Clinical Condition Research Articles

Spider Bite Dermonecrosis: A Review of Loxoscelism

Loxoscelism is the clinical condition caused by the bite of spiders belonging to the genus Loxosceles and is the only verified arachnological cause of dermonecrosis worldwide. More than 150 different species of this spider genus have been described, being Loxosceles laeta the only recognized cause of Loxoscelism in Chile. It is of public health importance due to its potentially lethal bite, which results from venom containing catabolic enzymes, primarily sphingomyelinase-D and phospholipase-D. These enzymes participate in lipid hydrolysis within the cell membrane, triggering an inflammatory response and complement activation, leading to cutaneous dermonecrosis, also known as cutaneous Loxoscelism. In systemic cases, it can cause hemolysis, Disseminated Intravascular Coagulation (DIC), renal failure and thrombocytopenia, a condition known as cutaneous-visceral Loxoscelism. Loxoscelism remains a diagnostic and clinical challenge due to both the difficulty, in identifying the spider species and the lack of consensus regarding treatment. Advances in bioengineering have facilitated research into new therapeutic strategies aimed at better understanding the venom’s mechanism of action. This review discusses the nature of Loxosceles laeta in the context of diagnostic importance, as well as the clinical manifestations, medical and surgical management and new therapeutic strategies proposed based on the pathophysiology of Loxoscelism.

Efficacy and safety of stereotactic body radiotherapy for cervical cancer (SCORE): Systematic review and meta-analysis.

e17537 Background: Locally advanced cervical cancer (LACC) remains a critical global health issue, disproportionately impacting low- and middle-income countries despite advancements in prevention and early detection. For LACC, treatment typically involves external beam radiotherapy (EBRT) with chemotherapy followed by brachytherapy (BCT). However, due to resource challenges, anatomical limitations, and patients’ comorbidities or preference, Stereotactic Body Radiotherapy (SBRT) is being considered as an alternative to BCT due to its high precision and potential to reduce side effects. This study aimed o evaluate the efficacy and safety of SBRTboost as an alternative for patients without conditions to receive traditional BCT. Methods: A systematic review and meta-analysis, registered with PROSPERO and adhering to PRISMA guidelines, focused on studies of women with LACC treated with SBRT as an alternative to BCT. A comprehensive literature search was conducted in PubMed, Embase, and Cochrane databases. The analysis included retrospective and prospective studies, excluding those with fewer than five participants or a follow-up of less than 12 months. Due to study heterogeneity, a random-effects model was used for statistical analysis. The review measured outcomes such as local control (LC), overall survival (OS) and rate of late toxicity, with meta-regression analyses examining correlations between treatment parameters and the primary endpoints. Results: The meta-analysis reviewed 11 studies from 2012 to 2022 across various regions. Median ages ranged from 52 to 80 years, with sample sizes between 6 and 55 patients. The pooled LC rate was 92.3% (CI 95% 88–96%), and the OS rate was 56% (CI 95% 48–63%), both with no heterogeneity. LC rates at 1, 3, and 5 years were 94%, 90%, and 88%, respectively; OS rates were 76%, 62%, and 59%. No significant relationships were found between treatment parameters and LC or OS in meta-regression analyses. The rate of late grade 3 or higher genitourinary toxicity was 2%, and gastrointestinal toxicity was 3.3%. Only the SBRT boost interval of 24 hours or less was linked to increased late GI toxicity (p = 0.009). Conclusions: SBRT emerges as a promising boost therapy for cervical cancer patients with no anatomical or clinical condition or who refuse to receive BCT. SBRT produced robust LC and low rates of late severe toxicity. Further investigations to optimize SBRT treatment regimens and validate long-term clinical outcomes are warranted.

Ginkgo biloba leaf extract EGb 761® for the treatment of various diseases: Overview of systematic reviews.

Ginkgo biloba leaf extract EGb 761® for the treatment of various diseases: Overview of systematic reviews.

Automated dispensing cabinets and the effect on omitted doses of ward stock medicines; can implementation reduce delays to first dose antimicrobials?

Automated dispensing cabinets and the effect on omitted doses of ward stock medicines; can implementation reduce delays to first dose antimicrobials?

Cytoreductive surgery in advanced epithelial ovarian cancer: a real-world analysis guided by clinical variables, homologous recombination, and BRCA status.

Guidelines endorse both interval and primary debulking cytoreductive surgeries in the treatment of epithelial ovarian cancer, emphasizing that the treatment strategy should be tailored to the patient's clinical condition and tumor burden. Despite these recommendations, experts have yet to agree on a definitive surgical approach. A retrospective longitudinal analysis of 929 women diagnosed with advanced-stage (International Federation of Gynecology and Obstetrics stage III-IV) epithelial ovarian cancer between January 2002 and January 2025 was conducted. The effects of interval debulking surgery versus primary debulking surgery on median overall survival and progression-free survival were evaluated. Additionally, we aimed to identify patients who may benefit from a particular surgical approach based on clinical variables, mutation in either of the BRCA1 or BRCA2 genes, and homologous recombination profile. A total of 929 patients were diagnosed with stage III to IV disease (87.2%) and underwent either primary debulking (n = 389, 41.9%) or interval debulking surgery following neoadjuvant chemotherapy (n = 540, 58.1%). Patients treated with primary debulking had a longer median overall survival than those treated with interval debulking surgery (68.40 months, 95% CI 62.92 to 76.45 vs 52.01 months, 95% CI 47.15 to 57.86, HR 1.2, p = .0004). However, when adjusted for age at diagnosis, stage, histology, BRCA status, and tumor resectability, multivariate analysis demonstrated no significant difference in survival between the two surgical groups (HR 1.15, 95% CI 0.96 to 1.39, p = .12). Younger women (<69 years), stage III, and BRCA-wild-type and/or homologous recombination proficient had longer survival with primary debulking than with interval debulking surgery (74.55 months, 95% CI 65.35 to 93.27 vs 55.98 months, 95% CI 48.10 to 64.79, HR 1.38, p = .03). Patients with a pathogenic BRCA variant or homologous recombination deficient profile had similar survival outcomes with either debulking approach, regardless of age and disease stage (p > .05). Propensity score analysis demonstrated comparable median overall survival with the two surgical timings (64.39 months, 95% CI 58.38 to 71.23 vs 57.69 months, 95% CI 50.66 to 64.79, HR 1.33, p = .27). Our findings support the use of neoadjuvant chemotherapy followed by interval debulking surgery without compromising survival outcomes, regardless of age and stage, particularly among harder-to-treat patients. We identified a specific subset of patients who may benefit from primary debulking surgery as the optimal intervention. These findings advocate for a personalized treatment approach and the potential for tailored surgical strategies guided by patient clinical variables, homologous recombination, and genetic factors.

Immunological Activity of Vaccine Systems Containing Liposomal Nanocarriers against Protozoan-Induced Diseases: A Systematic Review.

Neglected parasitic diseases constitute a broad spectrum of clinical conditions that, in the chronic phase, lack effective therapies for the target population. The utilization of vaccines based on liposomal nanocarrier systems is emerging, thereby enhancing clinical outcomes in various comorbidities. Consequently, this study aims to assess the immunological activity induced by liposomal nanocarriers against neglected parasitic diseases. For the review, the Pubmed, Embase, and Lilacs databases were used using the descriptors vaccine, parasite, and liposome. The following inclusion criteria were adopted: in vivo and in vitro experimental articles. As exclusion criteria: book chapters, editorials, literature reviews and duplicate articles found during the database search. A total of 226 articles were identified, from which 34 were selected for review. The primary diseases identified included Babesia bovis, Entamoeba histolytica, Leishmania braziliensis, Leishmania donovani, Leishmania major, Leishmania infantum, Plasmodium falciparum, Plasmodium chabaudi, Plasmodium chabaudi, Plasmodium yoelii, Toxoplasma gondii and Trypanosoma cruzi. An elevation in cytokines such as GM-CSF, MCP-1, INF-γ, TNF-α, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, and IL-17 was observed in the studies evaluated regarding the parasitic diseases. Furthermore, cytokines such as IL-4, IL-10, and TGF-β were diminished with the administration of the vaccine systems in those studies. Therefore, the administration of liposomal nanovaccine systems can effectively ameliorate the clinical condition of patients by modulating their immunological profile.

Prospective multicenter comparison of the diagnostic value of IgG and IgGAM antibodies for heparin-induced thrombocytopenia.

Prospective multicenter comparison of the diagnostic value of IgG and IgGAM antibodies for heparin-induced thrombocytopenia.

Emerging Frontiers in acute kidney injury: The role of extracellular vesicles.

Emerging Frontiers in acute kidney injury: The role of extracellular vesicles.

Long-term prognostic value of CRP-albumin-lymphocyte index in elderly patients with heart failure with preserved ejection fraction.

Long-term prognostic value of CRP-albumin-lymphocyte index in elderly patients with heart failure with preserved ejection fraction.

Risk factors for aspiration pneumonia related to postoperative chemoradiotherapy for high-risk head and neck cancer: A supplementary analysis of a phase II/III JCOG1008 trial.

6059 Background: A randomized phase II/III trial (JCOG1008) suggested that postoperative chemoradiotherapy (POCRT) with weekly cisplatin is a treatment option for patients with postoperative high-risk locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). Aspiration pneumonia (AP) is one of the most important toxicities associated with CRT. This study investigated the clinical risk factors for AP during and after POCRT. Methods: Patients enrolled in JCOG1008 were analyzed to evaluate the incidence of AP, to identify the clinical risk factors for AP during and after POCRT, and to assess the influence of AP on treatment outcomes. AP was defined as a clinical condition meeting all of the following criteria: (i) patients had both subjective and objective symptoms suggesting pneumonia, (ii) the presence of aspiration was suspected clinically or by endoscopic or video-fluorographic examinations, (iii) no evidence of micro-organisms that cause atypical pneumonia. Analyses were performed by logistic regression model. Results: Of 251 patients who underwent POCRT, 100 patients who underwent laryngectomy was excluded. Among the 151 patients who received POCRT, 93 (61.6%), 85 (56.3%), and 113 (74.8%) developed AP during, after, and overall period of POCRT, respectively. The multivariable analyses identified two independent risk factors for AP occurring during or after POCRT: PS 1 [vs. PS 0; odds ratio (OR) 3.416, 95% CI (1.192-9.789), p = 0.0222] and dysphagia ≥grade 3 (vs. grade 1-2; OR 46.333, 95% CI (2.901-740.080), p = 0.0067). The multivariable analyses also identified two independent risk factors for AP occurring after POCRT: dysphagia ≥grade 3 (OR 3.995, 95% CI (1.538-10.375), p = 0.0045) and reconstruction surgery (OR 3.452, 95% CI (1.616-7.374), p = 0.0014). Charlson comorbidity score ≥4 and the use of sleeping pills at the end of POCRT were marginally associated with the onset of AP after POCRT (OR 2.699, 95% CI (0.919-7.926), p = 0.0708, OR 2.107, 95% CI (0.918-4.837), p = 0.0788, respectively). The occurrence of AP was not significantly associated with overall survival, relapse-free survival, and local relapse-free survival. Conclusions: PS 1, dysphagia ≥grade 3, and prior reconstruction surgery were associated with the onset of POCRT-related AP. Careful attention should be paid to these risk factors for AP in patients with LA-SCCHN undergoing POCRT. Clinical trial information: jRCTs031180135 .

A case of Sjögren's syndrome with selective anion exchanger 1 defect causing distal renal tubular acidosis.

Distal renal tubular acidosis (dRTA) is a significant clinical expression of Sjögren's syndrome (SS). While SS-related dRTA is traditionally linked to impaired H+-ATPase, we report a unique case demonstrating selectively decreased anion exchanger 1 (AE1) expression with preserved H+-ATPase expression. A 16-year-old girl with SS presented with muscle weakness, difficulty in ambulation, and severe hypokalemia. Laboratory studies revealed non-anion gap metabolic acidosis, elevated urinary potassium excretion, and overt proteinuria. Renal histology identified a notably reduced expression of AE1 but normal H+-ATPase in intercalated cells, a previously undescribed finding. Despite high-dose potassium and bicarbonate supplementation, her hypokalemia and metabolic acidosis showed inadequate response; however, the clinical condition improved dramatically following corticosteroid therapy. This case sheds light on an atypical SS-associated dRTA mechanism characterized by selective AE1 impairment, presumed to be mediated by autoantibodies. The discovery accentuates AE1's critical role in SS-induced renal pathology and underscores the efficacy of steroids in the management of SS-related dRTA.

Prediction of hyper-bilirubinemia in healthy neonates using umbilical cord blood bilirubin

Jaundice is a clinical condition characterized by transient deficiency of bilirubin conjugation, leading to neonatal hyper-bilirubinemia. Therefore, it is of interest to assess cord blood bilirubin at birth as a predictor of neonatal hyper-bilirubinemia needing phototherapy in full-term neonates. In 220 neonates with hyper-bilirubinemia needing phototherapy were assigned as cases and without hyper-bilirubinemia as controls to assess association in serum total bilirubin and cord blood bilirubin were assessed after identifying the cut-off level of cord blood bilirubin. The mean cord blood bilirubin level was 2.64ą0.63 and total serum bilirubin estimated on 3rd day of life was 16.14ą1.4. 3rd day serum bilirubin and cord blood bilirubin were correlated positively with the (r=0.087). Umbilical cord blood bilirubin estimation is a non-invasive, economical, and simple method of predicting subsequent neonatal hyper-bilirubinemia that can help clinicians for early discharge of normal neonates and follow-up in high-risk infants.

AGENESIS OF ISTHMUS OF THYROID GLAND

The thyroid gland is an important endocrine gland in the human body, which is bilobed and is connected by a tissue called isthmus. The agenesis of thyroid isthmus is a clinical condition but this condition does not cause any clinical manifestations itself. The lack of isthmus is usually detected when investigations are done for other pathological conditions like autonomous thyroid nodule, thyroiditis, primary carcinoma, neoplastic metastasis and infiltrative diseases such as amyloidosis or during cadaveric dissections. This case purely observational study done in the department of Anatomy JSS Medical college Mysuru during the routine dissection of Head and neck for Under graduate students. Intact to the midline of the neck incision give according to the Cunninghams Manual after reflecting the skin and fascia we noted that the absence of isthmus to thyroid gland 2 out of 10 formalin fixed cadavers. The full outlook awareness of agenesis of the isthmus and its associated thyroid anomalies will significantly contribute to Safety measures to be taken during surgical procedures to avoid surgery related complications and assurance diagnosis and planning.

Questions and Caveats in Antigen-Defined Membranous Nephropathy.

Remarkable progress has been made in the discovery of autoantigens in membranous nephropathy. With increasing testing for membranous antigens in daily practice, it is important to consider the varying strength of association between certain antigens and underlying conditions. This review explores questions and caveats which arise when assessing results of membranous antigen testing. Specifically, we will discuss: 1) discrepancy between tissue antigen and clinical scenario, focusing on PLA2R; 2) one antigen ≠ one clinical condition, i.e., the heterogeneity of membranous antigens seen in one clinical condition (such as in sarcoidosis), and conversely, heterogeneity of conditions associated with one antigen (such as for neural epidermal growth factor-like 1 (NELL1)); 3) rare presence of multiple membranous associated antigens in tissue or blood (such as with anti-protocadherin 7); and 4) lupus membranous nephritis related antigens and their influence on diagnosis or treatment.

The use of lipopolysaccharide adsorption employing advanced domestically manufactured cartridges in the comprehensive treatment of maternal sepsis and septic shock

Objective. To estimate the results of lipopolysaccharide adsorption using a domestic Efferon LPS cartridge in the complex treatment of maternal sepsis and septic shock. Materials and methods. In Perm Regional Clinical Hospital, a comprehensive treatment of 22 patients with maternal sepsis or septic shock was carried out using LPS adsorption with domestic Efferon LPS columns in Perm Regional Clinical Hospital. The results of clinical and laboratory examination were compared before extracorporeal selective adsorption of endotoxin and in 24, 48 and 72 hours. The APACHE and SOFA scales were used. The level of inflammation biomarkers and endotoxin activity were determined. Results. After LPS adsorption, the median SOFA score decreased significantly to 5 (p = 0.00). A distinct decline was observed in the levels of creatinine, lactate dehydrogenase, procalcitonin, interleukins 1b, 8, 10, a tendency to decrease in the amount of C-reactive protein, presepsin, interleukin 6, tumor necrosis factor and endotoxin activity. The maximum effect of LPS adsorption using Efferon LPS columns occurred after the first session. After the second procedure, the severity on SOFA scale, endotoxin activity, procalcitonin and lactate levels decreased insignificantly. In 72 hours, the amount of procalcitonin and lactate tended to increase again. The hospital 28-day mortality rate was 22.73 %. The fatal outcomes correlated with the patients` initial condition. The higher the scores on the APACHE, SOFA scales, the Charlson index, the initial dose of norepinephrine (r = 0.38, p = 0.00; r = 0.37, p = 0.00; r = 0.34, p = 0.00; r = 0.43, p = 0.02, respectively) were, the worse was the result of the comprehensive treatment for maternal sepsis. Improvement of the clinical condition on the SOFA scale, an oxygenation index, and a decrease in vasopressors dose (r = 0.71, p = 0.00; r = -0.54, p = 0.00; r = 0.61, p = 0.00, respectively), as well as the results of laboratory studies (lactate – r = 0.58, p = 0.00; EAA – r = 0.57, p = 0.00; PCT – r = 0.59, p = 0.00) had a medium or strong correlation with the patients` recovery. Conclusions. The inclusion of lipopolysaccharide adsorption with domestic Efferon LPS columns in the comprehensive treatment for maternal sepsis and septic shock makes it possible to achieve a significant improvement in the patients` clinical condition, reduce the level of inflammation biomarkers, endotoxin activity and interleukins.

Breast Lymphedema Secondary to Lymph Node Tuberculosis: Case Report.

Breast lymphedema is a common but underdiagnosed condition that affects the quality of life of patients. It may be caused by any pathology that disrupts lymphatic drainage in the breast. We present the case of a woman with axillary lymph node tuberculous infection with breast edema, clinically and radiographically indistinguishable from tuberculous mastitis. After six months of comprehensive antituberculosis pharmacological treatment, the persistence of breast edema required repeating diagnostic tests searching for malignancy, all of which were negative. Rehabilitation treatment with complex physical therapy improved the patient's clinical and symptomatic condition. Clinical suspicion of secondary lymphedema is crucial to avoid unnecessary diagnostic procedures and ensure adequate and timely treatment.

Retrospective analysis of neuroblastoma and pheochromocytoma therapy with I-131 metaiodobenzylguanidine at a reference oncology hospital in Brazil.

Metaiodobenzylguanidine (MIBG) is a norepinephrine analogue with high affinity and specificity for the norepinephrine transporter. I-131-labeled MIBG (I-131 MIBG) is a therapeutic radiopharmaceutical used in selected cases of refractory or metastatic neuroblastoma and pheochromocytoma, tumors that overexpress the norepinephrine transporter. While the use of I-131 MIBG in neuroblastoma and pheochromocytoma therapy is well-established, the literature shows significant variability in treatment response, regarding the dose of the radiopharmaceutical, previous therapies administered, and the clinical condition of the patients involved in the studies. To contribute to the current literature, this study analyzed the use of I-131 MIBG at a cancer treatment institution in Brazil. Retrospective, observational, single-center study was conducted, with a descriptive and exploratory character, involving patients diagnosed with neuroblastoma and pheochromocytoma treated with I-131 MIBG from 2010 to 2025. Demographic, clinical, and laboratory parameters were collected before and after I-131 MIBG therapy. The outcome was determined through survival analysis. Thirty-two patients were treated with I-131 MIBG, including 24 patients with neuroblastoma and six patients with pheochromocytoma. Leukocytes and platelets showed a reduction, and aspartate aminotransferase (AST) levels exhibited a significant increase posttherapy in patients with neuroblastoma. Survival rate was 84% in patients with pheochromocytoma and 55% in patients with neuroblastoma in the first year following I-131 MIBG therapy; however, both groups showed a gradual reduction in the cumulative survival rates, reaching 20% after 5 years. I-131 MIBG was primarily used for the treatment of neuroblastoma in pediatric patients, and pheochromocytomas in adults. Anemia, leukopenia, thrombocytopenia, and increased serum AST were the main adverse events, and cumulative survival rates were 20% after 5 years.

Unusual and rare manifestations after bronchoscopy: Pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum—Case report

Introduction: Pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum are rare findings in the absence of visceral perforation or trauma. While often asymptomatic, these conditions can complicate clinical decision-making, particularly when they occur after endoscopic procedures such as bronchoscopy. Typically caused by barotrauma, air leakage in such cases is often explained by the Macklin effect—a phenomenon where air dissects through the interstitial tissues following alveolar rupture. Although flexible bronchoscopy is generally considered a safe procedure, timely recognition of these complications is essential to prevent adverse outcomes. Medical imaging, especially computed tomography (CT), plays a vital role in diagnosing these conditions, evaluating associated complications, and identifying potential underlying causes such as perforation. Case Report: We report the case of a 17-year-old female patient hospitalized for surgical management of a left pulmonary hydatid cyst. Following a diagnostic bronchoscopy, the patient developed pneumomediastinum, pneumoperitoneum, and pneumoretroperitoneum. Imaging studies were instrumental in the rapid identification of these rare complications. Despite radiological findings suggestive of visceral perforation, further endoscopic evaluations revealed no injury to the esophageal, digestive, or bronchial structures. The patient was admitted to the intensive care unit for close monitoring due to an initially unstable clinical condition. The management was conservative, and the patient’s condition improved progressively. He was discharged without any further complications. Conclusion: This case highlights the importance of imaging in the diagnosis and monitoring of rare complications following bronchoscopy. Even in the absence of overt visceral injury, clinicians should be aware of these potential presentations to ensure prompt and appropriate management.

Prognostic model of a patient with sepsis readiness to early mobilization with assistance

To develop a prognostic model of patient with sepsis readiness to early mobilization with assistance. A single-center retrospective cohort observational study with analysis of 780 electronic medical records of patients with sepsis from the «Intensive therapy of patients with severe community-acquired pneumonia» base of the North-Western State Medical University named after I. I. Mechnikov in the period from 2013 to 2022 was carried out. Statistical analysis by binary logistic regression method and ROC-analysis were performed using Jamovi 2.3.21 and IBM SPSS Statistics 26 softwares package. The study includes the data of 519 patients with sepsis. Patients are divided into 2 study groups according to the score on the Intensive Care Unit Mobility Scale (IMS): IMS 0/1 (281 patients) and IMS ≥2 (238 patients). The predictors of IMS ≥2 for patients with sepsis have been determined: score on the APACHE II assessment scale of patient's state severity ≤20.0 (adjusted odds ratio (AOR) 6.38; 95% CI 3.01-13.5; p<0.001), score on the CCI Charlson comorbidity index ≤3.0 (AOR 3.84; 95% CI 1.72-8.58; p=0.001), score on the mNUTRIC critical state risk scale ≤5.0 (AOR 2.81; 95% CI 1.33-5.96; p=0.007), PO2/FiO2 index >119.0 mm Hg (AOR 104; 95% CI 29.59-365.6; p<0.001), albumin level >25.0 g/l (AOR 2.37; 95% CI 1.11-5.06; p=0.025). The prognostic model that considers 82.3% of factors determining the dispersion of IMS ≥2 probability has been developed. Area under ROC-curve amounted to 0.967±0.007 (95% CI 0.952-0.982). Sensitivity and specificity of IMS ≥2 prognostic model in patients with sepsis at 65% threshold were 92.0 and 92.6%, respectively, and accuracy - 92.3%. The prognostic model of patient with sepsis readiness to early mobilization with assistance has been developed based on IMS ≥2 independent predictors. This model allows to use individual approach to early mobilization with assistance and identify patients who are ready to increase physical exertion without worsening clinical condition.

Lower Gastrointestinal Bleeding: Etiology and Outcomes at a Tertiary Care Center in South India—Are These Different from the West?

AbstractLower gastrointestinal bleeding (LGIB) is a common clinical condition with limited prospective data from South Asia. This study aimed to describe the clinical characteristics, diagnostic evaluation, therapeutic interventions, and outcomes of patients with LGIB at a tertiary care center in South India.This prospective observational study included 150 patients with LGIB from August 2023 to July 2024. Patient demographics, clinical presentation, diagnostic procedures, interventions, and outcomes were recorded. Patients were followed up until 28 days post-discharge.The mean age of the patients was 50 years, with a male predominance (72%). Colitis (26%) was the most common etiology, followed by benign anorectal disorders (19%). Diagnostic yield for LGI endoscopy was 61%. Endoscopic therapy was performed in 5% of patients, radiological intervention in 3%, and surgery in 7%. Rebleeding rate was 7.9%, and readmission rate was 6.6%. Overall mortality was 5.3%, with higher rates among inpatient LGIB compared with those admitted with LGIB (19.2% versus 2.4%, p = 0.004). Seven of the eight deaths were secondary to underlying comorbid illnesses.The etiological spectrum of LGIB in this South Indian center differs from Western studies, with colitis being the predominant cause. Most patients were managed conservatively. Mortality rates were similar to Western studies and primarily attributed to underlying comorbidities. Further multicenter studies are needed to develop appropriate management guidelines for the South Asian region.