Sri Devaraj Urs Medical College

Head and neck squamous cell carcinoma (HNSCC) is a complex multivariable disease posing a significant challenge in therapeutics. OXPHOS and PPP are centrally implicated in metabolic heterogeneity influencing tumor behavior, treatment response, and patient outcomes. This study aims to stratify HNSCC based on OXPHOS and PPP gene expression to construct a clinical outcome risk predictive model. HNSCC patients were stratified into four metabolic subtypes including mixed, OXPHOS-leaning, PPP-leaning, and quiescent. The quiescent metabolic subtype showed longest survival with lower proliferation scores, whereas mixed subtype showed the worst survival with higher proliferation scores. Metabolic proteins of the CPTAC and ICPC cohorts affirmed the existence of metabolic heterogeneity among tumor samples. A prognostic risk predictive model was developed based on thirteen genes, which performed better than the OXPHOS-PPP-glycolysis model and other predictive forty-seven metabolic gene’s model. Existence of metabolic heterogeneity was successfully determined in HNSCC. OXPHOS and PPP genes enriched in mixed metabolic subtype having the worst clinical outcome are suggestive of higher metastatic potential, which might offer advisement in personalized therapeutics.

Nipah virus (NiV) outbreaks have garnered global attention due to their potential for devastating consequences on public health. Following two recent deaths from Nipah virus infection in Kerala in 2025, and considering the overall case fatality rate (CFR) of 69.4% reported in India to date, this review article presents a comprehensive analysis of NiV outbreaks, covering their historical background, epidemiology, transmission patterns, clinical features, diagnostic approaches, treatment options, preventive strategies, and current research advancements. Nipah virus, a zoonotic pathogen primarily transmitted from fruit bats to humans, poses a persistent threat to various regions, especially in Southeast Asia. Through a critical examination of past outbreaks and the lessons learned, this review aims to contribute to a better understanding of Nipah virus and enhance preparedness and response efforts for future outbreaks.

Introduction: Oral squamous cell carcinoma (OSCC) is the sixth most common cancer globally. Despite advances in therapeutic modalities, improvements in mortality and morbidity remain limited in early-stage OSCC. This variability in prognosis is due to the tumors biological heterogeneity and challenges in accurately predicting loco-regional recurrence (LRR). Objectives: The objective of the study is to evaluate the influence of the parameters that are included in Brandwein-Gensler (BG) risk model, i.e., lymphovascular invasion (LVI), lymph node metastasis, and depth of invasion (DOI) in predicting LRR in early-stage cases. Materials and Methods: A retrospective analysis was conducted on patients diagnosed with early-stage (T1/T2) OSCC over a 5-year duration who underwent primary surgical resection and had complete follow-up data available. Histopathological parameters were assessed using hematoxylin and eosin-stained sections, and BG risk score was applied based on standard criteria. Statistical analysis: Statistical analysis was done using Chi-square test and Fisher exact test where count is less than 5. Software used to conduct statistical analysis were MS Excel, and SPSS version 26, and P < 0.05 was considered to indicate statistical significance. Results: A total of 101 cases were included in this study, out of which 34 cases (33.67%) showed recurrence. Among evaluated parameters, LVI ( P = 0.004), perineural invasion (PNI) ( P < 0.001), worst pattern of invasion (WPOI) ( P < 0.001), DOI ( P < 0.001), lymphocytic host response (LHR) ( P < 0.001), and risk score ( P < 0.001) were found to be statistically significant predictors of LRR. Conclusions: The integration of histopathological factors such as LVI, PNI, WPOI, and LHR, particularly when evaluated using BG risk model, offers a valuable framework for identifying high-risk patients. Routine incorporation of this scoring system into initial diagnostic assessment can enhance prognostication and inform the selection of candidates for post-surgical adjuvant therapy, ultimately improving patient management and outcomes in early-stage OSCC.

Background and objectiveDistal radius fractures represent the most common upper extremity injury requiring surgical intervention. Volar plate fixation necessitates division of the pronator quadratus muscle, yet the necessity of systematic muscle repair remains controversial. While some studies suggest enhanced functional outcomes with repair, others demonstrate equivalent recovery patterns regardless of muscle reconstruction. This study aimed to analyze functional outcomes following volar plate fixation for distal radius fractures, comparing patients with and without pronator quadratus repair.Methodology A retrospective cohort study was conducted involving sixty patients with displaced distal radius fractures treated with volar plate fixation between September 2023 and October 2024. Patients were stratified into pronator quadratus repair (n=31) and non-repair (n=29) groups. Functional assessment utilized the validated Patient-Rated Wrist Evaluation questionnaire at eight weeks, three months, and six months postoperatively. Additional measurements included range of motion parameters, grip strength assessment using standardized dynamometry, and isokinetic forearm rotation strength evaluation. Statistical analysis employed independent t-tests, chi-square tests, repeated measures analysis of variance, and multivariate linear regression modeling.ResultsNo significant differences existed in baseline demographics between groups. Patient-Rated Wrist Evaluation scores demonstrated equivalent functional recovery at six months, with scores of 105.65 ± 13.15 versus 107.07 ± 12.43 (p=0.663). While initial advantages occurred in pronation strength 58.55 ± 4.12 degrees versus 55.17 ± 4.12 degrees (p=0.002) and wrist extension 65.97 ± 5.23 degrees versus 60.17 ± 1.63 degrees (p<0.001) in the repair group, grip strength showed no significant differences 6.16 ± 0.90 versus 6.07 ± 0.96 (p=0.695). Satisfactory isokinetic rotation strength was achieved in 71% versus 69% of patients, respectively (p=0.863). Multivariate regression confirmed that pronator quadratus repair was not a significant predictor of functional outcomes.ConclusionPronator quadratus repair following volar plate fixation does not significantly improve long-term functional outcomes despite initial mild biomechanical advantages. These findings support surgical decision-making frameworks that prioritize operative efficiency without compromising patient care standards, while acknowledging potential protective benefits for soft tissue coverage.

Small for gestational age (SGA) neonates have an increased risk of obesity, diabetes mellitus, and glucose intolerance in adult life. Understanding the factors that can increase the risk of SGA and complications might help with management. Hence, we quantified the cellular parameters, random blood sugar (RBS), and insulin-like growth factor (IGF)-axis proteins in appropriate for gestational age (AGA) ( n = 40) and SGA ( n = 20) neonates cord blood samples. Cord blood cell parameters and RBS were measured using an automated analyzer; insulin-like growth factor 1 (IGF1) and insulin-like growth factor binding protein 2 (IGFBP2) proteins were measured using enzyme-linked immunosorbent assay (ELISA). Mean % hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), red blood cell distribution width (RDW), packed cell volume (PCV), MCH concentration (MCHC), white blood cells (WBC), basophils, neutrophils, monocytes, lymphocytes, and RBS did not alter between AGA and SGA, except an increased red blood cells (RBC) ( P = .034) and platelet ( P = .025), and decreased eosinophils ( P = .037). The cord blood plasma IGF1 did not differ ( P = .79), and insulin-like growth factor binding protein 2 (IGFBP2) was significantly higher ( P = .04) in SGA. Overall, the RBC, platelets and IGFBP2 proteins were increased, and eosinophils were reduced in SGA neonates.

randomized controlled trials, meta-analyses, and systematic reviews that investigated the role of faradic foot bath therapy in improving foot function. Evidence from these studies demonstrates that faradic stimulation enhances muscle activation, promotes local blood circulation, and strengthens the intrinsic muscles of the foot, thereby improving the structural integrity of the arch. The results of this study suggest that faradic foot bath stimulation can serve as a valuable physiotherapeutic intervention for individuals with flexible flat foot, aiding in restoring proper foot alignment, reducing pain and discomfort, and improving overall functional mobility. This non-invasive and cost-effective approach offers significant potential for inclusion in comprehensive rehabilitation programs for flat foot management. Flat foot, also known as pes planus, is a prevalent musculoskeletal condition that affects approximately 20% of the adult population, with its occurrence steadily rising. The condition is commonly observed in individuals who are overweight or obese, as excessive body weight places increased stress on the medial longitudinal arch, leading to its gradual collapse. This research focuses on assessing the therapeutic effectiveness of faradic foot bath stimulation in the management of flexible flat foot. An extensive review of relevant literature was conducted using reputable databases such as PubMed and Cochrane Library, emphasizing.

Abstract Background Physical activity is crucial for maintaining the health and well-being of young adults, particularly in an era characterized by sedentary lifestyles. Objective This study aimed to evaluate leisure-time physical activity levels among university students aged 18–25 years using the Godin Leisure-Time Exercise Questionnaire (GLTEQ), which categorizes physical activity into three levels: strenuous, moderate, and light. Methodology A total of 878 undergraduate and postgraduate students from Garden City University were surveyed during an acculturation program on 28th June 2023. Data were analyzed using descriptive statistics to determine weekly activity scores. Results Mean scores were similar across genders: strenuous (2.55), moderate (3.48), and light (4.45–4.46) activities. The average weekly leisure activity score was 53.81 for males and 53.74 for females. Based on GLTEQ classification, 762 participants (86.8%) were categorized as “Active,” 67 (7.6%) as “Moderately Active,” and 49 (5.6%) as “Insufficiently Active.” Conclusion The findings suggest that the majority of the young adult participants are engaging in adequate levels of physical activity. These baseline values can inform targeted interventions to promote physical activity in similar populations.

In cervical carcinoma, lymph node involvement is a key indicator of disease progression and a critical prognostic factor that influences staging and treatment. Accurate identification of metastatic lymph nodes is essential for optimal management. Diffusion-weighted MRI combined with apparent diffusion coefficient (ADC) mapping provides a non-invasive approach for evaluating tissue cellularity and may enhance the identification of metastatic lymph nodes, surpassing traditional size-based criteria. The purpose of the study is to assess the effectiveness of diffusion-weighted imaging (DWI) and ADC values in differentiating between metastatic and non-metastatic lymph nodes in patients with cervical cancer. The study focuses on imaging findings without histopathological confirmation, aiming to determine whether ADC measurements can reliably indicate nodal metastasis. Thirty patients with histologically confirmed cervical cancer (International Federation of Gynecology and Obstetrics (FIGO) stage IB to IIIC) were prospectively enrolled in a study with a duration of three months. All patients underwent pre-treatment pelvic MRI including DWI on a 1.5 T scanner (b-values: 50, 400, and 800 s/mm²). ADC maps were obtained, and the ADC values of lymph nodes were quantitatively analyzed. Lymph nodes were categorized as suspicious for metastasis based on MRI features, including a short-axis diameter of ≥10 mm, round shape, or the presence of necrosis. Nodes lacking these characteristics were considered benign. Histopathological confirmation of lymph nodes was not conducted. A sample size of 30 was calculated via Fisher's z-test formula for correlation (assuming r = 0.685, 99% confidence, 90% power). Of 30 patients (mean age -63.5 years, range 51-80), one-third had radiologic evidence of lymph node involvement on MRI (stage IIIC1 by the FIGO 2018 criteria), while the remainder had no enlarged nodes. DWI showed qualitatively restricted diffusion in nodes suspected of metastasis. Quantitatively, ADC values were markedly lower in suspicious (metastatic-appearing) nodes compared to non-suspicious nodes. The mean ADC of nodes deemed metastatic was approximately 0.90 × 10-3mm²/s, versus ~1.30 × 10-3mm²/s for benign nodes (p < 0.001). Notably, all nodes with ADC < 1.0 × 10-3mm²/s were in the metastatic-suspect group, whereas nodes with ADC > 1.0 × 10-3mm²/s were benign, suggesting a clear separation. Using an ADC threshold of ~1.0 × 10-3mm²/s to define positive nodes, the sensitivity for detecting metastatic nodes was ~93% and specificity ~100% in this cohort. DWI and ADC mapping demonstrated strong potential in differentiating metastatic from non-metastatic lymph nodes in cervical carcinoma patients. Metastatic nodes showed significantly lower ADC values (around or below 1.0 × 10-3mm²/s) compared to non-metastatic nodes. These findings indicate that ADC measurements can augment conventional MRI assessment of lymph nodes, providing a non-invasive indicator of nodal metastasis. This could be especially valuable when surgical nodal sampling is not performed.

BackgroundOral squamous cell carcinoma (OSCC) represents a significant global health burden with complex pathophysiology involving tumor microenvironment interactions. The tumor stroma, particularly cancer-associated fibroblasts (CAFs), plays a crucial role in tumor advancement, invasion, and metastasis. CAFs, identified by alpha-smooth muscle actin (α-SMA) expression, influence tumor behavior through extracellular matrix remodelling and pro-tumorigenic signalling. Despite emerging evidence of their prognostic significance, the relationship between CAF expression patterns and clinicopathological parameters in OSCC remains inadequately characterized.ObjectivesThis study aimed to detect CAFs using α-SMA immunohistochemistry in OSCC and evaluate their association with LNM and pTNM staging, potentially identifying new prognostic markers for clinical management.MethodologyThis laboratory-based analytical study was conducted between September 2022 and December 2023. Histopathologically confirmed OSCC cases (n=88) treated by composite resection and cervical lymph node dissection were included, excluding recurrent cases, patients who received neoadjuvant chemotherapy, and second primary cancers. H&E slides were reviewed for LNM and pTNM staging. Immunohistochemical staining for α-SMA was performed on 4 μm formalin-fixed paraffin-embedded tissue sections using heat-induced antigen retrieval, followed by incubation with primary antibody and horseradish peroxidase (HRP)-conjugated secondary antibody. CAF expression was quantified using Kellermann et al.'s scoring system (Score 1 is <1%, Score 2 is between 1% and 50%, and Score 3 is >50% stained cells) and categorized by distribution pattern (focal, network, or spindle). Additional parameters assessed included tumor-stroma ratio (TSR), worst pattern of invasion (WPOI), tumor budding (TB), and tumor-infiltrating lymphocytes (TILs).ResultsThe study population comprised 88 patients (69.3% female, 30.7% male) (average age: 56.97 years). The buccal mucosa represented the most frequent site (50%), with well-differentiated tumors predominating (80.7%). Pathological staging revealed Stage IVA as the most prevalent (33%), followed by Stage III (31.8%). Regarding CAF expression, Score 3 (abundant CAFs) was observed in 55.7% of cases, Score 2 in 40.9%, and Score 1 in only 3.4%. Network pattern CAF distribution predominated (38.6%), with equal representation of focal and spindle configurations (30.7% each). Statistical analysis revealed no significant association between CAF scores and LNM (p=0.758); however, CAF distribution patterns demonstrated a statistically significant association with pTNM staging (χ²=26.716; p=0.001), with advanced stages showing a distinct pattern shift toward network and spindle arrangements. Notably, significant correlations were observed between TSR and CAF score (p<0.0001), TB and CAF score (p=0.021), and TB and LNM (p=0.047). More aggressive invasion patterns demonstrated higher CAF scores and increased TB intensity.ConclusionWhile CAF scores alone did not predict LNM, CAF architectural patterns demonstrated significant associations with pathological staging in OSCC. The correlations between CAF expression, TB, and invasion patterns suggest that CAF distribution may serve as a valuable prognostic indicator. These findings highlight the potential of CAF architectural evaluation as an adjunctive histopathological parameter for risk stratification in OSCC patients.