Kokilaben Dhirubhai Ambani Hospital is a tertiary-care hospital in Four Bungalows, Mumbai, India. The hospital is named after Kokilaben Ambani, wife of industrialist Dhirubhai Ambani, who was the founder of Reliance Industries.
We used Delphi methodology to provide guidance on gender equality and equity issues in professional life in intensive care, where information is evolving and no clear standard exists. A 12-member Steering Committee (7 women, 5 men) from 7 countries and 46 international panelists [(23 women, 21 men, 2 preferred not to disclose; median age 52 (33–75) years] from 32 countries (43
STUDY OBJECTIVE:To evaluate the effectiveness of intraoperative proctosigmoidoscopy in patients undergoing bowel endometriosis surgery DESIGN: Retrospective, single-centre observational study. SETTING:Department of Gynecology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India PATIENTS: Patients undergoing bowel endometriosis surgery and intraoperative proctosigmoidoscopy at the end of the intervention, from April 2022 to March 2025. INTERVENTIONS:Description of findings at intraoperative proctosigmoidoscopy after bowel endometriosis resection. MEASUREMENTS AND MAIN RESULTS:Among 300 endometriosis surgeries, 126 involved bowel lesions: 100 partial thickness discoid excisions/shaving, 18 full-thickness discoid excision, and 8 segmental bowel resections. This study reports on the latter 2 groups (26 patients in total) who also underwent intraoperative proctosigmoidoscopy. In these 26 patients, findings included 1 case each of bleeding and leak at the anastomosis site (bleed identified only on proctosigmoidoscopy). Postoperatively, 4 patients reported persistent constipation, and another 2 had chronic pelvic pain. No rectovaginal fistulas or luminal narrowing or dyschezia/dyspareunia were observed. CONCLUSION:Intraoperative proctosigmoidoscopy is a feasible and valuable adjunct to endometriosis surgery involving the bowel. It may refine intraoperative decision-making and has the potential reduce both short- and long-term complications.
Abstract This chapter examines semaglutide as a multiorgan therapeutic strategy for cardiometabolic risk reduction, with particular focus on cardiovascular disease, chronic kidney disease, and metabolic dysfunction-associated steatotic liver disease/metabolic dysfunction-associated steatohepatitis. It integrates contemporary guidance from the American Diabetes Association (ADA) 2025 Standards of Care, the ADA/European Association for the Study of Diabetes /EASD consensus, and Kidney Disease: Improving Global Outcomes recommendations with evidence from Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes-6, Semaglutide Effects on Cardiovascular Outcomes In People With Overweight or Obesity, effect of semaglutide versus placebo on the progression of renal impairment in subjects with type 2 diabetes and chronic kidney disease (FLOW), Semaglutide Cardiovascular Outcomes Trial, and effect of semaglutide in subjects with noncirrhotic nonalcoholic steatohepatitis, alongside mechanistic literature on glucagon-like peptide-1 receptor agonist-mediated cardioprotective and nephroprotective effects. In cardiovascular prevention, semaglutide is positioned early in high-risk type 2 diabetes on the basis of risk-factor clustering, visceral adiposity, inflammation, and residual cardiometabolic risk, independent of glycated hemoglobin alone. In chronic kidney disease, the review highlights FLOW as a practice-changing kidney outcomes trial demonstrating reduction in major kidney events, slower estimated glomerular filtration rate decline, and reduction in albuminuria. In metabolic dysfunction-associated steatotic liver disease/MASH, semaglutide is presented as a clinically meaningful option for steatohepatitis resolution and fibrosis-related benefit, particularly in obesity- and diabetes-associated liver disease. Overall, the chapter supports semaglutide as an organ-protective therapy whose benefits extend beyond glucose lowering toward integrated cardiovascular, renal, and hepatic risk reduction.
AIM:The 2019 WHO classification of pancreatic ductal adenocarcinoma (PDAC) recognizes undifferentiated carcinoma with osteoclast-like giant cells (UCOG) as a rare subset. There is sparse literature on the imaging appearances of this type of cancer. Pathologists also increasingly recognize that poorly-differentiated PDAC may occasionally contain osteoclast-like giant cells (PDO). This study aims to compare the imaging features and natural history of these two groups. MATERIALS AND METHODS:In this retrospective case-controlled study, we searched the Institutional pathology and imaging databases for "pancreas cancer" and "osteoclasts." Of the 59 subjects identified, preoperative imaging (CT or MRI) and acceptable pathology data were available in 25 patients who formed the final study cohort. Two specialist abdominal radiologists independently reviewed the imaging findings. The cohort included 10 patients with PDO and 15 with UCOG. RESULTS:There were no differences in age or gender between these groups. On logistic regression analysis, only the presence of tumor hemorrhage (p=0.007), and pancreatic duct obstruction (p=0.02) were significantly different between the groups. UCOG had fewer metastases at presentation and follow-up, though the differences were not significant. UCOG had significantly higher overall survival (median 35.4 months vs. 10.7 months, p=0.007) and progression-free survival (median 33.0 months vs. 9.1 months, p=0.003), compared to PDO. CONCLUSION:The presence of a large (>6 cm) solid pancreatic mass that shows hemorrhage, exophytic growth, and lack of pancreatic duct obstruction may raise the possibility of UCOG. Despite larger size at presentation, these tumors generally have a better prognosis than the published prognosis for conventional PDAC.
Pulmonary embolism (PE) is a serious cardiovascular emergency typically linked to recent surgery, immobility, malignancy, or thrombophilia. Herbal supplements may also contribute to thrombosis. Moringa oleifera , often used for antioxidant and metabolic benefits, demonstrated procoagulant activity in vitro . We describe a 77-year-old gentleman with hypertension and diabetes who presented with severe dyspnea, hypotension, hypoxemia, and imaging-confirmed bilateral PE requiring thrombolysis. With no conventional risk factors identified, his recent Moringa use for 4 months was considered the likely trigger. This case highlights the need to assess supplement use in unexplained venous thromboembolism and to further investigate Moringa’s vascular risks.
