D L Kewalramani

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This review examined 49 studies covering 341 AI models built for acute care surgery, the high-stakes field of emergency operations. Most AI focused narrowly on predicting surgical risk before operations and was tested only on the data it was trained on, with almost none independently validated or approved for real use. The gap between what these tools promise and their actual readiness for clinical practice remains wide.

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A surgical educators' committee laid out a framework for responsibly bringing AI into the training of medical students, residents, and fellows in surgery. The guidelines cover both narrow AI tools like computer vision and generative AI like large language models, and give practical advice to accrediting bodies, institutions, and individual surgeons. The core message is that AI should enhance—not replace—the mentorship relationship that defines surgical training.

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With a global shortage of surgeons threatening healthcare in low-resource settings, this article argues for modernizing how surgeons are trained. Technology like virtual reality simulation, telementoring, and AI-assisted learning can expand access and compress training timelines. Pairing these tools with policy reforms like national surgical plans and task-sharing could help close the workforce gap faster.

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A 10-month-old girl with DiGeorge syndrome (a genetic immune deficiency) had an initial seizure episode that was treated, but then developed progressive brain disease over the next decade. Brain biopsy ultimately confirmed chronic herpes simplex virus encephalitis, a rare presentation that had been missed because spinal fluid tests kept coming back negative. Long-term antiviral therapy led to meaningful improvement, highlighting the need to consider chronic viral brain infection in children with immune deficiencies and atypical neurological decline.

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Researchers tested whether better instructor feedback leads to better skill acquisition, using an AI tool called Teach1 to rate the quality of feedback given to medical students learning a bedside procedure. Higher-quality feedback was directly tied to greater skill improvement, with every 10% increase in feedback quality corresponding to a measurable score gain. This shows that AI can objectively evaluate teaching quality and help standardize surgical education at scale.

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This survey of five major Indian hospitals found that programs to track and prevent surgical site infections—which are common but largely preventable—varied widely and had significant gaps in oversight, education, and data infrastructure. Drug-resistant bacteria rates were high across all sites, with one hospital reporting that nearly 58% of certain infections involved resistant organisms. The findings underscore an urgent need for standardized stewardship programs across India.

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This essay argues that deploying AI in healthcare settings that lack adequate staffing, equipment, and infrastructure is not only ineffective but potentially harmful. Using Paul Farmer's framework for what health systems actually need to function, the authors warn that AI investment in under-resourced contexts risks diverting limited funds from more foundational needs. Concrete questions are proposed to help policymakers assess whether a health system is ready for AI before committing resources.

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After India passed a Good Samaritan Law in 2016 protecting bystanders who help road accident victims from legal and financial liability, this study compared survey data from before and after the law. Willingness to help jumped by 65% and fear of legal consequences dropped by 81%. The law worked, but awareness remained much higher in smaller cities than in major metros, pointing to a need for targeted public education campaigns.

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A 10-month-old boy had a metabolic crisis at birth and later developed infantile spasms; genetic testing revealed a mutation causing carbonic anhydrase VA deficiency, a rare enzyme disorder affecting ammonia processing. What was unusual was the combination of epilepsy with this condition, which had not been reported before. The case expands the known range of neurological problems this rare disease can cause and adds to the small worldwide count of documented patients.

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A 7-year-old boy with a specific type of autoimmune brain inflammation kept having severe, uncontrollable seizures despite multiple medications and immune therapies. Switching to a ketogenic diet stopped the seizures within two days. The case suggests this dietary approach may be an effective add-on treatment for children with autoimmune-driven epilepsy when standard therapies fail.

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Three patients developed serious spinal cord injury after chiropractic manipulation of the neck, with all three losing the ability to move their arms and legs within 24 hours of the procedure. Two had fractures found on imaging; one required surgery and only one of the three recovered meaningful function. The report warns that neck manipulation can cause severe and potentially irreversible neurological damage.