Background/Aims: Sarcopenia is implicated in inflammatory bowel disease (IBD) complications and surgical outcomes. This study aimed to investigate the prevalence and follow-up of sarcopenia in patients with IBD. Methods: Consecutive consenting patients with IBD aged > 18 years were included. Patients with associated sarcopenic diseases were excluded. All had measurements of anthropometry, body mass index (BMI), mid-arm muscle circumference, muscle strength, physical performance, and muscle mass (on computed tomography scan). They were followed up for up to 12 months, and incidence of flares, fractures, and surgery was noted. Results: Of 157 patients screened, 35 refused participation; 5 with associated sarcopenic diseases were excluded. Of 117 patients (median age, 41 years; interquartile range, 18–81 years; 65 men), 73 had ulcerative colitis, 42 Crohn’s disease, and 2 IBD-unclassified. Forty (34.2%) had probable sarcopenia; 47 (40.2%) had sarcopenia (29 ulcerative colitis and 18 Crohn’s disease) including 10 (8.5%) with severe sarcopenia. Ten (21.3%) were in disease remission. Of factors associated with sarcopenia in univariate analysis, only BMI was significant in multivariate analysis. Ninety-nine patients followed up for a median of 7 months (interquartile range, 2–12 months). Freedom from flares was 5.3% in patients with sarcopenia and 46.1% in those without (P= 0.004). Three patients (1 with sarcopenia, 2 without) required surgery. Conclusions Sarcopenia was present in 40% of patients with IBD; one-fifth of these had severe sarcopenia. One-fifth were in remission. Low BMI correlated with sarcopenia. More patients with sarcopenia had disease flare. Screening for sarcopenia should be considered in patients with IBD.

Introduction: The occurrence of rotator cuff tendinopathy, which is invariably symptomatic, increases as populations age, being largely observed among patients with diabetes. The objective of the present study is to find out the occurrence of rotator cuff tendinopathy in elderly diabetic patients who were asymptomatic, composed of healthy individuals and those with diabetes mellitus. Materials and methods: The participants in this study included 87 elderly diabetic patients and 56 controls (mean age: 69.3±4.9 and 71.8±3.6, respectively), who were asymptomatic from shoulder. All patients, including, underwent shoulder MRI examination using 1.5 tesla MRI. Results: We recorded greater tendons thickness in the diabetic patients as compared with the controls (supraspinatus tendon: 6.6±0.7mm vs 5.3±0.8mm, p<0.001; biceps tendon: 3.9±0.7mm vs 3.1±0.8mm, p<0.002). Moreover, higher incidence of supraspinatus tendon tear was noted in diabetics as compared to biceps tendon (major tears: 32 (36.7%) vs 6 (10.7%), p=0.052; minor tears: 51 (58.6%) vs 11 (19.6%), p=0.032). Conclusions: The present study suggests that age-related rotator cuff tendinopathy is more prevalent among patients with diabetes. Therefore, MRI is an investigation of choice for early detection i.e., at pre-symptomatic stages of rotator cuff tendinopathy, as the patients may develop symptoms later. Keywords: asymptomatic

Trans-spinal motor evoked potentials (TsMEP) represent a novel intraoperative neuromonitoring technique designed to localize motor deficits when transcranial motor evoked potentials (TcMEP) are lost or unreliable. This technique involves direct electrical stimulation of the spinal cord through pedicle screws using a train of biphasic square-wave pulses, with myogenic responses recorded from limb muscles. In the presented case of kyphoscoliosis correction, TsMEP was employed after TcMEP signals failed to recover despite corrective measures. Stimulation at various vertebral levels allowed TsMEP to localize the level of motor pathway compromise, guiding targeted decompression. Unlike sensory-based methods such as dynamic spinal cord mapping, TsMEP directly evaluates motor tract integrity and provides real-time, segmental information without the need for epidural instrumentation. This technique also enabled monitoring of functional recovery through threshold changes, demonstrating its clinical utility. TsMEP holds promise as an intraoperative diagnostic and decision-making tool, especially in complex spinal surgeries with high neurological risk.

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. Tumor heterogeneity is a major obstacle to effective treatment and is poorly understood using traditional bulk sequencing methods. This review highlights the transformative role of single-cell and multi-omics technologies in determining the cellular and molecular complexities of HCC. We summarize recent advances in single-cell transcriptomics, epigenomics, multi-omics, and spatial transcriptomics platforms, emphasizing their applications in characterizing tumor subclones, cancer-associated fibroblast-immune interactions, circulating tumor cells, and immune-resistant phenotypes. Spatial approaches have revealed the architecture of cancer stem cell niches and tertiary lymphoid structures, providing unprecedented insights into tumor organization and microenvironmental crosstalk. Although still in their early stages, clinical trials have begun to incorporate these technologies, underscoring their translational potential. Single-cell and spatial omics have reshaped HCC research by enabling high-resolution profiling of tumor ecosystems and driving the discovery of biomarkers, therapeutic targets, and strategies for patient stratification. However, high cost, technical expertise, and limited accessibility, particularly in resource-constrained settings, are major barriers to its widespread adoption. Addressing these challenges is critical for translating these powerful approaches into clinical practice and for advancing precision medicine for the treatment of liver cancer.

Objective: Biological processes are the sum of metabolic reactions that result in intermediate and end metabolite products. These processes are the reflection of genetic regulation and are profoundly impacted by environmental influence and changes, including those associated with attention-deficit/hyperactivity disorder (ADHD). This study aimed to assess the untargeted plasma metabolomic profile of children and adolescents with ADHD and to compare them with healthy controls and to study associations of dysregulated metabolic parameters with the clinical and socio-demographic parameters of ADHD. Methods: This study involved 42 registered cases of ADHD among children aged 6 to 16 years, diagnosed based on DSM-5 criteria. Each case was matched by age and gender with 24 healthy controls. The severity of ADHD was evaluated using the ADHD Rating Scale, while behavioral issues were assessed through the Child Behavior Checklist. The gas chromatography-mass spectrometry technique was employed to examine changes in plasma metabolite content. Results: We identified a total of 45 metabolites in the ADHD subtypes, which exhibited altered levels compared to the control group. The content of these metabolites and associated metabolic pathways showed significant differences between ADHD subjects and controls. Furthermore, we analyzed biomarkers derived from the compounds with the greatest fold changes in accumulation levels. Conclusion The identification and analysis of these metabolites and metabolic pathways represent a promising new approach for tracking disease progression in ADHD. The findings of this study indicate that metabolite-based biomarkers may hold considerable potential for effective disease management.

Objective: This study aims to analyze the angiographic features, demographic factors, and outcomes of endovascular treatment for ruptured intracranial aneurysms (IAs) in Central India. Methods: This retrospective observational study was conducted in the Department of Interventional Radiology at a tertiary care hospital in Central India. It included 102 patients diagnosed with subarachnoid haemorrhage due to ruptured IAs between December 2021 and November 2024. Demographic data, comorbidities, angiographic features (size, location, morphology, and multiplicity), and clinical severity were analyzed. Patients underwent endovascular treatments such as unassisted coiling, stent-assisted coiling, and other techniques. Functional outcomes were evaluated using the Modified Rankin Scale (mRS). Results: Females (62.8%) were more affected than males, with a peak incidence in the 51–60 years age group. Hypertension (44.1%) was the most common comorbidity. Most aneurysms (88.4%) were located in the anterior circulation, with the anterior communicating artery (27.7%) being the most common site. Small (<5 mm) and saccular aneurysms (96.4%) predominated. Unassisted coiling was the most performed procedure (68.6%). At admission, 83.3% of patients had poor functional outcomes (mRS 3–6), but 68.6% achieved good outcomes (mRS 0–2) by discharge. Conclusions Ruptured IAs in Central India predominantly affect females and involve the anterior circulation. Endovascular treatment significantly improves functional outcomes by reducing the re-rupture risk of an aneurysm, underscoring its effectiveness in managing this high-risk condition.

Objective:Human mortality is affected by a lot of different factors.Geographic and demographic variations are two such criteria that play significant importance in establishing the variation in mortality rate.Methods:The current work uses data collected from the Centers for Disease Control and Prevention from 2018 to 2021 to study the dependence of mortality on several parameters such as gender,race,and age group.The analysis looks at all the different causes of death registered in the database and shows how they vary with not only the demographic variables mentioned above but also geographic variables such as states in the USA.The variation in trends pre-,during,and post-pandemic is also investigated.The study undertakes several multi-factorial relations such as location-age group,location-gender,age group-gender,and a blanket study across all the races for 2018-2021.Results:Texas,California,and Florida were analyzed to be the states with the most number of deaths for the majority of causes.The study shows that before the pandemic two of the most critical causes of death identified were Atherosclerotic heart disease and Alzheimer's disease which was outnumbered by coronavirus disease 2019 in years 2020 and 2021 for the age groups of 35-84 years.Conclusion:The outcome of the study clearly shows the irrational availability of data among different ages,states,and races.In addition,it helps to provide interesting insights into how the mortality trends relate to demographic and geographic factors and point out the discrepancies among them.

Objective:Human mortality is affected by a lot of different factors.Geographic and demographic variations are two such criteria that play significant importance in establishing the variation in mortality rate.Methods:The current work uses data collected from the Centers for Disease Control and Prevention from 2018 to 2021 to study the dependence of mortality on several parameters such as gender,race,and age group.The analysis looks at all the different causes of death registered in the database and shows how they vary with not only the demographic variables mentioned above but also geographic variables such as states in the USA.The variation in trends pre-,during,and post-pandemic is also investigated.The study undertakes several multi-factorial relations such as location-age group,location-gender,age group-gender,and a blanket study across all the races for 2018-2021.Results:Texas,California,and Florida were analyzed to be the states with the most number of deaths for the majority of causes.The study shows that before the pandemic two of the most critical causes of death identified were Atherosclerotic heart disease and Alzheimer's disease which was outnumbered by coronavirus disease 2019 in years 2020 and 2021 for the age groups of 35-84 years.Conclusion:The outcome of the study clearly shows the irrational availability of data among different ages,states,and races.In addition,it helps to provide interesting insights into how the mortality trends relate to demographic and geographic factors and point out the discrepancies among them.