Objective: Interlaminar endoscopic lumbar decompression is an increasingly used minimally invasive technique for treating lumbar disc herniation and lumbar spinal canal stenosis. However, technical difficulty varies substantially across cases because of anatomical and patient-related factors. This prospective study evaluated clinical and radiological predictors of surgical ease using an objective Endoscopic Ease Index (EEI). Methods: This prospective observational study included 122 patients who underwent interlaminar endoscopic lumbar decompression between January 2021 and May 2025. Preoperative clinical data and magnetic resonance imaging morphometric parameters—including interlaminar window dimensions, ligamentum flavum (LF) thickness, facet hypertrophy, and canal stenosis—were analyzed. Intraoperative difficulty was quantified using the EEI, which incorporates operative time, docking time, bleeding score, field clarity, and surgeon-rated difficulty. Predictors of difficult surgery (defined as the upper EEI tertile) were examined using multivariable logistic regression. Results: Of 122 cases, 41 (33.6%) were classified as difficult. Difficult cases had significantly narrower interlaminar windows (10.8±1.9 mm vs. 13.6±2.4 mm, p<0.001), greater LF thickness (5.0±0.9 mm vs. 3.6±0.7 mm, p<0.001), and a higher prevalence of facet hypertrophy (58.5% vs. 27.1%, p=0.004). In the multivariable model, 3 variables independently predicted difficult surgery: LF thickness >4 mm (odds ratio [OR], 5.22; p<0.001), interlaminar height <11 mm (OR, 4.48; p=0.001), and facet hypertrophy ≥ grade 2 (OR, 3.27; p=0.02). The predictive model demonstrated excellent discrimination (area under the receiver operating characteristic curve, 0.87). Despite greater operative complexity, postoperative improvements in pain (visual analogue scale) and disability (Oswestry Disability Index) were comparable between groups. Conclusion LF hypertrophy, reduced interlaminar height, and facet hypertrophy independently predict greater technical difficulty during interlaminar endoscopic lumbar decompression. Preoperative identification of these morphometric parameters may improve surgical planning and help optimize outcomes.

Background: In children, C3 glomerulopathy (C3G) is a heterogeneous disease characterized by diverse clinicopathological profiles and kidney outcomes. However, diagnostic work-up in resource-limited settings is challenging because of the unavailability of complement assays and limited access to electron microscopy or genetic testing.Purpose: This study aimed to describe the clinicopathological features and response to immunosuppression and evaluate renal outcomes among children with C3G in a resource-limited setting. Methods: This retrospective cohort study involved a review of the hospital records of 46 children (2013–2021) diagnosed with C3G on kidney biopsy. Their clinical, laboratory, treatment, and outcome details at onset and follow-up were noted. Results: The mean (standard deviation) age was 9 (4) years. The common presentation was acute nephritis (27 [58.6%]), while 1 in 5 (19.5%) presented with rapidly progressive glomerulonephritis. Focal crescentic glomerulonephritis (14 [30.4%]) was the common histological pattern. Electron microscopy was performed in 22 (47.8%), of which 17 were C3 glomerulonephritis and 4 were dense deposit disease (DDD). None of the patients underwent complement assay or genetic testing. Almost two-thirds (63%) received empirical immunosuppressive therapy, most commonly steroids. Of the 31/46 who completed follow-up (median [interquartile range] duration, 11.5 [6–24] months), 6 (19.4%) demonstrated complete kidney recovery, while the other 25 (80.7%) had kidney sequelae; of them, 5 (16.1%) progressed to end-stage kidney disease and 2 (4.3%) died by the last follow-up. Conclusion Pediatric C3G has a variable clinicopathological spectrum, while DDD is less common. Most patients present with glomerulonephritis and significant morbidities. The lack of genetic and C3Nephritic factor testing is a barrier to the comprehensive phenotyping and management of C3G in resource-limited settings.

Surface mould brachytherapy is a conformal radiotherapy technique that can deliver high dose to the target while sparing nearby normal structures, Here, we aim to describe the procedurals details for high-dose rate (HDR) surface mould brachytherapy in sebaceous carcinoma of eyelid in a 54-year old lady. She was hesitant for surgery and any form of invasive intervention like interstitial brachytherapy. So, she was treated with surface mould HDR brachytherapy to a total dose of 52 Gy in 13 fractions at a dose of 4 Gy per fraction delivered twice daily using Iridium-192 isotope with no acute side effects. She was evaluated on a weekly basis for any radiation side effects and now she is disease-free for 6 months post-treatment with only mild dry eye. A detailed step-by-step procedure of surface mould technique, simulation procedure, dose prescription, planning, plan evaluation and treatment has been described in this paper. Surface mould HDR brachytherapy can be safely used as organ preserving modality of treatment for eyelid carcinoma.

Purpose: In India, the age of 14 years is the legal age threshold for child labour. Therefore, in suspected instances of child labour, age assessment plays a crucial role in determining whether a violation of the law on the employment of children has occurred. The aim of this retrospective cross-sectional study was to assess the discriminatory ability of stages of cervical vertebral maturation (CVM) in predicting the legal age threshold of 14 years. Materials and Methods: Routinely taken lateral cephalograms from 408 subjects aged 10 to 18 years were evaluated retrospectively using the CVM stages described by Baccetti et al. Descriptive statistics, accuracy, sensitivity, specificity, positive and negative predictive values, and likelihood ratios were calculated for stages 2, 3, and 4 of CVM. Results: Real age increased as the CVM stage gradually increased. The results of 2×2 contingency tables showed that CVM stage 4 produced an accuracy of 71% and 73%, a false positive rate of 7% and 18%, and a post-test probability of 59% and 68% for boys and girls, respectively. Conclusion Based on these findings, it can be concluded that the stages of CVM are of limited use for predicting the attainment of the legal age threshold of 14 years. Future studies should investigate whether combinations of skeletal and dental methods could achieve better accuracy and post-test probability.

Treatment of bovine mastitis caused by Staphylococcus (S.) aureus is becoming very difficult due to the emergence of multidrug-resistant strains. Hence, the search for novel therapeutic alternatives has become of great importance. Consequently, bacteriophages and their endolysins have been identified as potential therapeutic alternatives to antibiotic therapy against S. aureus. In the present study, the gene encoding lysin (LysSA4) in S. aureus phage SA4 was cloned and the nucleotide sequence was determined. Sequence analysis of the recombinant clone revealed a single 802-bp open reading frame encoding a partial protein with a calculated mass of 30 kDa. Results of this analysis also indicated that the LysSA4 sequence shared a high homology with endolysin of the GH15 phage and other reported phages. The LysSA4 gene of the SA4 phage was subsequently expressed in Escherichia coli. Recombinant LysSA4 induced the lysis of host bacteria in a spot inoculation test, indicating that the protein was expressed and functionally active. Furthermore, recombinant lysin was found to have lytic activity, albeit a low level, against mastitogenic Staphylococcus isolates of bovine origin. Data from the current study can be used to develop therapeutic tools for treating diseases caused by drug-resistant S. aureus strains.
Animals ; Base Sequence ; Cloning, Molecular ; Gene Expression Regulation, Viral/physiology ; Mucoproteins/genetics/*metabolism ; Phylogeny ; Polymerase Chain Reaction/methods ; Recombinant Proteins ; Staphylococcus Phages/genetics/*metabolism/physiology ; Staphylococcus aureus/*virology

The current Western psychiatric wisdom states that suicide is always or almost always associated with mental disorder. Careful Asian studies are casting doubt on this conclusion. Using information from the public record (newspapers, coroner’s reports, and various web-based sources), we sought evidence that, in the absence of mental disorder, suicide may be associated with major financial loss. Reports of 15 individuals who completed suicide following major financial loss were identified, thus an association between these events is supported.