Hydroureteronephrosis due to a misplaced suprapubic catheter.

Unintentional ureteral catheterisation, especially during the placement of suprapubic catheters, is extremely rare. We present a case of a suprapubic catheter misplaced in the left ureter leading to hydroureteronephrosis in a paediatric patient with history of complex pelvic fracture with urethral distraction defects after a motor vehicle accident. We highlight that emergent imaging evaluation and timely intervention saved us from the potential catastrophe.

A protocolised approach provides a favourable outcome in patients with severe pelvic trauma.

Background Pelvic fractures are often a result of injuries caused by a major force and lead to considerable morbidity and mortality. Despite advances in acute management protocols involving angioembolization as a prime intervention, mortality in complex pelvic fractures remains high. We analysed our experience with the outcomes of a pelvic trauma management protocol using surgical haemostatic techniques over 5 years.

Clinical determinants for survival following emergency thoracotomy in trauma patients: An 8-year experience from a level 1 trauma center.

Purpose: Emergency thoracotomy (ET) is a life-saving procedure performed during emergency resuscitation of patients in extremis. The controversy around such an invasive and resource-consuming procedure still lingers after so many years of its introduction. ET can serve as one of several indicators of trauma center efficiency and with information about the trauma system's overall preparedness, resources, and training.

Adoption of the New Nomenclature of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) by the Indian National Association for Study of the Liver (INASL): Implications for the INASL Guidance Paper on NAFLD.

The transition from nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated steatotic liver disease (MASLD) reflects a paradigm shift in hepatology, emphasising metabolic dysfunction as the central driver in patients with MASLD. This inclusive terminology, endorsed by over 70 international organisations including the Indian National Association for Study of the Liver (INASL), reduces stigma of 'fatty and alcohol' and allows the co-existence of other liver disease etiologies along with MASLD. In the present commentary, we discuss the implications of the adoption of new nomenclature of MASLD on the INASL guidance paper on NAFLD, which was published in 2023, before the Delphi consensus on MASLD.

Outcome of Kidney Alone Transplantation in Patients with End Stage Kidney Disease with Compensated Cirrhosis.

Background: There is a lack of data regarding the need for liver transplantation in end-stage kidney disease (ESKD) patients with compensated cirrhosis. Overall outcomes of isolated kidney transplants in these patients in terms of renal graft outcome, hepatic decompensation, and survival are less clear.

Materials And Methods: This is the retrospective analysis of patients treated at a single center.

Pathophysiological underpinnings of metabolic dysfunction-associated steatotic liver disease.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is emerging as the leading cause of chronic liver disease worldwide, reflecting the global epidemics of obesity, metabolic syndrome, and type 2 diabetes. Beyond its strong association with excess adiposity, MASLD encompasses a heterogeneous population that includes individuals with normal body weight ("lean MASLD") highlighting the complexity of its pathogenesis. This disease results from a complex interplay between genetic susceptibility, epigenetic modifications, and environmental factors, which converge to disrupt metabolic homeostasis.

Consensus guidelines for the diagnosis and management of metabolic dysfunction-associated steatotic liver disease in adult Asian Indians with type 2 diabetes.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as a critical health concern among Asian Indians with type 2 diabetes (T2D), characterized by particularly high prevalence and risk of progression. The need for specific guidelines addressing this dual epidemic is vital, given the adverse metabolic characteristics of Asian Indians.

Methods: A comprehensive literature review was conducted across major databases (PubMed, Embase, Cochrane Library, and Google Scholar) up to December 2024.

LTSI Consensus Guidelines: Preoperative Cardiac Evaluation in Adult Liver Transplant Recipients.

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality among LT candidates and accounts for up to 40% of the overall mortality within one month. It is influenced by traditional and nontraditional risk factors related to end-stage liver disease. A large proportion of CLD patients have underlying cardiovascular disease (CVD) especially if the etiology is metabolic associated steatohepatitis.

A pilot study on hemodynamically stable isolated chest trauma patients reveals dysregulation of oxidative metabolism.

Background: Metabolomic dysregulation precedes clinical deterioration following injury. However, despite receiving comparable treatment, patients with similar injury severity often follow different clinical trajectories and outcomes.

Methods: This prospective cohort study at a level 1 trauma centre screened 4541 acutely injured patients with chest trauma between September 2019 and February 2023.

Acute-on-chronic liver failure (ACLF): the 'Kyoto Consensus'-steps from Asia.

Acute-on-chronic liver failure (ACLF) is a condition associated with high mortality in the absence of liver transplantation. There have been various definitions proposed worldwide. The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set in 2004 on ACLF was published in 2009, and the "APASL ACLF Research Consortium (AARC)" was formed in 2012.

Knowledge, attitude, and reasons for non-uptake of human papilloma virus vaccination among nursing students.

Background: Cervical cancer is a significant health issue, especially in low- and middle-income countries like India, where it ranks fourth among women. The Human papillomavirus (HPV) vaccination, a vital preventive measure, has suboptimal uptake among nursing students. We aimed to assess the level of knowledge, attitudes, willingness, and reasons for non-uptake of HPV vaccination among nursing students.

Ionised calcium levels during trauma resuscitation in predicting outcomes-a prospective cohort study.

Background: Haemorrhage remains the leading cause of preventable mortality following trauma, often aggravated by the acidosis, hypothermia and coagulopathy-the lethal triad of trauma. However, the impact of trauma-induced hypocalcemia on the haemorrhage remains unclear. It is intuitive to consider perturbations of ionised calcium early during trauma resuscitation in acutely injured patients given its pathophysiological significance for an improved outcome.

Relevance of intra-abdominal pressure monitoring in non-operative management of patients with blunt liver and splenic injuries.

Purpose: Non-operative management (NOM) has been validated for blunt liver and splenic injuries. Literature on continuous intra-abdominal pressure (IAP) monitoring as a part of NOM remains to be equivocal. The study aimed to find any correlation between clinical parameters and IAP, and their effect on the NOM of patients with blunt liver and splenic injury.

Role of low-pressure negative pleural suction in patients with thoracic trauma - a randomized controlled trial.

Background: Thoracic trauma frequently includes a pneumothorax, hemothorax, or hemopneumothorax, which may necessitate an Intercostal drainage (ICD) for air and fluid evacuation to improve breathing and circulatory function. It is a simple and life-saving procedure; nevertheless, it carries morbidity, even after its removal. Efforts have been made continuously to shorten the duration of ICD, but mostly in non-trauma patients.

Benefits of Rib Fixation Utilizing Low-Cost Materials: A Randomized Pilot Trial.

Introduction: Surgical stabilization of rib fractures (SSRF) using standard rib plating systems has become a norm in developed countries. However, the procedure has not garnered much interest in low-middle-income countries, primarily because of the cost.

Methods: This was a single-center pilot randomized trial.

Cytomegalovirus Duodenitis Causing Persistent Hypoalbuminemia and Ascites After Liver Transplantation.

A 44-year-old male had persistent hypoalbuminemia and ascites after liver transplantation. Imaging of the liver and gastrointestinal system was normal. Urine examination was negative for proteinuria.

Managing HBV and HCV Infection Pre- and Post-liver Transplant.

Hepatitis B and C are common causes of end-stage liver disease and etiologies of liver transplantation. It is important to prevent recurrence in cases of hepatitis B. Nucleos(t)ide analogs are the mainstay of HBV treatment before (in patients with decompensated cirrhosis) and after liver transplantation.