenous malformation.

Arteriovenous malformations of the lung are rare pulmonary vascular disorders which can suddenly lead to life threatening complications. Haemothorax due to rupture of a pulmonary arteriovenous malformation (PAVM) is very rare. We report here a case of a 39 year-old lady who presented with an acute onset of shortness of breath due to right-sided massive haemothorax and was subsequently detected to have pulmonary as well as cerebral arteriovenous malformation (CAVM).

Posterior mediastinal biphasic synovial sarcoma in a 12 year-old boy: a case report and review of literature.

We report a case of biphasic synovial sarcoma of the mediastinum, a very rare tumor, in a 12-year-old boy with left-sided chest pain of 3 years duration at presentation. Chest X-ray showed left-sided opacity with loss of cardiac silhouette and the mediastinum deviated to the opposite side. Computed tomography (CT) of thorax showed left-sided posterior mediastinal mass with left-sided pleural effusion and pleural thickening.

Proportionate increase in incidence of colorectal cancer at an age below 40 years: an observation.

Aim: Colorectal cancer is particularly a disease affecting individuals above 40 years of age and 90% of cases occur in persons over the age of 50. Genetic and familial factors, viz, HNPCC and FAP, contribute to less than 20% and environmental or acquired factors are the cause of the rest. The aim of this study is to find out the relative proportion of patients < 40 years of age affected by this disease, registered in our institute.

A young male with paraplegia, massive cervical adenopathy and nondiagnostic biopsy specimens.

An 18-year-old man presenting with paraplegia due to spinal epidural infiltration at D6-D7 underwent laminectomy and spinal decompression followed by near-complete resolution of neurological symptoms; but this resolution was followed by progressively enlarging cervical lymph nodes. Leucocytosis, an elevated erythrocyte sedimentation rate, a marked polyclonal hypergammaglobulinemia and a moderate hepatosplenomegaly were found. The diagnosis of sinus histiocytosis with massive lymphadenopathy (SHML), also known as Rosai-Dorfman disease was established histologically by lymph node biopsy about 2 years after presentation.

FIbrous dysplasia of right upper jaw - uncommon presentation.

30 years, male patient presented with huge nasal mass for 25 years and nasal obstruction for 15 years. On examination, a mass of 10" × 8 " size found involving the right side of face, nose, cheek, orbit and palate. The right eye was proptosed eccentrically and was completely blind.