ESIC Medical College, Kolkata

Background Oncoplastic breast reconstruction mitigates chest wall deformities following mastectomy or post-radiation therapy after lumpectomy. It is associated with lower morbidity, improved quality of life, and more natural aesthetic outcomes compared to traditional techniques. While free flaps yield excellent cosmetic results, their reliance on advanced microsurgical expertise poses challenges in resource-limited settings. In such contexts, pedicled flaps like the Vertical Rectus Abdominis Myocutaneous (VRAM) and Transverse Rectus Abdominis Myocutaneous (TRAM) flaps provide safe, reliable alternatives. Patients and methods This retrospective observational study analysed 45 patients who underwent post-mastectomy chest wall reconstruction at Medical College Hospital, Kolkata, between October 2020 and March 2024. Twenty-three patients received VRAM flaps (Group A), and twenty-two received TRAM flaps (Group B). The groups were compared regarding the timing of adjuvant therapy initiation, postoperative complications, donor-site morbidity, recurrence rates, and adequacy of tissue coverage. Results Adjuvant therapy was initiated in 21/23 (91.3%) of Group A (95% CI: 73.2% to 97.6%) compared to 11/22 (50.0%) of Group B (95% CI: 30.7% to 69.3%) (p=0.02). Flap necrosis occurred in 2/23 (8.7%) of Group A (95% CI: 2.4% to 26.8%) vs. 11/22 (50.0%) of Group B (95% CI: 30.7% to 69.3%) (p=0.01). Donor-site skin necrosis was absent in Group A 0/23 (0.0%) (95% CI: 0.0% to 14.3%) but occurred in 7/22 (31.8%) of Group B (95% CI: 16.4% to 52.7%) (p=0.02). Umbilical necrosis and activity limitation were only reported in Group B, each in 2/22 (9.1%) of patients (95% CI for both: 2.5% to 27.8%). Both groups achieved complete defect coverage and had no recurrences at six months. Conclusion VRAM flaps offer superior outcomes in terms of reduced postoperative complications and earlier initiation of adjuvant therapy, making them preferable in resource-constrained environments. However, longer follow-up and larger cohorts are needed to validate these findings.

To assess the effectiveness of the vasoactive-inotropic score (VIS) in predicting outcomes for pediatric sepsis. A one-year prospective observational study in a tertiary level pediatric intensive care unit (PICU), enrolled children (1 month to 12 years) with fluid-refractory septic shock. VIS and aggregate VIS (AVIS) was calculated at 6, 12, 24, 48, 72, and 96 h post-hospitalization. The primary outcome assessed was mortality and secondary outcomes included duration of PICU stay, ventilation and inotrope support. Ninety (64.4

Probiotics serve as essential wound healers, particularly in diabetic patients, where they eliminate the interfering hindrance caused due to enhanced oxidative stress, inflammation, and microbial imbalances. Probiotic strains are also reported to enhance the level of tissue regeneration-specific cytokines and growth factors. Similarly, probiotics also stop infections by preventing the growth of harmful bacteria at the lesion site, which may be helpful for susceptible diabetic ulcers. Thus, probiotics may be a viable adjuvant treatment to hasten the healing of diabetic wounds. The present study aims to evaluate the efficacy of probiotic and synbiotic supplementation on wound healing in diabetic mice. Accordingly, probiotic strains Bacillus cereus strain BWN SC and Bacillus aerophilus strain BWN SC were isolated from whey water and fermented rice water on MRS agar media. Their wound-healing potential was investigated in male Swiss albino mice. Initially, streptozotocin was used to induce diabetes in the animals, after which 3 mm subcutaneous puncture wounds were induced on the dorsal region. Next, they were treated with different probiotics or synbiotics applied topically on the wounded area. Simultaneously, oral supplementation of the respective strains was also done using gavage. Wound contraction rate was studied at intervals of 1, 5, 10, and 14 days, followed by subsequent histological assay and hematological analysis. Animals treated with probiotics and synbiotics supplementation showed a faster wound contraction rate as compared to the control. Hematological analysis also showed improved wound-healing parameters in the treated mice. Thus, isolated probiotic strains can be effectively used for wound healing in diabetic mice. They can be combined with prebiotics to get even more potent therapeutic tool in the form of synbiotics.

Acute lymphoblastic leukemia (ALL) diagnosed during pregnancy is rare and causes ethical and therapeutic challenges. We performed a retrospective search of ALL patients ( n = 202) treated at our institution from 2015 to 2020 and found five patients diagnosed during pregnancy. In this report, we discuss the individual patients in detail and the challenges faced during their treatment. The use of established lymphoblastic leukemia treatment protocols and the modifications made therein to prevent untoward chemotherapy-related toxicities to the fetus are discussed in this study. We report the second use of rasburicase during pregnancy in literature with favorable maternal and fetal outcomes. We also present an extensive literature review of 41 cases of ALL in pregnancy previously reported. It is important to note that there is a dearth of guidelines for the treatment of these complex situations, and although certain general principles can be established, an individualized approach is needed in most cases of leukemia diagnosed during pregnancy.

Increased evaporative losses and flow obstructions can present substantial impediments to current paper analytical devices (mu PADs) for efficient on-site testing of biological fluids. Strategic enhancements in wicking rates of paper may thereby counter these limitations and enable on-demand healthcare monitoring. Therefore, herein we have leveraged the features of paper fold-crease regions and developed a novel fast-flowing platform using laser printing to accelerate fluid flow through paper. A series of extensive experiments have been conducted to optimize the design and maximize wicking rates of mu PADs for smaller liquid volumes, making it wellsuited for analysing biofluids. The investigation delves into structural alterations within the creased regions, employing both static and dynamic force application strategies. A first-generation Washburn type model in excellent agreement with the experimental findings is developed, providing a comprehensive insight into the fundamental physics involved. Finally, the folded channels are utilized for a distance-based hematocrit sensor employing grade-1 filter paper at very low-cost, simplified fabrication, lesser sample volume and faster analysis. The findings of this work unveil a plethora of potentialities for employing paper and paper folds to develop affordable medical devices with advanced analytical functionalities, specifically tailored for the resourceconstrained settings.