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Eosinophilic gastrointestinal disorders (EGIDs) are representative of eosinophilic invasion of various sections of the gastrointestinal tract and do not pertain to any secondary causes. To affirm the diagnosis of eosinophilic infiltration of the gastrointestinal tract, tissue biopsy evidence must be demonstrated. Both iron deficiency anemia and gastritis symptoms may be brought on by mucosal eosinophilic infiltration. One of the most common dietary deficiencies globally is iron deficiency anemia which affects most developing populations. Reduced dietary iron and poor iron absorption are significant reasons for iron deficiency anemia (IDA), although the most common causes are menstruation and GI bleeding in women. Here, we describe a case of an 18-year-old female, with iron deficiency anemia, who was diagnosed with eosinophilic duodenitis., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Bal et al.)

Total hip replacement (THR) is a common surgical procedure aimed at alleviating pain and improving function in patients with hip joint pathology. Effective postoperative pain management is crucial for patient recovery, satisfaction, and overall outcomes. This narrative review examines the comparative efficacy, safety, and implications of using opioids versus non-opioid analgesics in managing postoperative pain following THR. Opioids, while effective for severe pain, pose significant risks such as addiction, tolerance, and adverse effects. Non-opioid analgesics, including non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and regional anesthesia techniques, offer alternatives with potentially fewer side effects. This review synthesizes current evidence from clinical trials, observational studies, and expert guidelines to provide a comprehensive understanding of the benefits and drawbacks of each analgesic approach. The goal is to inform clinical decision-making and optimize pain management strategies for THR patients, balancing efficacy and safety., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Singh et al.)

This narrative review analyzes muscle strength recovery following total hip replacement (THR) and looks at various factors affecting postoperative muscle function restoration. The review synthesizes evidence from various studies regarding the timing and degree of muscular strength recovery, different rehabilitation protocols, and patient-specific variables such as age, preoperative physical condition, and comorbidities, among others. Overall, it appears that THR is associated with improved hip function and quality of life, but this usually takes a long time due to individualized physical therapy interventions. In addition, postoperative rehabilitation has been found not to exist without any personal factors involved such as age or gender whereby for instance senior citizens have no alternative but to go for THR surgery, making their lower limbs weaker than those who are younger. Based on the findings in this review on muscle recovery after THR surgeries, one may conclude that this endeavor should begin as early as possible and include regular resistance training programs with performance-focused functional training after surgery. In addition, more longitudinal studies should be conducted regarding post-surgical outcomes comparing other traditional medical practices., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Singh et al.)

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among individuals with type 1 diabetes (T1D), necessitating effective prevention strategies. This comprehensive review consolidates current knowledge and evidence on preventing CVD in T1D patients. It begins by exploring the pathophysiological mechanisms that link T1D to an increased risk of CVD, highlighting factors such as chronic hyperglycemia, hypertension, dyslipidemia, and inflammation. The review also examines the epidemiology and specific risk factors for CVD in this population, emphasizing the need for rigorous risk assessment and screening. Lifestyle modifications, including dietary interventions, regular physical activity, and smoking cessation, are evaluated for their effectiveness in reducing CVD risk. Additionally, the review discusses pharmacological interventions, such as insulin therapy for glycemic control, antihypertensive medications, lipid-lowering agents, and antiplatelet therapy, underscoring their critical role in CVD prevention. Emerging therapies and future research directions are explored, focusing on novel pharmacological agents, advances in insulin delivery systems, and personalized medicine approaches. The importance of integrated care models involving multidisciplinary teams and the use of technology is highlighted as essential for comprehensive management. Challenges and barriers to implementing these strategies, including healthcare system limitations, patient adherence, and socioeconomic factors, are also addressed. This review provides a detailed synthesis of current strategies and future directions for preventing CVD in individuals with T1D, serving as a valuable resource for clinicians, researchers, and policymakers dedicated to improving cardiovascular outcomes in this high-risk population., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ahuja et al.)

Introduction Iron deficiency anemia and beta-thalassemia trait are two common and important differentials of microcytic hypochromic anemia. Various discrimination indices using two or more common complete blood cell count (CBC) parameters have been used to distinguish between the two since 1973. Recently, a new discriminant index, the CRUISE index, was proposed in the year 2019. The efficacy of various older indices along with the CRUISE index was evaluated for patients in our geographical area. Materials and method Ours was a laboratory-based, cross-sectional study where 100 patients, based on inclusion and exclusion criteria, with microcytic hypochromic anemia were evaluated for CBC parameters along with serum ferritin and hemoglobin-high performance liquid chromatography (Hb HPLC). A total of eight discrimination indices namely, Mentzer, Srivastava, Shine & Lal, Green & King, RDWI, England & Fraser, Kerman I and CRUISE index were used and evaluated for their diagnostic efficacy using different statistical parameters. ROC curves were obtained and a new cut-off value was proposed for our population. Data was analysed using Microsoft Excel (Microsoft ® Corp., Redmond, WA, USA) and SPSS v29.0.2.0 (20) (IBM Corp., Armonk, NY, USA). Results Out of the total 100 cases, 39 were beta-thalassemia trait and 61 were iron deficiency anemia cases. The average age was 36.7 (±12.7 SD) years. Among the 73 females, 43 were diagnosed as iron deficiency anemia (IDA) and 30 as beta-thalassemia trait (BTT) cases. Among the 27 males, 18 were diagnosed as IDA and nine as BTT cases. The mean values were significantly lower in IDA patients for mean corpuscular volume (MCV) (p=.008), mean corpuscular haemoglobin (MCH) (p=.003), and mean corpuscular haemoglobin concentration (MCHC) (p=.003) and significantly higher for red cell distribution width (RDW) (p=.020). The mean ferritin levels in cases of IDA were 7.61 (±3.75) mcg/L and in BTT were 87.09 (±66.77 SD) mcg/L. The mean HbA2 levels in IDA cases were 2.75% (±0.41% SD) and BTT cases were 5.57% (±0.73% SD). CRUISE index revealed the highest AUC (0.934), YI (76.21) and accuracy (90%) followed by the Mentzer index with a diagnostic accuracy of 81%. Shine & Lal index revealed the lowest AUC (0.710), YI (3.28) and accuracy (41%). Conclusion CRUISE index, which was recently proposed, was ranked 1 st in terms of AUC, YI, and accuracy and was considered 2 nd best in terms of sensitivity for differentially diagnosing the two conditions. Mentzer index, a commonly used index, also revealed a high diagnostic accuracy in our study for differentiating BTT from IDA. CRUISE index being a novel index, more research work needs to be carried out in various other geographical setups to evaluate the efficacy of this index., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. MMIMSR Ethical Committee issued approval 2528. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Hans et al.)

Labial fusion, though rare, can present during puberty, or even adolescence leading to challenges in diagnosis and management. This case report offers a detailed examination of the clinical manifestation, diagnostic process, and therapeutic approach in an adolescent girl with labial fusion. This report emphasizes the importance of early intervention to improve patient outcomes for this complex medical condition., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Gupta et al.)

The vertebrobasilar system is made up of the two vertebral arteries that unite to form the basilar artery near the base of the skull. Aneurysms in the vertebrobasilar system are distinct from other cerebral aneurysms due to their unique morphologic characteristics. They can be large and bulging (massive), pressing on the brainstem. Alternatively, they might be weak and splitting apart (dissecting) or have an elongated shape (fusiform). On the other end of the spectrum, Vertebral artery aneurysms (VAAs) can also be small and rounded (saccular). These aneurysms can occur at the vertebral artery itself or where it joins the posterior inferior cerebellar artery (PICA). Anatomically, they are situated near the brainstem and cranial nerves, deep within the posterior fossa. The cerebrospinal fluid is kept in transit and flux by the ventricular system's chambers circulating the fluid within themselves. An intraventricular hemorrhage (IVH) can occasionally result from vertebral artery aneurysmal ruptures that result in bleeding into the subarachnoid space and then extravasate into the ventricles. Persistent and poorly controlled hypertension affects about 50% of individuals with IVH. In this case report, we study a 74-year-old woman who complained of a sudden onset headache that had been bothering her for three days at the medical emergency room. She had been diagnosed with systemic hypertension eight years prior and had not taken her medicines as prescribed. She was discovered to have rigidity in her neck and a blood pressure reading of 170/100 mmHg, which had been followed by an episode of vomiting. Radiological investigations revealed a VAA that had a high risk of rupturing and causing an IVH., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Chavhan et al.)

Complications of acute-on-chronic liver failure (ACLF) include increased short-term mortality. Extrahepatic organ failures result from chronic liver disease and acute hepatic injury. This combination characterizes end-stage liver disease. Its rapid progression makes it challenging for hepatologists and intensivists to treat. The varied definitions of this condition lead to varied clinical presentations. Hepatic or extrahepatic failures are more prevalent in chronic hepatitis B or cirrhosis patients who receive an additional injury. Numerous intensity parameters and prognosis ratings, including those for hepatitis B virus (HBV), have been developed and verified for various patients and causes of the disease. Liver regeneration, liver transplantation (LT), or antiviral therapy for HBV-related ACLF are the main treatment aims for various organ failures. LT is the best treatment for HBV-ACLF. In some HBV-related ACLF patients, nucleos(t)ide analogs and artificial liver assistance may enhance survival. Combining epidemiological and clinical studies, this review updates our understanding of HBV-ACLF's definition, diagnosis, epidemiology, etiology, therapy, and prognosis., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Batra et al.)

Hepatitis B viral infection poses a significant challenge during pregnancy, as the risk of vertical transmission carries serious consequences for both maternal and neonatal well-being. This comprehensive review delves into the intricacies surrounding hepatitis B infection during the perinatal period, shedding light on its impact on pregnancy outcomes and stressing the necessity of addressing it within the broader framework of perinatal care. By scrutinizing current evidence, diagnostic methodologies, management techniques, and preventive measures, this review emphasizes the urgent need for enhanced screening protocols, timely interventions, and augmented public health initiatives. Notably, key findings underscore the elevated likelihood of chronic hepatitis B virus (HBV) infection in infants and its enduring implications for the health of both mothers and newborns. The imperative call to action advocates for a multifaceted approach, engaging healthcare professionals, policymakers, and public health agencies to optimize strategies for management and prevention, thereby striving for improved outcomes for pregnant women and their infants affected by hepatitis B viral infection., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Singh Thakur et al.)

This review explores recent advancements in wearable digital health technology specifically designed to manage epilepsy. Epilepsy presents unique challenges in monitoring and management due to the unpredictable nature of seizures. Wearable devices offer continuous monitoring and real-time data collection, providing insights into seizure patterns and trends. Wearable technology is important in epilepsy management because it enables early detection, prediction, and personalized intervention, empowering patients and healthcare providers. Key findings highlight the potential of wearable devices to improve seizure detection accuracy, enhance patient empowerment through real-time monitoring, and facilitate data-driven decision-making in clinical practice. However, further research is needed to validate the accuracy and reliability of these devices across diverse patient populations and clinical settings. Collaborative efforts between researchers, clinicians, technology developers, and patients are essential to drive innovation and advancements in wearable digital health technology for epilepsy management, ultimately improving outcomes and quality of life for individuals with this neurological condition., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Ahuja et al.)

This comprehensive review delves into the multifaceted landscape of postpartum depression (PPD), exploring its prevalence, impact on maternal and infant well-being, and the efficacy of existing screening and intervention practices. PPD emerges as a critical concern, with implications extending beyond individual mental health to encompass the dynamics of mother-infant relationships and societal well-being. The analysis underscores the complexity of addressing PPD, emphasizing the challenges associated with screening tools and the importance of evidence-based interventions. A call to action resonates throughout, urging healthcare providers, policymakers, and stakeholders to prioritize mental health support for new mothers through enhanced screening protocols and improved accessibility to interventions. Furthermore, the review highlights the need for destigmatization and awareness campaigns to foster a supportive environment. Future research directions are outlined, emphasizing the refinement of screening tools, developing innovative interventions, and exploring cultural and socioeconomic influences on PPD outcomes. The review envisions a collaborative effort to dispel the shadows of PPD, striving for a future where mothers receive comprehensive support, ensuring optimal mental health and overall well-being., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Gupta et al.)

After total abdominal hysterectomy (TAH), intestinal prolapse is uncommon. We report an instance of a 48-year-old woman who had TAH and then intestinal prolapse. Two weeks after the operation, symptoms started to show up, and the vaginal vault developed a bulging bulge. The problem was satisfactorily treated with an urgent laparotomy. The significance of being vigilant for unusual complications following TAH is shown by this example., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Singh Thakur et al.)

This case report is about a middle-aged female who presented with complaints of pain in the abdomen with intractable vomiting for three months, pain and weakness in bilateral lower limbs for two months, and irritability for three days. She was previously treated for lumbar disc bulge and severe narrowing of the spinal cord whose treatment also included vitamin D supplements. After taking high doses of a vitamin D supplement daily for approximately four months, it resulted in vitamin D toxicity. The sodium level of the patient was in the normal range throughout the treatment. Her magnetic resonance imaging brain revealed features of central pontine myelinolysis. The development of central pontine myelinolysis due to vitamin D toxicity, with normal sodium levels, makes this a rare case for discussion., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Ahuja et al.)

This comprehensive review explores the complex dynamics of nosocomial infections in individuals with sickle cell anemia (SCA) and advocates for a collaborative strategy to enhance prevention. SCA patients, marked by compromised immunity and susceptibility to infections, face unique challenges that necessitate tailored preventive measures. The review underscores the importance of vaccination, antibiotic prophylaxis, education, and environmental hygiene in mitigating the risk of nosocomial infections. Addressing socioeconomic factors, healthcare system limitations, patient-related issues, and cultural considerations is imperative for effective prevention. The call to action emphasizes the pivotal roles of healthcare professionals, policymakers, researchers, and community engagement in implementing targeted interventions. By fostering a collective effort, this review envisions an improved landscape for infection prevention in SCA patients, enhancing their overall health outcomes and quality of life., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Batra et al.)

This review provides a comprehensive exploration of the roles of placenta growth factor (PlGF) and pregnancy-associated plasma protein A (PAPP-A) in the context of pre-eclampsia, a pregnancy-related hypertensive disorder with significant implications for maternal and fetal health. The background elucidates the clinical significance of pre-eclampsia, highlighting its prevalence and impact. The review delves into the biological importance of PlGF and PAPP-A, emphasizing their critical roles in normal placental development and their dysregulation in pre-eclampsia. Notably, altered levels of these biomarkers emerge as potential diagnostic indicators, offering insights into the pathophysiology of the disorder. The exploration of pathophysiological mechanisms, including angiogenic imbalance and placental dysfunction, provides a nuanced understanding of pre-eclampsia's molecular landscape. The therapeutic implications of targeting PlGF and PAPP-A open avenues for future research, aiming at effective intervention strategies. The conclusion summarizes key findings, outlines implications for future research, and underscores the crucial role of PlGF and PAPP-A in understanding and managing pre-eclampsia, with the ultimate goal of improving outcomes for both mothers and infants., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Singh Thakur et al.)

Objective: The location of infraorbital foramen varies between geographic locations. Thus, population-specific information is required to facilitate the prediction of its exact location., Methods:  A cross-sectional study was conducted on 100 cone beam computed tomography (CBCT) sections to evaluate the distance between the infraorbital foramen and incisal edge of the maxillary central incisor, the occlusal plane of the maxillary second premolar, and the alveolar crest over the maxillary second premolar using CBCT in Central Gujarat, Indian population. Descriptive statistical analysis was performed to calculate means and standard deviations for each measured parameter. The statistical significance level was defined at p<0.05., Results: The distance between the infraorbital foramen and incisal surface of the maxillary central incisor was (mean ± standard deviation) R=49.39 ± 3.12 mm and L=49.49 ± 3.29 mm, the occlusal plane of the maxillary second premolar was R=39.02 ± 2.65 mm and L=39.49 ± 2.53 mm, and the alveolar crest over the maxillary second premolar was R=32.64 ± 2.67 mm and L=31.64 ± 2.33 mm. There was no significant difference in the mean values of all variables between genders and age groups (p>0.05). The distance between the infraorbital foramen and the alveolar crest over the maxillary second premolar was greater on the right side (p<0.05)., Conclusion: The results of this study were analogous to those observed in a cohort of the Turkish population but varied from those observed in a cohort of the Sri Lankan population. Hence, more population-specific studies are required., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Desai et al.)

Catamenial epistaxis is a rare form of epistaxis (nosebleed) that occurs in women during menstruation due to hormonal changes. There are numerous hypotheses on the cellular mechanisms and pathophysiology of endometriosis. Endometriosis may present a wide range of symptoms depending on where endometrial tissue was implanted. This entity's diagnosis is neither simple nor difficult. There are numerous clinical and laboratory diagnostic techniques in use, but none of them is considered to be the best. Every woman who experiences recurrent symptoms (such as epistaxis and hemoptysis) of extrapelvic organs should be clinically suspicious of endometriosis because of its multipotent location and the variety of clinical manifestations of the condition. This case report demonstrates that periodic epistaxis may infrequently be the root cause of the extra pelvic endometrium in the nasal septum in a woman who has had treatment for recurrent pelvic discomfort and dysmenorrhea., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Batra et al.)

Mucoepidermoid carcinoma is a locally invasive tumor of the major and minor salivary glands. A 29-year-old male patient reported a complaint of slow-growing, painless, non-ulcerated palatal swelling. On clinical evaluation, the swelling appeared benign; hence, the complete excision of the lesion was carried out under general anesthesia, with closure by reconstruction with a partial-thickness flap. Healing was uneventful. The histopathological evaluation revealed low-grade mucoepidermoid carcinoma. This case report aims to highlight the importance of proper clinical and histopathological evaluation to rule out malignancy, as mucoepidermoid carcinoma can have variable presentations and mimic various benign salivary gland lesions, similar to the occurrence in the present case., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Mishra et al.)

Patients present to the orthopedic outpatient department with complaints of shoulder pain on movement or restriction of movement in the shoulder joint and are referred for magnetic resonance imaging (MRI) of the shoulder joint. Almost all the patients have similar complaints but may have a wide range of pathology affecting the joint and causing pain. Rotator cuff tears or tendinopathy are the most common causes of shoulder pain. Ultrasound (USG) and MRI are the most commonly used imaging modalities for assessing rotator cuff pathologies. There is a wide range of pathologies affecting the shoulder joint, other than rotator cuff tendinopathies or tears, for which USG is less sensitive and specific in detecting accurate pathology. MRI is the choice of imaging for shoulder joint pathologies. We present a pictorial review discussing and depicting MRI features of a wide list of pathologies of the shoulder joint complex that should be kept in mind when the patient presents with shoulder pain., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Sood et al.)

Degeneration of the lumbar intervertebral disc is the most common cause of lower back pain. It is directly related to daily activities, mechanical stress, and other biological factors. We use imaging modalities to assess the degree of disc degeneration, out of which magnetic resonance imaging (MRI) is the most popular non-invasive modality. It is believed that early changes in disc degeneration are due to the biochemical events in the disc and can be evaluated by sequences in MRI involving the diffusion of water molecules. The apparent diffusion coefficient (ADC) is one such sequence that captures the signals based on the diffusion of water molecules. Ten articles were chosen from PubMed and Google Scholar using the MeSH terms 'lumbar spine degeneration' and 'apparent diffusion coefficient'. This review article has summarized various studies intending to gain a better understanding of the biochemical events leading to the development of disc degeneration. This study has also gathered the role of various sequences in MRI that can quantitatively assess disc degeneration., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Sood et al.)

Simultaneous bilateral spontaneous pneumothorax is a situation that rarely occurs. The patient can have various presentations, from dyspnoea and chest pain to significant respiratory failure. Although it causes lung collapse in nearly two thirds of cases, early diagnosis and treatment are of the utmost importance. Here, we present the case of an 18-year-old boy who presented with complaints of sudden onset respiratory distress. He was immediately put on mechanical ventilation. He was diagnosed with simultaneous bilateral spontaneous pneumothorax on chest X-ray. He needed bilateral intra-thoracic drainage, following which a video-assisted thoracoscopy was done on the left side., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Gaidhane et al.)

Lightning strikes are frequently encountered and are a major cause of morbidity and mortality. It could impair several organs, but the effects of electric current on the cardiovascular system contribute to the primary cause of cardiorespiratory arrest. These effects can be either transient or persistent, ranging from benign or life-threatening arrhythmias, ischemic injury, myocardial contusion, aortic injury, cardiomyopathy, and ventricular failure. Myocarditis has been an important but not very well-understood cause of cardiac dysfunction. Fulminant myocarditis is defined as patients presenting with severe heart failure, having a duration of <2 weeks of symptoms, and requiring inotropic or mechanical circulatory support. This condition can rapidly lead to hemodynamic instability and death. Resuscitation for a longer time increases the probability of favorable outcomes in young and previously healthy patients. This case report accounts for a case of a healthy young male who was struck by lightning while working on the farm and developed electrocardiographic changes along with positive cardiac biomarkers., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Mahajan et al.)

The presence of an extra (third) kidney is an unusual congenital anomaly of the urinary system (US), having less than a hundred cases reported globally. Owing to the rare occurrence of this complex anomaly, the fused supernumerary kidney and horseshoe portion is very scarcely reported with unknown incidence. This paper presents a rare renal anomaly case of a fused supernumerary kidney with a horseshoe portion in a 41-year-old male who presented with fever, abdominal pain, and burning micturition. CT of the kidney urinary bladder showed non-rotation of the right kidney with a supernumerary malrotated horseshoe-shaped kidney and malrotated left kidney with features of acute pyelonephritis. The patient was managed with double J stenting and appropriate antibiotics till discharge., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Nimkar et al.)

Background/Aims Glioblastoma multiforme (GBM) is the most aggressive primary brain tumor. Cyclin D1 is a protein that in humans is encoded by the CCND1 gene. Cyclin D1 protein is frequently overexpressed in malignant gliomas. Methods It is an observational study comprising 40 biopsy-proven cases of GBM in a span of one and half years. Immunohistochemistry (IHC) was used with Cyclin D1 monoclonal antibody. Cyclin D1 on the outcome was assessed using the Kaplan-Meier survival estimate and compared by log-rank test. Results Cyclin D1 was expressed in 60% of patients. The majority (72.5%) of patients expired during the study period, out of which 69% showed immune-expression in contrast to living subjects, out of which only 45.5% of patients exhibited expression. The maximum number of glioblastoma patients were aged between 41 and 50 years (40%), followed by those aged between 31 and 40 years (20%). The male to female ratio of study subjects was 3.44:1. Conclusion The study concluded that there is no significant association between Cyclin D1 expression status and different demographic, clinical, and outcome variables., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Jaiswal et al.)

Factor V Leiden (FVL) G1619A mutation and prothrombin gene (PTG) G20210A are the most common inherited thrombophilias. They have been associated with various obstetric complications such as venous thromboembolism, recurrent pregnancy loss, preeclampsia, abruptio placentae, and small for gestational age fetus. The prevalence of these two mutations is 3-15% in Caucasians and is assumed to be far less common in other ethnic populations. However, there have been several controversies regarding advising routine screening of these thrombophilias because of a widely variable strength of association between different ethnic groups, as well as contradictory conclusions by different studies in regards to the association. In this study, the literature was analyzed thoroughly for the effect of FVL G1619A and PTG G20210A mutations on various obstetric outcomes. A review of multiple case-control and prospective studies suggests that despite the availability of robust data on this subject the results remain inconclusive and insubstantial. Further superior quality research, preferably prospective studies, is warranted to conclusively establish this relationship and to enable practitioners to follow a definitive protocol in the screening of various populations for these mutations to achieve an improved pregnancy outcome., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Padda et al.)

Various studies have established the prognosis of anemia in myocardial infarction (MI). Both chronic and acute anemia lead to poor outcomes in MI. Regardless, the association of anemia with MI and its management varies. In this study, the literature was analyzed to determine the association between acute anemia and MI based on the pathophysiology, outcomes, and management options. Acute anemia results in decreased blood supply and sudden hypoxia to the heart. Additionally, it exacerbates the preexisting compromised coronary blood supply in patients with MI. Thus, there is a disproportionate oxygen supply and demand ratio to the heart. It was found that anemia increases all-cause mortality in acute MI. However, it is unclear whether anemia is the direct contributor to mortality in these patients. For the management of MI, percutaneous coronary intervention (PCI) is commonly used. Increased incidence of hospital-acquired anemia (HAA) is reported in patients after PCI. However, the cause of HAA in these patients is not well established. Antiplatelet therapy in these patients is also considered to be the culprit for HAA. Nonetheless, no clear evidence is available. There is no consensus or criteria for the treatment of acute anemia in MI patients. Researchers have explored management options such as blood transfusion, erythropoietin-stimulating agent, and iron therapy. Further studies are warranted for a better understanding and management of MI in patients with anemia and vice versa., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Padda et al.)

A strong association is noted between depression and early perimenopause as well as menopause. The association was found to be the greatest in women with natural menopause at the age less than 40 years. Excessive corticotropin-releasing hormone (CRH) levels in depression lead to inhibition of the hypothalamic-pituitary-gonadal (HPG) axis and increased cortisol levels which further inhibits the action of gonadotropin-releasing hormone (GnRH) neurons, gonadotrophs, and gonads. The resulting changes in luteinizing hormone (LH) amplitude, follicle-stimulating hormone (FSH) levels, and LH pulse frequency were noted in patients with depression. Besides depression, earlier surgical menopause is associated with cognitive decline. In addition, it is seen that menopausal changes predisposed females to an increased risk of depression. The association between dysmenorrhea and depression was found to be bidirectional and congruent in most studies. Patients with dysmenorrhea and coexisting depression had enhanced pain perception along with a poor response to pain relief measures. Even the treatment of underlying depression has been shown to cause menorrhagia. On the other hand, amenorrhea has also been reported as a side effect of sertraline and electroconvulsive therapy. Menstrual disorders contribute to a significant number of outpatient gynecological visits per year in the United States. Co-existing or history of depression can either be the cause of or interfere in the treatment of these disorders. Furthermore, the treatment of depression can be the etiology of various menstrual abnormalities, while menstrual disorders themselves could be the cause of depression. The increasing prevalence of depression, women's health, multiple female-specific subtypes, and the preexisting burden of menstrual disorders necessitates more detailed studies on the effects of depression on the menstrual cycle., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Padda et al.)

Background Marijuana is a widely used recreational substance. Few cases have been reported of acute myocardial infarction following marijuana use. To our knowledge, this is the first ever study analyzing the lifetime odds of acute myocardial infarction (AMI) with marijuana use and the outcomes in AMI patients with versus without marijuana use. Methods We queried the 2010-2014 National Inpatient Sample (NIS) database for 11-70-year-old AMI patients. Pearson Chi-square test for categorical variables and Student T-test for continuous variables were used to compare the baseline demographic and hospital characteristics between two groups (without vs. with marijuana) of AMI patients. The univariate and multivariate analyses were used to assess and compare the clinical outcomes between two groups. We used Cochran-Armitage test to measure the trends. All statistical analyses were executed by IBM SPSS Statistics 22.0 (IBM Corp., Armonk, NY). We used weighted data to produce national estimates in our study. Results Out of 2,451,933 weighted hospitalized AMI patients, 35,771 patients with a history of marijuana and 2,416,162 patients without a history of marijuana use were identified. The AMI-marijuana group consisted more of younger, male, African American patients. The length of stay and mortality rate were lower in the AMI-marijuana group with more patients being discharged against medical advice. Multivariable analysis showed that marijuana use was a significant risk factor for AMI development when adjusted for age, sex, race (adjusted OR 1.079, 95% CI 1.065-1.093, p<0.001); adjusted for age, female, race, smoking, cocaine abuse (adjusted OR 1.041, 95% CI 1.027-1.054, p<0.001); and also when adjusted for age, female, race, payer status, smoking, cocaine abuse, amphetamine abuse and alcohol abuse (adjusted OR: 1.031, 95% CI: 1.018-1.045, p<0.001). Complications such as respiratory failure (OR 18.9, CI 15.6-23.0, p<0.001), cerebrovascular disease (OR 9.0, CI 7.0-11.7, p<0.001), cardiogenic shock (OR 6.0, CI 4.9-7.4, p<0.001), septicemia (OR 1.8, CI 1.5-2.2, p<0.001), and dysrhythmia (OR 1.8, CI 1.5-2.1, p<0.001) were independent predictors of mortality in AMI-marijuana group. Conclusion The lifetime AMI odds were increased in recreational marijuana users. Overall odds of mortality were not increased significantly in AMI-marijuana group. However, marijuana users showed higher trends of AMI prevalence and related mortality from 2010-2014. It is crucial to assess cardiovascular effects related to marijuana overuse and educate patients for the same., Competing Interests: The authors have declared that no competing interests exist.