Nil Ratan Sircar Medical College and Hospital

Sellar–suprasellar lesions are most commonly pituitary adenomas; however, rare vascular tumors such as hemangioblastomas (HBs) may closely mimic them, posing significant diagnostic challenges. HBs are typically associated with von Hippel–Lindau (VHL) disease and are seldom encountered in the sellar region, with only a few cases documented. We report a 37-year-old male presenting with chronic headache and progressive visual impairment characterized by bitemporal hemianopia. Neuroimaging revealed a heterogeneously enhancing sellar–suprasellar mass with bony erosion, initially suggestive of pituitary macroadenoma. Hormonal evaluation was unremarkable, and endoscopic biopsy proved inconclusive. The patient underwent right pterional craniotomy, during which a highly vascular tumor limited complete excision. Histopathological analysis confirmed HB (World Health Organization Grade I). Post-operative evaluation excluded associated VHL disease. This case underscores the importance of including HB in the differential diagnosis of hypervascular sellar lesions. Pre-operative recognition is crucial to anticipate intraoperative hemorrhagic risk and optimize surgical planning.

Aplastic anaemia (AA) is a rare bone marrow failure disorder with a notably higher incidence in Asian populations, including India. Due to limited access to bone marrow transplantation (BMT) in resource-limited settings, immunosuppressive therapy (IST) remains the mainstay of treatment. However, the optimal combination of available IST regimens in low-resource environments remains uncertain. Therefore, we performed a meta-analysis to evaluate the effectiveness and safety of various immunosuppressive strategies—particularly equine antithymocyte globulin (eATG) combined with cyclosporine A (CSA), with or without eltrombopag (EPAG), as well as CSA and anabolic steroids-based monotherapies, for the treatment of AA in Indian patients. Fifty-nine studies (49 single-arm, 10 multi-arm) from PubMed, Google Scholar, and Indian Society of Haematology Blood Transfusion (ISHBT) conference proceedings from December 2024 to December 2024 were included. The primary outcomes comprised overall response rates (ORRs) at 3, 6, and 12 months. Secondary outcomes included 5-year overall survival (OS), event-free survival (EFS), and treatment-related adverse events (TRAEs). Pooled estimates were calculated using a random-effects model, and heterogeneity was assessed with I² statistics. Meta-regression was used to explore sources of variability, and sensitivity analyses assessed the robustness of the pooled outcomes. Response rates (RR) varied significantly across treatment modalities and time points. In single-arm analysis, monotherapy with CSA or anabolic steroids showed limited efficacy, with pooled ORRs at 3 months of 26.9

In this study, we aimed to understand the interplay of the epigenetic modifier genes DNMT1 and TET1 along with HPV infection in the cervical epithelium and how it changes during tumorigenesis. For this purpose, initially the bioinformatical analysis (methylation and expression profile) of DNMT1 and TET1 was analyzed in the TCGA dataset. Next genetic (deletion) and epigenetic profiling (promoter methylation) of DNMT1 and TET1 were done in our sample pool and also validated in CACX cell lines as well. The results were further correlated with different clinicopathological parameters. Our data revealed that HPV infection in basal/parabasal layers of cervical epithelium actually disrupts the epigenetic homeostasis of DNMT1 and TET1 proteins which ultimately leads to the high expression of DNMT1 along with further reduction in TET1 protein during the development of carcinoma. Further, in-depth look into the results revealed that comparatively low methylation frequency of DNMT1 coupled with high promoter methylation and deletion frequency [22-46%] of TET1 were the plausible reasons of their antagonistic expression profile during the progression of the disease. Interestingly, the prevalence of DNMT1 [9.1%] and TET1 promoter methylation [22.7%] found in both the plasma DNA of the respective CACX patients implicated its diagnostic importance in this study. Lastly, molecular alteration of TET1 alone or in combination with DNMT1 showed the worst overall survival among the patients. Hence, it may be concluded that an inverse molecular profile of DNMT1 and TET1 genes seen in the proliferative basal-parabasal layers of the cervical epithelium was aggravated during the development of CACX along with genetic and epigenetic changes due to HPV infection.

OBJECTIVE:This study aims at develop and evaluate an artificial intelligence programming software, an integrated system that automatically detects and classifies cells from microscopic Pap smear slide images taken on Android phones or tabs to diagnose the cervical cell morphology in a time-efficient and cost-effective manner. METHODS:This study presents an integrated system designed to automatically detect and classify cells in Pap smear slide images, differentiating cellular morphologies. The system leverages three deep learning (DL) and one machine learning (ML) models, each tailored to specific tasks in the image analysis pipeline. The analysis of 292 hospital in-house microscopic Pap smear images was conducted from July 2023 to December 2024 at CliniMed LifeSciences, Kolkata, India. The following article describes the datasets used, the training procedures and the performance metrics for each model.  Results: Pap smear images have been validated and standardized by using SipakMed, Herlev (public datasets) and hospital in-house data. A total of 292 in-house Pap smear images have been analysed through the newly developed AI software. Standardization and validation include an Intersection-over-Union score of cell-nuclei boundary extraction model of 71.14%, the accuracy of cell classification model and morphological feature based ML model are 99.213% and 91.23% respectively. The custom AI model could successfully classify 98.09% and 80.49%  of normal and abnormal cells in hospital in-house samples respectively. Also a significant meaningful correlation is observed between biopsy (gold standard) and AI reports. CONCLUSION:AI offers a lot of promise for diagnosing cervical cancer, and its uses in cervical cytology screening are particularly well-established. Manual screening of cervical cytology smears is a time-tested method, but AI is set to revolutionize the process by improving outreach, availability, accuracy and economy. A total of 292 hospital in-house Pap smear images have been validated and examined in this study with significant accuracy percentages between AI and expert eyes.

Background:CAR T-cell therapy represents a substantial advance for relapsed/refractory hematologic cancers, but toxicities still limit its benefits. A particular concern is immune effector cell-associated neurotoxicity syndrome (ICANS), whose mechanisms remain only partly resolved. In parallel, work across immunology and neurogastroenterology shows that gut microbial communities can shape systemic inflammation and show correlations with brain function. Together, these strands suggest-without yet proving-that microbiome features could bear on both CAR T efficacy and ICANS risk. Objectives:We examined human clinical evidence at three touchpoints: how CAR T and the gut microbiota interact; how gut profiles relate to brain function; and which signals accompany CAR T-related neurotoxicity. The aim was to locate areas of overlap, not to claim a single causal chain. Methods:Following PRISMA, PubMed, Scopus, and Embase were searched from 2015 to 11 April 2025. We included randomized trials, prospective cohorts, and retrospective series reporting gut microbial composition, inflammatory or neurobiological markers, CAR T outcomes, or ICANS. Study quality was appraised with the Newcastle-Ottawa Scale and certainty graded with GRADE. Results:Twenty-five studies were included (four CAR T-gut, eleven gut-brain, ten CAR T-neuro). Recurrent signals were (i) reduced microbial diversity, (ii) loss of short-chain fatty-acid producers, and (iii) prior antibiotic exposure-each linked to poorer clinical outcomes and higher or more severe ICANS. Candidate markers (e.g., C-reactive protein, interleukin-6, neurofilament light chain) and imaging findings, including PET abnormalities, were reported but remain exploratory and variably measured. Included studies are small and methodologically varied, and results should be interpreted with caution. Conclusion:Taken together, the data support a convergence model: the gut microbiota may correlate with both treatment efficacy and neurotoxicity in CAR T recipients. The signal is consistent yet preliminary. Microbiome interventions such as probiotics and FMT are investigational and not yet recommended for CAR T recipients. Prospective, mechanism-rich studies-ideally pairing longitudinal stool profiling with inflammatory panels and neuroimaging-are needed before clinical translation. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42024548645.