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AbstractAlthough the concept of total time on test transforms and its applications in various disciplines continue to occupy literature for more than five decades, its extension to higher dimensions has not attracted much investigation. In the present work, we define bivariate version of the transforms and study some of its properties. A method of estimating the transforms through its empirical version and an illustration for real data are also discussed. [ABSTRACT FROM AUTHOR]

A system can be considered to be reliable if it operates successfully for a long period of time and has fewer uncertainties during its lifespan. In other words, lower the uncertainty of a random variable implies higher reliability [see Ebrahimi N. How to measure uncertaintyin the residual life time distribution. Sankhya: Indian J Stat SerA. 1996;58:48–57]. Motivated by this, the present study considers a generalized entropy function, namely the Rényi entropy in the quantile framework as a measure of uncertainty and proposes two nonparametric estimators for its computation. Asymptotic properties of the estimators are established under suitable regularity conditions. Simulation study and real data analysis are carried out to compare the performance and usefulness of the estimators. [ABSTRACT FROM AUTHOR]

The Laplace transform order of residual life is viewed as a tool for the stochastic comparison of two life distributions. In this paper, we study new notions of stochastic comparisons based on the bivariate Laplace transform order of residual lives. We investigate relationships the new stochastic order has with other existing bivariate orders. The interpretation of the new orders and their applications in different contexts are also pointed out. We propose nonparametric estimators for the Laplace transform of bivariate residual lives and perform a simulation study. The usefulness of the estimators are also illustrated using a real data set. [ABSTRACT FROM AUTHOR]

In the present work, we propose a method of constructing Archimedean copulas using the total time on test transform, extensively used in reliability modelling. It is observed that the copula can be specified in terms of a univariate life distribution with a finite mean and monotone hazard rate. We discuss some new properties of the Kendall distribution arising from the proposed new generator and the associated measures of dependence. [ABSTRACT FROM AUTHOR]

Objective: To evaluate machine learning models' performance in predicting acute pancreatitis severity using early-stage variables while excluding laboratory and imaging tests., Summary Background Data: Severe acute pancreatitis (SAP) affects approximately 20% of acute pancreatitis (AP) patients and is associated with high mortality rates. Accurate early prediction of SAP and in-hospital mortality is crucial for effective management. Traditional scores such as APACHE-II and BISAP are complex and require laboratory tests, while early predictive models are lacking. Machine learning (ML) has shown promising results in predictive modelling, potentially outperforming traditional methods., Methods: We analysed data from a prospective database of AP patients admitted to Vall d'Hebron Hospital from November 2015 to January 2022. Inclusion criteria were adults diagnosed with AP according to the 2012 Atlanta classification. Data included basal characteristics, current medication, and vital signs. We developed machine learning models to predict SAP, in-hospital mortality, and intensive care unit (ICU) admission. The modelling process included two stages: Stage 0, which used basal characteristics and medication, and Stage 1, which included data from Stage 0 and vital signs., Results: Out of 634 cases, 594 were analysed. The Stage 0 model showed AUC values of 0.698 for mortality, 0.721 for ICU admission, and 0.707 for persistent organ failure. The Stage 1 model improved performance with AUC values of 0.849 for mortality, 0.786 for ICU admission, and 0.783 for persistent organ failure. The models demonstrated comparable or superior performance to APACHE-II and BISAP scores., Conclusions: The ML models showed good predictive capacity for SAP, ICU admission, and mortality using early-stage data without laboratory or imaging tests. This approach could revolutionise AP patients' initial triage and management, providing a personalised prediction method based on early clinical data., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose of Review: This study aims to identify health inequities related to the medical treatment and supportive care of patients with advanced/metastatic cancer and recommend solutions to promote health equity., Recent Findings: Despite robust strides in the development of therapeutic strategies for advanced and metastatic cancer, significant disparities in treatment access and implementation exist. Race, socioeconomic status, gender, and geography represent just a few of the individual-level factors which contribute to challenges in treatment administration, thorough evaluation of germline genetics and tumor genomics, and quality palliative and end-of-life care. Given the increasing complexity of cancer treatments and our enhanced understanding of tumor biology, efforts to uniformly provide equitable and high-level care to all patients are needed. In this review we will discuss factors that contribute to health inequities in patients with advanced and metastatic cancer diagnoses, highlighting opportunities for intervention, ongoing challenges in change implementation, and national and international society recommendations to eliminate disparities. Acknowledging existing inequities and engaging in multilevel discourse with key stakeholders is needed to optimize care practices to the benefit of all patients., (© 2024. The Author(s).)

Background: Rift Valley fever virus, a pathogen to ruminants, camelids, and humans, is an emerging mosquito-borne bunyavirus currently endemic to Africa and the Arabian Peninsula. Although animals are primarily infected via mosquito bites, humans mainly become infected following contact with infected tissues or fluids of infected animals. There is an urgent need for adequate countermeasures, especially for humans, because effective therapeutics or vaccines are not yet available. Here we assessed the safety, tolerability, and immunogenicity of a next-generation, four-segmented, live-attenuated vaccine candidate, referred to as hRVFV-4s, in humans., Methods: A first-in-human, single-centre, randomised, double-blind, placebo-controlled trial was done in Belgium in which a single dose of hRVFV-4s was administered to healthy volunteers aged 18-45 years. Participants were randomly assigned using an interactive web response system. The study population encompassed 75 participants naive to Rift Valley fever virus infection, divided over three dosage groups (cohorts) of 25 participants each. All participants were followed up until 6 months. Using a staggered dose escalating approach, 20 individuals of each cohort were injected in the deltoid muscle of the non-dominant arm with either 10 4 (low dose), 10 5 (medium dose), or 10 6 (high dose) of 50% tissue culture infectious dose of hRVFV-4s as based on animal data, and five individuals per cohort received formulation buffer as a placebo. Primary outcome measures in the intention-to-treat population were adverse events and tolerability. Secondary outcome measures were vaccine-induced viraemia, vaccine virus shedding, Rift Valley fever virus nucleocapsid antibody responses (with ELISA), and neutralising antibody titres. Furthermore, exploratory objectives included the assessment of cellular immune responses by ELISpot. The trial was registered with the EU Clinical Trials Register, 2022-501460-17-00., Findings: Between August and December, 2022, all 75 participants were vaccinated. No serious adverse events or vaccine-related severe adverse events were reported. Pain at the injection site (51 [85%] of 60 participants) was most frequently reported as solicited local adverse event, and headache (28 [47%] of 60) and fatigue (28 [47%] of 60) as solicited systemic adverse events in the active group. No vaccine virus RNA was detected in any of the blood, saliva, urine, or semen samples. Rift Valley fever virus nucleocapsid antibody responses were detected in most participants who were vaccinated with hRVFV-4s (43 [72%] of 60 on day 14) irrespective of the administered dose. In contrast, a clear dose-response relationship was observed for neutralising antibodies on day 28 with four (20%) of 20 participants responding in the low-dose group, 13 (65%) of 20 responding in the medium-dose group, and all participants (20 [100%] of 20) responding in the high-dose group. Consistent with the antibody responses, cellular immune responses against the nucleocapsid protein were detected in all dose groups, whereas a more dose-dependent response was observed for the Gn and Gc surface glycoproteins. Neutralising antibody titres declined over time, whereas nucleocapsid antibody responses remained relatively stable for at least 6 months., Interpretation: The hRVFV-4s vaccine showed a high safety profile and excellent tolerability across all tested dose regimens, eliciting robust immune responses, particularly with the high-dose administration. The findings strongly support further clinical development of this candidate vaccine for human use., Funding: The Coalition for Epidemic Preparedness Innovations with support from the EU Horizon 2020 programme., Competing Interests: Declaration of interests PJWS and JK are inventors of a patent describing the RVFV-4s vaccine technology and PJWS is the non-executive Scientific Officer of BunyaVax that currently owns the intellectual property of this technology. CP is CEO of BunyaVax. IL-R declares receiving funding from various vaccine manufacturers, paid to CEVAC. GL-R is an independent consultant in vaccinology. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)

Introduction: Although several studies report that the robotic approach is more costly than laparoscopy, the cost-effectiveness of robotic distal pancreatectomy (RDP) over laparoscopic distal pancreatectomy (LDP) is still an issue. This study evaluates the cost-effectiveness of the RDP and LDP approaches across several Spanish centres., Methods: This study is an observational, multicenter, national prospective study (ROBOCOSTES). For one year from 2022, all consecutive patients undergoing minimally invasive distal pancreatectomy were included, and clinical, QALY, and cost data were prospectively collected. The primary aim was to analyze the cost-effectiveness between RDP and LDP., Results: During the study period, 80 procedures from 14 Spanish centres were analyzed. LDP had a shorter operative time than the RDP approach (192.2 min vs 241.3 min, p = 0.004). RDP showed a lower conversion rate (19.5% vs 2.5%, p = 0.006) and a lower splenectomy rate (60% vs 26.5%, p = 0.004). A statistically significant difference was reported for the Comprehensive Complication Index between the two study groups, favouring the robotic approach (12.7 vs 6.1, p = 0.022). RDP was associated with increased operative costs of 1600 euros (p < 0.031), while overall cost expenses resulted in being 1070.92 Euros higher than the LDP but without a statistically significant difference (p = 0.064). The mean QALYs at 90 days after surgery for RDP (0.9534) were higher than those of LDP (0.8882) (p = 0.030). At a willingness-to-pay threshold of 20,000 and 30,000 euros, there was a 62.64% and 71.30% probability that RDP was more cost-effective than LDP, respectively., Conclusions: The RDP procedure in the Spanish healthcare system appears more cost-effective than the LDP., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: The Burkholderia cepacia complex (BCC) comprises a group of bacteria with a growing threat as a contaminant of non-sterile solutions. We describe an outbreak of a BCC involving patients at intensive care unit related to a no-rinse bathing solution (NRBS)., Methods: We carried out patients, environmental and laboratory investigation performing analyses of cases, pulsed-field-gel electrophoresis and whole genome sequence (WGS) of isolates., Results: We investigated 32 cases and 16 isolates that were identified as Burkholderia contaminans, belonging to two different clones. One clone (new ST2175) was identified in 6 sequences (4 from patients; 2 from bath cart samples) and for the remaining 10 isolates (7 isolates from patients; 3 from NRBS) we identified the ST762. The investigation demonstrated that NRBS was the source of the outbreak caused by ST762 clone of B. contaminans., Discussion: Early suspicion of a common source, rapid implementation of control measures and laboratory support are vital in an outbreak investigation. We also highlight the role of WGS which was very important to conclude our investigation regarding environmental samples and bacterial typing., Conclusion: We highlight the need to regulation water-based products and the role of WGS for investigate environmental samples., (Copyright © 2024 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Older people have greater comorbidity and medication burden. Adverse drug reactions occur in up to 30% of older people within one month of hospital discharge. General practitioners are key stakeholders in transitions of care from hospital to the community., Aim: The study aimed to explore general practitioner perspectives of adverse drug reactions in older people after hospitalisation, investigating the medication-related issues encountered and possible approaches to reduce the risk., Method: An invitation to participate in the study was sent to general practitioners in Southern Tasmania, Australia. A semi-structured interview occurred in person at their practice or online. The questions covered experiences with managing medication in older people after hospital discharge, challenges and risks involving adverse drug reactions and suggestions to prevent adverse drug reactions. The interviews were transcribed and analysed through thematic analysis., Results: Twelve general practitioners were interviewed, revealing four themes describing challenges, including (i) complex patients and acceptance of risk, (ii) patient confusion and decline in hospital, (iii) time taken to manage older patients and (iv) communication challenges. Three themes describing recommendations were identified, including (i) clear communication on discharge, (ii) patient involvement and (iii) roles for pharmacists., Conclusion: Prevention of adverse drug reactions after hospital discharge may require clear and timely communication to general practitioners, patients and families to be educated and empowered to help manage their own health and risk, and pharmacists to support both patients and general practitioners in managing the risks., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Total joint arthroplasty (TJA) is well recognized for improving quality of life and functional outcomes of patients with osteoarthritis; however, TJA's impact on body weight remains unclear. Recent trends have demonstrated a shift among TJA patients, such that patients who have higher body mass indices (BMIs) are undergoing this common surgery. Given this trend, it is critical to characterize the impact TJA may have on body weight/BMI. This meta-analysis aimed to quantitatively assess whether patients lose, gain, or maintain body weight/BMI after TJA., Methods: This study followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Ovid MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials databases were queried from inception through July 2022., Included Studies: (1) reported on weight or BMI after elective, primary total hip arthroplasty (THA) or total knee arthroplasty (TKA); (2) weight/BMI change was deemed to be associated with THA/TKA. Excluded studies: (1) included weight/BMI interventions; (2) reported on unicompartmental/partial arthroplasty, revision arthroplasty, or joint arthroscopy. Meta-analyses for weight change, BMI change, and proportion of patients achieving clinically significant change were performed using random-effects models. Factors associated with clinically significant change were systematically reported. A total of 60,837 patients from 39 studies were included., Results: No significant differences existed between preoperative and postoperative weights (P = 1.0; P = 0.28) or BMIs (P = 1.0; P = 1.0) after THA or TKA, respectively. Overall, 66% of THA patients (P < 0.01) and 65% of TKA patients (P < 0.01) did not experience clinically significant weight change. Age, preoperative BMI, and sex were most often reported to be associated with clinically significant weight/BMI change., Conclusions: There were two-thirds of the patients undergoing TJA who maintained their preoperative body weight/BMI after surgery. With these results, orthopaedic surgeons can better manage patient expectations of TJA., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The study was designed to investigate the effects of dietary zinc deficiency and supplementation on antioxidant system viz. superoxide-dismutase, glutathione reductase, glutathione peroxidase, glutathione- S-transferase, catalase and sulfhydryls levels (GSH, TSH, NPSH and PBSH) in testes of Wistar rats. Pre-pubertal rats were divided into two groups with 6 sub-groups each viz. zinc control (ZC), pair fed (PF), zinc deficient (ZD), zinc control supplementation (ZCS), pair-fed supplementation (PFS) and zinc deficient supplementation (ZDS). Experiments were set for 2- and 4-weeks followed by 4 weeks of zinc supplementation. The zinc deficient group animals exhibited significant decrease in gonado-somatic index (2- and 4- weeks), sulfhydryls levels, GSH, GPx, GR (2 and 4-weeks) and GST concentration (2-weeks). However, after zinc supplementation significant improvement in gonadosomatic index, SH, GSH, antioxidant enzyme levels (GR, GPx, and GST) in deficient groups has been observed. Zinc deficiency during pre-pubertal period affected growth and caused dysregulation of the glutathione antioxidant system. The significant alterations in the levels of antioxidant enzymes and non-enzymatic antioxidant system (GSH and SH) in zinc deficient groups could be due to alleviated generation of free radicals, causative factor for increased oxidative stress which may lead to infertility as oxidative stress is a common pathology seen during infertility. Altered antioxidant system and sulfhydryls levels in testes due to dietary zinc deficiency reflect the significance of optimum zinc for maintaining homeostatic balance in gonadal physiology. Supplementing zinc for 4 weeks could reduce the redox imbalance which may help in alleviating oxidative stress induced alterations in testes., Competing Interests: Conflict of interestAuthors declare that they have no conflicts of interests., (© The Author(s), under exclusive licence to Association of Clinical Biochemists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

A man in his early 50s with previously treated pulmonary tuberculosis (TB) presented with a 3-month history of cough, expectoration and progressive breathlessness, accompanied by significant weight loss. Examination revealed tachycardia, tachypnoea, hypoxaemia and unilateral diminished breath sounds. Investigations showed anaemia, leucocytosis and a homogeneous opacity on the left side of the CXR. ECG and echocardiography suggested pulmonary thromboembolism (PTE). A CT pulmonary angiogram confirmed a chronic embolus and a severely fibrosed left lung. A comprehensive thrombophilia workup yielded normal results and the PTE was attributed to his history of TB. Sputum analysis confirmed reactivated TB, leading to the initiation of antitubercular therapy. The patient improved clinically with plans for a repeat CT pulmonary angiography to assess the need for pulmonary thromboendarterectomy after completing TB treatment. This case highlights the possible association of TB and PTE, its management and why it should be considered as a differential diagnosis in patients with a history of TB presenting with exacerbated breathlessness., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: We aimed to study the clinical characteristics, myocardial injury, and longitudinal outcomes of COVID-19 vaccine-associated myocarditis (C-VAM)., Methods: In this longitudinal retrospective observational cohort multicenter study across 38 hospitals in the United States, 333 patients with C-VAM were compared with 100 patients with multisystem inflammatory syndrome in children (MIS-C). We included patients ≤30 years of age with a clinical diagnosis of acute myocarditis after COVID-19 vaccination based on clinical presentation, abnormal biomarkers and/or cardiovascular imaging findings. Demographics, past medical history, hospital course, biochemistry results, cardiovascular imaging, and follow-up information from April 2021 to November 2022 were collected. The primary outcome was presence of myocardial injury as evidenced by late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging., Findings: Patients with C-VAM were predominantly white (67%) adolescent males (91%, 15.7 ± 2.8 years). Their initial clinical course was more likely to be mild (80% vs. 23%, p < 0.001) and cardiac dysfunction was less common (17% vs. 68%, p < 0.0001), compared to MIS-C. In contrast, LGE on CMR was more prevalent in C-VAM (82% vs. 16%, p < 0.001). The probability of LGE was higher in males (OR 3.28 [95% CI: 0.99, 10.6, p = 0.052]), in older patients (>15 years, OR 2.74 [95% CI: 1.28, 5.83, p = 0.009]) and when C-VAM occurred after the first or second dose as compared to the third dose of mRNA vaccine. Mid-term clinical outcomes of C-VAM at a median follow-up of 178 days (IQR 114-285 days) were reassuring. No cardiac deaths or heart transplantations were reported until the time of submission of this report. LGE persisted in 60% of the patients at follow up., Interpretation: Myocardial injury at initial presentation and its persistence at follow up, despite a mild initial course and favorable mid-term clinical outcome, warrants continued clinical surveillance and long-term studies in affected patients with C-VAM., Funding: The U.S. Food and Drug Administration., Competing Interests: SSJ, LGW, SA, JMS, HCW, JCM, JHS, RSB, VM, XJ, OHF, BF, SB, RCA, SAM, NM, JAS, SS, DV, AKVH, MJC, JK, SH, CM, MDC, MS, LN, JYA, SCU, PR, JKP, JGM, JAV, MPD, MB, PB, PE, KM, KG, MLD, KAA, AK, SBB, ALD, PKM, JS, ALC, JDR, ZP, AC, YS, LG, MA, MJ, JDR, NN, EDD report no competing interests. ASH: Site PI for the CAMP study—NHLBI funded, Site PI for MUSIC—NIH funded, Site PI for PREVAIL, supported by a sub-agreement from the Johns Hopkins University with funds provided by Grant No. R61HD105591 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development and the Office of the Director, National Institute of Health (OD). Scientific advisory board member of OP2 DRUGS (“OP2”), states that no work has been done. ABY: Institution received funds for conducting phase 3 clinical trials for Pfizer mRNA COVID-19 vaccine (C4591007 and C4591048). LEH: Patent US11457889B2, issued: Oct 4, 2022, Patent US2023/0016283A1 Published: Jan 19, 2023. JK: $530 Honorarium for speaking at Cleveland Clinic Valve Disease, Structural Interventions, and Diastology/Imaging Summit in 2/2023. FH: Payment for Expert Testimony in pending court case as an expert witness to discuss the risk of C-VAM. DT and SS: Grant or contract from New England Research Institute for participation in Pediatric Heart Network CAMP Study. MJC: Subject matter expert for CDC CISA program, Consulting fees Longerone Inc., (© 2024 The Author(s).)

Recent advancements in assisted reproductive technology (ART) have enabled couples to achieve pregnancy, who were previously unable to conceive. However, recurrent implantation failure (RIF) remains a significant challenge. This case study exhibits the effective use of hysteroscopic-guided platelet-rich plasma (PRP) instillation in the treatment of a female patient aged 33 who was nulliparous and diagnosed with RIF and a thin endometrium, which resulted in primary infertility. The couple had a history of 10 years of infertility and had previously undergone ART procedures, including intrauterine insemination (IUI) and intracytoplasmic sperm injection (ICSI), which failed. The female partner was diagnosed with a thin endometrium (<7 mm) and underwent hysteroscopy, revealing no other significant intrauterine pathologies. Following hormonal treatment and ovum pick-up, hysteroscopic PRP was administered, resulting in improved endometrial thickness (ET) and successful embryo implantation, as evidenced by a positive serum β-hCG level of 1470 mIU/mL. This case demonstrates the hysteroscopic injection of PRP's potential for increasing endometrial receptivity and enhancing ART outcomes in women with RIF due to thin endometrium, making it a promising alternative to conventional therapies., 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, Tej et al.)

Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Dr. Navya Nair is an editorial board member for Gynecologic Oncology Reports and serves on the SGO Board of Directors and is Chair of the SGO Diversity, Inclusion, and Health Equity Committee].

Urachal tumors are rare and comprise of both benign and malignant neoplasms. Epithelial origin tumors are more common than mesenchymal origin tumors. We report a case Urachal inflammatory myofibroblastic tumor (IMFT) in a 12 year old boy who presented with symptoms of lower abdominal pain and burning micturition. Upon evaluation was found to have a soft tissue mass anterior to urinary bladder wall. A laparoscopic excision of tumor was done. Histopathological and immunohistochemical examination confirmed the diagnosis of IMFT. Next generation sequencing identified FN1-ALK gene fusion., (© 2024 The Authors. Published by Elsevier Inc.)

Breast cancer poses a significant global health challenge, with higher incidence rates in developed countries. However, low- and middle-income countries (LMICs) suffer from higher mortality rates due to various factors, including limited screening programs, delayed diagnosis and inadequate access to healthcare and advanced treatments. Approximately 5%-10% of breast cancer cases stem from germline mutations in BRCA -1/2 genes. A positive BRCA 1/2 status obtained through genetic testing significantly influences surgical and medical treatment decisions. Therefore, genetic counseling, proper surveillance and customized interventions for BRCA 1/2 carriers are essential to maximizing the benefits of monitoring, chemoprevention and risk-reducing surgeries for breast and ovarian cancers. Identification of BRCA mutations also impacts treatment strategies, leading to the integration of chemotherapeutic agents like platinum-based chemotherapy and PARP inhibitors. However, implementing these advanced treatment guidelines in LMICs with complex, fragmented and underfunded healthcare systems presents numerous challenges. In this review, we explore the current status and obstacles associated with managing BRCA 1/2-associated breast cancer in LMICs., Competing Interests: There are no relevant conflicts of interest to declare., (© the authors; licensee ecancermedicalscience.)

Objective: This study aimed to explore the correlation between morphological patterns and multidetector computed tomography (MDCT) enhancement patterns in gallbladder cancer with locoregional infiltration among the Indian population., Methodology: This cross-sectional study was conducted across the pathology, surgery, and radiodiagnosis departments at Lady Hardinge Medical College, New Delhi. It focused on patients diagnosed with gallbladder disorders during the study period, identified through clinical examination or MDCT. Each patient underwent a fasting computed tomography (CT) scan using a Philips Brilliance 40-slice MDCT scanner. A neutral oral contrast, consisting of 1200 ml of water and 300 ml of 20% w/v mannitol, was administered. Additionally, for two patients suspected of gallbladder perforation extending to the pyloric duodenal area, a 2% non-ionic water-soluble contrast agent was used., Results: The study found no statistically significant association between intraluminal polypoidal growth and other infiltration sites. However, wall thickening was significantly associated with various infiltration sites, including the liver, colon, bile ducts, and vascular structures. A strong positive correlation was observed between portovenous hyperenhancement and all examined morphological patterns, with the most notable correlations found with non-contrast CT (NCCT) hypo-isoenhancement. Conversely, arterial hyperenhancement showed an inverse relationship with some morphological patterns, with correlation coefficients of -0.60 for intraluminal polypoidal growth versus gallbladder wall thickening and mass replacement of the gallbladder versus intraluminal polypoidal growth., Conclusion: Gallbladder cancer frequently leads to the replacement or damage of the gallbladder, with both focal and diffuse wall thickening being common findings. Hypo-isoenhancement was the most prevalent imaging pattern, while hyperenhancement was less common. Although intraluminal polypoidal growth did not significantly correlate with metastasis, wall thickening was significantly associated. These results emphasize the importance of specific imaging patterns in assessing the severity of gallbladder cancer and informing treatment strategies., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital issued approval ECHR/PR/2011/29. 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, Meena et al.)