Demography of brain stem death and factors leading to successful consent for organ donation.

Background: There is a widening gap between the patients requiring transplants in proportion to the availability of organs donated. After brain stem death (BSD), counselling for consent is mandatory and if successful, and viable organs are recovered. A low consent rate for donation results in failed donation in a number of potential donors.

Using Doppler duplex ultrasound to determine hemodynamic alterations in renal vasculature: Crucial pathophysiological event preceding renal dysfunction in decompensated cirrhosis.

Background: Renal dysfunction is a watershed event in cirrhosis, often preceded by renal vasoconstriction. However, our reliability on elevated serum creatinine often delays interventions. Measurement of Renal Resistive Index (RI) and Renal Venous Stasis Index (RVSI) by Doppler ultrasound offers insight into renal vasoconstriction.

Inflammatory biomarkers and adverse outcome in COVID-19: Prelude for future viral pandemics.

Background: Dysregulated inflammatory response plays a key role in the pathogenesis of COVID-19. The role of inflammatory markers to predict adverse clinical outcome is still controversial. The aim of this study was to analyze the association of inflammatory markers with disease outcomes independent of the effect of age and co-morbidities.

A cross-sectional study to estimate the cost of managing patients with acute on chronic liver failure at a tertiary care centre.

Background: Acute-on-chronic liver failure (ACLF) is a life threatening disease. This study seeks to identify factors that contribute to greater financial burden in ACLF.

Methods: In total, 55 patients were included.

Protected or not? Hepatitis B vaccination status among healthcare workers and the level of protection post-vaccination.

Background: Hepatitis B virus infection is one of the major concerns in global health care. With a far-reaching health, social, economic impact, preventive strategies form the cornerstone of its management. Knowledge about vaccination status and protection rendered thereof would aid in more wholesome management among highrisk population groups like healthcare workers.

Disseminated talaromycosis: Truly uncommon or uncommonly recognized?

34 years old male from north-east India, a known case of retroviral disease, presented with shortness of breath and significant weight loss and was found to have pancytopenia, skin lesions, organomegaly, generalized lymphadenopathy, cavitary lung disease with very low CD4 counts. He failed to improve on empirical antitubercular therapy and further evaluation revealed features of disseminated talaromycosis on bone marrow studies. We hereby present an interesting case of a systemic fungal disease in the setting of advanced HIV infection.

Endoscopic ultrasound-guided pancreatic fluid collection drainage: Where are we?

Pancreatic fluid collections (PFCs) result from injury to the pancreas from acute or chronic pancreatitis, surgery, or trauma. Management of these collections has evolved over the last 2 decades. The choice of interventions includes percutaneous, endoscopic, minimally invasive surgery, or a combined approach.

Chronic hepatitis B and occult infection in chemotherapy patients - evaluation in oncology and hemato-oncology settings: The CHOICE study.

Background: Reactivation of hepatitis B virus (HBV) infection is a well-known risk that can occur spontaneously or following immunosuppressive therapies, including cancer chemotherapy. HBV reactivation can cause significant morbidity and even mortality, which are preventable if at-risk individuals are identified through screening and started on antiviral prophylaxis.

Aim: To determine the prevalence of chronic HBV (CHB) and occult HBV infection (OBI) among oncology and hematology-oncology patients undergoing chemotherapy.

Unknown presentation of a rare genetic disorder: Monogenic diabetes in young type 4 presenting with hepatic cysts and procoagulant state.

Maturity onset diabetes in young (MODY) is the most common form of monogenic diabetes, which characteristically presents in adolescents and young adults. Till date, pathogenic variations involving 14 different genes have been causally implicated with the development of MODY. Maturity onset diabetes in young type 4 (MODY-4) is a very rare form of MODY.

Diabetes mellitus as a consequence of acute severe pancreatitis: Unraveling the mystery.

The occurrence of diabetes mellitus (DM) in pancreatitis is being increasingly recognized lately. Diabetes can develop not only with chronic pancreatitis but even after the first episode of acute pancreatitis (AP). The incidence of diabetes after AP varies from 18% to 23% in 3 years and reaches up to 40% over 5 years.

Coexistence of human immunodeficiency virus infection and autoimmune hepatitis: A double trouble.

A wide spectrum of hepatobiliary manifestations occur in Human Immunodeficiency Virus (HIV)-infected patients. Among the common causes are the infectious hepatitis, drug-related hepatitis, opportunistic infections, non-alcoholic steatohepatitis, HIV cholangiopathy and neoplasm. Auto-immune hepatitis (AIH) is rarely reported in this setting.

Real-world experience of monoclonal antibodies in mild-to-moderate COVID-19 patients at a tertiary care center.

Background: Neutralizing antibodies cocktail (casirivimab and imdevimab) has received emergency use authorization recommendation by Food and Drug Administration (FDA) and WHO for mild-to-moderate COVID-19 infection in specific high-risk groups. Antibodies cocktail has shown promising results in preventing progression to severe disease, but the real-world experience is still evolving. Herein, we present a retrospective analysis of 22 patients who were administered the antibodies cocktail between August 2021 and March 2022 at our tertiary care center.

Controversies in the management of acute pancreatitis: An update.

This review summarized the current controversies in the management of acute pancreatitis (AP). The controversies in management range from issues involving fluid resuscitation, nutrition, the role of antibiotics and antifungals, which analgesic to use, role of anticoagulation and intervention for complications in AP. The interventions vary from percutaneous drainage, endoscopy or surgery.

The prevalence of osteoporosis and its association with serum testosterone and serum vitamin D in the elderly male population: A cross-sectional study.

Background: Male osteoporosis is under-diagnosed and poorly studied. With the ageing population, osteoporotic fracture in men is an emerging health problem. The aim of this study was to study the prevalence of osteoporosis and its association with serum testosterone and serum vitamin D in elderly men (>60 years old) attending the outpatient department (OPD).

Association of promoter methylation status of NRF2 and PNPLA3 genes in alcoholic liver disease.

Background: Alcoholic liver disease (ALD) is the leading cause of chronic liver disease. In the liver, metabolism of alcohol occurs through multiple mechanisms and it results in the generation of various toxic products. Multiple genetic causes have been identified that are associated with the development and progression of ALD.

Anemia in cirrhosis: An underestimated entity.

Anemia in a patient with cirrhosis is a clinically pertinent but often overlooked clinical entity. Relevant guidelines highlight the algorithmic approach of managing a patient of cirrhosis presenting with acute variceal hemorrhage but day-to-day management in hospital and out-patient raises multiple dilemmas: Whether anemia is a disease complication or a part of the disease spectrum? Should iron, folic acid, and vitamin B complex supplementation and nutritional advice, suffice in those who can perform tasks of daily living but have persistently low hemoglobin. How does one investigate and manage anemia due to multifactorial etiologies in the same patient: Acute or chronic blood loss because of portal hypertension and bone marrow aplasia secondary to hepatitis B or C viremia? To add to the clinician's woes the prevalence of anemia increases with increasing disease severity.

Current and emerging therapeutic strategies in pancreatic cancer: Challenges and opportunities.

Pancreatic carcinoma (PC) is one of the leading causes of cancer-related deaths worldwide. Despite early detection and advances in therapeutics, the prognosis remains dismal. The outcome and therapeutic approach are dependent on the stage of PC at the time of diagnosis.

Hepatitis B vaccination in Indian children: Seroprotection and age-related change in antibody titres.

Background: Childhood immunization against hepatitis B is one of the most effective strategies for reducing the global burden of chronic hepatitis B infection and its sequelae. There are limited data from India on both the anti-Hep B antibody titres in children after vaccination and the age-related decline in the titres. This study was planned to estimate the proportion of children in the age group of 1-10 years who develop protective levels of anti-hepatitis B antibodies after childhood vaccination and to examine the change in antibody titres with age in these children.

Profile of Hepatobiliary Dysfunction in Hematopoietic Stem Cell Transplant Recipients - An Indian Perspective.

Background/aims: Hematopoietic stem cell transplantation (HSCT) is an established curative modality for various hematological malignancies and other diseases. Hepatobiliary dysfunction and subsequent sequelae constitute a common cause of morbidity and mortality in post-transplant scenario. However, data among Indian HSCT recipients is lacking.