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.

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.

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

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.

Introduction: Smartphone usage among medical students is on the rise due to their vast academic commitment subsequently leading to smart phone addiction. Global studies have demonstrated that smartphone addiction is associated with poor sleep quality. However, regional studies in Eastern India are limited using standardized tools like the Smartphone Addiction Scale – Short Version (SAS-SV) and Pittsburgh Sleep Quality Index (PSQI) together which is used in the present study to unveil the association between smart phone addiction and sleep quality among Indian medical undergraduates. Aim and Objectives: To determine the prevalence of smart phone addiction and relationship between smartphone addiction and sleep quality among medical undergraduates. Materials and Methods: A cross-sectional observational study was conducted among 205 first and second year undergraduate medical students in a tertiary care hospital Kolkata using Smartphone Addiction Scale–Short Version (SAS-SV), a validated 10-item instrument and Pittsburgh Sleep Quality Index (PSQI), a standardized questionnaire consisting of 19 items assessing sleep quality over the preceding one month across seven components. Data was entered and analysed using IBM SPSS Statistics for Windows, version 26.0. Results: A total of 205 students were included in the present study. The mean global PSQI score was 5.51 ± 2.93, and the mean SAS-SV score was 31.15 ± 9.71. Based on SAS-SV cut-offs, 48.3% were classified as smartphone addicted and 51.7% as non-addicted. In multivariable linear analyses, smartphone addiction status showed a significant association with moderate to large effect sizes with global PSQI score (F = 20.22, p < 0.001, partial η² = 0.094). Conclusion: Nearly half of the participants were classified as smartphone-addicted and disturbed sleep is common in this age group, reflecting academic demands, irregular schedules, and lifestyle factors. Females showed higher sleep latency scores and higher daytime dysfunction scores than males.