Background: s/Aims: Left lateral sectionectomy (LLS) is a commonly performed liver resection. The Rex-recess technique, an extrahepatic Glissonian approach through the umbilical fissure, provides earlier extrahepatic vascular control, potentially resulting in safer and faster resections. However, comparative data between these approaches is limited. This study aims to compare the Rex-recess technique with the standard technique for LLS regarding operative parameters, intraoperative blood loss, and postoperative outcomes. Methods: This retrospective cohort study included 48 consecutive adult patients who underwent open LLS at a tertiary hepatobiliary centre between January 2021 and November 2025. Patients were categorized based on the surgical technique used: standard technique (n = 25) and Rex-recess technique (n = 23). Primary outcomes assessed included operative time, blood loss, transfusion requirements, and postoperative complications. Secondary outcomes focused on selected early postoperative recovery parameters. Results: Baseline demographics were comparable between groups. The Rex-recess technique significantly reduced operative time (90 ± 17.1 minutes vs. 162 ± 27.2 minutes; p < 0.0001) and intraoperative blood loss (80 ± 42.3 mL vs. 250 ± 67.2 mL; p < 0.0001).Other postoperative outcomes, including complication rates and length of hospital stay, were comparable between the two groups. Conclusions The Rex-recess approach appears to be a feasible and anatomically sound technique for LLS, offering advantages in operative efficiency, such as reduced operative time and blood loss. However, due to the retrospective design and non-randomized allocation, these findings should be interpreted with caution. Further prospective studies are needed to validate these results.

Background and Objectives: The widespread use of mobile phones and personal listening devices (PLDs) poses potential health risks, particularly noise-induced hearing loss. Among younger generations, high-volume PLD use is associated with auditory and vestibular system changes. Clinical vestibular testing, including vestibular-evoked myogenic potentials (VEMP) and the video head impulse test (vHIT), may reveal peripheral vestibular impacts from prolonged PLD exposure at volumes over 60%. This study examines VEMP and vHIT results in individuals with normal hearing who have had extended high-volume PLD exposure. Subjects and Methods: A cross-sectional comparative study was conducted on individuals aged 15-24 years. All the participants had normal pure tone thresholds with “A” type tympanogram, present acoustic reflexes, and history of PLD usage. Participants were divided into groups according to PLD exposure of <1 year (group A), 1.1-2 years (group B), 2.1-3 years (group C), and 3.1-4 years (group D). The output sound pressure level (dB SPL) near the tympanic membrane was measured. Furthermore, cervical VEMP, ocular VEMP, and vHIT were assessed. Results: The VEMP and vHIT findings were statistically analyzed and compared across groups. The peak-to-peak amplitudes of VEMP showed a statistically significant difference between groups A and D. Conclusions Potential subclinical damage to the otolith organs can be associated with increased PLD exposure. No damage to the semi-circular canals was observed as the participants used lower dBA values by the PLDs.

Background and Objectives: The widespread use of mobile phones and personal listening devices (PLDs) poses potential health risks, particularly noise-induced hearing loss. Among younger generations, high-volume PLD use is associated with auditory and vestibular system changes. Clinical vestibular testing, including vestibular-evoked myogenic potentials (VEMP) and the video head impulse test (vHIT), may reveal peripheral vestibular impacts from prolonged PLD exposure at volumes over 60%. This study examines VEMP and vHIT results in individuals with normal hearing who have had extended high-volume PLD exposure. Subjects and Methods: A cross-sectional comparative study was conducted on individuals aged 15-24 years. All the participants had normal pure tone thresholds with “A” type tympanogram, present acoustic reflexes, and history of PLD usage. Participants were divided into groups according to PLD exposure of <1 year (group A), 1.1-2 years (group B), 2.1-3 years (group C), and 3.1-4 years (group D). The output sound pressure level (dB SPL) near the tympanic membrane was measured. Furthermore, cervical VEMP, ocular VEMP, and vHIT were assessed. Results: The VEMP and vHIT findings were statistically analyzed and compared across groups. The peak-to-peak amplitudes of VEMP showed a statistically significant difference between groups A and D. Conclusions Potential subclinical damage to the otolith organs can be associated with increased PLD exposure. No damage to the semi-circular canals was observed as the participants used lower dBA values by the PLDs.

Background and Objectives: The widespread use of mobile phones and personal listening devices (PLDs) poses potential health risks, particularly noise-induced hearing loss. Among younger generations, high-volume PLD use is associated with auditory and vestibular system changes. Clinical vestibular testing, including vestibular-evoked myogenic potentials (VEMP) and the video head impulse test (vHIT), may reveal peripheral vestibular impacts from prolonged PLD exposure at volumes over 60%. This study examines VEMP and vHIT results in individuals with normal hearing who have had extended high-volume PLD exposure. Subjects and Methods: A cross-sectional comparative study was conducted on individuals aged 15-24 years. All the participants had normal pure tone thresholds with “A” type tympanogram, present acoustic reflexes, and history of PLD usage. Participants were divided into groups according to PLD exposure of <1 year (group A), 1.1-2 years (group B), 2.1-3 years (group C), and 3.1-4 years (group D). The output sound pressure level (dB SPL) near the tympanic membrane was measured. Furthermore, cervical VEMP, ocular VEMP, and vHIT were assessed. Results: The VEMP and vHIT findings were statistically analyzed and compared across groups. The peak-to-peak amplitudes of VEMP showed a statistically significant difference between groups A and D. Conclusions Potential subclinical damage to the otolith organs can be associated with increased PLD exposure. No damage to the semi-circular canals was observed as the participants used lower dBA values by the PLDs.

Background: Liver transplant (LT) is a well‑established therapeutic strategy for endstage liver diseases. In the absence of a biopsy diagnosis, it is a common practice to increase immunosuppression for raised liver function tests, which may prove harmful in a non-rejection setting, hence, an accurate histopathological diagnosis from liver biopsy plays a significant role in the management of transplant recipients.We aim to study the spectrum of histopathological findings in post-transplant graft biopsies performed within 3 months of LT. Methods: This was a retrospective study of 81 patients who underwent LT at Medanta-The Medicity in the year 2022 and had a liver biopsy performed within 3 months following the LT. All biopsies with T cell-mediated rejection (TCMR) and antibody-mediated rejection (AMR) were graded according to the 2016 Banff criteria by two assessors in a blinded manner. Immunohistochemistry for anti-C4d (polyclonal; BioGenex, Fremont, CA, USA), anti-cytokeratin7 (clone RM416; BioSB, Santa Barbara, CA, USA), anti-cytokeratin-19 (clone RCK108; BioGenex, Fremont, CA, USA), and anti-CMV (clone 8B1.2, 1G5.2, and 2D4.2; BioSB, Santa Barbara, CA, USA) were performed wherever required. Results: The median age of the cohort was 45.5 years with a male predominance.The main indications of LT were alcoholic liver disease (22.22%), cryptogenic cirrhosis (20.98%), non alcoholic steatohepatitis (11.11%), and hepatocellular carcinoma (7.2%). A total of 113 biopsies were performed in 81 patients. The most common histopathological findings were TCMR (n=43, 53.08%), cholestatic changes (n=19, 23.45%), cholangitis (n=16, 19.75%), and preservation/reperfusion injury (PRI) (n=13, 16.04%). Two patients who underwent ABO-incompatible LT showed AMR. Conclusion The most common pathological diagnosis was TCMR, followed by cholestasis, cholangitis, and PRI. A non-TCMR diagnosis was present in 28.39% of cases.

Background: s/Aims: The implementation of enhanced recovery after surgery (ERAS) protocols has demonstrated significant advantages for patients by mitigating surgical stress and expediting recovery across a spectrum of surgical procedures worldwide. This investigation seeks to assess the effectiveness of the ERAS protocol specifically in the context of major liver resections within our geographical region. Methods: Our department conducted retrospective analysis of prospectively collected data, gathered from consenting individuals who underwent liver resections from January 2018 to December 2023. The assessment encompassed baseline characteristics, preoperative indications, surgical outcomes, and postoperative complications among patients undergoing liver surgery. Results: Among the included 184 patients (73 standard care, 111 ERAS program), the baseline characteristics were similar. Median postoperative hospital stay differed significantly: 5 days (range: 3–13 days) in ERAS, and 11 days (range: 6–22 days) in standard care (p < 0.001). Prophylactic abdominal drainage was less in ERAS (54.9%) than in standard care (86.3%, p < 0.001). Notably, in ERAS, 88.2% initiated enteral feeding orally on postoperative day 1, significantly higher than in standard care (47.9%, p < 0.001). Early postoperative mobilization was more common in ERAS (84.6%) than in standard care (36.9%, p < 0.001). Overall complication rates were 21.9% in standard care, and 8.1% in ERAS (p = 0.004). Conclusions Our investigation highlights the merits of ERAS protocol; adherence to its diverse components results in significant reduction in hospital length of stay, and reduced occurrence of postoperative complications, improving short-term recovery post liver resection