Artemis Hospital is a JCI and NABH accredited hospital in Gurgaon, India. The hospital was founded in 2007 by the promoters of the Apollo Tyres Group, as a multi speciality hospital providing research and technology oriented medical procedures. It acquired the NABH accreditation in 2017 and was the first hospital in Gurgaon to be accredited by Joint Commission International (JCI) in 2013.
Introduction: Partial posterior urethral valves (PUV) constitute a milder but progressive subset of lower urinary tract obstruction (LUTO) that often evades early prenatal detection. Persistent sub-obstruction provokes an inflammatory response in the fetal kidney, resulting in echogenic parenchyma, reduced urine production, and evolving renal dysfunction. This study aimed to describe the role of fetal urine biochemistry in evaluating renal function and prognosis in partial PUV and to outline the underlying inflammatory and biochemical changes associated with progressive obstruction. Methods: Evidence regarding the pathophysiology of partial PUV, fetal renal inflammatory responses, next-generation sequencing (NGS) utility in congenital anomalies of the kidney and urinary tract (CAKUT), and fetal urine biochemical thresholds was synthesized. Key biochemical markers obtainable via vesicocentesis or amniotic fluid sampling were examined for renal functional assessment. Results: Partial PUV induces sustained tubular injury accompanied by cytokine-mediated inflammation involving IL-6, TNF-alpha, and MCP-1, ultimately promoting interstitial fibrosis and nephron loss. Fetal urine biochemical parameters specifically sodium >100 mmol/L, chloride >90 mmol/L, osmolality >210 mOsm/kg, and beta 2-microglobulin >6 mg/L correlate with impaired tubular reabsorption and declining renal function. These abnormalities can appear before overt sonographic indicators of severe obstruction. When NGS results are normal, fetal urine biochemistry provides critical prognostic information and enhances prenatal counseling. Conclusion: Fetal urine biochemistry serves as a valuable functional biomarker for detecting early renal compromise in partial PUV. Integration of biochemical profiling into prenatal diagnostic pathways can improve prognostication, guide counseling, and may be applicable to other subtle forms of urinary tract obstruction due to its reproducible reflection of inflammatory and tubular injury processes.
Objective:To describe the revised APSIC Environmental Hygiene Guidelines for prevention of healthcare-associated infections inclusive of surface cleaning, air and water quality. Design:The revised guideline was developed by Infection Prevention and Control key opinion leaders from Asia Pacific. Setting:This guideline emphasizes on practical implementation of environmental hygiene for prevention of healthcare-associated infections inclusive of surface cleaning, air and water quality relevant to Asia Pacific settings. Patients or participants:Any patients hospitalized in healthcare setting. Interventions:Literature search was done for recent international updates in environmental hygiene inclusive of surface cleaning, air and water quality. Recommendations were evaluated for practical and feasible recommendation in low-resourced settings in Asia Pacific. Results:The key recommendations are listed in the best practices for cleaning patient care areas. Additional measures are recommended to improve the air and water quality in healthcare settings. Conclusions:Implementation of environmental hygiene in Asia Pacific should take into consideration of the air and water quality in addition of surface cleaning. Measures to assess the cleanliness should be performed using conventional visual assessment, environmental cleaning and disinfection checklist, auditing, and additional measures (e.g., environmental culture or fluorescence).
e14060 Background: Gliomas have few approved targeted therapies. Given frequent blood-brain-barrier disruption in gliomas, molecular targets with FDA-approved therapies in other solid tumors represent relevant precision-oncology opportunity. Methods: A total of 235 glioma tumor tissue samples underwent targeted next-generation sequencing at Datar Cancer Genetics. Clinical actionability was assessed using ESCAT. Subgroup analyses were performed based on IDH status. Results: Of 235 samples, 6 were grade I (2.6%), 17 grade II (7.2%), 38 grade III (16.2%), and 159 grade IV (67.8%); grade was unavailable in 15 (6.4%). Overall, 43.8% (103/235) harbored ≥1 tumor-agnostic or cross-indication actionable alteration with an FDA-approved therapy in solid tumors. Tumor-agnostic biomarkers included TMB-H (11.6%; 16/138), dMMR (1.7%; 2/116), BRAF V600E (4.9%; 11/225), and NTRK fusions (0.6%; 1/178); HER2 amplifications and RET fusions were not detected. Canonical CNS alterations included IDH1/2 (24.0%; 54/225), TERT promoter (36.1%; 73/202), TP53 (42.4%; 95/224), H3F3A (3.8%; 7/185), ATRX (8.2%; 18/219), EGFR amplification (21.2%; 43/203), CDKN2A/2B loss (18.8%; 38/202), EGFRvIII (12.9%; 23/178), and EGFR mutations (10.7%; 24/225). Cross-indication alterations involved PI3K-AKT-mTOR ( PIK3CA 8.4% [19/225], PTEN 18.3% [41/224]) and FGFR (4.3%; 10/235); KIAA1549-BRAF and PTPRZ1-MET fusions were each detected in 1.1% (2/178). ESCAT Tier I alterations were present in 29% (69/235) and Tier II–III in 56% (132/235). Though incidence of tumor-agnostic biomarkers was similar in IDH -mutant and IDH -wildtype ( IDH -WT) gliomas (13.0% [7/54] vs 11.6% [21/181]), the cross-indication biomarkers were enriched in IDH -WT gliomas (40.9% [74/181] vs 20.4% [11/54]). In grade IV gliomas, cross-indication biomarkers were more frequent in IDH -WT than IDH -mutant tumors (45.3% [62/137] vs 18.2% [4/22]), with similar findings in combined grade III–IV gliomas (42.9% [66/154] vs 25.6% [11/43]). Conclusions: Despite poorer prognosis, IDH -WT gliomas are enriched for cross-indication actionable alterations, reflecting biological actionability without established clinical benefit, and supporting comprehensive molecular profiling to guide indication-expanded therapies, clinical trial enrolment, and prospective interventional basket trials. Tumor-agnostic and cross-indication actionable alterations in gliomas. Biomarker Overall % (n/N) IDH -WT (%) IDH -Mutant (%) Approved Indication PTEN mutations 18.3 (41/224) 21.8 7.4 Breast FGFR1/2/3 alterations 4.3 (10/235) 5.5 0.0 Multiple ERBB2 mutations 0.0 (0/179) 0.0 0.0 Multiple BRCA1/2 mutations 0.6 (1/156) 0.8 0.0 Multiple PIK3CA mutations 8.4 (19/225) 7.6 11.1 Breast TMB-H 11.6 (16/138) 8.9 23.1 Tumor-agnostic dMMR/MSI-H 1.7 (2/116) 2.0 0.0 Tumor-agnostic NTRK fusions 0.6 (1/178) 0.7 0.0 Tumor-agnostic
Interleukin 18 (IL18) induce severe inflammation, promotes Th1 cells and express in the small intestinal mucosa in patients with celiac disease (CeD). Association of promoter region polymorphisms at position 137G > C and 607C > A were reported in autoimmune diseases but sparsely in CeD and in their first-degree relatives (FDRs). A total of 558 children with CeD and their 1565 FDRs were evaluated. About 263 FDRs were anti-tissue transglutaminase antibody (tTG-IgA) positive and out of these, 222 were histopathology positive. Serology negative FDRs served as controls. IL18 gene polymorphism and HLA DQ2 DQ8 genotypes were assessed by Polymerase Chain Reaction-Sequence Specific Primer (PCR-SSP) method. The most frequent genotype was GC allele of 137G > C polymorphism, being 465 (62.5
