Tamil Nadu Government Multi-Super-Speciality Hospital is a 400-bed government-owned super-speciality hospital in Chennai, India. It is located at the Omandurar Government Estate on Anna Salai and was opened in February 2014. Originally built as Tamil Nadu legislative assembly and secretariat complex in 2010 to house the assembly hall, secretariat and offices of the chief minister and cabinet ministers, the complex was later converted into a super-speciality hospital. It was built in 1.93 million sq ft. at a total cost of ₹ 4,250 million in 2010.
Traditional anthropometric measures such as body mass index (BMI) have limitations in accurately assessing cardiometabolic risk and body fat distribution. Consequently, advanced anthropometric indices have emerged as more specific tools for assessing metabolic health and predicting cardiovascular complications. To assess the prevalence of metabolic syndrome (MetS) in the study population and evaluate its relationships with advanced anthropometric indices and selected cardiometabolic marker. The study comprised of 2354 participants from the tertiary care setting and screened for metabolic syndrome using IDF and revised NCEP ATP III criteria. The demographic, anthropometric and biochemical data were recorded. BMI and advanced anthropometric indices and cardiometabolic marker, viz., body roundness index (BRI), conicity index (CI), waist-to-height ratio (WHtR), relative fat mass (RFM) and triglyceride-glucose index (TyG index), were computed. Advanced anthropometric indices and cardiometabolic marker showed significant associations with age, gender, BMI and BMI classification stages (p < 0.000). The prevalence of MetS was 40.2
Background: High-grade gliomas (HGG) are aggressive central nervous system tumors with a poor prognosis. Techniques such as intensity-modulated radiotherapy (IMRT) aim to improve dose conformity and spare normal tissues compared to three-dimensional conformal radiotherapy (3DCRT). Aims and Objectives: The aim is to assess the dosimetry and treatment quality of 3DCRT versus IMRT in HGG. Materials and Methods: In this prospective study, 30 patients were allocated to 3DCRT (n=15) or IMRT (n=15). Both groups received 59.4 Gy in 33 fractions with concurrent and adjuvant temozolomide. Dosimetric parameters of the planning target volume (PTV) and organs at risk were analyzed. Acute neurological toxicities were assessed. Statistical analysis used Mann–Whitney U and Chi-square/Fisher’s exact tests. Results: Baseline characteristics were comparable (P>0.05). IMRT showed significantly lower PTV Dmax (64.56 vs. 65.69 Gy), Dmean (61.67 vs. 62.57 Gy), D2 (63.23 vs. 64.78 Gy), and D50 (61.65 vs. 62.62 Gy) (all P=0.01). IMRT significantly reduced doses to critical structures, including brain Dmax (62.54 vs. 65.07 Gy), brainstem Dmean (27.74 vs. 32.12 Gy), optic chiasm Dmean (32.91 vs. 45.03 Gy), and pituitary Dmean (28.67 vs. 44.00 Gy) (P≤0.05). Hippocampal and temporal lobe doses were also lower with IMRT. Right cochlea doses were reduced with IMRT (Dmean 26.20 vs. 49.76 Gy, P=0.05). Left eye and lens doses were higher with IMRT (P=0.01). Conformity index was significantly better with IMRT (1.52 vs. 1.61, P=0.003), whereas homogeneity index was similar (P=0.54). Acute neurological toxicities showed no significant differences (P>0.05). Conclusion: IMRT offers superior dose distribution and organ sparing compared to 3DCRT, with comparable toxicity profiles. Larger studies with long-term follow-up are needed.
Abstract Anticipatory control organises motor output prior to predictable perturbations and is expressed in multi-digit tasks as anticipatory synergy adjustments (ASAs), which coordinate digit forces before movement onset. Whether such feedforward coordination depends on peripheral sensory input remains unclear. Carpal tunnel syndrome provides a model of altered median nerve afference with within-subject restoration following surgical decompression. We quantified ASA onset and amplitude in eleven individuals with carpal tunnel syndrome performing a multi-finger grasp-and-release task before and three weeks after decompression surgery. Postoperatively, sensory function improved, and total grip force decreased significantly across task phases, indicating more efficient force regulation. In contrast, ASA onset timing and amplitude were unchanged. Equivalence testing confirmed that pre- and post-operative ASA measures fell within predefined bounds of practical equivalence. These findings demonstrate a central-peripheral dissociation: feedback-mediated grip force scaling is sensory-dependent and rapidly recalibrates following afferent restoration, whereas feedforward synergy coordination remains stable despite months of degraded peripheral input. The preserved ASA suggests that central motor planning circuits maintain anticipatory coordination through efferent copy or cerebellar-mediated internal models that do not require continuous peripheral recalibration. This resilience may reflect the brain’s ability to maintain predictive motor planning despite chronic sensory degradation, with implications for understanding compensatory mechanisms in peripheral neuropathies and the limits of sensory-dependent motor adaptation.
Arteriovenous malformations (AVMs) are rare vascular anomalies, predominantly congenital and intracranial. We report a unique case of multiple extracranial acquired AVM in a 44-year-old man with ethanol-related decompensated chronic liver disease presenting with severe gingival hemorrhage. Angiography showed focal microarteriovenous shunting with early venous drainage in the absence of a mature, compact nidus involving the facial and lingual arterial systems, which was successfully treated with endovascular embolization. In the absence of earlier vascular pathology, an acquired etiology is suspected. Cirrhosis-associated angiogenic and inflammatory dysregulation may contribute to de novo AVM formation, and reported regression following liver transplantation suggests a potentially reversible, hepatic-driven mechanism.
Robotic surgery has rapidly gained acceptance in rectal cancer owing to improved visualization and precision. This study compared perioperative and short-term oncologic outcomes of laparoscopic versus robotic rectal resections at a single tertiary oncology centre. All patients undergoing curative rectal cancer resection between 2016 and 2022 (laparoscopic) and 2022–2025 (robotic) were retrospectively reviewed. Propensity score matching (1:1) was performed based on age, neoadjuvant chemoradiotherapy (NACRT), pathological stage, tumour grade, circumferential resection margin (CRM) and preoperative CEA, yielding 35 matched cases per group. Balance between groups before and after matching was assessed using standardized mean differences (SMD), with an SMD < 0.1 considered indicative of adequate covariate balance. Perioperative parameters, complications, and disease-free survival (DFS) were compared. Kaplan–Meier analysis was used; projected 36-month DFS was reported where robotic follow-up was < 36 months. Seventy matched patients were analysed. Baseline characteristics, including CRM status and lymph node harvest, were comparable. Estimated blood loss was significantly lower in the robotic group (82.6 ± 22.3 ml vs. 129.4 ± 48.6 ml; p < 0.001). Operative duration was longer for robotic surgery (138.4 ± 21.2 min vs. 99.0 ± 9.1 min; p < 0.001). Postoperative morbidity, including ileus, urinary retention, and stoma-related complications, did not differ significantly. Observed 24-month DFS was numerically higher in the robotic group (81
