The Dr. Ram Manohar Lohia Institute of Medical Sciences (Dr.RMLIMS), is a medical Institute under State Legislature Act with teaching hospital established by the Government of Uttar Pradesh in Gomti Nagar, Lucknow. The institute offers MBBS, DM, MCh, MD and Ph.D. degrees. It was established in 2006 and was affiliated with King George's Medical University for students enrolled till academic year 2018–2019. On 12 September 2018, it was notified an Institute under State Legislature Act with degree-granting status and privileges.
Children with empyema thoracis often respond to medical management, but some do not, and require surgical intervention. Prediction of failure of medical management will help to guide further management and plan surgical intervention. To systematically review literature for clinical, radiological, laboratory, or microbiological predictors, associated with failure of medical management or the need for surgery in children with empyema thoracis. A systematic search was conducted in seven databases (PubMed, Embase, Cochrane Library, Scopus, Web of Science, ProQuest, and Open Grey) and four trial registries. Observational studies exploring predictors of treatment failure in empyema thoracis were eligible. Two reviewers independently screened the studies, extracted the data, and assessed the risk of bias. Data were analyzed in accordance with the review protocol. Amongst 12,311 citations identified, seven studies were included. One study identified three statistically significant predictors of medical treatment failure, viz. immediate ICU admission: OR (95
BACKGROUND:Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), poses significant diagnostic challenges, particularly in South-East Asia, where its prevalence has risen sharply. Although endoscopic biopsies and histopathological evaluations are central to IBD management, inconsistencies in sampling, processing and reporting hinder accurate and reliable diagnosis. METHODS:To address these gaps, the Indian Association of Pathologists and Microbiologists (IAPM), the Indian Society of Gastroenterology (ISG) and the Colitis and Crohn's Foundation, India, (CCFI) collaborated to formulate comprehensive guidelines. Using a structured Delphi process and expert consensus, recommendations were developed to standardize biopsy protocols, histological evaluation and reporting of mucosal biopsies and tackling critical diagnostic challenges. RESULTS:The recommendations cover biopsy sampling, optimal processing, orientation, interpretation methods, histopathological algorithms, recommendations on histological scoring, follow-up biopsies and differentiation of IBD from its mimickers based on existing literature and expert's experience. Reporting formats were suggested to ensure uniformity in practice. CONCLUSION:These evidence-based, practical recommendations aim to enhance diagnostic precision, unify practices and improve patient outcomes in IBD care, providing pathologists in resource-diverse settings with a standardized approach to gastrointestinal mucosal biopsy evaluation.
Neurosyphilis is a well-recognized mimicker and may present with diverse movement disorders resembling neurodegenerative or autoimmune syndromes. This systematic review aims to elucidate the comprehensive clinical, laboratory, imaging, and outcome spectrum of movement disorders in neurosyphilis. This systematic review followed PRISMA guidelines with a protocol registered in PROSPERO (CRD420251135620). PubMed, Embase, Scopus, and Google Scholar were searched. Eligible studies included case reports, case series, and observational cohorts with confirmed or probable neurosyphilis and clinically diagnosed movement disorders. Data on demographics, clinical features, cerebrospinal fluid, neuroimaging, treatment, and outcomes were extracted. We analyzed a total of 48 individual cases reported across 44 publications and two retrospective cohorts (n = 223, with 61 movement disorder patients). The mean age was 47 years (range 10–83), with 76.3
BACKGROUND:The most common causes for ulcero-stricturing diseases of the ileo-cecal region and colon in Southeast Asia are Crohn's disease (CD) and gastrointestinal tuberculosis (GI TB). Diagnosing these conditions is challenging because they share several clinical, endoscopic, radiological and histological features on mucosal biopsies. Therefore, there is a need to standardize the sampling, processing and interpretation of mucosal biopsies to aid clinical decision-making. METHODS:Recognizing this challenge, core subject experts nominated by the Indian Association of Pathologists and Microbiologists (IAPM), the Indian Society of Gastroenterology (ISG) and the Colitis and Crohn's Foundation, India (CCFI), collaborated to formulate comprehensive recommendations for pathologists regarding optimal biopsy protocols, histological interpretation and reporting for differentiating CD from GI TB. A structured Delphi process was followed. RESULTS:The recommendations from the core domain expert groups were based on discussions, brainstorming sessions and extensive literature reviews conducted over three virtual group meetings, multiple online voting sessions and one physical meeting involving all experts. This document is expected to standardize the practice of luminal gastroenterology by providing a ready reference for budding specialists and pathologists, thereby promoting uniformity in practice. CONCLUSION:These multi-society, evidence-based and practically applicable recommendations developed by core subject experts aim to promote uniformity and confidence in pathology reports, facilitate timely patient management and prevent complications arising from erroneous treatment.
Introduction Tumor immune escape represents a fundamental mechanism of cancer progression, and therapeutic modulation of the tumor immune microenvironment has become an integral component of modern oncology. The programmed death-1/programmed death-ligand 1 (PD-1/PD-L1) axis is a key immune checkpoint regulating antitumor immune responses and is an established target for immunotherapy. In patients with advanced malignancies, cytological specimens from malignant effusions may constitute the only available material for both diagnosis and predictive biomarker assessment. This study was undertaken to evaluate PD-L1 expression in carcinomatous effusions and to determine its concordance with matched histological specimens from primary or metastatic tumors. Objective This study aimed to evaluate PD-L1 protein expression in carcinomatous effusion samples and to determine the level of concordance between PD-L1 expression in effusion cytology and corresponding histological specimens in patients with advanced malignancies, wherever paired samples were available. Materials and Methods A combined retrospective (January 2019-March 2022) and prospective (April 2022-March 2024) observational study was performed at a tertiary care center. Seventy paired cases of carcinomatous effusions with corresponding histological samples were included. PD-L1 immunohistochemistry was performed using the 22C3 pharmDx clone in breast carcinoma cases and the SP263 clone in all other malignancies. Tumor cell membrane staining in >= 1% of cells was considered positive.Results The study population comprised predominantly female patients (87.1%), with ascitic fluid being the most frequent effusion type (82.9%). PD-L1 expression was negative in the majority of cytology (92.8%) and histology samples (87.1%). Concordant PD-L1 expression between cytology and histology was observed in 64 of 70 cases (91.4%), while discordance was identified in 6 cases (8.6%). The level of agreement was moderate, with a Cohen's kappa value of 0.528. Conclusion The findings demonstrate a moderate level of concordance between PD-L1 expression in carcinomatous effusions and corresponding histological samples, supporting the potential utility of cytological specimens for PD-L1 assessment in advanced cancers with metastatic effusions. Larger, multi-institutional studies are warranted to further validate these observations.
