Amrita Institute of Medical Sciences (AIMS), also referred to as Amrita Hospital, is a super-specialty quaternary care health center and medical school in Kochi, India. It is one of the largest medical facilities in the country with a total built-up area of over 3.33 million sq.ft, spread over 125 acres of land. It is a 1,450-bed hospital which supports a daily patient volume of about 3,000 outpatients with 95 percent inpatient occupancy. It was inspired by Mata Amritanandamayi and inaugurated on 17 May 1998 by the then Prime Minister, Atal Bihari Vajpayee. The Mata Amritanandamayi Math is its parent organisation. Ron Gottsegen is the executive director and Prem Nair is the medical director of AIMS. Dr.(Col). Vishal Marwaha is the Principal/Dean of AIMS.AIMS is part of the Health Sciences campus of Amrita Vishwa Vidyapeetham (Amrita University). The hospital has received the ISO 9001:2008 accreditation and also enjoys accreditation from the National Accreditation Board for Testing and Calibration Laboratories (NABL) for its laboratories and the National Accreditation Board for Hospitals and Healthcare Providers NABH for the hospital overall. In April 2019, Amrita School of Medicine was ranked the fifth best medical college in India by the Ministry of Human Resource Development in their annual NIRF rankings.
Small renal masses (SRMs), defined as renal tumors < 4 cm, are increasingly detected due to the widespread use of imaging modalities. Data from India regarding the clinical characteristics and outcomes of SRMs remain limited. This multi-institutional study led by the Society of Genitourinary Oncologists aims to delineate the demographic, radiological, and pathological profiles of SRMs in the Indian population and evaluate management outcomes following partial nephrectomy. A retrospective analysis was conducted across multiple tertiary care centers in India from January 2013 to December 2022. Patients aged ≥ 18 years with SRMs undergoing partial nephrectomy were included. Data on demographics, clinical presentation, radiology (including RENAL nephrometry score), intraoperative factors, postoperative outcomes, and histopathology were analyzed. Statistical associations between renal scores, BMI, tumor stage, and histologic type were assessed. A total of 432 patients were analyzed, with a male predominance (76.6
Cluster headache (CH) is a severe unilateral trigeminal autonomic cephalalgia with limited well tolerated therapies. Calcitonin gene related peptide monoclonal antibodies, including galcanezumab, fremanezumab, and eptinezumab, have established efficacy in migraine and are under evaluation in CH. This study assesses their efficacy and safety using pairwise and network meta analysis. PubMed, Embase, Scopus, and ClinicalTrials.gov were searched through April 2025. Randomized controlled trials enrolling adults with episodic or chronic CH were included. The primary endpoint was change in weekly attack frequency. Secondary outcomes included subtype specific effects and adverse events. Frequentist random effects network meta analysis and pairwise meta analysis were performed in R. Five trials with approximately 1,000 participants were included. No agent demonstrated statistically significant reduction in weekly attack frequency versus placebo, although consistent numerical improvements were observed. Dose specific network estimates showed mean differences of − 0.81 for galcanezumab 300 mg, − 0.17 for eptinezumab 400 mg, 0.71 for fremanezumab 675/225 mg, and − 1.27 for fremanezumab 900/225 mg. Pooled dose estimates were − 0.81 for galcanezumab, − 0.27 for fremanezumab, and − 0.17 for eptinezumab. Pairwise meta analysis yielded a pooled mean difference of − 0.41. Subgroup analysis indicated minimal change in chronic CH and greater numerical reduction in episodic CH. CGRP monoclonal antibodies demonstrate modest directional reductions in attack frequency without statistical significance. Signals appear more pronounced in episodic CH, supporting the need for adequately powered, subtype specific trials.
BackgroundLiterature on caregiver burden is limited in India and Kerala. We examined the prevalence and factors associated with caregiver burden and its impact on their quality of life.MethodsWe conducted a cross-sectional study among 115 informal caregivers (mean age 70 years, 80% female) of palliative care patients in Kerala. Caregivers were interviewed using the Zarit Burden Interview-22 and the WHOQOL-BREF questionnaires. Factors associated with caregiver burden were analysed using binary logistic regression.ResultsThe prevalence of moderate to severe burden was 32.1% (95% CI 23.7% to 41.5%), with 6.2% reporting severe burden (95% CI 2.4% to 12.1%). Caregivers of patients aged ≥73 years (adjusted OR (aOR)=7.19, 95% CI 1.87 to 27.71, p=0.004), children acting as caregivers (aOR=11.09, 95% CI 1.21 to 101.03, p=0.033) and those caring for patients with prolonged disease duration (aOR=3.62, 95% CI 1.04 to 12.67, p=0.044) reported significantly higher burden compared with their counterparts. Moderate to severe burden was associated with lower physical (p<0.001), psychological (p<0.001) and social relations (p=0.002) quality of life scores.ConclusionTargeted interventions for caregivers of older patients, children acting as caregivers and those taking care of patients with prolonged disease duration are likely to reduce burden and improve their quality of life.
Plasma exchange (PLEX) improves survival in acute liver failure (ALF); however, there is no study specifically analyzing its utility in hepatitis A virus-related ALF (HAV-ALF). A few reports suggest that ALF patients who are not on inotropes tolerate PLEX better. We aimed at comparing the efficacy of PLEX and of standard medical treatment (SMT) to treat HAV-ALF. We retrospectively compared consecutive HAV-ALF patients treated with PLEX (2018–2024) vs. SMT (2011–2024) at 13 centers across India. We compared in-hospital native liver survival in both groups. In the subset of patients not on inotropes, we compared survival and assessed predictors of poor outcome in PLEX and SMT groups. Eighty-four HAV-ALF patients in PLEX group (61 males; age = 23.5 [21–33] years, median [IQR]; King’s College Criteria [KCC] fulfilled = 22 patients, 26.2
