is. We therefore recommend radiological staging in all patients with positive sentinel lymph node biopsy.Background Rheumatoid arthritis (RA) is an immune-mediated inflammatory disease. Antirheumatoid treatment reduces disease activity and inflammation, but not all patients respond to treatment. Autonomic dysfunction is common in RA leading to frequent cardiovascular complications. Yoga therapy may be useful in these patients, but there are little data on the effect of yoga on disease activity, inflammatory markers, and heart rate variability (HRV). Objectives This study assessed the effect of 12-week yoga therapy on disease activity, inflammatory markers, and HRV in patients with RA. Materials and Methods This randomized control trial was conducted on newly diagnosed RA patients attending outpatient services at the Department of Clinical Immunology, JIPMER. One hundred and sixty-six participants were randomized into two groups the control group (CG) (n = 83) and yoga group (YG) (n = 83). Yoga therapy was administered to participants in the YG for 12 weeks, along with standard medical treatment. read more The CG received only standard medical treatment. Primary outcomes were disease activity score 28, interleukin-1α (IL-1α), IL-6, tumor necrosis factor-α (TNF-α), cortisol, and HRV parameters. All parameters were measured at baseline and after 12 weeks. Results Disease activity significantly decreased in both groups after 12 weeks, but it was reduced more in YG, which was statistically significant (p  less then  0.05). In both YG and CG, IL-1α, IL-6, TNF-α, and cortisol decreased after 12 weeks, but IL-1α and cortisol decreased more significantly in YG than in CG. Low-frequency component expressed as normalized unit (LFnu) and the low-frequency/high-frequency (LF-HF) ratio decreased significantly, and total power and HF component expressed as normalized unit (HFnu) increased significantly in the YG compared with CG. Conclusion Twelve-week yoga therapy, if given along with standard medical treatment, significantly reduces disease activity and improves sympathovagal balance in RA patients.Pain is a common problem for patients undergoing radiation therapy, exacerbated by inconsistent pain documentation. Free-form templates, pain score prompts, and forcing functions are a hierarchy of constraint systems that can be applied to data entry. This study assessed the impact of incorporating these models into electronic health records on pain documentation rates during 450 on-treatment visits and pain severity of 258 patients with bone metastases and breast and thoracic cancer during radiation therapy. Pain documentation is associated with more robust constraint systems free form (0.11, 95% CI [0.07, 0.18]), pain score prompts (0.87, 95% CI [0.81, 0.92]), and forcing functions (0.97, 95% CI [0.93, 0.99]). Forcing functions also were associated with improved pain control over the course of radiation treatment for bone metastases compared with pain score prompts (P = .026, nonparametric Kruskal-Wallis). Use of forcing functions correlates with increased pain documentation rates, which contributes to improved pain management.Small bowel obstruction from internal hernias is a familiar pathology for the surgeon, with an incidence of 0.5-5.8%. However, pericaecal hernia is a very uncommon type of internal hernia. Diagnosis and early treatment are essential to avoid strangulation and necrosis of the incarcerated small bowel. We report a case of an 84-year-old woman with no previous history of abdominal surgery who came to our hospital having endured 6 hours of abdominal pain and vomiting. Following physical examination and computed tomography, a diagnosis of small bowel obstruction caused by pericaecal hernia was made and emergency surgery was performed. The hernia was successfully reduced with a laparoscopic approach. Although pericaecal hernia is a rare disease, surgeons should bear it in mind as a differential diagnosis in small bowel obstruction.INTRODUCTION Endoscopic vein harvest is the technique of choice in North America, where it constitutes 80% of conduit harvest for coronary artery bypass grafting. The UK has much lower rates, despite demonstrable perioperative benefits. Concerns about patency and long-term survival are often cited as reasons for poor uptake and evidence in the literature thus far has only addressed mid-term outcomes. We sought to identify the long-term survival of patients undergoing endoscopic vein harvest compared with a contemporaneous cohort of open vein harvest. MATERIALS AND METHODS This was a retrospective cohort study of all consecutive patients undergoing isolated coronary artery bypass grafting at a single institution between 2007 and 2017. All-cause long-term mortality was compared using Kaplan-Meier curves and log-rank analysis. RESULTS A total of 7,527 patients undergoing coronary artery bypass grafting (1,029 receiving endoscopic vein harvest) were studied. The groups were well matched for preoperative characteristics, except that there were more patients with triple-vessel disease and good left-ventricular function in the endoscopic vein harvest group. There was no statistically significant difference in the long-term survival (p = 0.23). At five years (median follow-up), survival was 86.1% (95% confidence interval 85.3-87.0) in the open vein harvest group compared with 85.5% (95% confidence interval 82.8-88.2) in the endoscopic vein harvest group. DISCUSSION AND CONCLUSION Endoscopic vein harvest does not affect long-term survival in an unselected population. The contraindications for minimally invasive vein harvest in coronary artery bypass grafting are increasingly diminishing.Necrotising enterocolitis (NEC) is a rare cause of the acute abdomen in adults and carries one of the highest mortality rates in gastroenterology. However, its rarity confines research to small case reports. Both its pathogenesis and aetiology remain enigmatic in adult patients, proving timely diagnosis and management a challenge. This paper reports on one case of NEC in an adult patient with underlying anorexia nervosa, following a seven-day period of starvation. She underwent emergency laparotomy for resection of necrotic bowel and subsequently made a good recovery. To date, there have only been eight reports linking NEC with anorexia nervosa. We review our patient in the context of plausible mechanisms hypothesised in these cases. Successful management depends on prompt diagnosis, resuscitation and surgical intervention.