1.Morphological characteristics, size, location of ruptured intracranial aneurysms & endovascular treatment in a tertiary teaching hospital of central India: A retrospective study
Nishant BHARGAVA ; Jayesh DHOLAKIYA ; Partisha GUPTA
Journal of Cerebrovascular and Endovascular Neurosurgery 2026;28(1):1-9
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.
2.Comparing the Effect of Oil Massage on Phototherapy Efficacy in Term Neonates with Hyperbilirubinemia:A Randomized Controlled Trial
Dinesh KUMAR ; Durgesh KUMAR ; Pankaj Kumar ARYA ; Muniba ALIM ; Indra Kumar SHARMA ; Rajesh Kumar YADAV ; Nishant SHARMA
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(2):93-100
Purpose:
This study aimed to evaluate the efficacy of oil massage as an adjunct therapy for neonatal jaundice during phototherapy.
Methods:
A total of 160 neonates with unconjugated hyperbilirubinemia were enrolled and randomly allocated into two study groups using a computer-generated random number table.Group 1 (Intervention Group) consisted of 84 patients who received both phototherapy and massage therapy, while Group 2 (Control Group) consisted of 76 patients who received only phototherapy. The intervention group underwent massage therapy three times daily for 20 minutes over two consecutive days. Transcutaneous bilirubin levels were measured every eight hours. Additionally, the total duration of phototherapy and the 24-hour stool and urine output frequency were recorded in both groups.
Results:
There were no significant differences in the demographic characteristics between the two groups. However, stool frequency and urine output were significantly higher in the intervention group. The average duration of phototherapy was 19.4±4.17 hours in the intervention group compared to 28.4±6.58 hours in the control group (p<0.001). The rate of Transcutaneous bilirubin reduction was significantly higher in the intervention group during the first 24 hours. A rebound increase in bilirubin levels was observed at 40 and 48 hours in both groups after phototherapy was discontinued.
Conclusion
Phototherapy combined with massage significantly reduced total bilirubin levels in newborns with neonatal hyperbilirubinemia, making it a valuable adjunct treatment for the rapid reduction of bilirubin in neonates.
3.Comparing the Effect of Oil Massage on Phototherapy Efficacy in Term Neonates with Hyperbilirubinemia:A Randomized Controlled Trial
Dinesh KUMAR ; Durgesh KUMAR ; Pankaj Kumar ARYA ; Muniba ALIM ; Indra Kumar SHARMA ; Rajesh Kumar YADAV ; Nishant SHARMA
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(2):93-100
Purpose:
This study aimed to evaluate the efficacy of oil massage as an adjunct therapy for neonatal jaundice during phototherapy.
Methods:
A total of 160 neonates with unconjugated hyperbilirubinemia were enrolled and randomly allocated into two study groups using a computer-generated random number table.Group 1 (Intervention Group) consisted of 84 patients who received both phototherapy and massage therapy, while Group 2 (Control Group) consisted of 76 patients who received only phototherapy. The intervention group underwent massage therapy three times daily for 20 minutes over two consecutive days. Transcutaneous bilirubin levels were measured every eight hours. Additionally, the total duration of phototherapy and the 24-hour stool and urine output frequency were recorded in both groups.
Results:
There were no significant differences in the demographic characteristics between the two groups. However, stool frequency and urine output were significantly higher in the intervention group. The average duration of phototherapy was 19.4±4.17 hours in the intervention group compared to 28.4±6.58 hours in the control group (p<0.001). The rate of Transcutaneous bilirubin reduction was significantly higher in the intervention group during the first 24 hours. A rebound increase in bilirubin levels was observed at 40 and 48 hours in both groups after phototherapy was discontinued.
Conclusion
Phototherapy combined with massage significantly reduced total bilirubin levels in newborns with neonatal hyperbilirubinemia, making it a valuable adjunct treatment for the rapid reduction of bilirubin in neonates.
4.Comparing the Effect of Oil Massage on Phototherapy Efficacy in Term Neonates with Hyperbilirubinemia:A Randomized Controlled Trial
Dinesh KUMAR ; Durgesh KUMAR ; Pankaj Kumar ARYA ; Muniba ALIM ; Indra Kumar SHARMA ; Rajesh Kumar YADAV ; Nishant SHARMA
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(2):93-100
Purpose:
This study aimed to evaluate the efficacy of oil massage as an adjunct therapy for neonatal jaundice during phototherapy.
Methods:
A total of 160 neonates with unconjugated hyperbilirubinemia were enrolled and randomly allocated into two study groups using a computer-generated random number table.Group 1 (Intervention Group) consisted of 84 patients who received both phototherapy and massage therapy, while Group 2 (Control Group) consisted of 76 patients who received only phototherapy. The intervention group underwent massage therapy three times daily for 20 minutes over two consecutive days. Transcutaneous bilirubin levels were measured every eight hours. Additionally, the total duration of phototherapy and the 24-hour stool and urine output frequency were recorded in both groups.
Results:
There were no significant differences in the demographic characteristics between the two groups. However, stool frequency and urine output were significantly higher in the intervention group. The average duration of phototherapy was 19.4±4.17 hours in the intervention group compared to 28.4±6.58 hours in the control group (p<0.001). The rate of Transcutaneous bilirubin reduction was significantly higher in the intervention group during the first 24 hours. A rebound increase in bilirubin levels was observed at 40 and 48 hours in both groups after phototherapy was discontinued.
Conclusion
Phototherapy combined with massage significantly reduced total bilirubin levels in newborns with neonatal hyperbilirubinemia, making it a valuable adjunct treatment for the rapid reduction of bilirubin in neonates.
5.Comparing the Effect of Oil Massage on Phototherapy Efficacy in Term Neonates with Hyperbilirubinemia:A Randomized Controlled Trial
Dinesh KUMAR ; Durgesh KUMAR ; Pankaj Kumar ARYA ; Muniba ALIM ; Indra Kumar SHARMA ; Rajesh Kumar YADAV ; Nishant SHARMA
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(2):93-100
Purpose:
This study aimed to evaluate the efficacy of oil massage as an adjunct therapy for neonatal jaundice during phototherapy.
Methods:
A total of 160 neonates with unconjugated hyperbilirubinemia were enrolled and randomly allocated into two study groups using a computer-generated random number table.Group 1 (Intervention Group) consisted of 84 patients who received both phototherapy and massage therapy, while Group 2 (Control Group) consisted of 76 patients who received only phototherapy. The intervention group underwent massage therapy three times daily for 20 minutes over two consecutive days. Transcutaneous bilirubin levels were measured every eight hours. Additionally, the total duration of phototherapy and the 24-hour stool and urine output frequency were recorded in both groups.
Results:
There were no significant differences in the demographic characteristics between the two groups. However, stool frequency and urine output were significantly higher in the intervention group. The average duration of phototherapy was 19.4±4.17 hours in the intervention group compared to 28.4±6.58 hours in the control group (p<0.001). The rate of Transcutaneous bilirubin reduction was significantly higher in the intervention group during the first 24 hours. A rebound increase in bilirubin levels was observed at 40 and 48 hours in both groups after phototherapy was discontinued.
Conclusion
Phototherapy combined with massage significantly reduced total bilirubin levels in newborns with neonatal hyperbilirubinemia, making it a valuable adjunct treatment for the rapid reduction of bilirubin in neonates.
6.Comparing the Effect of Oil Massage on Phototherapy Efficacy in Term Neonates with Hyperbilirubinemia:A Randomized Controlled Trial
Dinesh KUMAR ; Durgesh KUMAR ; Pankaj Kumar ARYA ; Muniba ALIM ; Indra Kumar SHARMA ; Rajesh Kumar YADAV ; Nishant SHARMA
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(2):93-100
Purpose:
This study aimed to evaluate the efficacy of oil massage as an adjunct therapy for neonatal jaundice during phototherapy.
Methods:
A total of 160 neonates with unconjugated hyperbilirubinemia were enrolled and randomly allocated into two study groups using a computer-generated random number table.Group 1 (Intervention Group) consisted of 84 patients who received both phototherapy and massage therapy, while Group 2 (Control Group) consisted of 76 patients who received only phototherapy. The intervention group underwent massage therapy three times daily for 20 minutes over two consecutive days. Transcutaneous bilirubin levels were measured every eight hours. Additionally, the total duration of phototherapy and the 24-hour stool and urine output frequency were recorded in both groups.
Results:
There were no significant differences in the demographic characteristics between the two groups. However, stool frequency and urine output were significantly higher in the intervention group. The average duration of phototherapy was 19.4±4.17 hours in the intervention group compared to 28.4±6.58 hours in the control group (p<0.001). The rate of Transcutaneous bilirubin reduction was significantly higher in the intervention group during the first 24 hours. A rebound increase in bilirubin levels was observed at 40 and 48 hours in both groups after phototherapy was discontinued.
Conclusion
Phototherapy combined with massage significantly reduced total bilirubin levels in newborns with neonatal hyperbilirubinemia, making it a valuable adjunct treatment for the rapid reduction of bilirubin in neonates.
7.Is Surgery for Lumbar Facet Cysts a Thing of the Past? Evaluating the Efficacy of Percutaneous Facet Cyst Rupture as a Primary Treatment Modality
Nishant Dineshkumar JUVA ; Abhay M. NENE ; Priyank PATEL
Journal of Minimally Invasive Spine Surgery and Technique 2025;10(Suppl 2):S171-S176
Objective:
Lumbar facet cysts are a common cause of radiculopathy. Percutaneous facet cyst rupture (PFCR) offers a minimally invasive alternative to surgical decompression The aim of this study was to evaluate the effectiveness of PFCR based on facet orientation, focusing on pain relief and recurrence.
Methods:
A retrospective analysis was conducted of 55 patients (2014–2024) with acute radiculopathy from unilateral lumbar facet cysts. Patients were grouped by facet orientation (favorable vs. unfavorable). Outcomes included visual analogue scale score reduction, recurrence, and need for surgery.
Results:
Forty-nine of the 55 patients (90.9%) experienced immediate relief. Long-term pain relief was significantly better in patients with favorable orientation (23 of 24). Patients with unfavorable orientation had higher recurrence and surgical conversion. The complication rate was 0%.
Conclusion
PFCR is highly effective and safe, especially for patients with favorable facet orientation. It should be considered a first-line treatment, particularly for high-risk or older patients.
8.Opioid-free anesthesia using a combination of ketamine and dexmedetomidine in patients undergoing laparoscopic cholecystectomy: a randomized controlled trial
Vishnuraj K R ; Kunal SINGH ; Nishant SAHAY ; Chandni SINHA ; Amarjeet KUMAR ; Neeraj KUMAR
Anesthesia and Pain Medicine 2024;19(2):109-116
Background:
Opioids administered as bolus doses or continuous infusions are widely used by anesthesiologists worldwide for major and day care surgeries. Opioid-free anesthesia is a multimodal anesthesia and analgesia technique that does not use opioid drugs, thereby benefitting patients from opioid-related adverse effects. In this study, we compared the postoperative analgesic requirements of patients scheduled for elective laparoscopic cholecystectomy under opioid-free and opioid-based anesthesia.
Methods:
This study included 88 patients aged 18–60 years with American Society of Anesthesiologists physical status 1 and 2 who underwent elective laparoscopic cholecystectomy. Participants were randomly divided into two groups with forty-four participants in each group. The opioid-free anesthesia group was administered an intravenous bolus of ketamine and dexmedetomidine, whereas the opioid-based group was administered fentanyl with conventional general anesthesia. The primary outcome was to compare the total amount of fentanyl consumed by both groups during the 6 h postoperative period following extubation. Episodes of postoperative nausea and vomiting (PONV) and vital signs were noted throughout the postoperative period to analyze the secondary outcomes.
Results:
Both the groups had similar demographic characteristics. The opioid-free group required less postoperative analgesia within the first 2 h (61.4 ± 17.4 vs. 79.0 ± 19.4 of fentanyl, P < 0.001), which was statistically significant. However, fentanyl consumption was comparable between the groups at the sixth postoperative hour (opioid-free group 152 ± 28.2 vs. opioid group 164 ± 33.4, P = 0.061). Compared with 4.5% of the participants in the opioid-free group, 34% of those in the opioid-based group developed moderate PONV.
Conclusions
The opioid-free anesthesia technique in patients undergoing laparoscopic cholecystectomy reduced the requirement of analgesia in the first two hours of the postoperative period and was associated with decreased PONV.
9.Diagnostic Pitfall and Clinical Characteristics of Variant Versus Wild-Type Transthyretin Amyloid Cardiomyopathy in Asian Population: The Korean Nationwide Cohort Study
Darae KIM ; Jong-Chan YOUN ; Hye Won LEE ; Jaewon OH ; Jung-Woo SON ; Hyun-Jai CHO ; Seul LEE ; Nishant R. SHAH ; Michelle M. KITTLESON ; Eun-Seok JEON
Journal of Korean Medical Science 2024;39(19):e163-
Background:
Transthyretin amyloidosis cardiomyopathy (ATTR-CM) is an under-recognized cause of heart failure (HF) with clinical phenotypes that vary across regions and genotypes.We sought to characterize the clinical characteristics of ATTR-CM in Asia.
Methods:
Data from a nationwide cohort of patients with ATTR-CM from six major tertiary centres in South Korea were analysed between 2010 and 2021. All patients underwent clinical evaluation, biochemical laboratory tests, echocardiography, and transthyretin (TTR) genotyping at the time of diagnosis. The study population comprised 105 Asian ATTR-CM patients (mean age: 69 years; male: 65.7%, wild-type ATTR-CM: 41.9%).
Results:
Among our cohort, 18% of the patients had a mean left ventricular (LV) wall thickness < 12 mm. The diagnosis of ATTR-CM increased notably during the study period (8 [7.6%] during 2010–2013 vs. 22 [21.0%] during 2014–2017 vs. 75 [71.4%] during 2018–2021).Although the duration between symptom onset and diagnosis did not differ, the proportion of patients with HF presenting mild symptoms increased during the study period (25% NYHA class I/II between 2010–2013 to 77% between 2018–2021). In contrast to other international registry data, male predominance was less prominent in wild-type ATTR-CM (68.2%). The distribution of TTR variants was also different from Western countries and from Japan.Asp38Ala was the most common mutation.
Conclusion
A nationwide cohort of ATTR-CM exhibited less male predominance, a proportion of patients without increased LV wall thickness, and distinct characteristics of genetic mutations, compared to cohorts in other parts of the world. Our results highlight the ethnic variation in ATTR-CM and may contribute to improving the screening process for ATTR-CM in the Asian population.
10.Thoracolumbar Injury Classification and Severity Score Is Predictive of Perioperative Adverse Events in Operatively Treated Thoracic and Lumbar Fractures
Gabriel LIU ; Jiong Hao TAN ; Jun Cheong KONG ; Yong Hao Joel TAN ; Nishant KUMAR ; Shen LIANG ; Seah Jing Sheng SHAWN ; Chiu Shi TING ; Lau Leok LIM ; Hey Hwee Weng DENNIS ; Naresh KUMAR ; Joseph THAMBIAH ; Hee-Kit WONG
Asian Spine Journal 2022;16(6):848-856
Methods:
We performed a retrospective review of 199 patients with surgically treated thoracolumbar fractures operated between January 2007 and January 2018. The potential risk factors for the development of AEs as well as the development of common complications were evaluated by univariate analysis, and a multivariate logistic regression analysis was performed to identify independent risk factors predictive of the above.
Results:
The overall rate of AEs was 46.7%; 83 patients (41.7%) had nonsurgical AEs, whereas 24 (12.1%) had surgical adverse events. The most common AEs were urinary tract infections in 43 patients (21.6%), and hospital-acquired pneumonia in 21 patients (10.6%). On multivariate logistic regression, a Thoracolumbar Injury Classification and Severity (TLICS) score of 8–10 (odds ratio [OR], 6.39; 95% confidence interval [CI], 2.33–17.51), the presence of polytrauma (OR, 2.64; 95% CI, 1.17–5.99), and undergoing open surgery (OR, 2.31; 95% CI, 1.09–4.88) were significant risk factors for AEs. The absence of neurological deficit was associated with a lower rate of AEs (OR, 0.47; 95% CI, 0.31–0.70).
Conclusions
This study suggests the presence of polytrauma, preoperative American Spinal Injury Association score, and TLICS score are predictive of AEs in patients with surgically treated thoracolumbar fractures. The results might also suggest a role for minimally invasive surgical methods in reducing AEs in these patients.

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