Yashoda Hospitals is a chain of hospitals based in Hyderabad, Telangana, India. It has branches in Somajiguda, Secunderabad, and Malakpet, with another branch coming up in Hitec City. All of its branches are NABH and NABL accredited.It was recognised as a leading hospital for oncology in 2015 after becoming the first hospital to achieve the milestone of treating 10,000 patients using RapidArc technology.
Ventral hernia repair (VHR) is a common general surgical procedure. While robotic VHR (RVHR) has shown advantages in large, complex hernias, comparative evidence with laparoscopic VHR (LVHR) for smaller defects is limited. We conducted a prospective, real-world evidence study across 12 centers in India. Adults aged 18–65 years undergoing primary or incisional VHR with a defect ≤ 5 cm requiring mesh placement were included. Primary outcomes were postoperative pain and analgesic use within 14 days; secondary outcomes included quality of life (QoL), hospital stay, and perioperative complications. A total of 200 patients (101 RVHR, 99 LVHR) were analyzed, with comparable baseline characteristics. Defect size was larger in the RVHR group (p < 0.001). Median operative time was longer in RVHR (p < 0.001), while post-anesthesia care unit stay was shorter (p = 0.0026). RVHR was associated with faster recovery, including earlier return to daily activities (median 5 vs. 7 days, p < 0.001), fewer analgesic doses (2.55 ± 0.97 vs. 3.25 ± 1.55, p < 0.001), and shorter work restrictions (14 vs. 30 days, p = 0.0042). Pain outcomes favored RVHR, with consistently lower Numeric Rating Scale (NRS) scores, greater improvement in PROMIS pain intensity scores at day 14 (p = 0.0072), and more patients reporting low pain intensity (51.5
Ewing sarcoma (ES) refers to a collection of undifferentiated growths that originate from neuroectoderm cells. The occurrence of ES in the kidneys is exceedingly uncommon. ES of kidney frequently metastasize to various areas of the body. A 21-year-old female presented with complaints of palpable lump in the left hypochondrium since past 3 months associated with intermittent pain and hematuria. Contrast enhanced computed tomography (CECT) revealed heterogeneously enhancing lesion involving entire left kidney associated with pulmonary nodules and pleural effusion. Fluorodeoxyglucose-positron emission tomography computed tomography (FDG PET) scan confirmed lung and liver metastasis. In view of metastatic disease, a percutaneous biopsy of renal mass was performed preoperatively and ES was diagnosed on immunohistochemistry (IHC) and not confirmed before. Neoadjuvant treatment started as per EFT-2001 protocol, which resulted in resolution of distant metastasis and downstaging of tumor. Then the patient underwent laparoscopic left radical nephrectomy and the final Histopathology report (HPR) showed a significant reduction in tumor size with no signs of metastasis. Given the spread of several metastases and the harsh treatment approach, the likelihood of surviving for ES confined to the kidney is improved, although individuals with cancer that has metastasized from the beginning have a reduced survival probability. The neoadjuvant chemotherapy is very effective in ES. The multidisciplinary approach is beneficial in this tumor.
Dyslipidemia plays a critical role in the pathogenesis of both cardiovascular (CVD) and chronic kidney diseases (CKD). Although modifiable, dyslipidemia remains undertreated, probably due to the differences in management across clinical guidelines and the lack of evidence supporting treatment benefits in patients with advanced CKD and those on dialysis. High levels of lipids or changes in their structure are involved in kidney damage due to oxidative stress, inflammation, and lipotoxicity. This review explores the pathophysiology of dyslipidemia in kidney injury and the current strategies for lipid management across different CKD populations, including non-dialysis, dialysis, and kidney transplant recipients. Statins remain the first-line therapy; however, their efficacy is reduced in advanced CKD and patients on dialysis. Emerging therapies, including proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, bempedoic acid, inclisiran, and icosapent ethyl, offer promising options for patients with statin intolerance or persistent dyslipidemia and have been tested in patients with CKD with a glomerular filtration rate (GFR) > 30 mL/min/m 2 . Newer targets, such as ANGPTL3, APOC3, CETP, and Lp(a), are currently being studied. Effective lipid management in patients with CKD requires a personalized, multidisciplinary approach involving nephrologists, cardiologists, endocrinologists, and primary care physicians to implement evidence-based interventions and improve long-term outcomes.
