Transcallosal approach, being minimally invasive, exploits the natural extra-axial corridor (interhemispheric) obviating the need for a cortical incision. The suprachoroidal approach mitigates the risks of thalamostriate vein injury, basal ganglia stroke, and hemiparesis.
Transcallosal approach, being minimally invasive, exploits the natural extra-axial corridor (interhemispheric) obviating the need for a cortical incision. The suprachoroidal approach mitigates the risks of thalamostriate vein injury, basal ganglia stroke, and hemiparesis.
Minimally invasive spine surgery (MISS) is a set of techniques and procedures that reduces the local tissue injury while achieving the same results through traditional open surgery. The techniques for the treatment of lumbar disc herniation and degenerative canal stenosis have evolved from tubular discectomy to endoscopic discectomy. This helps in preserving spine function. Good clinical outcomes have been reported with the use of an endoscope for degenerative lumbar disc disease.

In this video abstract, we present a case lumbar foraminal stenosis in an elderly man that was treated successfully using unilateral biportal endoscopic spine surgery. (UBESS).

A 70-year-old man presented with progressive neurogenic claudication and left L4 numbness and paresthesias. His claudication distance was 200 m. His MRI Lumbosacral spine showed severe left L4-5 foraminal stenosis due to a disc prolapse. The patient underwent a left-sided unilateral biportal endoscopic transforaminal decompression and discectomy at L4-5 successfully. Postoperative period was uneventful and the patient had significant relief in his symptoms. Postoperative MRI Lumbosacral spine showed no muscle damage with adequate decompression at left L4-5 level.

The patient had an uneventful recovery.

Biportal percutaneous transforaminal endoscopic discectomy/decompression is an ideal alternative to the uniportal endoscopic and minimal invasive microsurgery for foraminal and paracentral disc herniations and lateral recess and foraminal stenosis.
Biportal percutaneous transforaminal endoscopic discectomy/decompression is an ideal alternative to the uniportal endoscopic and minimal invasive microsurgery for foraminal and paracentral disc herniations and lateral recess and foraminal stenosis.
Anterior clinoidectomy for aneurysm clipping is generally performed intradurally. Despite obvious advantages, accidental drill slippage or indirect damage from heat and bone dust remain major drawbacks.

To demonstrate the surgical technique and utility of a combined extra- and intra-dural clinoidectomy in the clipping of dorsal wall paraclinoid internal carotid artery aneurysm.

A case of dorsal wall paraclinoid aneurysm which was stuck to the anterior clinoid process on preoperative angiogram is presented. The surgical technique is shown stepwise, and the intricacies of the technique are described.

The hybrid clinoidectomy allowed for proper delineation of the aneurysm, mobilization of the optic nerve and intracranial proximal control on the clinoidal segment by dint of "apparent" intracranial ICA lengthening. This allowed the aneurysm to be clipped successfully and the patient made an uneventful recovery.

Hybrid clinoidectomy is a useful technique and must be learnt.
Hybrid clinoidectomy is a useful technique and must be learnt.
Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment. One of the most devastating complications is complex regional pain syndrome.

The aim of this study was to systematically analyze available evidence about complex regional pain syndrome after carpal tunnel syndrome surgery (CTSS), its risks, associated factors, and treatments.

Research conducted from 1962 through December 31, 2018, in the following databases PubMed, Web of Science, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials. The quality assessment of the methodology followed the definitions by the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. The GRADE system (Grades of Recommendation, Assessment, Development, and Evaluation) was applied to evaluate the efficacy of the stellate ganglion block, one of the most cited and recurrent treatments.

Of the 246 studies retrieved, 44 articles were included. Concerning patients' gender, we identified a ratio of 5 femaletments include physiotherapy and stellate ganglion block. Most patients show improvement of symptoms within one year. Further clinical trials comparing treatment modalities are required.
For a favorable outcome, patients admitted to critical care units require continuous monitoring and swift decision-making ability regarding management. One of the biggest challenges in neurocritical care units is the identification and management of autonomic dysfunction and in the worst-case scenario, autonomic storms.

Most of the literature available focuses mainly on autonomic storms following traumatic brain injury. However, due to the myriad neurological presentations in a critical care setting, it is particularly important for physicians and intensivists to suspect and manage autonomic dysfunction in various neurological scenarios.

Understanding the mechanism of paroxysmal sympathetic hyperactivity (PSH) is essential for early recognition and treatment. PSH-AM is an assessment measurement scale to diagnose and assess the severity of PSH in traumatic brain injury. However, this is not yet standardized across all neurological settings.

We present a comprehensive report on understanding the mechanism of autonomic storms across various neurological disorders and outline the management.
We present a comprehensive report on understanding the mechanism of autonomic storms across various neurological disorders and outline the management.Prof B Ramamurthi was a pioneer of Indian neurosurgery and a major force in the development of Indian neuroscience. Founding the Madras Institute of Neurology and later the A Lakshmipathi Neurosurgical Centre (ALNC), both at Madras (or Chennai as it is now called), he developed centres of excellence in his career that spanned over five decades. During this period of time he made Madras, a destination for neurosurgery and neuroscience. Along with his colleagues a large number of publications were produced which influenced the world. Notable among his contributions were those in Stereotaxy for movement disorders, epilepsy, pain and psychiatric illness. He also had notable contributions in brain tumours especially acoustic neurinomas and pituitary tumours. His papers on the low incidence of aneurysms is still quoted widely. Head injuries formed a major part of the neurosurgical work and major contributions were made in that field too. As a developing country with socio-economic issues, infections of the nervous system were seen commonly. His publications on tuberculomas of the brain are noteworthy. He was intrigued by the neurophysiological basis of consciousness. He writings on the subject reflect his attempt to bring together ancient eastern thoughts and concepts of consciousness and life and western science. In the later part of his career he spoke on ethics in and the changing milieu of neurosurgery. While contributions to spinal surgery were not seen in the first half of his career, he along with his colleagues from ALNC published original articles on spinal surgery especially tumours and OPLL. Prof B Ramamurthi, has not only influenced, taught and mentored, during his lifetime, a great many neuroscientists, but he also continues to do so through his publications which continue to be relevant in todays world. A glimpse into his contributions show us how without the technology of today a lot was achieved - and we need to see that, to inspire us to achieve more and to strive for greater heights.Foodborne diseases (FBDs) are a public health threat that can result in loss of lives and are a hurdle to socioeconomic development. The Foodborne Disease Burden Epidemiology Reference Group estimated that the annual burden of FBDs in the South-East Asia Region was more than 150 million illnesses, causing about 175,000 deaths. This review paper aims to compile evidence from the published articles and gray literatures on food-related disease outbreaks in Bhutan. Information was generated from the annual health bulletin published by the Ministry of Health and data from the National Early Warning Alert Response Surveillance and Information System hosted by Royal Centre for Disease Control. The laboratory confirmation rate of FBD investigation outbreaks increased from 25.5% (2012-2018) to 91.7% in 2020, as per the National Food Safety Indicator (FSI). At least 0.15% of the total population had suffered FBD from 2015 to 2020, and the baseline report shows that most of the FBD events occurred during hot and wet seasons (June and August). The common pathogen causing FBD was Salmonella species accounting for 42.9% of cases, followed by Shigella species (21.4%). Most of the FBD events were reported in schools (46.5%). The frequency of the reported FBD outbreaks had increased from 8 events in 2015 to 15 events in 2017 and 10 events in 2018. https://www.selleckchem.com/products/cddo-im.html The study confirms the improved surveillance for FBDs in Bhutan and highlights the need to raise public awareness on food safety.This study investigates the prevalence of and associated factors with depression and anxiety among chronic obstructive pulmonary disease (COPD) outpatients at Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam. A cross-sectional study was conducted between March and May 2020 at the hospital's outpatient department. Those aged ≥18 years, diagnosed with COPD and undergoing COPD treatment, were eligible. The Hospital Anxiety and Depression Scale was used to measure depression and anxiety. Dyspnea was assessed using the modified Medical Research Council (mMRC) dyspnea scale. Among 392 patients, 381 (97%) participated in the study. The number of patients with depression and anxiety was 33.1% and 21.3%, respectively. Compared to men, women were more likely to experience depression (adjusted odds ratio [aOR] = 2.12, 95% confidence interval [CI] = 1.06-4.24) and anxiety (aOR = 4.11, 95% CI = 1.90-8.87). Those not having caregivers were more likely to experience depression (aOR = 3.03, 95% CI = 1.27-7.20) and anxiety (aOR = 3.47, 95% CI = 1.26-9.60). Having mMRC dyspnea scale ≥2 was associated with higher odds of experiencing depression (aOR = 5.94, 95% CI = 3.63-9.72) and anxiety (aOR = 6.78, 95% CI = 3.48-13.18). Those not adhering to medication treatment (aOR = 2.32, 95% CI = 1.15-4.70) and having comorbidity (aOR = 2.02, 95% CI = 1.10-3.73) were more likely to experience anxiety. Routine screening of COPD patients for depression and anxiety is necessary so that early interventions could be provided.High sugar consumption is associated with increased risk of noncommunicable diseases. This study identifies the dietary sources of free sugars and explores association of sugar intake with related factors among adult population in Brunei. Data from the National Health and Nutritional Status Survey 2010, of 1559 adult residents of Brunei, aged 18-75 years, were extracted and analyzed. The results revealed that mean daily free sugar intake was 55.5 g/day (standard deviation [SD] -51.4), contributing to 14.5% of total energy intake. The prevalence of free sugar intake of less then 10% and 5% among the adult population was 60.1% (95% confidence interval [CI] 57.6, 62.5) and 82.6% (95% CI 80.6, 84.4), respectively. Free sugar from sugar-sweetened beverages was sourced from beverages prepared with sugar (17.9%), cordial and syrup (15.1%), and carbonated drinks (14.6%). Free sugar consumption was significantly higher in men (66.6 g/day, SD - 61.2) than women (46.2 g/day, SD - 39.1) (P less then 0.001). Younger participants had significantly higher free sugar intake and percentage of energy from free sugar compared to older participants.