It is associated with Guru Teg Bahadur Hospital, which serves as the teaching hospital.
Angular pregnancy is a rare eccentric intrauterine implantation often misdiagnosed as interstitial pregnancy, leading to severe complications. A 28-year-old woman presented in shock following a 21-week spontaneous abortion. She had prior abdominal pain and spotting, with normal ultrasounds reported. Emergency laparotomy revealed massive hemoperitoneum and focal placenta percreta with asymmetric uterine enlargement. Hysterectomy was performed, and histopathology confirmed the diagnosis. Early recognition of angular pregnancy through expert imaging is crucial. Timely diagnosis can prevent catastrophic hemorrhage and allow planned, conservative management, improving maternal outcomes.
Background and objectives Chronic pain represents a significant health concern affecting a large segment of society. To date, no systematic review and meta-analysis has evaluated the prevalence of chronic pain in the general population aged 18 to 95 years. The present study aimed to assess prevalence of chronic pain in this age group and examine its variation across age, sex, geographical regions, and psychosocial factors. Methods Cochrane Library, PubMed, and MEDLINE, were searched by combining combination of two categories of keywords (prevalence, chronic pain, epidemiology, population-based study, meta-analysis) in the general population till May 2024. Results A total of 52 studies with 2,89,490 participants were included to ascertain the global prevalence of six types of chronic pain: non-specific chronic pain, fibromyalgia, chronic lower back pain, chronic back pain, chronic widespread pain, and chronic musculoskeletal pain. The overall pooled random-effect prevalence percentage of chronic pain was 26.99%. The chronic pain prevalence percentage was significantly higher in those above 45 yr of age (46.7%), compared to 24.2% in those between 18-45 yr (P<0.001). The prevalence of chronic pain was higher in women as compared to men (31.42% vs. 21.63%) (P=0.07). Interpretation and conclusions The present global meta-analysis of chronic pain across the age group of 18-95 yr, observed a higher prevalence in women and in those alone 45 years of age. There was no geographical difference.
Thomas J. Fogarty was a transformative figure in modern surgery whose innovations reshaped the management of vascular disease. Best known for the balloon embolectomy catheter, Fogarty introduced a simple yet revolutionary concept that converted a high-risk open procedure into a rapid, minimally invasive intervention, saving countless limbs and lives worldwide. Beyond a single device, his career exemplified the clinician-inventor model—where bedside observation, engineering ingenuity, and relentless problem-solving converge to advance patient care. This editorial reflects on Fogarty’s life, his seminal contributions to vascular and endovascular surgery, and the enduring relevance of his philosophy of innovation in an era increasingly driven by technology, interdisciplinary collaboration, and precision medicine.
Introduction Using outdated breakpoints can lead to a considerable overestimation of susceptibility, which can result in ineffective treatments; therefore, it's crucial to adopt current standards to improve patient outcomes. Methods This retrospective analytical study analyzed 9,279 bacterial isolates. Reporting errors in antimicrobial susceptibility testing (AST) by the Kirby-Bauer disk diffusion method due to the use of outdated breakpoints was assessed by comparing the revised cutoff breakpoints of specific antibiotics with previous Clinical and Laboratory Standards Institute (CLSI) guidelines. Chi-square testing and McNemar's test were used to evaluate paired interpretive shifts between the older and updated CLSI breakpoints. Results Among Enterobacterales, analysis of 2,262 aminoglycoside zone diameters revealed significant misclassification when outdated CLSI breakpoints were applied. Gentamicin also showed a significant shift in susceptibility distribution (χ² = 95.27, p < 0.0001), with paired analysis confirming correction of susceptible isolates to the intermediate category using updated breakpoints (McNemar χ² = 36.0, p < 0.0001). Amikacin demonstrated a borderline overall shift (χ² = 6.00, p = 0.0499) but substantial paired misclassification (McNemar χ² = 36.0, p < 0.0001). In Pseudomonas aeruginosa, piperacillin-tazobactam (χ² = 6.62, p = 0.0366) and tobramycin (χ² = 77.94, p < 0.0001) demonstrated a significant redistribution of susceptibility categories, with older criteria overestimating susceptibility. Among Staphylococcus aureus, implementation of revised 34th-edition CLSI linezolid breakpoints introduced an intermediate category and resulted in significant reclassification from susceptible to intermediate (χ² = 17.45, p = 0.00016; McNemar χ² = 17.0, p < 0.0001). Conclusion Unregulated and delayed implementation of updated CLSI breakpoints results in significant misclassification of antimicrobial susceptibility, leading to overestimation of susceptibility and masking emerging resistance. Standardized and timely adoption of revised breakpoints, along with supportive laboratory systems, is essential to ensure accurate susceptibility interpretation, effective antimicrobial stewardship, and reliable antimicrobial resistance surveillance.
Obesity is a global health crisis affecting developing nations, including India. The management of obesity continues to evolve with newer drugs, metabolic and bariatric surgery and endoscopic interventions, requiring family physicians and specialists to adapt their clinical practice accordingly. There is an urgent need for a standardized algorithm to diagnose, stage, and treat obesity. The Endocrine Society of India (ESI) and the Obesity Surgeons Society of India (OSSI) appointed a steering committee to develop an evidence-based algorithm for managing patients with obesity in India. This was put to vote by 80 specialists (38 from OSSI and 42 from ESI) in a physical meeting. A proposed stage-wise algorithm based on Edmonton Obesity Staging System, Asian definition of obesity, and resources in India, received 100
