All India Institute of Medical Sciences Bhubaneswar (AIIMS Bhubaneswar), formerly Netaji Subhas Chandra Bose All India Institute of Medical Sciences, is a medical college and medical research public university located in Bhubaneswar, Odisha, India. The institute operates autonomously under the aegis of the Ministry of Health and Family Welfare. It was established in 2012 and the foundation stone was laid by late Bharat Ratna; Shri. Atal Bihari Vajpayee on 15 July 2003.
One reliable sociodemographic predictor of sleep is marital status. Being lonely, separated, residing away from a spouse may have distinct consequences, particularly for middle-aged and older persons. The objective is to determine the association between sleep disorders and current marital status among Indian population aged 45 years and above, stratified into gender and age group. Longitudinal ageing study in India (LASI) is an ongoing cohort study to collect information on health aspects of ageing in India. Current study is conducted using 1st wave of LASI data set (April 2017 to December 2018). Sleep disorders including sleep disturbance was assessed using the Jenkin Sleep Scale (JSS-4). It covers four sleep related questions in last one month and participants were classified as presence or absence of sleep disorder. We have assessed the association of sleep disorder (outcome/ response variable) with current marital status (explanatory/ exposure variable) adjusted with covariate using multivariable logistic regression. P value < 0.05 was considered statistically significant. STATA version 17 was used for analysis. Sleep disorder was highest among participants in live-in relationship (15.88
Extrahepatic portal vein obstruction (EHPVO) is a major cause of noncirrhotic portal hypertension, particularly in children and young adults. Traditionally, definitive management relied on surgical shunts such as proximal splenorenal shunt and meso-Rex bypass; however, extensive porto-mesenteric thrombosis, unfavorable anatomy, perioperative morbidity, and limited surgical expertise may restrict surgical feasibility in many patients. Over the last decade, advances in interventional radiology have substantially expanded therapeutic options beyond surgery. Portal vein recanalization (PVR) is increasingly considered a physiological endovascular treatment strategy in anatomically suitable patients because it restores hepatopetal portal flow while preserving native hepatic perfusion. In patients with diffuse intrahepatic involvement, persistent portal hypertension, or inadequate portal inflow, adjunctive transjugular intrahepatic portosystemic shunt (TIPS) may improve decompression and long-term patency. Transjugular extrahepatic portosystemic shunt (TEPS) serves as an advanced salvage option in complex anatomy unsuitable for conventional TIPS, while partial splenic embolization and variceal embolization complement management of hypersplenism and refractory variceal bleeding. This review provides an overview of endovascular interventions in EHPVO, highlighting the underlying rationale, patient selection, techniques, outcomes, and complications.
Chronic low back pain (CLBP) is a leading cause of disability worldwide, yet optimal pharmacological management remains debated. This letter to the editor appraises the observational study by Sardar et al , which compared amitriptyline and duloxetine in a tertiary rehabilitation setting. The study, involving 254 patients, demonstrated that amitriptyline provided rapid early pain relief, while duloxetine offered more sustained pain reduction at 12 weeks with fewer anticholinergic and sedative side effects. These findings are consistent with existing evidence supporting duloxetine’s efficacy and tolerability in chronic pain management. Although the absence of a placebo group limits causal inference, the study underscores the importance of individualized treatment strategies. We recommend further randomized controlled trials to validate these findings and strengthen evidence-based guidelines for CLBP management.
The ileal conduit is one of the most commonly performed urinary diversion procedures for muscle-invasive bladder cancer, and among the various complications, bleeding from an ileal conduit is rare. In patients with recurrent stomal haemorrhage, one must consider the possibility of atypical varices and assess for liver cirrhosis if it has not been previously established. Here, we describe a case of bleeding ectopic varices at the ileal conduit site in a patient in his 50s who underwent surgery for urinary bladder carcinoma, which was successfully managed through percutaneous transhepatic glue embolisation. Selective embolisation of these ectopic varices with coils or glue produces impressive results, offering the benefit of being minimally invasive, and can be considered an initial treatment option for stomal variceal bleeding. Other techniques, such as transjugular intrahepatic portosystemic shunt or antegrade and retrograde variceal occlusion using balloon or plug assistance, can also be attempted to eliminate varices.
An otherwise healthy female infant presented with left-sided, rapidly progressive, severe periorbital swelling, erythema and proptosis for 7 days’ duration. Imaging revealed multiple fluid-filled lobulated pockets in both intraconal and extraconal orbital spaces suggestive of multiple orbital abscesses which had an extension to the nasal cavity. Surgical drainage of the abscess was done along with administration of intravenous antibiotics. Diagnostic lacrimal system probing revealed soft stop warranting a nasal endoscopy during which a membranous thick-walled outpouching from the inferior meatus was noted. It was a congenital nasolacrimal duct cyst. Transnasal endoscopic complete marsupialisation of the cyst was done followed by successful silicone intubation. The child recovered well with resolution of orbital signs and no recurrence at follow-up. This case underscores the importance of early recognition of a congenital nasolacrimal duct cyst which can complicate vision and life-threatening complications.
