The KIMS (Kerala Institute of Medical Sciences) Global is a healthcare organization headquartered in Trivandrum with multi-specialty hospitals and health care centres in South India and the Middle East. The KIMS Global started off as KIMS Hospital, a multi-specialty hospital in Trivandrum, the capital of Kerala. The hospital was launched in 2002 and expanded as the KIMS Global, which went through an expansion in 2013 and obtained centres in other parts of the state: Kollam, Kottayam, Perinthalmanna, and Kochi and well as in the Middle East, in Saudi Arabia, Qatar, Bahrain, Oman, United Arab Emirates, and Dubai..
Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but serious complication of adenoviral vector COVID-19 vaccines, characterized by thrombosis, thrombocytopenia, and elevated D‑dimer. In this descriptive study (June–November 2021), 19 patients with suspected VITT were evaluated at a tertiary hematology lab in northern India. Anti‑PF4 antibodies were screened using a gel card immunoassay, with confirmation by platelet activation test (PAT; >20
Background: Post-thyroidectomy hypocalcaemia is one of the most frequent complications of thyroid surgery, with reported incidence ranging from 1.6% to 50%. While surgical technique and parathyroid preservation are well-established determinants, the role of intra-operative haemostatic agents remains uncertain. This study aimed to evaluate the association between haemostatic agent use and post-operative hypocalcaemia. Materials and Methods: We conducted a retrospective cohort study of adult patients who underwent total thyroidectomy at a tertiary care teaching hospital between August 2023 and August 2024. Patients with pre-existing hypocalcaemia, hypoparathyroidism, concomitant parathyroid surgery or completion thyroidectomy were excluded. Clinical and operative data were collected, including the use of haemostatic agents, calcium levels and hypocalcaemia symptoms. Hypocalcaemia was defined as serum calcium <8.0 mg/dL or <8.5 mg/dL with symptoms. Statistical comparisons were performed using Fisher’s exact test, with P < 0.05 considered significant. Results: Fifty patients met inclusion criteria. Haemostatic agents (oxidised regenerated cellulose, SURGICEL ™ FIBRILLAR) were applied in 25 patients, while 25 underwent surgery without adjuncts. All patients in the haemostatic group (100%) developed hypocalcaemia, compared with none in the non-haemostatic group (0%), a highly significant difference ( P < 0.001). Mean post-operative day 1 calcium was lower in the haemostatic group (7.4 ± 0.4 mg/dL) compared with the non-haemostatic group (8.7 ± 0.5 mg/dL, P < 0.001). Symptomatic hypocalcaemia requiring intravenous supplementation occurred in 15 of 25 patients (60%) in the haemostatic group, but in none of the controls. Conclusion: The use of intra-operative haemostatic agents was strongly associated with hypocalcaemia following thyroidectomy in this single-centre retrospective series. Although limited by the small sample size, the findings highlight a potential safety concern. Larger prospective studies are warranted, but until then, surgeons should use haemostatic agents selectively and ensure vigilant post-operative calcium monitoring.
ABSTRACT Background Hereditary cancers account for approximately 5% to 10% of all malignancies and are more frequently observed in individuals with early-onset disease or a significant family history of cancer. However, large pan-India datasets describing germline variant distributions across multiple cancer types remain limited. Methods We retrospectively analysed 23,070 individuals who underwent germline hereditary cancer testing at MedGenome Labs Ltd., Bangalore, India from 2016 to 2025. Clinical indication based major cancer sub-type groups were breast cancer (N=10486), ovarian cancer (N=3990), colorectal cancer (N=1275), prostate cancer (N=765), endometrial cancer (N=541) and asymptomatic individuals (N=2,775). Germline testing was conducted using clinically validated multigene next-generation sequencing (NGS) panels, with multiplex ligation-dependent probe amplification (MLPA) used for copy number variant detection in a subset of cases. Results The overall diagnostic yield of genetic testing was 23.85%, with the highest yields observed in colorectal (42%) and ovarian cancers (31.6%), followed by endometrial (22.6%), breast (20.2%) and prostate cancer (8.6%) formed the top 5 cancer types. In addition, there is an asymptomatic group where individuals with no symptoms reported but had a positive family history of cancer, where diagnostic rate was 18.9%. Among breast cancer patients diagnosed at ≤50 years of age, one of the National Comprehensive Cancer Network (NCCN) criteria for hereditary cancer testing, the diagnostic yield was 24.2%. Individuals with a positive family history had a significantly higher diagnostic rate (2.5% to 16%) compared to those without a positive family history across all cancer types. BRCA1 and BRCA2 were the most frequent genes with pathogenic variants in breast and ovarian cancers, while mismatch repair genes ( MLH1 , MSH2 , MSH6 ) predominated in colorectal and endometrial cancers, and BRCA2 was the most frequently altered gene in prostate cancer. The well-known BRCA1 gene founder frameshift variant (c.68_69delAG; p.Glu23ValfsTer17) was identified in 358 individuals, representing the most frequent pathogenic variant in the cohort. Additional BRCA1 gene recurrent variants observed in the sample set includes a canonical splice-site variant (c.5074+1G>A; N=123), followed by a non-sense mutation (c.3607C>T; p.Arg1203Ter; N=44). A strong concordance between clinical classification and functional annotations was observed when compared with BRCA1 saturation mutagenesis findings. Reanalysis of variants of uncertain significance and undiagnosed cases improved the diagnostic yield by approximately about 5% average across major cancer types. A multivariate regression analysis showed a positive family history significantly contribute to improved diagnosis. Notably, early genetic testing correlated well with significantly contribute to improved diagnosis, suggestive for universal genetic testing over guideline-based testing. In addition, the regression analysis showed a decline in diagnostic yield with increasing age for all five major cancer types analysed, suggesting that the universal criteria for genetic testing is preferable for early detection. Among breast cancer cases with hormone receptor data, the triple-negative and ER+PR-HER2+ cases had a higher diagnostic rate compared to other subtypes of breast cancer. The MLPA-based CNV analysis further validated additional clinically relevant variants in a subset of the cohort. Conclusions To the best of our understanding, this retrospective study showcases the largest comprehensive characterization of the hereditary cancer genetics in India and South Asian region till date, demonstrating a substantial burden of inherited cancer susceptibility and distinct gene-cancer associations across major tumor types. These findings support the implementation of comprehensive multigene testing, periodic variant reinterpretation, and population-adapted hereditary cancer testing strategies to improve hereditary cancer risk assessment and advance precision oncology in underrepresented populations.
Background Irritant diaper dermatitis is a morbidity which is often overlooked from a preventive point of view in neonatal intensive care units (NICU), when other more pressing priorities take precedence. Prolonged hospitalisation, immaturity of the skin barrier, frequent exposure to urine and stool contribute to aetiology. It causes much distress to the infant and parents, increases risk of infection and adds to nursing care load. Objectives This quality improvement (QI) initiative was designed to reduce the incidence of irritant diaper dermatitis among neonates admitted to the NICU by at least 50% within six months and to achieve near-zero incidence within one year through implementation of standardised, evidence-based skin care practices. Methods A QI project using Plan−Do−Study−Act (PDSA) methodology was conducted over a 12-month period (May 2024−April 2025). Baseline surveillance was followed by sequential implementation of targeted interventions focusing on staff training, standardised diaper care protocols, skin protective strategies and parental engagement. The primary outcome measure was monthly incidence of diaper dermatitis. Results Baseline incidence ranged from 18-21.6%. Following successive PDSA cycles, incidence reduced to 3−4 cases per month after the first two cycles and further declined to 0−1 in later cycles with sustained improvement for 3 months post-intervention. Implementation of the preventive care bundle resulted in over 95% reduction in diaper dermatitis with rates declining from ∼20% at commencement of the project to near-zero levels with sustained effects for over 6 months thereafter. Limitations Cost effectiveness analysis and impact on length of hospital stay were not formally done. Conclusion Simple, low-cost interventions implemented through a structured QI framework significantly reduced irritant diaper dermatitis in the NICU. Standardisation of diaper care practices and sustained staff and parent engagement were key drivers of success.
This multicenter study assessed knowledge, attitudes, and practices (KAP) regarding antibiotic use among 1,081 patients and caregivers. Despite positive attitudes, knowledge gaps were substantial. Education level significantly influenced KAP scores. Targeted awareness interventions are needed to improve knowledge gaps and to promote rational antibiotic use.
