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.

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.

Background: In recent years, medical thoracoscopy has been well established to play an important role in undiagnosed pleural effusion; however, this procedure is underutilized due to limited availability of the instruments it requires. This study analysed the outcome of single port rigid thoracoscopy in patients with undiagnosed pleural effusions. Methods: This study retrospectively analysed the outcomes of all patients with undiagnosed pleural effusion presenting to our centre between 2016 to 2020 who underwent single port rigid medical thoracoscopy as a diagnostic procedure. Results: In total, 92 patients underwent single port rigid medical thoracoscopy. The most common presenting symptom was shortness of breath. A majority of the patients had lymphocytic exudative pleural effusion. The average biopsy sample size was 18 mm, and no major complication was reported in any of the patients. Conclusion Single port rigid thoracoscopy is a safe and well-tolerated procedure that yields a biopsy of a larger size with high diagnostic yield. Moreover, the low cost of the instruments required by this procedure makes it particularly suited for use in developing countries.

Background: High blood glucose levels in diabetes lead to vascular inflammation which accelerates atherosclerosis. Herein, Morin was orally administered in male Wistar rats, at the dose of 40 mg/kg for 28 days, and on the 27th and 28th day, ISO was administered to designate groups at the dose of 85 mg/kg s.c., to induce myocardial infarction. Results: Free radical generation, including ROS, in diabetes following ISO administration, leads to the activation of both intrinsic and extrinsic pathways of apoptosis. Morin significantly (p ≤ 0.05) reduced oxidative stress (GSH, MDA, SOD), cardiac injury markers (CK-MB, LDH), inflammation (TNF, IL-6), and apoptosis (Bax, ­BCl 2 , Caspase-3). In addition, it also reduced insulin and blood glucose levels. Akt/eNOS, Nrf2/HO-1, MAPK signaling pathways, and Insulin signal transduction pathways were positively modulated by morin pre-treatment. Conclusions Morin attenuated oxidative stress and inflammation and also modified the activity of various molecular pathways to mitigate cardiomyocyte damage during ISO-induced MI in diabetic rats.

Objectives: The aim of the study was to quantify and compare craniofacial asymmetry in subjects with and without symptoms of temporomandibular joint disorders (TMDs). Materials and Methods: A total of 126 adult subjects were categorized into two groups (63 with a TMDs and 63 without a TMDs), based on detection of symptoms using the Temporomandibular Joint Disorder-Diagnostic Index (TMD-DI) questionnaire. Posteroanterior cephalograms of each subject were traced manually and 17 linear and angular measurements were analyzed. Craniofacial asymmetry was quantified by calculating the asymmetry index (AI) of bilateral parameters for both groups. Results: Intra- and intergroup comparisons were analyzed using independent t-test and Mann–Whitney U test, respectively, with a P<0.05 considered statistically significant. An AI for each linear and angular bilateral parameter was calculated; higher asymmetry was found in TMD-positive patients compared with TMD-negative patients. An intergroup comparison of AIs found highly significant differences for the parameters of antegonial notch to horizontal plane distance, jugular point to horizontal plane distance, antegonial notch to menton distance, antegonial notch to vertical plane distance, condylion to vertical plane distance, and angle formed by vertical plane, O point and antegonial notch. Significant deviation of the menton distance from the facial midline was also evident. Conclusion Greater facial asymmetry was seen in the TMD-positive group compared with the TMD-negative group. The mandibular region was characterized by asymmetries of greater magnitude compared with the maxilla. Patients with facial asymmetry often require management of temporomandibular joint (TMJ) pathology to achieve a stable, functional, and esthetic result. Ignoring the TMJ during treatment or failing to provide proper management of the TMJ and performing only orthognathic surgery may result in worsening of TMJ-associated symptoms (jaw dysfunction and pain) and re-occurrence of asymmetry and malocclusion. Assessments of facial asymmetry should take into account TMJ disorders to improve diagnostic accuracy and treatment outcomes.

Objectives: This study provides insights on the impact of a targeted intervention (TI) programme on behaviour change among injecting drug users (IDUs) in India. Methods: This paper examined the data from the Integrated Biological and Behavioural Surveillance 2014-2015 for IDUs in India. Logistic regression was performed to understand the factors (TI programme services) that affected injecting risk behaviours by adjusting for covariates. Propensity score matching was conducted to understand the impact of the TI programme on using new needles/syringes and sharing needles/syringes in the most recent injecting episode by accounting for the covariates that predicted receiving the intervention. Results: Participants who received new needles and syringes from peer educators or outreach workers were 1.3 times (adjusted odds ratio, 1.29; 95% confidence interval [CI], 1.09 to 1.53) more likely to use new needles/syringes during most recent injecting episode than participants who did not receive needles/syringes. The matched-samples estimate (i.e., average treatment effect on treated) of using new needles in the most recent injecting episode showed a 2.8% (95% CI, 0.0 to 5.6) increase in the use of new needles and a 6.5% (95% CI, -9.7 to -3.3) decrease in needle sharing in the most recent injecting episode in participants who received new needles/syringes. There was a 2.2% (95% CI, -3.8 to -0.6) decrease in needle sharing in the most recent injecting episode among participants who were referred to other services (integrated counselling and testing centre, detox centres, etc.). Conclusions The TI programme proved to be effective for behaviour change among IDUs, as substantiated by the use of new needles/syringes and sharing of needles/syringes.