Impact of COVID-19 pandemic on cancer surgery: Patient's perspective.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has impacted cancer care globally. The aim of this study is to analyze the impact of COVID-19 on cancer healthcare from the perspective of patients with cancer. METHODS: A cross-sectional survey was conducted between June 19, 2020, to August 7, 2020, using a questionnaire designed by patients awaiting cancer surgery. We examined the impact of COVID-19 on five domains (financial status, healthcare access, stress, anxiety, and depression) and their relationship with various patient-related variables. Factors likely to determine the influence of COVID-19 on patient care were analyzed. RESULTS: A significant adverse impact was noted in all five domains (p = < 0.05), with the maximal impact felt in the domain of financial status followed by healthcare access. Patients with income levels of INR < 35 K (adjusted odds ratio [AOR] = 1.61, p < 0.05), and 35K- 100 K (AOR = 1.96, p < 0.05), married patients (AOR = 3.30, p < 0.05), and rural patients (AOR = 2.82, p < 0.05) experienced the most adverse COVID-19-related impact. CONCLUSION: Delivering quality cancer care in low to middle-income countries is a challenge even in normal times. During this pandemic, deficiencies in this fragile healthcare delivery system were exacerbated. Identification of vulnerable groups of patients and strategic utilization of available resources becomes even more important during global catastrophes, such as the current COVID-19 pandemic. Further work is required in these avenues to not only address the current pandemic but also any potential future crises.

Fisetin Prevents Oxidized Low-density Lipoprotein-Induced Macrophage Foam Cell Formation.

ABSTRACT: Foam cell formation is an important event in atherosclerosis. Fisetin, a bioflavonoid, has been identified to possess anti-inflammatory, antilipidemic, and anticancerous properties; however, its role as a lipid homeostasis regulator in macrophages, specifically in the presence of metabolic stressors such as oxidized low-density lipoprotein (oxLDL) is not well understood. In this study, we have investigated the role of fisetin in preventing oxLDL-induced macrophage foam cell formation. U937-derived macrophages were stimulated with oxLDL with or without fisetin for varied time points, and various parameters were assessed including cell viability by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay; reactive oxygen species (ROS) by dichlorofluorescin diacetate assay; lipid accumulation by Oil Red O staining; and expression of NLR family pyrin domain containing 3 (NLRP3), sterol regulatory element-binding protein (SREBP)-1, and associated downstream proteins 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMGCR) and fatty acid synthase (FAS) by quantitative reverse transcription polymerase chain reaction (RT-qPCR) and immunoblotting. Functionality of FAS enzyme was determined using enzyme activity assay. Docking studies were performed to determine the in silico interaction between NLRP3 and fisetin. The results showed that fisetin up to the dose of 10 µM did not alter cell viability but at the same dose could decrease the accumulation of lipids in macrophages and prevented foam cell formation. Fisetin could also ameliorate and reduce oxLDL-induced upregulation of SREBP-1 and thereby the expression of its downstream lipid synthesis genes HMGCR and FAS and inhibited ROS-induced NLRP3 inflammasome activation. In conclusion, fisetin could inhibit foam cell formation by blocking oxLDL-induced ROS formation and subsequent NLRP3 activation, thereby inhibiting SREBP-1 and its downstream genes including FAS and HMGCR.

Effect of the Quadrupolar Trap Potential on the Rayleigh Instability and Breakup of a Levitated Charged Droplet.

The experimental demonstration of Rayleigh instability that results in the breakup of a charged droplet, levitated in a quadrupole trap, has been investigated in the literature, but only scarcely. We report here the asymmetric breakup of a charged drop, levitated in a loose trap, wherein the droplet is stabilized at an off-center location in the trap. This aspect of levitation leads to an asymmetric breakup of the charged drop, predominantly in a direction opposite to that of gravity. In the present work, we report the evidence of successive events of the deformation and breakup of a charged drop and its subsequent relaxation after jet ejection using high-speed imaging at a couple of hundred thousand frames per second. Several relevant aspects of this phenomenon such as the effect of the electrodynamic (ED) trap parameters in terms of the applied potential as well as physical parameters such as the size of the drop, gravity, and conductivity on the characteristics of droplet breakup are explored. A clear effect of the trap strength on the deformation (both symmetric and asymmetric) is observed. Moreover, the cone angle at the pole undergoing asymmetric breakup is almost independent of the applied field investigated in the experiments. All of the experimental observations are compared with numerical simulations carried out using the boundary element method (BEM) in the Stokes flow limit. The BEM simulations are also extended to other experimentally achievable parameters. It is observed that the breakup in our study is mostly field-influenced and not field-induced. A plausible theory for the observations is reported, and a sensitive role of the sign of the charge on the droplet and the sign of the end-cap potential, as well as the off-center location of the droplet in the trap, is elucidated.

Regulation of oxidized LDL-induced inflammatory process through NLRP3 inflammasome activation by the deubiquitinating enzyme BRCC36.

OBJECTIVE: Oxidized Low-Density Lipoprotein (oxLDL) is a well-established pro-inflammatory marker that activates the NLRP3 inflammasome. Ubiquitination plays an important role in modulating the stability and functions of various proteins. BRCC36 is a ubiquitin-modifying enzyme that plays a crucial role in protein stabilization and activation in the cytosol, but its role in OxLDL-induced NLRP3 inflammasome activation is not known. Here, we have investigated the role of deubiquitinating enzyme BRCC36 in regulating NLRP3 inflammasome during oxLDL stimulation. METHODS: Raw 264.7 murine macrophages were stimulated with oxLDL and effect of BRCC36 deubiquitination activity was assessed by fluorometric assay, and protein expression was assessed by Western blotting. The level of IL-1ß measured by ELISA and LDH activity as pyroptotic cell death marker was assessed by fluorometric assay. RESULTS: The results showed that oxLDL increased the level of NLRP3 in macrophages and also the level of active caspase-1 and IL-1ß. It also modulated the expression of deubiquitinating enzymes and caused pyroptotic cell death as indicated by LDH release. Inhibiting the proteasomal activity by MG132 and siRNA-mediated silencing of BRCC36 in macrophages potentially suppressed oxLDL-induced NLRP3 inflammasome activation and IL-1ß secretion. Furthermore, the inhibition of proteasomal deubiquitinating activity with specific BRCC36 inhibitor G5 also reduced the inflammatory cell death. CONCLUSION: Taken together, our study suggests that deubiquitinating enzyme BRCC36 inhibition could potentially suppress oxLDL-induced inflammatory process by inhibiting NLRP3 activation and resultant IL-1ß secretion.

Effect of noise on the stability of electrodynamically levitated one or many charged droplets.

The theory of the effect of external fluctuations on the stability and spatial distribution of mutually interacting and slowly evaporating charged drops, levitated in an electrodynamic balance, is presented using a classical pseudo-potential approach. The theory is supplemented with numerical simulations where the non-homogeneous modified Mathieu equation is solved for single-droplet as well as many-droplet systems. In this essentially non-equilibrium system a pseudo-potential is identified, and a Boltzmann-like pseudo-equilibrium distribution is suggested that describes the variance of the deterministic configuration of particles levitated in a quadrupolar trap. This formalism seems to explain the numerical results in a fairly close and convincing manner. A transition from a well-ordered Coulombic crystal to a randomly distributed liquid-like structure is observed above a threshold value of noise. A surprising finding of the present work is the observation that the strength of the threshold noise for the transition of a 2-particle system into a noise-dominated regime is identical to the critical noise required for a solid melting transition in a 100-particle system. The simulations could prove useful in analysing an ordered assembly of levitated micro- and nano-particles from the air streams using a contactless membrane.

In-situ vaccination using focused ultrasound heating and anti-CD-40 agonistic antibody enhances T-cell mediated local and abscopal effects in murine melanoma.

The success of melanoma immunotherapy is dependent on the presence of activated and functional T-cells in tumors. The objective of this study was to investigate the impact of local-focused ultrasound (FUS) heating (∼42-45 °C) and in-situ anti-CD-40 agonistic antibody in enhancing T-cell function for melanoma immunotherapy. We compared the following groups of mice with bilateral flank B16 F10 melanoma: (1) Control, (2) FUS, (3) CD-40, and (4) CD-40 + FUS (FUS40). FUS heating was applied for ∼15 min in right flank tumor, and intratumoral injections of CD-40 were performed sequentially within 4 h. A total of 3 FUS and 4 anti-CD-40 treatments were administered unilaterally 3 days apart. Mice were sacrificed 30 days post-inoculation, and the treated tumor and spleen tissues were profiled for T-cell function and macrophage polarization. Compared to all other groups, histology and flow cytometry showed that FUS40 increased the population of tumor-specific CD-4+ and CD-8+ T cells rich in Granzyme B+, interleukin-2 (IL-2) and IFN-γ production and poor in PD-1 expression. In addition, FUS40 promoted the infiltration of tumor-suppressing M1 phenotype macrophages in the treated mice. The resultant immune-enhancing effects of FUS40 suppressed B16 melanoma growth at the treated site by 2-3-folds compared to control, FUS, and CD-40, and also achieved significant abscopal effects in untreated tumors relative to CD40 alone. Additionally, the local FUS40 prevented adverse liver toxicities in the treated mice. Our study suggests that combined FUS and CD-40 can enhance T-cell and macrophage functions to aid effective melanoma immunotherapy.

Taking the Road Less Travelled: A Case Report of Distal Splenic Artery Embolisation via the Pancreaticoduodenal Arcade in Splenic Trauma With Celiac Artery Stenosis.

Celiac axis stenosis (CAS) is one of the most prevalent splanchnic arterial pathologies. It seldom results in clinically severe ischemic bowel disease because of the rich collateral circulation from the superior mesenteric artery. Knowledge about the collaterals in celiac artery stenosis guides various interventional procedures. Here, we describe a case of a 19-year-old female with American Association for the Surgery of Trauma (AAST) grade IV splenic injury found to have CAS. Distal splenic artery embolisation was performed via the collateral pathway through the pancreaticoduodenal arcade.

Variations in origin level of superior mesenteric artery, inferior mesenteric artery, and coeliac trunk in Indian population.

OBJECTIVE: The abdominal aorta is a continuation of the thoracic aorta and gives off the coeliac trunk, superior mesenteric artery, and inferior mesenteric artery. The focus of our study is to evaluate variations in the origin level in the coeliac trunk, superior mesenteric artery, inferior mesenteric artery, and aortic bifurcation in the Indian population and compare with various demographics. METHODS: The study was retrospective and the local ethics committee approval was taken before starting it. Three hundred patients who were more than 18 years of age and required contrast-enhanced CT studies were included in this. The vertebral origin level of the arteries from the abdominal aorta and aortic bifurcation level was analysed. RESULTS: The most common origin level of the coeliac trunk for both males and females was T12-L1 disc level. The most common origin level of the superior mesenteric artery was L1 upper level. The most common origin level of the inferior mesenteric artery was L3 upper level. The most common level of aortic bifurcation was L4 middle level. There was no statistical difference between the origin of any arteries in males and females in the Indian population. CONCLUSION: As per our study of the Indian population and the published literature, it is realized that there are significant variations in the origins of the coeliac trunk, superior mesenteric artery, inferior mesenteric artery, and abdominal aorta bifurcation in different populations. ADVANCES IN KNOWLEDGE: This study elaborates on potential anatomical variations in the Indian population, particularly the Mumbai city population. Also, our study compares it to different countries' data and their results in variations found in abdominal aorta branches.

Evaluation of Emerging Predictors for Contrast-Induced Nephropathy in High-Risk Patients Undergoing Percutaneous Coronary Intervention.

OBJECTIVE: The objective of this study is to investigate the occurrence and factors that influence the development of contrast-induced nephropathy (CIN) in high-risk patients undergoing angioplasty and to evaluate the effectiveness of the Mehran risk score in predicting CIN among this patient population. MATERIALS AND METHOD: This prospective, observational study enrolled patients undergoing elective coronary angiography or a percutaneous coronary intervention (PCI) procedure. The patients were stratified into four risk groups based on the Mehran risk score, a validated tool for predicting the risk of CIN. Univariate and multivariate analyses were conducted to evaluate the risk factors associated with the development of CIN. A p-value of <0.05 was considered to indicate statistical significance. RESULTS: During the study period, a total of 55 high-risk patients underwent PCI. The incidence of CIN was 25.5% (n=14). Univariate and multivariate analyses revealed that age >75 years and estimated glomerular filtration rate (eGFR) <60 (p<0.05) were independently associated with a significantly increased risk of developing CIN. A considerable proportion of patients (23; 41.8%) in the study were categorized as having an intermediate risk for CIN based on the Mehran risk score. CONCLUSION: This study observed a high incidence of CIN and encourages the use of predictive tools like the Mehran risk score to assess the risk of CIN occurrence, with age over 70 years and eGFR less than 60 emerging as significant.

Cholic Acid-Derived Gemini Amphiphile Can Eradicate Interkingdom Polymicrobial Biofilms and Wound Infections.

Biofilm infections are mainly caused by Gram-positive bacteria (GPB) like Staphylococcus aureus, Gram-negative bacteria (GNB) like Pseudomonas aeruginosa, and fungi like Candida albicans. These infections are responsible for antimicrobial tolerance, and commensal interactions of these microbes pose a severe threat to chronic infections. Treatment therapies against biofilm infections are limited to eradicating only 20-30% of infections. Here, we present the synthesis of a series of bile acid-derived molecules using lithocholic acid, deoxycholic acid, and cholic acid where two bile acid molecules are tethered through 3'-hydroxyl or 24'-carboxyl terminals with varying spacer length (trimethylene, pentamethylene, octamethylene, and dodecamethylene). Our structure-activity relationship investigations revealed that G21, a cholic acid-derived gemini amphiphile having trimethylene spacer tethered through the C24 position, is a broad-spectrum antimicrobial agent. Biochemical studies witnessed that G21 interacts with negatively charged lipoteichoic acid, lipopolysaccharide, and phosphatidylcholine moieties of GPB, GNB, and fungi and disrupts the microbial cell membranes. We further demonstrated that G21 can eradicate polymicrobial biofilms and wound infections and prevent bacteria and fungi from developing drug resistance. Therefore, our findings revealed the potential of G21 as a versatile antimicrobial agent capable of effectively targeting polymicrobial biofilms and wound infections, suggesting that it is a promising antimicrobial agent for future applications.

Network-wide safety impacts of dedicated lanes for connected and autonomous vehicles.

Cooperative, Connected and Automated Mobility (CCAM) enabled by Connected and Autonomous Vehicles (CAVs) has potential to change future transport systems. The findings from previous studies suggest that these technologies will improve traffic flow, reduce travel time and delays. Furthermore, these CAVs will be safer compared to existing vehicles. As these vehicles may have the ability to travel at a higher speed and with shorter headways, it has been argued that infrastructure-based measures are required to optimise traffic flow and road user comfort. One of these measures is the use of a dedicated lane for CAVs on urban highways and arterials and constitutes the focus of this research. As the potential impact on safety is unclear, the present study aims to evaluate the safety impacts of dedicated lanes for CAVs. A calibrated and validated microsimulation model developed in AIMSUN was used to simulate and produce safety results. These results were analysed with the help of the Surrogate Safety Assessment Model (SSAM). The model includes human-driven vehicles (HDVs), 1st generation and 2nd generation autonomous vehicles (AVs) with different sets of parameters leading to different movement behaviour. The model uses a variety of cases in which a dedicated lane is provided at different type of lanes (inner and outer) of highways to understand the safety effects. The model also tries to understand the minimum required market penetration rate (MPR) of CAVs for a better movement of traffic on dedicated lanes. It was observed in the models that although at low penetration rates of CAVs (around 20%) dedicated lanes might not be advantageous, a reduction of 53% to 58% in traffic conflicts is achieved with the introduction of dedicated lanes in high CAV MPRs. In addition, traffic crashes estimated from traffic conflicts are reduced up to 48% with the CAVs. The simulation results revealed that with dedicated lane, the combination of 40-40-20 (i.e., 40% human-driven - 40% 1st generation AVs- 20% 2nd generation AVs) could be the optimum MPR for CAVs to achieve the best safety benefits. The findings in this study provide useful insight into the safety impacts of dedicated lanes for CAVs and could be used to develop a policy support tool for local authorities and practitioners.

Xanthone Derivatives Enhance the Therapeutic Potential of Neomycin against Polymicrobial Gram-Negative Bacterial Infections.

Gram-negative bacterial infections are difficult to manage as many antibiotics are ineffective owing to the presence of impermeable bacterial membranes. Polymicrobial infections pose a serious threat due to the inadequate efficacy of available antibiotics, thereby necessitating the administration of antibiotics at higher doses. Antibiotic adjuvants have emerged as a boon as they can augment the therapeutic potential of available antibiotics. However, the toxicity profile of antibiotic adjuvants is a major hurdle in clinical translation. Here, we report the design, synthesis, and biological activities of xanthone-derived molecules as potential antibiotic adjuvants. Our SAR studies witnessed that the p-dimethylamino pyridine-derivative of xanthone (X8) enhances the efficacy of neomycin (NEO) against Escherichia coli and Pseudomonas aeruginosa and causes a synergistic antimicrobial effect without any toxicity against mammalian cells. Biochemical studies suggest that the combination of X8 and NEO, apart from inhibiting protein synthesis, enhances the membrane permeability by binding to lipopolysaccharide. Notably, the combination of X8 and NEO can disrupt the monomicrobial and polymicrobial biofilms and show promising therapeutic potential against a murine wound infection model. Collectively, our results unveil the combination of X8 and NEO as a suitable adjuvant therapy for the inhibition of the Gram-negative bacterial infections.

Examining road safety impacts of Green Light Optimal Speed Advisory (GLOSA) system.

Mobility and environmental benefits of Green Light Optimal Speed Advisory (GLOSA) systems have been reported by many previous research studies, however, there is insufficient knowledge on the safety implications of such an application. For safe deployment of GLOSA system, it is most critical to identify and address potential safety issues in the design process. It can be argued that implementation of GLOSA system can improve safety by reducing traffic conflicts associated with the interrupted traffic flow at signalised intersections. However, more research findings are needed from field and simulation based studies to evaluate the impacts on safety under a variety of real-world scenarios. As part of the LEVITATE (Societal Level Impacts of Connected and Automated Vehicles) project under European Union's Horizon 2020 Programme, the main objective of this study is to examine the safety impacts of GLOSA under mixed traffic compositions with varying market penetration rates (MPR) of connected and automated vehicles (CAVs). A calibrated and validated microsimulation model (developed in Aimsun) of the greater Manchester area was used for this study where three signalised intersections in a corridor were identified for implementing GLOSA system. An improved algorithm was developed by identifying the potential issues/limitations in some of the GLOSA algorithms found in literature. Behaviours of CAVs were modelled based on the findings of a comprehensive literature review. Safety analysis was performed through processing the simulated vehicular trajectories in the surrogate safety assessment model (SSAM) by the Federal Highway Administration (FHWA). The surrogate safety assessment results showed small improvement in safety with the GLOSA implementation at multiple intersections in the test network only at low MPR (20%) scenarios of CAVs, as compared to the respective without GLOSA scenarios. No or rather slightly lower improvement in safety was observed with GLOSA implementation under mixed fleet scenarios with 40 % or higher 1st Generation or 2nd Generation CAVs, as compared to the respective scenarios without GLOSA. The implementation of GLOSA system was also found to have some impact on the traffic conflict types (although not consistent across all MPR scenarios), where rear-end conflicts were found to decrease while a slight increase was observed in lane-change conflicts.

Leveraging neuroscience education to address stigma related to opioid use disorder in the community: a pilot study.

Opioid use disorder (OUD) and overdose deaths are a public health crisis. One contributing factor is stigma towards people who use opioids. We developed and conducted a public-facing, half-day educational event designed to challenge misperceptions about OUD from a contemporary neuroscience perspective. Participants engaged with three different resources on the neurobiology of addiction, and, at the end of the event, they rated its effectiveness. We also collected and compared pre- and post-event composite OUD stigma scales. Participants rated our approach and the overall event as highly effective. Additionally, OUD stigma scores were lower immediately following the event, and this decrease was primarily driven by decreased internalized stigma. Here, we demonstrate an effective proof-of-concept that an accessible, public-facing, neuroscience education event may reduce OUD stigma in the community.

Groundwater quality index development using the ANN model of Delhi Metropolitan City, India.

Groundwater is widely recognized as a vital source of fresh drinking water worldwide. However, the rapid, unregulated population growth and increased industrialization, coupled with a rise in human activities, have significantly harmed the quality of groundwater. Changes in the local topography and drainage systems in an area have negative impacts on both the quality and quantity of groundwater. This underscores the critical need to assess the susceptibility of groundwater to pollution and implement measures to mitigate these risks. The water quality index (WQI) is an approach that simulates the water quality at peculiar locations for a particular period of time. The artificial neural network (ANN) model approach is such an idealistic methodology that can be utilized for WQI development and provides better results for specific locations in optimum time. Therefore, the goal of the current study is to provide a unique way for using artificial neural networks (ANN) to characterize the groundwater quality of Delhi Metropolitan City, India. In order to make the water fit for residential and drinking use, the research also pinpoints the geographical variability and spots where the contaminated region has to be sufficiently cleaned. A minimum WQI of 41.51 was obtained at the Jagatpur location while a maximum value of 779.01 was at the Peeragarhi location. During the training phase, the results obtained using the ANN model were highly favorable, demonstrating a strong association with an R-value of 98.10%, thus highlighting the program's exceptional efficiency. However, in accordance with the correlation regression findings, the prediction outcomes of the ANN model in testing are observed to be an R-value of 99.99-100%. This study confirms the promise and advantages of employing advanced artificial intelligence in managing groundwater quality in the studied area.

Association of sagittal alignment of tibial and femoral components with clinical outcome in total knee arthroplasty: A prospective cohort study.

Background: In total knee replacement component alignment is a very crucial parameter to achieve better clinical outcomes. Only a few studies exist in the literature on the association between sagittal alignment of components and clinical outcomes. The study aimed to measure the functional outcome and association between the sagittal alignment of total knee replacement components and their clinical outcome. Material & methods: Prospectively we collected data of 81 knees (cases) following total knee replacement. The sagittal femoral angle, anterior and posterior tibial slopes were assessed on 2nd postoperative week using a lateral radiograph. Based on these measures 2 groups were made. Group A comprises of the femoral component which was further divided into A1 (41 cases) and A2 (40 cases) based on the component's sagittal femoral angle in flexion or extension.Group B comprises of Tibial component subgrouped based on the degree of Tibal angle as the posterior tibial slope or anterior tibial slopes. The B1 subgroup has posterior tibial slope of more than 5° (23 cases), B2 posterior tibial slope within 5° (53 cases), and B3 anterior tibial slope (5 cases). Preoperative and follow-ups at one month, 6 months, and 3 year; the functional assessment was performed using the American Knee Society score and Oxford knee scores. The duration to raise the leg straight (in days) was also measured. Results: 52 patients (81 total knee replacement cases) with a mean age of 62.88 ± 8.21 were enrolled. Results showed significant improvement in mean American Knee Society score (preoperative 32.91 ± 2.61 to 86.68 ± 2.52 postoperatively at 3 years; P < 0.001) and mean Oxford knee score (preoperative 34.69 ± 1.06 to 19.20 ± 1.91 postoperatively at 3-years; P < 0.001). The correlation of American Knee Society score between the femoral component angle and tibial component angle suggested that the maximum correlation was between Group A2 (Femoral angle = 91 to 95) and Group B2 (Tibal angle = 86 to 90), with p-value <0.0001. Conclusions: There is a positive association between the proper sagittal alignment of femoral component and tibial component in total knee replacement with clinical outcome. The functional outcome (in terms of mean American Knee Society score) is better when the femoral component is positioned in extension and the posterior tibial slope of less than 5° is achieved.

Mycobacterium Tuberculosis infection of the wrist joint: A current concepts review.

Background: Osteoarticular Tuberculosis (TB) of wrist joint is a rare, often misdiagnosed form of site affected by Mycobacterium Tuberculosis infection that can lead to severe disability and morbidity. This review aims to summarize the current literature on the diagnosis and management of Mycobacterium Tuberculosis infection of the wrist joint. Materials and methods: A comprehensive search strategy using the PEO (Population, Exposure, Outcome) framework was conducted on PubMed, Google Scholar, and Web of Science databases from 1967 to 2022, excluding single case reports and correspondence articles. The keywords used for the search included 'Mycobacterium tuberculosis' 'osteoarticular' and 'wrist'. Clinical presentation, demographic details, complementary investigations undertaken, trends, and complications of different management interventions were recorded to generate this review. Results: Osteoarticular Tuberculosis (TB) of the wrist joint accounts for fewer than 1% of all skeletal TB cases across a spectrum of age ranges. Magnetic Resonance Imaging (MRI) represents an excellent modality to reveal the extent of the disease at an early stage of the condition. Synovial fluid analysis has been recommended for microbiological diagnosis. Treatment options include anti-tubercular therapy (ATT), incision and drainage, debridement, synovectomy, and arthrodesis. Conclusion: Early diagnosis and treatment of wrist tuberculosis is crucial for achieving good functional outcomes in patients with this uncommon condition. Polymerase Chain Reaction (PCR) and GeneXpert technology for the detection of Mycobacterium tuberculosis (MTB) have improved diagnostic accuracy in detecting MTB DNA and rifampicin resistance. Anti-Tubercular Therapy (ATT) regime remains a foundation pillar in the overall management of these patients with focused surgical interventions leading to improved clinical outcomes.