1.Re-expression of embryonic stem cell markers in malignant tissue: an observational study in pancreatic cancer
Sashikanta SWAIN ; Sipra ROUT ; Sarojini RAMAN ; Praveen Kumar RAVI ; Sruthy BABU ; Pravash Ranjan MISHRA
Anatomy & Cell Biology 2026;59(1):115-124
Pancreatic cancer is one of the most lethal malignancies, primarily due to late-stage diagnosis and limited therapeutic options. Cancer stem cells (CSCs) contribute to tumor heterogeneity, therapy resistance, and recurrence through activation of developmental pathways such as Hedgehog, Wnt, Notch, JAK-STAT, and Hippo. Identifying CSCs is therefore essential for understanding pancreatic ductal adenocarcinoma (PDAC) pathogenesis and advancing targeted therapies. This study compares the expression of key CSC-associated markers (CD44, CD117, OCT3/4, and c-Myc) in PDAC, fetal, and adult pancreas to elucidate CSC dynamics. Immunohistochemistry for CSC markers (CD44, CD117, OCT3/4, and c-Myc) was performed on PDAC tissues and control pancreatic samples (fetal pancreas 28–36 weeks and adult pancreas) to evaluate marker expression. Proliferative potential was assessed using CK7 and Ki-67 expression patterns. CD44 showed strong membranous and cytoplasmic expression in PDAC, moderate in fetal pancreas (epithelial/ductal regions), and minimal expression in adult tissue. CD117 was mainly restricted to stromal cells in PDAC, also present in fetal tissue but low in adults.c-Myc and Ki-67 were moderately expressed in PDAC, significantly higher than the control samples. CK7 demonstrated strong cytoplasmic staining in PDAC, moderate expression in adults, and weak expression in fetal samples. CD44 and c-Myc re-expression in PDAC supports their role as CSC-associated markers and potential drivers of tumor progression. CD117’s stromal localization suggests tumor–stroma interactions. These findings highlight developmental reactivation of CSC markers in PDAC, with implications for early detection and targeted therapy.
3.Burden of inflammatory bowel disease in India: analysis of the Global Burden of Disease study from 1990 to 2019
Suprabhat GIRI ; Anuraag JENA ; Praveen KUMAR-M ; Jaikumar Rajavoor MUNISWAMY ; Preetam NATH ; Vishal SHARMA
Intestinal Research 2026;24(1):84-94
Background/Aims:
Inflammatory bowel disease (IBD) is increasing across the globe, more so in populous countries like India. We aimed to study the disease burden and epidemiological trends of IBD in India and look closer into the disease pattern across the country from 1990 to 2019.
Methods:
The burden of IBD was estimated in India using the data from the Global Burden of Disease estimate for 2019, which is a comprehensive worldwide project. The analysis included various parameters like incidence, prevalence, mortality, disability-adjusted life years, years lived with disability, and years of life lost as age-adjusted rates (per 100,000 population). Using modeling, the prediction was also made for 2050 in India.
Results:
The age-standardized incidence, prevalence, mortality, and disability rates of IBD in India for 2019 were 2.34, 20.34, 0.40, and 13.04, respectively. These are lower than the global incidence, prevalence, mortality, and disability rates of 4.97, 59.25, 0.54, and 20.15, respectively. The annual rates of change in incidence, prevalence, mortality, and disability rates in India from 1990 to 2019 were 0.05, –0.02, –0.36, and –0.35, respectively. The annual rates of change in incidence and prevalence are higher than the global rate of –0.18 and –0.19, while the annual rates of change in mortality and disability are lower than the global rate of –0.19 and –0.26.
Conclusions
The incidence and prevalence of IBD in India are lower compared to the global population but are increasing at a faster rate than the global population.
4.Effectiveness of intramuscular electrical stimulation using conventional and inverse electrode placement methods on pressure pain threshold and electromyographic activity of the upper trapezius muscle with myofascial trigger points: a randomized clinical trial
Sukumar SHANMUGAM ; Fabio Vieira DOS ANJOS ; Arthur de SÁ FERREIRA ; Ramprasad MUTHUKRISHNAN ; Praveen Kumar KANDAKURTI ; Satheeskumar DURAIRAJ
The Korean Journal of Pain 2025;38(2):187-197
Background:
This study investigates whether intramuscular electrical stimulation (IMES) with inverse electrode placement (IEP) or conventional electrode placement (CEP) more effectively modulates pain. The current study’s aim was to compare the effects of IMES using IEP and CEP, and sham-IMES on the pressure pain threshold (PPT), EMG activity, upper trapezius (UT) muscle length and pain severity among adults with UT myofascial trigger points (MTrPs).
Methods:
Thirty-six male adults with UT-MTrPs were allocated into three groups. IEP, CEP and sham groups were respectively treated with a single IMES session using IEP, CEP, and sham-IMES. Pain intensity, PPT, EMG activity (root mean square, RMS) and UT muscle length were measured on day one before the treatment, day one post treatment and at a day three follow-up to determine the immediate and short-term effectiveness of IMES.
Results:
IMES using both IEP and CEP methods produced significant higher changes in UT-PPT (median, interquartile-interval, IEP group: 3.25, 2.56–3.50 and CEP group: 2.75, 1.75–3.00, vs. sham group: 1.07, 0.89–1.71 kg/cm 2 ), RMS (IEP: 0.31, 0.26–0.35 and CEP: 0.36, 0.23–0.38, vs. sham: 0.21, 0.16–0.25 mV), and UT muscle length (IEP: 9.50, 8–12.75 and CEP: 8, 7–10, vs. 1.5. 1–2.75 degrees) and UT-pain severity (IEP: 3.00, 2.25–4 and CEP: 3, 3–3, vs. sham: 2, 2–2.75 points on VAS) compared to the score change in sham-IMES at day three follow up.
Conclusions
Pain modulation can be effectively achieved using IMES regardless of electrode placement method, with different electrode configurations.
5.Effectiveness of intramuscular electrical stimulation using conventional and inverse electrode placement methods on pressure pain threshold and electromyographic activity of the upper trapezius muscle with myofascial trigger points: a randomized clinical trial
Sukumar SHANMUGAM ; Fabio Vieira DOS ANJOS ; Arthur de SÁ FERREIRA ; Ramprasad MUTHUKRISHNAN ; Praveen Kumar KANDAKURTI ; Satheeskumar DURAIRAJ
The Korean Journal of Pain 2025;38(2):187-197
Background:
This study investigates whether intramuscular electrical stimulation (IMES) with inverse electrode placement (IEP) or conventional electrode placement (CEP) more effectively modulates pain. The current study’s aim was to compare the effects of IMES using IEP and CEP, and sham-IMES on the pressure pain threshold (PPT), EMG activity, upper trapezius (UT) muscle length and pain severity among adults with UT myofascial trigger points (MTrPs).
Methods:
Thirty-six male adults with UT-MTrPs were allocated into three groups. IEP, CEP and sham groups were respectively treated with a single IMES session using IEP, CEP, and sham-IMES. Pain intensity, PPT, EMG activity (root mean square, RMS) and UT muscle length were measured on day one before the treatment, day one post treatment and at a day three follow-up to determine the immediate and short-term effectiveness of IMES.
Results:
IMES using both IEP and CEP methods produced significant higher changes in UT-PPT (median, interquartile-interval, IEP group: 3.25, 2.56–3.50 and CEP group: 2.75, 1.75–3.00, vs. sham group: 1.07, 0.89–1.71 kg/cm 2 ), RMS (IEP: 0.31, 0.26–0.35 and CEP: 0.36, 0.23–0.38, vs. sham: 0.21, 0.16–0.25 mV), and UT muscle length (IEP: 9.50, 8–12.75 and CEP: 8, 7–10, vs. 1.5. 1–2.75 degrees) and UT-pain severity (IEP: 3.00, 2.25–4 and CEP: 3, 3–3, vs. sham: 2, 2–2.75 points on VAS) compared to the score change in sham-IMES at day three follow up.
Conclusions
Pain modulation can be effectively achieved using IMES regardless of electrode placement method, with different electrode configurations.
6.Effectiveness of intramuscular electrical stimulation using conventional and inverse electrode placement methods on pressure pain threshold and electromyographic activity of the upper trapezius muscle with myofascial trigger points: a randomized clinical trial
Sukumar SHANMUGAM ; Fabio Vieira DOS ANJOS ; Arthur de SÁ FERREIRA ; Ramprasad MUTHUKRISHNAN ; Praveen Kumar KANDAKURTI ; Satheeskumar DURAIRAJ
The Korean Journal of Pain 2025;38(2):187-197
Background:
This study investigates whether intramuscular electrical stimulation (IMES) with inverse electrode placement (IEP) or conventional electrode placement (CEP) more effectively modulates pain. The current study’s aim was to compare the effects of IMES using IEP and CEP, and sham-IMES on the pressure pain threshold (PPT), EMG activity, upper trapezius (UT) muscle length and pain severity among adults with UT myofascial trigger points (MTrPs).
Methods:
Thirty-six male adults with UT-MTrPs were allocated into three groups. IEP, CEP and sham groups were respectively treated with a single IMES session using IEP, CEP, and sham-IMES. Pain intensity, PPT, EMG activity (root mean square, RMS) and UT muscle length were measured on day one before the treatment, day one post treatment and at a day three follow-up to determine the immediate and short-term effectiveness of IMES.
Results:
IMES using both IEP and CEP methods produced significant higher changes in UT-PPT (median, interquartile-interval, IEP group: 3.25, 2.56–3.50 and CEP group: 2.75, 1.75–3.00, vs. sham group: 1.07, 0.89–1.71 kg/cm 2 ), RMS (IEP: 0.31, 0.26–0.35 and CEP: 0.36, 0.23–0.38, vs. sham: 0.21, 0.16–0.25 mV), and UT muscle length (IEP: 9.50, 8–12.75 and CEP: 8, 7–10, vs. 1.5. 1–2.75 degrees) and UT-pain severity (IEP: 3.00, 2.25–4 and CEP: 3, 3–3, vs. sham: 2, 2–2.75 points on VAS) compared to the score change in sham-IMES at day three follow up.
Conclusions
Pain modulation can be effectively achieved using IMES regardless of electrode placement method, with different electrode configurations.
7.Effectiveness of intramuscular electrical stimulation using conventional and inverse electrode placement methods on pressure pain threshold and electromyographic activity of the upper trapezius muscle with myofascial trigger points: a randomized clinical trial
Sukumar SHANMUGAM ; Fabio Vieira DOS ANJOS ; Arthur de SÁ FERREIRA ; Ramprasad MUTHUKRISHNAN ; Praveen Kumar KANDAKURTI ; Satheeskumar DURAIRAJ
The Korean Journal of Pain 2025;38(2):187-197
Background:
This study investigates whether intramuscular electrical stimulation (IMES) with inverse electrode placement (IEP) or conventional electrode placement (CEP) more effectively modulates pain. The current study’s aim was to compare the effects of IMES using IEP and CEP, and sham-IMES on the pressure pain threshold (PPT), EMG activity, upper trapezius (UT) muscle length and pain severity among adults with UT myofascial trigger points (MTrPs).
Methods:
Thirty-six male adults with UT-MTrPs were allocated into three groups. IEP, CEP and sham groups were respectively treated with a single IMES session using IEP, CEP, and sham-IMES. Pain intensity, PPT, EMG activity (root mean square, RMS) and UT muscle length were measured on day one before the treatment, day one post treatment and at a day three follow-up to determine the immediate and short-term effectiveness of IMES.
Results:
IMES using both IEP and CEP methods produced significant higher changes in UT-PPT (median, interquartile-interval, IEP group: 3.25, 2.56–3.50 and CEP group: 2.75, 1.75–3.00, vs. sham group: 1.07, 0.89–1.71 kg/cm 2 ), RMS (IEP: 0.31, 0.26–0.35 and CEP: 0.36, 0.23–0.38, vs. sham: 0.21, 0.16–0.25 mV), and UT muscle length (IEP: 9.50, 8–12.75 and CEP: 8, 7–10, vs. 1.5. 1–2.75 degrees) and UT-pain severity (IEP: 3.00, 2.25–4 and CEP: 3, 3–3, vs. sham: 2, 2–2.75 points on VAS) compared to the score change in sham-IMES at day three follow up.
Conclusions
Pain modulation can be effectively achieved using IMES regardless of electrode placement method, with different electrode configurations.
8.Effectiveness of intramuscular electrical stimulation using conventional and inverse electrode placement methods on pressure pain threshold and electromyographic activity of the upper trapezius muscle with myofascial trigger points: a randomized clinical trial
Sukumar SHANMUGAM ; Fabio Vieira DOS ANJOS ; Arthur de SÁ FERREIRA ; Ramprasad MUTHUKRISHNAN ; Praveen Kumar KANDAKURTI ; Satheeskumar DURAIRAJ
The Korean Journal of Pain 2025;38(2):187-197
Background:
This study investigates whether intramuscular electrical stimulation (IMES) with inverse electrode placement (IEP) or conventional electrode placement (CEP) more effectively modulates pain. The current study’s aim was to compare the effects of IMES using IEP and CEP, and sham-IMES on the pressure pain threshold (PPT), EMG activity, upper trapezius (UT) muscle length and pain severity among adults with UT myofascial trigger points (MTrPs).
Methods:
Thirty-six male adults with UT-MTrPs were allocated into three groups. IEP, CEP and sham groups were respectively treated with a single IMES session using IEP, CEP, and sham-IMES. Pain intensity, PPT, EMG activity (root mean square, RMS) and UT muscle length were measured on day one before the treatment, day one post treatment and at a day three follow-up to determine the immediate and short-term effectiveness of IMES.
Results:
IMES using both IEP and CEP methods produced significant higher changes in UT-PPT (median, interquartile-interval, IEP group: 3.25, 2.56–3.50 and CEP group: 2.75, 1.75–3.00, vs. sham group: 1.07, 0.89–1.71 kg/cm 2 ), RMS (IEP: 0.31, 0.26–0.35 and CEP: 0.36, 0.23–0.38, vs. sham: 0.21, 0.16–0.25 mV), and UT muscle length (IEP: 9.50, 8–12.75 and CEP: 8, 7–10, vs. 1.5. 1–2.75 degrees) and UT-pain severity (IEP: 3.00, 2.25–4 and CEP: 3, 3–3, vs. sham: 2, 2–2.75 points on VAS) compared to the score change in sham-IMES at day three follow up.
Conclusions
Pain modulation can be effectively achieved using IMES regardless of electrode placement method, with different electrode configurations.
9.Optimising deformity correction: a retrospective comparative analysis of two techniques in high magnitude curves in adolescent idiopathic scoliosis
Arvind Gopalrao KULKARNI ; Priyambada KUMAR ; Thonangi YESHWANTH ; Sharvari GUNJOTIKAR ; Praveen GOPARAJU ; Yogesh Madhavrao ADBALWAD ; Aditya Raghavendra Sai Siva CHADALAVADA ; Arvind UMARANI ; Shankargouda PATIL
Asian Spine Journal 2024;18(6):794-802
Methods:
Twenty-four patients with AIS (Cobb >65°) underwent surgery at a single center between January 2014 and December 2021. The first 10 patients underwent surgery using only IOT (T group), whereas the subsequent 14 patients underwent surgery with a combination of IOT and PO (TP group).
Results:
The mean preoperative Cobb angles in the T and TP groups were 89.35°±6.05° and 92.32°±9.28°, respectively (p=0.59). The mean flexibility index (FI) of the T and TP groups were 0.31±0.016 and 0.36±0.03, respectively (p=0.41). The mean postoperative Cobb angle in the T and TP groups were 40.25°±5.95° and 19.1°±3.20°, respectively (p=0.041). Apical vertebral rotation improved from mean grade 3.2 (2–4) to grade 2.6 (1–3) in the T group and from mean grade 3.6 (2–4) to mean grade 1.8 (1–3) in the TP group. Postoperatively, the mean thoracic kyphosis was 13.84°±2.10° and 21.02°±1.68° in T and TP groups (p=0.044). Transient signal-loss intraoperatively was noted in two patients, one in each group. No episodes of postoperative neurological deficits were reported. No incidences of pseudarthrosis/implant-related complications were reported at the end of 2 years in either group.
Conclusions
IOT and PO complement one another and can be safely combined without an attributable risk of neurological injury.
10.Optimising deformity correction: a retrospective comparative analysis of two techniques in high magnitude curves in adolescent idiopathic scoliosis
Arvind Gopalrao KULKARNI ; Priyambada KUMAR ; Thonangi YESHWANTH ; Sharvari GUNJOTIKAR ; Praveen GOPARAJU ; Yogesh Madhavrao ADBALWAD ; Aditya Raghavendra Sai Siva CHADALAVADA ; Arvind UMARANI ; Shankargouda PATIL
Asian Spine Journal 2024;18(6):794-802
Methods:
Twenty-four patients with AIS (Cobb >65°) underwent surgery at a single center between January 2014 and December 2021. The first 10 patients underwent surgery using only IOT (T group), whereas the subsequent 14 patients underwent surgery with a combination of IOT and PO (TP group).
Results:
The mean preoperative Cobb angles in the T and TP groups were 89.35°±6.05° and 92.32°±9.28°, respectively (p=0.59). The mean flexibility index (FI) of the T and TP groups were 0.31±0.016 and 0.36±0.03, respectively (p=0.41). The mean postoperative Cobb angle in the T and TP groups were 40.25°±5.95° and 19.1°±3.20°, respectively (p=0.041). Apical vertebral rotation improved from mean grade 3.2 (2–4) to grade 2.6 (1–3) in the T group and from mean grade 3.6 (2–4) to mean grade 1.8 (1–3) in the TP group. Postoperatively, the mean thoracic kyphosis was 13.84°±2.10° and 21.02°±1.68° in T and TP groups (p=0.044). Transient signal-loss intraoperatively was noted in two patients, one in each group. No episodes of postoperative neurological deficits were reported. No incidences of pseudarthrosis/implant-related complications were reported at the end of 2 years in either group.
Conclusions
IOT and PO complement one another and can be safely combined without an attributable risk of neurological injury.

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