Pramukhswami Medical College

Infection-related movement disorders (IRMD) represent an important group of secondary movement disorders whose prevalence, patterns, treatment and outcomes remain poorly understood. To survey members of the International Parkinson and Movement Disorder Society regarding prevailing practices in IRMD. A cross-sectional online survey was conducted. Of 95 responses received, 75 (78.9%) were from the Asia-Oceania (AO) region and were further analyzed. The highest number of responses was from India (67/75, 89.3%). The most frequent phenotypes included ataxia (64, 85.3%), chorea (49, 65.3%), myoclonus (55, 73.3%) and parkinsonism (43, 57.3%). Tuberculosis-related (61, 81.3%), subacute sclerosing panencephalitis (50, 66.7%), and dengue-related movement disorders (49, 65.3%) were most frequent. Variable outcomes were observed by 46 (61.3%) respondents and 66 (88%) indicated that up to 50% of patients experienced persistence of IRMD. This survey provides critical insights into prevailing practices in the field of IRMD from the AO region.

Background: Urothelial lesions, both neoplastic and non-neoplastic, commonly present with haematuria. Urinary bladder cancer, the 10th most common cancer globally, is 90% of urothelial origin. Cystoscopic biopsies and Trans Urethral Resection of Bladder Tumour remain the gold standards for diagnosis, staging, and prognostic evaluation. Methods: This study analysed 100 cases (retrospective, prospective) of all urothelial lesions. Neoplastic cases were classified as per the 2022 World Health Organization classification of urothelial carcinoma and reported as per College of American Pathologists (CAP) protocol. Demographics, clinical history, and radiological data were collected from hospital databases. Descriptive statistics [Frequency, Mean, SD, P-value] was used to depict the baseline profile and clinical diagnosis of all the study participants. Statistical analysis was performed using STATA 14.2. Results: Neoplastic lesions (65%) were more common than non-neoplastic ones (35%), with a male predominance (Male: Female = 5:1) and peak occurrence in the seventh decade (36.92%). Hematuria was the most frequent presentation (81.53%), with smoking being the leading risk factor (36.92%, P=0.021). The most common non-neoplastic and neoplastic lesion were interstitial cystitis (71.43%) and invasive urothelial carcinoma (73.83%), respectively. Radiological and histopathological findings were concordant in 90% of cases. Conclusion: Invasive urothelial carcinoma predominates among neoplastic lesions, occurring in older males with smoking as a significant risk factor. Hematuria remains the primary clinical symptom. Evaluating muscle invasion is critical for prognosis and treatment planning. Radiology and histopathology play a vital role in diagnosis, while immunohistochemistry and molecular studies are essential for precise classification and typing.

Background Neonates, particularly those born preterm, undergo multiple painful procedures in neonatal intensive care units (NICUs). Evidence shows that such exposures are not transient but induce long-lasting neuroimmune and epigenetic changes, creating a phenomenon termed “pain memory,” with effects on brain development and behavior. Methods This scoping review was conducted using a PICOT framework. Population: neonates (preterm and term); Intervention: procedural or surgical pain and its management (pharmacological and non-pharmacological); Comparator: infants with lower/no pain exposure or alternative management; Outcomes: (a) biological mechanisms, (b) neurodevelopmental and behavioral sequelae such as anxiety and dysregulation, (c) demographic/sex-specific differences, (d) clinical management strategies; Timeframe: immediate to long-term follow-up. Searches of PubMed, Embase, Web of Science, Scopus, and Cochrane (1990-May 2025) identified 342 records. Following duplicate removal, 270 abstracts were screened, 90 full texts were reviewed, and 30 studies were included. Screening was performed independently by two reviewers, with conflicts resolved by a third adjudicator. Data were charted for design, demographics, interventions, outcomes, and limitations. Results Studies have revealed that early nociceptive injury primes microglia and reprograms macrophages through epigenetic pathways. Clinical cohorts showed cumulative pain exposure associated with altered thalamic/cortical development, reduced white-matter integrity, lower cognitive scores, and higher risks of anxiety and behavioral dysregulation. Females exhibited stronger immune-mediated programming, while extremely preterm infants were most vulnerable. Non-pharmacological strategies (skin-to-skin, breastfeeding, sucrose), alongside judicious pharmacological use, reduced acute pain and may influence long-term outcomes. Conclusions Neonatal pain memory represents durable biological and behavioral alterations. Multimodal, family-centered approaches should be standard, while future trials must clarify whether early interventions reduce later neurodevelopmental risks and how sex-specific mechanisms can inform personalized care.

Abstract The field of forensic facial reconstruction blends scientific techniques with artistic abilities. This approach is employed to recreate the soft tissue features of the skull, aiming to produce an image of an individual that can be used for recognition and identification purposes. In forensic science, this method is used in the identification of an individual, where the conventional\usual methods of identification are unsuccessful or reference samples for DNA typing and matchings are absent. This paper presents a case report, wherein forensic facial reconstruction was performed on the skull of an unidentified deceased individual, thereby narrowing the search for reference DNA samples. In forensic investigations, the combined use of DNA analysis and forensic facial reconstruction techniques can significantly improve the accuracy of human identification. These two methods work together synergistically to enhance the overall effectiveness of the identification process.

Brucellosis, a zoonotic disease, is responsible for multitude of health issues and economic burden in community and is widely studied in high-risk population. The prevalence of disease or exposure to the organism causing brucellosis in a specific community has not been studied widely. This study was conducted to measure community-based seroprevalence of human brucellosis in livestock-rearing villages in three districts of central Gujarat. We collected a total of 2561 blood samples of individuals from households of 93 villages. Multistage random sampling techniques were used for sample collection during the study period of 2021-2023. Serum samples were tested for immunoglobulin (Ig) G and IgM by the Novatech enzyme-linked immunosorbent assay Brucella kit. District-wise seropositivity ranged from 18.35% to 26.81%, and overall, 579 (22.60%) samples were found to be positive for IgG, IgM, or both antibodies to Brucella spp . The seroprevalence of human brucellosis is high in the community of livestock-rearing villages and requires to be studied in more detail.

Background and aimPleural empyema remains a serious complication of pulmonary infections, with high morbidity and mortality if not managed effectively. While antibiotics and drainage are sufficient in the early stages, chronic empyema often requires surgical intervention. This study evaluates the outcomes of early thoracotomy and decortication for pleural empyema at a tertiary cardiac center in India.MethodsA retrospective observational study was conducted on nine patients who underwent early thoracotomy and decortication between 2018 and 2024. Demographics, radiological findings, etiology, complications, survival, and follow-up outcomes were analyzed. Survival and event-free survival were assessed using the Kaplan-Meier method.ResultsSix patients were female (66.7%), and three were male (33.3%). Four patients underwent right-sided, four left-sided, and one bilateral decortication. Six patients (66.7%) had moderate pleural fluid, three (33.3%) had large fluid collections, and all nine (100%) had pleural thickening ≥2 cm. Etiologies included non-tuberculosis (TB; n = 7; 77.8%) and TB (n = 2; 22.2%). Postoperative complications occurred in three patients (33.3%), including prolonged air leak (n = 2) and superficial wound infection (n = 1). One patient (11.1%) died from nosocomial pneumonia, acute respiratory distress syndrome, and septic shock. Kaplan-Meier estimated survival probability was 88.9% at 30 days and remained stable at 12 months. Event-free survival at 12 months was 66.7%. The median hospital stay was 12 days (range, 8-21). All survivors demonstrated satisfactory lung re-expansion with no recurrence during three to 12 months of follow-up.ConclusionsEarly thoracotomy and decortication is a safe and effective treatment for advanced-stage pleural empyema, yielding favorable survival and functional outcomes. Despite advances in minimally invasive surgery, thoracotomy remains indispensable for selected patients, particularly in TB-endemic regions.

Abstract Disclosure: S. Sahu: None. T. Jain: None. A.J. Augustine: None. G. Palaniswamy: None. T. Mareedu: None. P.R. Patel: None. B. Padamati: None. N. Koduri: None. A. Dixit: None. Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder among reproductive-age women, characterized by hormonal imbalance, insulin resistance, and metabolic dysfunction. Despite growing evidence linking PCOS to cardiovascular risk factors such as hypertension, dyslipidemia, and chronic inflammation, longitudinal studies examining the direct association between PCOS and cardiovascular disease (CVD) remain limited. Women under 40 with PCOS face an elevated risk of cardiovascular disease due to metabolic and hormonal imbalances. Key risk factors include insulin resistance, obesity, and hypertension. Lifestyle interventions and management of weight and diabetes are essential strategies to reduce this risk. While PCOS is associated with increased cardiovascular risk, further research is needed to fully understand the independent effects of PCOS on CVD. This study aims to evaluate the long-term cardiovascular risk in women diagnosed with PCOS through a retrospective cohort analysis and address this research gap.Methods: A retrospective analysis was conducted using a dataset comprising 1,000 women aged 18-40, with 500 diagnosed with PCOS and 500 age-matched controls without PCOS. Key cardiovascular risk markers, including systolic and diastolic blood pressure (BP), lipid profile (LDL, HDL, triglycerides), fasting glucose, insulin resistance (HOMA-IR), and inflammatory marker C-reactive protein (CRP), were compared between groups. T-tests were used for continuous variables, and a chi-square test was performed to assess the association between PCOS and CVD. Additionally, logistic regression was conducted to evaluate PCOS as an independent predictor of CVD after adjusting for confounders such as BMI, smoking status, and physical activity.Results: Women with PCOS exhibited significantly higher systolic BP (p < 0.01), LDL cholesterol (p < 0.001), triglycerides (p < 0.001), fasting glucose (p < 0.01), and CRP (p < 0.001) compared to controls. The prevalence of CVD was markedly elevated in the PCOS group (chi-square test, χ² = 26.24, p < 0.0001), suggesting a strong association between PCOS and cardiovascular risk. Logistic regression confirmed that PCOS remained an independent predictor of CVD (OR: 2.45, 95% CI: 1.78–3.42, p < 0.001) even after adjusting for confounders.Conclusion: This study provides compelling evidence that PCOS is a significant risk factor for cardiovascular disease, independent of BMI and lifestyle factors. The elevated levels of atherogenic lipids, blood pressure, and inflammatory markers in PCOS patients underscore the urgent need for early cardiovascular screening and risk management in this population. Future research should focus on long-term interventions to mitigate CVD risk in women with PCOS and further clarify the independent role of PCOS in cardiovascular outcomes. Presentation: Saturday, July 12, 2025

Introduction:Giant cell tumor (GCT) in Orthopedics is a clinically challenging problem pertaining aggressive expansion and recurrence. While GCT’s typically occur at epiphyseal ends of long bones, unusual locations, such as tendon sheath, distal ulna, and proximal tibia have been reported, which impose different challenges for management.Case Series:In this case series, we present surgical methodology tailored for individual characteristics of GCTs, with emphasis on functional recovery. We demonstrate four cases involving different sites GCT – tendon sheath in hand, distal ulna, distal radius, and proximal tibia. Each case was managed using a site-specific surgical approach, ranging from en bloc resection with ulna transposition and arthrodesis to Illizarov assisted bone transport. Emphasis is laid on strategic surgical technique coupled with functional preservation and prevention of recurrence. All patients were successfully treated without recurrences at follow-up ranging 6 months to 2 years. Functional outcomes varied depending on the location and extent of surgical dissection, but improved overall, as evident by patients’ return to routine daily activities with significant relief from pain. This case series underscores importance of a tailored, site-specific approach for managing GCT.Conclusion:Strategic surgical intervention employed with limb-sparing technique using reconstructive surgery, highlights the potential for restoration of optimal function while minimizing the risk of recurrence. However, the diversity of GCT presentation necessitates vigilant surveillance and an individualized patient management plan.