Laparoscopic management of splenogonadal fusion with contralateral crossed ectopic preperitoneal testis presenting as ambiguous genitalia.

We report an extremely rare case of ambiguous genitalia presenting with bilateral non-palpable cryptorchidism and scrotal hypospadias with long-term follow-up. The patient had discontinuous splenogonadal fusion of the left testis and an ectopic preperitoneal right testis located to the left of the urinary bladder. Laparoscopic bilateral orchidopexy was performed after the excision of splenic tissue on the left side.

Insulin glargine supplementation during early management phase in children with diabetic ketoacidosis: a double-blinded randomised controlled trial.

Objective: To evaluate the efficacy and safety of early supplementation with insulin glargine (GI) during the acute management of paediatric diabetic ketoacidosis (DKA).

Design: Double-blinded randomised controlled trial conducted from July 2022 to June 2023.

Setting: Emergency department and paediatric intensive care unit of a tertiary care teaching hospital in North India.

Isolation and Characterization of Cervical Cancer-Associated Mesenchymal Stem Cells From Primary Tumors Using Explant Culture.

Cancer-associated mesenchymal stem cells (Ca-MSCs), an integral part of the tumor microenvironment, play a major role in modulating tumor progression; they have been reported to progress as well as inhibit various cancers, including cervical cancer. To understand the exact role of Ca-MSCs in tumor modulation, it is necessary to have an optimized protocol for Ca-MSCs isolation. This work demonstrates the isolation and expansion of a primary culture of cervical cancer-associated MSCs (CCa-MSCs) from the biopsy sample of cervical cancer patients using the explant culture technique.

Unlocking effective decision-making and critical thinking in orthopaedics: Insights from a narrative review.

Background: Clinical decision-making and critical thinking are vital in orthopaedic practice, directly impacting patient outcomes. Surgeons often face complex cases requiring both experience and systematic reasoning to ensure the best treatment approach. This review aims to explore the factors influencing decision-making in orthopaedics, focusing on the role of critical thinking in enhancing clinical choices.

Expected health risk out of black carbon and particulate matter in the indoor environment of an industrial cluster of chandigarh in India.

The global increase in industrialization and its attendant exponential air pollution has posed a significant hazard to the indoor pollution levels of cities and the associated health risks. This study evaluated the health effects of air pollutants discovered inside the bottling industries in Chandigarh cluster in India. PM PM, PM, and black carbon concentrations in the post-monsoon season were monitored, and associated health implications and lung disease were estimated.

Expression of ALDH1 isotypes and its potential as a prognostic and diagnostic marker in patients with muscle invasive bladder cancer.

ALDH1 isotype is an established cancer stem cell marker. In this study, immunohistochemical (IHC) expression of ALDH1/2 and ALDH1A3 protein was evaluated in a retrospective cohort of 99 pathologically confirmed MIBC patients and 11 distant normal bladder urothelium. IHC expression was assessed quantitatively using histopathology score (H score).

Serum estradiol on the day of final oocyte maturation and outcome of assisted reproduction in women with thyroid autoimmunity.

This retrospective study included 52 euthyroid women (with TAI, n = 26; without TAI, n = 26) undergoing ART. Based on E2 levels on the day of final oocyte maturation (DFOM) they were subdivided into Group A1 (TAI, E2 < 7,000 pmol/l), Group A2 (TAI, E2 > 7,000 pmol/l), Group B1 (no TAI, E2 < 7,000 pmol/l), and Group B2 (no TAI, E2 > 7,000 pmol/l), to compare outcomes related to oocytes, embryos, and pregnancy. Group A2 had significantly more retrieved oocytes than A1, but no difference in good-quality oocytes, retrieved embryos, top-quality embryos, or pregnancy outcomes.

Outcome analysis of surgical complications in pediatric solid tumors: a retrospective clinical study.

Purpose: Postoperative complications can significantly impact patient outcomes and quality of life, particularly in children with solid tumors. These complications may delay the commencement of adjuvant therapy. This study aimed to evaluate the severity and effects of these complications and to validate the Clavien-Dindo classification system in pediatric patients following surgery for solid tumors.

Lightweight versus heavyweight synthetic mesh for inguinal hernia repair.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and risks of lightweight mesh compared with heavyweight mesh in any open mesh-reinforced hernia repair as well as in laparoscopic repair (TAPP, TEP, or robotic TAPP) in adults with an inguinal hernia.

Chordoma: Site-Wise Predilections and Pathological Tenets.

Background: Chordomas are rare tumours of presumptive notochordal origin, mostly occurring in the axial skeleton of the body. These tumours are slow growing but are locally invasive neoplasms. Diagnosis requires qualification of the radiological, histopathological, and immunohistochemical criteria.

Joint Clues to a Silent Killer: Hypertrophic Osteoarthropathy and Lung Cancer.

54-year-old male presented with dyspnea on mild exertion of mMRC grade II, chronic cough, pandigital clubbing (figure 1A) along with painful swelling involving distal part of both forearms for past 1 year. He is a chronic smoker since past 30 years with a smoking index of 680. Investigations revealed anemia of chronic disease with slight A/G reversal.

Posterior Mediastinal Mass With Intracardiac Protrusion: A Diagnostic Conundrum Resolved With Multimodality Imaging.

Background: Posterior mediastinal masses are rare and remain asymptomatic until they enlarge enough to compress vital vascular structures, the tracheobronchial tree, the spine, or cardiac chambers. Computed tomography (CT) and cardiac magnetic resonance (CMR) provide precise locations and characterization of lesions.

Case Summary: A young woman was found to have a cystic mass in the posterior mediastinum extending into the interatrial septum and left atrium (LA) on echocardiography.

Effectiveness of Kushal Maa, a group-based mhealth interactive education and social support intervention for maternal and neonatal health outcomes: study protocol for a multisite randomised controlled trial in India.

Introduction: Perinatal care continuity across the full continuum is essential for optimising maternal and infant health; however, a stark gap occurs post partum, with less than one half of Indian mothers receiving postpartum care due to significant logistical and sociocultural barriers, particularly for periurban and rural residents. To overcome these barriers and reduce women's postpartum isolation, our international team of maternal and infant health clinicians and researchers developed and pilot-tested a culturally-tailored mobile interactive education and support group intervention, ), confirming feasibility and acceptability and preliminary effectiveness. The current study seeks to estimate the effectiveness of the intervention compared with standard care on maternal and neonatal health-related behaviours and health, characterise the mechanisms of intervention impact and evaluate the cost-effectiveness of the intervention in improving postpartum maternal and neonatal health compared with the standard of care.

Prevalence, Concordance, and Risk Factors of Antibiotic Resistance Genes in Breast Milk and Neonatal Oral Cavity of Preterm Mother-Infant Pairs.

Mothers delivering preterm are very often exposed to antibiotics in the peripartum period. We hypothesize this may select bacteria bearing antibiotic resistance genes (ARGs) in the breast milk and be transmitted to the neonate's mouth while feeding. This study aimed to determine the prevalence of ARGs coding for extended-spectrum beta-lactamases (ESBLs) (including AmpC beta-lactamases [ACBLs]) and carbapenemases in breast milk and neonatal oral swab samples of preterm mother-infant pairs, the concordance of ARGs between paired samples, and risk factors of ARGs coding for ESBLs and carbapenemases.

Impact of gut microbiome on atrial fibrillation: Mechanistic insights and future directions in individualized medicine.

Atrial fibrillation (AF) is a growing global health burden, with a prevalence of over 52.55 million cases. Rising disability-adjusted life-years, increasing age, and disparities in care have contributed to the worsening severity and mortality of AF.

Echocardiographic speckle tracking as a tool for detecting acute total occlusion in non-ST-elevation myocardial infarction: a case-control study.

Background: Non-ST-elevation myocardial infarction (NSTEMI) is conventionally attributed to subtotal or transient occlusion. ECG is crucial but has limited sensitivity for detecting acute total occlusion in patients with NSTEMI. We propose that speckle tracking echocardiography-derived indices serve as early indicators of coronary artery occlusion in NSTEMI.

IDEAL: A Comprehensive Virtual Training Program for Pediatric Diabetes Educators in Low-Resource Settings - Structure, Strengths, and Challenges.

Introduction: Pediatric diabetes educators (PDEs) are scarce in low-resource settings (LRSs), compromising diabetes care and increasing morbidity and mortality.

Methods: The Indian Society for Pediatric & Adolescent Endocrinology (ISPAE) developed ISPAE Diabetes Education And Learning (IDEAL), a 12-week virtual program with 24 interactive sessions of 2 h each, 58 faculty members, practical assignments, a rigorous exit exam, and ongoing post-certification engagement via WhatsApp.

Results: Since October 2021, 177 PDEs (128 nonphysicians, 49 physicians) have been trained in 8 batches, 9th batch completing.

Serial Serum Immunoglobulin G Levels and Correlation with Outcomes in Children with Guillain Barre Syndrome.

Objectives: Guillain-Barré Syndrome (GBS) has variable severity, inconsistent therapy response, and uncertain recovery. Intravenous immunoglobulins (IVIG) are used to treat this immune-mediated disorder. The authors investigated serial IgG levels and outcomes in IVIG-treated GBS patients.

Interplay between exercise and neuregulin in providing neuroprotection.

Exercise has been shown to have a positive impact on brain health including neuroprotective function. It has been demonstrated to increase the synthesis of neurotrophic factors, support neuronal survival, and improve neuroplasticity. Concurrently, neuregulin plays a vital role in the development, maintenance, and repair of both the central and peripheral nervous system.

Pituitary incidentaloma: a Pituitary Society international consensus guideline statement.

This Pituitary Society Consensus article presents an evidence-based consensus on the management of pituitary incidentaloma, defined as an unexpected sellar or parasellar finding incidentally discovered on an imaging study that was not performed for a clinically suspected pituitary lesion. Recommendations are offered for when endocrinology, neurosurgery and ophthalmology consultation, dedicated pituitary imaging, pituitary hormone testing and visual assessment are warranted for macroadenomas, microadenomas, cystic lesions and empty sella, as well as when surgical resection is indicated for incidental pituitary adenomas and cystic sellar lesions. Special considerations in patients with multiple endocrine neoplasia type 1, children and adolescents, older people, and pregnant women are addressed.