Background: s/Aims: Hepatic artery pseudoaneurysm (HAP) is a condition associated with high mortality rates when untreated. Current literature lacks comprehensive understanding of complication rates and optimal treatment strategies. This study aims to analyze the etiology, technical success, and complication rates associated with endovascular and percutaneous management of HAP. Methods: A retrospective analysis was conducted, examining data on demographics, comorbidities, etiology, and embolic agents. A comparative analysis of hemoglobin levels, liver function tests, and renal function tests was performed before and 24–48 hours after the procedure. Results: The study included 49 patients (71% males) with a mean age of 46.44 (± 15.88) years. The common etiologies were post-operative complications (36.7%) and blunt abdominal trauma (26.5%). The right hepatic artery (RHA) was the most frequently involved site (57%). Endovascular embolization involved the use of coils, glue, and stent grafts, while percutaneous embolization was performed in six cases. The technical success rate for the endovascular approach was 97.6%, compared to 33% for the percutaneous approach. Hemoglobin levels stabilized post-procedure (mean post-procedure 8.9 g/dL vs. 7.9 g/dL at presentation), indicating effective hemostasis.Post-procedural complications included transient elevation of liver enzymes (22.4%), hepatic abscess (4.1%), and cholangitis (2.0%). Conclusions HAP is primarily caused by iatrogenic injury or blunt abdominal trauma, with a predilection for the RHA. Endovascular therapy proves to be a safe and effective treatment for this life-threatening condition. Although high technical success rates are achievable, the potential for ischemic complications necessitates a tailored treatment approach and the implementation of prophylactic measures when indicated.

Emphysematous pyelonephritis (EPN) is a severe necrotizing kidney infection characterized by gas formation. While EPN is recognized in native kidneys and occasionally in functional renal allografts, its occurrence in nonfunctional allografts is extremely rare.We present a case of EPN in a 38-year-old female with a history of renal transplantation who developed EPN in a nonfunctional graft 1 year after returning to hemodialysis.The patient initially demonstrated excellent graft function posttransplant but later developed chronic antibody-mediated rejection and calcineurin inhibitor toxicity, which led to graft failure and resumption of hemodialysis. One year later, she presented with fever and graft site tenderness. Imaging revealed stage 3 EPN in the allograft. Empirical broad-spectrum antibiotics and percutaneous drainage were initiated, followed by graft nephrectomy due to persistent fever spikes. This case highlights the occurrence of EPN in a nonfunctional graft, even after cessation of immunosuppression. The presence of a nonfunctioning graft with impaired blood supply may have provided a nidus for infection. It underscores the importance of considering nephrectomy as a primary therapeutic approach in such cases. This case also emphasizes the need for heightened clinical suspicion and prompt intervention in transplant recipients with suspected EPN, even in the absence of a functioning graft.

Methods: This study included 36 patients with HGS in whom reduction, posterior instrumentation, and fusion were achieved with MIS– TLIF. They were evaluated for lower back pain and radicular pain, scaled by Visual Analog Scale (VAS) score. Erect radiographs were performed to calculate slip angle (SA) and sacropelvic and spinopelvic parameters preoperatively, postoperatively, and at each follow-up until 4 years. Results: This study identified 30 patients with grade III HGS and six patients with grade IV/V HGS. Spinopelvic parameters were unbalanced in 13 patients. Complete reduction was achieved in 24 patients, with end-stage reduction of grade I with adequate spinopelvic balance achieved in 12 patients. Intraoperative neuromonitoring demonstrated no loss of signals throughout the procedure in any of the patients. Excellent functional outcome was achieved with back pain as well as leg pain VAS score improvements postoperatively in all patients. No implant-related complications or pseudoarthrosis incidences were reported at long-term follow-up at 4 years. Conclusions MIS–TLIF for HGS is a specific solution for a complex pathology, enabling one to achieve an excellent clinical as well as radiological outcome.

Methods: This study included 36 patients with HGS in whom reduction, posterior instrumentation, and fusion were achieved with MIS– TLIF. They were evaluated for lower back pain and radicular pain, scaled by Visual Analog Scale (VAS) score. Erect radiographs were performed to calculate slip angle (SA) and sacropelvic and spinopelvic parameters preoperatively, postoperatively, and at each follow-up until 4 years. Results: This study identified 30 patients with grade III HGS and six patients with grade IV/V HGS. Spinopelvic parameters were unbalanced in 13 patients. Complete reduction was achieved in 24 patients, with end-stage reduction of grade I with adequate spinopelvic balance achieved in 12 patients. Intraoperative neuromonitoring demonstrated no loss of signals throughout the procedure in any of the patients. Excellent functional outcome was achieved with back pain as well as leg pain VAS score improvements postoperatively in all patients. No implant-related complications or pseudoarthrosis incidences were reported at long-term follow-up at 4 years. Conclusions MIS–TLIF for HGS is a specific solution for a complex pathology, enabling one to achieve an excellent clinical as well as radiological outcome.

Methods: This study included 36 patients with HGS in whom reduction, posterior instrumentation, and fusion were achieved with MIS– TLIF. They were evaluated for lower back pain and radicular pain, scaled by Visual Analog Scale (VAS) score. Erect radiographs were performed to calculate slip angle (SA) and sacropelvic and spinopelvic parameters preoperatively, postoperatively, and at each follow-up until 4 years. Results: This study identified 30 patients with grade III HGS and six patients with grade IV/V HGS. Spinopelvic parameters were unbalanced in 13 patients. Complete reduction was achieved in 24 patients, with end-stage reduction of grade I with adequate spinopelvic balance achieved in 12 patients. Intraoperative neuromonitoring demonstrated no loss of signals throughout the procedure in any of the patients. Excellent functional outcome was achieved with back pain as well as leg pain VAS score improvements postoperatively in all patients. No implant-related complications or pseudoarthrosis incidences were reported at long-term follow-up at 4 years. Conclusions MIS–TLIF for HGS is a specific solution for a complex pathology, enabling one to achieve an excellent clinical as well as radiological outcome.

Students’ Satisfaction and Learning Outcomes with Virtual and Light Microscopy in Undergraduate Pathology: A Randomised Cross-Over Trial Virtual microscopy (VM) has emerged as a valuable adjunct to light microscopy (LM) in medical education, enabling remote access to high-quality histopathological images. While many studies report improved satisfaction and comparable better learning outcomes with VM, effectiveness in student performance was not properly studied. This study evaluated students’ satisfaction and effectiveness of VM compared to LM in undergraduate pathology teaching of a Malaysia private institution. A randomised cross-over trial was conducted among Year 1 and Year 2 medical students. Pre- and post tests consisting of 10 one-best-answer (OBA) questions, mapped to the histopathology slides used in pathology practical sessions, were used to analyse effectiveness of VM and LM. After crossover swapping the groups, students completed pre-validated 5-point Likert scale questionnaires to assess the satisfaction on both methods. A majority (≥65%) expressed satisfaction with both LM and VM; however, VM scored higher for ease of use, time efficiency, and image quality. Group (B) with VM followed by LM had higher mean pre-test scores (6.85 ± 1.80) than Group A with LM followed by VM (5.92 ± 2.29), suggesting possible baseline differences. Post-test scores improved significantly in both groups (p < 0.001). Although Group B’s post test mean was higher (9.13 ± 1.19) than Group A’s (8.61 ± 1.63), this may reflect initial group performance rather than VM superiority alone. Although the reliability statistics of tests could not be analysed, this study concluded that VM is a reliable adjunct tool to replace traditional LM in teaching learning. However, differences in baseline performance between groups highlight the need for cautious interpretation when comparing modalities. Integration of VM into e-learning platforms may enhance blended pathology education.

OBJECTIVE: To obtain detailed understanding on the gene regulation of natural compounds in altering prognosis of head and neck squamous cell carcinomas (HNSC). METHODS: Gene expression data of HNSC samples and peripheral blood mononuclear cells (PBMCs) of HNSC patients were collected from Gene Expression Omnibus (GEO). Differential gene expression analysis of GEO datasets were achieved by the GEO2R tool. Common differentially expressed gerres (DEGs) were screened by comparing DEGs of HNSC with those of PBMCs. The combination was further analyzed for regulating pathways and biological processes that were affected. RESULTS: Totally 110 DEGs were retrieved and identified to be involved in biological processes related to tumor regulation. Then 102 natural compounds were screened for a combination such that the expression of all 110 commonly DEGs was altered. A combination of salidroside, ginsenoside Rd, oridonin, britanin, and scutellarein was chosen. A multifaceted, multi-dimensional tumor regression was showed by altering autophagy, apoptosis, inhibiting cell proliferation, angiogenesis, metastasis and inflammatory cytokines production. CONCLUSIONS This study has helped develop a unique combination of natural compounds that will markedly reduce the propensity of development of drug resistance in tumors and immune evasion by tumors. The result is crucial to developing a combinatorial natural therapeutic cocktail with accentuated immunotherapeutic potential.
Humans ; Leukocytes, Mononuclear ; Head and Neck Neoplasms/drug therapy* ; Squamous Cell Carcinoma of Head and Neck/drug therapy* ; Immunotherapy ; Prognosis

Objective: To assess the effectiveness of leukocyte–platelet-rich fibrin (L-PRF) compared with conventional treatment on canine retraction, rotation, pain, and soft tissue healing. Methods: Sixteen adult patients aged 18–25 years (10 females, and 6 males; mean age 22.25 ± 2.26 years) with Class I bimaxillary protrusion and Class II div 1 malocclusion participated in this single-center, split-mouth randomized controlled trial at the Orthodontics Department of a single hospital in SCB Dental College and Hospital, Cuttack, India.Randomization was performed using a computer-assisted function with a 1:1 allocation ratio. The intervention included the placement of L-PRF on the experimental side and follow-up for 90 days. The primary outcome measures were canine retraction, rotation, pain, and soft tissue healing. The range of tooth movement was evaluated at 15-day intervals: 0th day (T0), 15th day (T1), 30th day (T2), 45th day (T3), 60th day (T4), 75th day (T5), and 90th day (T6).Canine rotation was assessed at T0 and T6, and pain and soft tissue healing were evaluated on the 3rd, 7th, and 15th days of the treatment. Results: Cumulatively, the L-PRF group demonstrated a significantly greater tooth movement as compared to conventional treatment group (P < 0.001). Overall, canine retraction was 1.5 times greater on the L-PRF side than on the control side. Canine rotation showed no significant relationship, whereas pain and soft tissue healing were significantly better on the L-PRF side than on the control side. Conclusions Local administration of L-PRF amplifies canine retraction while improving pain and soft tissue repair.