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Introduction: There is an unmet need for high-quality data for Robot-assisted partial nephrectomy (RAPN) in the Indian population. Indian study group on partial nephrectomy (ISGPN) is a consortium of Indian centers contributing to the partial nephrectomy (PN) database. The current study is a descriptive analysis of perioperative and functional outcomes following RAPN. Methods: For this study, the retrospective ISGPN database was reviewed, which included patients who underwent RAPN for renal masses at 14 centers across India from September 2010 to September 2022. Demographic, clinical, radiological, perioperative, and functional data were collected and analyzed. Ethics approval was obtained from each of the participating centers. Results: In this study, 782 patients were included, and 69.7% were male. The median age was 53 years (interquartile range [IQR 44-62]), median operative time was 180 min (IQR 133-240), median estimated blood loss was 100 mL (IQR 50-200), mean warm ischemia time was 22.7 min and positive surgical margin rates were 2.5%. The complication rate was 16.2%, and most of them were of minor grade. Trifecta and pentafecta outcomes were attained in 61.4% and 60% of patients, respectively. Conclusions: This is the largest Indian multi-centric study using the Indian Robotic PN Collaborative database to evaluate the outcomes of robot assisted PN, and has proven its safety and efficacy in the management of renal masses. [ABSTRACT FROM AUTHOR]

PURPOSE: To identify risk factors for disease progression or death and assess outcomes by risk categories in real-world patients with advanced ovarian cancer. METHODS: This retrospective study included adult patients from a nationwide electronic health record–derived deidentified database with stage III/IV ovarian cancer who received first-line therapy and had ≥12 weeks of follow-up after index date (end of first-line therapy). Factors predictive of time to next treatment and overall survival (OS) were assessed. Patients were grouped according to the cumulative number of high-risk factors present (stage IV disease, no debulking surgery or neoadjuvant therapy and interval debulking surgery, visible residual disease after surgery, and breast cancer gene [ BRCA ] wild-type disease/unknown BRCA status), and time to next treatment and OS were assessed. RESULTS: Region of residence, disease stage, histology, BRCA status, surgery modality, and visible residual disease were significant predictors of time to next treatment; age, Eastern Cooperative Oncology Group performance status, disease stage, BRCA status, surgery modality, visible residual disease, and platelet levels were significant predictors of OS (N = 1,920). Overall, 96.4%, 74.1%, and 40.3% of patients had at least 1, 2, or 3 high-risk factors, respectively; 15.7% of patients had all four high-risk factors. Observed median time to next treatment was 26.4 months (95% CI, 17.1 to 49.2) in patients with no high-risk factors and 4.6 months (95% CI, 4.1 to 5.7) in patients with four high-risk factors. Observed median OS was shorter among patients with more high-risk factors. CONCLUSION: These results underscore the complexity of risk assessment and demonstrate the importance of assessing a patient's cumulative risk profile rather than the impact of individual high-risk factors. They also highlight the potential for bias in cross-trial comparisons of median progression-free survival because of differences in risk-factor distribution among patient populations. Does the total number of risk factors matter? Real-world outcomes in patients with #ovariancancer. [ABSTRACT FROM AUTHOR]

Chronic exposure to Ultraviolet B radiation (UV‐B) evokes a myriad of toxic signalling events in the irradiated skin. One of such response is ER stress, which is known to exacerbate photodamage responses. Also, recent literature has highlighted the adverse impact of environmental toxicants on mitochondrial dynamics and mitophagy. Impaired mitochondrial dynamics escalates oxidative damage and causes apoptosis. There have been evidences that support crosstalk between ER stress and mitochondrial dysfunction. However, mechanistic clarification is still needed to verify the interactions between UPR responses and mitochondrial dynamics impairment in UV‐B‐induced photodamage models. Lastly, plant‐based natural agents have garnered attention as therapeutic agents against skin photodamage. Thus, gaining mechanistic insights of plant‐based natural agents is required for their application and feasibility in clinical settings. With this aim in view, this study was performed in primary human dermal fibroblasts (HDFs) and Balb/C mice. Different parameters regarding mitochondrial dynamics, ER stress, intracellular damage and histological damage were analyzed using western blot, rt‐PCR and microscopy. We demonstrated that UV‐B exposure leads to induction of UPR responses, upregulation of Drp‐1 and inhibition of mitophagy. Further, 4‐PBA treatment leads to reversal of these noxious stimuli in irradiated HDF cells, thereby, indicating an upstream role of UPR induction in mitophagy inhibition. Also, we explored the therapeutic effect of Rosmarinic acid (RA) against ER stress and impaired mitophagy in photodamage models. RA prevents intracellular damage via alleviation of ER stress and mitophagic responses in HDFs and irradiated Balb/C mice skin. The current study summarizes the mechanistic insights into UVB‐mediated intracellular damage and role of natural plant‐based agent (RA) in ameliorating these toxic responses. [ABSTRACT FROM AUTHOR]

A case study of a 70-year-old retired man with no known co-morbidities presented with a slowly progressive area of ulceration over the right shin of a 1-year duration. Topics include the patient was diagnosed as having chromoblastomycosis (CBM) with the typical ‘sclerotic bodies' in histology; and secondary ulceration of the exophytic or verrucous growths is a common complication regarding the number of cases with ulcerative morphology.

Intermittent vagus nerve stimulation (VNS) can reduce the frequency of seizures in patients with refractory epilepsy, but can affect respiration in sleep. Untreated obstructive sleep apnea (OSA) can worsen seizure frequency. Unfortunately, OSA and VNS-induced sleep disordered breathing (SDB) may occur in the same patient, leading to a therapeutic dilemma. We report a pediatric patient in whom OSA improved after tonsillectomy, but coexistent VNS-induced SDB persisted. With decrease in VNS output current, patient's SDB improved, but seizure activity exacerbated, which required a return to the original settings. Continuous positive airway pressure titration was attempted, which showed only a partial improvement in apnea–hypopnea index. This case illustrates the need for clinicians to balance seizure control and SDB in patients with VNS. [ABSTRACT FROM AUTHOR]

The article presents the case study of a 10‑month‑old boy who was referred because of greenish pigmentation on his deciduous teeth from the time of eruption. It mentions that intra‑oral examination revealed yellowish‑green pigmentation in the crown of the incisors. It reveals that treatment options include composite resin restorations, bleaching techniques, and transillumination with ultraviolet light.

A letter to the editor is presented on the effectiveness of isotretinoin drug for treatment of keratosis follicularis spinulosa decalvans skin disease. [ABSTRACT FROM AUTHOR]

We report a rare case of uterovaginal duplication in a prepubertal female. The patient also had a permeable ureter (ureter with urine passing through it) subtending a poorly functioning kidney with ectopic insertion in the obstructed hemivagina. [ABSTRACT FROM AUTHOR]

In the ENGOT-OV16/NOVA study, maintenance therapy with niraparib significantly prolonged progression-free survival (PFS) in patients (pts) with platinum-sensitive recurrent ovarian cancer (PSROC) regardless of germline BRCA mutation (g BRCA m) or homologous recombination deficiency (HRd) biomarker status. This analysis updates long-term safety and available data on secondary efficacy outcomes. In this randomized, double-blind, placebo-controlled, phase III trial, pts with PSROC were enrolled into 1 of 2 independent cohorts by g BRCA m status (g BRCA m or non-g BRCA m). Stratification factors were PFS after the penultimate platinum therapy (6 to <12 months vs ≥12 months), best response to the last platinum-based therapy (complete or partial), and prior bevacizumab (Y/N). Pts were randomized 2:1 to niraparib 300 mg QD or placebo. The primary endpoint was PFS as assessed by blinded independent central review. Progression-free survival 2 (PFS2) and overall survival (OS) were exploratory secondary endpoints. A total of 553 pts were randomized in the NOVA study. Median follow-up was 66 months at the time of the current analysis. Hematologic treatment-emergent adverse effects (TEAEs) primarily occurred in the first year of niraparib treatment: incidence of grade ≥3 thrombocytopenia decreased from 33.8% to 2.8%, anemia decreased from 25.6% to 0.7%, and neutropenia decreased from 19.3% to 2.1% from year 1 to year 2–3, respectively. A total of 13 (3.5%; 9 g BRCA m, 4 non-g BRCA m) pts who received niraparib developed MDS/AML vs 3 (1.7%) placebo pts. Survival status could not be obtained for ~15% of pts. Data on post-progression therapy, including PARP inhibitors, were not available for 25% of the study pts. Based on data cut-off on October 2020, 127 and 238 deaths occurred in the g BRCA m and non-g BRCA m cohorts, respectively. For pts with available data, placebo pts received subsequent PARP inhibitor therapy (crossover) after disease progression: 46% (30/65) in the g BRCA m cohort and 13% (15/116) in the non-g BRCA m cohort. Hazard ratios for PFS2 were 0.67 (95% CI: 0.48, 0.95) in the g BRCA m cohort and 0.81 (95% CI: 0.62, 1.05) in the non-g BRCA m cohort. Restricted mean survival time analyses for OS up to 72 months were 43.2 months in placebo vs 45.9 months in niraparib (Δ of 2.7m, 95% CI: -4.1, 9.5) in the g BRCA m cohort and 39.1 months in placebo vs 38.5 months in niraparib (Δ of -0.6m, 95% CI: -6.0, 4.7) in the non-g BRCA m cohort. These final data support the safe long-term use of niraparib for maintenance treatment in pts with PSROC. PFS2 analysis indicates that the benefit of niraparib maintenance therapy extends beyond first progression. No difference in survival was observed. The NOVA study was not powered for OS, and analysis is confounded by a high rate of crossover and missing data thus limiting its interpretation. GlaxoSmithKline. NCT01847274. [ABSTRACT FROM AUTHOR]