Medanta is an Indian chain of multi-specialty medical institutes based in Gurgaon in the National Capital Region of India. Medanta was started in 2009 with one institute, Medanta - The Medicity in Gurgaon, with cardiac surgeon Naresh Trehan as its main director along with co-founder Sunil Sachdeva. Global Health Limited is the company which owns and manages the hospital.The chain has since expanded its outreach to other cities including Gurgaon, Noida, Lucknow, Indore, Ranchi and Patna.
Compartmental glossectomy has emerged as an oncologically sound approach for tongue carcinoma; however, it is often associated with the need for reconstruction due to the resulting floor-of-mouth defect. This prospective study focuses on reconstruction, including its surgical and functional outcomes for speech and swallowing, using the Infra Hyoid Myocutaneous Flap (IHMCF) after compartmental resection for tongue squamous cell carcinoma. A total of 36 patients with histologically proven squamous cell carcinoma of the lateralized tongue were enrolled during the study period from January 2021 to November 2022. Patients undergoing conventional compartmental resections were included in the study. The male-to-female ratio was 5:1, and the median age of the cohort was 43.5 years. The T-stage distribution for the study population was: T2–18; T3–16; and T4a − 2. Outcomes were assessed objectively using cine fluoroscopy for swallowing and subjectively for speech. The flap outcomes were evaluated for survival, partial necrosis, and complete necrosis. Partial necrosis was termed for superficial epithelial necrosis with preserved underlying muscle. Complete flap survival was seen in 83.3
e15723 Background: Relationships between DNA driver alterations and downstream transcriptional pathway activation in colorectal cancer (CRC) are not well defined in routine specimens. We assessed driver–pathway concordance using paired DNA and transcriptome profiling. Methods: Tumors from 192 CRC patients (male = 85; female = 107) were profiled by a 517-gene DNA panel and AmpliSeq tissue transcriptome. Pathogenic/likely pathogenic SNV/indels defined driver status. A priori driver–pathway associations based on established CRC biology ( APC →WNT/β-catenin; RAS/RAF→MAPK; PIK3CA →PI3K/AKT/mTOR; SMAD4 →TGF-β/EMT) were evaluated. Pathway activity scores were computed as the average log 2 fold-change of curated pathway marker genes (scores calculated when ≥4 marker genes were available). Mutant vs wild-type groups were compared using Mann–Whitney; Δmedian with bootstrap 95% CI; BH-FDR across a priori tests. Multivariable linear regression adjusted for age, sex, and AJCC stage. Results: Median age was 55 years (IQR 44–63). AJCC stage was IV in 122/192 (63.5%) and unknown in 58/192 (30.2%); adenocarcinoma comprised 166/192 (86.5%). Frequent drivers were TP53 152/192 (79.2%), APC 109/192 (56.8%), KRAS 102/192 (53.1%), BRAF 20/192 (10.4%), PIK3CA 28/192 (14.6%), and SMAD4 30/192 (15.6%); RAS/RAF alterations occurred in 128/192 (66.7%). APC -mutant tumors showed higher WNT/β-catenin activation (evaluable n = 139; Δmedian +0.66, 95% CI +0.15 to +1.40; p = 0.0059; FDR = 0.029), remaining significant after adjustment (β = +0.74, 95% CI +0.04 to +1.44; p = 0.039). SMAD4 -mutant tumors showed lower TGF-β signaling (evaluable n = 159; Δmedian −0.87, 95% CI −1.94 to −0.30; p = 0.0116; FDR = 0.029), also significant after adjustment (β = −1.10, 95% CI −2.12 to −0.08; p = 0.036). RAS/RAF→MAPK and PIK3CA →PI3K/AKT/mTOR were not significant (FDR > 0.05). Conclusions: In routine CRC specimens, paired genomic and transcriptomic profiling demonstrated biologically coherent driver–pathway concordance for APC /WNT activation and SMAD4 /TGF-β signaling. Integrated multi-omics provides pathway-contextual interpretation alongside DNA comprehensive genomic profiling and may support molecular stratification in translational CRC studies.
