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Does topical vancomycin prevent fracture-related infections in closed fractures undergoing open reduction and internal fixation?A randomised controlled trial

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Chinese Journal of Traumatology 2024年第2期27卷 71-76页

作者： Mohit Gandhi Gopisankar Balaji Jagdish Menon Ruben Raj Thomas Department of Orthopaedics Jawaharlal Institute of Postgraduate Medical Education and ResearchPondicherryIndia Department of Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education and ResearchPondicherryIndia

Purpose:The role of topical vancomycin in fracture-related infection(FRI)is *** few studies have reported their efficacy in open and high-risk extremity *** study aimed to assess topical vancomycin's role in reducing FRI in closed fractures undergoing open surgical intervention with an ***:This prospective randomized cohort study was carried out between February 2021 to January *** with isolated closed fractures,who were planned for open reduction and internal fixation within 2 weeks from the time of injury were included for this *** data collected included age,gender,socioeconomic status,mechanism of injury,diagnosis,Tscherne classification,and time interval to take up for *** were randomized into the intervention and control groups using the block randomization *** control group received only systemic antibiotic prophylaxis,whereas the intervention group received topical application of vancomycin powder in the surgical wound alongside systemic antibiotic *** primary outcome measure was the incidence of FRI among these *** and radiological findings and culture reports(in cases with infection)were recorded during the post-operative period and at 6 weeks of *** relevant statistical calculations were done using STATA statistical/data analysis-parallel edition version 16.0(StataCorp LLC).The quantitative variables like age and duration of the surgery were assessed for normalcy by Shapiro-Wilk W *** independent samples t-test with equal variances was applied to the age ***'s exact test was used for the analysis of the primary outcome measure(presence of FRI following surgery),and"Risk of FRI"and"Risk difference"between the 2 groups was *** strength of the association between qualitative variables was assessed using the Fisher's exact and Chi-square tests,***:There were 88 patients included in this *** statistical si

关键词： Infections Antibiotics Vancomycin Fractures

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Advancements in medical treatment for pancreatic neuroendocrine tumors:A beacon of hope

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World Journal of Gastroenterology 2024年第12期30卷 1670-1675页

作者： Somdatta Giri Jayaprakash Sahoo Department of Endocrinology and Metabolism Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry605006India

This editorial highlights the remarkable advancements in medical treatment strategies for pancreatic neuroendocrine tumors(pan-NETs),emphasizing tailored approaches for specific *** surgery and somatostatin analogs(SSAs)play pivotal roles in managing tumors,while palliative options such as molecular targeted therapy,peptide receptor radionuclide therapy,and chemotherapy are reserved for SSA-refractory ***,insul-inomas,glucagonomas,carcinoid tumors and VIPomas necessitate distinct thera-peutic *** the genetic basis of pan-NETs and exploring immunotherapies could lead to promising avenues for future *** review underscores the evolving landscape of pan-NET treatment,offering renewed hope and improved outcomes for patients facing this complex disease.

关键词： Pancreatic neuroendocrine tumor medical management Somatostatin analog Immunotherapy Everolimus

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Can we predict the incidence of high-grade Clavien-Dindo complications in patients with forgotten encrusted stents undergoing endourologic management?

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Asian Journal of Urology 2024年第1期11卷 99-104页

作者： Praanjal Gupta Ramanitharan Manikandan Lalgudi Narayanan Dorairajan Kodakattil Sreenivasan Sreerag Sidhartha Kalra Swapnil Singh Kushwaha Department of Urology Jawaharlal Institute of Postgraduate Medical Education and ResearchPondicherryIndia

Objective:Ureteral stents are customarily inserted to facilitate urinary drainage,but they come with their own glitches of being forgotten and/or encrusted leading to serious *** present study aimed to report the complications in patients with forgotten and encrusted stents according to the Clavien-Dindo system specific to urological procedures and identify the factors leading to high-grade(Clavien-Dindo Grade 4A or above)***:The hospital records of patients with forgotten encrusted double-J stents over a period of 8 years were *** parameters recorded included patient demographics,indwelling time,need for percutaneous nephrostomy,hemodialysis,urine culture,blood culture,total blood counts,serum creatinine,radiologic findings,management techniques,number of surgical interventions,modified Clavien-Dindo complications,follow-up,and mortality,if ***:Forty patients were included in the *** median age was 52(range 6-85)*** the total,25(62.5%)patients had a“significant”stent load;31(77.5%)had renal failure or acute kidney injury on presentation;19(47.5%)patients had sepsis at *** the patients presented with sepsis,11(57.9%)patients demonstrated a positive urine culture;and 7/11(63.6%)patients exhibited pan-resistant *** out of 40(30.0%)patients in our series developed high-grade Clavien-Dindo *** univariate analysis,sepsis at presentation(p=0.007),stent load(p=0.031),diabetes(p=0.023),positive urine culture(p=0.007),and stent indwelling time of more than 1 year(p=0.031)were found to be *** multivariate logistic regression analysis,sepsis at presentation(p=0.017)and positive urine culture(p=0.016)were significant predictors for high-grade ***:It is prudent to identify specific risk factors,namely sepsis at presentation and positive urine culture to triage and optimize these patients before surgical management.

关键词： Forgotten Encrusted stent Outcome Predictor Clavien-Dindo complication

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Digital psychiatry in low-and-middle-income countries:New developments and the way forward

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World Journal of Psychiatry 2024年第3期14卷 350-361页

作者： Subho Chakrabarti Department of Psychiatry Postgraduate Institute of Medical Education and ResearchChandigarh 160012UTIndia

Low-and middle-income countries(LMICs)bear the greater share of the global mental health burden but are ill-equipped to deal with it because of severe resource constraints leading to a large treatment *** remote provision of mental health services by digital means can effectively augment conventional services in LMICs to reduce the treatment *** psychiatry in LMICs has always lagged behind high-income countries,but there have been encouraging developments in the last *** is increasing research on the efficacy of digital psychiatric ***,the evidence is not adequate to conclude that digital psychiatric interventions are invariably effective in LMICs.A striking development has been the rise in mobile and smartphone ownership in LMICs,which has driven the increasing use of mobile technologies to deliver mental health *** innovative use of mobile technologies has been to optimize task-shifting,which involves delivering mental healthcare services in community settings using non-specialist health *** evidence from LMICs shows that it is possible to use digital tools to train non-specialist workers effectively and ensure that the psychosocial interventions they deliver are *** these promising developments,many barriers such as service costs,underdeveloped infrastructure,lack of trained professionals,and significant disparities in access to digital services impede the progress of digital psychiatry in *** overcome these barriers,digital psychiatric services in LMICs should address contextual factors influencing the delivery of digital services,ensure collaboration between different stakeholders,and focus on reducing the digital divide.

关键词： Digital psychiatry Low-and middle-income countries Developments Mental health

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Diabetes is affecting everyone everywhere

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World Journal of Diabetes 2024年第2期15卷 305-307页

作者： Parul Chawla Gupta Mona Duggal Arvind Kumar Morya Department of Ophthalmology Post Graduate Institute of Medical Education&ResearchChandigarh 160012PunjabIndia School of Public Health Post Graduate Institute of Medical Education and ResearchChandigarh 160002PunjabIndia Department of Ophthalmology All India Institute of Medical SciencesHyderabad 508126TelanganaIndia

The article titled“Accessibility and Utilization of Healthcare Services Among Diabetic Patients:Is Diabetes a Poor Man’s Ailment?”gave insights into a pandemic systemic disease known as diabetes *** modern-era pandemic affects everyone,regardless of their financial *** a result,diabetes is not a systemic disease which just involves people of low socioeconomic status.

关键词： Diabetes Incidence and prevalence Diabetes mellitus

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Colorectal cancer cell dormancy:An insight into pathways

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World Journal of Gastroenterology 2024年第33期30卷 3810-3817页

作者： Anil Kumar Lekha Saha Department of Pharmacology Post Graduate Institute of Medical Education and ResearchChandigarh 160012India

Cancer cell dormancy(CCD)in colorectal cancer(CRC)poses a significant challenge to effective *** CRC,CCD contributes to tumour recurrence,drug resistance,and amplifying the disease's *** molecular mechanisms governing CCD and strategies for eliminating dormant cancer cells remain largely ***,understanding the molecular mechanisms governing dormancy is crucial for improving patient outcomes and developing targeted *** editorial highlights the complex interplay of signalling pathways and factors involved in colorectal CCD,emphasizing the roles of Hippo/YAP,pluripotent transcription factors such as NANOG,HIF-1αsignalling,and Notch signalling ***,ERK/p38α/β/MAPK pathways,AKT signalling pathway,and Extracellular Matrix Metalloproteinase Inducer,along with some potential less explored pathways such as STAT/p53 switch and canonical and non-canonical Wnt and SMAD signalling,are also involved in promoting colorectal *** their clinical significance,these findings may offer the potential for identifying key dormancy regulator pathways,improving treatment strategies,surmounting drug resistance,and advancing personalized medicine ***,insights into dormancy mechanisms could lead to the development of predictive biomarkers for identifying patients at risk of recurrence and the tailoring of targeted therapies based on individual dormancy *** is essential to conduct further research into these pathways and their modulation to fully comprehend CRC dormancy mechanisms and enhance patient outcomes.

关键词： Colorectal cancer Colorectal cancer cell dormancy Cancer cell dormancy Pathways in colorectal cancer dormancy

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Understanding female urinary continencedlessons from complications of female urethral surgery

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Asian Journal of Urology 2024年第3期11卷 504-506页

作者： Sidhartha Kalra Atanu Kumar Pal Lalgudi Narayanan Dorairajan Department of Urology and Renal Transplantation Jawaharlal Institute of Post Graduate Medical Education and ResearchPuducherryIndia

Dear Editor,We share our experience of two significant complications associated with female urethroplasty and their management in understanding the factors contributing to urinary *** have also tried to assess the different components of female urinary continence mechanism and the ways to combat the postoperative urinary continence while performing female urethral surgeries(Fig.1).Informed consent was taken from each of the patients before their evaluation and *** were explained properly and informed consents were taken from them before the publication of this article.

关键词： urinary female urethral

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Unlocking new potential of clinical diagnosis with artificial intelligence:Finding new patterns of clinical and lab data

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World Journal of Diabetes 2024年第3期15卷 308-310页

作者： Pradeep Kumar Dabla Department of Biochemistry Govind Ballabh Pant Institute of Postgraduate Medical Education and ResearchDelhi 110002India

Recent advancements in science and technology,coupled with the proliferation of data,have also urged laboratory medicine to integrate with the era of artificial intelligence(AI)and machine learning(ML).In the current practices of evidencebased medicine,the laboratory tests analysing disease patterns through the association rule mining(ARM)have emerged as a modern tool for the risk assessment and the disease stratification,with the potential to reduce cardiovascular disease(CVD)*** are the well recognised leading global cause of mortality with the higher fatality rates in the Indian population due to associated factors like hypertension,diabetes,and lifestyle ***-driven algorithms have offered deep insights in this field while addressing various challenges such as healthcare systems grappling with the physician *** medicine,well driven by the big data necessitates the integration of ML techniques and high-quality electronic health records to direct the meaningful *** technological advancements enhance the computational analyses for both research and clinical *** plays a pivotal role by uncovering meaningful relationships within databases,aiding in patient survival prediction and risk factor *** potential in laboratory medicine is vast and it must be cautiously integrated while considering potential ethical,legal,and privacy ***,an AI ethics framework is essential to guide its responsible *** AI algorithms with existing lab practices,promoting education among healthcare professionals,and fostering careful integration into clinical settings are imperative for harnessing the benefits of this transformative technology.

关键词： Laboratory medicine Artificial intelligence Machine learning Association rule mining Cardiovascular diseases

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Inhibiting HMGCR represses stemness and metastasis of hepatocellular carcinoma via Hedgehog signaling

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Genes & Diseases 2024年第5期11卷 470-483页

作者： Zhirong Zhang Jiayao Yang Rui Liu Jing Ma Kai Wang Xiaojun Wang Ni Tang Key Laboratory of Molecular Biology for Infectious Diseases(Ministry of education) Institute for Viral HepatitisDepartment of Infectious DiseasesThe Second Affiliated HospitalChongqing Medical UniversityChongqing 400016China institute of Hepatobiliary Surgery Southwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China

Cancer stem cells(CSCs)play a crucial role in tumor initiation,recurrence,metastasis,and drug ***,the current understanding of CSCs in hepatocellular carcinoma(HCC)remains *** a comprehensive analysis of the database,it has been observed that 3-hydroxy-3-methylglutaryl-coenzyme A reductase(HMGCR),a critical enzyme involved in cholesterol synthesis,is up-regulated in HCC tissues and liver ***,high expression of HMGCR is associated with a poor prognosis in patients with ***,HMGCR promotes the stemness and metastasis of HCC both in vitro and in *** screening various signaling pathway inhibitors,we have determined that HMGCR regulates stemness and metastasis by activating the Hedgehog signaling in ***,HMGCR positively correlates with the expression of the Smoothened receptor and facilitates the nuclear translocation of the transcriptional activator GLI family zinc finger *** of the Hedgehog pathway can reverse the stimulatory effects of HMGCR on stemness and metastasis in ***,simvastatin,an FDA-approved cholesterol-lowering drug,has been shown to inhibit stemness and metastasis of HCC by targeting *** together,our findings suggest that HMGCR promotes the regeneration and metastasis of HCC through the activation of Hedgehog signaling,and simvastatin holds the potential for clinical suppression of HCC metastasis.

关键词： Cancer stem cells Hedgehog Hepatocellular carcinoma Metastasis Statin

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Debate on direct-anterior vs posterior approach for hip hemiarthroplasty:The authors’insights

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World Journal of Orthopedics 2024年第5期15卷 486-488页

作者： Deepak Kumar Tarkik Thami Manjunath Nishani Department of Orthopedics Post Graduate Institute of Medical Education and ResearchChandigarh 160012India

We read and discussed the study entitled“Complication rates after direct anterior vs posterior approach for Hip Hemiarthroplasty in elderly individuals with femoral neck fractures”with great *** authors have done justice to the topic of comparison of anterior and posterior surgical approaches for bipolar hemiarthroplasty which has been an everlasting debate in the existing ***,there are certain aspects of this study that need clarification from the authors.

关键词： Commentary Direct anterior approach Posterior approach Hip hemiarthroplasty

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